Q:I have been suffering from swollen ankles due to congestive heart
failure and my doctor has given me Lasix to get rid of the excess
water.
He also gave me a potassium pill to take with it. Why is this
necessary? I thought I could get enough potassium in my diet by eating
oranges and bananas? I am 85.
A: There isn’t a simple answer to this question because there are
several different ways of treating heart failure these days. People can
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live a long time with heart failure, which is now becoming common as
people live to a much greater age than they used to.
More elderly people are taking medications for this condition. Heart
failure sounds ominous, but it doesn’t mean that your heart is about to
stop any minute.
It is just not as efficient at pumping the blood around the body, so
fluid can collect in the feet, ankles and sometimes in the lungs.
You can tell if you have the condition known as “pitting edema” if you
press your thumb onto your ankle or top of your foot, and it leaves an
impression or shallow mark.
One of the treatments for heart failure is to use diuretics. A stronger
diuretic such as Lasix is often used to start with until the condition
is under control. Then you might be able to switch to a less powerful
one, such as Spironolactone, which does not deplete the body’s
potassium levels.
People who have poorly functioning kidneys should not be given
diuretics if possible.
Doctors vary in their approach to whether they routinely give
potassium supplements or wait and see if a person needs them.
You may be getting enough potassium in your diet if you eat bananas and
oranges, so discuss this with your doctor.
Diet effects
Q: Is it true that dieting can actually make you gain weight rather
than lose it?
A: Yes, this is true. Perhaps we should call this the Oprah syndrome,
as she is a prime example of this phenomenon. The reason is that when
you restrict food, the body thinks you are starving.
It goes into a slow holding pattern. Your metabolism lowers itself so
you burn calories at a slower rate.
Unfortunately, this can continue to occur even after you stop the diet,
resulting in actual weight
gain over the long run.
Actually, most overweight people do not eat enough early in the day.
They will skip breakfast and have little for lunch, so that by the
evening they are starving.
Clare Rowson is a medical doctor with a practice near Belleville, Ont.
Her columns are intended for general information only. Individuals are
encouraged to also seek the advice of their own doctor regarding
medical questions and treatments.
