Dear Dr. Solomon: My husband is recovering from a heart attack, and his doctor has referred him to an exercise program. I know that other heart patients take part in exercise programs, but my husband was never physically active. How can it do him any good to start an exercise program after he's had a heart attack when he never exercised before he had his attack? I think it can kill him. -- Mrs. J.J. McC., Baltimore
Dear Mrs. McC.: The purpose of involving a cardiac patient in an exercise program is to improve physical conditioning, not to make an athlete out of a non-athlete. Such a program may consist simply of walking on a treadmill for a given length of time or riding a stationary bicycle.
The level of exercise will vary from one patient to another. The appropriate level can be determined through a physical examination, exercise tests and other tests such as an electrocardiogram. Since you say that your husband was never physically active, it is very possible that his level of activity in the exercise program will be greater than that before his heart attack. But that, in itself, is nothing to be concerned about.
The advantage of a well-supervised exercise program is that it enables the patient to return to work and other routine activities more quickly than would otherwise be the case. This activity should be continued even after the recovery phase following the heart attack has ended.
Dear Dr. Solomon: Will you please comment on the news report I read that mentioned a connection between the use of diuretics and heart attacks? My doctor doesn't think it's very important. -- Tina, Manassas, Va.
Dear Tina: I assume you are referring to a report that the use of diuretics was found to be associated with an increase in blood cholesterol levels, not in the incidence of heart attacks. The report indicated that the subjects involved in the study had been taking diuretics for only a few months.
The results of other studies have shown that while the use of diuretics may cause a temporary increase in blood cholesterol levels, the increase does not persist with continued use. Your physician is undoubtedly aware of this.
Dear Dr. Solomon: What's the best thing to do if I get a blister on my foot? Or is the best advice nothing? -- Mickey, Lancaster, Md.
Dear Mickey: If a blister is small, it should be left alone. If it is large, it can be punctured with a sterile needle and permitted to drain.
For Angela, Wilmington, Del.: It is better to shop for shoes in the afternoon rather than in the morning because feet tend to swell during the day. It is also advisable to try on both shoes before purchasing them because a person's feet may differ slightly in size.
Dr. Neil Solomon will answer questions from Baltimore area readers in his Tuesday column in Accent on Health.
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