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dr eon Peter Qott MD Pancreas may be cause of problem By Peter Gott MD DR For Several years I have been absolutely ravenous for carbohydrates especially in the morning I understand that a brain chemical neuropeptide might be responsible Could you give me more Information on this DEAR READER 1 am not aware of any brain neuropeptide that has been shown to govern carbohydrate craving Carbohydrates are branchchained collections of sugar That is all starches are composed of basic sugar molecules strung together like beads In a necklace Glucose is the most common sixcarbon compound In all carbohydrates although galac tose fructose and mannose also com bine in various combinations to form starch For example when glucose is attached to fructose table sugar su crose is formed If glucose and galac tose are combined milk sugar lac tose results Glucose has been termed the carbo hydrate currency of the human body In the intestinal tract all starches are converted to glucose be fore being absorbed into the blood stream and used for energy This pro cess of digestion starts with saliva that attacks starch then proceeds in the upper Intestine under the control of other digestive Although many body chemicals regulate carbohydrate metabolism insulin is probably the most Impor tant It enables muscle liver brain and fat cells to absorb the glucose molecules floating in the blood Therefore carbohydrate craving is usually due to chemical reactions in volving insulin Check with your doctor to discover the cause of your need for carbohy drates If there Is a problem the fault dear reader is not In our brains but in our pancreas glands DEAR DR GOTT Three years ago I bad a cervical fusion A bone chip fell into my spinal cord leaving me paralyzed I can now walk to some extent and have partial use of my left hand If the chip were removed would my problems be over DEAR READER Possibly This is a complicated Issue something like BRIDGE James switchboard with a hammer and then trying to determine what role the hammer played Operations on the neck cervical spine are tricky and complications can be difficult to diagnose and treat Your paralysis could be due to the original condition for which you had surgery or to the consequences of the operation Itself Unquestionably a bone chip that is out of place could cause your symptoms However be- fore reoperating a neurosurgeon would insist on testing you thoroughly I to make sure If the booe chip is press- lng on the spinal nerves and causing I paralysis its removal could be i- even curative I recommend that you ask for a re ferral to a neurosurgical clinic at a university hospital In this setting specialists have both the experience and the testing devices to analyze your problem and If appropriate to treat It II you have questions about HIA TAL HERNIA you can get answers in Dr Gotts new Health Report on the subject Send and your name and address to PO Box Cleveland OH Be sure to ask for the Health Report on Hiatal Hernia Don Ask about anesthesia By Peter H Gotl Mtt B THE HERALD DMemberIIM7 fiOITUTE HALTON HILLS HOT LINE 8772201 ASS 10 SI NORTH KS KJS43 EAST AQJ87S SOUTH AJB33 Kioa North East Sooth Opening lead Crushing defense By James Its great fun to defend a hand welt Afterward you mentally congratulate yourself then you and partner con gratulate each other East made a good decision to defend two spades it was tempting to bid three dia monds a contract with little or no chance Watch how careful defense look every trick not nailed down When declarer rose with dummys king of diamonds at trick one East won the ace and returned bis lone queen of clubs West took the ace and returned the club 10 East ruffed and returned a heart fallowing the die- tates of suit preference The play of the club suggested an entry in hearts in the West hand West won with the two of clubs The defenders now had five tricks and another diamond would be the ting trick If that trick was won by East that would be the last trick for the defense But what if West could win the diamond East could see a possible advantage to that so he now led a low diamond West won the mood and played back still another club ruffed by Easts queen Although declarer could with the ace the 1087 of spades now took another trick to net for the defense for a twotrick set How could East know to bis of diamonds Having support- diamonds West would not have led low unless he bad as much as the 10 of diamonds With 842 for example he would have led the eight A new book by James and his father the late Oswald is now available at bookstores It Is on Card Games published by Pharos Books DEAR DR GOTT I had a cere bral angiogram for which I was un der genera anesthesia for an hour and a half Is this normal procedure DEAR READER No an hour and a half is more time than an un complicated cerebral angiogram should require This is not to suggest that your doctors were Inexperienced or in error Some procedures take longer than normal if they are tech nically more difficult or if unforeseen arise Your doctor may been especially cautious and your case more difficult than the average Ask the doctor why you were under anesthesia so long I am sure he or she will give you a satisfactory answer DEAR DR GOTT Is it possible to get worms from pets I had a cat that bad a tapeworm Ever since my abdomen has been distended and pain ful and I have no energy My blood treasure Is low and Im losing weight ut mostly I have a wriggling sensa tion inside Its almost fike the first stirring of life In a pregnancy but Im not expecting What should I do DEAR READER Get a stool analysis for worms Tapeworms from cats can be spread to humans by fin gertomouth contact when the para sites eggs are present In soil and are inadvertently ingested I doubt that symptoms are due to tapeworm use we are usually not aware of tapeworm infestation until anemia develops You have to look for other factors to explain your distension loss of energy low blood pressure and wriggling sensations Nonetheless stool analysis is in order DEAR DR Ive read that If a betablocker Tenormin and a calciumchannel blocker Procardia are taken together heart failure could result Is this true If no why DEAR READER The real prob lem Is not so much the combination of drugs as the effects of the beta- blocker Tenormin does depress vig orous contraction of heart muscle and with time some patients will fluid overload congestive failure as a result Calcium- channel blockers do not have this complication The two drugs usually can be taken together however the manufacturer of Procardia does advise that In rare cases for unknown reasons the drugs may enhance tendency to cause heart failure In my experience the use of both medicines simultaneously is seldom warranted One or the other in suffi cient dose Is usually preferable When patients taking Tenormin de velop heart failure I change to anoth er drug or add a diuretic kidney stim ulant to rid the body of excess water Be Informed about 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