DR. ROACH: Putting heart-rate worries to rest
DEAR DR. ROACH: I am a 32-year-old woman, and for my whole life, as long as I can remember, I have had a very fast resting heart rate. When I was in my late teens and early 20s, it was around 80 beats per minute. Now it is not uncommon for it to be 100 to 140 beats per minute. I am overweight and take multiple medications for bipolar and anxiety. As I understand, all of these can increase a heart rate. Nurses do not seem alarmed when taking my reading. I've asked a doctor about it, and he basically said that some people are just "wired high." Should I be worried about the long-term effects of a fast heart rate? Should doctors be looking into the cause of this? Could this contribute to hyperhydrosis? -- B.F.
ANSWER: The normal resting heart rate is considered to be between 60 and 100, although there are healthy people on both sides of that range. There are many causes of a fast heart rate, and you have mentioned several of them. Being overweight, simply having anxiety or being bipolar, and medications, including some used to treat those conditions, all may cause an elevated heart rate. An elevated heart rate by itself is not dangerous, although there are conditions that cause a fast heart rate that are dangerous (such as uncontrolled high thyroid levels). It's reasonable to check this using a blood test and an EKG at least once.
I don't think the fast heart rate is causing hyperhidrosis (excessive sweating); rather, it seems likely that something is causing both. Anxiety is a common cause. There are many rare causes, such as the thyroid issue I mentioned, and also an extremely rare cause, a pheochromocytoma, a tumor that secretes adrenaline. Almost everybody with a pheochromocytoma has high blood pressure.
Assuming you don't have any of the rare causes, some regular exercise, such as daily walking, can bring the heart rate down.
DEAR DR. ROACH: You recently advised Kegel exercises. Where can I find out more about how to do them? Are they applicable to men as well? -- J.B.
ANSWER: Kegel exercises definitely can be used by men, and may be beneficial for incontinence or dribbling, especially after prostate surgery. Some men have noted improvement in sexual function as well. They are done the same way as for women, as I outlined in my column last July. But if you have access to a computer, you can get very detailed instructions by going to http://www.nlm.nih.gov/medlineplus and searching for "Kegel exercises." All the information on this site has been reviewed by the National Library of Health (part of National Institutes of Health), and it is my first stop if I am looking for patient information.
DEAR DR. ROACH: Will my berserk bursa go away? I have a fluid-filled sac starting at one elbow and extending 3 inches down my forearm. It is 1.5 inches wide and about three-quarters of an inch thick with arm flexed. With the arm straight, it hangs down as a limp, mostly empty bag. No pain, redness or any other sign of anything worrisome. That elbow is somewhat sensitive to lean on. My doctor only suggests wearing a protective cuff. I'd like it to go away. Any chance? -- A.
ANSWER: A bursa is a sac, usually filled with a very small amount of fluid, which protects soft tissues from bony prominences. Bursitis is an inflammation, often from trauma, that causes the bursa to go "berserk," sometimes swelling to many times its normal size, and sometimes with redness and warmth.
It may go away by itself, but it is more likely to with an anti-inflammatory medicine or, better yet, a steroid injection. Surgery rarely is needed.