Out of breath? Check it out

DEAR DR. GOTT: I am concerned about blocked arteries. I am 60 years old, 5-feet-5, and weigh 115 pounds. I exercise three times a week, do 400 stairs a day, and walk two miles. My total cholesterol is 180, and the good/bad ratios are within good limits. I don’t have any problems with my blood pressure. I have an annual physical exam and blood workups.

However, lately, when doing my stairs, I experience occasional shortness of breath. I have a family history of stroke through my mother and father. Could I possibly have some type of blockage, even though all signs and tests appear normal? Should I request a stress test at my next physical?

DEAR READER: Yes, you should. While you don’t mention your diet, I can only assume it is a healthful one. Otherwise, it’s likely that your HDL, LDL and total cholesterol levels would be out of the normal range. You mention routine exams and lab work but don’t indicate that you have ever had a baseline EKG. You exercise extensively but have a positive family history that could be of concern. And you are 60. My guess is that you are a young 60, but because you even question the possibility of blocked arteries, you should request a stress test. Your physician should order one because of your age and the shortness of breath.

A final possibility is that your problem is arising directly from your lungs. Request a chest X-ray and evaluation for possible pulmonary disease.

DEAR DR. GOTT: Please explain where the idea of drinking “eight glasses of water a day� comes from. I have found no logical explanation.

DEAR READER: Water makes up almost 60 percent of a person’s body weight and is vital for our well-being. It flushes toxins from the system, carries nutrients to all cells, and keeps us properly hydrated. So how much is too much?

There is no scientific basis for the amount of fluids a person should ingest. Eight glasses of water daily is simply an easy rule of thumb. The recommendation for all fluid intake is 9 cups for women and 13 cups for men. This includes coffee, tea, milk, breakfast juices, soup broth and so forth. Keep in mind that we lose almost four cups of fluids daily because of sweating, urination, bowel movements and breathing. Then there’s humidity, illness, the occasional fever and exercise to consider. People who live in humid areas, have specific disorders, or are physically active may require additional fluids because they sweat a good deal.

Unless a medical condition or daily routine dictates diligent attention to fluid consumption, it certainly isn’t necessary to keep a checklist. Drink when you are thirsty. If you plan to hike, jog, play tennis, or perform physical activity, take along a water bottle and hydrate periodically.

Peter Gott practiced medicine in Lakeville for 40 years.