Stationary bike helps blood recirculate

Dear Dr. Gott: What is the role of exercise – especially on a stationary bicycle – in preventing blood clots in the legs? I am 82 and have had several instances of this for which my doctor prescribed Coumadin. He neither discourages nor endorses exercise, telling me only not to overdo it.

Dear Reader: I urge you to exercise on a regular basis. Not only is this activity beneficial for your cardiovascular system, but it may prevent blood clots in the legs.

As you pump with your leg muscles, arterial blood flow increases and venous blood is milked up into the thorax where it is oxygenated and recirculated. These effects will reduce the possibility of future clotting in your legs.

You needn’t limit yourself to a stationary bike; brisk walking will also prevent blood stasis in your legs. So vary your routine to avoid boredom.

Also, I recommend continuing the Coumadin.

With respect to “overdoing it,” I suggest that you merely listen to what your body tells you. If you’re tired and out of breath, stop exercising for a few minutes. As your muscles and circulatory system adapt to your new plan of activity you will be less fatigued and can then exercise at a higher level of intensity for longer periods.

Finally, check in with your physician at periodic intervals and heed his advice. Good luck.

Dear Dr. Gott: Because of multiple back operations, I must take OxyContin pills for pain relief. But the pills constipate me.

However, I have found success in taking three magnesia pills, six prunes and 8 ounces of prune juice a day. Is this practice going to hurt my organs in any way?

Dear Reader: The combination of magnesia and prunes (which are rich in potassium, a natural laxative) should not harm you. You can safely continue your laxative program.

Of course, getting off the narcotic analgesic would be an admirable goal. For instance, your physician might consider switching you to Ultram, a new non-narcotic pain reliever that is, by early reports, as effective as codeine without the constipation effect.

Dear Dr. Gott: Your consistent preference for generic thyroid supplements – as opposed to brand names – is shameful. Don’t you know that generics are inferior?

Dear Reader: No, I don’t.

To back up my claim that brand-name thyroid supplements are not superior to cheaper generics, I refer you to The Medical Letter (Sept. 27, 2004), which is the “gold standard” publication on drugs and therapeutics. The authors concluded that at least three generic preparations are therapeutically equivalent to brand-name products and have been so approved by the Food and Drug Administration.