Ask the doctors: Readers respond

Hello, dear readers! Welcome to our monthly letters column. We are in the heart of allergy season, which means some of us are stuffed up and sneezing. If you are affected, it can be helpful to check with your doctor about starting medication early. This may help get ahead of the inflammatory response. Now, on to your letters.

• A recent column explored why heartbeats can often be more noticeable when sleeping on your left side. It is due in part to the off-center placement of the heart within the chest. This led to an interesting question from a reader. “I am a 72-year-old female, and had a pacemaker/defibrillator implanted in 2020,” she wrote. “I prefer sleeping on my left side, but since the implant, I’m not comfortable doing so. Is there any reason I shouldn’t?”

In most people, pacemakers are implanted on the left side, below the collarbone. If the discomfort you mention is physical, then avoiding that sleep position makes sense. If your discomfort stems from worry, know that normal pressure when sleeping on your left side will not adversely affect the pacemaker. That said, we often recommend to our patients that they try sleeping on their backs. We believe it to be the most ergonomically sound position, and doing so avoids strain on the hips, back, neck, shoulders and arms.

• Researchers continue to explore the possible cognitive benefits of drinking coffee. This had a reader wondering whether she should drink a bit more. “I have been reading about coffee drinking helping to protect against dementia, and I wonder if I should add a morning cup of coffee to my usual diet?” she asked. “Usually, I drink a weak cup after lunch and maybe another weak one if I want a pick-me-up later.” Although the link between coffee and a protective effect against dementia has been implied, it has not been proven. What researchers are seeing is that, when analyzing years of health data from large groups of people, those who drank coffee regularly were less likely to develop dementia. However, due to the additional health and lifestyle variables involved, a definitive connection cannot be made.

Also, and this goes to your question, the studies do not define a minimum or an optimum amount of coffee. As we age, our bodies metabolize coffee and the caffeine it contains more slowly. This can have a negative effect on sleep. So, unless you genuinely crave that additional cup, there’s no need to add it.

• We recently wrote about dogs who, due to their extraordinary senses of smell, have been trained to sniff out certain diseases. We heard from a reader about his own best friend. “Our family dog became obsessed with a mole on my back and sniffed it nonstop,” he wrote. “Turns out it was an early-stage melanoma. Got it removed and so far, all is well.”

Thank you, as always, for your letters. We love hearing from you. If you have a comment or a question, write to askthedoctors@mednet.ucla.edu.

Send your questions to askthedoctors@mednet.ucla.edu.