A weighty problem

DEAR DR. DONOHUE: I read about how people want to lose weight. OK. Now how about my problem? I am too thin and have been all my life. I am 45, weigh 95 pounds and am 5 feet 2 inches tall. I am married with three children. I have great energy and good health. I eat three meals a day, and I eat well-balanced meals. I have no problem with appetite. Skinniness runs in my family. Have you any suggestions? I have had my thyroid checked. It's normal. -- M.H.

ANSWER: By heightweight charts and by body mass index criteria, you are underweight. But let's put the brakes on. You have been this way all your life. You have raised three children. You have great energy and a good appetite. You eat healthful meals. Does being thin classify you as sick or unhealthy? I don't think so. It sounds more like a genetic trait. It will probably add years to your life.

If you want to gain more weight to have a cushion in case you get sick, you can do so by increasing your daily calorie count by 500 calories. You have to buy a caloriecounter book that gives you the calorie content of foods. Such books are cheap, and you can find them in all bookstores. An additional 500 calories a day will add one more pound to your weight in a week.

If you don't want to be bothered by calorie counting, then take these steps: Increase the food portions eaten at every meal. Have a between-meal snack, but don't snack so much that it kills your appetite for meals. Yogurt, dried fruits, fresh fruits and nuts are good sources of calories. They won't kill your meal appetite. A large banana has 130 calories. A banana at midmorning and midafternoon gives you more than half of the 500 extra calories goal.

Another snack before bed can provide the remaining calories needed to reach 500. A peanut-butter sandwich, made with two tablespoons of peanut butter, comes close to 300 calories.

If the snack approach doesn't appeal to you, try a liquid supplement like Ensure. (There are many other brands.)

DEAR DR. DONOHUE: Please discuss the side effects of Flomax, especially its effect on vision. A brother in-law and a friend have experienced vision difficulties from it and have been forced to eliminate its use. Please name some substitutes. -- A.A.

ANSWER: Flomax (tamsulosin) relaxes muscles in the prostate gland and muscles that surround the outlet of the urinary bladder. That allows urine to leave the bladder and pass out of the body more easily. Many men with large prostate glands are indebted to it.

IFIS -- intraoperative floppy iris syndrome -- is one visual complication of Flomax use. The iris is the colored, ring part of the eye. Some men, while on Flomax or who have taken it in the past, experience a peculiar reaction during cataract surgery. Their iris starts to billow outward, and it often constricts. It makes the operation most difficult. Men must tell their eye doctors they are using or have used this drug before such surgery.

Blurred vision is listed as a possible side effect, but it happens to very few users.

Men who have had vision problems can go on a different class of drugs, like Proscar or Avodart.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com. 2006 North America Syndicate Inc. All Rights Reserved