DEAR DR. ROACH: About 15 years ago (I am now 62), I had night sweats, and woke up frequently to urinate, sometimes five to six times a night, but not consistently. Days or weeks could go by without these symptoms, other than some urination one or two times a night due to very mild BPH. I was in excellent health, or so I thought, and saw my internist regularly. I exercised regularly, ate well and could do long cardio workouts without trouble. I brought these (sweats and urination) problems to my doctor’s attention, and he did further workups on me, including a treadmill cardiac stress test and tests for diabetes.
Over the years, I was tested again by my internist and by kidney specialists, with no findings of abnormalities. Then one day, during the day I raced up three flights of stairs and felt faint at the top. I went in to see my internal medicine physician immediately, who noted I was in A fib in his office. It was the first I ever heard of it. This led to ultrasounds, an angiogram, stress tests, different meds to try to control it, multiple visits to multiple cardiologists, two ablations and continued meds, which help but do not eliminate my A fib. It is always intermittent, and usually happens at night when I’m sleeping. Unfortunately, the years of uncontrolled A fib have led to poor heart function so that instead of doing mini-triathlons, I can pretty much only walk.
The electrophysiologist had a big, glossy chart on the wall that said, “Do you have …” and listed six to eight symptoms that could result from A fib, and prominent among them were night sweats and frequent urination (other symptoms were weakness, dizziness, heart palpitations, racing heart, etc.).
I wanted you to consider and mention the possibility of paroxysmal A fib when patients have some of these symptoms. Stress tests, EKGs, echocardiograms, etc., might not show any A fib. A monitor might pick it up, but even the 48-hour type might not if nothing occurs during that period. I just don’t want others to go undiagnosed for as long as I did. Earlier intervention might stop the cardiomyopathy I have developed because of the years of untreated, random, A fib. — A.B.
ANSWER: Thank you for sharing your story. My own personal (internal) short list of common causes of night sweats and urination did not include A fib, and I appreciate your writing to increase awareness of this presentation of a common condition.
DEAR DR. ROACH: In regard to the 72-year-old man who had difficulty passing stool: Years ago, I would become very dehydrated overnight. I found that drinking a large glass of water (16 ounces or more) as soon as I awoke would soften the stool and make for easy bowel movements a few hours later. I ate normally, but did include a lot of fruit, especially bananas. I notice when doctors advise drinking water, they rarely mention how much and when. — E.K.
ANSWER: Today is a day for listening to wise people. Dehydration is a common cause of constipation, and as the weather gets warmer it’s worthwhile to remind ourselves that an extra glass of water can prevent some problems. Prunes, dates, apricots and other fruits also can help with constipation.
The booklet on constipation explains this common disorder and its treatments. Readers can order a copy by writing: Dr. Roach — No. 504, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$5 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.