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Heart Bypass Surgery or Stenting—Which Is Best for Me?
Tweet Share on Facebook April 23, 2010 Comment (5)I see from a recent study published in Circulation that about half of the patients who would be better off having heart bypass surgery wind up getting a stent instead. Can I keep that from happening to me?
The decision regarding who should receive a stent and who should receive bypass surgery is complex and must be individualized for each patient. There are some general principles, though. For patients having a heart attack or otherwise unstable chest pain, urgent heart catheterization and stenting have been shown to save lives. For patients with a stable chest pain syndrome (pain only with exertion), both stenting and bypass surgery have been shown to reduce symptoms. If catheterization shows only one or two readily treatable blockages, stenting may make good sense because it relieves the symptoms without the need for open heart surgery. If there are more than a couple blockages, however, most experts believe that bypass surgery is preferable, particularly if the surgeon uses the internal mammary artery to perform one or more bypasses. Internal mammary bypasses have more durability in the years following surgery than bypasses using the veins harvested from the legs. -
Does Stress Hinder Wound Healing?
Tweet Share on Facebook April 16, 2010 Comment (2)
Psychological stress can extend the time required to heal wounds by 25 percent or more. Studies in which we and other researchers have created small wounds about the size of a pencil eraser, and then measured the rate of healing, show that stress slows closure. For example, dental students took an average of 40 percent longer to heal a small, standardized wound made prior to exams, compared to an identical wound made during their summer vacation.In contrast to the relatively mild and predictable stress of academic examinations, surgery is a high-stakes stressor, and people's anxiety levels before surgery are often very high. After surgery, anxiety and depression can make pain worse—and pain is certainly another stressor that can slow your healing.
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Should I Start a Strength-Training or Interval-Training Routine?
Tweet Share on Facebook April 14, 2010 Comment (11)Rather than steady aerobic exercise, I see many fitness pros extolling the virtues of strength training and interval training routines. Wouldn't going for an easy jog be just as good a workout?
It depends upon your goals. If you are involved in competitive running, interval training is necessary to improve your performance. That type of intense exercise is not advised for anyone having a diagnosis of heart problems or musculoskeletal abnormalities. My recommendation for the masses, particularly older Americans, is "long, slow is always better than fast, short."I do feel that a total fitness program consists of a cardiovascular base coupled with musculoskeletal conditioning. You can be too muscular just as you can be overweight, and the heart is going to suffer either way. But if you do both, then you can become "totally fit." The combination of aerobic conditioning and strength training should be as follows:
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Are Digital Mammograms Better Than the Conventional Kind?
Tweet Share on Facebook April 9, 2010 Comment (1)Are digital mammograms superior to the regular kind for women of every age?
In digital mammography, the X-ray is converted into an electrical signal that can be displayed on a computer screen or printed as an image that looks like a regular mammogram. The patient's experience is no different from having a traditional mammogram. Digital mammograms can sometimes use a lower overall dose of radiation to the breast.The differences between traditional and digital mammography are similar to the differences between traditional and digital photography. Some benefits of digital mammography are that the radiologist can manipulate the digital mammogram electronically to magnify an area, change contrast, or alter the brightness. In addition, the images are available immediately, without waiting for film to develop, and the images can be transmitted electronically from remote locations for centralized reading.
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One Fifth of Adolescents Have High Cholesterol. What's Your Take?
Tweet Share on Facebook April 6, 2010 Comment (2)Government health officials recently reported that 20 percent of American adolescents have abnormal cholesterol levels. What's your reaction?
This is very alarming. Although some adolescents are genetically predisposed to have high cholesterol levels, most authorities think that environmental causes are to blame. The diet of adolescents often includes more "fast food" than a generation ago, including burgers, pizza, french fries, and soft drinks sweetened with high-fructose corn syrup. Astonishingly, 15 percent of young people are now considered obese, which definitely increases cholesterol levels. Obese children and those with high cholesterol levels face a shortened life span and high risk of developing coronary heart disease at an early age. However, most authorities are reluctant to treat younger teenagers with cholesterol-lowering drugs, so diet, exercise, and weight loss are the most important interventions.Nonetheless, some children with an inherited disorder known as heterozygous familial hyperlipidemia will require statin drugs to reduce bad cholesterol (LDL-C), because their LDL can be very high (200 or more). There is controversy regarding when to start treatment, but most authorities recommend starting at about age 13. If your teenager is overweight or you have family history of high cholesterol, it may be prudent to have his or her cholesterol checked. If levels are very high, consult an expert in the treatment of cholesterol disorders.
[Statins for Prevention? Taking a Cholesterol-Lowering Drug When Cholesterol Is Normal]
