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May 17, 2011  In This Issue... - Discover How to Promote Better Prostate Health
- New Hope for Pulmonary Hypertension -- Cutting-Edge Care Brings Specialists Together
- Why Don't These Doctors Get Sick?
- Picky Eater Disorder
- What's Really Sexy to Women
Discover How to Promote Better Prostate Health Are you or a loved one making too many trips to the bathroom? - Help Get a Better Night’s Sleep
- Support Healthy Urinary Function
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New Hope for Pulmonary Hypertension Sometimes it is not technology or a new medication that makes the greatest difference in medical care but something far simpler. A new approach to treating pulmonary hypertension -- a particularly dangerous type of high blood pressure that affects the arteries leading from the heart to the lungs -- puts top specialists together as a "team" to work collaboratively with patients, with the goal of delivering a far better quality of care. While specialists have always discussed their patients with one another, this approach takes the concept much further, I learned from James Calvin, MD, director of the section of cardiology at Rush University Medical Center and a cardiologist at the new Rush Pulmonary Hypertension Clinic in Chicago, which offers this type of multidisciplinary care. Dr. Calvin told me that teamwork is built into every aspect of a patient’s care to comprehensively address the many different causes of this complex disease. He said that the doctors’ combined specialized training and clinical experience leads to more accurate diagnoses and more successful treatment. Patients can even schedule appointments with several different specialists on the same day in the same office, and the doctors can conveniently consult with one another to, as Dr. Calvin puts it, "put our heads together to come up with a solution." Hard to Diagnose Pulmonary hypertension is not uncommon, and doctors are well aware of its signs and causes, but it can nonetheless be tricky to diagnose because its symptoms mimic those of so many other heart and lung diseases. This condition develops in people whose hearts have had to pump especially hard to push blood through increasingly stiff and narrow arteries. It has many causes, including heart, lung and liver problems... living at altitudes higher than 8,000 feet... and heredity in some cases can contribute, too. When the body must expend intense effort to bring blood through the lungs to the left side of the heart the eventual result is weakening of the heart muscle on the right side leading to heart failure or other potentially fatal complications. Shortness of breath is usually the first warning sign of pulmonary hypertension, but other common symptoms include fatigue... dizziness... fainting... chest pain... leg and ankle swelling... palpitations (fast heartbeat)... and bluish lips and skin. How pulmonary hypertension is diagnosed: An echocardiogram, a form of ultrasound that enables your doctor to get a good look at your heart and pulmonary arteries, is usually the first step toward diagnosis. If "problems" are found, the next step is right heart catheterization, to measure how well blood moves through and to look for blockages or other abnormalities. Doctors often order other tests to obtain additional information on the extent of the patient’s problem, possibly a chest X-ray, CT scan, MRI and/or pulmonary function assessment (a measure of how well the lungs take in and release air). Life with Pulmonary Hypertension While treatment is complex, inroads have been made. A variety of medications may be used, and together, they can allow many patients to continue to live their lives fairly normally. These may include: - Vasodilators. These drugs -- including epoprostenol (Flolan) and iloprost (Ventavis) -- widen blood vessels and reduce scarring in them. Patients used to have to come to the hospital or a doctor’s office for intravenous (IV) administration of this therapy, but now new drugs can be taken orally by patients at home.
- Endothelin Receptor Agonists. ERAs -- such as bosentan (Tracleer) or ambrisentan (Letairis) -- block endothelin, a substance in blood vessel walls that causes them to narrow.
- Calcium channel blockers. Though these were once the first line of treatment, they work only 5% of the time.
- Other drugs. Your physician may also prescribe an anticoagulant such as warfarin (Coumadin)... a diuretic to prevent fluid accumulation... sildenafil (Revatio) to relax smooth muscle in pulmonary arteries... digoxin to help the heart pump blood... and/or oxygen to help you breathe.
- Surgical treatments. If drugs alone cannot control your condition, options include open-heart surgery to create an opening between the right and left chambers of the heart and relieve pressure on the right side... and, in very severe cases, a lung or heart-lung transplant (in patients with a diseased lung).
Put Yourself on the Team When you have pulmonary hypertension, it’s vital to control any other underlying conditions (for example, religiously take your blood pressure medications). Dr. Calvin also says that for the best quality of life, keep your focus on making sensible, healthful daily lifestyle choices... - Get lots of rest. Listen to your body. When you are tired, take a nap.
- Follow a healthy diet. In particular, avoid salt -- which can increase swelling in your legs. Eat more whole foods and fewer salt-laden processed products.
- Stay active. Ask your doctor what level of exercise is safe for you.
- Don’t smoke. Smoking severely damages your arteries, heart and lungs.
- Avoid stress. Improve your quality of life by meditating or practicing yoga or tai chi.
- Eliminate saunas and hot baths. These can cause your blood pressure to drop dangerously low.
- Avoid high altitudes (including air travel). Low oxygen levels worsen symptoms such as shortness of breath.
Source(s):
James Calvin, MD, professor of medicine, director, section of cardiology, department of internal medicine, Rush University Medical Center, Chicago.
Why Don't These Doctors Get Sick? They work impossible hours, hang around in germ-infested hospitals and treatment rooms filled with sick people all day -- yet they don't fall ill themselves. Why? We asked hundreds of leading doctors this question and their answers may shock you. They're secretly using blacklisted alternative therapies themselves! Now let more than 250 acclaimed MDs and scientists show you how to... - Cure acute infections in 2 to 6 hours...
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Picky Eater Disorder What if practically every type of food -- even the most delicious fresh foods, healthfully prepared -- made you ill? If you couldn’t bear the robust flavor of a juicy porterhouse steak right off the grill... if the intense, herby aroma of a hot, crisp slice of pizza repulsed you... if the crunchiness of a juicy, fresh-picked apple turned your stomach? This kind of thing is not a problem for the vast majority of us -- in fact, to the contrary! But medical researchers have recently started to study a group of people who have exactly these issues -- they have a problem that is being called "adult picky eating" or, in proper medical circles, avoidant/restrictive food intake disorder. They are adults who consume only a very narrow range of food... and that often doesn’t include fruits, vegetables, fish or most meats and just about anything else the world considers good-for-you foods. Is Help to Be Had? While this is not considered an eating disorder, since by definition that would require sufferers to have intense anxiety about weight or body image, it is a problem recently brought to public awareness -- thanks to a Web site ( www.PickyEatingAdults.com) established by a 63-year-old picky eater who was looking for support and wanted to gain the attention of the medical community in the hope that research will lead to treatment. Now the Duke Center for Eating Disorders Training Clinic has partnered with the University of Pittsburgh Medical Center to sponsor an online survey known as the Food FAD (Finicky Eating in Adults) Study. Jennifer Wildes, PhD, assistant professor of psychiatry at the University of Pittsburgh School of Medicine, told me that thus far they have input from more than 2,000 adults who classify themselves as picky eaters, and they are hopeful that the survey will soon provide much more insight into this condition. While results aren’t yet available, Dr. Wildes told me that the respondents have been predominately Caucasian, reasonably well-educated and more than two-thirds female. Why So Picky? There is considerable speculation about what might cause this odd eating problem. It may be telling that adult picky eaters very often want to (or can) eat only foods that are pale-colored and bland, such as bread, pasta and potatoes, and that picky eaters frequently speak with distaste about the sensory aspects of foods -- the textures and smells -- which, they often report, make them feel ill even when they think about them. These clues made doctors wonder whether these people have sensory differences that lead to aversion to the smell, texture and/or other characteristics of many foods. Some affected individuals may have autism spectrum disorders or obsessive compulsive disorder. There also may be other physiological or neurological factors at play, said Dr. Wildes. Curiously, though, few of these folks suffer malnourishment as a result of their very limited diets. In fact, the main health concern is that many are overweight or obese, which could be associated with their starchy, high-calorie diets. Just Say No... Nicely! Picky eaters typically aren’t looking for help expanding their food repertoires -- they are not interested -- but they often experience social embarrassment and isolation because of their own perceived need to hide their eating habits. For example, some picky eaters routinely arrive late to dinners so they don’t have to eat (or, more accurately not eat) -- many refuse social invitations altogether. They may develop elaborate coping strategies for holidays -- for instance, at Thanksgiving (what many of them call the worst day of the year), they may play with young children during the big meal to avoid sitting at the table. Even without understanding the medical reason for this problem, health practitioners are starting to develop therapies to help. Dr. Wildes told me that a key goal of treatment is teaching affected people how to become more comfortable in a culture of food. They may receive training in assertiveness to give them the skills to take part in social occasions while saying a polite "no" to most foods. Other goals include possibly broadening their palates to include foods that are only mildly objectionable... learning to adopt healthful lifestyle habits such as exercise to avoid further weight gain... and learning to balance their nutritional intake to avoid diet-related problems including diabetes and heart disease. Source(s):
Jennifer Wildes, PhD, assistant professor of psychiatry, University of Pittsburgh School of Medicine and research director at the Center for Overcoming Problem Eating (COPE), Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center.
What's Really Sexy to Women I've never studied this academically, nor taken any formal polls, but all of the women I talk to agree on when they find their husbands at their absolute sexiest. Any men reading this are probably thinking, "romantic dinner" or "walking hand-in-hand on the beach" or "double-bubble bath in an oversized tub" or fresh flowers or gifts of beautiful jewelry. These are each wonderful, tremendously appreciated and should certainly be encouraged, but they're not "it." Click here to read more...
Be well, 
Carole Jackson
Bottom Line's Daily Health News
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