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to your Address Book or Safe List. Learn how here. | June 5, 2011 | |  |  | Nervous About Needing a Breast MRI? Here’s What to Expect | | | New INSTANT Cure for Extra High Cholesterol—Cholesterol Drops 100 Points or More | | | This Crunch Won’t Hurt Your Neck | | | Arthritis Vanishes in Minutes | | | A Better Way to Assess Seniors’ Health Risks | | | |  |  | |  | |
 | | Nervous About Needing a Breast MRI? Here’s What to Expect My coworker’s mammogram revealed a suspicious area in one breast, so her doctor recommended a magnetic resonance imaging (MRI) test to provide more detailed pictures. But my coworker felt nervous, not only about the possible results but also about the MRI itself. To allay my colleague’s anxiety, I called radiologist Rachel F. Brem, MD, director of the Breast Imaging and Intervention Center at The George Washington University (GWU) Medical Center. Might a breast MRI be in your future, too? Here’s what you’ll want to know... What It Is and Who It’s For A breast MRI is a noninvasive test that uses a magnetic field, radio waves and a computer to produce detailed images that can reveal lesions not detectable with mammography or ultrasound. For the test, a nonradioactive contrast agent (dye) must be injected into the bloodstream. Since cancerous areas have more blood vessels, more dye goes to those areas, making the resulting MRI images clearer. A breast MRI may be prescribed if you... - Are at high risk because of a family history of breast cancer or because genetic testing revealed that you carry a breast cancer gene.
- Have a mammogram with inconclusive results that merit clarification (as was the case with my coworker).
- Are undergoing chemotherapy for breast cancer, since MRI can reveal whether the disease is responding to treatment.
- Were recently diagnosed with breast cancer—because MRI may be useful for presurgical planning. In one recent study from the University of Rome involving 164 breast cancer patients, MRI detected 51 additional suspicious lesions not seen on other tests... and changed the proposed treatment for 20% of patients. In a second study from the same researchers, presurgical MRI was associated with a reduced risk for cancer recurrence. (Dr. Brem noted that all GWU patients with newly diagnosed breast cancer have an MRI or other imaging test, though this is not the standard at all breast centers.)
Risks: The MRI scan itself poses no danger. Possible side effects of the contrast agent include headache, nausea, chest pain, skin rash and irregular heartbeat. Your doctor can help you weigh the test’s benefits against these risks. MRI may not be safe or appropriate if you... - Have an implanted device (pacemaker, cerebral aneurysm clip, cochlear implant, plate, screw or rod) made of any metal other than titanium anywhere in your body. Because MRI uses a powerful magnet, a nontitanium metal device could shift position during the test.
- Are pregnant or breast-feeding (the contrast agent could be toxic to the baby).
- Have kidney problems. Since patients with kidney disease eliminate the contrast agent from their bodies more slowly, they are at increased risk for side effects, including a serious condition that involves thickening of the skin and organ damage. Note: Before undergoing a breast MRI, women age 50-plus routinely have a blood test to check for kidney problems because decreased kidney function becomes more common with age.
- Weigh 300 pounds or more—you might have trouble fitting comfortably inside the MRI apparatus.
Where and When to Schedule Your MRI Ask your doctor to refer you to an imaging facility that handles a large volume of breast MRIs, so the staff will have extensive experience with the test. GWU, for instance, does four to six breast MRIs daily, Dr. Brem said. If you are having an MRI for screening purposes only and you are postmenopausal, simply schedule your MRI at your convenience. If you are premenopausal, the ideal time to have your MRI is between day seven and day 14 of your menstrual cycle (with day one being the first day of your period). Because this is when breasts are least affected by your natural hormones, the MRI results will be easiest to interpret. If you have an irregular cycle, just wait until you get your period and then schedule your MRI for day seven to 14. Exception: If you have breast cancer or an inconclusive mammogram, do not wait for that day-seven-to-14 window—schedule your MRI immediately, Dr. Brem advised. What Happens on the Day of the Test You remove any metal you are wearing (jewelry, hairpins, eyeglasses), and an intravenous (IV) line is placed in your arm to deliver the contrast agent. You lie face-down on a padded table, face nestled into a donut-shaped pillow and breasts hanging freely into cushioned openings containing a signal receiver. (After her MRI, my coworker suggested settling yourself into the pads until you’re really comfortable because you must remain motionless once the test begins.) Then you are slid into the MRI tube, which encircles your entire body. Do you get claustrophobic? Tell your physician ahead of time so he or she can prescribe a calming medication if necessary. To relax inside the tube, focus on your breathing (but don’t take deep belly breaths, since staying still is paramount) or imagine yourself in a pleasant place (a mountaintop, a beach). Many imaging centers provide headphones so patients can listen to music, which camouflages the MRI machine’s knocking and buzzing noises. The technician can see you and speak to you, and if you need to get out, you can signal the technician by squeezing a handheld device. (My coworker recommended testing that signaling device before entering the MRI to make sure it works.) After some initial images are taken, the dye is injected into your bloodstream via the IV. You may feel a spreading sensation of warmth and/or notice a metallic taste in your mouth. Expect to be in the tube for about 30 minutes as the MRI produces more than 3,000 images, each showing a thin slice of your breasts. With so many images to interpret, it may take a few days to get your results. At that point, you and your doctor can discuss the appropriate next steps to take to safeguard your health. Source: Rachel F. Brem, MD, is a professor of radiology and director of the Breast Imaging and Intervention Center at The George Washington University Medical Center in Washington, DC. She has published many articles on breast imaging in various journals, has won numerous awards and was named by Castle Connolly as one of America’s Top Doctors for Cancer.
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 | | This Crunch Won’t Hurt Your Neck
Q: My neck aches when I do abdominal crunches. What will help?
A: It is important to relax your neck and avoid pulling on your head during crunches. To help with this, do crunches using a resistance band, a strip of latex three to four feet long and about six inches wide (about $6 at sporting-goods stores and online). This move is easier on your neck than regular crunches because the band fully supports the weight of your head and also reminds you not to yank on your head. To start: Lay the band straight out on the floor. Lie face-up on top of it, knees bent, feet flat on the floor and hip-width apart, tailbone anchoring one end of the band and the other end extending beyond your head. Reach above your head and grasp the end of the band with both hands, pulling the end taut and creating a "hammock" for your head. (Don’t worry—even stretched, the band is wide enough to support your head.) Now do a crunch: Contract your abdominal muscles to lift your shoulders and upper back off floor... hold for two seconds... slowly return to starting position. Repeat the move as many times as you can while maintaining good form, until you are fatigued. Source: Joan Price is a fitness instructor and motivational speaker based in Sebastopol, California, and author of six books, including The Anytime, Anywhere Exercise Book: 300+ Quick and Easy Exercises You Can Do Whenever You Want! (iUniverse). www.JoanPrice.com
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| | | A Better Way to Assess Seniors’ Health Risks When it comes to gauging a person’s risk for obesity-related health hazards (diabetes, heart attack, stroke), many people automatically think of body mass index (BMI), a calculation based on weight and height. But: Surprisingly, a study that tracked longevity among seniors for 12 years found that people with higher BMIs did not tend to die sooner than their slimmer contemporaries. What really did matter for women age 70 and up was the waist-hip ratio (WHR), or waist measurement divided by hip measurement. For each 0.1 increase in WHR, the risk of dying during the study period rose by 28%. Theory: Changes in body size and composition that commonly occur with aging—such as loss of muscle mass (including in the hip area) and redistribution of fat (including an increase in abdominal fat)—make BMI a less useful indicator of obesity-related health risks among seniors than among younger people. Self-defense: Generally, the ideal WHR for women is 0.7, so get out your measuring tape and do the math. If your WHR is above 0.7, talk to your doctor about diet and exercise strategies that can help whittle your waistline and increase muscle mass... and add years to your life. Source: Preethi Srikanthan, MD, is an assistant clinical professor of medicine at the David Geffen School of Medicine, University of California, Los Angeles, and lead author of an analysis of data from a study involving 1,189 people ages 70 to 79.
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 |  | |  Tamara Eberlein, the editor of HealthyWoman from Bottom Line, has been a health journalist for nearly three decades. An award-winning author or coauthor of four books, she is committed to helping other women in midlife and beyond live healthy, fulfilling lives. Her latest book is the updated, third edition of When You’re Expecting Twins, Triplets, or Quads (HarperCollins). She is also the "chief health adviser" to her husband of 26 years and three college-age children. | |  | | Bottom Line Publications | 281 Tresser Boulevard, 8th Floor | Stamford, CT 06901
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