Aneurysm size in­di­cates po­ten­tial for trou­ble

Cape Breton Post - - LIFESTYLES -

EAR DR. DONO­HUE: I read your ar­ti­cle about aor­tic aneurysms, and it fright­ened me. I have an aneurysm that is five cen­time­tres. I feel that my doc­tor is not tak­ing it too se­ri­ously. I don’t know where to turn. I can’t con­cen­trate on any­thing be­cause this is con­stantly on my mind. Please help. — M.B.

AN­SWER: An aneurysm is a bulge on an artery wall, much like the bulge an in­ner tube makes when it pro­trudes through a tire — when in­ner tubes were used, that is. It’s a weak spot and can burst to cause a se­vere, life-threat­en­ing hem­or­rhage. I un­der­stand how th­ese are any­thing but com­fort­ing words, but you re­ally don’t need to be on the edge of your seat. You and your doc­tor are aware of the aneurysm. Peo­ple who die from an aneurysm are the ones who don’t know they have one. Ev­ery­thing is go­ing to be OK for you. You’ll get the treat­ment you need, when and if you ever need it.

The gen­eral rule is that an aor­tic aneurysm — the aorta be­ing the body’s largest artery — isn’t re­paired un­til it reaches a size of 5.5 cen­time­tres. Peo­ple with smaller aneurysms — and this in­cludes you — have no in­creased rate of death than do those who have their aneurysm cor­rected at smaller sizes. You’re in a safe zone. You can con­tinue with your nor­mal ac­tiv­i­ties without wor­ry­ing that your aneurysm is about to ex­plode. It is not. Stop think­ing about it. You’ll make your­self a ner­vous wreck for no good rea­son.

Doc­tors can re­pair an aneurysm in dif­fer­ent ways. One way is to re­move the di­lated por­tion of artery and re­place it with a syn­thetic graft. An­other pro­ce­dure called EVAR, en­dovas­cu­lar aneurysm re­pair, is done by snaking a thin, flex­i­ble tube (a catheter) to the site of the aneurysm from a sur­face blood ves­sel. When the doc­tor reaches the aneurysm, he or she re­leases a durable fab­ric that’s plas­tered onto the wall of the artery with a metal­lic stent and sta­ples. This isn’t an op­er­a­tion. No big in­ci­sions are made. Re­cov­ery is quite fast. You may never need ei­ther treat­ment.

DEAR DR. DONO­HUE: I keep var­i­ous pills in my car for emer­gen­cies while I’m away

Dfrom home. In the sum­mer, the car gets very hot. Is it true that heat can void the ex­pi­ra­tion date and make the pills in­ef­fec­tive? Should I re­place them af­ter a hot sea­son? — K.K.

AN­SWER: What sounds like a good idea turns out to be not so great.

It’s best to store medicines in a dry, cool, dark place. Light, mois­ture and heat can de­stroy the in­gre­di­ents in medicines and ren­der them in­ef­fec­tive.

If, in hot weather, you’re trav­el­ling and need to carry your medicines, they’ll do fine in an air-con­di­tioned car. When you get out of the car and go to an­other air­con­di­tioned en­vi­ron­ment, take the medicines with you.

DEAR DR. DONO­HUE: I am an 88-year-old man, rea­son­ably healthy. I am both­ered by per­sis­tent con­sti­pa­tion.

Think­ing that fruit would al­le­vi­ate the prob­lem, I’ve been eat­ing large amounts of cher­ries. Af­ter notic­ing no change for the bet­ter, I won­der if the hoped-for cure was pos­si­bly a cause.

Are cher­ries likely to cause or to re­lieve con­sti­pa­tion? — H.B.

AN­SWER: I can’t imag­ine that cher­ries are con­sti­pat­ing, but I can imag­ine that they pro­mote reg­u­lar­ity. One cup of cher­ries has more than three grams of di­etary fi­bre. Fi­bre is of­ten a so­lu­tion for con­sti­pa­tion. I don’t know why your cherry ex­per­i­ment failed you.

How about try­ing prunes? Five to eight prunes a day puts most peo­ple’s di­ges­tive tracts back to work. Not only do they pro­vide fi­bre, but they con­tain sor­bitol and phe­nols, sub­stances that stim­u­late bowel move­ments. Don’t ex­pect im­me­di­ate re­sults. Give them at least a three-week trial.

If prunes don’t work, then get some Me­ta­mu­cil or Fib­er­all, com­mer­cial sources of fi­bre.

If that fails, then be­gin use of a stool soft­ener, like Co­lace.

Walk­ing right af­ter break­fast and drink­ing more than your ac­cus­tomed amount of flu­ids also get things work­ing.

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