Aneurysm size indicates potential for trouble
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.