Dayton Daily News

Dear Dr. Roach:

- To Your Health

I had a TIA in July 2016. I had lots of risk factors: morbidly obese, cholestero­l of 255, elevated blood pressure, Type 2 diabetes (wellcontro­lled, but still) and heavy drinking. Since then, I have lost weight (from 250 pounds to 205, so far), reduced my cholestero­l to 172 (with statins and diet), started taking Plavix and stopped drinking. Losing weight helped me control my high blood pressure. I currently take losartan, instead of the four meds I needed when I was heavier. I am, alas, allergic to aspirin/ibuprofen.

I have made a lot of improvemen­t; my doctors are happy, but I am still very apprehensi­ve. Does that ever go away?

Answer: — S.S.

A TIA (transient ischemic attack) is a temporary loss of function in the brain: This may include localized weakness or a loss of speech. A TIA has the same risk factors as a stroke, and as such, a TIA is rightly called a warning sign of a stroke. The risk of developing a stroke is much higher among people with a TIA, compared with those without one. It’s a call to action: time to make a change.

You really have done so, and I am very impressed by your results. Between improved behaviors and medication, you have dramatical­ly reduced your risk for another TIA or stroke, and I understand why you and your doctors are happy. I congratula­te you. Anyone can have a stroke. You still have a risk for stroke, despite your outstandin­g efforts. However, that risk has dramatical­ly decreased, and will decrease further as you maintain your good behaviors. Plavix reduces stroke risk about as much as aspirin does (maybe a bit better, at least in women), and so does a statin.

If your question is about the apprehensi­on, I can’t answer that. For most people, it does wane over time. However, a TIA is a frightenin­g experience, and some people continue to have apprehensi­on about it. In some ways, it is like posttrauma­tic stress disorder, and can be treated the same way if the apprehensi­on is affecting your daily life. See a mental health profession­al if that’s the case.

The booklet on stroke explains this condition that is deservedly feared by all. Readers can obtain a copy by writing: Dr. Roach, Book No. 902, 628 Virginia Dr., Orlando, FL 32803

Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dear Dr. Roach:

Ina recent column on a glomerular filtration rate question, you commented that half of adults over 70 will have a GFR below 56. I am 73 and have noticed the same trend, albeit a small decrease versus five or six years ago. My doctor is watching my medication­s, as you suggested. I am also a vegetarian and eat a lot of veggies/plant food, as you recommende­d.

My blood-test results show the normal GFR levels for African-Americans and non-African-Americans. Is there a correspond­ing number for Asian Indians, or do they fall into the non-African-American category? The reason I ask is that I read somewhere that the red blood cell count is lower for Asian Indians versus Caucasians, and thus, they often get wrongly diagnosed as anemic. — H.Z.

Answer: While normal GFR levels have been created for people living in China and Japan, I could not find specific results for South Asians, including people from India, who should therefore use the non-African-American numbers.

The levels of red blood cells and hemoglobin are very similar in Asian Indian men compared with nonHispani­c white men in the U.S.; however, Asian Indian women have hemoglobin levels about 1 point (g/dL) lower than American women. This does have implicatio­ns when considerin­g whether a level is abnormal.

Prostate cancer is the most common type of cancer among men and is often treated successful­ly. Onehundred percent of men diagnosed with prostate cancer can expect to survive five or more years. More than 2 million men living in the U.S. today are prostate cancer survivors.

The American Cancer Society recommends men discuss the uncertaint­ies, risks, and potential benefits of prostate cancer screening with their primary care physician before getting screened. Screenings should not take place without having this discussion.

For men who are at average risk of developing prostate cancer and expected to live at least 10 more years, this informed discussion should occur at age 50.

For men at high risk of developing prostate cancer (such as African-American men and men who have a father, brother, or son diagnosed with prostate cancer before age 65), the informed discussion should take place at age 45.

For men who have more than one close male relative (father, brother, son) with prostate cancer that was diagnosed before age 65, the informed discussion should take place at age 40.

“Screenings include a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE),” says Jorge Arzola, MD, a urologist with Kettering Physician Network’s South Dayton Urological Associates. “The screening is repeated every one to two years, depending on the PSA level. Because prostate cancer often grows slowly, men without symptoms of prostate cancer and with less than a 10-year life expectancy are not likely to benefit from testing.”

Early stage prostate cancer usually has no symptoms. Advanced prostate cancers can cause some symptoms, such as:

Problems passing urine, including a slow or weak urinary stream or the need to urinate more often, especially at night Blood in the urine Trouble getting an erection Pain in the hips, back (spine), chest (ribs), or other areas

Weakness or numbness in the legs or feet, or even loss of bladder or bowel control

Other diseases cause many of these same symptoms. Still, it is important to tell your doctor if you have any of these problems so the cause is found and treated. The treatments for prostate cancer range from frequent check-ups to surgery, radiation therapy, cryotherap­y (freezing), hormone therapy, vaccine, and chemothera­py used one at a time or in combinatio­n.

Most men find it helpful to discuss all of their treatment options with a team of specialize­d doctors to make a decision that best fits their needs.

The types of doctors who treat prostate cancer include:

Urologists – Surgeons who specialize in the urinary system and male reproducti­ve system

Radiation oncologist­s – Doctors who treat cancer with radiation therapy

Medical oncologist­s – Doctors who treat cancer with medicines such as chemothera­py or hormone therapy

Kettering Health Network is a faith-based, notfor-profit healthcare system.

The network has eight hospitals: Grandview, Kettering, Sycamore, Southview, Greene Memorial, Fort Hamilton, Kettering Behavioral Health and Soin.

 ??  ?? Liz Ball, a Tipp City artist, has published 13 books of Hidden Treasures, including her latest, “Farm Fun.” To order, send a check for $6.95 (plus $3.50 shipping) to: Hidden Pictures, Box 1460, Cleveland, GA 30528 or order online at...
Liz Ball, a Tipp City artist, has published 13 books of Hidden Treasures, including her latest, “Farm Fun.” To order, send a check for $6.95 (plus $3.50 shipping) to: Hidden Pictures, Box 1460, Cleveland, GA 30528 or order online at...
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