Jagger’s heart op is no longer high-risk
ike millions of his lifelong fans, I could scarcely have imagined, buying my first Rolling Stones record aged 15 (Little Red Rooster), that the legendary Sir Mick would still be strutting his stuff 50 years on – and likely to continue doing so indefinitely, once recovered from his recent heart operation. Sir Mick’s sensible decision to have his narrowed aortic valve replaced by TAVI (or transcatheter aortic valve implantation) reflects a major shift in recent years in the perception of those who are most likely to benefit from the procedure.
The practicalities, as many will know, involve introducing a catheter into the femoral artery, which is then manoeuvred upwards to the heart, through which the replacement valve is “implanted”. Though technically ingenious, the TAVI used to be a high-risk procedure, with a significant risk of serious complications (such as stroke) and uncertainty as to its long-term effectiveness. Hence, its use was restricted to those who are too old (or too ill) to withstand the much more gruelling surgical aortic valve replacement (SAVR), which entails splitting the sternum, opening the chest, dissecting out the damaged valve and sewing a new one in place. But with time and experience, the several drawbacks of the TAVI have been addressed and overcome – with the recent recommendation that it should now be considered the treatment of choice for all those, like Sir Mick, aged 75 or over.
Calcium false alarm
There is no need for those taking calcium supplements to be in the least alarmed by the latest health scare, reported last week, that a recent study showed they “doubled the risk of cancer”. Even if true (unlikely), the scale of that increased risk is, for the individual, a minuscule 1.2 per cent.
Still, the study is at least useful in drawing attention to the important fact that the five million people in Britain taking calcium supplements (usually in combination with vitamin D, which helps the body more effectively absorb it) to treat or prevent osteoporosis gain no benefit from doing so: they obtain more than enough of the mineral from a sensible diet, and additional supplements do not reduce the likelihood of sustaining a fracture.
Why so? The thinning of the bones which occurs in later life, it cannot be emphasised enough, is due to the inability of osteoblasts, the cells that form new bone, to keep up with the activity of the osteoclasts, which resorb it, as part of the continual process of remodelling. But the chemical constituents of the bone that is laid down, its mineralisation with calcium and phosphate, is normal, so additional supplements are unnecessary. The only group for whom they may be of value are the very elderly in nursing homes who, due to a poor diet and insufficient exposure to sunshine, have measurably low levels of calcium and vitamin D.
Blocked up
The experience of the woman invariably troubled by stubborn constipation while on holiday or visiting friends for a few days is echoed by others. “I have had this problem for as long as I can remember,” writes a reader in her late 70s. “The moment I lock up my front door on leaving, I also lock up my bowel movements. No sooner have I returned and unlocked it, they return to normal.”
This could be, it is suggested, shy bowel syndrome, a psychological inhibition of normal bowel function in the presence of others in the same building. “I get round this problem by never sharing a hotel bathroom or, when staying with friends, rising early and using the lavatory prior to anyone waking.”
Two further possible causes suggested are hardness of the local water supply (avoided by sticking to bottled water); or relative dehydration in those accustomed to drinking (for example) several large cups of tea a day.
The specific laxative remedies commended – and which should preferably be commenced ahead of departure – include a daily sachet of Fybogel, sprinkling a tablespoon of linseed oil over the breakfast cereal, and the pineapple extract Bromelain.
TAVI should be considered the treatment of choice for those, like
Sir Mick, 75 or over