San Antonio Express-News (Sunday)
Robotic surgery can help cut risks during procedures
Q: My father is slated to have robotic surgery to fix a leaky mitral valve in his heart. They say it’s going to be minimally invasive. What does that mean? And is it really safe to have a robot poking around inside a person’s heart?
Gerry F., Franklin, Tenn.
A: Let’s talk about robots first and then minimally invasive heart surgery. Robotic surgery is done with a trained surgeon controlling a camera and mechanical arms with surgical instruments attached to them. The surgeon is at a computer console, where he or she sees a high-definition, magnified 3D view of the surgical site. This technology lets surgeons perform complex procedures (they control the arms of the robot) that may have been more difficult or even impossible with other methods — in part because the surgeon has such a clear view of a patient’s anatomy and because robots can be “told” precisely how to navigate in a body with information from CT scans and ultrasounds.
These days, a robot is often used in minimally invasive cardiac procedures that require only small incisions, often less than 2 inches long between the ribs. The precision of the robots’ movements and the delicacy of the process is great for patients. There is less risk of infection, fewer complications, less pain and blood loss, and quicker recovery with smaller scars. Some centers, like the Cleveland Clinic, which does more than 2,000 of these procedures annually, have complication rates of 0.5 percent or less. Just 10 years ago, your dad wouldn’t have had the chance to have his valve repaired without going through much higherrisk, open-heart surgery.
Still have questions? Make an appointment to talk to the surgeon, and take a list of topics to ask about so you discuss all your concerns. Your dad is lucky to have you in his corner.
Q: OK, one more time — what’s this new super study about how many steps you should walk a day really saying? Can you lay out the findings and let me know what your interpretation is?
Cassie R., Chicago
A: First, I want to make it clear that disease prevention and longevity are very important — and that is what the new metastudy by an international group of scientists who formed the Steps for Health Collaborative was looking at. Their analysis of the findings of 15 studies involved nearly 50,000 people from four continents.
But I believe quality of life is equally important — and that may be enhanced if you achieve optimal fitness — not just sufficient fitness. More on that later.
First, what the study found:
• The lowest step group averaged 3,500 steps per day; the second group, 5,800; the third, 7,800; and the fourth, 10,900.
• Among the three groups getting the most steps per day, there was a 40 percent-53 percent lower risk of death, compared with the group who walked the fewest steps.
• For adults age 60 and younger, health was protected and premature death was avoided with 8,000 to 10,000 steps a day. For folks over 60, it
seemed that 6,000 to 8,000 did the trick. Furthermore, it didn’t seem to matter how fast or slow a person walked.
This is in line with an earlier study in JAMA that found that middle-aged folks reduced their risk of premature death with 7,000 steps daily.
My recommendations, based on the deeply researched information in my upcoming book “The Great Age Reboot,” is to aim for that 10,000 level or the equivalent (swimming, jogging, biking, etc.) when you’re over 60, too! Self-engineering
your body — that’s what I call it — means you partner your 10,000-step walk with stress response management, smart nutrition and an engaged and active brain — then your quality of life will extend for decades beyond 60. After all, you don’t just want to live longer, you want to live better and live younger longer. You can email me questions about this or other studies at questions@GreatAgeReboot.com.