Move On

Dr. Victor Sierpina

Dr. Victor Sierpina

A recent ode to the benefits of tennis by a 74-year-old writer caught my eye. Citing various classical authors, philosophers, and the gradual improvement of his game since his 20s, the author championed the power of vigorous sport on his writing and his mind. Riffing off a Robert Frost poem that ended “Here are your waters and your watering place. Drink and be whole again beyond confusion,” the author concluded: “The tennis court is my watering place where I drink and am whole again beyond confusion — at least for a couple of hours.”

As an aging tennis player myself, I found his essay in The Wall Street Journal’s opinion page uplifting as he described “tennis as a refuge from the racket of everyday life.” We all need some kind of healthy activity and discipline to allow us to shut down the grinding gears of our minds for brief periods and refresh it with the drink of stillness and the water of life.

The Physical Activity Council recently reported 28 percent of Americans over 6 get no physical activity meaning they are totally sedentary in the past year. This report is also included a sharp increase in inactivity for those over 65. These are unhealthy trends. Continue reading

A body in motion

Dr. Victor Sierpina

Dr. Victor Sierpina

In high school physics class, I learned from Sir Isaac Newton that a body in motion will stay in motion. The opposite is true and it is called inertia. The other day in clinic, I went in to see Dylan, a 12 year old. He didn’t look up or say hi to me as I came into the room as he was intently working his thumbs on a handheld device. His mother told him to be polite and say hello. He raised his head briefly, said, “Hi,” then back to the gaming thing. She shrugged apologetically and helplessly. I won’t dwell on how we should socialize the digital generation to learn polite human interaction, though it is quite relevant to bodies in motion.

Dylan’s complaint was a minor one and he basically came in needing a school excuse. It could have been a 5 to 10 minute visit but I noticed he was a bit chunky. In fact, his BMI at 29 was close to the obese range. At mom’s request, we ran a urine and blood test to make sure he wasn’t diabetic. He wasn’t, fortunately, at least not yet.

I asked Dylan what kinds of sports or other activities he liked to do. Mom motioned to me with both thumbs moving rapidly to mime the reality of his activity. Continue reading

Smoking combined with your DNA increase lung cancer risk

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Smoking isn’t the only thing that raises your risk of lung cancer. As it turns out, your DNA can have that effect too.

A scientific study scanned the genomes, the entire genetic code, of 11,000 people of European descent in an effort to identify if there was any correlation between gene sequences and a common form of lung cancer, non-small cell carcinoma. They discovered that variants of certain genes increase a person’s susceptibility to developing lung cancer, especially in smokers.

One of the three gene variants they identified, named BRCA2, can double a smoker’s chance for developing lung cancer. BRCA2 is a tumor suppressor gene. It encodes a protein involved in the repair of damaged DNA, which is critical to ensure the stability of cell’s genetic material. When cellular DNA is damaged, there are several ways for the body to detect and repair that damage. If the damage to DNA cannot be repaired, then the cell is programmed to die by a process called apoptosis in order to prevent the damage being passed on to its daughter cells. Continue reading

I Spy for Heart Disease

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

While a shrink ray like the kind used in science fiction is still stuck in the future, miniature devices are not. Tiny devices have been created to perform a variety of tasks, from an implantable telescope to improve vision in those with macular degeneration to the new pacemaker in clinical trials that is about the size of a large vitamin pill. Now, researchers have developed a catheter-based device smaller than the head of a pin that can provide real-time 3-D images of the heart, coronary arteries and other blood vessels. This is an important invention as the casualties of heart disease continue to rise. Statistically, 1 in 4 people will have a heart attack.

Many Americans are at risk for developing coronary artery disease due to the buildup of cholesterol and plaque. If there is a rupture or breakage of the plaque, creating a blood clot, that can result in a heart attack with little to no warning. Traditional diagnostic tests such as stress tests and echocardiograms show how much blood is flowing to the heart. If there are regions of the heart that are not getting as much blood as others, it might be a sign of clogged coronary arteries. However, blood flow can also appear to be normal even with plaque buildup. Continue reading

4 key questions, 7 steps to health

Dr. Victor Sierpina

Dr. Victor Sierpina

The noted heart surgeon Christiaan Barnard once said that our goal in life should be “to die young, as late as possible.”

These words of wisdom suggest that we need to tend to those things that keep us young functionally, mind, body and spirit. As we ascend in age, our goal should be to postpone as long as we can the depredations of unhealthy aging, premature disease and loss of function.

At a recent national conference for the Osher Lifelong Learning Institutes, a nationwide organization including an OLLI here in Galveston that is dedicated to promoting healthy aging, I heard a terrific and highly practical presentation.

The keynote speaker was a friend of mine, Dr. Margaret Chesney, head of the University of California in San Francisco’s Osher Integrative Medicine Center and also former head of the National Institutes of Health National Center for Complementary and Alternative Medicine.

Dr. Chesney shared data that showed the answer to four simple questions can largely determine how healthy your lifestyle is.

The four questions were:
1. Are you a nonsmoker?
2. Is your Body Mass Index (BMI) less than 30?
3. Do you engage in mild or moderate physical activity at least 21⁄2 hours per week?
4. Do you eat at least five servings of fruits and vegetables daily?
Continue reading

Women: Care for your heart, know your risks

Dr. Rafic Berbarie

Dr. Rafic Berbarie

“I’m worried about my risk of having a heart attack.”

Whenever I start my office notes in seeing patients, the first line I fill out is the patient’s chief complaint. The above statement is a common complaint in my general cardiology practice. But often the patients have no symptoms; rather, a friend or loved one just had a heart attack and so they are worried and want a heart “checkup.”

February is heart disease awareness in women month, and as a physician, I want you to know what can be done to help prevent heart attacks.

While awareness is growing, people are often shocked to hear that heart disease is the No. 1 killer of women in the United States. In fact, if you added up how many women died of cancer, the number still would not equal the number of women dying from heart disease.

And while there are established screening guidelines for several cancers, there are no unifying screening guidelines for heart disease in women.

My first recommendation is to have a good primary care doctor who is reviewing your risk factors for heart disease. Continue reading

A top 10 list to die for

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

How are you going to die?

The Centers for Disease Control would answer that life expectancy depends greatly on where someone lives. Life expectancy in the United States ranks 40th in the world with 77.97 years. That addresses when someone might die but what about how? Most likely, it will be from one of these top 10 causes, based on how many Americans they kill each year.

10) Suicide – 38,285. Many factors are now known to influence suicide: mental illnesses, genetics, certain pharmaceuticals, traumatic brain injuries, drug and alcohol abuse and chemical or hormonal imbalances. To decrease these rates, education about the signs preceding suicide and accessible treatment is necessary.

9) Kidney Disorders – 45,731. Although dialysis can help people survive a little longer without a kidney, it is no cure. Kidney damage can occur from infection, high blood pressure, or toxic reactions to drugs, leading to chronic kidney disease that affects more than 26 million Americans. Continue reading

For some men, it’s “T” time – test or no test. Dr. Baillargeon explains.

Prescriptions for testosterone therapy have increased significantly during the last 10 years, according to a study in the current issue of JAMA Internal Medicine conducted by researchers at the University of Texas Medical Branch.

About 50 percent of the men in the study who had received testosterone therapy had been diagnosed as having hypogonadism, a condition where a man is unable to produce the normal levels of testosterone.

But the study also found that, among new users of a prescription androgen product, about 25 percent did not have their testosterone levels tested before starting the treatment.  In addition, it’s unclear what proportion of the 75 percent who were tested had a low level of testosterone.

Dr. Jacques Baillargeon, lead author of the study and an associate professor in preventive medicine and community health at UTMB, said that he believes this is the first national population-based study of testosterone-prescribing patterns.  

(See video of Dr. Baillargeon explaining main findings of the study) Continue reading

Women’s hearts, women’s health

Dr. Victor Sierpina

Dr. Victor Sierpina

In case you missed it, February was Women’s Heart Health Month, perfectly fitting with Valentine’s Day in the middle of the month. It isn’t too late to wear a red dress to support awareness of heart disease in women.

The pink ribbon of breast cancer awareness is easily recognized and well known, but the red dress of heart disease is not. Yet, roughly 10 times more women die from heart disease annually as do from breast cancer. Since the mid 1980s, more women have been dying annually of heart disease than men.

Part of the problem here is focus and part is history. Breast cancer is enormously emotional, frightening, and potentially disfiguring. The good news is that it is more and more curable with good screening, early detection, treatment and follow-up. Also, many of the same lifestyle choices to reduce breast cancer risk also reduce heart disease risk.

An important issue is that heart disease symptoms in women are often subtle and less obvious than in men. The common triad of chest pain brought on by exercise and relieved by rest, which is a common, presenting sign of heart problems is not always so clear-cut in women. Because women’s heart disease tends to occur in smaller vessels and is more diffuse symptoms can present more generically. These include fatigue, shortness of breath, indigestion, nausea, faintness, upper back, neck or shoulder pain.

Let me give you the example of Lila, a lovely woman in my practice now in her mid 60s, who is now on the transplant list for a new heart. She seemed to be at low risk for heart disease. She was a nonsmoker, thin, active, with well-controlled blood pressure, blood sugars and cholesterol. She had also breast-fed her several children lowering her risk of breast cancer. Continue reading

Socialization is good for your heart’s health

Drs. Ken Fujise and Naveed Adoni

Drs. Ken Fujise and Naveed Adoni

This past Valentine’s Day, we hope you thanked your loved ones for the company and good cheer they provide. A lonely heart can result in a sick heart, as multiple studies have shown.

There is strong evidence that loneliness and social isolation are associated with adverse heart health. Loneliness and social isolation are comparable to smoking, high blood pressure, obesity and lack of physical activity as risk factors for chronic heart disease and heart disease mortality.

Among otherwise healthy individuals, those with fewer social interactions and smaller social networks have been shown to have increased risk of cardiovascular events and cardiovascular mortality. Cardiovascular events include heart attacks which usually manifest with chest pain, but it is very important to note that heart attacks in women can present differently with symptoms other than chest pain, including shortness of breath, dizziness, fainting, extreme fatigue or pain or pressure in the upper back, lower chest or upper abdomen. Continue reading