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

High tech prostate imaging, biopsy and treatment: UTMB now offering MRI-guided prostate evaluation and therapy

RadiologySER

Cross sectional MRI view of prostate gland with needle guide in the rectum preparing for biopsy

 UTMB is proud to introduce a complete MRI solution for analysis, planning, biopsy and possible non-surgical ablative treatment of prostate cancer. The advanced imaging capabilities and biopsy tools allow state-of-art imaging and intervention for men experiencing persistently elevated PSA (prostate specific antigen) levels suspicious for prostate cancer.

 This new paradigm for evaluating and treating men with prostate cancer is a cooperative effort of the UTMB radiology and urology departments. The diagnostic MRI requires no special preparation and no rectal instruments and is highly sensitive and specific for focal cancers in the prostate gland. The prostate biopsy, done at a different setting, involves MRI-guidance and tissue sampling of areas of the prostate gland considered suspicious by the previous diagnostic MRI. Continue reading

Making diabetes care less costly

Dr. Victor Sierpina

Dr. Victor Sierpina

Some good news came out recently for those with type 2, non-insulin dependent diabetics that will lower the burden and costs of your care. If your hemoglobin A1C (HbA1C) level is under 8 and you are on oral medications, you don’t need to monitor your glucose daily beyond the first 6 months of starting therapy. This is also true of those on medical nutrition therapy. A review of multiple studies by the Cochrane Collaboration found that monitoring home blood sugars 4-7 times a week in such patients does not reduce the HbA1C more than less frequent self-monitoring of 1-2 times a week.

This is good news since the cost of glucose strips and the discomfort and inconvenience of daily finger sticks has long been a nuisance to patients. Diabetes is a costly disease already in terms of human suffering from serious issues such as heart disease, kidney failure, blindness, and circulatory problems sometimes requiring amputation. It is also expensive to manage diabetes due to the costs of medications, monitoring, doctor visits, testing supplies, special shoes, and hospitalizations.

So at least, this one component of perhaps reducing your monitoring frequency should make your life easier.  Consult with your doctor about this change in recommendations to make sure it is appropriate in your case. 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

Chocolate, Love, and Health

by Dr. Victor Sierpina

by Dr. Victor Sierpina

Maybe the reason chocolate is associated with Valentine’s Day is that it is associated with the release of phenylethylamine (PEA), a chemical released when we are falling in love. Chocolate also is known to affect pleasure receptors in our brain by stimulating endorphins. The theobromines in chocolate act like a mild dose of caffeine and are a brain stimulant. Of course, the carbs, sugar, and fat content of the typical chocolate bar all give us a burst of pleasure as well.

What you might not know is that dark chocolate, defined as chocolate with at least a 70% cacao (pronounced Ka-Kow) content, is a true health food. It is rich in anti-oxidants and packs three or more times the antioxidant strength of such antioxidant powerhouses as blueberries, green tea, and red wine. Though chocolate has a lot of saturated fats, they do not raise cholesterol since they are primarily oleic acid, which is like olive oil, and stearic acid, which is converted by the body to healthy mono-unsaturated and polyunsaturated fats. Chocolate contains abundant minerals and vitamins and perhaps its long considered benefits in alleviating premenstrual symptoms have more to do with the amount of magnesium and iron in chocolate than its effects on the brain. Polyphenols and other flavonoids in chocolate protect blood vessels against cholesterol, are low glycemic, and help control insulin secretion. Emerging science shows compounds in chocolate can help reduce cancer risk, improve immunity, and increase memory. Continue reading

Dr. Robot? Powerful new tool is just that, a tool

Dr. Dan Beckles

Dr. Dan Beckles

A recent article published by CNN/Fortune does a great job explaining the “rise of machines” in the nation’s operating suites.  Here at UTMB , our surgeons have been performing robotic assisted surgeries since 2000 (and other minimally invasive procedures such as laparoscopic surgery for much longer). During the past decade, the scope and number of surgical procedures that can be addressed using the robotic platform has increased dramatically.

UTMB features a state-of-the-art da Vinci Si Surgical System, not unlike the unit featured in the article. This new robotic surgery system has allowed us to expand the scope of our robotic surgeries and expertise even further. Enhancements such as high definition 3D video, fluorescence imaging for vascular structures, and enhanced safety features allow us to perform advanced procedures while maximizing patient safety and decreasing recovery time. However, as evidenced in the story, this great technology and everything it enables, only extends the capabilities of the surgeon and the OR Team.  There is no replacement for skill and experience, and the dynamic nature of the OR requires that your health care team be nimble and prepared to offer whatever therapy or approach best fits your condition. It’s with this  philosophy that we approach robotic surgery, all in order to offer  our patients the best possible outcome.

Advances in surgery usually attempt to ameliorate surgery’s essential nature: cutting someone to cure him. The less severe the tissue damage, the faster the patient heals — less time in recovery, less money spent recovering from the wounds. In health care this is known as “lowering the downstream costs,” and it is what is driving hospitals to invest $2 million a pop for surgical machines.

Read full  article: http://tech.fortune.cnn.com/2013/01/15/robotic-surgeons/

Libido Understood

Drs. Tristi Muir and Catherine Hansen

Drs. Tristi Muir and
Catherine Hansen

Meet Susan, a 56-year-old professional who’s finally come to terms with her hot flashes, night sweats and insomnia and made peace with her mood swings. At a visit to our clinic, she declares, “My libido has completely disappeared.”

Susan’s not joking and she’s not alone. Every day, women at all stages of life get up enough nerve to book an appointment. Some drag along a faltering, speculative, yet willing partner, while others arrive cautiously unaccompanied. For each, there is a different answer to the hide-and-seek game of where is my libido, but there are some underlying principles to consider. Sexual desire, once thought to be spontaneous, unplanned and at-the-ready, is now understood to be far more complex and multifaceted, especially for women and even more so for menopausal women. Continue reading

Healthy nuts: A super food for your daily diet

Dr. Victor Sierpina

Dr. Victor Sierpina

Checking out of Bucee’s on the way back from San Antonio last week, we grabbed a 99-cent pack of hot cashews that festooned the exit counter. The aroma and appearance were hard to resist. We both shrugged, smiled, and said, “Why not?”

Let’s face it, nuts have always had a bit of a seedy reputation. Calling someone a nut isn’t exactly a compliment. How would you like being called a health nut? The old song about, “Nuts, hot nuts, you get them anyway you can!” was truly edgy for the 60’s. Why are nuts so consistently hidden away in our favorite desserts and cookies, like they are somehow illegal, furtive, and suspect? It somehow reminds me of stashing marijuana in brownies. On airplanes or in fine restaurants, we get little packs of nuts more suitable for a four-year old’s appetite and hands than for an adult. Continue reading

Menopause: What is happening to me?

Dr. Catherine Hansen
Dr. Catherine Hansen

After talking to a group of women at a wellness clinic last night, I realized how a little information about our bodies can go a long way!  Enjoy this information about menopause and watch for more in the series:

 Not all women realize they are “menopausal” and many women go through these changes without needing to seek medical advice or note any problems at all.  If you are in this category, don’t worry about the lack of symptoms and don’t go looking for answers to questions you don’t have.  There is no need to test your “hormones” or start any medications but some of the following advice may help to maximize your preventative health strategies as you negotiate menopause gracefully. Continue reading