8/25/1945 – 1/27/2023
Medical Moment was a series of infomercials which was produced in collaboration with CHAT TV to help better inform the public about various health topics around the year 1999.
This specific Medical Moment is about heart disease, a very serious problem which everyone has heard of and should be cautious of.
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June is stroke month.
Stroke is the third leading cause of death. That means we should remind ourselves about the prevention and early recognition of stroke symptoms. Early recognition of stroke symptoms can lead to early treatment with clot busting drugs. That means you improve your chances of recovery from strokes disabling symptoms.
Heart and Stroke Foundation has been running ads which clearly tell the public how to recognize the signs of stroke when you see them. You should immediately call an ambulance if you recognize the following signs:
-weakness sudden loss of strength or sudden numbness in the face, arm or leg, even if temporary
-trouble speaking sudden difficulty speaking or understanding or sudden confusion, even if temporary
-vision problems sudden trouble with vision, even if temporary
-headache sudden severe and unusual headache
-dizziness sudden loss of balance, especially with any of the above signs
Each year in Canada stroke occurs in 50,000 people and account for seven per cent of all deaths. About five per cent of men and women over the age of 65 have been affected by stroke. Strokes kill 45 per cent more women than men in Canada, says a report from the Heart and Stroke Foundation. One of the reasons is that women live longer than man. Patients with stroke require a lot of care and health care resources.
A stroke occurs when blood flow to the brain is blocked, either by blood clots or narrowed blood vessels, or when there is bleeding in the brain.
Can we prevent stroke?
Chronic conditions like atherosclerosis (hardening of the arteries), atrial fibrillation (irregular heart rhythm), hypertension, high cholesterol levels and diabetes can lead to stroke if not appropriately managed.
For example, about 26 per cent of Canadian adult men and 18 per cent of women have hypertension. But 40 per cent of such people are unaware they have hypertension. This is not good.
Some risk factors like age, gender and genetic factors cannot be changed. Physical inactivity, smoking and heavy use of alcohol increases the risk of stroke. These risk factors can be changed if a person so desires.
According to an article in the Canadian Medical Association Journal, several agents can be used to manage underlying disease to prevent stroke:
-antiplatelet agents like aspirin
-blood thinners like Coumadin
-control of high blood pressure with thiazides and ACE inhibitors
-reducing the cholesterol level with statin
-if indicated, surgery for correction of narrowing of carotid artery in the neck
These measures should be combined with increased physical activity, no smoking and reduction in the amount of alcohol consumed. So stroke can be prevented if we take control of our health and modify the risk factors.
In an acute situation, if you recognize the signs of stroke then call an ambulance. Timely administration of aspirin and clot busting drugs can significantly modify the outcome of stroke.
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Dear Dr. B: What is the best screening tool for early detection of colorectal polyps and cancer? What are the guidelines for screening?
Answer: This subject is gaining more importance each day. In the month of March I was at Peter Lougheed Centre, Calgary to attend a seminar on Update on Colon Cancer and Endoscopy organized by the University of Calgarys Division of Gastroenterology. One of the topics for discussion was on colon cancer screening guidelines.
Colorectal cancer is the fourth most common cancer. It is the second leading cause of cancer death in Canada. In 2004, 19,100 new cases of colorectal cancers were diagnosed in Canada and 8300 deaths were reported.
Screening for colorectal cancer is recommended to pick up polyps and cancer at an early stage when they can be treated effectively. Currently we do not know what the best test is for screening purposes. A variety of tests are now available, each with advantages and disadvantages.
Every individual is at risk of developing colorectal cancer. The average lifetime risk of developing colorectal cancer is six per cent. If you have any of the following risk factors then the risk increases:
-Family history of colorectal cancer or polyps
-Ulcerative colitis or Crohns colitis
-Presence of polyps or previous history of colorectal cancer
What is the approach to an individual with average risk of colorectal cancer?
For asymptomatic men and women who are 50 years or older with no family history of colorectal cancer are considered to have average risk and the following options are available for screening:
-Fecal occult blood tests yearly or bi-annually
-Flexible sigmoidoscopy every five years
-Fecal occult blood tests plus flexible sigmoidoscopy every five years
-Barium enema every five years
-Colonoscopy every 10 years
What is the approach to an individual with above average risk of colorectal cancer?
For asymptomatic men and women age 50 or over with a positive family history of colorectal cancer the lifetime risk of developing colorectal cancer is anywhere from 15 per cent to 80 per cent depending on how many first degree relatives had colon cancer and at what age.
-If two or more first degree relatives have had colon cancer and if one of them is under the age of 60 then colonoscopy is advised at the age of 40 or 10 years earlier than the affected first degree relative and then every five years
-If only one first degree relative has colorectal cancer and is 60 years old or older then the individual is considered to have average risk and the screening starts at age 40
-If there is a hereditary history of polyps then genetic testing and colonoscopy is advised.
Fecal occult blood tests are done by patients and stool samples are taken to a lab to detect traces of blood not visible to naked eye. If positive then the patient needs a colonoscopy in the hospital. If negative then the test is repeated yearly or every two years. If done annually death rate from colorectal cancer is reduced by 30 to 45 per cent. The test can be combined with a short scope (flexible sigmoidoscopy) which is an office procedure. We do flexible sigmoidoscopy in our office on a regular basis. This can be repeated every five years.
Barium enema and colonoscopy are done in the hospital. If abnormality is found on a barium enema then colonoscopy is required. If colonoscopy is normal then it should be repeated every ten years for an average risk person. If less than one centimeter adenomatous polyp is found then the scope should be repeated in five years. If the polyp is bigger than one centimeter then it should be repeated after three years.
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The secret is out.
It is in the newspapers. It is on the radio. It is on television. Now every Canadian knows. The question is: what can we do about it?
Since it is not a secret anymore, do you know what I am talking about?
Just in case you missed the big news then let me tell you what it is all about. It is about you and your work habit.
Recently released data collected in 2005 by Statistics Canada says, one in three Canadian is a workaholic. Well, how would you define a workaholic? A workaholic is an individual who is addicted to working, spend excessive hours on the job or who becomes anxious when he or she is away from the office.
Are you one of them?
If you are then you are a kind of person who is rushed, feels trapped in a daily routine, always worried that you are not spending enough time with your family and consequently you have trouble sleeping. Sounds like you feel guilty and you are depressed. Have you seen a good doctor lately?
Is this information something new? No. Statscan says people who describe themselves as workaholics has not changed since this information was first collected 15 years ago. So, how does this information help us define our work habit in 2007?
These days almost everybody has to put in long hours to make a decent living whether you are addicted to your work or not. You have to pay your bills, find a decent place to live and pay the inflated rent, buy expensive gas for your car in a land full of oil, pay premium dollars to have a hot shower and turn on the lights in a land which boasts the cheapest utility rates. Would you call yourself a workaholic?
According to Statscan findings, if you are a self-professed workaholic then:
-usually you work 50 or more hours a week
-your general state of their health was fair or poor
-you have trouble sleeping
-you have problems using your time effectively
-you are unable to accomplish what you set out to do at the beginning of the day
-you do not have time for fun
-you are more dissatisfied with your work/life balance than other employees
-you are probably in the management and trades
-if you are a professional then you simply accept that working long hours is an integral part of your professional role
The message is if you are a workaholic then you are never going to be happy. Theyve bought the BMW, and they have the $3 million Mill Valley house. And they still wake up in the morning and say, I dont feel good about myself, says Stephen Goldbart, psychologist and cofounder of the Money, Meaning and Choices Institute.
So, what is the solution?
One has to step back and do a life review. Identify the problems and consider what changes are needed to make life more pleasurable and fulfilling. We have to balance different roles we play in life. To balance these different roles is a real challenge. Lack of balance is one of the most frequent problems people face in their lives.
Start by simplifying life. Make some choices and make some sacrifices. Remember, in trying to have everything all the time, it may just end up killing us! What are we good for when we are underground?
Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!