What happens if the calcium score is high?
Well, in theory it means that you have a risk of a heart attack. So one should start changing lifestyle, eat healthy, quit smoking, and reduce cholesterol. One should start to walk.
Can the machine be wrong?
Sure, like any machine, heart scan can create errors in interpretation. Sometimes the heart scan indicates you have calcium when there is in fact none. This is a false positive test and happens quite frequently. When a false positive test occurs, more studies are needed to confirm the results. This may involve undergoing a coronary angiography, more exposure to radiation, contrast dye and thus more expense.
On opposite side of the coin, if there is no calcium, then you just move on with your life as before without having to worry about a heart attack. However, one should be aware that coronary arteries can be very narrow or clogged up and yet not have calcium. In such a case, the heart scan may show there is no calcium but you may have serious blockage in your coronary vessels. This means the test is falsely negative. It shows you have no disease when you actually have disease.
Heart scan technology is still in infancy but is continuing to improve. Scientists are learning more about the role of calcium in heart disease and devising better machines.
In the meantime, one should not overlook the traditional risk factors that can increase your chance of developing heart disease. Moreover, remember that if you do have a heart scan, it is useful only if you actually follow up with your doctor and make lifestyle changes that can prevent worsening of heart disease
Final point
One of the reasons why medicine has become expensive is because of unscrupulous doctors offering unnecessary tests. There are hundreds of walk-in clinics and private health centers that offer quick scans which are nothing more than scams. These clinics falsely scare the public leading to unnecessary worries. These walk-in facilities rarely need any referrals. You just walk in, pay close to 1400 dollars, and you get your scan. The heart scans are not covered by medical insurance
As a consumer before you join the queue to get a heart scan, talk to your physician. Read about the procedure, get to understand your risk factors and ask yourself if the heart scan can make a difference in treatment. If you still decide to get a heart scan, make sure you go to a reputable center and get a copy of results sent to your physician.
Finally, if you do not have chest pain, shortness of breath and have no risks factors for heart disease, a heart scan is not recommended for you. If a physician still recommends a heart scan, you need a new doctor. The American College of Cardiology only recommends heart scans for individuals who have symptoms.
Wednesday, April 29, 2009
Do I need a Heart Scan? part 3
What are risks of a heart scan?
Heart scan machine uses electron beam computerized tomography to assess calcium in your blood vessels. These scans exposure you to a lot of radiation- the same amount that you would receive from 30 chest x rays. Repeated heart scans could expose you to a lot of radiation and increase your risk of cancer. Further, anyone who is pregnant should never have a heart scan.
Heart scan can also be performed using CT angiography. Here you are administered a dye that could cause an allergic reaction and you are also exposed to a lot of radiation. The dye can even cause kidney failure or worsen damage to your kidneys.
There are no special preparations required for a heart scan at many of these walk in centers. The majority of these walk in centers are more interested in your finances than your heart. Only a brief history is obtained, a superficial physical exam is performed and your risk factors assessed. Rest assured, the heart scan will be done irrespective of your risks or symptoms. To these physicians the only thing of concern is whether you can pay for the scan.
How does Heart Scan work?
A heart scan usually takes less than 5-10 minutes. You come in and lie down on a flat table. There are no intravenous fluids, no needles or anesthesia. The table enters a small tunnel and the machine takes pictures of your heart. You hold your breath for a few second while the machine takes the pictures. The computer quickly draws up images of your blood vessels and calculates the calcium score.
Heart scan machine uses electron beam computerized tomography to assess calcium in your blood vessels. These scans exposure you to a lot of radiation- the same amount that you would receive from 30 chest x rays. Repeated heart scans could expose you to a lot of radiation and increase your risk of cancer. Further, anyone who is pregnant should never have a heart scan.
Heart scan can also be performed using CT angiography. Here you are administered a dye that could cause an allergic reaction and you are also exposed to a lot of radiation. The dye can even cause kidney failure or worsen damage to your kidneys.
There are no special preparations required for a heart scan at many of these walk in centers. The majority of these walk in centers are more interested in your finances than your heart. Only a brief history is obtained, a superficial physical exam is performed and your risk factors assessed. Rest assured, the heart scan will be done irrespective of your risks or symptoms. To these physicians the only thing of concern is whether you can pay for the scan.
How does Heart Scan work?
A heart scan usually takes less than 5-10 minutes. You come in and lie down on a flat table. There are no intravenous fluids, no needles or anesthesia. The table enters a small tunnel and the machine takes pictures of your heart. You hold your breath for a few second while the machine takes the pictures. The computer quickly draws up images of your blood vessels and calculates the calcium score.
Do I need a Heart Scan? part 2
There is still a lot of controversy about heart scans. If you have no family history, or risk factors then your risk of having a heart attack is very low. The heart scan in this instance will tell you what you and your doctor already know. In this case, the best advice is to get a second opinion and keep away from the physician who owns the machine.
Because of the rampant abuse of heart scans by physicians to generate income, the American College of Cardiology has developed guidelines to determine if you need a heart scan.
Individuals who do not need a heart Scan:
You do not need a heart scan if you are younger than age 55, have normal cholesterol, well controlled blood pressure and you do not smoke. In such a scenario, you have a very low risk of a heart attack. Since you are already at low risk, a heart scan will not tell the doctor anything new or what it not already known. The only thing a heart scan does in such a case is increase the doctor’s income by another $1,500.
A heart scan is not needed in individuals who have high cholesterol, high blood pressure, smoke and are over 65. these individuals are at high risk of a heart attack. Since both you and your doctor know this, a heart scan is useless. Hopefully, you have a decent doctor who will try and help you bring the cholesterol down and control your blood pressure. If you are smoking, you better quit. But you definitely do not need a heart scan
Individuals who have already had a heart attack should not have a heart scan because it does not tell anything new.
Individuals who have already had a open heart bypass should not have a heart scan because the scan can not reveal anything new. Similarly, individuals who have had angioplasty or ballooning of their coronaries should not have a heart scan. In all these cases, it is known that you are already at a high risk for a heart attack or have had one. So a heart scan is useless.
So when does one need a heart scan?
There are some individuals who fall some where in the middle. These individuals are in between the age of 55-65, may have borderline cholesterol, high blood pressure or may be light smokers. In such cases, the risk for a heart attack is not known. Thus, a heart scan may help determine the risk if you have any chest pain, especially if the doctor does not know what is causing your chest pain.
Because of the rampant abuse of heart scans by physicians to generate income, the American College of Cardiology has developed guidelines to determine if you need a heart scan.
Individuals who do not need a heart Scan:
You do not need a heart scan if you are younger than age 55, have normal cholesterol, well controlled blood pressure and you do not smoke. In such a scenario, you have a very low risk of a heart attack. Since you are already at low risk, a heart scan will not tell the doctor anything new or what it not already known. The only thing a heart scan does in such a case is increase the doctor’s income by another $1,500.
A heart scan is not needed in individuals who have high cholesterol, high blood pressure, smoke and are over 65. these individuals are at high risk of a heart attack. Since both you and your doctor know this, a heart scan is useless. Hopefully, you have a decent doctor who will try and help you bring the cholesterol down and control your blood pressure. If you are smoking, you better quit. But you definitely do not need a heart scan
Individuals who have already had a heart attack should not have a heart scan because it does not tell anything new.
Individuals who have already had a open heart bypass should not have a heart scan because the scan can not reveal anything new. Similarly, individuals who have had angioplasty or ballooning of their coronaries should not have a heart scan. In all these cases, it is known that you are already at a high risk for a heart attack or have had one. So a heart scan is useless.
So when does one need a heart scan?
There are some individuals who fall some where in the middle. These individuals are in between the age of 55-65, may have borderline cholesterol, high blood pressure or may be light smokers. In such cases, the risk for a heart attack is not known. Thus, a heart scan may help determine the risk if you have any chest pain, especially if the doctor does not know what is causing your chest pain.
Do I need a Heart Scan?
Everywhere in America, doctors have set up machines to screen the body. There are machines to screen your breasts, others machines to screen your lungs, others for your brain, your bones, your rectum, etc and now we have a machine to screen the heart. The heart scan is the latest device on market. With marketing ploys that frighten consumers like “you will die”, “you will get a heart attack” , “cholesterol is bad” and so on, these hyped up ads have been designed to scare consumers into thinking that death can occur any second from a heart attack.
Come-on doctors, Enough with these ads- relax, take a pill, get an enema and chill out.
What is a heart scan?
The heart scan is a technique that takes pictures of your heart and measures levels of calcium in your coronary vessels. You lie on a table, which enters a Tunnel with a camera. The camera takes pictures and in 5 minutes, it is all over- just $1,500 for this great procedure that can look at anatomy of your heart.
Physician now use heart scans to determine amount of calcium in your coronary vessels. If you have more calcium in your blood vessels, then it is bad. The higher the calcium score, the worse it is for you- at least this is what is speculated by the doctors who use heart scans.
Rather than go into mundane details, it is known that when cholesterol deposits in your blood vessels. Calcium also accumulates at the same time. Since we have no good way of measuring cholesterol deposits in a live human, the next best thing is to measure calcium levels. If the levels of calcium are high in your blood vessels, then it is bad.
The ads claims that if you have lot of calcium in your coronary vessels, you have a high risk of heart attack even if you do not have any symptoms- Such claims are bull because many people have calcium in their blood vessels and live a long healthy life without getting a heart attack.
Today, heart scans have popped up everywhere; in supermarkets, shopping centers, in every health care facility and plazas. Almost all doctors have a heart machine in their office or know of someone who has it. There are some doctors who own mobile heart scans that can come to your home.
Come-on doctors, Enough with these ads- relax, take a pill, get an enema and chill out.
What is a heart scan?
The heart scan is a technique that takes pictures of your heart and measures levels of calcium in your coronary vessels. You lie on a table, which enters a Tunnel with a camera. The camera takes pictures and in 5 minutes, it is all over- just $1,500 for this great procedure that can look at anatomy of your heart.
Physician now use heart scans to determine amount of calcium in your coronary vessels. If you have more calcium in your blood vessels, then it is bad. The higher the calcium score, the worse it is for you- at least this is what is speculated by the doctors who use heart scans.
Rather than go into mundane details, it is known that when cholesterol deposits in your blood vessels. Calcium also accumulates at the same time. Since we have no good way of measuring cholesterol deposits in a live human, the next best thing is to measure calcium levels. If the levels of calcium are high in your blood vessels, then it is bad.
The ads claims that if you have lot of calcium in your coronary vessels, you have a high risk of heart attack even if you do not have any symptoms- Such claims are bull because many people have calcium in their blood vessels and live a long healthy life without getting a heart attack.
Today, heart scans have popped up everywhere; in supermarkets, shopping centers, in every health care facility and plazas. Almost all doctors have a heart machine in their office or know of someone who has it. There are some doctors who own mobile heart scans that can come to your home.
Monday, April 20, 2009
Overactive bladder and incontinence part 9
Surgery
There are several types of surgical procedures to help individuals with an overactive bladder. Surgery is usually the last resort after the individual has failed lifestyle changes and drug treatment. Surgery should never be the first choice as the results are not that good. In fact, most individuals remain dis-satisfied with results of surgery.
Surgery is essentially done to improve the bladder’s storing ability and relax the muscles.
Surgical interventions include:
Stimulation of pelvic nerves. The nerves running from the spinal cord to the bladder (sacral nerves) are the target. The activity of these nerves is altered with the use of an electrical device. A very thin wire is placed near your tailbone and connected to a small pacemaker placed underneath your skin. The device is programmed to deliver very low current that relaxes the bladder. Like any electrical device, there are a number of technical problems and it often fails to work.
Enlarging the bladder (Augmentation cystoplasty). Some surgeons can increase capacity of the bladder by using a piece of bowel. This is a major undertaking. Because bowel does not have strong muscles, one constantly retains urine and thus, life long use of a catheter is a must. Enlargement of the bladder is a surgical procedure with a lot of risks and complications; it is only done when everything else has failed. The decision to undergo such surgery should not be undertaken lightly. Incontinence can be a difficult disorder to live with, but some of the complications from augmentation cystoplasty can make things a lot worse.
Detrusor Myectomy: There is another procedure that can thin or remove part of the muscle surrounding the bladder. This helps to strengthen the bladder and also avoids recurrent muscle contractions. The procedure is still in its infancy and results are not guaranteed.
Laser has also been used to relax or destroy the muscles around the hyperactive bladder. Laser is not a a magic bullet for overflow incontinence and often fails to work. The treatment is painful and the results are only temporary. Laser is also expensive.
Final Note
For those who are affected with an overactive bladder, there are many national and local organizations that provide support to other members. These support organizations offer the latest advice, coping methods and help improve self-esteem. These local chapters can be found on the internet under "incontinence support."
The other problem with incontinence is that most of the lay public and even many health care professionals remain clueless about this devastating disorder. Educating these individuals can help improve understanding and alleviate embarrassment.
There are several types of surgical procedures to help individuals with an overactive bladder. Surgery is usually the last resort after the individual has failed lifestyle changes and drug treatment. Surgery should never be the first choice as the results are not that good. In fact, most individuals remain dis-satisfied with results of surgery.
Surgery is essentially done to improve the bladder’s storing ability and relax the muscles.
Surgical interventions include:
Stimulation of pelvic nerves. The nerves running from the spinal cord to the bladder (sacral nerves) are the target. The activity of these nerves is altered with the use of an electrical device. A very thin wire is placed near your tailbone and connected to a small pacemaker placed underneath your skin. The device is programmed to deliver very low current that relaxes the bladder. Like any electrical device, there are a number of technical problems and it often fails to work.
Enlarging the bladder (Augmentation cystoplasty). Some surgeons can increase capacity of the bladder by using a piece of bowel. This is a major undertaking. Because bowel does not have strong muscles, one constantly retains urine and thus, life long use of a catheter is a must. Enlargement of the bladder is a surgical procedure with a lot of risks and complications; it is only done when everything else has failed. The decision to undergo such surgery should not be undertaken lightly. Incontinence can be a difficult disorder to live with, but some of the complications from augmentation cystoplasty can make things a lot worse.
Detrusor Myectomy: There is another procedure that can thin or remove part of the muscle surrounding the bladder. This helps to strengthen the bladder and also avoids recurrent muscle contractions. The procedure is still in its infancy and results are not guaranteed.
Laser has also been used to relax or destroy the muscles around the hyperactive bladder. Laser is not a a magic bullet for overflow incontinence and often fails to work. The treatment is painful and the results are only temporary. Laser is also expensive.
Final Note
For those who are affected with an overactive bladder, there are many national and local organizations that provide support to other members. These support organizations offer the latest advice, coping methods and help improve self-esteem. These local chapters can be found on the internet under "incontinence support."
The other problem with incontinence is that most of the lay public and even many health care professionals remain clueless about this devastating disorder. Educating these individuals can help improve understanding and alleviate embarrassment.
Overactive bladder and incontinence part 8
Medications
Unlike may other bladder disorders, there are some decent medications that can treat overflow incontinence. These medications all work in the same manner. They relax the bladder muscles and reduce urge incontinence. The available drugs include
- tolterodine (Detrol)
- oxybutynin (Ditropan)
- oxybutynin skin patch (Oxytrol)
- trospium (Sanctura)
- solifenacin (Vesicare)
- darifenacin (Enablex).
For the best effects, it is highly recommended that these medications be combined with above mentioned lifestyle changes. There is a lot of clinical evidence showing that these drugs do work for hyperactive bladder but the problem is never cured. The treatment has to be continued for many months. Relapse is very common when drug treatment is stopped.
The major problem with the above drugs is side effects. Most individuals develop some type of side effect over time. The longer the treatment continues, the more prominent side effects become. The typical side effects of anti cholinergic drugs include
- Dry eye sensation
- Dry mouth
- Excessive thirst
- Headaches
- Nausea
- Constipation
To limit or eliminate these side effects, there are now some extended release preparations that can be applied as a skin patch. If dry mouth or dry eye sensation persists, one should use sugar free candy, apply eye drops or use products like Biotene that can help moisten the mouth for long periods
Botox
There is some anecdotal evidence that Botox can help relieve overflow incontinence. Botox can paralyze bladder muscles and reduce the urge to pee. Research is still ongoing and Botox has not yet been approved for use in this disorder. Some reports indicate that Botox when injected into bladder muscles can provide relief for as long as 4-6 months. However, it has also been observed that Botox injections in older men can create another problem- retention of urine. One develops a feeling of a full bladder but is unable to void. Often the only way to resolve this problem is to use a catheter to empty the bladder.
Unlike may other bladder disorders, there are some decent medications that can treat overflow incontinence. These medications all work in the same manner. They relax the bladder muscles and reduce urge incontinence. The available drugs include
- tolterodine (Detrol)
- oxybutynin (Ditropan)
- oxybutynin skin patch (Oxytrol)
- trospium (Sanctura)
- solifenacin (Vesicare)
- darifenacin (Enablex).
For the best effects, it is highly recommended that these medications be combined with above mentioned lifestyle changes. There is a lot of clinical evidence showing that these drugs do work for hyperactive bladder but the problem is never cured. The treatment has to be continued for many months. Relapse is very common when drug treatment is stopped.
The major problem with the above drugs is side effects. Most individuals develop some type of side effect over time. The longer the treatment continues, the more prominent side effects become. The typical side effects of anti cholinergic drugs include
- Dry eye sensation
- Dry mouth
- Excessive thirst
- Headaches
- Nausea
- Constipation
To limit or eliminate these side effects, there are now some extended release preparations that can be applied as a skin patch. If dry mouth or dry eye sensation persists, one should use sugar free candy, apply eye drops or use products like Biotene that can help moisten the mouth for long periods
Botox
There is some anecdotal evidence that Botox can help relieve overflow incontinence. Botox can paralyze bladder muscles and reduce the urge to pee. Research is still ongoing and Botox has not yet been approved for use in this disorder. Some reports indicate that Botox when injected into bladder muscles can provide relief for as long as 4-6 months. However, it has also been observed that Botox injections in older men can create another problem- retention of urine. One develops a feeling of a full bladder but is unable to void. Often the only way to resolve this problem is to use a catheter to empty the bladder.
Overactive bladder and incontinence part 7
Mattress covers: If incontinence causes accidents at night, then one should use mattress covers. Today, a whole range of mattress covers are available. The fabrics include linen, cotton, reinforced cotton, plastic and even soft flexible sheet protectors. These covers are often reinforced with extra padding to make cleaning easier. Many of these products also are anti deodorants impregnated into the lining to prevent urine odor.
Absorbent briefs designed for both men, women and children are now available. These briefs also protect outer garments and bed linen. Many of these briefs can be reused and are made from nylon. The waist and leg bands lined with elastic provide a good seal and protection. These fabrics are washable and come in many sizes. Those who have soft,fair, fragile skin and are prone to irritation should use disposable briefs.
Skincare: All individuals with incontinence should take good care of their skin. There are many products on the market to keep skin clean. It is essential to get a product which is fragrance free, free of synthetic chemicals and not irritating to the skin. Besides creams, there are lotions, sprays, soaps and ointments to keep skin clean
Absorbent briefs designed for both men, women and children are now available. These briefs also protect outer garments and bed linen. Many of these briefs can be reused and are made from nylon. The waist and leg bands lined with elastic provide a good seal and protection. These fabrics are washable and come in many sizes. Those who have soft,fair, fragile skin and are prone to irritation should use disposable briefs.
Skincare: All individuals with incontinence should take good care of their skin. There are many products on the market to keep skin clean. It is essential to get a product which is fragrance free, free of synthetic chemicals and not irritating to the skin. Besides creams, there are lotions, sprays, soaps and ointments to keep skin clean
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