The following is a true-to-life scenario described by a doctor. It reflects an all-too-frequent problem.

THE whole family was worried. Now even the doctor was too. “If his bleeding doesn’t stop soon,” the doctor said, “we may have to consider a blood transfusion.”

The man had been slowly losing blood through his bowels for several weeks, and the problem had been diagnosed as inflammation of the stomach, or gastritis. “Are you sure you’re not taking any medications?” asked the frustrated doctor.

“No. Only this natural over-the-counter stuff for my arthritis,” said the man.

Suddenly the doctor pricked up his ears. “Let me see it.” Carefully searching the ingredient label, he found what he was looking for. Acetylsalicylic acid! Problem solved. When the patient stopped taking the aspirin-containing compound and was given iron and some stomach-healing medicine, the bleeding stopped and his blood count slowly returned to normal.

In 1995 the Harvard Health Letter reported that “routine aspirin use saves lives.” Citing several worldwide studies, which have been repeated many times since then, researchers concluded: “Nearly everyone who has ever had a heart attack or stroke, suffers from angina, or has undergone coronary artery bypass surgery should take one-half to one aspirin tablet daily unless they are allergic to the drug.”

With all these presumed benefits of aspirin, why doesn’t everyone take it? For one thing, there is still much that is not known. Even the ideal dosage is unclear. Recommendations range from one standard tablet twice daily to as little as one baby aspirin every other day. Should the dosage for women be different from that for men? Doctors are not sure. While enteric-coated aspirin may be considered somewhat helpful, the advantage of buffered aspirin is still controversial.

Reasons for Caution

Though technically aspirin is a natural substance—American Indians obtained components of aspirin from the bark of a willow tree—it has many side effects. Besides the fact that it causes bleeding problems in some people, there are many other potential complications with aspirin, including allergic reactions in aspirin-sensitive people. Needless to say, daily aspirin usage is not for everyone.

A person who is at risk for heart attack or stroke or who has significant risk factors, however, may want to ask his or her doctor about the risks and benefits of daily aspirin use. Certainly the patient would want to make sure he or she has no bleeding problems, no aspirin intolerance, and no stomach or gastrointestinal problems. Other potential problems or medication interactions should be reviewed with the physician prior to beginning therapy.

As noted before, aspirin and aspirinlike medications carry the significant risk of bleeding. And that bleeding may be subtle, not immediately apparent, and slowly cumulative over time. Other medications too need to be considered with care, particularly other anti-inflammatory medicines. Be sure to inform your physician if you are using any of them. In most cases it would be wise to discontinue the medication prior to surgery. Perhaps even regular laboratory monitoring of blood levels would be helpful.

Tormented By Phobia

“Phobias have often been a subject of ridicule. But ‘funny’ is one thing they are not.”
—Jerilyn Ross, director of a treatment center for anxiety disorders

THE word “phobia” refers to an intense, unrealistic fear of an object, an event, or a feeling. But a definition alone cannot convey the terror and loneliness that mark this condition. Raeann Dumont, who has treated phobias for more than two decades, notes: “Phobic people may avoid so many situations that they become housebound, or they may live with constant, unrelenting anxiety, or they may relieve their anxiety with alcohol, which may cause additional problems.”

Phobias are classified among a group of ailments called anxiety disorders. It is estimated that 12 percent of the adult population in the United States will deal with a phobia at some point in their life. Many of these will suffer in silence for years. “Unfortunately,” reports the Anxiety Disorders Association of America, “about three-quarters of individuals with phobias never get help. Many people with phobias are reluctant to seek assistance because of embarrassment. Others don’t understand what they have or where to find help, and some fear the treatment itself.”

There are hundreds of known phobias, but experts usually arrange them in three categories. Simple phobias focus on an object or a situation, such as insects, animals, flying, and being in closed spaces. Agoraphobia usually occurs in conjunction with panic attacks. The sufferer fears having a panic attack to the extent that he or she avoids all places and situations where previous attacks occurred. Social phobias are characterized by a fear of being embarrassed in public settings, such as speaking before an audience.

It commonplace to think of how to protect ourselves against terrorist, rapist, and any other vicious attack. But have you ever thought of heart attack? Is your answer “no”, or did you answer “yes”? Pause a while till you finish reading this…

Each year millions of men and women worldwide have heart attacks. Many survive with few aftereffects. Others do not survive. For still others the heart is so damaged that “a return to useful activities is questionable,” cardiologist Peter Cohn says, adding: “It is imperative, therefore, to nip heart attacks in the bud whenever possible.”

The heart is a muscle that pumps blood throughout the body. In a heart attack (myocardial infarction), part of the heart muscle dies when deprived of blood. To stay healthy, the heart needs oxygen and other nutrients that are carried by the blood. It gets these by way of the coronary arteries, which wrap around the outside of the heart.

Diseases can affect any part of the heart. However, the most common is the insidious disease of the coronary arteries called atherosclerosis. When this occurs, plaque, or fatty deposits, develops in the artery walls. Over a period of time, plaque can build up, harden and narrow the arteries, and restrict blood flow to the heart. It is this underlying coronary artery disease (CAD) that sets the stage for most heart attacks.

Clogging in one or more arteries precipitates an attack when the heart’s demand for oxygen exceeds the supply. Even in arteries less severely narrowed, a deposit of plaque can crack and lead to the formation of a blood clot (thrombus). Diseased arteries are also more susceptible to spasm. A blood clot can form at the site of a spasm, releasing a chemical that further constricts the artery wall, triggering an attack.

When heart muscle is deprived of oxygen long enough, nearby tissue may be damaged. Unlike some tissue, heart muscle does not regenerate. The longer the attack, the more damage to the heart and the greater the likelihood of death. If the heart’s electrical system is damaged, the heart’s normal rhythm can become chaotic and the heart can begin to quiver wildly (fibrillate). In such an arrhythmia, the heart’s ability to pump blood effectively to the brain fails. Within ten minutes the brain dies and death occurs.

Thus, early intervention by trained medical personnel is vital. It can rescue the heart from ongoing damage, prevent or treat the arrhythmia, and even save a person’s life.

So how can you protect, or salvage your heart from the attack? That will be considered in another post.

If visiting a dentist makes you especially anxious, your dentist will want to help you to cope with your fear. So tell him how you feel. Talk with him about a hand signal you can use to indicate that you feel pain or are afraid. Many patients have found that this gives them more confidence.

Perhaps you fear being scolded. You may worry that the dentist will belittle you for not taking better care of your teeth. However, since such comments are bad for business, your fear of being chided is probably unfounded. Most dentists have an interest in speaking kindly to their clients.

Many people avoid the dentist because they fear the expense. But if it is possible for you to have a checkup now, you may avoid problems and expensive treatment later. In many places there are different levels of dental services to suit every pocket. Even the most basically equipped dental office will probably have X-ray equipment and a high-speed drill. Dentists can perform most procedures with very little discomfort to the patient. The cost of local anesthetic is low enough for most people to afford, even those with limited resources.

Dentists are dedicated to relieving pain, not causing it. Dental treatment is no longer the traumatic experience that your grandparents probably remember. Since healthy teeth contribute to improved general health and can help you to enjoy life more fully, why not pay your dentist a visit? You may be pleasantly surprised.

But why should you visit a dentist? We will look into that when next we meet. Till then, why not take some time and carefully look at your teeth.