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Senior Health News
 DEAR DR. ROACH: My husband has been diagnosed with cardiac amyloidosis. The doctor has started him on Vyndamax, a very expensive drug. Without this drug, he is lucky to live, at the most, two years. Is this drug a miracle, and does it guarantee that he will live many more years? — T.W.
ANSWER: There are several types of cardiac amyloidosis — a disease in which abnormal proteins are depos-ited in many tissues, including the heart, where the protein interferes with heart function and leads to heart failure. Tafadamis (also known by its brand name, Vyndamax) is used in transthyretin amyloid cardiomyopa-thy (ATTR, of which there are two types that both get treated with tafadamis). Subjects in the trial on tafadamis were followed for two-and-a-half years. Half of the group were given tafadamis, while the other half were given a placebo, which looked like the real drug but had no activity. Of those who got the inactive placebo, 43% died in the two-and-a-half-year time span of the study, but of those who received tafadamis, 30% died. Thirteen percent, or about one in eight people, who received tafadamis lived, when they were expected to die. In addition, there were fewer hospitalizations and less loss of ability to exercise in those taking tafadamis, com-pared with the placebo. There were no serious side effects that were more frequent in the tafadamis group. Tafadamis definitely affords a big improvement in the outcome of people with ATTR-CA. However, I would not call the drug a “miracle,” nor is there a guarantee of living many more years. To me, a miracle is when someone recovers when no doctor expected them to. I have seen a few in my career, and they are very powerful. I have seen many treatments that have incremental improvements in outcomes, and over time, that has led to dramatic improve-ments in many diseases. Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@ med.cornell.edu. © 2023 North America Synd., Inc. All Rights Reserved www.seniorvoiceamerica.org/senior-health-news/diagnosed-with-cardiac-amyloidosis-to-your-good-health-dr-keith-roach https://www.seniorvoiceamerica.org 813-693-5511
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5 Lifestyle Changes to Help Combat Incontinence
(Family Features) Sometimes living a healthy lifestyle can feel like an impossible task when combined with all your other responsibilities like working a full-time job, taking care of family and friends or spending time in the gym. Add dealing with an underlying health condition and it may seem almost overwhelming. For example, a condition such as urinary incontinence is a common problem that is often difficult to manage and can range from a light leak while coughing or sneezing to even greater loss of bladder control.
Consider these healthy lifestyle changes to help combat issues like urinary incontinence: Focus on Fluid Intake Make Dietary Modifications
Manage Bladder Leaks Maintain a Healthy Weight and Stay Active Stop Smoking Find more savvy tips to slow urinary incontinence at FitRightFreshStart.com. Understanding Urinary Incontinence
Common Kinds of Urinary IncontinenceStrong urges: That overwhelming need to use the restroom right away is known as urge incontinence, which frequently involves some level of unwelcome, involuntary leakage. Common Causes of Urinary IncontinenceMotherhood: Carrying a bundle of joy inside your body for nine months then giving birth is bound to put pressure on your pelvic floor muscles, which don’t always bounce back, especially after multiple births. Photos courtesy of Getty Images
FitRight Fresh Start Foot and Ankle Safety Tips for the Summer Months Foot and Ankle Safety Tips for the Summer Months
(StatePoint) From the beach to the backyard, taking care of your feet and ankles in summer is essential. “Nothing ruins summer fun faster than a problem with your feet. However, a few smart precautions can help keep you healthy and safe,” says Gretchen Lawrence, DPM, AACFAS, a board-certified foot and ankle surgeon and an associate member of the American College of Foot and Ankle Surgeons (ACFAS). To help you understand some of the most common summer risks to feet and how to avoid them, ACFAS is sharing these insights: • Puncture wounds: Millions of Americans go barefoot every summer, and thousands will sustain cuts and puncture wounds. To prevent injury and infection, wear shoes whenever possible and get vaccinated against tetanus. If you do get a puncture wound, see a foot and ankle surgeon within 24 hours and don’t swim until it’s healed. Bacteria in oceans and lakes can cause infection. • Pool problems: Always wear flip flops or other footwear in locker rooms and on pool decks to prevent contact with bacteria and viruses that can cause athlete’s foot, plantar warts and other problems. • Sun damage and skin cancer: Don’t overlook your feet during your sun protection routine. Feet get sunburned too, and melanoma on the foot or ankle is more likely to be misdiagnosed than on any other part of the body. A study published in “The Journal of Foot & Ankle Surgery” reported the overall survival rate for melanoma of the foot or ankle is just 52%, in sharp contrast to the 85% survival rate for melanomas on other areas of the body. Apply sunscreen to the tops and bottoms of feet and limit sun exposure. Dr. Lawrence notes, “If you spot abnormal moles or pigmented skin, including under toenails, visit a foot and ankle surgeon. Early detection and treatment could save your life.” • Pains and sprains: Summer sports can lead to arch pain, heel pain, ankle sprains and other injuries. Proper footwear with heel cushioning and arch support is essential, particularly on uneven surfaces, such as sandy beaches or hiking trails. If injury occurs, use the RICE approach: rest, ice, compression and elevation to ease pain and swelling. Any injury that doesn’t resolve within a few days should be examined by a foot and ankle surgeon. • Mower risks: Some 25,000 Americans sustain injuries from power mowers annually, according to the U.S. Consumer Products Safety Commission. Many of these injuries are preventable. Always cut the grass in protective shoes or work boots and keep children away during this chore. Never mow a wet lawn or pull the mower backward, and always mow across slopes, not up or down them. • Travel concerns: Sitting for long stretches can increase the risk of dangerous blood clots. “Whether road tripping or flying, regularly stretch your legs and pump your feet to circulate blood. Wearing compression socks for longer travel is also a good idea,” says Dr. Lawrence. • Diabetes complications: If you have diabetes, prolonged hot and humid weather can lead to numerous foot woes. Any type of skin break has the potential to get infected if it isn’t noticed right away, and exposure can cause dry, cracking skin. Inspect your feet daily and wear closed shoes whenever possible. Swelling is another hot-weather risk, potentially making shoes fit tighter which can cause blisters. Compression stockings may not sound appealing in hot temperatures, but they can reduce swelling and help prevent poor circulation. Finally, never go barefoot in summer. Impaired nerve sensation can make it hard to detect just how hot surfaces are. Just a few minutes walking barefoot on pavement to grab the newspaper can cause third-degree burns. For more information and to find a foot and ankle surgeon near you, visit FootHealthFacts.org, the patient education website for the American College of Foot and Ankle Surgeons.  DEAR DR. ROACH: Due to a slight genetic risk of breast cancer (my Tyrer-Cuzick Model score was 20.6%), my doctor wants me to get breast MRIs with contrast annual-ly. I am concerned about long-term exposure to the gadolinium-based contrast dye. I’ve learned that this heavy metal is considered safe, but traces of it can be stored in the brain and other body tissues. I am 49 and in very good health. I also get mammograms annually. I consulted my doctor about spac-ing out my MRIs every two to three years, but he said I should have an MRI every year. So I could be get-ting these MRIs for the next 35 or so years. Do the benefits of contrast dye outweigh the harm in a person with my health profile? — S.A. ANSWER: I’m afraid I don’t have a good answer for you. It is true that most authorities recommend an intensive breast cancer surveillance program for women at a high risk of breast cancer, in the range of a 20% to 25% lifetime risk. (The average risk for developing breast cancer for a woman born today is estimated to be about 13%.) The Tyrer-Cuzick model of esti-mating breast cancer risk tends to give higher estimates than the other commonly used models, such as the BRCAPRO. Other models may not put you over the threshold for inten-sive screening with MRIs, which is usually combined with mammograms. The question about gadolinium (the chemical element used in the contrast dye for MRIs) is important because some people do store gadolinium in various tissues, including the brain, but the clinical significance of this is unknown. (People with kidney disease can develop a skin disease due to gadolinium, so they aren’t recommended have MRIs with gadolinium.) Although gadolinium can stay in the body for months or years, there has been no evidence of harm from gad-olinium in brain tissue, despite these agents having been used for many years. Some agents have less retention than others. The U.S. FDA has man-dated patient guides for these contrast agents, which relay the information above. Given that there is a probable benefit to intensive screening for breast cancer in your case due to your high genetic risk, and no more than a theoretical risk from gadolinium, I believe that the benefits outweigh the risks, but I can’t say that with complete certainty.  DEAR DR. ROACH: A friend gave me a hemp product to try on the quite painful arthritis in my fingers, which affects my ability to enjoy golf. I was reluctant to try it, but for the last two weeks, I’ve used it top-ically on my fingers and have been pleasantly surprised by a significant reduction in pain and an improve-ment in flexibility. One of your recent columns mentions Voltaren, which I have also used, but without as much relief. Can you comment on CBD as an alternative treatment for arthritis? — P.H.A. ANSWER: There are animal studies suggesting benefit from oral cannabidiol , a component of cannabis (hemp) that has no psychoactive component (it’s the THC in cannabis that gets peo-ple “high”). I found some small studies showing pain relief from topical CBD in people with neuropathy , but not for arthritis. Several people, like you, have written to me with reports of pain relief. Topical CBD is probably very safe. Even oral CBD should be safe, but studies have found that many products labeled CBD have trace, or more than trace, amounts of THC, enough to make a urine test positive for cannabis. Until there is some evidence of effectiveness, I can’t recommend it, but people can try it based on safety and anecdotal reports. Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@ med.cornell.edu. © 2023 North America Synd., Inc. All Rights Reserved https://www.seniorvoiceamerica.org/senior-health-news/patient-with-risk-of-breast-cancer-questions-safety-of-yearly-mri https://www.seniorvoiceamerica.org 813-693-5511 Longtime Cannabis User |
If you’re experiencing bladder leaks, dealing with them and the frustrations they bring shouldn’t keep you from freely living your full, multifaceted life. Designed for women by women, FitRight Fresh Start offers this information to help you learn about leaks and understand what’s happening to give you the power to keep bladder leaks from disrupting or defining your life.
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