For years, Dr. Anthony Komaroff has answered his patients’ questions one-on-one. With the launch of Ask Doctor K, a daily newspaper column that appears in 450 newspapers, he will be answering questions from people across the U.S and beyond via daily newspaper and the Internet (at AskDoctorK.com). Dr. Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of Harvard Health Publications. In the column, he will offer clear answers and straight advice to readers’ questions, talk about new treatments that are available today or will be soon, and focus on proven changes in lifestyle that can keep readers healthy, help them cope with chronic diseases, and improve their quality of life.
Archive for September, 2011
About 10% of women who have heart attacks seem to have clear, unblocked arteries. They don’t, really. Instead, they have a problem inside tiny arteries supplying the heart muscle, called microvessels. Traditional diagnostic tests can’t “see” into microvessels. In larger coronary arteries, the buildup of cholesterol-filled plaque creates distinct bulges that narrow the vessel at a particular spot, reducing blood flow. In microvessels, plaque uniformly coats the inner layer. This reduces the space for blood flow and makes the arteries stiff and less able to expand in response to exercise or other stress. Researchers are still trying to determine the best ways to diagnose and treat microvessel disease. Talking to cardiologists at Harvard-affiliated Brigham and Women’s Hospital, Dr. C. Noel Bairey Merz said that the erectile dysfunction drug Viagra (sildenafil), which was originally developed to improve blood flow to the heart, is being tested as one possible therapy.
Sometimes chronic tinnitus can be fixed by taking care of the underlying cause, like grinding your teeth at night or taking aspirin. Otherwise, one of the simplest approaches is masking the noise by listening to music or having a radio, fan, or white-noise machine going in the background. Some companies make devices worn like hearing aids that generate low-level white noise. Hearing experts often recommend masking before turning to more expensive options such as cognitive behavioral therapy, tinnitus retraining therapy, biofeedback and stress management, and transcutaneous electrical stimulation of parts of the inner ear.
Smokers who want to quit can turn to a nicotine replacement products, prescription medications, and counseling. What about the newest stop-smoking aid, the electronic cigarette? Despite its appeal, we don’t know enough about the safety or effectiveness of electronic cigarettes to give them the green light. Preliminary studies from the FDA, New Zealand, and Greece raise some concerns about the dose of nicotine delivered and potentially harmful chemicals that might be in the vapor. Until good studies have been done on electronic cigarettes, the best way to quit involves using nicotine replacement or a medication along with some sort of counseling or support, either in person, by telephone, or even by text message.
Gluten, an umbrella term for proteins found in wheat, rye, and barley, makes dough resilient and stretchy. Some people can’t eat foods made with these grains because gluten triggers an immune reaction and causes inflammation of the lining of the small intestine. This can eventually interfere with the absorption of nutrients from food. This condition, called celiac disease, can cause symptoms like gas, bloating, and abdominal cramps. A growing number of people who don’t have celiac disease suffer many of its symptoms. They are classified as “gluten sensitive” or “gluten intolerant.” A new Special Health Report from Harvard Health Publications called “Food Allergy, Intolerance, and Sensitivity” covers how to cope with gluten sensitivity, lactose intolerance, and other food allergies and sensitivities.
The death of Kara Kennedy, the only daughter of the late Senator Edward M. Kennedy, at age 51 from an apparent heart attack while exercising offers a reminder of the possible long-term effects of cancer and its treatment. In 2002, Kennedy was diagnosed with lung cancer. After having part of her lung removed, she underwent chemotherapy and radiation therapy. She lived for another nine years, in apparently good health. One of the hazards of some cancer survivors face is that the treatments used to fight cancer—drugs, radiation, and hormones—sometimes damage the heart and arteries.
Many people have trouble telling whether they are having heartburn or a heart attack. “Many people” includes doctors. A personal story from a Harvard physician describes how he treated himself with strong acid-suppressing pills until a near heart attack made him realize he had heart disease. His story appears in an updated Special Health Report from Harvard Medical School called “Heart Disease: A guide to preventing and treating coronary artery disease.”
Back in June, federal authorities unveiled MyPlate, an icon designed to help Americans follow healthy eating patterns. It’s a nice, colorful image that was a welcome successor to the misguided MyPyramid. But it doesn’t offer much in the way of useful information. A group of my colleagues at Harvard Health Publications worked with nutrition experts [...]
Perfectionism has a dark side—it is often seen as obsessive and sometimes pathological. But it has a bright side, too. Desirable aspects of this personality trait include conscientiousness, endurance, satisfaction with life, and the ability to cope with adversity. This helps explain why some perfectionists become corporate leaders, skilled surgeons, or Olympic champions. In his new book, The Perfectionist’s Handbook, Dr. Jeff Szymanski describes how to become a better perfectionist—by building on the strengths of this quality and learning to minimize its drawbacks. A key step in becoming a better perfectionist is to learn how to turn mistakes into strategic experiments, says Szymanski, a clinical instructor of psychology at Harvard Medical School and executive director of the International OCD Foundation.
It isn’t easy to get rid of a harmful habit like drinking too much, or to make healthy changes like losing weight and exercising more. Media stories often sugar-coat changes like these, making them seem easier than they really are. In a moving essay in the American Journal of Health Promotion, Michael P. O’Donnell (the journal’s editor) describes his dad’s efforts to become healthier for his sake and the sake of his family. There was no monumental struggle, no epiphany—just a regular guy doing his best each day to become healthier for his sake and for his family. It’s a truly inspiring story.