The Aging Male
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Every winter, about 1,200 Americans die from a heart attack or some
other cardiac event during or after a big snowstorm, and shoveling is
often the precipitating event.
Why is shoveling so hazardous?
- Shoveling uses your shoulders and arms, and upper body exercise
tends to put strain on the heart because those muscles aren’t
- Working in an upright position adds to the arduousness because blood
pools in the legs and feet, so to maintain blood pressure, your heart
must work harder.
- Much of snow shoveling is isometric exercise: your muscles are working,
but there's little actual movement until you finally heave a shovelful
up on the bank. During isometric exercise of any type, your heart rate
goes up, and your blood vessels constrict, presumably to send more
blood to the straining muscles. As a result, your blood pressure goes
- Without knowing it, shovelers sometimes perform a version of the Valsalva maneuver,
bearing down as they would during a bowel movement while holding their
breath. Waiting to exhale while straining like that can lead to abrupt
changes in your heartbeat and blood pressure.
- First thing in the morning, the time when many people dig out from
a storm, stress hormone levels tend to be higher, platelets in the
“stickier,” and heart attacks more likely.
- Shoveling involves exposure to the cold, another cardiac stressor.
- People who are out of shape often shovel, making the sudden intense
exercise even harder on the heart.
- Most people don’t warm up before they shovel or cool down afterward.
If you have a heart condition, you shouldn’t shovel under any
circumstances. People older than 50 should also try to avoid it. Contact
your local council on aging to see if they provide a list of teens in
your neighborhood who you can hire to do the job for you. Or buy a snow
blower. If you must shovel, take it easy. Rest often. Dress warmly and
stay well hydrated. Wherever possible, push the snow rather than lift
it. Clear only the snow that blocks your path into the house, the rest
will melt on its own. And of course, listen to your body. Head home if
you experience potential signs of heart trouble, including chest pain,
palpitations, undue shortness of breath, fatigue, lightheadedness, or
nausea. Also stop if your fingers or toes get numb or hurt — you
could have frostbite.
January 2003 Update
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No link found
between prostate cancer and vasectomy
Good news for the millions of men worldwide who've had vasectomies:
a new study disputes a link between this birth-control operation and
prostate cancer. Two 1990 studies that connected prostate cancer and
vasectomies caused men to question the procedure, even though no medical
explanation for the connection could be found. Other research has both
confirmed and denied the association in the past 10 years.
But the new study, published in the June 19, 2002, Journal of the
American Medical Association, should ease men's minds. It involved
over 2,000 men of European descent living in New Zealand, the country
with the highest rate of vasectomies.
Researchers asked 953 men with prostate cancer and 1,260 who were cancer
free about their medical histories — including whether they had
had a vasectomy. It turned out that slightly fewer men with prostate
cancer had undergone the surgery, which supports claims that going under
the knife doesn't cause cancer. The same held true for the 38% of men
studied who had had the procedure more than 25 years ago, which suggests
that there are no long-term effects.
One reason why the link may have been found in earlier studies is that
men who have vasectomies generally see their urologists more often, which
may lead to more tumors being found in these men as compared to others,
the researchers said. The study also found no link between prostate cancer
and history of sexually transmitted disease, smoking, drinking alcohol,
and number of children.
Prostate cancer will be diagnosed in 198,000 Americans this year, and
it will take 31,500 lives. Although prostate cancer lags behind heart
attacks, strokes, and lung cancer as the leading cause of death in American
men, it's the disease many men fear most.
August 2002 Update
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Comparing the Side Effects of Prostatectomy vs. Radiation
Prostate cancer is the most commonly diagnosed non-skin cancer among
men in the United States. When caught early, it is also among the most
treatable. Two of the more aggressive and common methods
of treatment for early stage prostate cancer are radiation therapy and
surgery (radical prostatectomy) to remove the prostate gland. Although
both options have favorable outcomes, physicians have not reached a consensus
on which therapy is more effective. This means that men who are treated
with either surgery or radiation can usually expect to live for many
more years. The caveat is that they often have to live with the side
effects of their treatment. Deciding on a treatment option, then, becomes
a question of which side effects are more likely with each therapy, and
also which side effects are more tolerable to a particular patient.
A recent analysis of data from the Prostate Cancer Outcomes Study helps
to clarify this issue by comparing the side effects of the two therapies
in men between the ages of 55 and 74, two years after treatment. The
results showed that men in both treatment groups experienced significant
decreases in sexual function. Of the men in the surgery group, 80% became
impotent, compared to 62% of the men in the radiation group. Age and
status of sexual function prior to treatment affected these outcomes.
Twelve percent of the men who underwent surgery experienced dripping
or leaking urine, compared to only 2% of the men who had radiation therapy.
Few men in either group were bothered by bowel problems. Of the men who
were affected, however, radiation patients experienced more diarrhea,
bowel urgency, and painful hemorrhoids (33%, 30%, and 19%, respectively)
compared to surgery patients (22%, 16%, and 10%).
Overall, this study showed that men who opt for surgery can expect to
have more urinary and sexual problems, while men who choose radiation
are more likely to suffer from bowel disturbances. A man's age and initial
health are also important factors in the development and duration of
long-term side effects from either treatment. Physicians and their patients
should use this information, as well as a discussion of the patient's
priorities, preferences, and concerns, to help decide which treatment
method is appropriate.
March 2001 Update
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