Medical Tests & Procedures Archive

Many procedures require anesthesia, and which of the four types you have can affect your recovery.

If you've ever had a tooth filled without Novocaine, you know the difference anesthesia can make. Anesthesia—whether it numbs your mouth or puts you into a full sleep—is designed to keep you comfortable during a procedure that otherwise might be hard to tolerate physically, emotionally, or both. "We have four goals: to see that you have no pain, that you're drowsy or unconscious, that your body is still so that the surgeon can work on it, and that you aren't left with bad memories of the procedure," says Dr. Kristin Schreiber, an anesthesiologist at Harvard-affiliated Brigham and Women's Hospital.

There are four basic kinds of anesthesia—local, which is typically administered to numb a small area; regional, which numbs a larger area, like your hand, arm, or foot; neuraxial (spinal or epidural), which is injected near the spine and numbs the lower half of your body; and general, which works in the brain to render you completely unconscious and unable to sense pain. The type used depends upon the procedure you're having, your state of health, and, often, your preferences.

Known as hybrid coronary revascularization, this technique may become more widely available in the future.

Q. Why is my doctor checking me for tuberculosis? I thought that was eradicated long ago

A. It would be wonderful if tuberculosis (TB) had been eradicated long ago, but unfortunately that's not the case. It is true that the annual number of new cases in the United States has been dropping over the past 20 years; in 2013, there were about 9,500 new cases. However, around the world, particularly in developing nations, TB remains a huge problem. In 2013, there were nine million new cases of TB, and 1.5 million deaths from TB, in the world.

By Anne Fabiny, M.D., Editor in Chief

President Barack Obama recently announced the Precision Medicine Initiative, a new program to speed up discoveries based on information and technology stemming from the Human Genome Project. "Precision medicine" and "personalized medicine" are terms that describe health care tailored to an individual patient's genetic makeup, using information about a patient's genome to diagnose illness and design therapies to treat and cure disease. This approach has been described as "the medicine of the future."

However, it may be reassuring to know that although your doctor doesn't have your genome at hand, he or she is likely to be giving you personalized care as we understand it today.

Q. The other night I woke up at about 2 a.m., and my heart was pumping hard and my lower jaw ached. It lasted about an hour, even though I took aspirin. Then I fell asleep. In the morning everything was fine. Was that a heart attack?

A. If you were my patient and you called my office and told me this, I would tell you to come right in and let me check you out. Probably it was not a heart attack, but the chance that it might have been is high enough that you need to be examined and tested. I hope that's what you did. If you didn't then, you should check with your doctor now.

Hidden causes of shortness of breath can make the problem tricky to treat.

When your heart muscle doesn't get enough blood, chest pain is possible. But you might not feel anything at all.

Small, wireless skin patches may offer a convenient way to diagnose—or rule out—arrhythmias.

An abnormal heart rhythm—when your heartbeat is too slow, too fast, or irregular—may be a fleeting, harmless event. But it might be a sign of a more serious heart condition. If you have frequent palpitations (which feel like your heart is pounding, racing, or fluttering) or unexplained fainting spells, your doctor may recommend a Holter monitor. This portable electrocardiogram (ECG) machine records your heart rhythm over a day or two.

Q. I have a pacemaker and was told to never have an MRI scan. Is there any way around that?

A. In the past, people with pacemakers were told never to have magnetic resonance imaging (MRI), but in certain cases it may be safe.

Experts still advise getting regular blood lipid tests.

In late 2013, when the new national guidelines on managing cholesterol were released, many people wondered how the change would affect blood cholesterol testing. Also known as a lipid profile or lipid panel, the cholesterol test measures several different types of fats (lipids) in your bloodstream.