Greetings, Dr. Roach I am an 84-year-old man in exceptionally good physical and general health. However, I started to have some mild chest pain after running almost three miles. My doctor wanted to implant stents in my coronary arteries following a stress test and calcium score test.
According to a 2020 National Institutes of Health study, there was no difference in the results of stents compared to medicine and lifestyle modifications. I therefore chose not to perform the stents. I no longer run big distances, but I can work out with weights and a stationary bike for ten minutes without experiencing any chest problems. I currently use baby aspirin, blood pressure medications, and statins.
Is it reasonable for me to forego having the stents inserted, and are you aware of this study? — T.E.
ANSWER: There is still considerable debate regarding the usefulness of stents in patients with stable coronary artery disease. There isn’t any evidence that stents extend life expectancy or prevent heart attacks, even if they may help symptoms more effectively than medication and lifestyle modifications alone.
Your cardiologist intended to lessen your symptoms, but stenting isn’t necessary if you don’t currently have any. If chest pain forced you to cut back on your running, stenting might help you increase your workout without experiencing these symptoms.
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Greetings, Dr. Roach Is 18 years the longest period of time someone has gone without food? A 70-year-old family member had his stomach removed due to stomach cancer. After speaking with a dietitian, he was able to take vitamins, enzymes, and other supplements, as well as consume small but regular meals. He did, however, gradually lose weight.
He now weighs 84 pounds at the age of 88. His muscles are also impacted. During COVID, he stopped playing racquetball on a regular basis, and he never resumed the sport following the pandemic. He is now unable to walk on his own. In order to enhance his regular diet, they are inserting a feeding tube into his small intestine.
Do you know what this kind of item is? Is this it, or is there more to be done? Will he die of starvation? — Y.F.
ANSWER: Although weight loss is usual following stomach removal, I have seen numerous patients with stomach cancer and have never seen this level of weight loss. Effective therapy is long overdue because this level of severe weight loss is extremely upsetting and typically leads to worse outcomes. A feeding tube appears to be a significant short-term therapeutic, even though it isn’t always the best option for weight loss. I presume that he has undergone a thorough evaluation, including CT scans, for a return of illnesses.
You indicate that he has been taking vitamins; even if he has been taking supplements, his vitamin D and B12 levels should be examined because they are sometimes quite low following a gastrectomy (removal of the stomach). Using an appetite stimulant could be worth a try if no other cause is identified.
To find out if the issue is actually that he isn’t getting enough calories, I would also formally measure his daily caloric intake. I would worry if he isn’t taking them all in.
He has no justification for dying of starvation. In the worst situation, intravenous feeding can be administered while they determine the cause of his significant weight loss.
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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