What are male health warning signs?

Playwright George Bernard Shaw said that youth is wasted on the young. If you don’t understand what this means, you’re not 40 yet. Alas, having reached this milestone (a few years ago), I know perfectly well what it means.

Beyond things like not belonging to the “right” demographic advertisers covet or having 30-year-olds call you “sir,” the nagging aches, pains and medical issues that sometimes come with age are probably the worst things some men have to look forward to.

What are the health warning signs that things may not be right that every man should heed? I sat down with Dr. Timothy Boone, chairman of the Houston Methodist Department of Urology, to talk about men’s health – specifically an aging man’s health. Dr. Boone cautions that there are several warning signs that should send any man to visit their doctor right away.

“You should be aware of a strong family history of prostate cancer – mainly first-degree family members. So if you have a father, a brother or an uncle who’ve had prostate cancer you probably should get checked as early as 45 to 50 years old,” Dr. Boone said.

This doesn’t mean that men in their late 40s and early 50s without a history of prostate cancer shouldn’t have a conversation about a PSA test with their doctor – they should. PSA – or prostate-specific antigen – is a protein produced by cells in the prostate. An elevated level of PSA can sometimes point to cancer.

Perhaps a scarier warning sign something may be wrong is finding blood in your urine. Even if it’s not accompanied with pain, it’s still something you should get checked out immediately.

There are several warning signs that should send any man to visit their doctor right away Click To Tweet

“It could be something as simple as a small stone that isn’t really causing you any trouble. But it could also be something much more serious like bladder cancer – especially if you’re a smoker,” Dr. Boone said.

You should also pay attention to how often you’re urinating. “Frequent urination may be a sign of diabetes,” Dr. Boone said. “Diabetes can affect your bladder function if it gets out of control.”

If you’re feeling dehydrated and notice you’re going to the bathroom more than normal, you may want to call your doctor.

And while it’s probably no man’s favorite subject of discussion, if your erections are dropping off in terms of rigidity it’s probably time to make an appointment with your doctor.

“It’s an early warning sign of significant cardio vascular disease. In fact it may be the first sign because the blood vessels in the penis are so small they’re real sensitive to narrowing long before your cardiac vessels are,” Dr. Boone said. “Loss of erective function in men in their 40s and 50s warrants careful attention.”

Dr. Boone said that the best way to prevent some of these issues to maintain a healthy weight and lifestyle. “Weight loss, good diet and exercise all have preventative features relevant to urology.”

As to how do you get the younger generations to stop asking you about the Cold War, the first moon landing or disco … I can’t help you.

What travelers need to know about deep vein thrombosis

Back in the summer of 2008, I was talking to one of our doctors about my family’s impending trip to Australia to visit my brother-in-law and sister-in-law. He was telling me that I should buy some compression stockings. Now, when I was a kid, I used to see my mom wear these all the time after she had varicose vein surgery. They were ugly and I thought they were just for people with really bad veins. He informed me that was not the case and without them I might be at risk for deep vein thrombosis (DVT), a condition that most people don’t think about when they are packing for an exciting long distance vacation.

DVT occurs when blood clots form in the deep vein of the lower legs and thighs. Sitting for long periods of time, either on an airplane or a car, can limit circulation in the legs, leading to a blood clot forming in the vein. The clot can travel unnoticed through the blood stream and lodge in the brain, lungs, heart and other areas causing severe damage to organs and, in some cases, death. The good news is the problem can be easily avoided.

Deep vein thrombosis affects 2 million Americans each year Click To Tweet

Dr. Alan Lumsden, chief of cardiovascular surgery at Houston Methodist DeBakey Heart & Vascular Center, says if you plan to go overseas or on a long drive, make sure you get up and walk around at least every two hours, and try not to sleep more than four hours at a time. He adds you should drink plenty of water or juices, wear loose-fitting clothing, eat light meals and limit alcohol consumption. The aforementioned compression stockings are also a good idea, especially for people with venous problems or the elderly. These help prevent clots from forming in the deep veins.

If you do not have the opportunity to get up every couple of hours, the following exercise can be done while sitting down:

  • Extend both legs and move both feet back and forth in a circular motion.
  • Move the knee up to the chest and hold the stretch for at least 15 seconds.
  • Put both feet on the floor and point them upward. Also, put both feet flat and lift both heels as high as possible.
Deep vein thrombosis infographic
This infographic describes the symptoms of DVT, as well as tips on how to avoid it.

Some two millions Americans are stricken with DVT every year and nearly 200,000 die. DVT is most often found in people over 60, but can occur in any age group. The most famous death due to DVT involved late NBC reporter David Bloom, who got DVT in 2003 while embedded with the U.S. Troops in the Iraq War. He was 39.

Lumsden says symptoms can include pain and tenderness, swelling, redness, and increased warmth in one leg. In some cases, a physician might suggest that a patient go on blood thinners or simply take an aspirin before and during a long trip to avoid DVT. He adds that if you are pregnant, have a history of heart disease, cancer or blood clots, you should always consult with a physician before taking part in long travel.

DVT is a very serious condition that can ruin your vacation in an instant. Yes, I bought the compression stockings and wore them for the more than 24 hour trek to Australia. Did I feel a bit foolish? Yes I did, but at the end of the day I would rather feel foolish than be dead.

World Heart Day: the global issue of heart disease

e told my dad for years that he should stop smoking. First it was a pack a day, and then as he got older and the stresses of raising a family got to him, it was two packs and sometimes more. 

Photo courtesy of world-heart-federation.org.
Photo courtesy of world-heart-federation.org.

By age 66, he was having trouble breathing and had to be rushed to the hospital, where he was told he had congestive heart failure and would have to undergo a quadruple bypass operation. He made it through the operation, but never made it out of the hospital. He was gone; another victim of heart disease. 

According to the World Health Organization, more than 17 million people died from cardiovascular diseases in 2008, representing 30 percent of all deaths worldwide. Of these deaths, an estimated 7.3 million were due to coronary artery disease and 6.2 million were due to stroke. More than 80 percent of these deaths take place in low and middle-income countries. The WHO believes the number of cardiovascular disease deaths, mainly from heart disease and stroke, will increase to more than 23 million by the year 2030. The numbers are truly staggering. 

Cardiovascular disease accounts for 30% of all deaths worldwide Click To Tweet

The world has decided something needs to be done. The World Heart Federation, set up in 1970, and composed of heart foundations around the world, with the purpose of supporting international research, professional and public education, as well as community programs, is sponsoring World Heart Day on Sept. 29 as a way to alert the world about this growing health concern.

For the first time, the WHF has joined forces with the United Nations to try and reduce the number of deaths caused by cardiovascular disease. Dr. William Zoghbi, a cardiologist with the Houston Methodist DeBakey Heart & Vascular Center and a WHF Board Member, says for the first time in its history, the United Nations has taken an active role by putting non-communicable disease like cardiovascular disease on its agenda. He believes this will go a long way toward getting countries involved to do something about the world’s number one killer.

“The goal is to reduce this number by one-third by 2030 through prevention and treatment,” said Zoghbi, who currently chairs the WHF Global Task Force for cardiovascular disease. “We want to ensure that every country’s health plan includes an essential package for the prevention and treatment of cardiovascular disease.”

Zoghbi suggests countries must work on agriculture, transport, environmental and fiscal policies as well as international trade agreements that will have a strong impact on a person’s diet, physical inactivity and tobacco use.

“We need to help impress upon people lifestyle changes that will help reduce risk factors like high blood pressure, high cholesterol and smoking” Zoghbi said. “More importantly, we need to hammer home the importance of screening for heart disease. Many people go to the doctor when it’s too late. Our goal is to make sure people have the tools to prevent heart disease and I believe we can make that happen.”


Heroes of Houston heart history featured in book

At some point during his long career at Houston Methodist Hospital, Dr. William Winters realized he was working side by side with living heart history. He thought someone should compile a book to tell the stories he experienced, but never thought he’d be the one to eventually do it.

Houston Hearts: A History of Cardiovascular Surgery and Medicine at the Methodist DeBakey Heart & Vascular Center at Houston Methodist Hospital” is the title of Winters’ recently published history book, co-written with Houston writer Betsy Parish.

“Everywhere you looked at (Houston) Methodist Hospital, heart history was being made,” says Winters, who has worked as a cardiologist at the hospital since 1968. “So many breakthroughs, so many discoveries changed medicine around that time … and much of it took place right here in this institution.”

Dr. Winters with his recently-released book, "Houston Hearts."
Dr. Winters with his recently-released book, “Houston Hearts.”

“Houston Hearts”covers the 95-year history of Houston Methodist Hospital, and tells the stories of surgeons and cardiologists who worked here. The chronology kicks into overdrive during the swinging late 1960s, as Dr. Michael DeBakey and his team earned the world’s attention with an unprecedented string of surgical and medical breakthroughs.

“In 1968 we performed nearly one-third of the heart transplants in the country, and nearly one-fifth of the open heart procedures,” Winters says. “DeBakey and his team of surgeons would sometimes perform up to 12 successful surgeries a day. It was a great time to be a new cardiologist in this city.”

Winters and his medical partner Dr. Donald Chapman often marveled at the history that unfolded all around them. Chapman, also a cardiologist, is credited with bringing heart catheterization to Houston, while Winters began the use of echocardiography in Houston. Eventually Chapman would write three books about his own career, and those contained much of the history he experienced after coming to Houston in 1944.

In 1968 Houston Methodist Hospital performed nearly one-third of U.S. heart transplants Click To Tweet

Winters had an idea to create his own unique record by interviewing key physicians on video. He was able to talk with a number of important players in Houston Methodist’s history, including Chapman (who died in 2007) and DeBakey (who died in 2008) as well as other physicians and hospital administrators.

“A few years ago I realized there aren’t many of us left,” Winters recalls. “So I contacted Betsy Parish and we went to work writing this book. It has a lot of history, but it tells my story as well. As I’ve heard it said, the last man standing gets to tell the tale.”

“Houston Hearts” is available now on Amazon.com, and at select bookstores in the Houston area including the River Oaks Bookstore at 3270 Westheimer Ave., and the Houston Methodist Hospital gift shop.

Is your blood pressure too high, too low or just right?

Determining what a healthy blood pressure is can be confusing.  How do you know when it is too high? Or too low? What’s considered a normal reading? What can you do to prevent or reduce high blood pressure?

Let’s start with the basics

“Blood pressure is the force of blood pushing against the walls of your arteries as your heart beats,” says Earl Mangin, M.D., cardiologist with Houston Methodist Sugar Land Hospital. According to the Centers for Disease Control and Prevention, one in every three American adults suffers from high blood pressure, also known as hypertension. That’s a total of 67 million Americans.

“Your blood pressure reading is made up of two numbers measured in millimeters of mercury (mm Hg),” said Mangin. “Systolic pressure, the top number in your blood pressure reading, is the measurement of pressure when the heart is pulsating, pumping blood throughout the body. Diastolic pressure, the bottom number, is the pressure when the heart is at rest.”

What are your numbers?

Knowing your blood pressure numbers is just as important to your life as memorizing your social security number and address. Keep an eye on it and monitor for changes. Blood pressure is considered normal if it’s above 90/60 and less than 120/80 mm Hg.

When vessels narrow, blood pressure can increase, leading to multiple health issues. Image source: Bruce Blaus (Wikipedia)
When vessels narrow, blood pressure can increase, leading to multiple health issues. Image source: Bruce Blaus (Wikipedia)

If left unchecked, high blood pressure, the silent killer, has the potential to damage your body for years without any noticeable symptoms. Kidney damage, vision loss, stroke and damage to the heart and coronary arteries are a few possible health consequences.

Also known as hypertension, high blood pressure weakens and narrows arteries hindering the blood’s ability to smoothly travel throughout the body and adequately supply blood to your organs, putting you at much greater risk of having a stroke.

Normally, blood pressure doesn’t dip below 90/60 mm Hg. Hypotension, or low blood pressure, occurs when the supply of blood to your brain and other parts of the body is lower than normal.

1 in 3 American adults suffer from high blood pressure Click To Tweet

Low blood pressure can occur with pregnancy, while taking certain medications such as anti-anxiety or antidepressants, nutritional deficiencies or standing after a long period of sitting. It is usually not a cause for concern unless there is a significant and sudden drop in pressure of 20 mm Hg or more.

Rapid decreases in blood pressure cause dizziness, lightheadedness and fainting and can sometimes be an indicator of a more serious underlying problem.

How can you prevent or reduce high blood pressure?

  • Exercise regularly. Blood pressure often increases as weight increases. Regular physical activity of at least 30 minutes can lower blood pressure by 4 to 9 millimeters of mercury (mm HG). Losing weight can also make any blood pressure medications you’re taking more effective.
  • Watch what you eat. Keeping a food journal, if only for a week, can shed light on your true eating habits. Diets rich in whole grains, fruits, vegetables, and low-fat dairy products can lower your blood pressure by up to 14 mm Hg. Eliminating excess sodium, reducing alcohol intake, and cutting back on caffeine can also help lower your blood pressure.
  • Take a deep breath. Stress and anxiety increase blood pressure. Take a few minutes every day to sit quietly and breathe deeply, it releases tension and lowers your blood pressure.
  • Monitor your blood pressure. Keeping track of your blood pressure can call attention to any abnormalities or serious changes.

New heart procedure safer for women

Women with a family history of heart disease or other heart disease risk factors should schedule a doctor’s appointment for their annual heart checkup.

Surgeon Inserting Tube Into Patient During Surgery
Radial artery catheterization involves placing a small tube near the thumb side of the wrist. Using X-ray, the physician guides the catheter up to the shoulder and then down to the heart through the radial artery.

At the checkup, some physicians might recommend further testing to rule out or confirm a diagnosis. In the cases where a heart procedure such as a cardiac catheterization is required, women should ask their physicians about using a radial artery approach.

Standard heart catheterization involves inserting a catheter into the femoral artery in the groin and threading it to the heart to perform a variety of tasks, such as measuring the heart, diagnosing conditions, clearing a blockage or placing a stent. A new technique, called a transradial catheterization, inserts the catheter into the radial artery at the wrist.

“The radial artery approach is much safer for women,” said Colin Barker, M.D., cardiologist at the Houston Methodist DeBakey Heart & Vascular Center. “A recent clinical trial of more than 1,700 catheterizations in women showed the rates of bleeding or vascular complications were 59 percent lower when using the radial artery approach.”

The catheterization begins when a small tube is placed in the radial artery, which is located on the thumb side of the wrist. Using X-ray, the physician guides the catheter up to the shoulder and then down to the heart through the radial artery.

Barker says the radial artery catheterization is safer because the radial artery is located closer to the skin’s surface, which allows bleeding complications to be spotted sooner. It is also more comfortable for patients. The femoral approach requires patients to lay flat for four to six hours after the procedure, while radial artery catheterization patients are sitting up and getting out of bed within minutes.

Barker noted the radial artery catheterization is used in approximately five percent of cases in Houston and less than 20 percent of cases in the United States.

Transradial catheterization has a 59% lower risk of complications compared to standard heart catheterization Click To Tweet

Barker said the radial artery catheterization is used in 60 to 80 percent of cases outside the U.S. and has become standard medical practice in Europe. He added that it is not being used as often in the United States because it’s a difficult technique that is tedious to learn. More than 80 percent of patients surveyed prefer the radial artery approach, so Barker believes patient preference will help drive up the use of the procedure.

“I’ve seen the benefits it provides my patients, especially women,” Barker said. “I hope the technique becomes more widely available as doctors and hospitals continue to gain experience and proficiency in the procedure.”