Simple Strategies for Avoiding Heart Surgery
Heart surgeries are some of the most common inpatient surgeries — that is, surgeries requiring a hospital stay afterward. In 2010 alone, 395,000 people had a coronary artery bypass graft. Half a million people had a balloon angioplasty of a coronary artery. And 454,000 had a stent inserted in a coronary artery. However, just because these procedures have become routine doesn’t mean they don’t carry serious risks. The surest way to reduce these risks is to avoid needing surgery in the first place.
What these surgeries are, in plain English
Medicine has its own language. I like to call it “medicalese.” Medicalese is a very handy thing for doctors — it lets them put a lot of information into a few words. This is great when you’re making notes on patient’s charts or talking to other doctors, but for the average person it can be confusing. Confusion isn’t good. You should be fully informed and crystal-clear about your condition and each procedure. It’s your body, and your heart, and you deserve to understand just what’s going on. With that in mind, here’s a quick overview of the most common heart surgeries:
• Balloon angioplasty is commonly done when a coronary artery — an artery supplying your heart with oxygen-rich blood — becomes partially blocked. A thin, hollow tube called a catheter is inserted into an artery in your leg or arm. It’s then threaded through the artery all the way to the area near your heart where the blockage is. The catheter has a small balloon on the end of it, and once it’s in the correct place, the balloon is inflated and deflated. This flattens the blockage against the wall of the artery and lets blood flow freely again.
• Stent placement is usually done along with balloon angioplasty. The procedure is basically the same, with one difference. A tube of expandable metal mesh is slipped over the balloon before the catheter is inserted. This is the stent. Its job is to keep the artery open once the blockage is pushed out of the way. When it reaches the blockage and the balloon is inflated, the tube expands. The balloon is then withdrawn but the stent stays in place and holds the artery open.
• Coronary artery bypass graft surgery — or a “heart bypass” in non-medicalese — uses a blood vessel taken from another part of your body to reroute blood around the blockage. Your chest is opened up and your heart exposed. Your heart is usually stopped and your blood rerouted through a heart-lung machine, which works like an artificial heart to keep it circulating and full of oxygen. A healthy blood vessel is taken from another part of your body — usually your leg — and attached on either side of the blockage. Blood flows through the new blood vessel and goes around the blockage, which stays in place.
Interestingly, your body may perform its own natural type of bypass. If blood flow is reduced for a very long time, your body may grow new blood vessels which go around the blockage. Smaller vessels may also enlarge and expand to carry more blood and make up for the reduced flow through the artery. This is called collateral blood supply.
Change your habits, protect your heart
The cholesterol myth has been pretty thoroughly debunked, as has the idea of the low-fat diet. That doesn’t mean that lifestyle changes can’t have a profound effect on your heart. In fact, a few simple changes can dramatically reduce the likelihood of heart disease and surgery on down the line. Here’s what you can do:
• Lose weight. There’s no question that excess weight contributes to heart disease. While there’s no perfect weight, there is a strong link between your waist size and your risk of both heart disease and diabetes. If you’re a woman and your waist is more than 35 inches, or if it’s more than 40 inches and you’re a man, you’re at high risk.
• Get some exercise. You don’t have to hit the gym — walking, swimming, and biking for 30 minutes a day is just as beneficial. Yoga and Pilates are also good choices that are low-impact and low-stress.
• Reduce your stress. Stress leads to a whole host of negative health consequences. I personally believe that stress is the #1 killer in the world, and science is beginning to agree. Stress affects your blood pressure, your blood sugar, and it causes inflammation. It also triggers other unhealthy behaviors that can hurt your heart, your brain, and your immune system.
• Get enough sleep. Lack of sleep leads to inflammation, which plays a huge role in heart disease. Studies have found that older people who get less than 7.5 hours of sleep per night have a much higher risk of heart attack and stroke. But beware — too much sleep is just as bad for you. Aim for 7-8 hours per night.
• Cut the carbs. A high-carb diet is increasingly linked to inflammation and heart disease. Cutting the carbs is not only good for your heart, it also lowers your risk of diabetes and even Alzheimer’s disease.
Although all of these procedures are common and even routine today, for many people the risks may outweigh the benefits. For example, a 2007 study found that stents were no more effective than drug treatment in people with stable coronary disease, and few studies if any have shown bypass surgery to extend the lives of anyone but those with the most severe disease.
If you’ve already had heart surgery recommended, I strongly suggest getting a second opinion. Thoroughly discuss the risks and benefits with your cardiologist, and make sure you get concrete answers to your questions.
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