Physicians at Wuesthoff Health System shed light on treatments for four troublesome diseases

Dr. Dwayne Badgett, a vascular surgeon at Wuesthoff Medical Center—Rockledge, discusses with a patient prevention techniques and risk factors associated with Peripheral Arterial Disease (PAD).

When it comes to your health, an ounce of prevention can go a long way toward saving your life.

While people generally tend to have an optimistic view of their own well-being (hey, nothing hurts so everything must be good), the truth is there are a number of potential diseases that either don’t have any symptoms, or could be masked by something else.

Fortunately, the doctors and staff that make up the Wuesthoff Health System can help. Not only can they help treat your existing conditions, should you have any, but they can also offer tips on how to prevent something that could be catastrophic to you and your family if not detected.

Here is a look at four such conditions:

PERIPHERAL ARTERIAL DISEASE (PAD)
Do you have cramping in your legs when you walk? Do you experience pain in your feet when you lay down to go to sleep? Do you have leg or foot sores that aren’t healing? If that’s the case, you may have peripheral arterial disease, or PAD.

“The biggest problem out there is that it’s under-diagnosed,” says Dwayne Badgett, M.D., a vascular surgeon at Wuesthoff Medical Center – Rockledge. “There may be eight million people across the country who have PAD to some extent, and out of that eight million, probably only 2.2 million or so have been diagnosed with PAD.”

Not only can it lead to the loss of a limb if not treated properly, but there is also a strong association of PAD with other maladies such as heart disease, carotid artery disease, hypertension and a general reduction in life expectancy.

The No. 1 step in prevention, according to Dr. Badgett, is to avoid smoking cigarettes.

“Tobacco use is one of the strongest risk factors associated with peripheral vascular disease,” he says. “It’s also one of those things that is associated with poor outcomes after vascular surgery.”

Controlling your cholesterol and blood-pressure maintenance are two other ways to help prevent the onset of PAD. Exercise can mitigate the severity, along with a good diet and weight control.

Though the disease can target younger people who have a family history, the age bracket considered to be the highest risk (particularly for men) are those who are 65 and older. That may help explain why it is under diagnosed, because people in that age category could have other problems, such as arthritis or nerve problems, which can cloud the picture.

“A person, 45, having leg pain, that’s more unusual,” says Dr. Badgett. “Whereas (somebody) 65, everyone has an ache every once in a while.”

With more awareness, the number of undiagnosed patients will drop, and if the onset of the disease can be nipped in the bud, the better the long-term prognosis.

HEART ATTACK/CORONARY ARTERY DISEASE

Heart disease is not only the No. 1 killer of both men and women in this country. Among the risk factors are cigarette smoking, high cholesterol, high blood pressure, diabetes, abdominal obesity and psycho-social factors.

“Of the risk factors for coronary disease, nearly 80-90 percent are modifiable,” explains Sendhil Krishnan, M.D., a cardiologist at Wuesthoff Medical Center – Melbourne. “While genetics certainly plays a role in heart disease, it accounts for far less than the risk factors that we can truly do something about.”

Experiencing chest pain, particularly during exercise, can be a warning sign for underlying heart disease and coronary blockages. Does it get worse with exertion and better with rest? Is that feeling associated with shortness of breath and diaphoresis?

Don’t ignore the signs.

“Some people compensate by doing less,” says Dr. Krishnan. “Over time, they may feel more fatigued. That’s very key, to think about how you are doing now compared to perhaps one year ago, and see what’s changed. If you were functionally active a year ago, but notice that you’ve been slowly declining,well, what’s the reason?”

If that is the case, it might be time for a stress test. While the degree of chest pain can be rather subjective, a stress test is more objective and can quantify what is actually going on inside and determine if there is a significant blockage in your heart.

Not only are eating right and staying active big keys to staying healthy, but so is conditioning yourself to stay vigilant.

“You have to train yourself mentally to change your mindset. When you eat a donut or become a couch potato, you should feel guilty. When you eat something healthy or workout at the gym, reward yourself by doing even more heart-healthy activities and splurging on heart-healthy foods. That is the power of positive reinforcement,” says Dr. Krishnan. “If you train yourself to feel bad about doing things that are not good for you or your body, then you can do something about it.”

 

 

 

HIGH CHOLESTEROL
The problem with high cholesterol is that the warning signs are virtually non-existent, but the risks associated with it can contribute to some serious medical issues.

Rosanto Macam, M.D., an internal medicine specialist at Wuesthoff Medical Center – Melbourne, recommends all males ages 35 and older and females ages 45 and older have a periodic cholesterol measurement. For patients who have diabetes mellitus, cigarette smokers, are obese or have a history of coronary heart disease in their family, that test should start anywhere from ages 20-30.

A total cholesterol count of more than 200mg/dl is considered high. The goal to reduce bad cholesterol (LDL) can depend on a patient’s age, health and fitness level. An LDL of 130mg/dl might be acceptable for a person without risk factors such as diabetes, hypertension or a history of heart disease. Otherwise, LDL above 160mg/dl is considered high.

Dr. Rosanto Macam, an internal medicine specialist at Wuesthoff Medicine Center–Melbourne, discusses the seriousness of high cholesterol, and the life-threatening outcomes associated with not treating it properly.

“Having high cholesterol doesn’t give you symptoms, doesn’t make you sick,” says Dr. Macam. “But it can lead to the development of coronary heart disease, the leading killer in the U.S. That’s the debilitating and life-threatening part.”

Coronary heart disease, heart attacks and even strokes can become greater risks if high cholesterol is not treated properly.

The good news is that the number adults in the U.S. dealing with high bad cholesterol has been trending down significantly compared to the past two decades. “It’s gotten better because people are more aware now, and health care providers have been aggressive,” explains Dr. Macam.

Diet and exercise, again, are the keys. The type of fat consumed appears to be more important than the amount of total fat. Avoid processed foods high in saturated fat. Cut down on red meat, butter, regular margarine, cheese and deep-fried foods.

Watch out for transfat, which is also known as partially hydrogenated fat. Eat fewer baked goods that are store-made.

Among the alternatives are cooking food in canola oil, olive oil, or corn oil (these are rich in poly and monounsaturated fat), eating vegetables, legumes, taking fish oil, adding fiber, drinking soy milk and eating nuts like pistachios, almonds or walnuts.

All patients with high bad cholesterol should try to make some changes in their day-to-day habits. As the cholesterol levels fall, so does the risk of developing coronary heart disease and the risk of suffering heart attack. Lowering your cholesterol can be life-saving.

COLON CANCER
Colon cancer is the second leading cause of cancer deaths in the U.S. for both men and women. On average, 140,000 cases of colon cancer are reported annually, and 50,000 Americans die each year due to colon cancer.

Studies have shown there to be a lifetime risk of 6 percent of developing colon cancer, and the risk can double if there is a family history. Doctors typically recommend that, beginning at age 50, individuals should undergo a routine screening. Individuals with a family history of colon cancer, however, should consult their doctor to consider being screened at an earlier age.

A colonoscopy is a test that is performed in order to detect early signs of cancer and to remove pre-cancerous polyps in the colon. Over time, if these polyps are not removed, there is a greater risk that they can develop into cancer.

“In the early stages of colon cancer, it is over 90 percent curable,” says Murali Krishna, M.D., a board-certified gastroenterologist at Wuesthoff Medical Center – Rockledge. “But once it spreads beyond the colon and goes to the liver, the success rate drops dramatically.”

Dr. Murali Krishna, a gastroenterologist at Wuesthoff Medical Center–Rockledge, reviews the results of a colonoscopy with a patient.

Dr. Krishna urges people over age 50 to schedule a colonoscopy. A routine screening can detect polyps and cancer early, and most importantly, it can save lives. Unfortunately, only 60 percent of the people who should be screened actually follow through and schedule an appointment.

“The whole idea with screening is that you’re taking healthy people off the street and putting them through a test,” says Dr. Krishna. “It’s sometimes difficult to get people to do it. But you’ve got to weigh the pros and cons of it very closely. I think with the risk of colon cancer and the benefits of early detection, the pros are pretty clear. If not diagnosed early enough, colon cancer can present itself in the form of bleeding, pain and obstruction as it continues to develop.”

For those who are concerned about having a colonoscopy, Dr. Krishna says there have been a number of advances in the procedure that make it both easier to tolerate and more successful in preventing colon cancer.

“These days, we make sure the patient is sleeping and comfortable, which wasn’t always the case years ago,” says Dr. Krishna, who has been performing colonoscopies for 10 years. “As far as the procedure itself, it’s also much more accurate now. The cameras used in the colonoscopies have improved tremendously, giving a more precise view of the colon and any potential abnormalities.”

For more information on Wuesthoff Health System’s preventative services, call the Melbourne medical center at (321) 752-1200 or the Rockledge medical center at (321) 636-2211 or visit Wuesthoff.com.

 

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