Retirement with Zest; 12; Heart Diseases

today we have two guests both specialists in matters of great concern to our age group the first is dr durie a will be interviewed by ms mary stockwell producer of retirement or incest our guest today is dr a wilbur during a professor of clinical medicine new york university and former president of the new york art association we're very happy that you're with is today back to dairy at what is meant by heart disease it's important that each individual the study did find out is what kind of heart disease they have but at least ninety percent of the cases were going to discuss today are due to the aging process hardening of the arteries arteriosclerosis is a medical tourism this affects the artery says supply the blood to the heart and causes the heart to work in efficiently in talking about the different kinds of heart disease that affect the

senior citizen can you also tell us what the president finding vested the chance of recovery from knee well the disease which we mentioned as being the most common arteriosclerosis is a disease which is not a rapidly advancing disease today she is to develop and there are many periods when it does not progress at all one of the best examples that we have in america today is that of the late president eisenhower he developed evidence of heart disease when he was president of the united states and they're made in action and recovery and carried out his two terms as president and did not develop a nice for this serious heart disease for many years later show that the prognosis is we caught in these people with hardening of the arteries is usually good unfortunately there are some cases where this condition

progresses and a serious outcome results but there upright without present knowledge of workers grosses and with our management of the condition people can live for many many years was either some other causes of heart disease other than the arteriosclerosis you mentioned the romantic hot does become a problem of times in the older age group because people have rheumatic fever and childhood frequently have effective thousand the heart and sees the effects are not too bad people can live in their seventies and eighties and even nineties oh well when the effect of the owl's one it is not apt to have the so called heart attack or carnegie this is quite different from the country's gross is that that has the contrary a tech lead throughout

a career as these defective welds in the hype doesn't work efficiently but with modern drugs and modern treatment that can be kept going for a long long time we hear a lot about strokes can a layman distinguish between a heart attack on the stroke and is the first aid rented the same for both a heart attack is due to some sudden acute episode that it involves the efficiency of the har and the symptoms of that are quite different from the symptoms of a stroke the stroke involves the blood vessels through the brain and that the heart has not affected by a stroke in a stroke an individual would usually developed difficulty and speaking or difficulty moving in our lady and these are not symptoms connecting with hard to see the heart

attack is usually do one in which the individual has real pain in the chest and people of stroke really have pain of any so that to jerry of many of us have read a lot in the literature about exercise and smoking what are the latest findings of the specialists the american heart association though put out a pamphlet some years ago and had had five so call risk factors conditions which lead to heart disease and to the main ones related to exercise and smoking from the exercise than blind individuals who also exerted themselves on the issue the tension issue their physical exercise would give up our tax and therefore the public as well as a doctor for many arabs felt that in an individual with a

heart condition should have very limited access but following the work of the white boston aren't pioneer in the field of exercise we have found that the individual has heart disease or who has had a heart attack does much better if he's put on graduated regular steady exercise and some individuals who had been very in act two before their heart attack or through their lives by increasing their exercise gradually under supervision can actually do more than they did before the heart attack and in so doing they stimulate that a circulation to the heart muscle and they are the heart becomes more efficient at fishing and they're better able to carry on a normal life and if they didn't exercise or the second or even

question deals with smoking the first information on smoking that dates back to nineteen thirty three when it was discovered by two physicians and michigan that debt tobacco caused a spasm of blood vessels in my spares them i mean it closing off of the blood vessels and it has been well recognized over the years that this is a detrimental effect and that people with heart muscle already the fishing in blood supply if they add to that smoking then the blood supplies for the cutback and in some instances may actually produce a heart that individuals who stop smoking in the virus in cruel when a better situation just nailing i'm like that we were talking about with regard to exercise and smoking that the jury a un are there any shall i say other precautions

that one can take to help prevent heart trouble a moment ago i mentioned the eu various risk factors at the american heart association has published two of them to our disgust to exercise and smoking two of the others you can do something about the this one you cannot but this one has already you can't pick your ancestors unfortunately but the other to deal with that and wait again there is some conflict in medical opinion but for the most part it is felt that people who take in large amounts of fat similar system special facts of records saturated fats the vault and a high cholesterol or fat in the blood and that this is deposited in the arteries and tends to callers or at least hasten the development of

arteriosclerosis so that the majority of specialists in this field and to prescribe data center lowen the so called saturated fats how the main sources of saturated fats are dairy products particularly the cream is almost pure fat the yoke of the egg is water is are cheeses that are made for more milk oh very high in fat and of course meat itself can be leaner fatten laurie the francis has a large amount of fat and that's so that we prescribe that's where these fats were low and substitute unsaturated fats in various forms for instance corn oil oil made from corn or soybean oil made from soybeans those are on saturated

fats and they can be used to take the place of water in the only marjorie and can replace water and now as far as the weight fact is concern the remaining risk factors it is fairly well known that the individual who's overweight tends to the top high blood pressure more readily than the and the way to a normal weight individual and their art is gross is when they develop but progress is more rapidly now i know this is due entirely to the fact that they're overweight or only a lot of fat then this great player all nobody's ever be cited but at least one piece of advice that is given to day is that individuals should keep their weight normal to prevent our duty and if they do have heart disease the wage should be brought down for two reasons one of the reason i've already given of the development of fadi deposits but

the other one is you have to work if the way to thank you for listing these precautions dr durie a does the hard get any warning when something is going wrong prior to any major development of a struggle either one can be true that patient can be perfectly healthy as an old story about the man who had a physical examination of doctor's office and like bacardi graham and walked out and dropped dead and it's pretty hard for the layman don't understand why such a thing can happen but it does happen an individual or for may have this arteriosclerosis involving the arteries of his car and he may have no symptoms at all and the document it may be able to find evidence and yet a sudden plot may develop an are even a few minutes after an examination and the patient could die this is a rare condition most people who

have heart attacks have warnings and symptoms and i'm going to give a list of these symptoms but they don't always mean the jail heart disease or just because you have some of the symptoms and i'm going to mention it doesn't mean that they are a dude odyssey economist juan as shoppers abreast an individual cops after going up a forest areas may have heart disease or a maybe just thought of but he may not have good muscles but that is a simple competition coming in the chest can come from heart disease or it can come from earth so again is not a definite impression of hard to see it hacking cough that hangs on without any other explanation may be connected with heart disease then as the disease advances and that becomes more marked and the heart doesn't work as

well a patient has some difficulty lying flat in bed at night they breathe better if they set up one two three four prop up onto his report likewise the individual may develop swelling of the legs because the heart is not pumping that blood around the body sufficiently and in the acute attack at least eighty percent or more of the individuals have acute pain in the chest one word about that is that it is a free police described by the patient more as a pressure as though somebody was standing on his chest and real pain a sharp pain in the chest is usually not from lahore those are some of the symptoms of a patient should note and go to the turin find out if a main heart disease so when they're coming from some of the cost may we now and just recapitulate what the outlook for a

patient with heart disease might be broke the statistics compiled by the american heart association about four or five years ago would indicate that the longevity of an unusual suffering from heart disease has been wrong anywhere from five to ten years in the last two decades and that is chiefly because of several factors one of the earlier recognition of the conditions and mistreatment secondly the recognition of these risk factors and i've mentioned and the elimination of those factors certainly a better understanding in the use of drugs in managing our city and fourthly a rather uncommon but frequently necessary procedure a surgery and with these four factors the chances of living longer day with

heart disease or with potential heart disease is so far greater than it was twenty years ago just as a final question dr durie where it can i and our listeners get further information on the subject the new york art association has offices at forty sixty four straight if you need help and advice as to where to go for treatment and so forth and there is a fulltime individual at the association throughout the day to answer these questions we make note that the newer car association to treat patients that's up to the dock all we can do is to me for people up to the proper channels where they can get help thank you very much for being with is today back to jury and just a note as you came and you mentioned that a new book had just been published in paperback form called

your heart and it's headed by dr montague with chapters by paul dudley white and other distinguished heart specialist including yourself dr barry i you said the price was ninety eight cents so this book was compiled by dr montague who is president of the medical writers association and has published four hundred and fifty books mostly scientific books through his life he felt there was a need for a book which a layman could read and get up to date information on the problems of the heart and circulation and he interviewed the various fourteen doctors that make up the contributors to this book and got their responses to various questions so this book is published as a paperback and can be purchased i think for about a dollar many thanks to act to do it thank you most of our second guest is dr john book one assistant chief of the diabetic

service at mount sinai hospital and chairman of the committee and community education of the new europe diabetes association dr godwin what is diabetes cubbies is a disease that we call a metabolic disease a disease that interferes with the body's utilization of some of its basic foodstuffs in this instance the sheer foods the carbohydrates diabetes his easy to define that sometimes and if we were to really trying to find what it is i must say at this moment we do not know we had until recently a lot of patients with diabetes did not have enough

insulin in their bodies however in the last few years we've learned how to measure insulin and the blood a unique type of measurement and we have discovered that many diabetics particularly those who developed at an older age group have insulin in their blood and this has made us change our thinking as to what this is and has now become apparent to us that the individual who has diabetes has some insulin but for some reason that we do not yet know less insulin is not working properly to burn the sugar out so basically it is still a disorder in which there is improper use of the bodies and so how common is it diabetes is an exceedingly common disease surveys have been done

in many countries and the incidence of diabetes interestingly enough as almost the same country after country it relates partly the two age groups the younger age groups have less diabetes in the older age groups but in the surveys done in the united states their air are approximately two diabetics and every hundred people that you will screen and there are another two who have it and so milder form that it is not recognized in the special tests are done so that the incidence is almost four percent of the population if you do surveys and people in their sixties and seventies you will for an abnormal blood sugar tests in between ten and twelve percent of the population so this is an enormous frequency of this disease in the older age group frequently

unrecognized how do you all recognize it when the symptoms we recognize diabetes by taking a patient's history firing his symptoms or by certain laboratory tests a basic symptoms in general are fears sgt and excessive ear nation frequency of your nation and increasing appetite and despite this increased appetite weight loss or other symptoms is itching that can be any part of the body besides this the symptoms are so diverse are that the disease today can mimic almost any type of disease that you can think of but in general these are the basic symptoms that will bring a patient to the opposition however many diabetics as i just indicated to you don't know they have they have no symptoms and there's only one real

test for that we find that they have diabetes talk at the present time and they are diabetes association the american diabetes association puts on a campaign the third week of nov every year called diabetes detection week and you may have heard spot announcements on radio television urging you to have a blood test done to see if you have diabetes because a blood test is the essential way to find out if an individual has diabetes this is a test to see how much sugar is in the blood and there are several ways that this can be done but for screening purposes for attempts to find large numbers of diabetics the tiger test a patient should ask his physician

to do he's what we call a two hour post pran neil blood sugar post perennial means after eating in other words a blood sugar test done two hours after eating a large meal which has plenty of sugar a normal person will be able to handle the sugar in his blood sugar will not go up too high but an individual with diabetes can't properly handle this load of sugar and his sheer in the blood will be much higher than normal i stress this two hour test rather than the test that some of you may have heard of which is a casting glitch or a blood sugar done when you have nothing to eat and separate out the night before we object to this as a definite ten is because some people with very mild

diabetes will have normal casting casts but abnormal after eating tests so that the recognition and comes through the symptoms if you have them or by the blood sugar tests suppose a patient hasn't noticed any of these symptoms she's still have these tests i think that this should be an integral part of any complete annual physical examination what kind of people are most likely to get diabetes there are several predictive factors one of course is family history there is a tendency for genetic transmission of this disease and families thousand individual who has gone a family history of this is more likely to develop that and again of

musician who takes a careful history who know the family history no that some member the patient's family had diabetes and then the more are alerted to looking for this disease and that individual the other large factor is obesity are if you take a thousand obese people versus a thousand normally people you'll find much more diabetes in the obese group than you in the normal way beyond this we are at a loss to predict that in other individuals and there is no other great tendency what can you do have you have diagnosed the disease what do you do for a patient with diabetes is almost a nice disease to get to day in some ways because we can do a lot or an enormous amount there was a very famous physician who is professor of medicine at johns

hopkins and professor of medicine university of oxford so when oscar and his prescription for on jeopardy was to get the chronic disease early in life and then have your physician keep an eye on you and this is not totally untrue because if you do have a disease such as diabetes it requires that you go physician three or four times a year and if something else non diabetics comes along they're much more liable to have a found untreated and taken care of diabetes in some ways has a little bit of an advantage terms of treatment ah we really can control the sugar phase of that these very nicely and there are two basic forms of tree one of which is dire and this is at the basis of all treatment of diabetes than that x must watch their data the degree of that restriction will vary all diabetics don't have to be as

strict as some others in general the older you are the more mild your diabetes will be and many diabetics in the age groups over sixty are controlled by merely simple restriction came the syrup ski i'm sure the highly refined pure carbohydrate foods they can have peace of plain cake and small amounts of bread ice cream all of this that principle is predicated on the individual being normal weight if you're all bees within that district and weight reduction is a must for any diabetic one says wait is down to normal many of them as i said can be carried on alone especially in the older age groups if that does not satisfactory control that we then have two different kinds of

medications one of which our payrolls and the other of which is insane given by injection the vast majority of people developing diabetes in the older age groups can be treated with pills there has been some misconception about what the pills are they are not in some insulin as a specific hormone produced by the pancreas which i unfortunately cannot be taken by mouth because destroyed a gastric juices and by the digestive juices and must be given by injection does the diabetes association have any free printed material yes we do know we would be happy to send to thank you very much if any of you would like any of the printed material mentioned on this program we appease right to me constant ball fair riverside radio diary rv our new york one that below to seven thank you