Welcome to some of the happiest time of your life. After childhood, The Golden Years (the life stage of 65+) is considered to be a favorite among many.
Q&A: Shukri David
Dr. Shukri David and a team of physicians from Ascension Michigan helped run the Ascension Michigan Healthy Heart Project this year. It’s a community outreach event focused on cardiological health that the hospital has hosted for the past 15 years. Attendees receive a free electrocardiogram in addition to other heart health screenings. David has won an Excellence in Care Award for his efforts. Read more about the honor, here.
Hour Detroit: Tell us about your community outreach.
Shukri David: The Ascension Michigan Healthy Heart Project is a one-day [event] focused on heart health, where participants receive screenings including EKGs, blood work, and more. Since the inception of the event, more than 10,000 people have participated.
Why is this good for the community?
Many people don’t have access to health care, can’t afford insurance, or have high deductibles. Our event helps the community with real health education and advice.
What motivates you to work on this?
Each year, we see participants whose heart health is so poor, they need emergency medical attention. This year, a woman ended up in the emergency department and had to have coronary artery bypass surgery. The event potentially saved her life.
What is the best part about your job as a cardiologist?
The grateful letters that I get from my patients keep me energized.
What are the most prevalent health issues you encounter in patients 65+?
Nearly half of adults in the United States have hypertension, and coronary artery disease is the No. 1 killer.
How can our readers prevent those?
Hypertension often has no symptoms, so it’s important to talk to your doctor to find out if you’re at risk. Know your total cholesterol, good cholesterol, bad cholesterol, and blood pressure. You can also reduce your sodium intake, exercise, and check your blood pressure daily.
—AW
New technology is helping doctors save lives by detecting lung cancer earlier in The Golden Years
The first screening test for lung cancer is helping people age 65 and older spot the disease early enough to be cured.
“We can remove the disease surgically, provided the lung cancer is in the early stage and the patient is fit,” says Dr. Sanjay Dogra, a pulmonary and critical care specialist who heads up the Lung Nodule Clinic at Beaumont Hospital in Royal Oak. “We also have a special kind of radiation treatment provided the disease is caught early.”
The nodules typically range in size from a pinhead to a pea, but they can potentially reach any greater size. Surgical removal provides the most effective treatment, but the condition can also be cured using chemotherapy or radiation for those who aren’t surgical candidates.
The clinic’s patients are referred by doctors who’ve had the patient screened with a low-dose CT scan. The scans have been used as a screening tool for lung cancer since a national study with more than 53,000 people showed those who had a spiral CT that detected the disease early had a 15-20% lower risk of dying from lung cancer than those who depended on chest X-rays.
“Before that, there was absolutely no screening, which is the reason that, a majority of the time when we saw patients, they were in the advanced stages of the disease,” says Dogra. “They were beyond treatment.”
There are screening criteria. They include screening those in the golden years who are 55-74 years old, who lit up for at least 30 years, and who have smoked continued to smoke within the last 15 years.
The Beaumont clinic is multidisciplinary, meaning all of the relevant specialists gather there to evaluate patients and recommend treatment plans. Not only is it more convenient for the patient, but it also ensures that all of the necessary specialists consider each case.
Dogra not only wants to catch lung cancer early; he also wants to help prevent it by speaking to student groups about the dangers of smoking.
“There’s no doubt, the science tells us that lung cancer is related to smoking,” he says.
—IW
Coronary artery disease causes 25% of all deaths in the U.S., but CT scans are making detection easier
One of medicine’s happy coincidences is that CT scans to screen for lung cancer in smokers can also show whether they have coronary artery disease. What shows on the scans is calcium, which combines with cholesterol and other substances to clog arteries and give rise to atherosclerosis. “No doubt about it,” says Dr. Justin Trivax, interventional cardiologist in Farmington Hills. “Calcification is a sign of atherosclerosis and that’s what we pick up on the CAT scan.” As a result, radiologists can record calcium in the arteries around the heart — the site of the condition — but also in the aorta and the carotid arteries.
Coronary artery disease is one of the most common conditions that Trivax sees in patients who are in the golden years (65 and older). The others are heart rhythm problems and atherosclerosis, which is from high cholesterol but can be prevented even in those with high lipid levels. “We really use the prevention measures when the primary care physician has exhausted the typical measures to control risk factors,” Trivax says.
For example, a patient with hypertension may be on multiple drugs to control it, but their blood pressure is still high. Or their cholesterol levels are not in a good range despite the most aggressive doses of lipid-lowering drugs. “Often, we see patients who have been treated by a primary care physician, and sometimes they simply need confirmation that their doctor’s recommendation is the correct approach,” Trivax says. “Or sometimes patients have side effects due to multiple drug interactions and we can take a closer look and help them out.”
Cardiologists are also more familiar with the drugs less commonly used to lower cholesterol for patients who can’t tolerate statins or have genetically high cholesterol. “Those medications are often harder to access via primary care because of insurance mandates.”
—IW
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