More women get heart attacks than men and young women are at more risk than men of the same age. Risk factors in women are being overweight, smoking, diabetes and hypertension. There can be some gender bias because the classic visualisation is of an overweight middle-aged man grabbing his chest and falling backwards. We see that on the movies. Women should report any symptom like chest pain and get it investigated.
Sudden cardiac death on the sports field
Cardiac arrest amongst elite athletes occurs, although it is less common than lightning strikes, which also kill people. Screening is not all that helpful as there can be concealed variations. Things to look for are chest pain, light-headedness and shortness of breath, unexplained reasonably. Probably the best thing is to have a defibrillator present at the site with someone who knows how to use it.
‘I fainted after a shower.’ What can it be?
A list of the possibilities was given by Dr Vivienne Miller in Cardiology Today - heart block, vasovagal episode, hypotension after a hot shower, severe bradycardia, ventricular tachycardia, pulmonary embolus, acute haemorrhage into the gut, TIA, hypoglycaemia, hysteria and a medication-related cause. Simple presentations can get complicated.
Shingles can be painful
Shingles, herpes zoster, is a painful condition caused by a virus which lives in the nerve system and has a characteristic rash which is confined to the distribution of a particular nerve. There is medication to reduce the impact of it and to suppress it, but, once established, it is there for ever. The incidence of shingles appears to be increasing at an annual rate of something like five per cent. There is a vaccine for it and we are going to see more people in the older age groups getting the vaccine when they see other people have picked up shingles.
Is the boat people business a bit of hysteria?
There are half a million fee-paying students from overseas countries in Australia. There is a labour shortage. Boat people certainly know they are risking their lives in trying to get to Australia. If we are going to have migration, then maybe those who are prepared to risk their lives to get here could be worth having. Or is it just that we fear they will take our jobs?
A lot of people reading this will live to be 100
Life expectancy has doubled in the last couple of hundred years. The main reasons for this are clean water, sewerage, better housing, more food, vaccinations and infrastructure improvements that have reduced accidents. Medicine has done a bit, too. When Bismarck picked the magic figure of 65 as the retirement age back in the 1870s, most people didn't get to this figure anyway. When Australia introduced the idea of 65, the life expectancy of the working man was about 55. We still have a working structure which tends to put people out the door while they remain productive.
Clinics by appointment
Dr Ann Stephenson, psychiatrist: Friday January 19.
Sue Leitner, foot nurse: December 14, January 4 and 18.