Truth in HealthCare: Setting Fact Apart from Fiction When Researching Online

Setting Fact Apart from Fiction When Researching Online

words | DYLAN ROCHE

Who hasn’t been told by a cautionary parent or teacher, “Don’t believe everything you read”? This prudent bit of advice proves especially true in the era of the internet, when a simple Google search can yield thousands of results. But amid all the facts is a lot of fiction — and when it comes to your health, being misinformed could lead to lots of trouble.

Which Websites Are Reliable? Ultimately, your doctor is your best resource for health guidance, as they know all the aspects of your specific history and present circumstances. In situations where your doctor is unavailable, however, you can do research on your own as long as you are careful about what sources you consult. Not all health-related information available on the internet comes from a trustworthy source, and some of it might be out of date. So how’s a person supposed to figure out whether a resource is reliable or not? First, you should consider what individual or organization is running the website, which will help you understand their level of expertise and what their priorities are.

One of the more trusted ways to do that is to look at what’s called the top-level domain, the formal term for those three letters following the dot at the end of the website’s domain name:

IF THE WEBSITE ENDS IN .GOV: it indicates a government agency. Relevant examples of these are the Food & Drug Administration (www.fda.gov) or the Centers for Disease Control and Prevention (www.cdc.gov).

IF THE WEBSITE ENDS IN .EDU: it indicates that the website belongs to an educational institute, medical school or university. A relevant example is Harvard Medical School (www.health.harvard.edu).

JOIN OURHEALTH ON SOCIAL MEDIA IF THE WEBSITE ENDS IN .ORG: it indicates that the website belongs to a nonprofit organization, such as a research society or an advocacy group. Relevant examples of these might be the American Academy of Family Physicians (www.familydoctor.org) or the American Heart Association (www.heart.org).

IF THE WEBSITE ENDS IN .COM:

37www.OurHealthRichmond.com it indicates the website is a commercial website. When consulting a .com source, it’s especially important to make sure that sources are cited and that there are no conflicts of interest (for example, a company might stand to gain a profit by promoting certain information).

If you’re ever in doubt, don’t be afraid to fact-check what you’re reading against another source. The following websites are good go-to places for reliable information, whether you’re looking for weight loss tips, cancer advice, disease prevention or just general health wisdom:

Academy of Nutrition and Dietetics www.eatright.org The world’s largest organization of credentialed food and nutrition professionals offers guidance on incorporating more nutritious foods into your diet and what functions certain foods support.

American Academy of Family Physicians www.familydoctor.org This organization comprising 129,000 physicians and medical students, which has been in operation since 1947, offers expert guidance on everything from nutrition to disease recovery.

American Council on Exercise www.acefitness.org The nation’s leading nonprofit exercise professional and health coach certification organization has information on workout advice and safety with step-by-step instructions on how to perform exercises. It’s also important to check the date on the article or page that you’re consulting. If it’s older than five years, you should try to find more recent information. Sometimes medical advice is disputed or proven wrong by more recent research.

“I Found a Site that Says…” Let’s say you find a website with a lot of information on the topic you need to research. It’s not the website of a government agency, nonprofit organization or medical school, so does that mean you have to rule it out? Not necessarily.

First, check who is providing the information. If there’s a byline with the name of an author or contributor, that person should have the proper background and training. Check for credentials like MD (medical doctor), RN (registered nurse), RD (registered dietitian) or something similar. In some cases, an article might be compiled or written by a someone without credentials but reviewed by an expert in the field.

American Heart Association www.heart.org The nation’s oldest and largest nonprofit organization dedicated to cardiovascular health offers all kinds of heart-healthy advice and vital information on heart disease.

Centers for Disease Control and Prevention www.cdc.gov A public health institute under the U.S. Department of Health and Human Services, the CDC provides guidance on important health and safety topics like infectious disease, occupational safety, injury prevention, environmental health and foodborne illness.

Food and Drug Administration www.fda.gov The FDA regulates food, medicine, dietary supplements and cosmetics, determining which ones are safe for public use and consumption. Its website provides relevant consumer updates such as “What to Know About Products Containing Cannabis and CBD” and “Some Medicines and Driving Don’t Mix.”

Harvard Medical School www.health.harvard.edu Harvard Medical School provides insight and advice on all topics relating to health and wellness, from weight loss to cancer prevention. The information on the site is contributed by the more than 10,000 faculty physicians at the school.

Mayo Clinic www.mayoclinic.org This nonprofit academic medical center, which focuses not only on practice but also on education and research, provides guidance on healthy lifestyles, explanations of specific diseases, in-depth looks at drugs and supplements, and much more.

National Cancer Institute www.cancer.gov The federal government’s agency for cancer research offers information on different types of cancer, prevention advice and treatment options, as well as the latest news about cancer.

38 OurHealth | The Resource for Healthy Living in Greater Richmond USDA Nutrition www.nutrition.gov The U.S. Department of Agriculture’s website for healthy eating and food safety provides insight into nutritional needs, how nutrition affects your health, and the nutritional panel of everyday foods. You might find a website run by somebody who has experience with your condition, but it’s important to remember that health is different for each individual. One person’s cancer battle or fitness journey won’t be the same as yours — and even though that person means well by offering tips and advice, it doesn’t mean that their method is scientifically supported. It’s entirely possible — and even likely — that a writer is not trying to mislead you. However, that writer could be misinformed or could misunderstand what they’ve been told.

Secondly, check where the author or organization is getting their information. Are statistics and facts attributed to another reputable source? It’s not enough to say, “Many studies have shown that…” A reliable resource will specifically mention which studies it is citing, ideally providing links to them. Check for studies that have been published by reputable medical journals within the last five years, and always read through the study yourself. In some cases, studies may report certain outcomes but conclude that more research is ultimately needed.

Finally, ask why the author or organization is providing this information. If you read an article that supports the use of an alternative medical treatment, you might start thinking it’s a good option for you. But if the article is written by the owner of the company trying to sell that treatment option, you should be wary. The information might be more reliable if it is coming from a medical doctor not associated with the company. Be sure to distinguish between fact and opinion.

ON THE WEB More at ourhealthrichmond.com

There’s no shortage of online health information. BUT HOW MUCH OF IT IS ACCURATE? Here are some reliable sources you can trust to learn more about endodontic care and treatment. RELIABLE ONLINE RESOURCES

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American Association ofEndodontics www.aae.org

American Board ofEndodontics www.amboardendo.org

Journal ofEndodontics www.jendodon.com

Truths and a Lie...

UNCOVERING THE TRUTH ABOUT ENDODONTIC CARE

Root canal treatment is no longer painful like it used to be.

Decades ago, pain associated with a root canal was considered a more painful procedure, but with modern technology and anesthetics you won’t experience any more pain than if you went to have a cavity filled. The pain from a severe toothache, often caused by damaged tissues in the tooth, can be easily remedied when an endodontist removes the damaged tissue through root canal treatment. In addition, endodontists are experts in pain management, and most cases can be treated quickly and comfortably.

Root canal treatment does not cause other illnesses. A root canal treatment to save a tooth is better than pulling the tooth.

Information you may find on the Internet or elsewhere, claiming that if you receive a root canal treatment you’re more likely to become ill or contract a disease in the future simply isn’t true. This false claim was based on long-debunked and poorly designed research conducted nearly a century ago, long before modern medicine understood the causes of many diseases. There is no valid, scientific evidence linking root canal treatment to disease elsewhere in the body. Saving your natural teeth, if possible, is always the best option. Nothing artificial can replace the look or function of a natural tooth so it’s important to always consider root canal treatment as an option. Endodontic treatment has a high success rate and many root canaltreated teeth last a lifetime. Replacing an extracted tooth with a bridge or implant requires more time in treatment and may result in further procedures to neighboring teeth and supporting tissue.

If the tooth doesn’t hurt, there’s no need for a root canal. While a throbbing toothache usually results in the need for root canal treatment, many times a tooth can require root canal treatment when there is no pain present. Dentists and endodontists are specially trained to test a tooth to see if the pulp has been infected or damaged. If this is the case, a root canal would be necessary to save the tooth.

Your Local Resource:

Commonwealth Endodontics Commonwealth Endodontics is a specialty dental practice with seven endodontic providers and four office locations in the greater Richmond area. At CWE, you will find a team of expert doctors and support staff that are dedicated to providing patients the highest standard of endodontic care in a professional, friendly, and comfortable environment.

PROVIDERS: (pictured from left to right) Timothy Finkler, DDS | Harold Martinez, DDS | Steve Barbieri, DDS Ronald Vranas, DDS | Madelyn Morris, DDS | Michael Morris, DDS | Stephen N. Schroeder, DDS

PROCEDURES: Root Canal Therapy, Endodontic Retreatment, Endodontic Microsurgery, Management of Cracked Teeth and Dental Trauma, CBCT Imaging, Nitrous Oxide, Oral Anxiolysis, Conscious Sedation, General Anesthesia

COMMONWEALTH ENDODONTICS OFFICE LOCATIONS: WEST END OFFICE: 3107 Hungary Spring Road, Richmond, VA 23228 SOUTHSIDE OFFICE: 2312 Robious Station Circle, Midlothian, VA 23113

MECHANICSVILLE OFFICE: 7347 Bell Creek Road, Suite 300, Mechanicsville, VA 23111 SHORT PUMP OFFICE: 12320 West Broad Street, Suite 209, Richmond, VA 23233 w www.cwendo.com | c 804.501.0501

There’s no shortage of online health information. BUT HOW MUCH OF IT IS ACCURATE? Here are some reliable sources you can trust to learn more about geriatric care. RELIABLE ONLINE RESOURCES

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American Geriatrics Society www.americangeriatrics.org

Healthy in Aging Foundation www.healthinaging.org

American Medical Association www.ama-assn.org/specialty/geriatric-medicine

Truths and a Lie...

UNCOVERING THE TRUTH ABOUT GERIATRIC CARE

Forgetfulness doesn’t always indicate the onset of dementia. Growing older doesn’t mean you will become frail. Seniors can continue to have normal sleep patterns as they age.

Memory loss can be caused by medications, medical conditions, or by depression related to life events. Forgetfulness may be an early sign of dementia, but it does not necessarily mean a person will be diagnosed with dementia. It’s also important to recognize that only six to eight percent of people over the age of 65 will have dementia, and one third of those over age 85 will have some dementia symptoms. About one-third of people older than 65 fall every year, according to the Centers for Disease Control and Prevention. That’s due in part to a natural decrease in blood flow to the cerebellum – the brain’s balancing center – as well as inner ear and vision changes that make it more difficult to orient yourself. This decline is often exacerbated by conditions like arthritis and nutritional deficiencies that can lead to nerve damage in the feet. It’s important for older people to be aware of their limitations related to their balance and strength. Even at age 75, a person should be able to get up from a chair without using their arms, walk across the room, turn quickly and sit down without any unsteadiness. If a person is unable to perform this test, he or she should consider seeing a doctor to check for underlying conditions that can affect balance, such as a vitamin B12 deficiency, a slow heart rate, or cataracts, for example.

Your Local Resource:

Sleep patterns do change as people age. Some of these changes can include taking longer to fall asleep and waking up more during the night than when they were younger. Senior-aged people also get less delta – or slowwave – sleep. This deeper sleep stage helps consolidate memory, which without, can lead to feeling more tired, irritable and forgetful during the day. But many sleep problems common among older people stem from other causes, notably medication used to treat unrelated health conditions. For example, diuretics taken to lower high blood pressure or treat heart failure can cause a person to wake up frequently during the night to go to the bathroom. An effective way to determine if a problem with sleep patterns exists in older people is for the person to ask him or herself if any changes experienced are affecting quality of life. If the change is making the person unhappy, it may be time to speak with a doctor to find out if any medication taken or underlying health problem could be affecting the ability to sleep soundly.

JenCare Senior Medical Center At JenCare Senior Medical Centers, you will benefit from top-notch physicians who specialize in senior healthcare. Our physicians spend more with you during every visit. Because when we know you better, we can help you feel your best. Colonial Heights Office: 524 Southpark Boulevard | Colonial Heights | c 804.504.7980 Hull Street Office: 6530 Hull Street Road | Richmond | c 804.674.3425 Mechanicsville Office: 3806 Mechanicsville Turnpike | Richmond | c 804.228.1143 Shockoe Bottom Office: 1712 E. Broad Street | Richmond | c 804.344.9848 w www.jencaremed.com

There’s no need to see a geriatrician if you already have a primary care provider. Geriatricians are medical providers (often family practice doctors or internists) with special training in the health needs of older adults. Geriatricians specialize in the care of people with multiple chronic medical conditions that cause challenges with their day-to-day physical and mental functioning. Adults who see a geriatrician are less likely to end up in the hospital, possibly because these physicians are more likely to be on the lookout for warning signs such as frailty and appetite loss, and also are more likely to avoid prescribing potentially risky medications. Research conducted by the Journal of the American Medical Association – Surgery (JAMA) shows that older adults who receive care from a geriatrician or related medical provider while in the hospital do better once discharged. The same study showed that the median hospital stay for older patients is two days shorter and readmission rates are sharply lower when a geriatrician specialist is involved.

There’s no shortage of online information about addiction. BUT HOW MUCH OF IT IS ACCURATE? Here are some reliable sources you can trust to learn more about substance use, substance use disorders and related issues. RELIABLE ONLINE RESOURCES

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Recovery Research Institute www.RecoveryAnswers.org

American Society ofAddiction Medicine (ASAM) www.ASAM.org

World Health Organization (WHO) on Substance Abuse www.WHO.int

Truths and a Lie...

UNCOVERING THE TRUTH ABOUT ADDICTION

In the United States, the daily number of fatal opioid overdoses is equivalent to a commercial airline plane crashing every day – 192 deaths.

• Since 2013, fatal drug overdose has been the leading method of unnatural death in Virginia, surpassing all other forms of unnatural death including homicide, suicide, motor vehicle accidents, and undetermined deaths. • Like heroin; Vicodin, Percocet, and Oxycontin are opiates and can cause an overdose. • The only effective way to reverse an overdose is to use Naloxone. When taking an opioid medication, the body can develop a dependency on the drug within 5 days. 66% of teens (12-18 yearolds) who report misusing prescription pain relievers get them from friends and family members.

• Opioid addiction is an equal opportunist. • Between 8-12% of people prescribed opioid medications develop an opioid use disorder. • This can lead to polysubstance use as well. • About 80% of people who use heroin first misused prescription opioids. • In response to this research, all states in the United States have created safe prescribing laws and policies (VACEP). For example, emergency departments in Virginia are recommended to prescribe opioid medications for only 3 days. • Every day 2,500 teens in the United States take prescription medication for non-medical use. • When a medication is prescribed to you by your doctor, it is not safe for your family members to use even if they display the same symptoms. • More than 70,000 children under the age of 18, go to the ER due to unintentional medication overdoses in the United States each year. • It is important to keep your medications stored in a safe and secure location. Contact your local Community Service Board or Health Department to learn methods for safe storage of your medications.

Your Local Resource:

Substance Abuse Free Environment Inc. (SAFE) has been serving Chesterfield County’s 348,000 residents since 1999. SAFE utilizes awareness and education, community partnerships, youth leadership and advocacy to address substance misuse issues. The coalition works to create community-level change in behaviors and attitudes relating to substance misuse. P.O. Box 35413 | North Chesterfield, VA 23235 | c 804.694.7794 w www.chesterfieldsafe.org | m safe@chesterfieldsafe.org f ChesterfieldSAFE | f ChesterfldSAFE | f chesterfieldSAFE | f SAFEChesterfield

It is safe to dispose of your unused/ expired medications by flushing them down the sewer system.

• “Most medicines are not removed by wastewater treatment plants or septic systems. Medicines that are flushed or poured down the drain can end up polluting your waters, impacting aquatic species, and contaminating your food and water supplies.” • The safest methods to dispose of unused or unwanted prescription medication are to bring it to the local DEA Medication Take Back Day or leave it in a medication dropbox. • The October 2019 DEA Medication Take-Back Day brought in 23,958 pounds of prescription medication and vape devices across Virginia. • Find your local Take-Back day: https://takebackday.dea.gov/

There’s no shortage of online information about dentistry. BUT HOW MUCH OF IT IS ACCURATE? Here are some reliable sources you can trust to learn more about dental care and treatment. RELIABLE ONLINE RESOURCES

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American Dental Association www.ada.org

Mouth Healthy www.mouthhealthy.org

Centers for Disease Control and Prevention: Oral Health www.cdc.gov/oralhealth

Truths and a Lie...

UNCOVERING THE TRUTH ABOUT DENTISTRY

More than 1 in 4 adults in the United States have untreated tooth decay. If you skip flossing, you miss cleaning 40% of your tooth surface. Today, 1 in 4 orthodontic patients is an adult.

Tooth decay, more commonly referred to as cavities, is permanently damaged areas in the hard surface of the teeth that develop into tiny openings or holes. You may not notice symptoms of decay until a filling or crown is required to repair. Initial stages of tooth decay may be undetectable without the examination of a dentist. This is why having a cleaning and checkup every 6 months is so important for maintaining a healthy mouth. Flossing ensures that plaque on the teeth is removed before it can harden into tartar. Tartar causes inflammation and bleeding of the gums, also known as gingivitis. Gingivitis, a form of gum disease, is linked to other serious conditions, including heart disease, stroke, Alzheimer’s diabetes and more.

Flossing 101: Start with about 18” of floss. Wrap around middle finger and pinch middle leaving about 1-2” between fingers. Guide floss between teeth using a back-and-forth and an up-and-down motion around each tooth and under the gumline. Use a new section of floss with each tooth. Do not snap floss down hard on your gum. Teeth straightening is not just for kids. In fact, more and more adults are turning to orthodontic treatment and coming away with excellent results. For adults, aesthetics is often the main consideration. Adults considering braces today have more options to choose from. • Conventional Braces – Metal or ceramic brackets affixed to the surface of the teeth connected with archwires to move the teeth into the desired position. • Aligners (Invisalign®) – Custom made transparent tray aligners to help shift teeth. • Lingual Braces – Similar to conventional braces but worn on the back of the teeth. A great cosmetic alternative for those who want their teeth straightened, without the braces showing.

Your Local Resource:

Virginia Family Dentistry Services: General Dentistry | Orthodontics | Pediatric Dentistry | Sedation Dentistry | Dental Implants | Cosmetic Dentistry | Periodontics | Endodontics | Wisdom Teeth Removal Locations: Atlee | Brandermill – Woodlake | Chester | Huguenot – Bon Air | Huguenot Pediatric & Orthodontic Specialty Center | Iron Bridge – Courthouse | Mechanicsville | Midlothian | New Kent – Quinton | Patterson – Parham | Powhatan | Short Pump | Staples Mill Road | Tri-Cities | West End Orthodontic & Pediatric Specialty Center w www.vadentist.com

Bad Breath Is a Sign of Gum Disease.

Although bad breath (halitosis) indicates you might have gum disease, it’s also a sign of other potential health issues. The only way to know is by making an appointment with your dentist. If you are given a clean bill of health from your dental provider, consult your primary care physician. Bad breath could be a sign of acid reflux, a mouth, nose or throat condition like tonsil stones or sinus inflammation, a bowel obstruction or some other digestive issue.

Did you Know? In the US, nearly 60 million people suffer from chronic halitosis.

Local health. Anywhere you go.

OurHealth magazine is Richmond’s only resource entirely dedicated to delivering information about local healthcare services and healthy living topics. Pick up our print edition at more than 900 locations throughout the area or get the digital edition by visiting ourhealthrichmond.com.

ALTERNATIVE TO Open Heart Surgery DOES EXIST Yes, an

The thought of trying to pronounce the name of this procedure – Transcatheter Aortic Valve Replacement – is intimidating enough. But once you learn how this medical advancement can replace the need for open heart surgery, you will likely want to give it a second look.

words | DYLAN ROCHE

One of the lessons we’re taught at an early age is recognizing when something is too good to be true. This advice is especially important to heed when it comes to embracing a change to a process or technique that we traditionally know as very complex. Like open heart surgery, for example. From a lay person’s perspective, we know this procedure as one that’s reserved for treating highly complex heart-related issues. The very words to describe it – open heart surgery – refers to a technique that multiple generations have come to recognize as an essential way of treating heart disease. So, when we hear there’s an alternative way for treating heart conditions traditionally addressed through open heart surgery that eliminate the need for hours long surgery, deep incisions and months of often painful physical rehabilitation, naturally our red flags are going to raise. While the words Transcatheter Aortic Valve Replacement (TAVR) don’t evoke the feelings among the general public that perhaps announcing a cure to disease might, they do represent something that’s groundbreaking – something that is both good and true. In fact, TAVR, which is also known as Transcatheter Aortic Valve Implementation (TAVI), has been used instead of open-heart surgery in high risk patients for years. And as the procedure has advanced, it has become a more safe and acceptable option used by cardiologists – like those at James River Cardiology in Richmond – to treat patients in all risk categories. TAVR has become so common in recent years that a February 2020 article set to publish in the Journal of Cardiothoracic and Vascular Anesthesia describes how the procedure has gone from once being considered a last resort for people with a high risk for mortality and, over the past 15 years, has become a viable option for more and more people. It’s not just in medical circles that awareness of the procedure is growing, but also in general culture — Mick Jagger of the Rolling Stones underwent TAVR back in spring 2019.

WHAT IS TAVR, ALSO KNOWN AS TAVI? TAVR, or TAVI, is a minimally invasive surgical procedure used to repair a heart valve without the need for removing the old, damaged aortic valve. Instead, it wedges a replacement valve into the aortic valve’s place. Somewhat similar to a stent placed in an artery, the TAVR approach delivers a fully collapsible replacement valve to the valve site through a catheter. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow.

WHAT IS INVOLVED IN A TAVR PROCEDURE?

Usually valve replacement requires an openheart procedure with a “sternotomy”, in which the chest is surgically separated (opened) for the procedure. The TAVR or TAVI procedure can be done through very small openings that leave all the chest bones in place.

A TAVR procedure is not without risks, but it provides beneficial treatment options to people who may not have been candidates for them a few years ago while also providing the added bonus of a faster recovery in most cases. A patient’s experience with a TAVR procedure may be comparable to a balloon treatment or even an angiogram in terms of down time and recovery, and will likely require a shorter hospital stay (average of three-five days).

47www.OurHealthRichmond.com The TAVR procedure is performed using one of two different approaches, allowing the cardiologist or surgeon to choose which one provides the best and safest way to access the valve: A Entering through the femoral artery (large artery in the groin), called the transfemoral approach, which does not require a surgical incision in the chest, or B Using a minimally invasive surgical approach with a small incision in the chest and entering through a large artery in the chest or through the tip of the left ventricle (the apex), which is known as the transapical approach.

MITESH AMIN, MD FREDERICK SCHNATZ, DO MANUELA SCHUKSZ, MD JASPREET SINGH, MD

TAVR IS FDA APPROVED FOR PEOPLE WITH AORTIC STENOSIS The Food and Drug Administration has approved TAVR for people with aortic stenosis, a condition described by the American Heart Association as a narrowing of the aortic valve opening. This narrowing restricts blood flow from the heart to the aorta. The restricted blood flow causes chest pains, fainting, breathlessness, palpitations, and even fatigue or a limited ability to do physical activities. In the long term, it can lead to heart failure or even sudden cardiac death. “In the past, getting a valve replacement required a sternotomy, a procedure where the chest is opened up,” explains Jaspreet Singh, MD, an interventional cardiologist with James River Cardiology. “However, with TAVR, we can insert the replacement valve through either the femoral artery in the groin or through a small incision in the chest that leaves the chest bones in place.”

Dr. Singh details how he inserts a catheter to place a collapsible replacement valve at the valve site. “Once the new valve is expanded, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow,” he explains. Although TAVR can improve quality of life for patients who need a replacement aortic valve, those who are considering the procedure should consult medical and surgical heart specialists to decide what their best treatment option is. “A TAVR procedure is not without risks,” notes Dr. Singh. “But it provides beneficial treatment options to people who may not have been candidates for them a few years ago while also providing the added bonus of a faster recovery in most cases.” Risks associated with TAVR, according to Dr. Singh, are bleeding, blood vessel complications, problems with the replacement valve (such as the valve slipping out of place or leaking), stroke, heart rhythm abnormalities, kidney disease, heart attack, infection and even death. But compared with open heart surgery, TAVR has distinct advantages. In addition to a shorter recovery time, Dr. Singh lists such positives as lower risk of infection and less trauma to the chest and heart muscle tissues.

TAVR CAN OFFER IMPROVED QUALITY OF AND LONGER LIFE Overall, those who undergo TAVR can expect to not only realize an improved quality of life, but a longer one, as well. Of particular note, breathing becomes easier, which allows for the intake of more oxygen. And because the heart is functioning properly, it can more effectively transport oxygen-rich blood throughout the body, resulting in improved energy levels and the ability to perform tasks that were previously considered to tasking to take on. Dr. Singh notes that factors like age, health history, and the type and severity of the valve problem, as well as the overall health of the patient, can help a doctor determine whether TAVR or a more traditional heart procedure is the right way to go.

IF YOU ARE A CANDIDATE FOR TAVR, WHAT SHOULD YOU EXPECT? As with most surgeries, patients need to prepare for TAVR during the weeks and days before having the procedure. The following timetable provides a high-level overview of what patients can expect leading up to surgery. Keep in mind that not every patient’s journey is the same, with some requiring more preparation than others depending on their current health and other factors. Patients are encouraged to ask questions of their doctor to become more informed and to help reduce the stress and anxiety that can come from having surgery.

WEEKS AND DAYS BEFORE TAVR SURGERY • Undergo Recommended Testing: Patients can expect to have several tests performed to determine the best treatment plan and to evaluate if they are a candidate for TAVR. Some of these tests may include:

» Angiogram: a medical imaging test that uses x-rays and dyes to see how blood flows through the arteries and veins. » Echocardiogram: a test that uses sound wave technology, or ultrasound, to show threedimensional images of the heart to better assess its function. » Other Diagnostic Tests: other tests that may be performed to confirm the patient has aortic stenosis include cardiac catherization, chest x-ray and electrocardiogram (EKG).

• Determine How Much Exercise is Appropriate: Depending on how severe a patient’s aortic stenosis is will determine how much exercise is advisable. Patients should make note of any new symptoms that arise when exercising, such as shortness of breath, chest pain or feeling faint and report it to their doctor.

• Discuss Current Medications with the Doctor: Some medications may need to be stopped well in advance of the procedure, which will be determined by the doctor.

• Eat a Healthy Diet: The cardiologist will discuss which foods are recommended and which should be avoided and when leading up to the day of the procedure.

• Get a Dental Check-Up: Because oral bacteria can cause infection of the valve, it is important to visit the dentist prior to having the TAVR procedure to ensure patients are in good dental health.

• Make a Recovery Plan: While some patients are released from the hospital within a few days of the procedure, others may take longer to go home. The doctor will be able to tell when it’s safe for patients to return home. It’s important to work out details such as who will take the patient home as well as to make sure someone is able to stay with the patient to help out when needed.

THE DAY BEFORE AND DAY OF SURGERY

• Fasting Before Surgery: Patients will be advised to avoid drinking fluids and eating foods for a number of hours prior to having the procedure, which will be determined by when it is performed. • What Not to Wear: Patients should remove all jewelry and nail polish and take out contact lenses, dentures or other removable dental appliances.

• Hospital Stay: The TAVR procedure will be performed in the hospital. The type of anesthesia used will depend on the patient’s health. The patient may be fully asleep or may remain awake but given medication to help him or her relax and block pain. Patients will likely receive an intravenous medication to prevent blood clots. • Length of Surgery: The procedure itself lasts about one and a half hours, but patients will spend the night in the intensive care unit for monitoring afterward.

CAREGIVER’S TIP: Before your loved one leaves the hospital, make sure to ask his or her doctor specific questions about eating, sleeping, activity level, medications, and follow-up appointments.

AFTER SURGERY: THE ROAD TO RECOVERY After surgery is complete, the medical team will offer recommendations on healthy lifestyle habits to adopt to help maintain cardiovascular well-being. Such lifestyle changes will likely include following a heart-healthy diet and regular exercise. Smokers will be encouraged to quit, and those who are overweight or obese will be encouraged to lose weight. After being discharged from the hospital, patient will be given follow-up appointments so the doctor can evaluate his or her progress.

FOR MORE INFORMATION To learn more about the TAVR procedure offered by the cardiology specialists at James River Cardiology, visit www.jamesrivercardiology.com or call 804.520.1764. James River Cardiology has locations in Colonial Heights, Chesterfield, Emporia, Franklin, Richmond and South Hill.

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