less invasive and has a shorter recovery period than bypass, which is open-heart surgery.
The problem: A groundbreaking study of more than 2,000 heart patients indicated that a completely nonsurgical method — heart medication — was just as beneficial as angioplasty and stents in keeping arteries open in many patients.
The bottom line: Angioplasty did not appear to prevent heart attacks or save lives among nonemergency heart subjects in the study.
Do This Instead: Listen to your doctor. “If you have chest pain and are stable, you can take medicines that do the job of angioplasty,” says William Boden, M.D., of the University of Buffalo School of Medicine, Buffalo, New York, and an author of the study. Medicines used in the study included aspirin, and blood pressure and cholesterol drugs — and they were taken along with exercise and diet changes.
“If those don’t work, then you can have angioplasty,” Boden says. “Now we can unequivocally say that.”
Of course, what’s right for you depends on the severity of your risks (blood pressure, cholesterol, triglycerides) along with any heart-related pain. The responsibility is also on the patient to treat a doc’s lifestyle recommendations — diet and exercise guidelines — just as seriously as if they were prescription medicines.
Nearly 60 million Americans experience heartburn at least once a month; 16 million deal with it daily. So it’s no wonder that after suffering nasty symptoms (intense stomach-acid backup or near-instant burning in the throat and chest after just a few bites), patients badly want to believe surgery can provide a quick fix. And, for some, it does.
A procedure called Nissen fundoplication can help control acid reflux and its painful symptoms by restoring the open-and-close valve function of the esophagus. But Jose Remes-Troche, M.D., of the Institute of Science, Medicine, and Nutrition in Mexico, reported in The American Journal of Surgery that symptoms don’t always go away after the popular procedure, which involves wrapping a part of the stomach around the weak part of the esophagus.
“That may be because surgery doesn’t directly affect healing capacity or dietary or lifestyle choices, which in turn can lead to recurrence in a hurry,” he says.
The surgery can come undone, and side effects may include bloating and trouble swallowing. Remes-Troche believes it’s best for very serious cases of long-standing gastroesophageal reflux disease, or GERD, or for those at risk of Barrett’s esophagus, a disease of the upper gastrointestinal tract that follows years of heartburn affliction and can be a precursor to esophageal cancer.
Do This Instead: Make lifestyle changes. A combination of diet, exercise, and acid-reducing medication may help sufferers beat the burn without going under the knife. But it’s a treatment that requires perseverance.
“It took me four years of appointments, diets, drugs, sleeping on slant beds — and even yoga — to keep my heartburn manageable,” says Debbie Bunten, 44, a Silicon Valley business-development manager for a software firm, who was eager to avoid surgery. “But I did it, and am glad I did.”
Since the 1980s, operations for lower-back pain and sciatica have increased roughly 50 percent, from approximately 200,000 to more than 300,000 surgeries annually in the United States. That rise is largely due to minimally invasive advances that include endoscopic keyhole tools used in tandem with magnified video output.
To its credit, surgery (endoscopic or the traditional lumbar-disc repair) does relieve lower-back pain in 85 to 90 percent of cases, docs say. “Yet the relief is sometimes temporary,” says Christopher Centeno, M.D., director of the brand new Centeno-Schultz Pain Clinic near Denver, Colorado. And that adds up to tens of thousands of frustrated patients who find the promise of surgery was overwrought or short-lived.
Do This Instead: Try painkillers and exercise. Despite the relentless nature of lower-back pain, the most common cause is a relatively minor problem — muscle strain — not disc irritation, disc rupture, or even a bone problem, experts say. Despite its severity, this type of spine pain most often subsides within a month or two. That’s why surgery, or any other invasive test or treatment beyond light exercise or painkillers, is rarely justified within the first month of a complaint. Even pain caused by a bulging or herniated disc “resolves on its own within a year in some 60 percent of cases,” orthopedists claim.
“Seventy to eighty percent of the time we can get to a concrete diagnosis, find a way to manage pain, and get patients off the drugs without surgery,” Centeno says. “Or, more appropriately, never start the drugs.”
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