Q: My dad has been taking an acid reflux medication for years, and he recently had a heart attack. I heard those meds can raise that risk. Do you think it caused his? - Debbie D., Arlington, Texas
A: Well, taking acid reflux drugs called "proton pump inhibitors" could have contributed, but other factors such as age, diet, physical activity, stress, sleep habits and tobacco use all work together to create a person's risk for a heart attack, or myocardial infarction. For instance, if your dad ate red meat and smoked, taking something like omeprazole (Prilosec) to control gastroesophageal reflux disease wouldn't top his list of cardiovascular risks.
But if Dad is healthy and doesn't smoke PLUS regularly takes omeprazole for GERD, then, according to a recent study, taking that PPI is associated with a 16 percent increase in his risk for MI. Folks with previous heart problems double their risk. (Unfortunately, the data could be flawed if the reporting were skewed toward people who were sicker to begin with. The study didn't provide that info.)
PPIs may decrease levels of nitric oxide in the blood, negatively affecting the health of the cardiovascular system. The good news is that 16 percent increased cardio risk probably drops to normal after the drugs are stopped. The same study found that H2 blockers - such cimetidine (Tagamet) and famotidine (Pepcid) - carried no increased cardiovascular risk.
But before you stop taking a PPI, you should check with your doc. You also need to make a plan to improve your lifestyle choices (diet, physical activity, etc.) to lessen or eliminate your GERD symptoms and reduce your heart attack risk.
Say "no" to trans fats and most saturated fats, all added sugars and syrups, and any grain that isn't 100 percent whole, plus eat five to nine servings of fruits and veggies daily. See "This Is Your Do-Over" for tips. Hope your dad gets back to 100 percent soon.
Q: My 8-year-old son broke a finger, and we had to wait five hours in the emergency room before we saw a doctor. There must be some way to make this a less traumatic experience! What should we do if there's a next time? - Jennifer H., Evanston, Illinois
A: Emergency-department visits can be tough to handle. A lot of folks still use the ER as a primary care environment, because their insurance coverage is indecipherable or inadequate, or because they don't have a primary physician (some areas have a severe shortage). That increases wait times. Also, if you're there for a "minor" emergency, you may be repeatedly moved to the back of the line as more urgent cases, like heart attacks, come into the facility. So, what's the solution?
First, learn what defines URGENT care versus EMERGENGY care. An urgent care clinic is basically an alternative to seeing a primary care physician for a twisted ankle, a minor cut or minor fracture, a mild fever or illness. At an urgent care clinic, your son may have received the medical attention he needed much more quickly.
ERs are the right place if you have a severe burn; serious injury/head trauma/break/cut; an acute attack or seizure; trouble breathing; or any symptom that might indicate a heart attack. Look online and ask your doctor about the plusses and minuses of emergency departments in your area.
Other ways to improve your ER experience:
-Have someone present as a patient advocate for whomever is getting emergency care.
-Many emergency departments now post their current wait times on the Internet for each type of emergency - a child with a broken bone or a senior with chest pain, for example. Use these to select the ER with the shortest wait time when a semi-urgent emergency arises.
-Keep asking about insurance coverage; they can stick you with the bill for out-of-network doctors.
-Ask for names, areas of expertise and levels of training of everyone providing you with care.
-Get your own doctor involved ASAP.
Distributed by King Features Syndicate, Inc.
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