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BIOMARKERS

Molecular Biopsy of Human Tumors

- a resource for Precision Medicine *

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  • 21. My doctor says I have sick sinus syndrome. I was recently hospitalized because of runs of rapid heart rates. When they gave medications to make my heart slow down, it went too slowly. Finally, they put a pacemaker in me and now I take pills every day. Is all this necessary?
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  • 22. Ask the doctor. A few months ago I gradually lost about 50% of the vision in my right eye. My ophthalmologist says this was caused by a small stroke. Am I now at higher risk for future strokes or heart attacks than someone who has not had a stroke?
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  • 23. Ask the doctor. My blood pressure is 180/80 mm Hg. My doctor tells me this a common problem for people in their 70s, like me. The problem is that whenever I try medicines at doses high enough to get my top number under 140 mm Hg (which I understand to be the goal), I get exhausted or have other side effects. Do I really need to worry about my blood pressure when the bottom number is so good?
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  • 24. Ask the doctor. My doctor and I are confused by my cholesterol levels. My good cholesterol is extraordinarily high, at 94, but my bad cholesterol is on the high side, too, at 154. To resolve this good news/bad news story, my doctor ordered a C-reactive protein test which, of course, came back right in the middle of the normal range. I don't smoke or have other factors for heart disease. Would you advise me at start a statin or some other drug?
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  • 25. On call. I am a 72-year-old man with gout. I was getting three or four painful attacks every year until my doctor put me on Zyloprim. The medicine has been great--I haven't had an attack in more than two years. But I developed a bad rash and had to give up my Zyloprim. What can I do now?
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  • 26. Ask the doctor. I am generally healthy, but I had a heart attack last year. At my age, 78 years old, I find it hard to take it seriously when my doctor and my children tell me that I should be lowering my cholesterol and exercising. It seems to me that the idea of trying to prevent "premature" death is silly in someone my age. It's not like I feel ready to die, but it's hard for me to believe that prevention works in someone who has already gone beyond his "three score ten" years.
    Lee TH
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  • 27. Ask the doctor. I take medicine to lower my cholesterol. My doctor says that I've reached my target (my LDL is just under 100 mg/dL), but I wonder whether I should try to get my cholesterol even lower. I haven't heard that you'll get hurt by taking too much of these drugs, so why shouldn't I increase my dose?
    Lee TH
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  • 28. On call. I am a 71-year-old man with diabetes and high blood pressure. I take Glucophage for my diabetes and Zestril for my blood pressure, and my doctor says both problems are under good control, but I've developed a very annoying problem. Every time I eat, I develop terrible sweating on my face and neck. It only lasts 10-15 minutes, but my shirt collar gets soaked and I'm too embarrassed to go out to dinner. Am I allergic to something in food? Am I getting hot flashes as my wife did when she had the change of life?
    Simon HB
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  • 29. Ask the doctor. When I was diagnosed with atrial fibrillation four years ago, my doctor put me on a calcium-channel blocker. A year or so later, after I had angioplasty and got a stent, my doctor switched me to twice-a-day sotalol. Now I feel tired all the time and have gained weight, even though I feel like I am eating less. Can this be from the sotalol?
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  • 30. I'm 56 years old and have total cholesterol of 217 milligrams per deciliter, LDL of 131 mg/dl, HDL of 67 mg/dl, and a total-to-HDL ratio of 3.24. My doctor says that ratio is good for a woman my age, so why does she want me to lower my LDL?
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  • 31. Ask the doctor. I am 74 years old, and recently had a chest x-ray. My doctor told me it was fine. But I saw the report, and it said that I had calcification of the arch of my aorta. Should I be worried?
    Lee TH
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  • 32. By the way, doctor. Although I've always been prone to cold hands and feet, this winter my hands began to turn blue and really ache in the cold. My doctor suspects Raynaud's phenomenon. Is this a common condition? Should I do anything more for this than wear warm gloves?
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  • 33. Ask the doctor: I started taking estrogen four years ago because I have a family history of heart disease and I have high cholesterol. Now I read that estrogen may even increase my risk for heart problems. I assume I should stop taking it, right?
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  • 34. Countertransference revisited.
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  • 35. Ask the doctor. I had a heart attack last year and have resumed most of my activities, including some tennis, without problems. However, both my wife and I are reluctant to have sexual intercourse. To be frank, she is concerned that it would be dangerous for me. Is she right? If not, what can I do to put her mind at ease?
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  • 36. Ask the Doctor. My older brother recently had a heart attack and bypass surgery at the age of 53! I am physically active and don t have any risk factors for heart disease. But neither did my brother, who also had normal cholesterol and blood pressure numbers. I ve been wondering if I should be taking a cholesterol-lowering medication, even though my cholesterol is normal.
    Lee TH
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  • 37. Ask the Doctor: I am a woman, age 48, in generally good health, although I've gained about 10 pounds over the past two years. My LDL cholesterol us 142 mg/dL and my HDL cholesterol is 58 mg/dL. I looked at the news reports on the new cholesterol guidelines and was extremely unhappy to see that my LDL is "borderline high". My doctor says I don't need drug therapy. What do you think?
    Lee TH
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  • 38. Ask the doctor. I am 72 and have had diabetes for about 10 years. My doctor wants me to start taking insulin because my sugar levels are usually high get (about 300). I don't want to, though, because I am sure I will be stuck taking it forever. Isn't it true that the kind of diabetes you get when you are older is mild?
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  • 39. Ask the doctor. A few years ago, I had a heart attack. My doctor treated me with angioplasty, and I haven't had any symptoms of heart disease since. I do carry a bottle nitroglycerin with me, but haven't taken any in years. I renew my prescription every six months because I know the pills go bad. My problem is that I also need Viagra to have sexual intercourse. Whenever I refill my prescription for Viagra, the pharmacist gives me a hard time because he knows I also have a prescription for nitroglycerin. Just how dangerous is Viagra?
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  • 40. My daughter-in-law has been diagnosed with Raynaud's. Can you tell me more about this condition?
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