STONE: Don't let winter take your breath away - Odessa American

Posted: 19 Jan 2020 12:00 AM PST

Having had a mild winter thus far, in fact one of the warmest recorded in the Permian Basin, the past week finally brought a steady flow of cooler weather.

While the change may be welcomed by many, colder temperatures can be very difficult for those suffering from chronic respiratory diseases (CRD), such as emphysema, occupational lung diseases, pulmonary hypertension, and asthma.

Fall and winter are among the most challenging times of year in caring for our respiratory health, particularly those already managing a chronic illness.

According to the American Thoracic Society, flare up of CRD symptoms occur twice as often in the winter than during the summer months.

A major contributing factor to this is cold, dry air. Our lungs prefer a very warm and moist environment to function at their best and when anything other than this exists; our bodies react to compensate for the change in conditions. As cold air enters the lungs, both blood vessels and airways constrict reducing airflow. Since those with COPD and asthma can already have damaged airways and reduced lung function, further restriction caused by cold air puts these individuals at even greater risk.

To help relieve the worsening effects of winter weather, warmth and moisture are two important items to maintain. When indoors, use humidifiers to add moisture to the air but do make sure the indoor air you breathe is free of germs by following the manufacturers' cleaning and maintenance requirements.

A moistened airway and lungs work more efficiently by helping trap harmful particles and letting clean air pass through. Another key to maintaining clean air is changing the filters in your home. Depending on the type of filter used this can be as frequent as every month. As mentioned earlier, cold air causing constriction of airways which can further aggravate into a full blown coughing spell, forcing some to reach for their rescue inhaler and fighting to catch their breath.

If you must go outdoors on cold days, it's best to breathe through your nose or even use a scarf to cover your face to warm the air before it gets to the lungs.

This time of year is also flu and cold season, leaving everyone more susceptible to illness. Colder weather and shorter daylight hours can have us spending more time indoors, thus increasing the risk of passing bacteria and viruses (like the cold and flu) from one person to the next. Other upper-respiratory infections, particularly pneumonia can spread just as easily, sidelining even the healthiest of people.

Respiratory infections can have a devastating, even deadly, effect on those who already have trouble breathing normally.

Proper hand washing and avoiding people with colds/flu can help keep you and others from getting sick, but getting vaccinated is just as essential. Bottom line, if you haven't received your flu vaccine yet, get it as soon as possible. On top of that, if you or a loved one is among the higher risk populations with chronic respiratory illness, getting a pneumonia vaccine is recommended as well.

Even with all the precautions and careful planning to help breathe a bit easier, we can still find ourselves having trouble and asking whether or not we should see a doctor. The following are certain times when you need to seek help and see your doctor:

>> If your cough produces phlegm that is blood tinged or you notice a change in color.

>> You feel an increase or severe breathlessness.

>> You have difficulty sleeping at night.

>> You become more fatigued throughout the day with a pronounced lack of energy.

>> Begin to have frequent headaches, particularly in the morning.

>> You have fever.

>> You have an unexpected weight gain or weight loss.

>> You begin to have swelling around your ankles and legs.

With an early glimpse of colder weather and more of it likely to be in the forecast, it's never too late to plan ahead and breathe a little easier this winter.

Expert Alert: Robotic repair offers benefits for many patients with leaky mitral valve - Newswise

Posted: 16 Jan 2020 12:00 AM PST

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Newswise — ROCHESTER, Minn. ― During each human heartbeat, four valves in the heart open and close once, moving blood through the heart's chambers. But in some people, the flaps of the mitral valve between the heart's left atrium and left ventricle do not work like they should. The opening may become narrow, or more commonly, the flaps may prolapse and not line up properly.

In cases of mitral valve prolapse, the gap allows blood to flow backward into the heart, and that causes problems.

Richard Daly, M.D., a Mayo Clinic cardiovascular surgeon, explains that when mitral valve leakage is severe, oxygen-rich blood cannot move efficiently through the heart to the rest of the body, causing shortness of breath and fatigue. Advanced mitral valve disease progresses quickly and can lead to heart failure. People with less mitral backflow may not feel symptoms, but they are still at risk of heart failure and other complications, such as stroke, blood clots, atrial fibrillation and pulmonary hypertension.

If mitral disease is mild, doctors often suggest monitoring with regular evaluations and sometimes medication. However, for people with severe mitral valve regurgitation, including those without symptoms, surgery may be the best option.

Research has found that repairing the mitral valve earlier, before the disease progresses, can correct the valve's structure and potentially protect the heart's function to avoid needing a more complex valve replacement later or developing heart failure.

Dr. Daly says open-heart surgery and minimally invasive robotic surgery use the same technique to correct mitral valve leakage, but they access the heart in different ways. With the robotic procedure, surgeons do not cut through the breastbone or open the chest cavity. Instead, they make several incisions, each about an inch long. One surgeon works from a remote console and views the heart through a high-definition 3D video monitor to conduct the surgery. Each tiny movement of the surgeon's hands at the console controls is precisely replicated by small robotic instruments moving inside the patient's chest. At the bedside, another surgeon works with the first surgeon and performs some aspects of the surgery to make sure the procedure is performed safely and efficiently.

Mayo Clinic physicians have repaired more than 900 mitral valves using the robotic technique since 2008. More than half of all mitral valve repairs at Mayo are now performed robotically. Besides using smaller incisions, the minimally invasive procedure has a shorter hospital stay ― typically three days, compared to five or six days for an open-heart procedure. Patients usually recover stamina and energy quicker with robotic surgery, and are back to work and normal activities a few weeks sooner.

"I was skeptical at first because I practiced open-heart mitral valve repair for years, and robotic surgery requires learning a new technique," Dr. Daly says. "But now I feel that, for the right patients, robotic repair is clearly superior, with better visibility and equal movement of hands. I think this is quite an advance."

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