Dear Doc: I have arthritis; my husband has arthritis and Parkinsonism. We both hurt. I can get around the house easier than he can, but the pain and our joint stiffness really keep us from enjoying our golden years. Any thoughts? – S.S., Spokane
Dear S.S.: Tai chi may be the right thing for you. A study published a few years ago evaluated more than 25 studies to see how tai chi improved life – looking at how well people who did tai chi functioned, how good they felt and how much they did in life.
There are valid ways to measure this. Physical and occupational therapists do this all the time when they counsel people. Tai chi seemed to help this significantly.
This is especially true of Parkinsonism. Victims of this condition suffer from impaired balance and difficulty starting and stopping movement, which leads to falls – always very dangerous for a senior.
So my recommendation in this time of COVID-19 is to look into one of the virtual classes from the Tai Chi Foundation – taichifoundation.org. You can Zoom in, learn tai chi and do tai chi with others.
It’s a great way to get things moving in your house, strengthen muscles and do something together that will be fun. Enjoy.
Dear Doc: Why does the medical profession use dementia, a Middle Ages term, to describe short-term memory loss? It would be much less pejorative if expressed differently, as these folks are not demented but merely suffering from a memory loss.
I realize short-term memory loss could cause behavior that might seem demented, but it is a pretty broad brush. Thank you. – Bob M.
Dear Bob: You’re certainly right – dementia is an archaic word. Short-term memory loss isn’t really the same as dementia because many forms of dementia are long-term – stroke, atherosclerosis, Parkinsonism, alcoholism, frontal head injury, football injuries, boxing, etc.
Using the words “cognitive impairment” sounds much better to me.
Dear Doc: I was diagnosed with A-fib about a year ago. I am taking daily meds to treat it and have not had an episode in a year.
I am curious about ablation treatment and how safe the procedure is. It seems a bit risky. What’s your take on it, and how effective is it?
Gentle Reader: Atrial fibrillation is a quivering of the heart, an irregular heart rhythm that starts in the atria. Instead of one impulse coming from the sinus node, there are many different impulses rapidly firing at once, causing a fast, chaotic rhythm from the atria.
The pulses are so fast and crazy that the atria cannot contract effectively to squeeze blood into the ventricles. The result is a drop in cardiac output, shortness of breath and a reduction in your ability to exercise.
More importantly, it can lead to “sludge” in the atria, a small blood clot that can form and travel through the circulatory system, possibly stopping in the brain, causing a stroke. Bad news.
First-line treatments are medications that move to reduce the risk of a blood clot by controlling the rhythm. Blood thinners such as warfarin and Xeralto do this quite effectively – not reducing A-fib to zero but dropping it quite a bit.
The rhythm also can be controlled by “shocking” the heart back into a normal rhythm. But here’s the problem: Sometimes when you shock the heart into a normal rhythm, it goes back into A-fib anyway. Same for some of the medications.
That’s where electrical ablation comes in. This is where an electrical physiological cardiologist goes into the heart through the blood vessels, similar to when they do a cardiac catheterization, and zap the parts of the heart that send off those extra beats.
You’re right to be concerned about it – it’s something not to be taken lightly. But for a good number of patients, this can be a godsend. It can return and keep the heart in a normal rhythm for a lifetime.
It’s worth considering, especially for the younger atrial fibrillation patient who is active and wants to stay that way.
My spin: If you have A-fib, it’s important to learn about it, including how it’s treated, and make a decision along with your doctor on what’s best for you. An educated patient gets the best care. Stay well.
Dr. Zorba Paster is a family physician and host of the public radio program “Zorba Paster on Your Health.” He can be reached at firstname.lastname@example.org.
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