Katsuya Nagaoka writes:
The most important issue for T is
that T thinks his condition is not serious. This is a hindrance to improve
his chances for recovering his full health, because physicians, basically,
help patient's natural ability of healing, and when patients are not aware
of their bad condition, their recovering would be behind.
Besides lack of exercise and heavy smoking, he has some risk factors of coronary heart disease, for example, hypertension, being a type A personality, and, his mother's death after heart by-pass surgery complicated by hardening of the arteries. Furthermore, a survey shows that long-distance runners have a greater capacity to dilate their coronary arteries and thus markedly increase blood flow to their heart muscle. He was a marathon racer, and so there is the likelihood of a dilating capacity of his coronary arteries. And another survey says that men are generally more likely to have high rates of heart disease then women.
The patient frequently experiences feelings of weakness and mild pain in the neck and upper chest areas. First, I should prescribe medicines for relieving pain, because the doctor's duty is lessening patient's suffering. In addition to the pain, hypertension will be lowered by continuous doses of suitable medicines. However, at the same time I should pay attention to encouraging him to go to the hospital to relieve pain. I must explain that his condition is very serious, and persuade him to continue medical care. Although he tells me that both his parents lived well into their sixties and that he is "just too young," a study appears that systolic blood pressure in men peaks at middle age. His hypertension may increase, and so I never would say that his age, 39, is "too young."
Speaking in the long term, first, he must stop smoking. Smoking accelerates thickening of the walls of the arteries. That is to say, smokers are increasing their risk of stroke and heart attack. Second, he should take exercise. A moderate amount of exercise is necessary for keeping normal circulation system and getting rid of his stress. Continuous stress can cause hardening arteries. Thinking that he has type A behavior and he works in hard surroundings, I conjecture that he is under considerable pressure. I recommend to him that he exercises for enjoyment and relaxation. And describing the future, clinical analyses indicate early atherosclerosis. His consciousness of his condition can be the best effective care. I think it is my duty that I get a lot of data about heart diseases for having him realize his serious condition.
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