Ryouhei Nejima writes:
I think the most important issue for
patient T now is to realize his situation. He thinks his health condition
is not so bad, but in fact, his condition is much more serious than he
thinks. For example, pain in the neck may be caused by atherosclerosis
at the carotid arteries. His smoking habit is one of the main factors of
atherosclerosis. (Of course, cholesterol and other things may be factors,
as well.) With respect to smoking, a study by the American Heart Association
says that there are differences in internal carotid wall thicknesses between
current smokers and non smokers. In addition, T's pain in the upper chest
area may be a risk factor of his respiratory system or further heart trouble.
Next, hypertension is one of the causes of heart diseases. T was once a long distance runner. He should know that long distance runners have much dilating capacity of their coronary arteries, and the more exercise they can do, the greater the blood flow to their heart muscles. It is unfortunate that he is no longer a long distance runner, but he can correct this by taking up exercise now. If he doesn't, it will be no wonder his heart condition could become worse in the future.
So I hope that patient T thinks about these factors seriously and changes his life style, especially his thought about health.
I think there are two additional factors regarding T's heart condition. First, overworking and busyness. His hard working may elevate stress and pressure. These are not only risk factors of all diseases but may be causes of his heavy smoking. And because he is busy, he has no room to think about his health seriously.
Second, his family history may be another factor of his heart condition, because his mother died after heart surgery for hardening of the arteries. And now he has a symptom of early atherosclerosis. This relationship is enough reason for T to be careful about his heart condition.
In the short term, I will give him medicine that will calm his pain in the neck and upper chest area, but at the same time I will suggest that he must think about his health more seriously. This is because medicine calms down pain, but it does not cure the root problem. I think the root problem is T's lack of thinking about his health and this lack is the most important problem which should be changed.
I advise him to stop smoking and do exercise, because as I said before a smoking habit is the most harmful thing for health. If he can not stop smoking right now, it is OK, but he really must reduce cigarettes. And he needs to do exercise, only twenty or thirty minutes exercise will help his health and reduce his stress.
In the long term, I think the most important advice for him is that he must change his life style and make free time for relaxation. What I want him to do is think about his health by himself (of course I hope he considers my advice). If he realizes his health condition is serious by himself, this may be the most powerful thing that will lead him to make important changes in his daily habits which will help him achieve a healthy life.
| Click the BACK button to return to the student index.|