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Dr. Joshua Wynne

HEALTH MATTERS: How to stay well to stave off the flu

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HEALTH MATTERS: How to stay well to stave off the flu
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Q. A lot of people seem to have come down with the flu. What can I do to try to stay well?

A. You are quite right that there has been a spike in influenza cases this year, caused mainly by the H1N1 virus that caused the worldwide 2009 epidemic.

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For most of us, influenza is an inconvenience to be sure, but one that passes. Certain numbers of us, however, are at particular risk of complications or even death, including the young, elderly, nursing home residents, those with chronic health conditions, and pregnant women.

As I mentioned in a recent column, some people who get pneumonia also have influenza, so this possibility needs to be considered. But what can each of us do to try to ward off catching the virus, or at least getting only a mild illness? Most important is to get a flu shot if not contraindicated. While not 100 percent effective, the current vaccine does help protect against the H1N1 strains of virus that are now making the rounds.

People at high risk who contract the flu despite receiving the vaccine should promptly contact their health care provider for possible treatment with an antiviral medication. And all of us with flu symptoms should try to reduce the spread of the virus to friends, co-workers and other contacts by staying at home at least for the first three to four days of the illness, covering our noses and mouths when coughing or sneezing, and washing our hands frequently.

Q. I heard about a new artificial heart valve that can be inserted without surgery. That sounds fantastic. How do the results compare with surgery?

A. The normal human heart has four valves. Their purpose is to open to let blood in and then close to prevent the blood from leaking out. When they malfunction, they either can leak or not open sufficiently and thus impede the flow of blood. Narrowing of one of the valves— called aortic stenosis — is especially common in the elderly, and once the narrowing is severe enough to cause symptoms, the valve usually has to be surgically replaced with an artificial valve.

Although a reasonably safe procedure, valve replacement still requires open heart surgery. It is uncommon to find that narrowed or stenotic valves can be repaired surgically; they usually require replacement with an artificial valve. Over the past several years, there has been increasing enthusiasm for the use of an expandable valve that can be inserted through a vessel in the leg.

Called TAVR for transcatheter aortic valve replacement, the procedure isn’t as extensive as is required with cardiac surgery. Patients deemed too ill for surgery often have tolerated TAVR and noted clinical improvement after the procedure. Studies have shown that in the majority of patients TAVR results in improved health and mobility as well as the ability to accomplish daily living activities. About 20 to 30 percent of patients treated with TAVR have noted no improvement, but most feel better and are able to do more after the procedure.

Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training. Submit a question to Health Matters at healthmatters@med.und.edu or Health Matters, 501 North Columbia Road, Stop 9037, Grand Forks, ND 58202-9037. Remember, no personal details, please.

The content of this column is for informational purposes only and does not substitute for professional medical advice or care. 

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