Medical replacements for heart, lungs, liver, pancreas

 Medical replacements for heart, lungs, liver, pancreas, and other important organs become routinely feasible. For your convenience, the diseases are arranged in alphabetic sequence and thus the order in which they are presented has nothing to do with I heir frequency or seriousness. In this part of our book we tell you about a number of diseases-some potential killers, others disablers, some just nuisances. You may be puzzled by our approach and by use of some words new to you in discussions about your health. For example, you will find mentioned scenario, also primary, secondary, and even tertiary prevention of disease.

We use the word scenario because it conveys the idea of the dynamic picture the physician can foresee for the course of a disease after he completes his questioning to understand the patient's symptoms, his physical examination, and his study of x-ray and laboratory reports. Sometimes, there can be no valid scenario until the physician sees the patient in several return visits. For example, two patients may have high blood pressure. 

Mr. One has a pressure reading of 164 over 98; so does Mr. Two. But in subsequent measurements of blood pressure, Mr. One's has settled down to 150 over 86 whereas Mr. Two's has gone to 190 over 110. Mr. One has no signs and symptoms, whereas Mr. Two shows a small hemorrhage in his retina and slight enlargement of the heart.

The physician will see very different scenarios or possible future courses for these two patients, and his preventive treatments will be much more active for Mr. Two than for Mr. One. By primary prevention, we mean measures that can be used to prevent a disease completely. A good example would be the use of the Sabin vaccine to keep polio from developing. By secondary prevention, we mean the use of measures to keep a disease that is already present from progressing.

 For example, for a patient with a definite ulcer of the duodenum, the physician can foresee and wants to avoid a scenario in which hemorrhage, perforation, or scarring and obstruction may take place; so he institutes diet and medical therapy as part of a secondary prevention program. We may be the first to employ the word tertiary for preventive medicine.

 Our concept is that when every type of secondary prevention may fail, there is still a chance of providing new health for the patient in a special way-that is, by giving him a new organ to replace the destroyed organ. For that, however, the patient's general health must not become so undermined that the new organ would be of little use. 

For example, suppose every effort has failed to stop the ravages of nephritis (Bright's disease); the kidneys have failed; the patient is in uremic poisoning. If the physician institutes tertiary preventive measures at this time to avoid damage to the heart and brain and eyes, then at a suitable time he can save the patient with a kidney transplant. In the future, this type of tertiary prevention may become very common as transplants or mechanical

How to Guard your heart?

You can guard your heart, too, by avoiding obesity and, if now over- weight, by sensible reducing. If you are overweight, your heart has to work harder routinely, day in and day out, minute after minute. Take your heart seriously-but don't worry about it. If this sounds contradictory, it is really not. Fear can injure the heart; and too many people are more afraid ~f heart trouble than of anything else. Because of their fear and anxiety, they may actually be contributing to the development of heart trouble. Not worrying about your heart simply means this: Have your heart examined at regular intervals by your physician.

If he says your heart is sound, get your mind off it and on to other advice he may have for you on proper nutrition and exercise. We should like to emphasize very strongly here that only a physician can tell whether or not there is really anything wrong with the heart. Pounding of the heart (palpitation) can be alarming, but it is more likely to be caused by nervousness than by a serious organic condition. When your heart suddenly seems to "flop over" in your chest, you may be frightened, but needlessly, for the phenomenon often is due to nothing more than the fact that you have been smoking too many cigarettes or drinking too much coffee. Between medical checkups, you can help yourself and your physician keep your heart in good shape by avoidance of excessive smoking.

 If you must smoke (see the chapter on that subject), cut down as much as possible or, preferably, switch to a pipe or mild cigar. Good diet, with regular spacing of relatively small meals, helps the heart to work at its best, and, as noted in the chapter on nutrition, there is evidence that sound diet may well reduce the likelihood of clogging of the arteries feeding the heart. Good diet also can reduce the likelihood of arterial damage elsewhere in the body, helping to maintain the integrity of the whole circulatory system. Keep your work and social life under reasonable control so that you are not chronically fatigued. If you feel tense and "driven" in our competitive world, talk to your physician. He may have advice that will be helpful; he may suggest little patterns of physical activity to be used at particularly tense moments to reduce the tension; if necessary, he may prescribe medication that may help tide you over a tense period; he may, if advisable, have you talk with a psychotherapist. You may be able, by any or all of these measures, to reduce nervous tension to the point where you can avoid trouble with your heart in later life.

Physical fitness, excercises, health issues- health education-calories

Your exercise program should be balanced, just as diet should be balanced. You need one or more activities to exercise the heart and lungs and to build endurance. Brisk walking, jogging, and swimming relatively long distances are good for this. Other parts of the program should be aimed at improving strength, agility, flexibility, and muscle tone. Suggestions for a home exercise program to achieve these objectives can be found in such publications as these: Adult Physical Fitness. 

President's Council on Physical Fitness

Washing- ton, D.C., Supt, of Documents, U.S. Government Printing Office

Physical Fitness

Department of Health Education, American Medical Association, 535 N. Dearborn, Chicago, Ill. Seven Paths to Fitness.

Department of Health Education, American Medical Association, 535 N. Dearborn, Chicago, Ill Most people understand how. Specific exercises for various muscles and parts of the body can develop strength. These are certainly worthwhile. For some reason, one particular area of relative neglect is the abdominal muscle area. 

Another is the muscles of the back. Both are important in terms of good posture; both are important, too, as aids in avoiding sagging waistlines and backaches. We give exercises for these in this chapter along with another exercise for the muscles of the buttocks; and the four exercises, in addition to their general value, are helpful in restoring muscle tone in these areas in people who are slimming down.

But we think it important to go on at once to emphasize here the activities that exercise the heart and lungs and build endurance. 

When you are at rest, all the muscles in your body use only about one thirtieth of the oxygen they can use during maximum effort. The more oxygen they use, the more the heart will respond, pumping harder to get more oxygen- Physical Activity I 87 carrying blood into circulation. Over a period of time, as a result of this, heart pumping efficiency will increase. 

The heart will become able to pump much more blood with each stroke. At the same time, lung capacity, much of it never used in sedentary living, will increase to absorb and feed more oxygen into the bloodstream.