
Ask Dr. Gott 10/4
'Artery hardening' uncommon in younger men
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    DEAR DR. GOTT: My 39-year-old son was recently diagnosed with "hardening of the arteries." I have heard of this condition for many years but have never known exactly what it is, why it happens and what the prognosis is. The doctor didn't go into a lot of detail but did say it was very unusual for a person his age to have hardening of the arteries. There is a narrowing of the lower part of the aorta, and sometime in the next few weeks he will have a stent put in. He is a smoker, and the doctor just told him he needed to quit smoking and keep his cholesterol under control. Just four years ago, my 39-year-old daughter died from a congenital heart defect. Could the problem my son is having be caused by a congenital defect? We have a history of children being born with birth defects in our family.
    DEAR READER: Hardening of the arteries is an archaic expression that refers to age-related calcium deposits in arterial linings, leading to heart disease, peripheral vascular disease and other serious consequences.
    Your son is extremely young to have such a metabolic problem. Granted, there is a strong family history of cardiac disease, but this is no reason to withhold aggressive therapy. To begin with, your son must stop smoking, take cholesterol-lowering medication, exercise regularly and lose weight if he is stout. Next, your son needs to be under the care of a cardiologist, who can prescribe the medicine and testing he needs.
    To give you related information, I am sending you a copy of my Health Report "Coronary Artery Disease."

    DEAR DR. GOTT: I am a 55-year-old, very active, healthy female with an inguinal hernia. Is my only choice a surgical repair? If so, when should it be repaired? Also, should it be repaired with or without mesh? If I ignore it, will it go away?
    DEAR READER: An inguinal hernia is a weakness or defect in the muscles of the lower abdomen. It is uncommon in women. These hernias never go away. They enlarge over time and should be corrected surgically. There is no hard-and-fast rule about when. If the defect is small, surgery can be put off. In contrast, large hernias often need prompt surgery (with mesh to provide additional strength).
    The main concern with inguinal hernias is the possibility of incarceration, when a loop of bowel slips through the opening, twists and kinks, leading to considerable pain and a surgical emergency.
    I recommend that you discuss your options with a surgeon.
    To give you related information, I am sending you a copy of my Health Report "An Informed Approach to Surgery."
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