Size of Aneurysm Determines Whether Surgery Is Necessary
DEAR DR. ROACH: My husband will be 83 in September and was recently diagnosed with an ascending thoracic aortic aneurysm measuring 4.8 cm. Five centimeters is when the doctors decide to do something. After hearing about the survival rate based on your recent column, along with your comment that “most people do not survive a rupture of the aorta,” I’m scared. Why do they wait until 5.0 or rupture? His doctor says to test again in six months and to just keep his blood pressure down. Shouldn’t he be careful about strenuous activities until repair? We can only wait at this point, it seems. — C.G.
ANSWER: The aorta, the largest blood vessel in the body, comes directly off the heart, ascends to form an arch, and then descends through the chest into the abdomen. The aorta is then considered in three divisions: the ascending thoracic aorta; the descending thoracic aorta; and the abdominal aorta. Aneurysms can occur in each of these areas, and each has slightly different criteria for when to intervene. In my most recent column, that was an abdominal aortic aneurysm. Most adults with an ascending TAA are recommended for surgical repair at a diameter of 5.5 cm. However, if the aneurysm is rapidly expanding, surgery may be considered earlier. If a person has a medical illness, making surgery very risky, surgeons may wait until the size exceeds 6 cm. The decision on when to operate requires judgement from an experienced surgeon and cardiologist. This is a major surgery with potential for harm, including death, and it’s not to be undertaken unless the benefits clearly outweigh the risks. Rupture is unlikely at less than 6 cm. Keeping the blood pressure down (below 120 systolic) is a good idea. Beta blockers are most commonly used for that, based on studies in people with genetic risk for TAA, such as Marfan syndrome. Statin drugs are often used, as there is evidence to suggest that they slow down expansion of the aneurysm. • • • DEAR DR. ROACH: You recently wrote on the concerns of bisphosphonate drugs like alendronate (Fosamax) in people with osteoporosis. These drugs, especially intravenous zoledronic acid, have been game-changers in patients with breast and other cancers that spread to bone. They have dramatically reduced the incidence of dangerously high calcium in people with cancer and have substantially reduced bone fractures due to cancer. There is a considerable body of literature supporting their use as therapy to reduce recurrence, and even mortality, in selected patients with early stages of breast cancer. When we first started using them [at the University of Michigan Rogel Cancer Center], we observed osteonecrosis of the jaw in about 10% of treated patients. We quickly realized we could reduce the risk by using them less frequently and by having our patients see dentists to ensure hygiene before we start. With these considerations, the incidence of osteonecrosis of the jaw with bisphosphonates (or denosumab) has dropped to less than 1%. These medicines are very important for patients with cancers that have spread to bone, and we don’t want people afraid of these very effective agents that are safe when used correctly. -- D.H. ANSWER: I appreciate the information from Dr. Daniel F. Hayes and am happy to share with my readers. Dr. Roach regrets that he is unable to answer
individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. © 2022 North America Synd., Inc. All Rights Reserved 
Craving Comfort Foods
In the fall, we crave warm, hearty foods like cheesy casseroles and hearty soups. Often, though, these “comfort foods” are high in fat, sodium, and calories.
The next time you make your favorite “comfort foods,” try these tips to make them healthier and even more enjoyable: • Add extra vegetables of all types—dark green; red and orange; beans, peas, and lentils; starchy; and other vegetables—without added sauces, fats, or salt. Double the vegetables in a soup or casserole recipe to add extra vitamins, minerals, and fiber. • Switch up your grains, making at least half of your grains whole grain. Try replacing white rice with brown rice in your recipe. • Choose reduced-fat dairy foods, including fat-free or low-fat milk, yogurt, and cheese, in casseroles and cream soups. • Use lean protein foods, including lean meats, poultry, and eggs; fish and seafood; beans, split peas, and lentils; and nuts, seeds, and soy products. Source: Dietary Guidelines for Americans 2020-2025, bit.ly/3kf72S4 Adapted from WOW (Words on Wellness) Newsletter, Iowa State University Extension and Outreach, August 2020. To receive the monthly newsletter, contact Kelsey Salow, ksalow@iastate.edu Pizza on a Potato Serving Size: 1 potato Serves: 1 Ingredients: 1 potato (scrubbed clean) 2-3 tablespoons pizza sauce or tomato sauce ½ cup frozen vegetable mix or chopped raw vegetables (like peppers, onions, mushrooms) ¼ cup cheese, shredded (mozzarella or monterey jack) Directions: • Puncture with a fork. Bake potato at 425° for about 60 minutes or microwave for 5 minutes, flip over and microwave 2 to 5 minutes more or until potato is tender. • Cut in half lengthwise. • Spread 2-3 tablespoons pizza sauce or tomato sauce on each half. • Run warm water over frozen vegetables until thawed. Strain them in a colander. Spread frozen or fresh vegetables on each half of potato. • Sprinkle cheese over vegetables. • Microwave until cheese bubbles or bake at 375° for 5-10 minutes (until cheese is melted). Tips: Add a protein such as cooked ground beef or turkey and other pizza toppings. Nutrition information per serving: 300 calories, 6g total fat, 3g saturated fat, 0g trans fat, 20mg cholesterol, 220mg sodium, 48g total carbohydrates, 5g fiber, 7g sugar, 12g protein, 20% DV Calcium, 20% DV Potassium This recipe is courtesy of ISU Extension and Outreach’s Spend Smart. Eat Smart. website. For more information, recipes, and videos, visit spendsmart.extension.iastate.edu 
October is Fire Prevention Month. Fire Prevention Month has been observed since 1922. It is observed every second week in October to commemorate the Great Chicago Fire that occurred in 1871. This will mark the 100th anniversary for Fire Prevention Month. This year’s theme is “Fire won’t wait, Plan your escape.” Here are some things you can do to be better prepared in the event of a fire.
The National Fire Protection Association suggests making the first Saturday of each month “Smoke Alarm Saturday.” Test all the smoke alarms in your home once a month. Fires can move very fast and having working smoke alarms helps to give early detection of the potential danger. Check smoke alarms to make sure they are less than 10 years old. If they aren’t, then they need to be replaced. Make sure that you have a smoke alarm in each sleeping area, outside each sleeping area and on every level of your home. Develop a fire escape plan for your home and practice it at least several times a year. During a fire is not the time to practice your escape plan. Knowing two ways out of each room is very important. Make sure to include children when developing an escape plan so they can become familiar with the plan. Develop a meeting place where everyone meets after leaving the home. This may be a mailbox, a tree, a neighbor’s house or a fire hydrant. Pick a place that is a safe distance from the home. This allows for accountability to ensure that everyone has safely made it out of the home. Teach children what number to dial in case of an emergency. Teach them to know their home address. Precious minutes could be wasted in an emergency if emergency response is trying is trying to figure out where to go. Teaching children that their address has a first and last name is an easy way to teach them. The numbers in their address are the first name and the street name is the last name. Go to NFPA.org for more fire safety information. If you have any questions or would like further information, I can be reached at 563-589-4195 or at Dpaulson@cityofdubuque.org. |
• Before I pluck my eyebrows, I rub on a bit of my granddaughter’s teething gel. She’s done teething and doesn’t need it anymore, but it works well for me. Be very careful to apply, let dry and wash your hands before touching your eye any further! — M.L. in California
• Lemon juice mixed together with coarse salt makes an inexpensive copper cleaner. • When figuring up the cost of moving yourself or using a service, be sure to consider the cost of your time and your health. And be certain that you are able to drive the moving van if you rent a large truck. • If you don’t keep a lot of foods in your freezer, you can fill large gallon-size zipper-top bags with ice cubes. You will always have plenty of ice on hand, and your freezer will not have to work as hard to keep the items in it frozen. • “If you have a fish tank, you can use the fish tank water to fertilize your rose bushes. I do this, and it’s rich in minerals that the bushes love!” — A.U. in Alabama • Make your own bed buddy hot pad with a long sock and rice. Use a sock that’s knee high, and fill it about two-thirds with plain, uncooked white rice. Knot it an inch or two from the top of the rice, so it’s nice and loose. Once it’s secure, you can stick the sock into the microwave for 1-2 minutes. The rice heats up and the heat is stored in the rice. It’s wonderful for aches and pains — or just for keeping toes toasty! • Shower caps can be placed over a planter and used to make a kind of greenhouse for planting cuttings. Just water and place it in a sun-filled window. Be sure to check it often, because even though it may be moderate or even cool out, your little greenhouse can get pretty hot with only a few hours of sun. Send your tips to
Now Here’s a Tip, 628 Virginia Drive, Orlando, FL 32803. © 2022 King Features Synd., Inc. 
Chicken Burgers
1 pound ground chicken breasts
1 medium carrot, grated (1/2 cup) 2 green onions, minced 1 clove garlic, crushed with garlic press 4 hamburger buns, warmed Sliced cucumber, lettuce leaves and green onion (optional) 1. In medium bowl, with hand, mix ground chicken, carrot, green onions and garlic until evenly combined. 2. On waxed paper, shape chicken mixture into four 3 1/2-inch round patties (mixture will be very soft and moist). 3. Place patties on grill over medium heat and cook about 12 minutes or until juices run clear when center of burger is pierced with tip of knife, turning over once. (If you have a grill with widely spaced grates, you may want to place burgers on a perforated grill topper to keep them intact.) 4. Place burgers on warmed buns. Serve with cucumber slices, lettuce leaves and green onions if you like. Serves 4. • Each serving: About 275 calories, 30g protein, 24g carbohydrate, 5g total fat (1g saturated), 2g fiber, 72mg cholesterol, 310mg sodium. For thousands of triple-tested recipes, visit our website at www.goodhousekeeping.com/food-recipes/.
© 2022 Hearst Communications, Inc.
All rights reserved 
Tomato and Basil Onion Soup
Homegrown tomatoes soon will be nothing but a pleasant memory. But before they are, why not stir up a pot of this wonderful soup. It’s perfect for all of us tomato and basil fans!
1 cup finely chopped onion 1 (10 3/4-ounce) can reduced-fat tomato soup 1 cup water 3 cups peeled and chopped fresh tomatoes 2 tablespoons minced fresh basil or 2 teaspoons dried basil In a large saucepan sprayed with butter-flavored cooking spray, saute onion for 6-8 minutes. Stir in tomato soup and water. Bring mixture to a boil. Stir in tomatoes and basil. Lower heat and simmer for 10 to 12 minutes, stirring occasionally. Makes 4 (1 1/4 cup) servings. HINT: 1 (15-ounce) can diced tomatoes can be used in place of fresh tomatoes. • Each serving equals: 109 calories, 1g fat, 2g protein, 23g carb., 300mg sodium, 3g fiber; Diabetic Exchanges: 2 Vegetable, 1/2 Starch. © 2022 King Features Synd., Inc. 
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