Dr Ben Anderson

Let’s talk about TAVI

(transcatheter Aortic Valve Implantation)

WITHIN THE HEART, THE AORTIC VALVE IS AN IMPORTANT VALVE. THE LARGEST ARTERY IN THE BODY, THE AORTA IS THE MAIN ARTERY THAT CARRIES BLOOD AWAY FROM YOUR HEART TO THE REST OF YOUR BODY. THE BLOOD LEAVES THE HEART THROUGH THE AORTIC VALVE. THEN IT TRAVELS THROUGH THE AORTA, MAKING A CANE-SHAPED CURVE THAT ALLOWS OTHER MAJOR ARTERIES TO DELIVER OXYGEN-RICH BLOOD TO THE BRAIN, MUSCLES AND OTHER CELLS.

Degeneration can occur with ageing, along with previous heart valve infection or rheumatic fever. These processes can lead to both restriction (aortic stenosis) and/or leakiness (aortic regurgitation) of the heart valve.

When the valve is diseased, this can cause tiredness, breathing difficulty, chest pain or stroke.

The conventional method for aortic stenosis treatment is open heart surgery where the valve is usually excised and replaced with either a tissue valve or mechanical valve. This will improve forward flow from the heart and improve a patient’s symptoms as well as increasing their life span.

Transcathether aortic valve implant is an alternative to open heart surgery in selected patients. A collapsed stent valve is inserted usually through the groin artery into the heart, like a conventional coronary angiogram.

Once the valve is in position, it will then be opened up, securing it in the desired position. In some patients the TAVI will be done through a small incision in the chest, with a wound that is smaller than traditional open-heart surgery.

Not all patients are suitable for TAVI. All patients who end up having a TAVI need to be seen by both a cardiac surgeon as well as a cardiologist, along with a team of specialists to determine the best treatment option.

DR BEN ANDERSON

MBBS BMedSci FRACS

VMO Gold Coast Private, Pindara and John Flynn Private Hospital and The Tweed Hospitals. Treating patients at Goonellabah Medical Centre.

heartsurgerygoldcoast.com.au

Mainstream menopause

CELEBRITIES LIKE GWYNETH PALTROW, MEG MATHEWS AND THE CASTS OF THE REAL HOUSEWIVES FRANCHISES ARE HELPING TO MAKE THE MENOPAUSE MAINSTREAM THIS YEAR, ACCORDING TO HEALTH AND WELL-BEING COMPANY KAMWELL THAT WORKS WITH ORGANISATIONS TO TRANSFORM THEIR STRUCTURE FOR THE BENEFIT OF EMPLOYEES.

Gwyneth Paltrow, founder of lifestyle website, Goop says she wants to rebrand menopause and side-step the stigma and negative connotations.

The 48-year-old star recently shared that she’s perimenopausaul, a precursor to menopause in which the ovaries gradually begin making less oestrogen. It’s a natural phase to enter in life, and often causes women to experience irregular menstrual cycles and fluctuations in hormones, along with symptoms like a drop in libido. Most women will experience it in their 40s, while some will even experience the changes as early as their mid-30s.

“I think when you get into perimenopause, you notice a lot of changes. I can feel the hormonal shifts happening, the sweating, the moods— you’re all of a sudden furious for no reason,” she shared with Goop.

“Menopause gets a really bad rap and needs a bit of rebranding. I remember when my mother went through menopause and it was such a big deal, and I think there was grief around it for her and all these emotions. I don’t think we have in our society a great example of an aspirational menopausal woman.”

In dealing with the new stage in her life, Gwyneth said that she’s altered her fitness regime to take this into account, incorporating weights to build bone density, while also continuing to keep her clean-eating diet which focuses on whole foods, leafy greens and lean, ethically-sourced protein.

She also closely monitors her hormone levels. “I wasn’t overly focused on my hormones in my 30s,” she said. “But now, I do a panel [hormone test] every six months to ensure that everything is aligned.”

In 2021-2, Kamwell predicts a boom in products to help cope with symptoms, such as supplements, hair removal devices and cooling sprays to deal with hot flushes. Kamwell also predicts menopause technology will be the next big thing, such as the wrist-worn device known as “Grace”, which tracks and fends off hot flushes via a cooling patch.

Just one of the symptoms of menopause, hot flushes affect millions of women around the world. They can be uncomfortable, embarrassing and inconvenient, striking day and night, disrupting sleep. Grace is pitched as the world’s first automated tracking and cooling bracelet, ready to detect and fend off your flushes 24 hours a day. The device aims to detect a hot flush before you know you’re going to have one. At that point, a cooling patch is activated on your wrist, aiming to reverse the effects of a flush. With full automation, Grace can also be worn while you’re asleep to combat your night sweats. Users can download the GraceApp for Smartphone to understand hot flushes in detail and combat them.

How it works:

At the onset of a hot flush, the body’s thermoregulatory system is falsely triggered and acts to lose heat. This causes sweating, a rise in heart rate, shortness of breath and a reddening of skin. Using three sensors in a wristband, a hot flush can be detected around one minute prior to the user becoming aware of it. At this point, a localised cooling mechanism is triggered, comprising a Peltier Module (Thermoelectric Chip). This intense cooling sensation on the wrist sends a signal to the brain. The body's reaction acts in a directly opposite way to a hot flush, thereby countering the event.

More at gracecooling.com