Dear Dr. Roach • I am because minimally invasive back surgery. About 19 years ago, I had a appropriate total-knee replacement, which still functions actual well. I accept the backup genitalia are fabricated with stainless steel. No physician I accept questioned about the crisis of accepting an MRI with metal genitalia in my anatomy has been accommodating or able to accord me a beeline acknowledgment about the assurance of an MRI with a metal knee. They acknowledge with “It should be OK” or “It ability calefaction up a little,” etc., but no agreement of safety. No analgesic surgeon I accept contacted is accommodating to accede anaplasty afterwards an MRI.
It appears that I am amid a bedrock and a adamantine place. Can you help? — B.M.
Answer • Most collective replacements are fabricated with abstracts that are safe for an MRI scanner; however, to be sure, you charge to acquisition out from the surgeon who did the collective backup (or maybe you still accept the information) the exact architect and archetypal of the prosthesis you have. A account at mrisafety.com shows which of these accessories are safe in MRI. I additionally contacted two bogus collective manufacturers (Zimmer and Stryker), who were able to accommodate me admonition (and should be able to do so for you or your doctor) about MRI assurance for specific products.
Dear Dr. Roach • I am an 80-year-old macho and counterbalance 193 pounds. I airing one mile anniversary day and do adamantine yardwork about daily.
My botheration apropos statin drugs. I had a affection advance in 1993. I accept had several angioplasties, one stent and a bypass anaplasty in 2003. I’ve been in acceptable bloom back the surgery. In 1993 I started demography statin drugs with no problem. Starting in aboriginal 2013, I’ve gotten astringent diarrhea afterwards demography my statin. My doctor has put me on simvastatin, pravastatin, atorvastatin, Crestor and now Zetia in an advance to stop the diarrhea, and none has worked. Through all of these episodes, I accept been off the statins for about 80 percent of the time, because I couldn’t buck the diarrhea. I additionally had a colonoscopy, which was normal. My cholesterol has gone up from 107 to 122, with HDL 47 and LDL 54 actual the same.
It seems aberrant that afterwards demography the statin biologic for 20 years, I would advance this acute diarrhea problem. All systems assignment abundant back I don’t booty the statin.
My doctor says with my affection history, I am a absolute applicant for demography the statin drug. Do you accept any acquaintance with this bearings or accept any admonition for me?
Answer • It does assume aberrant to advance the botheration afterwards so long, but I can’t altercate with the affirmation as you present it. With statins, I accept apparent balmy diarrhea that usually goes abroad afterwards a few days. Sometimes demography the statin with the black meal helps. Using the everyman accessible dosage additionally is account trying. I accede with your doctor that you are a acceptable candidate.
The alone affair I can anticipate of is an old drug, cholestyramine. It was originally developed for aerial cholesterol but is actual advantageous for abounding types of diarrhea. If all abroad fails, you ability try abacus cholestyramine to the lowest-dose statin at mealtime.
No amount what your cholesterol, if you accept blockages in your arteries — abnormally if you accept had a affection advance or anaplasty — statins can admonition anticipate added blockages and damage. Unfortunately, some bodies can’t abide the ancillary furnishings of a statin. Zetia is a non-statin medication that hasn’t been accurate to abate affection ache risk.
Readers • The album on ache explains this accepted ataxia and its treatments. Readers can adjustment a archetype by writing: Dr. Roach — No. 504, Box 536475, Orlando, Fla. 32853-6475. Enclose a analysis or money adjustment for $4.75 with the recipient’s printed name and address. Please acquiesce four weeks for delivery.
Dr. Keith Roach is a physician at Weill Cornell Medical College and New York Presbyterian Hospital.Readers may email questions to [email protected] or appeal an adjustment anatomy of accessible bloom newsletters at P.O. Box 536475, Orlando, Fla. 32853-6475
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