Katsuya Nagaoka writes:
The most important issue for T is
that T thinks his condition is not serious. This is a hindrance to improve
his chances for recovering his full health, because physicians, basically,
help patient's natural ability of healing, and when patients are not aware
of their bad condition, their recovering would be behind.
Besides lack of exercise and heavy smoking, he has some risk factors of
coronary heart disease, for example, hypertension, being a type A personality,
and, his mother's death after heart by-pass surgery complicated by hardening
of the arteries. Furthermore, a survey shows that long-distance runners
have a greater capacity to dilate their coronary arteries and thus markedly
increase blood flow to their heart muscle. He was a marathon racer, and
so there is the likelihood of a dilating capacity of his coronary arteries.
And another survey says that men are generally more likely to have high
rates of heart disease then women.
The patient frequently experiences feelings of weakness and mild pain in
the neck and upper chest areas. First, I should prescribe medicines for
relieving pain, because the doctor's duty is lessening patient's suffering.
In addition to the pain, hypertension will be lowered by continuous doses
of suitable medicines. However, at the same time I should pay attention
to encouraging him to go to the hospital to relieve pain. I must explain
that his condition is very serious, and persuade him to continue medical
care. Although he tells me that both his parents lived well into their
sixties and that he is "just too young," a study appears that
systolic blood pressure in men peaks at middle age. His hypertension may
increase, and so I never would say that his age, 39, is "too young."
Speaking in the long term, first, he must stop smoking. Smoking accelerates
thickening of the walls of the arteries. That is to say, smokers are increasing
their risk of stroke and heart attack. Second, he should take exercise.
A moderate amount of exercise is necessary for keeping normal circulation
system and getting rid of his stress. Continuous stress can cause hardening
arteries. Thinking that he has type A behavior and he works in hard surroundings,
I conjecture that he is under considerable pressure. I recommend to him
that he exercises for enjoyment and relaxation. And describing the future,
clinical analyses indicate early atherosclerosis. His consciousness of
his condition can be the best effective care. I think it is my duty that
I get a lot of data about heart diseases for having him realize his serious
condition.
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