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Tuesday, May 25, 2010

Staying Healthy and Safe While Enjoying Your Honeymoon

Words by Jennifer Stein
Words by Mark J. Savant, MD

I got an email from a friend who was on vacation about some chest pain she was having and I thought there were some interesting points about her situation and chest pain in general that could be helpful to think about. Now, our bride and groom are fit but work too hard, like most successful people tend to do. They like to swim and surf so they took a long overdue vacation to a remote beach in Nicaragua for two weeks of surfing. The weather was great but a little windy and on some days the waves were pretty choppy. After a few days our bride started having pain in her chest that got progressively worse, so she stopped surfing. It hurt when she was paddling her board out and then ached all night, especially when she took deep breaths or pressed on her sternum. Of course, having chest pain freaked her out and being in such a remote place made her even more anxious about it. As it turned out her chest pain came from inflammation in the joint where the rib attaches to the sternum (breastbone) and was likely caused by strain and excessive use. Paddling in rough water, holding up her board on a windy beach, and even surfing more than usual are what caused the inflammation. The treatment for it is ice and using an anti-inflammatory medication like aspirin or ibuprofen.

So the question is what kind of chest pain should you be worried about? For the most part, everybody thinks about their heart when they have chest pain but there are lots of causes so here’s a quick way to think about it. The chest pain caused by a heart attack is more commonly not even a pain at all but rather more like a crushing chest pressure. It’s as if an elephant were sitting on your chest and you just couldn’t get a breath in. Heart attack type chest pressure will not last for more than 30-60 minutes. It will either get better suddenly or get much worse but won’t last all night. Sometimes it can come on with exertion and stop with rest. Many times chest pain; especially in young, healthy, active people; is caused by an injury to the chest wall. Remember, your heart is protected in a cage that is layered with bone, muscle, cartilage, and other soft tissue so if you can reproduce the pain by pressing on your chest it’s not your heart. Of course, it’s always important to know your health history, which includes your family’s history of heart disease, especially if it happened in someone at a young age. The best way to do this is to check in with your doctor every year or two for a physical. This way you can feel confident when you engage in strenuous activities, and that includes sex (a vacation must).

About
Dr. Savant heads up the Savant Medical Group in San Francisco. Dr. Savant attended the Medical College of Wisconsin and completed his Internal Medicine residency at Santa Clara Valley Medical Center in San Jose, California in 1997 where he was given the “Grace Under Fire” Award by the Emergency Department. He then went to New York City to be on the Faculty of the Division of General Internal Medicine at St. Luke’s-Roosevelt Hospital where he also served as a clinical instructor to the third year medical students at Columbia University’s College of Physicians and Surgeons. He was identified by the medical students as an excellent clinical teacher and role model for the 1998-99 academic year.

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