Dear Doc: I love going to go Florida in the winter. Escaping the Wisconsin chill is something that warms my bones. Last year, I had a funny feeling in my chest. My heart was thumping wildly. The doc I saw there diagnosed me with atrial fibrillation. The diagnosis was correct but his delivery was awful. He said, and I quote, “This is going to kill you.” I was floored. My wife was floored. A. Fib is not a death sentence at all. Any thoughts on this miserable delivery? — RR from Wisconsin

Dear RR: There is the science and there is art of medicine. Clearly this doc was efficient in one and deficient in the other. And truth be told it was absolutely the wrong message. Yes, you need to treat A. Fib because the risk of stroke is higher than average. The best treatment is a cardioversion — a procedure that can restore a normal heart rhythm. But even with that there’s a higher stroke risk. Which is why many people with A. Fib go on a blood thinner to reduce that risk.

My spin: If your health care provider doesn’t meet your expectations, it’s time to switch. Art and science go hand in hand.

Dear Doc: I vape. I worry what it may do. I’d like to stop but I can’t. What’s the best way to quit? — DC from Milwaukee

Dear DC: I’ve been against vaping ever since it was introduced. I warned that this was a drug entry system for teens—I was right. Recent research from the CDC uncovered that 1 out of 4 teens in the US vaped within the last 30 days. The vaping companies were clearly selling to kids. How many adults want to vape bubble gum and gummy bears? Amazing that we didn’t control this.

Your question is how to stop. The short answer is we don’t know. There’s lots of research on stopping smoking meds such as Bupropion, and Chantix can help some and nicotine replacement such as Nicorette gum and the nicotine patch may also help. But we don’t know if this works for vapers.

I certainly would try them. I certainly would get some anti-smoking counseling as I suspect that this would work as well. And I’d do what’s most important with any addiction—I’d use my self-reliance to gut it out.

I was a smoker, back in ‘69. It took me four times to quit. Cigs had gone up from 32 cents to 35 cents—and I couldn’t afford it. That pushed me over the edge.

Now what about the present mini-epidemic of lung disease and deaths associated with vaping. What’s it from? We don’t know. Is it chemicals in the vaping liquid? They’re not regulated so there’s no quality control. It may also be the heat it takes to aerosolize them.

My spin: If you don’t start, you don’t have to stop. Vaping is dangerous – plain and simple. The only safe thing to breathe is clean air—now and forever.

Who wants to go out for a bite?

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This column provides general health information. Always consult your personal health care provider about concerns. No ongoing relationship of any sort is implied or offered by Dr. Paster to people submitting questions. Any opinions expressed by Dr. Paster in his columns are personal and are not meant to represent or reflect the views of SSM Health.

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