Brief Answer:
Vitamine B12 seems not to be related to the hat

Detailed Answer:
Hello!

Thank you for asking on HCM!

Vitamin B12 deficiency is not related to holding a hat.

I would like to explain that there are different causes of vitamin B12 deficiency in this age like:

1.Atrophic gastritis, in which your stomach lining has thinned
2.Pernicious anemia, which makes it hard for your body to absorb vitamin B12
Surgery that removed part of the stomach or small intestine, including weight loss surgery
3.Conditions affecting the small intestine, such as Crohn's disease, celiac disease, bacterial growth, or a parasite
4.Heavy chronic drinking
5.Immune system disorders, such as Graves' disease or lupus
6-Long-term use of acid-reducing drugs
7- Vegan's diet

I recommend performing some tests like a fibrogastroscopy, a routine blood test, liver and kidney function tests to find out the possible cause. Other tests like immunologic tests may be needed.

Another possible serious cause in this age which should be excluded is a cancer in the body, especially in the digestive tract, including the liver.

Hope to have been helpful!

Feel free to ask any question whenever you need!

Greetings! Dr. Iliri

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Brief Answer:
Several cardio-pulmonary variables (as well as others) should be considered

Detailed Answer:

Hi again, XXXX!

Regarding your last question, I would explain that when facing a combined chronic cardiac and pulmonary disorders, it is necessary to consider several variables (cardiac and pulmonary function variables), to determine an approximate life expectancy.

Cardiac performance indices like EF, cardiac output and index, as well as valvular integrity are important when dealing with patient prognosis. A cardiac ultrasound as well as a cardiac stress test may be used to answer these questions.

From the other hand, pulmonary function test variables may help to add prognostic information, and possible implications to overall physical performance.

At the end, a very important clue is how we live our life (level of quality), rather than only how long.

Best regards,

Dr. Iliri

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Brief Answer:
An appropriate management strategy is necessary.

Detailed Answer:

Hi, XXXX!

Inhalers improve simptomatology. But, the most important issue is to prevent and promptly treat respiatory infections, as they deteriorate clinical status and risk for life-threatening conditions.

With an appropriate pulmonary therapy (in the absence of severe cardiac performance implication from an abnormally increased pulmonary hypertension or other reasons), a COPD patient may live even more than 10 years.

Best wishes,

Dr. Iliri

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Brief Answer:
Close medical follow ups are of utmost importance.

Detailed Answer:

Hello!

If the person doesn't have impaired cardiac function, and bypass grafts patency is steady; chronic pulmonary function is properly treated, than he may live as long as every other non bypass individuals.

Frequent cardiac follow ups are necessary to identify possible pathological clinical changes (if venous grafts are used during bypass, then approximately 50% of them may be at risk of occlusion after 10 years).

So, being aware, and intervening promptly in time, is more important than e single successful medical procedure.

Best wishes,

Dr. Iliri

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