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                                                                                                              DEAR DR. ROACH: I am a 74-year-old ac-
                                                                                                           tive male currently taking a daily 81-mg aspirin
                                                                                                           due to a periodic heart arrythmia. I have elec-
                                                                                                           tive sinus surgery scheduled, requiring that I be
                                                                                                           under a general anesthetic for 90 minutes and
                                                                                                           that I be off aspirin for the two weeks preceding
                                                                                                           the procedure.
                                                                                                              I’m beginning to have second thoughts
                                                                                                           about the surgery as I wonder if I’m risking a
                                                                                                           stroke. Would you please share your thoughts
                                                                                                           on this? Thank you. -- R.B.
                                                                                                              ANSWER: Aspirin is used in some people
                                                                                                           with atrial fibrillation (the likely heart arryth-
                                                                                                           mia you would be put on aspirin for) when they
        1.  Pitcher Larry Sherry, 1959 World Series      ELIGARD INJECTIONS CAUSE MAN TO
            MVP, and his brother, catcher Norm Sherry,   DEVELOP BREAST TISSUE                             are at a low risk for a stroke.
            played together on what Major League Base-       DEAR DR. ROACH: I have been treated for          There is a score called the CHA2DS2-VASc
            ball team from 1959-62?                                                                        that is used to estimate risk. People at a higher
        2.  Woody Strode, who played for the NFL?s       prostate cancer and stopped my semiannual El-     risk are recommended anticoagulants such as
            Los Angeles Rams (1946) and the CFL?s        igard injections three years ago. I’m 75 years old   apixaban (Eliquis). Since you are 74, you get at
            Calgary Stampeders (1948-49),  received a    and about 5 feet, 9 inches tall. Before treatment,
            Golden Globe Award nomination for his        I weighed 227 pounds; I currently weigh 209       least one point for your age, and unless you have
            acting role in what 1960 gladiator movie?    pounds. My testosterone level is 49.6 ng/dL. My   another risk factor that I don’t know about, you
        3.  What two-sport pro athlete played with the                                                     have an estimated risk of stroke without treat-
            NBA?s Los Angeles Lakers and San Francis-    breasts have become somewhat feminine.            ment of approximately 0.6% per year.
            co Warriors (1964-65), and Major League          My question is: Will they regain their nor-
            Baseball?s Chicago White Sox (1967) and      mal appearance? I’m losing weight slowly, and        While it is true that being off aspirin for a
            Minnesota Twins (1969-70)?                   I’m trying to build muscle with weights. -- Anon.  period of time around a surgery increases your
        4.  Julie Krone became the first female to win a     ANSWER: Gynecomastia is the growth of         stroke risk, your risk is already so low that the
            Triple Crown race when she jockeyed what                                                       absolute risk of being off aspirin for two weeks
            horse to victory at the 1993 Belmont Stakes?   male breast tissue, specifically when not due to   is quite small. You should always consider the
        5.  Name the Ukrainian boxer who became the      breast cancer. It can happen during puberty in
            first undisputed world heavyweight champi-   healthy males, but it is a common side effect of   risks of any surgery against the benefits, but the
            on in 24 years when he beat Tyson Fury in    androgen deprivation therapy for prostate can-    risk of stroke in your case is small compared to
            May 2024.                                    cer. Up to 75% of men treated with antiandro-     the risks anyone has with sinus surgery (such as
        6.  What is the nickname of the University of                                                      bleeding or an infection).
            Delaware?s athletic teams?                   gen therapy like leuprolide (Lupron or Eligard)
        7.  What multinational sports entertainment      will develop breast tissue.                          I am a little surprised about it being two
            franchise was founded in 2000 by twin            It isn’t likely that the breast tissue will go   weeks; normally when a person comes off as-
            brothers Steve and Dave Jolliffe?            away on its own. For men who want treatment       pirin before surgery, it’s for five to seven days.
                                                         due to the appearance or tenderness of the breast   Also, not all surgeons require aspirin to be
                          Answers:                       tissue, there are radiation, medication and sur-  stopped before sinus surgery.

                                                         gical treatments available. Radiation therapy is     Since your reason to be on aspirin is to pre-
                                    7. Topgolf.
                                                         the most effective for men who develop breast     vent a stroke due to your arrythmia, and this
                                                   5. Oleksandr Usyk. 6. The Fightin? Blue Hens.
                                                         tissue with androgen-depletion treatment.         risk appears to be very small, it may be that the
                                              3. Cotton Nash. 4. Colonial Affair.
                                                  1. The Los Angeles Dodgers. 2. “Spartacus.”
                                                             Tamoxifen is the usual medical treatment,     surgeon determined the risk of stopping aspirin
                                                         and you may ask the physician treating your       was so small. So, it wouldn’t be worth the pos-
                                                         prostate cancer about these choices. Men who      sible increased risk of bleeding from the sinus
                                                         can’t take or choose not to take either of these   surgery if you’re still taking aspirin.
                                                         treatments can be referred for surgical treat-       If you haven’t talked to your regular doctor
                                                         ment, which can be liposuction or a mastecto-     or cardiologist about this, I recommend doing
                                                         my.                                               so since I don’t have your full medical history.









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