Rolling Stones fans were concerned by the news Mick Jagger needs a new heart valve. But they’ll be happy to know that these days most patients in his situation can get what they need – and often without intensive surgery.

Giving the millions of fans some Satisfaction, is that Jagger is recovering and in good health after undergoing the heart valve procedure in New York City, reports the Associated Press.

Jagger is being monitored for any complications that could occur, such as excess bleeding, sources told Billboard.

Plenty of company

Jagger has plenty of company. More than 5 million Americans live with heart-valve disease. In 2013, the most recent year for which numbers are available, more than 100 000 people had heart-valve surgery, according to the National Center for Health Statistics.

Dr Catherine Otto, a professor of medicine at the University of Washington in Seattle, offered this primer on the heart’s four valves – and how they can malfunction.

The two valves on the right side, which pump blood into the lungs, are rarely a problem, said Otto, co-chair of the committee that wrote the latest American Heart Association guidelines on heart-valve disease. The valves on the left, which pump blood into the body, are typically the issue when something goes wrong, she said.

If one of these valve narrows, blood can’t go forward without the heart working extremely hard to push it, she said. And if a valve leaks, the heart has to pump extra blood to make up for it.

Wear and tear

“It’s a very delicate structure that with time can become a little bit thicker and get a little bit of scar tissue,” said Dr Robert Bonow, professor of cardiology at Northwestern University Feinberg School of Medicine in Chicago and co-author of those AHA guidelines.

A small percentage of people are born with malformed valves; many live for decades without problems. But even an anatomically normal valve is opening and closing with every heartbeat. Dr Bonow did the math: For someone with an average heart rate, the valve opens about 3 billion times over 80 years.

“It’s just one of those things that if you live long enough, these valves will begin to wear out at some point,” said Bonow, a past AHA president.

Risk factors include the same ones that lead to heart attacks, high cholesterol, smoking, high blood pressure and diabetes, Bonow said.

“But even people who have no risk factors, including athletes, can develop problems,” he said.

Valves can be replaced

Symptoms can include chest pain or palpitations; shortness of breath; fatigue; lightheadedness or swelling in the ankles, feet or abdomen. But the warning signs can be “very subtle,” Otto said. (Jagger, in fact, was spotted frolicking with his girlfriend and toddler son in Miami Beach just after the band cancelled upcoming tour dates because of his health.)

Otto said the most common symptoms she sees include reduced ability to exercise. Patients get out of breath, fatigued or just don’t feel like doing it.

“If they get to the point of actually having chest pain with exertion or shortness of breath or dizziness or passing out – those are really more severe symptoms of the disease,” she said.

Worn-out valves can be replaced with new ones made from metal or from animal tissue. And treatment has undergone a “transformative” change in recent years, Bonow said, with the growth of a procedure called transcatheter aortic valve replacement, or TAVR. The aortic valve is on the left side of the heart and releases blood to the body’s main artery, the aorta.

Some risk

Until recently, complicated open-heart surgery was standard. But with TAVR, a replacement valve can be inserted without surgery by puncturing a leg artery, inserting a new valve, threading it up to the heart “and just popping it in place”, Otto said.

“It’s a very short procedure – it takes an hour or two at the most,” she said. The patient is the hospital overnight or maybe a couple of days, followed by a week or two of recovery at home. That compares with six weeks to three months of recovery for surgery.

TAVR is currently approved in people for whom open-heart surgery would be considered risky, although both doctors were excited about a recent study indicating TAVR can produce results comparable to traditional surgery in even low-risk patients.

Also, Dr Otto noted, if the problem is related to the mitral valve – that’s less likely in someone Jagger’s age – a transcatheter approach is possible, but a patient is more likely to need open-heart surgery.

The good news is that barring complications, heart valve problems are usually “pretty much alleviated completely” by treatment, she said. “There is some risk up front, but the outcomes are excellent.”

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Good news for kids: Next flu season, you can avoid a painful needle jab and get the nasal vaccine spray instead, according to a leading US paediatricians’ group.

In recent flu seasons, the American Academy of Pediatrics recommended the shot over the nasal spray – except if a child refused a shot – due to questions about the nasal spray’s effectiveness. However, changes to the nasal spray appear to have improved its effectiveness, and the academy is now endorsing the either/or vaccine scenario.

The new recommendation matches advice from the US Centers for Disease Control and Prevention.

Flu virus unpredictable

“All children six months and older should receive the flu vaccine, in whatever form their paediatrician recommends,” said Dr Bonnie Maldonado, chair of the AAP Committee on Infectious Diseases.

“Every year, we are never sure if the vaccine strains are going to be perfectly matched up with incoming flu strains, but based on the information that we have now, we believe the nasal spray is an acceptable option,” she explained in an academy news release.

Both types of flu vaccination were approved by the AAP board of directors after a review of the latest data. The decision was announced now because doctors are placing vaccine orders for the 2019-2020 flu season.

“The flu virus is unpredictable and can cause serious complications even in healthy children,” said Dr Flor Munoz, a member of the AAP Committee on Infectious Diseases. “Children who have been immunised are less likely to be hospitalized due to flu.”

The rate of flu vaccination among US children rose from 38% in November 2017 to 45% in November 2018, according to the AAP.

The academy also said parents should talk with their paediatrician if they have any questions about their child’s immunisations.

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Winter 2018 saw an intense outbreak of influenza in the Northern Hemisphere. It is therefore vital for South Africans to get their “flu shot”. According to Netcare, the last flu cycle in the Northern Hemisphere resulted in the death of 30 infants in the US alone.

Dr Annamarie Richter,  medical director at Netcare’s Primary Care Division, stated on their website that a new vaccination was produced to match changes in two of three flu strains, and that this latest vaccination is now being made available throughout South Africa.

Still unsure whether you need the flu shot or not? Here’s what you should know:

1. It’s never too late, but rather do it sooner

While the middle of winter is not too late to receive the flu shot, remember that it takes about two weeks for the body to produce the necessary protective antibodies. Give your body enough time to develop adequate protection by getting your flu shot sooner rather than later.

2. You’re not only protecting yourself, but also other more vulnerable people

“Flu is not so bad for me, I recover quite quickly,” you may argue. Not only does the influenza virus change strains yearly, producing more severe symptoms, but you as an individual should also protect anyone vulnerable close to you, such as the elderly, infants, and those with a compromised immune system.

Some people argue that flu is simply a more severe form of the cold, but it is potentially fatal. According to Harvard Medical School, flu activity significantly increased in the US during their last winter, with the A(H3N2) virus being the most prevalent, leading to increased hospitalisations, especially in children and those over 65.

And even if you don’t show symptoms, you may still be spreading the virus without realising it – about 20% to 30% of those carrying the virus have had no symptoms.

3. You need to get an annual flu shot

You need to keep your vaccination up to date to make sure you are protected against the latest strains, as the influenza virus mutates yearly. So even if you had your shot last year, the 2019 vaccination was developed to fight the most prevalent strains of the latest flu season.

4. The flu shot will not give you the flu

Repeat after us, “You will not get the flu from the flu vaccination.” While some people experience minor side-effects such as localised swelling, mild fever and soreness, the best way to protect yourself against the flu remains the flu vaccine.

However, even if you still get flu after the flu vaccination, your symptoms will be milder.

5. There are other measures to protect yourself against the flu

While the flu vaccination is a key step in protecting yourself, it shouldn’t end there. Boost your immunity by including loads of fresh fruit and vegetables in your diet. If you start feeling run down, get more sleep. Avoid close contact with people who have the flu, and make sure you regularly wash your hands. If you are sick, stay away from work to avoid the flu from spreading. Not sure how long you should book yourself off sick? Read here.

Get your flu vaccination

If you haven’t had your shot yet, get it from a credible pharmacy or medical professional to make sure it is the most up-to-date version.

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Marelize Wilke

Have you been neglecting your calves? Many people forget about these important muscles when doing strength training. These exercises will add definition and help protect against some lower leg injuries.

Start with seated calf raises. Sit on a chair or bench with feet flat on the floor. Lift your right heel as high as you can, pressing toes into the floor and flexing your calf muscles, then slowly lower your heel. Do this 12 to 15 times, then repeat with your left heel. Build to two sets of 15 reps with each leg.

Increase the challenge

To increase your range of motion, place a block in front of your feet and position the ball of your foot on the block for the calf raises. To add resistance, place a weight cuff around the working thigh, about 3 inches (7.6cm) from the knee.

Now move to standing calf raises. Stand behind a sturdy chair, holding it for balance if necessary. With feet shoulder width apart, slowly rise up on your toes as you tighten your abs. Keep your back and knees straight. Hold briefly, then slowly lower heels to the floor. Build up to two sets of 12 to 15 reps.

To increase the challenge, hold dumbbells at your sides, palms facing inward as you do the exercise.

For another variation, lift your left foot off the floor while doing raises with your right foot, then reverse. Or do your standing raises on a stair to increase intensity and range of motion. Place toes on the edge of a step, heels hanging off. Slowly raise to tiptoes, hold briefly, then lower all the way back down. Be sure to hold the bannister for balance or place your hands on the sides of the stairwell.

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If you need a new hip or knee, take heart: The vast majority of these joint replacements last decades, new research shows.

The conclusion stems from an exhaustive review of several hundred thousand joint replacements in Australia, Denmark, Finland, Norway, Sweden and New Zealand.

Replacements last for decades

The researchers followed nearly 216 000 hip replacement patients for 15 years. They also tracked 74 000 for 20 years, and more than 51 000 patients for 25 years.

Overall, 89% of hip replacements lasted 15 years, and 70% lasted 20 years. Nearly six in 10 lasted 25 years, the study findings showed.

In addition, the researchers looked at knee replacement patients, including nearly 300 000 patients who were tracked for 15 years; 92 000 who were followed for 20 years; and about 80 000 who were tracked for 25 years.

Of those who had total knee replacement, 93% lasted 15 years. The same was true for about 77% of patients who had partial knee replacement, the investigators found.

Reliable and evidence-based answer

Two decades out, 90% of total knee replacements and 72% of partial replacements were still in good form. Twenty-five years out, those figures dipped to 82% for total knee replacement and 70% for a partial replacement.

Senior study author Michael Whitehouse, of the trauma and orthopaedics unit at Bristol Medical School in the United Kingdom, said the findings answer important questions about the long-term outcomes of joint replacement.

“As a clinician, it gives me the information that I need, to give my patients a reliable and evidence-based answer to one of the questions they consider most important when deciding whether it is the right time for them to have a joint replacement,” he said in a University of Bristol news release.

The report was published online in The Lancet.

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