Health & Fitness Ask Your Doctor

Ask Your Doctor

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Illustration by Taylor Roberge

We are our own best advocates when it comes to our health, so it’s up to us to take care of ourselves and talk to our doctors about our questions and concerns. Of course, we don’t know what we don’t know, so we asked Jennifer Monti, MD, MPH, director of The Innovation Cohort at Maine Medical Center and co-director of both Cardiac Rehabilitation and Prevention at Maine Health Cardiology, for guidance on what to ask your doctor, what heart symptoms to be aware of, and why trusting your gut when something feels off is so important.

We are our own best advocates when it comes to our health, so it’s up to us to take care of ourselves and talk to our doctors about our questions and concerns. Of course, we don’t know what we don’t know, so we asked Jennifer Monti, MD, MPH, director of The Innovation Cohort at Maine Medical Center and co-director of both Cardiac Rehabilitation and Prevention at Maine Health Cardiology, for guidance on what to ask your doctor, what heart symptoms to be aware of, and why trusting your gut when something feels off is so important.

Am I moving enough?

The two most-important topics to discuss with your physician are your level of physical activity and the quality of your diet, Dr. Monti says. “In the era of Fitbits, we are mistaking activity for exercise. We know that the ideal ‘dose’ of exercise to prevent the development of a range of cardiovascular diseases is 150 to 210 minutes of exercise per week.” That’s about 30 minutes a day, five to six days a week.

What tweaks can I make to my diet?

Diet is an essential part of taking care of your heart—and your family, says Dr. Monti. “A balanced diet that derives the majority of its protein from plant-based sources is a great place to start. The average person makes 226 food decisions per day. Finding a way to change or improve even 10 percent of these choices can make a large difference. Also, it is important to recognizes that women make the majority of decisions as to what food comes into the home. Those choices will have a ripple effect on the overall health of a family.”

What are my numbers?

“It is important to know what your blood pressure, cholesterol level, weight and hemoglobin A1c are. These numbers are general and not useful in isolation, so they should be discussed in the context of your overall health with a skillful provider.” While great for screening, Dr. Monti notes that these numbers help inform a realistic plan to drive down the risk of significant cardiovascular problems.

What are my risk factors?

“In the vast majority of cases, healthy diet, regular exercise and abstaining completely from smoking can fend off several varieties of cardiovascular disease. Genetics is generally over-emphasized as a risk factor. Each time I have a patient tell me ‘heart attacks run in my family,’ I encourage that patient to think about what else runs in the family. The food ecosystem, the physical environment, levels of exercise and stress—these tend to be more important shared characteristics than genetics.”

What symptoms should I look out for?

“Symptoms of obstructive coronary disease are highly variable and can range from crushing chest pain to dizziness and fatigue or a ‘heartburn’ like feeling. I am a big believer in the sixth sense. If you feel like something is ‘off,’ reach out for medical assistance.”

“Truth is, all the prevention in the world may not completely mitigate the risk of coronary disease. We regularly do interventions in runners. Half of heart attacks happen in people with normal cholesterol. Vague symptoms are real symptoms; pursue them until you are satisfied your concerns have been addressed. Our science is not perfect. Intuition matters.”

Dr. Jennifer Monti is director of The Innovation Cohort at Maine Medical Center and co-director of both Cardiac Rehabilitation and Prevention at Maine Health Cardiology.

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