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— BY MICHAEL ROIZEN, M.D., AND MEHMET OZ, M.D.

Q: I was training for a two-day, 187-mile bike ride called RSVP (Ride from Seattle to Vancouver and Party!) when my coach said he felt a little short of breath. He ended up in the hospital getting a stent for a 95 percent blockage in an artery! He’s one of the healthiest people I know. How is that possible? -- Sonja G., Tacoma, Washington

A: It’s true that running, biking and swimming convey enormous health benefits. People in their 70s who have been exercising regularly for a long time can maintain the heart, lung and muscle fitness of people at least 30 years younger. (That’s what we call a real younger RealAge!)

However, endurance training puts a big strain on not just your respiratory and musculoskeletal systems, but your cardiovascular system too. A National Institutes of Health report that looked at eight runners who died from doing the London marathon found that only one of them had reported any cardiac symptoms to family or doctors.

But endurance athletes aren’t the only folks who get bushwhacked by potentially lethal cardiac events. About 47 percent of sudden cardiac deaths occur outside a hospital -- possibly because many people, especially if they’re generally healthy and younger than 60, don’t recognize or rationalize signs they’re on the road to problems.

Those signs include dizziness, chest discomfort, shortness of breath, sweating, a rapid pulse or even heart palpitations. That’s why everyone should have regular cardiovascular health screenings.

Check for high blood pressure: Every two years starting at age 20, if your blood pressure is below 120/80 mmHg. Higher? Ask your doc about more frequent checks and aim to get BP under 125/85.

Monitor cholesterol levels: Every four to six years starting at age 20. Younger if you have a family history of hypercholesteremia, are overweight or have Type 2 diabetes, and more frequently if your LDL is elevated or your HDL level is low.

Additional checks:

Over age 50, get an evaluation of your diet and coronary calcium. Keep tabs on waist size and blood sugar levels.

Q: I had shoulder surgery, and when I went to the pharmacy to get my pain medication (hydrocodone), the pharmacist asked how long I had been taking those pills. I told him I hadn’t been until the surgery, but he made me feel like a criminal. What was that all about? -- Tony G., Madison, Wisconsin

A: What you experienced is a well-meaning overreaction by your pharmacist to the government’s attempt to curb the opioid epidemic.

In 2016, the Centers for Disease Control and Prevention issued guidelines for prescribing opioid meds, but they are just recommendations, and each patient’s needs are unique. Far too often doctors and pharmacists take these recommendations as written-in-stone directives.

This hyper-vigilance is a result of the bad eggs who’ve cranked out unneeded prescriptions for painkillers to anyone who will pay for them, and some doctors (and dentists) who don’t appreciate the risks of casually prescribing opioids when other pain control drugs or techniques would work.

In 2017, more than 17 percent of Americans had at least one opioid prescription filled; the average was 3.4 opioid prescriptions dispensed per patient.

These bad actors have demonized legitimate pain management to the point where people like you, recuperating from an operation, have to argue with the pharmacist to receive your appropriate prescription.

The result is that folks who need to have opioid medications for acute pain management are often undertreated -- and that slows healing. Chronic pain sufferers or those in hospice face even more dire consequences if their medications are cut off.

So, if you have pain or expect pain, work with a pain management specialist who can, along with your doctor, make sure that you don’t become addicted and that your quality of life remains good as you heal and rehabilitate through your physical therapy. That’s a safe and effective approach. Remember, in 2017, 70,000 people in the U.S. died from overdoses.

•••

(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is chief wellness officer and chair of Wellness Institute at Cleveland Clinic. Email your questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com. Distributed by King Features Syndicate, Inc.)

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