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"Many patients will wonder: 'I have a lump on my arm or my leg. Should I have this evaluated? Who should I see, and when are these symptoms concerning?'" says Dr. Krista Goulding, a Mayo Clinic orthopedic surgeon.

She explains when you should seek medical care, "If you have a lump on your arm or your leg that is growing rapidly or is bigger than the size of a golf ball, this needs rapid attention."

The first step in diagnosing a lump is to get advanced imaging, typically starting with a radiograph or X-ray.

"The next step is to get cross-sectional imaging, which means either an MRI or a CT scan," says Dr. Goulding.

Imaging is then followed by a biopsy to remove a sample of tissue for testing.

"And this helps our multidisciplinary team make decisions about how to treat these tumors because these tumors can be benign. They can be benign aggressive, meaning that they are not cancerous, but they can cause problems locally. And then there can be cancer diagnosis similar to sarcomas and other types of cancers that will need rapid attention," says Dr. Goulding.

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Phoenix – Heart disease is the leading cause of death worldwide. One of the most common types of cardiovascular disease is a heart attack. In the United States alone, it is estimated that every 40 seconds, someone has a heart attack. One of those people is country rap music artist Colt Ford.

"I couldn't have been anymore on death's door. I died twice that day," recalls Colt, describing the massive heart attack that nearly claimed his life following a concert performance last year. "When one of the top heart doctors in the world looks at you and goes, 'You're 1% of 1%,' it can't get more dire than that."

The 55-year-old musician was performing a sold-out show with his band in Gilbert, Arizona, last April. After what Colt describes as "one of the band's best shows ever," he walked backstage, and moments later, he was found slumped over in a chair due to a massive heart attack. Colt says he was feeling great during the concert. "When I played the show that night, I could do anything," he recalls. Emergency crews quickly responded to the scene and rushed Colt to the hospital. "I woke up eight days later, and I couldn't pick up a cup with ice in it and feed it to myself," he says.

Colt went into cardiac arrest twice. He was revived with electric shocks from a defibrillator to restart his heart in both instances. "He would simply not have survived in most parts of the world that don't have access to such a high level of cardiogenic shock care. Most people do not survive globally," says Kwan Lee, M.B., B.Ch., M.D., interventional cardiologist at Mayo Clinic. Colt also underwent a 10-hour surgery and, for a time, was placed in a medically induced coma.

Doctors often warn about the signs and symptoms of a heart attack, such as chest pain or pressure, shortness of breath, and fatigue. However, roughly 21% of heart attacks in the U.S. occur with minimal or even no symptoms, according to the American Heart Association. These "silent" heart attacks are known as silent ischemia or a silent myocardial infarction.

"This is the unfortunate nature of heart attacks. It is possible to have tests which don't show blockages, but the nature of blockages is that they can behave unpredictably and suddenly occur," says Dr. Lee. "Despite our best efforts, on a populational level, heart attacks can still occur in patients out of the blue."

Eight months after suffering his heart attack, tests show Colt is healing well and on the road to recovery. Exercise combined with a heart-healthy diet has helped him shed 60 pounds. While his strength improves, Colt admits the health scare has left him with anxiety and panic attacks. "For me to say I'm having anxiety and panic attacks, that's even hard for me to say because I ain't scared of nothing," Colt says. "But I'm having to deal with that, and share my feelings and all that kind of stuff. So, if you're feeling something, advocate for yourself. Don't just tough it out. Tell somebody."

Colt is back to writing his signature blend of music that combines country, rap and hip-hop. The Georgia-born singer just released a new song and is about embark on a new tour. He's hoping his music and his story will serve as inspiration for others. "Be happy that you're here and you're alive and you get a chance," Colt says. "I get a second chance, and I want to do something positive with it. I hope I can make a difference in somebody else's life."

You can watch more about Colt's story here.

###

Media contact:

Marty Velasco Hames, Media Relations, Email: newsbureau@mayo.edu Phone: 507-284-5005

Media kit including interviews, video and photos available for download here.

About Mayo Clinic

Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network to learn more.

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It was the evening of April 4, 2024 on a concert stage in Gilbert, Arizona.

Colt Ford and his band were performing their signature blend of country, rap and hip-hop music. It was a sold-out crowd. Colt was feeling at the top of his game, and the concert was shaping up to be one of the band's best shows ever.

No one expected how this night would end.

Watch Colt Ford's story of survival

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"Like it was really clicking. We had just made some changes in the set and it was feeling really good. The vibe was good, it all felt good," remembers Colt. "My stage manager said 'That's the best show we've done this year, man, you killed it,' It was incredible."

At the end of the show Colt thanked fans, turned and exited the stage.

No one expected what happened minutes later

"I woke up seven or eight days later, whatever, and I woke up in the hospital and was like 'What's going on?' I had no concept of anything," says Colt. "When I played the show that night I could do anything but when I woke up in the hospital I couldn't pick up a cup with ice in it and feed it to myself."

Minutes after exiting the stage, Colt suffered a massive heart attack. He was found slumped over in a chair backstage by one of his fellow band members. Emergency crews responded immediately and Colt was rushed to the hospital.

"When one of the top heart doctors in the world looks at you and goes 'You're 1% of 1%,' it can't get anymore dire than that," says Colt about his odds of surviving his heart attack.

Colt went into cardiac arrest twice. He was revived with electric shocks from a defibrillator to restart his heart in both instances. "He would simply not have survived in most parts of the world that don't have access to such a high level of cardiogenic shock care. Most people do not survive globally," says Dr. Kwan Lee, interventional cardiologist at Mayo Clinic. Lee is part of the multidisciplinary team overseeing Colt's care at Mayo Clinic. Colt also underwent a 10-hour surgery and, for a time, was placed in a medically induced coma.

A silent killer

Heart disease is the leading cause of death worldwide. One of the most common types of cardiovascular disease is a heart attack. In the United States alone, it is estimated that every 40 seconds, someone has a heart attack.

Doctors often warn about the signs and symptoms of a heart attack, such as chest pain or pressure, shortness of breath, and fatigue. However, roughly 21% of heart attacks in the U.S. occur with minimal or even no symptoms, according to the American Heart Association. These "silent" heart attacks are known as silent ischemia or silent myocardial infarction.

Colt says he had recently undergone a regular check-up at a different medical center and got a clean bill of health.

"This is the unfortunate nature of heart attacks. It is possible to have tests which don't show blockages, but the nature of blockages is that they can behave unpredictably and suddenly occur," says Dr. Lee. "Despite our best efforts, on a populational level, heart attacks can still occur in patients out of the blue."

Nearly nine months after his heart attack, test results at Mayo Clinic indicate Colt is making excellent progress. Exercise combined with a heart-healthy diet has helped him shed 60 pounds. "I'm about back to being in my college shape," says Colt, who played on the golf team for the University of Georgia before his singing career took off.

While his physical health improves, Colt admits the health scare has left him battling anxiety and panic attacks. "For me to say I'm having anxiety and panic attacks, that's even hard for me to say because I ain't scared of nothing," Colt says. "But I'm having to deal with that and share my feelings and all that kind of stuff. So, if you're feeling something, advocate for yourself. Don't just tough it out. Tell somebody."

Dr. Lee says it is not uncommon for patients to experience anxiety, panic attacks and even depression following a heart attack. He recommends patients maintain an open dialogue with their health care team and discuss any issues that arise.

"I'm back, baby!"

Colt has been open about sharing his experience with his nearly three million followers on social media. "I'm back, baby!" Colt shared recently on Instagram. "It's been quite a journey but you guys have inspired me, you kept loving me, kept praying for me, kept sending me messages and I'm working hard to get better."

Just a year shy of his heart attack, Colt has released a new song and is embarking on a new tour. He is hoping his music and story will serve as inspiration for others.

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Dr. Carrie Jadlowiec, a Mayo Clinic transplant surgeon, says a living-donor kidney transplant has benefits for organ recipients, including better survival rates.

Who is eligible to become a donor and what can you expect? Learn more in this Mayo Clinic Minute.

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"As long as you're healthy and have good kidney function, then you could potentially qualify to be a kidney donor," says Dr. Jadlowiec.

It starts with a thorough medical evaluation.

"That gives us a good sense of where we're starting, and then it also allows us to better predict where will your kidney function be at in five years and 10 years after you donate," she says.

Risks

Both surgical and medical risks are low, thanks to advanced technology.

"For all kidney donors, that risk is less than 1%, which is what we see within the general population," says Dr. Jadlowiec.

It's a minimally invasive surgery. "Meaning that we do it through small incisions, which helps with faster recovery," she says.

Full recovery can take up to six weeks, but many people start feeling better around three weeks after surgery.

"The biggest benefit is the ability to help someone and to really change their life," Dr. Jadlowiec says.

Related posts:

• Mayo Clinic Q and A: Living kidney donation can start a chain reaction
• Mayo Clinic Minute: Why diverse organ donors are needed

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Bold. Forward. Unbound. in Arizona will reimagine the healthcare experience for patients and staff and expand clinical space on the Phoenix campus by nearly 60%

PHOENIX — Today, Mayo Clinic announced a nearly $1.9 billion investment in the continued transformation of its Phoenix campus as part of its Bold. Forward. strategy to Cure, Connect and Transform healthcare for the benefit of patients everywhere.

Bold. Forward. Unbound. in Arizona will enable new innovative care concepts, physical spaces and integrated technologies to create seamless care experiences for patients and a better workplace for staff.

Mayo’s largest investment in the state, Bold. Forward. Unbound. in Arizona underscores Mayo Clinic's leadership in creating a next-generation healthcare model that scales solutions for more patients when and where they need them. By harnessing the power of innovative technology and integrating physical and digital care, Mayo Clinic aims to deliver more cures, improve patient outcomes and elevate the patient experience.

"Bold. Forward. Unbound. in Arizona is the final major building block of Bold. Forward. Unbound., our complete reimagining of our physical infrastructure to enable all of Bold. Forward.," says Gianrico Farrugia, M.D., president and CEO of Mayo Clinic. "Through this work, we are physically and digitally transforming healthcare and blurring the lines between inpatient and outpatient care to support Category-of-One healthcare for our patients, a Category-of-One workplace for our staff and to serve as a blueprint for the world."

This 1.2-million-square-foot expansion includes the construction of a new procedural building, a four-floor vertical and horizontal expansion of the Mayo Clinic Specialty Building, the integration of leading-edge technology, the addition of 11 new operating rooms and two new patient units supporting 48 additional beds, and an enhanced arrival experience for patients and visitors.

The plan calls for a two-story, indoor promenade that wraps around the front of the campus, creating cohesion and convenience for patients and visitors as they move from building to building. Another prominent feature in the new design will be the development of care neighborhoods that cluster complementary clinical services for a more intuitive and connected patient experience.

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"This incredible investment will forever change the patient and staff experience in Arizona as Mayo Clinic grows and reinvents its nationally recognized clinical care, research and education," says Richard J. Gray, M.D., CEO of Mayo Clinic in Arizona. "Bold. Forward. Unbound. in Arizona will increase clinical space on the Phoenix campus by nearly 60 percent, allowing us to care for more patients than ever before. We look forward to setting new standards for patient care and medical innovation."

Bold. Forward. Unbound. in Arizona is part of Mayo Clinic’s Bold. Forward. Unbound. physical plan to achieve seamless integration of physical spaces and digital capabilities to meet patients’ unmet and evolving needs across all sites. Projects are underway in Rochester, Minnesota, and Jacksonville, Florida, and Mayo Clinic Health System recently completed projects in Mankato, Minnesota, and La Crosse, Wisconsin. Design for the Arizona expansion begins this year with completion slated for 2031. This endeavor will involve numerous architectural and general contractor firms. An initial design and construction team of McCarthy, Gensler and Arup Group has been formed, and more collaborators will be named in the coming months.

"The dramatic growth in our metropolitan area, state and region has led to an escalating need for care of patients with complex medical conditions that is difficult to accommodate with our current technology and infrastructure," according to Dr. Gray. "We continue to believe that Arizona is a great place to advance new cures, new collaborations and Mayo's distinctive model of care."

Media kit, including video, interviews, design renderings, and photos, available for download here.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Marty Velasco Hames, Mayo Clinic Communications, newsbureau@mayo.edu

Related stories

• Bold. Forward. Unbound. in Rochester
• Mayo Clinic Board of Trustees approves plans to transform healthcare, improve experience for staff and patients, redesign Rochester campus
• Mayo Clinic invests in major hospital expansion to enhance patient experience
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• Mayo Clinic recognized as ‘World’s Best Hospital’ by Newsweek for the seventh straight year
• 10 Mayo Clinic research advances in 2024, spanning stem cell therapy in space to growing mini-organs

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Dr. Regis Fernandes, a Mayo Clinic cardiologist, says triglycerides provide the body with energy from food. High levels can indicate signs of other conditions, like diabetes or prediabetes, that can increase the risk of heart disease and stroke.

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Triglycerides, the main kind of fat in your body, store extra energy from the food you eat. 

"It's an energy source. It's like a little battery used for energy. But too many triglycerides can also cause heart disease," says Dr. Fernandes.

People who are overweight, in general, have high triglyceride levels and good cholesterol levels that are low.

"They may get heart disease not because their LDL is high, they get heart disease because the HDL is low and the triglycerides is high," he says.

And this is significant for people in their 30s and 40s.

So what can you do? Reducing simple carbohydrates, such as refined sugars and flours, can help lower your weight and improve your cholesterol and triglyceride levels. And you can back that up with exercise.

"One of the best ways to lower triglyceride levels is to exercise. Also, exercise helps to lose weight. And when you lose weight, your triglycerides improve a lot," says Dr. Fernandes.

Tips to lower triglcyerides 

• Aim for 30 minutes of exercise most days.
• Cut sugar and refined carbs.
• Lose weight and focus on reducing calories.
• Choose healthier fats like olive oil and fish that are rich in omega-3.
• Limit alcohol, which can be high in calories and sugar.

Medications, including statins, may be prescribed if lifestyle modifications don't help.

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Asthma is a condition in which the airways in the lungs narrow and swell and may produce extra mucus, making breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma affected an estimated 262 million people in 2019 and caused 455,000 deaths, according to the World Health Organization.

There is no cure for asthma, but its symptoms can be controlled. For patients with asthma, remission is considered the primary treatment goal, with fewer or no symptoms, and the patient requiring minimal to no medication to manage their condition.

Current asthma guidelines, including those of the European Respiratory Society and the American Thoracic Society, define asthma severity based on a patient's medication dose — without taking into consideration the healthcare burden, such as how successfully patients can control their asthma, how often they visit their doctor, visit the emergency room and receive other healthcare services. In other words, what has been missing from the research behind current guidelines is data from the perspective of the patient's quality of life.

Mayo Clinic researchers propose a new, personalized approach to asthma using patient-centered information based on healthcare burden data instead of prescribed medication, according to a study published in The Lancet Respiratory Medicine.

The Mayo-led study is the first to use two longitudinal asthma cohorts from the U.S. and 11 European countries to introduce a tool that measures both asthma control and severity and translates that data into a quantifiable exacerbation – a way to measure the risk of an asthma attack.

The investigators analyzed data from 1,037 adult participants from the Severe Asthma Research Program III in the U.S. and the European Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes to calculate a composite asthma burden score based on asthma attacks and healthcare. They also added the number of instances each patient needed a rescue bronchodilator to reflect asthma symptom burden.

The lead author, Joe Zein, M.D., Ph.D., a pulmonary medicine and asthma researcher at Mayo Clinic in Arizona, says the findings show discrepancies between the current definition of asthma severity and the research team's burden score.

"The standard definition of severe asthma is based on prescribed asthma medications," says Dr. Zein. "Our personalized healthcare burden score includes patient-centered data that reflect disease severity and accurately predicts asthma remission."

Dr. Zein says the study looks at asthma remission using two well-characterized asthma cohorts. "Asthma remission has been proposed as a hypothesis. That is something we look at, but no one was analyzing the data to test it. This is the first study to test the concept of asthma remission," he says.

If further studies support the team's method of calculating asthma burden, it ultimately could help care teams better manage cases of high-risk individuals with asthma and improve their treatment.

For a complete list of authors, disclosures and funding sources, read the manuscript.

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DEAR MAYO CLINIC: I am in my 30s and overweight, but I thought I was too young to worry about cholesterol. I just learned my cholesterol is high. I know diet and exercise are important. Do I need medication? 

ANSWER: Cholesterol is a type of fat in our blood. Our bodies need a small amount of cholesterol to build the structure of cell membranes, make certain hormones and help with metabolism, such as producing vitamin D. The catch: We don't need too much cholesterol. 

Atherosclerosis, also known as narrowing of the arteries, happens when cholesterol builds up and blocks blood flow. This buildup is called plaque, which can clog arteries and can burst, leading to a blood clot. Atherosclerosis can cause heart problems such as chest pain (angina) or heart attack. It also can lead to problems in the brain, including transient ischemic attack, stroke, peripheral artery disease in the legs or arms, and even kidney failure.

Cholesterol and triglycerides are types of lipids. They travel in our blood by attaching to proteins. Adults 20 and older should ask their healthcare team about their lipid profile and how to interpret the numbers. 

• Low-density lipoprotein (LDL) cholesterol: We call LDL "bad" cholesterol. Below 100 milligrams per deciliter (mg/dl) is optimal for healthy people in the absence of coronary artery disease. If you have heart disease, your LDL should be below 70 mg/dl. Treatment decisions to reach appropriate levels need to be based on personal risk factors.

• High-density lipoprotein (HDL) cholesterol: We call HDL "good" cholesterol. It absorbs cholesterol in the blood and brings it to the liver, which flushes it from the body. For females, it should be above 50 mg/dl. For males, it should be above 40 mg/dl.

• Triglycerides: Triglycerides are a type of fat we use for energy. If you have too high of a triglycerides level, it can cause heart disease. Less than 150 mg/dl is optimal. 

• Total cholesterol: This is the sum of LDL and HDL cholesterol plus 20% of triglyceride levels. A total cholesterol level below 200 mg/dl is desirable.

Some people who are overweight may get heart disease not because their LDL is high but, rather, because their HDL is low and their triglycerides are high. That relationship can cause heart disease as much or even more than just high LDL cholesterol. These lipid abnormalities are significant for young people in their 30s or 40s who are overweight. Their triglyceride levels increase, and their HDL lowers. They're becoming prediabetic. Their LDL is staying the same, but they're still heading to heart disease. 

Treating high cholesterol depends on individual risk. The higher the risk — for example, with someone who already had a heart attack — a higher percent of reduction is needed. Medication to lower cholesterol can reduce LDL by about 60% to 65%. Lifestyle changes can reduce LDL by 10% to 15%. 

Several medications can help manage lipids. Discuss options with your healthcare team.

The body's ability to handle cholesterol is genetically determined. Genetic disorders that raise cholesterol levels are common. Familial hypercholesterolemia usually is caused by a genetic mutation preventing the body from clearing cholesterol. People with the condition are more likely to require medication to reduce their cholesterol levels. 

For people with genetic disorders that expose them to elevated cholesterol since birth, heart disease can happen at a younger age. So we start treating their high cholesterol with medication at a young age. 

Beyond medication, lifestyle modifications help manage lipids:

• Limit meat and dairy intake; they have saturated fat, which raises LDL cholesterol.
• Consume more fish, soluble fiber, fruit and vegetables. 
• Avoid diets high in carbohydrates, particularly refined carbs like sugar and white flour. They raise the blood sugar level quickly, raising triglycerides. Reducing simple refined carbohydrates helps lower triglycerides and weight because you store less fat. 
• Control your weight. It lowers your triglycerides and improves your HDL levels. 
• Exercise about 150 minutes of aerobic activity a week at a moderate intensity. Moderate intensity means you must breathe through your mouth. If you're breathing through your nose, that is low intensity. Exercise prevents cholesterol from building up, but it doesn't change LDL concentration levels. You must burn about 2,000 calories a week to lower LDL concentration. However, exercise helps lower triglyceride levels and maintain weight loss. 
• Do strength training at least twice a week. It helps your cardiovascular and muscular systems. Not everything we do to prevent heart disease is about cholesterol. 

The National Heart, Lung and Blood Institute recommends people get their first cholesterol screening between ages 9 and 11, and repeat it every five years. For men 45 to 65 and women 55 to 65, cholesterol screenings should occur every one to two years. Over 65? Test annually. More frequent testing may be needed for people who have or are at risk for coronary artery disease. — Regis Fernandes, M.D., Cardiovascular Medicine, Mayo Clinic, Phoenix

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Dr. Jesse Bracamonte, a Mayo Clinic family medicine physician, says it's important to seek medical advice if the condition persists. Getting evaluated can help identify and treat any underlying health conditions.

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Sometimes, cold feet simply mean you need warmer socks. But if your feet are always cold, no matter the weather, it might be something more.

"Anything from circulatory problems, not having adequate blood flow, heart condition problems, immune or autoimmune conditions such as like having thyroid disease, and sometimes nerve or neuropathic problems. Having nerve disorders can cause cold feet," says Dr. Bracamonte.

Where to start? He offers a few immediate steps.

"Warm socks, lifting your feet, staying hydrated, diet, nutrition is really important. Exercise is important. And, obviously, if you smoke, don't smoke," he says.

If your feet remain to feel cold but are not cold to the touch, it might be time to see your healthcare team.

"There are certain tests that it can easily be done to ensure that you have no circulatory issues, and a few blood tests may be warranted just to make sure you have no autoimmune issues or even signs of anemia," Dr. Bracamonte says.

Related posts:

• Tapping regenerative sciences to unlock mysteries of peripheral neuropathy
• Mayo Clinic Minute: What may be causing your hands and feet to tingle

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Dr. Richard Sharpe Jr., a Mayo Clinic radiologist, says it's crucial to talk with your healthcare team to find the screening method that is right for you. An MRI is one option.

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"The first thing to know if you get notified is that dense breast tissue is completely normal. 

Half of all women will have dense tissue," says Dr. Sharpe.

He says dense breasts are identified through a mammogram. Additional testing is the next step.

"The most widely available supplemental screening test for women with dense tissues is probably an ultrasound of the breast or an MRI," says Dr. Sharpe. "There have been lots of studies showing that MRI is the most sensitive test for finding breast cancer."

An MRI is meant to be used along with a mammogram, not instead.

"MRI is the most sensitive test we have for finding breast cancer. It can see through density. It can find hard-to-see, small cancers," says Dr. Sharpe.

But it's not for everyone. You'll lie face down on a table and then guided into the MRI machine."Some patients that have challenges with claustrophobia might struggle to be comfortable in the smaller space of the MRI scanner," explains Dr. Sharpe.

The benefit is clear, he says.

"Women with dense tissue or high risk for breast cancer that undergo breast MRI, we are able to see cancers that would be hiding from the mammogram."

Supplemental screening options

Other supplemental screening options include molecular breast imaging (MBI), ultrasound and contrast-enhanced mammography. 

Dr. Sharpe says choosing what screening method works for you is an individual decision that should be made with your healthcare team, but he says it's important to start with your annual screening.

"The most important thing for women to know is that you should get your annual mammogram, starting at age 40. Also, if you have dense tissue, consider a supplemental screening, another imaging test looking at the breast tissues in a different way — and you should get that exam regularly as well," he says.

"The most important thing for women to know is that you should get your annual mammogram, starting at age 40. Also, if you have dense tissue, consider a supplemental screening, another imaging test looking at the breast tissues in a different way — and you should get that exam regularly as well," he says.

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