General Health


In a survey commissioned by Healthy Women, The National Stroke Association and the American College of Emergency Physicians, only 30% of adult women surveyed knew that women are at higher risk for stroke than men. Only 27% of women surveyed could name more than 2 of the six primary stroke symptoms. How would you do?

  1.   Sudden numbness or weakness on one side of the face
  2.     Sudden numbness or weakness in an arm or leg
  3.     Sudden confusion, trouble speaking or understanding speech
  4.     Sudden trouble seeing
  5.     Sudden trouble walking, dizziness, loss of balance or coordination
  6.     Sudden severe headache with no known cause

The common element here is the sudden onset of symptoms. If you experience any of the above symptoms, call 911 or have someone drive you to the emergency room. Women are used to taking care of family members, friends, and even casual acquaintances…remember to take care of yourself!

Researchers at the Norwegian University of Science and Technology have found that women who exercised four or more times weekly were 29% less likely to develop fibromyalgia than sedentary women. Obese women (women with a BMI of at least 30) had a 64% higher risk than normal-weight women of developing the disorder.

Fibromyalgia causes long-term muscle and connective tissue pain, extreme fatigue, and disturbed sleep patterns. It also causes elevation of serum levels of proinflammatory cytokines and dysregulation of the hypothalamic-pituitary-adrenal axis (HPA). These symptoms are the same as those caused by obesity and depression. Therefore, treating the symptoms with exercise and anti-depressants can often help fibromyalgia sufferers.

The researchers in the Norwegian study stated, “Regular physical exercise, and thereby improved physical fitness, may serve as a buffer against the perpetuation of musculoskeletal symptoms that eventually lead to the development of fibromyalgia.” Another great reason to incorporate regular physical activity into your routine!

What puts you at risk for heart attack? Is it high blood pressure? Poor diet and lack of exercise? Or maybe high cholesterol? The answer can be any or all of these, but that’s not the whole story. Half of all heart attack victims have normal cholesterol levels…their heart attack was the first sign that something was wrong. Now there is a test that can tell you not only the standard total cholesterol, LDL, HDL and triglyceride levels…but the number of LDL and HDL particles and how big the particles are. Why is that information important? How can that knowledge affect the determination of risk?

 

First, let’s review some basic information about cholesterol. About 75% of the cholesterol in your blood is made in your liver and other assorted cells. The other 25% comes from the food you eat. Cholesterol is only found in animal products. Your body uses the cholesterol to produce hormones and several vitamins. Cholesterol doesn’t dissolve readily in water, so not much can be transported by the blood. For this, your body relies on lipoproteins to move cholesterol and triglyceride particles to where they need to go. Triglycerides travel on the inside of the particle, cholesterol sticks to the outside. Low density lipoproteins (LDL) have lots of cholesterol and very little protein in them. LDL lipoproteins are the major carriers of cholesterol in the blood. When there is a lot of cholesterol in the cells, the receptors are blocked which leaves the LDL circulating in the blood. The LDL is oxidized and taken up by macrophages which then swell and stick to the arterial walls, forming plaque. Plaque takes up valuable room in the artery, making it harder for blood to go through. This raises blood pressure and can eventually cause a heart attack by blocking an artery completely. High density lipoproteins have a lot of protein, so not much room for cholesterol; therefore they have less chance of depositing plaque on the arterial walls. HDL particles contain cholesterol that is not easily oxidized. It is thought that they “scour” the arterial walls and clean out excess cholesterol. The cholesterol that was removed from the walls is then transported back to the liver where it is processed and can do no harm. Triglycerides are chains of high-energy fatty acids that provide much of the energy your cells need to function.

 

In assessing cardiac risk, you need to know how much cholesterol a person has (we’ll call cholesterol particles “passengers”), how many lipoprotein particles a person has (“vehicles”), and how big the lipoprotein particles are (“busses vs. compact cars”). Now, if your arteries are the roads, the best scenario would be a small number of large vehicles to keep traffic flowing smoothly. Imagine 150 people (number of particles) being transported down a road (in the artery) - you could fit all the people into 3 busses (large particles) and traffic would be very manageable or you could have 150 little cars (small particles) vying for space slowing everyone down. It would also be prudent to take a closer look at the size and number of LDL particles vs. HDL particles.

 

The NMR LipoProfile test will report the traditional lipid panel with the addition of number and size of particles. Those readings are then used to determine insulin resistance and diabetes risk. One of the earliest signs of impending insulin resistance is alteration of lipoprotein metabolism. All these results combined with family history can help your physician create a much more effective treatment plan. 

Heart disease is America’s No. 1 killer. It effects both men and women and almost everyone could improve their heart health. The good news: there are a lot of things you can do to boost your heart health that don’t cost a lot of money, and aren’t complicated or difficult.

  • Eat less fat- Everyone knows this, but few people know how easy it is to make small changes in your diet that have big impact. Be conscious of what you are putting into your mouth. You want chips and dip while watching the game? Try baked tortilla chips and salsa instead. Like to bake? Substitute applesauce for vegetable oil in your cake. Going to a BBQ? Grilled salmon is just as easy and delicious as a hamburger…with less saturated fat. When you make small substitutions to your diet it doesn’t seem as painful, but makes a big difference to your heart!
  • Eat more fruits and vegetables- The reason for this is two-fold. Not only do you get fiber and nutrients from fruits and veggies, which can help you process your foods efficiently; you also fill your stomach with low-fat, nutrient-dense foods leaving less room for the fatty stuff.
  • Don’t skip breakfast- FACT: Most heart attacks occur between 7 a.m. and Noon. There is no conclusive data explaining this, but researchers have found that your platelets (the cells that help your blood to clot) are the stickiest during that time. Eating makes the platelets less sticky and possibly less likely to clump together and form a blockage in an artery.
  • Lower your cholesterol- Depending on your genes, eating right may not be enough to keep your cholesterol at healthy levels. If you find after changing your eating habits your cholesterol is still high, your doctor may prescribe a statin to help lower it. Be consistent in taking your medication and make sure your doctor monitors your levels closely to ensure good heart health.
  • Keep your blood pressure in check-This too may be genetic. You may have inherited more than your father’s green eyes. Monitor your blood pressure and if your doctor prescribes medication, be sure to take it as directed.
  • Find your inner peace- Do you blow up when you are stressed? Over-react when you are frustrated? Studies have shown that people who over-react to stress  are more likely to have reduced blood flow to the heart. Relaxation techniques aren’t just for your flaky friend Sunshine anymore…yoga, meditation, deep breathing, stretching and massage are great ways to relax your body and increase blood flow to your heart.
  • Invest in anti-oxidants-Vitamins A, C and E, beta-carotene, and CoQ10 are important to your heart. These will slow plaque formation in your arteries, keeping the pathways open for your blood to carry oxygen and nutrients to your cells.
  • Stop Smoking- Smoking isn’t just bad for your lungs, it also constricts your blood vessels and increases your risk for plaque formation, both of which make it hard for your blood to get around. The good news is that a few years after quitting, your risk of heart attack goes down dramatically.
  • Move it!- A sedentary lifestyle is one of the greatest risk factors for heart attack death. You don’t need to be a triathlete to reap the benefits…a half hour of moderate exercise (like brisk walking) can make all the difference. You say you don’t even have time for that? Incorporate exercise into your everyday life. Take the stairs at work, park on the outer edge of the parking lot and hike in to the grocery store, hide the remote for the TV, join your kids in a basketball game, there are plenty of little changes you can make to add activity and fun to your life!

Many of us don’t realize that calcium is vital to our entire body, not just our bones. It is the most common mineral in the body and is required for proper function of our brain, our heart, and many other organs. Priority is given to the body’s organs. Not eating enough calcium-rich foods can cause the body to pull the needed calcium out of our bones, causing them to become weak and sponge-like. This condition is called Osteoporosis and can cause bones to fracture during every day activities.

The easiest and least expensive ways to protect your bones are through your food and lifestyle choices. What you put in your mouth will affect your total health in the long run! Some of basic suggestions for strong, healthy bones are as follows:

  • Make sure you get 1200-1500mg of calcium per day, divided into 3 doses
  • Vitamin D is necessary for your body to absorb the calcium-drink fortified milk, take a supplement, or get some sun!
  • Maintain a moderate intake of phosphorus-too little and your body can’t form bones and teeth-too much and it will upset the calcium balance in your body. Carbonated beverages and too much protein in your diet will give you too much phosphorus
  • Get  enough fiber for proper function of the digestive tract, but not so much that it decreases the absorption of calcium. Up to 35 gm per day should be enough
  • Lighten up on caffeine! Not only does it cause sleep issues, but more than 3 cups of caffeinated beverages per day can cause a loss of calcium in your body
  • Alcohol has a toxic effect on the formation of bone cells, save your drinks for special occasions, not every day
  • Cigarette smoking has been shown to increase bone loss and decrease estrogen levels (estrogen protects your bones). Quitting smoking is not only good for your lungs!
  • Regular weight-bearing exercise helps prevent bone loss. Try adding a few extra steps everywhere you go by parking further away from your destination, using the stairs instead of the elevator, etc. Every little bit helps!
  • Make sure your estrogen levels in your blood are high enough to protect your bones-a decrease in estrogen with menopause corresponds directly to an increase in bone loss. Menopause is a time when women are especially vulnerable to bone loss.
  • Check out your diet for simple ways to increase calcium intake-dairy products, dark green leafy vegetables, tofu, fish and whole grains are good sources of calcium. Some juices, grains and dairy products are fortified with calcium as well.

If you and your physician have decided you should take  a calcium supplement, how do you know which one is best? Generally Calcium Carbonate is recommended because it has the highest amount of absorbable calcium. Less effective are Calcium Citrate, Calcium Lactate and Calcium Gluconate. Bone meal and dolomite are not recommended because they may contain toxic substances such as lead, arsenic and mercury. Chelated Calcium is expensive and generally no better than any other form of calcium. Make sure you take no more than 2000mg of calcium per day, as long term use of large doses can cause unhealthy side effects. Your physician can help you determine the correct dose for you as an individual.
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ABC World News recently reported on a new study that showed 100,000 lives could be saved each year if a few preventative steps were taken.

  1. Take a daily aspirin. About 45,000 people would be saved each year if they took a daily dose of aspirin. Men over 40, women over 65, and adults with a high risk of heart disease would benefit the most.
  2. Quit smoking. An estimated 42,000 lives would be saved if patients were encouraged to quit smoking, and offered assistance.
  3. Have a colonoscopy. If 90% of adults aged 50 and older were up-to-date on recommended screening for colorectal cancer, an additional 14,000 lives would be saved each year.
  4. Have a mammogram. All women 40 and older should be screened for breast cancer. 3,700 deaths from breast cancer could be prevented each year with the proper screening.
  5. Get your flu shot. The flu shot is recommended for children under 5, people over 50, anyone with a diminished immune system, and people caring for any of the above. The flu vaccination is an easy and affordable way to protect yourself.

These are some easy ways to care for your body and prevent serious disease. Make sure you and your loved ones are up-to-date.

Finding a lump in your breast can be scary. Fortunately, 80% of breast lumps turn out to be benign-not dangerous. What can you expect after finding a lump?

First, your physician will want to do a clinical breast exam. After ruling out the obvious, like bug bites and swollen lymph nodes, your physician will order tests to determine what the lump is. Here are some of the tests they will be considering:

  • Diagnostic mammogram-Your breast will be x-rayed from a variety of angles to get a clear view of the area of concern. Digital mammograms are typically more accurate than analog mammograms-especially for premenopausal women and women with dense breasts.
  • Ultrasound-Your breast may be viewed using a wand-like device that emits high-frequency sound waves. An ultrasound can distinguish a fluid-filled cyst from a solid mass.
  • MRI (magnetic resonance imaging)-A dye is introduced into the veins of the breast creating a 3-D image of the breast on a screen. Distinguishing different types of tissue is then fairly easy…normal tissue looks different than cysts and tumors. MRI is a good option for women with breast implants and women who have already had breast cancer.
  • Breast biopsy-If non-invasive tests are inconclusive, your physician may order a breast biopsy. A small sample of tissue will be removed from the area of concern to be examined further. You may have a fine-needle biopsy if your lump can be felt, but not seen on film; a core-needle biopsy for solid lumps or masses; or an excisional biopsy, during which the entire lump is removed in the hospital while you are under sedation.

Whichever test your physician chooses, it is important for you to have the additional tests necessary to protect your health. While 80% of lumps are benign, don’t assume yours is-follow up on it and be sure.

The colonoscopy is the most comprehensive test available to screen for polyps (which can turn into cancer) and cancers of the rectum and colon. Your doctor will order a colonoscopy as a screening test around your 50th birthday.

The day before the test, you will be asked to follow a clear liquid diet. You’ll have to take laxatives beforehand, and possibly have an enema the day of the test. This ensures that no stool blocks the view of the colon.

During the test, the doctor uses a lighted instrument called a colonoscope to examine the entire length of the colon and the rectum. This usually takes 20-30 minutes and is done under sedation in an outpatient facility or hospital.

There is a slight risk of bleeding or tears in the lining of the colon, but the benefits outweigh the risks, with a cancer detection rate of over 90%. If a polyp or early cancer is found, it can be removed during the procedure.

The colonoscopy is an important tool your doctor uses to prevent colon cancer or detect it at an early, curable stage. Talk to your doctor about how often the colonoscopy needs to be done-many doctors recommend once every 10 years.

We all know smoking is bad for us…but it’s not easy to stop. There is help if you are ready to quit. The FDA has approved a drug called Chantix to help stop smoking. Many people feel a sense of calm or relief when they smoke, Chantix blocks that feeling so there are no positive feelings associated with smoking. It also lessens the symptoms of withdrawl, making it easier for a person to quit.

Chantix is a capsule you take daily. The recommended dosing is:

  • 0.5mg daily for days 1-3
  • 0.5mg twice daily for days 4-7
  • 1mg twice daily for weeks 2-12
  • If another course is needed, you can continue the 1mg twice daily for the next 12 weeks

Does it work?

Several studies have shown Chantix to be more effective than Zyban (another name for Wellbutrin), which is more effective than placebos or no assistance. Some numbers from one of the studies:

  • 44% of those on Chantix were not smoking at 12 weeks
  • 29.5% of those on Zyban were not smoking at 12 weeks
  • 18% of those on a placebo were not smoking at 12 weeks

Another study followed the participants who had quit smoking after 12 weeks on Chantix. Half of the group continued taking Chantix for another 12 weeks, half took a placebo. At the end of the 24 week period, 70.5% of those on Chantix were still not smoking, 49.6% of those on placebo were still not smoking. Obviously, Chantix is not a “silver bullet”, it doesn’t guarantee success. But, people trying to quit smoking have had more success taking Chantix than the other typical cessation aids.

Chantix can cause some side effects…the most common are:

  • nausea
  • insomnia
  • headache
  • abnormal dreams
  • abdominal pain
  • fatigue
  • flatulence
  • dry mouth

The most common side effect we hear about from patients is nausea with the pills. An effective way to deal with that is to drink 8 oz. water, take your pill with another 8 oz. of water, and then drink another 8 oz. water. The large amount of water seems to cut down on the nausea. The nausea typically passes after the first few weeks and patients have found it gets easier and easier to be a non-smoker.

What is cholesterol?

Cholesterol is a type of fat that has good and bad effects on your body. It is used to make hormones and nerve cells. However, when your body has too much cholesterol, the excess is deposited on the inside of blood vessel walls (called plaque). This blocks the passage of blood and can lead to heart attacks and strokes. Most of the cholesterol in your body is made by your liver from the food you eat.

Lets break down the components of cholesterol:

HDL (high-density lipoproteins) clean artery walls and remove excess cholesterol from the body. This is what is commonly referred to as “good cholesterol” (think of “H” for healthy cholesterol).

LDL (low-density lipoproteins) leave fatty deposits behind on your arterial walls contributing to heart disease (think of “L” for lousy cholesterol).

Triglycerides are a form of fat that the body makes from sugar, alcohol, and excess calories. It is carried through the bloodstream by your LDL to be stored in tissues (that spare tire is a prime example). Most of the body’s fat tissue is in the form of triglycerides, stored for use as energy.

What should my cholesterol levels be?

Cholesterol is checked with a fasting blood draw. “Fasting” means nothing to eat for 12 hours before the blood draw (don’t fast longer than 14 hours) and no alcohol for 72 hours before. Always drink plenty of water, though.

  • Total cholesterol should be below 200
  • HDL should be 40-60 to help lower your risk for heart disease
  • LDL should be below 100 ideally…if you have diabetes, it is especially important to control LDL
  • Triglycerides should be below 150

How can I control my cholesterol?

There are a few very effective things you can do to keep your cholesterol at healthy levels.

  1. Limit the amount of fat and cholesterol in your diet. Nuts and high fiber foods (especially fresh fruits and vegetables) are excellent cholesterol controllers. Eating nuts raises your HDL levels and fiber will help lower LDL levels.
  2.  Exercise! Just 30 minutes of moderate aerobic exercise daily will work wonders in your body. It keeps your weight down, decreases LDL levles, increases HDL levels and is a great stress reliever.
  3. Stop smoking! Smoking increases your risk of heart disease because it lowers HDL levels.

Ask your provider if you have any other questions or concerns about cholesterol.