myhealthvillage

17 Search Results for "attacks"

• It's Dangerous to be a Man It's Dangerous to be a Man

  • From: Jennifer
  • Description:

    It’s Dangerous to be a Man!

     

    The #1 killer of men is heart disease, which means heart attacks and strokes. Men tend to live sicker and die at much younger ages than women. Men are 25% less likely than women to get  yearly check-ups and be hospitalized  more often for preventable illnesses.  What's up with the men?  One thing I found out is they don't like to go to the doctor.

     

    Here are some of the reasons men don’t go to the doctor:

     

    1. “The doc always want to check my privates,” with good reason men!  If you are 18-40 years of age this is peak time for testicular cancer to develop.  Once a year exam is recommended to screen for testicular cancer.
    2. “The doc wants to check my prostate,” That’s right they do!  If you are over 40 years of age and/or have any concerns about your digestive tract, it’s recommended the doctor check for prostate cancer and blood in the stool that you can’t see. 
    3. “I feel fine.”  The famous words my uncle used until he had a stroke at age 50 due to high blood pressure.  You often feel fine when your blood pressure is high, your cholesterol level is out the roof, your arteries are clogging with fat and your blood sugar has sky rocketed.  Men these are silent and very deadly over time. 
    4. “Going to the doctor is for women,” It’s not just for women; it’s for yourself and taking part in your own health and well-being.  Maybe you have a doctor that is rushing you or you can't connect with, find one you can.  You're more likely to go if you feel good about the doctor you see. 
    5. “I feel picked on!”  Maybe you like a 6 pack of beer on the weekends, love red meat, smoke and hate to exercise.  Guess what?  You are not alone and you get to decide what it is you want to do with your habits. 
    6. “I just know they will find something wrong with me,” Men, your doctors don’t want to find anything wrong with you, they want to prevent it.  A yearly check-up is meant to stay on top of  good health!  I know my uncle wishes he could go back in time and treat his high blood pressure instead of the damage left by his stroke.

     Men, the risks are known, it’s not a secret.  Get into your doctor every year for your check-up and don’t lose family time because you didn’t.  Ladies your next!!!

     

  • Blog post
  • 2 months ago
  • Views: 31

• Brown Rice and Bran Brown Rice and Bran

  • From: Julie_Stansfield_MD
  • Description:

    Brown Rice and Bran

     

    This month an Article was published in the Archives of Internal Medicine that showed that people that eat brown rice are less likely to get diabetes than people who eat white rice.  So in theory diabetes can be prevented by eating brown rice.  One of the problems with these kinds of studies is that people don’t substitute one food for another.  Instead they tend to eat a lot of the food that has health benefits.  However that won’t work.  The study only looked at the benefits of switching from white rice to brown rice.  It didn’t look at what happened if you eat lots and lots of brown rice.  The study cites many other articles that show that a high carbohydrate intake is associated with more diabetes.  Brown rice despite its benefits is still a carbohydrate.  Better than white rice, but still a carbohydrate. You can’t eat lots and lots. Swap a 1/2 cup serving of white rice for brown rice to get the benefits.

     

    What makes brown and white rice different?  Brown rice becomes white rice when the outer brown husk is removed.  In many cultures white rice is called “polished” rice, because that is what happens.  A traveling polisher once came to my Aunt’s house in the Philippines to polish her rice.   That was quite a sight, belts polishing the brown husks off, spitting brown chaff one way and white rice the other.  When the brown bits are removed, the rice is easier to cook and lasts longer.  However it also removes the fiber and many nutrients.  Scientists aren’t sure if the benefits from brown rice come from the fiber or the nutrients or both. 

     

    Another study recently published looked at the benefits of bran.  Nurses that eat bran and that have diabetes reduce their risk of death by 28% and their risk of dying from heart disease by 35%.  Impressive results.   Bran basically is the outer husk of wheat.  Once again no one knows if it is the fiber or the nutrients that help people.  Clearly it works.  Brown rice seemed to reduce the risk of diabetes by 16%.  The study about bran did not address the question if bran reduces the risk of diabetes.

     

    So yes once again, whole grains are better than highly refined grains.  Whole wheat flour is better than white flour.  Brown rice is better than white rice.  But the only food category that you can eat as much as you want is still vegetables.

     

     

    Archives of Internal Medicine. Vol. 170 (No. 11), June 14, 2010 pp. 961-969

     

    Circulation 2010 May 25 [doi:10.1161/circulationaha.109.907360]

     

  • Blog post
  • 3 months ago
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• Large Meals are Toxic Large Meals are Toxic

  • From: Julie_Stansfield_MD
  • Description:

    Large Meals are Toxic

    The Latest data shows that even temporary increases in blood sugars are toxic. Large meals increase blood sugar levels to high levels.  These large increases in blood sugar cause damage even in people without diabetes.  The high blood sugars directly damage and kill many tissues.  Pancreas cells seem to die from the high sugars, leading to diabetes. The lining of arteries is damaged and this causes much higher rates of heart attacks. 

    We’ve known for years that diabetics have damage to many body areas from high blood sugars. It is news that non diabetics have damage as well.  It is a surprise that even a temporary increase in blood sugar levels can cause damage.

    
    

    There are two ways to lower your damage today and start improving your health.

    1. Eat smaller meals.  Especially avoid sugar, juice and sweetened drinks.  These are foods without fiber and without the fiber the blood levels raise to high levels more quickly after eating these foods.  Other foods that are low in fiber can have a similar affect in some people.  These include bread, rice, potatoes and pasta.  Choosing the high fiber version of these kinds of foods can help lower blood sugars after a meal. It is very important to remember that only plain vegetables can be eaten in large amounts.  Any other food in large amounts will raise the blood sugar levels significantly. 

    2. It is good to have a back up plan.  No matter what your intentions may be, you may have a meal larger than you know you should have had.  Go for a walk.  If you walk immediately after a meal you can lower your blood sugar fairly quickly.  Make it a habit, walk after a meal.

     

    You can take control of your health.  Eating smaller meals, more vegetables and walking more will lower your health care costs.  You’ll feel better.  You can avoid burdening your family with your illness.  Heart attacks and other diseases cause families grief.  How long will you be sick? How many more health problems will you get?  How long will you be out of work?  You will have many more health problems and you will miss work. The latest estimates link high blood sugars to the development of diabetes within 2.5 years.  In these people the number of heart attacks is nearly double that of normal people.
    

     

    Eat smaller meals, large meals are like poison.
    

     

     

    The American Journal of Medicine.  Glycemic Control and Complications in Type 2 Diabetes Mellitus.   March 2010, Volume 123, Number 3A.  Pages S3-S11.

    Amjmed.com

     

     

  • Blog post
  • 5 months ago
  • Views: 105

• Herb News Herb News

  • From: Julie_Stansfield_MD
  • Description:

    Herbal Supplement News

     Herbal supplements make me nervous.  It is so hard to know what is really in a bottle.  The American College of Physicians is the national organization for Internal Medicine docs.  They publish a paper called “ACP Internist”.  Last week this paper had a great article about herbal supplements, warning Internal Medicine Physicians to be alert.  Here is a summary.

     

    Bitter Orange

    This a weight loss supplement linked to heart attacks and strokes.  It also interacts with heart medication.

     

    Black Cohosh

    It is used for menopausal symptoms. It has been shown to make chemotherapy less effective.  It should not be used in women that have had breast cancer.

     

    Feverfew

    This is used for headaches, but if it is used with migraine medications it can cause dangerous elevations in heart rate and blood pressure.

     

    Garlic, Gingko, Ginseng and Goldenseal

    All of these can increase the bleeding risk of blood thinner medicine.

    Gingko should not be used in people that have seizures.

    Concentrated garlic pills can decrease the effectiveness of HIV medicine.

     

    Kava Kava

    Used for relaxation.   It can cause liver damage.   This has been shown to have dangerous interactions with Parkinson medicine, alcohol and antidepressants.

     

    Red Clover

    Used for hot flashes, but it can interfere with the breast cancer drug tamoxifen.

     

    St. John’s Wort

    This is used to decrease depression.  This medication interferes with the liver metabolism of many medications including birth control pills, antidepressants and many other medications that may pass through the liver.    Sounds like more trouble than this licensed prescription writer needs.  

     

    Remember herbal supplements are considered food and don’t have to meet any standards.  They also aren’t tested since they don’t have to be.  That means unproven results and unproven safety.  Even with the information above, it is difficult to know what is in a bottle of herbal medicine.

     

     

  • Blog post
  • 11 months ago
  • Views: 116
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• Portion Size Health Tips Portion Size Health Tips

  • From: Judy_Bock_RN
  • Description:

     Portion Size Health Tips

    Recently my husband gave me a handout that came with his prescription from the pharmacy. It didn't have anything to do with his prescription. It was health tips about managing portion sizes of food.

    All the tips in the handout were common sense, but also based on research into the ways to prevent taking in too many calories. You may have heard them before, but here it is again to reinforce some healthy habits.

    Portion control when eating out is a real problem for me and many people. There's often more on the plate at a restaurant than we need to eat. Try splitting a meal with someone else. Some of the higher-end restaurants will charge a splitting fee, but many are happy to do it at no extra cost. If you are splurging calories on dessert, sharing is especially important. I've been known to ask for three or four extra forks to split a decadent piece of chocolate cake. If eating alone, ask for a to-go box when ordering and put half of your meal in it as soon as it comes.

    Portion control when eating in is also a problem, maybe bigger. Try putting the food directly onto individual plates instead of in serving dishes at the table. Avoid big bowls of popcorn or other snacks in front of the TV. Put the amount you plan to eat in a bowl or other container, like a sandwich-size plastic bag. If you are focused on something else besides what you are eating, it's easy to overeat.

    The handout said it's OK to ignore what your momma always said and to go ahead and spoil your dinner. Basically, if you feel hungry between meals, eat a healthy snack like a piece of fruit or bite-size veggies. You can keep a bowl of grapes handy, zip-lock bags of broccoli or carrots or containers of low-fat or fat-free yoghurt. Avoid bowls of candy or other fat-producing snacks in easy reach. In our house we keep a bowl of cherry tomatoes on the counter top for snack attacks and fat-free flavored yoghurt in the frig.

    Research shows that the larger the package the more people tend to consume from it without realizing it. Try dividing up the contents of a large package into several smaller containers and serve the food in a small bowl or container. I was very impressed when I saw my husband take a small zip-lock bag of one of his favorite cheese cracker treats to his chair in front of the TV the other night. Broccoli may have been better, but it was an improvement from sitting down with the whole box.

  • Blog post
  • 1 year ago
  • Views: 93

• “Myths” About Statin Drugs “Myths” About Statin Drugs

  • From: Julie_Stansfield_MD
  • Description:

    “Myths” About Statin Drugs

    Patients frequently ask me about statin drugs.  These are a powerful group of drugs used to prevent heart attacks and strokes.  The heart attack rate in my patients dropped when I started using these drugs.  The number of studies that supports their use is astounding.  So it is curious that many of the questions I get tend to be the same.  Last month a patient brought me a brochure with a list of “Cholesterol Myths”, really a list of reasons not to take statins.   Here are the answers I would give to my patients about these common “myths.”

     

    “Myth: People with high cholesterol aren’t more prone to heart attacks.  Cholesterol is an important part of normal body functioning.”

    Reality:

    There are many kinds of cholesterol.  Some kinds of cholesterol are “good” like HDL and some are “bad” like triglycerides and LDL.   The total cholesterol number is not a very important number.  It is more important to keep the “good” cholesterol high and the “bad” cholesterol low.  When the HDL or “good” cholesterol is elevated, the risk of heart attack drops. This is because HDL cholesterol protects against heart attacks when it is high.   A high LDL level is clearly related to a higher risk of heart attacks and strokes.  Lowering the LDL cholesterol lowers the risk of heart attacks and strokes.  It is not possible to decide a person’s risk based on their total cholesterol, the parts must be known.    Even though high LDL and triglyceride “bad” cholesterols are linked to heart attacks and strokes, other problems can cause heart attacks and strokes.  About 50% of all heart attacks occur in people with “normal” cholesterol numbers.  So it is true that cholesterol alone cannot predict exactly everyone who will have heart attacks and strokes.   Many kinds of cholesterol are important to normal body functioning, but some kinds of cholesterol increase the risk of getting sick.

     

    “Myth: Cholesterol doesn’t clog arteries and cause heart attacks.  There is very little cholesterol or saturated fat in the arterial plaque or clogs.  Most of the material is a calcium deposit akin to lime and most of the fatty acids are unsaturated.”

    Reality:

    The sentence above is kind of like saying “after the car wreck all we found were tires, so there wasn’t a car involved.” Getting the complete picture requires current information and the history of events. Cholesterol and saturated fats are clearly associated with arterial plaques and clogged arteries.  Plaques and clogged arteries are complicated and there are other parts.  Calcium deposits can be found near plaques and may be part of the common inflammation or irritation within the blocked arteries.  The exact way all these parts fit together isn’t clear.  What is clear is that blocked inflamed arteries lead to heart attacks and strokes.  Cholesterol and saturated fats are one part of this whole reaction. Statins can decrease inflammation as well as cholesterol, heart attacks and strokes.    The Jupiter trial looked at inflammation.  Inflammation is measured by the test HS-CRP.  HS-CRP decreases with the use of Crestor (a statin).  When the HS-CRP level drops the number of heart attacks drops as well.  This  happens in people with already low cholesterol numbers.  So statins can prevent heart attacks in people at high risk for heart attacks no matter what their cholesterol levels.  No one really knows how it works exactly. Calcium deposits occur in other parts of the body and are normal, like in your bones.

     

     

    “Myth: There is no evidence that saturated fat and cholesterol-rich foods contribute to heart disease.  As Americans have cut back on saturated fat and cholesterol rich foods, rates of heart disease have gone up.”

    Reality:

    The heart attack rate in the United States has dropped. “From 1995 to 2005 the death rate from coronary heart disease declined 34 percent, but the actual number of deaths declined only 19 percent.” http://www.americanheart.org/presenter.jhtml?identifier=4591

    No diet has been well tested that makes people only eat saturated fat and cholesterol-rich foods.   Fully testing any strict diet has its difficulties.  Some foods like olive oil and canola oil raise HDL and total cholesterol and reduce heart disease.  The best evidence shows that avoiding large amounts of saturated fat and trans fat will reduce the risk of heart disease and stroke.  This is easiest to do by eating lots of vegetables and fruit, low fat dairy products and liquid oils instead of solid fats.  Meat should not be most of what you eat.  Diet shouldn’t be the only strategy to be healthy. People shouldn’t smoke. They should exercise every day. People may recommend other kinds of diets, but they don’t have scientific studies to prove that they work.  What works for a few people may not work for everyone.  People that don’t want to take chances don’t experiment with homemade seat belts; they put on the seat belt that someone else tested.

     

    A recent study published in the American Journal of Medicine showed that when people actually take their statin, their risk of stroke and drops 25%.  A stroke will change your life, so a 25% reduction is significant.

    http://www.amjmed.com/article/S0002-9343(09)00286-1/abstract
    

     

    Any medicine can have side effects. The most common side effects of a statin are NONE.  About 10 percent of people that take these medicines may have muscle aches (Annals of Internal Medicine 2009; 150:858-868.)  

    Don’t be scared by half truths.  Not all medicine is right for all people.  Some people have side effects, but others have none.  But just because one person has problems doesn’t mean everyone else should miss out on a chance to be well. 

     

    Here is a source for cholesterol guidelines and research studies:

    http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3upd04.htm

     

  • Blog post
  • 1 year ago
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• Test your Diabetes IQ Test your Diabetes IQ

  • From: Julie_Stansfield_MD
  • Description:

    Test your Diabetes IQ
    

    Most people can tell they have diabetes true or false?

    1. True
    2. False

     

    The answer is false.  Most people cannot tell they have diabetes.  Early on in the disease lots of damage is happening and a person cannot tell.  This is the time when the chance to avoid illness with the least cost is the greatest. Early on daily changes in the kind and amount of food you eat can control diabetes and make you nearly normal.  Exercise early in the disease and at all stages makes diabetes much better controlled without having to spend more money on medication.   Getting testing for the disease before a person feels badly is very important.

     

    Diabetes causes which skin problems?

    1. itchy tattoos
    2. jock itch
    3. Skin tags, dark skin under the arms and thickened skin on the face.

     

    The answer is #2 and #3.  Diabetes makes a person much more likely to have fungal infections like jock itch and ringworm.  It also seems to be more common in people with skin tags, dark skin in the arm pits and neck and thickened skin on the face.  It does not make tattoos itch, but tattoos have their own problems.

     

     

    What does Hemoglobin A1c mean?

    1. A handy way to make things complicated?
    2. The best way to diagnosis diabetes.
    3. A way to find you average blood sugars over three months.

     

    So many terms in health care are odd. The answer if #3, “Hemoglobin A1c” is just a handy test to tell you what your average blood sugar is over the last 3 months.   For now it isn’t approved to diagnosis diabetes.  This is because the test is a little bit variable from lab to lab.  It can be drawn fasting or non fasting.  

     

    What is the best level for a Hemoglobin A1c?

    1. Anywhere above 8
    2. 7 is a good number
    3. Below 7.

     

    The best numbers are below 7 (number 3).  This is because many studies have shown the complications related to diabetes are cut in half when blood sugars are this low.  This corresponds with average blood sugars that are below 150.    When a person aims for blood sugars of about 100 to 120 they will meet this average.  If they aim for blood sugars of 150, their higher numbers will make their average too high.  To not miss out on a chance to cut your complications in half aim for 100 to 120.  Aiming for these numbers is a great chance to cut in half the number of strokes, heart attacks, blindness, impotence, limb loss and kidney failure that diabetes can cause.

     

    Which of the following are not complications caused by diabetes?

    1. Strokes
    2. Blindness
    3. Kidney failure and dialysis
    4. Impotence or decline in sex life
    5. Loss of limbs
    6. Heart attacks
    7. Pneumonia
    8. Lock jaw

     

    The answer is lock jaw #8.  Diabetes is a major reason for many diseases.  It is also an opportunity.  So many hospital visits and illness can be decreased by aggressively treating this disease it is mind boggling.

     

    This was a hard test.  If you got 3/5 correct or more you have a good basic knowledge of your disease.   Even if you didn’t get any correct I’ll bet you already know more.  If you got 4/ 5 correct or more super! You are well on your way to knowing a lot.  Now its just time for a short walk to lower those blood sugars and prevent diabetes, it’s good for everyone.

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  • 1 year ago
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• Prevent DVT’s/ Leg Clots Prevent DVT’s/ Leg Clots

  • From: Julie_Stansfield_MD
  • Description:

     

    Prevent DVT’s

    The last time I was on a plane last year I read lots of practical tips to prevent leg clots or DVT’s.  The standard advice is: do not sit still for too long.  Wiggle your legs and stand up now and then.  Not very high tech advice, but it is practical and certainly works for many people.
    

    New advances for a difficult problem are always appealing. In earlier blogs I’ve mentioned the Jupitor trial.  This trial shows that Crestor could prevent heart attacks in people with normal cholesterol numbers and an elevated hs-CRP test.  Last month more findings were published from this trial.  Further study of the data has produced a surprise.  Venous clots, also called DVT’s or deep venous thrombosis were much lower in people that took Crestor.  Compared to people that didn’t take Crestor, the reduction was 43%.  It is truly novel to think about preventing a DVT with a medicine that doesn’t increase a person’s risk of bleeding.   When you think about it, a heart attack it is really an arterial clot, the vessels leading away from the heart.  A DVT is a clot in a vessel leading to the heart.  Typically doctors treat both of these kinds of clots with blood thinners.  There is lots of data to support preventing clots with statin drugs. This is some of the first evidence that shows DVT’s can be prevented with statin drugs.

     

    A Randomized Trial of Rosuvastatin in the Prevention of Venous Thromboembolism.  NEJM. Volume 360:1851-1861. Number 18.

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  • 1 year ago
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• Aspirin and Heart Attacks Aspirin and Heart Attacks

  • From: Julie_Stansfield_MD
  • Description:

    Aspirin To Prevent Heart Attacks

    Many people know that aspirin can prevent heart attacks and strokes.  In the past aspirin has been recommended for people with known clogging or atherosclerosis of the arteries.   Certainly it has been shown to prevent second heart attacks after someone has already had a heart attack.  In March  2009 however there was a significant change in the recommendations for the use of aspirin.  The current guidelines now clearly recommend the use of aspirin to prevent a first heart attack.  Not just after the first event.  This applies to men from ages 45 to 79 and in women ages 55 to 79.  There isn’t enough evidence to recommend aspirin for people older than 80.  This guideline may be a surprise to many people.  Aspirin has been used to prevent heart attacks for years in people of many ages.  Formal guidelines did not support recommending aspirin in lower risk groups prior to March 2009. Nonetheless it has been used that way for many years safely by patients and physicians alike.   
    

    You may ask so why the change? Cardiovascular disease (heart attacks and strokes) causes 58% of all deaths in the United States.    It is the leading cause of death.  The lifetime risk of having cardiovascular problems for men is high. Two out of every three men will have problems.  For women the risk is, one of every two women.  In the past it has been difficult to show that the risks of aspirin use in lower risk groups outweighs the benefits.  Everything we do has risks, including eating the extra spicy chili from Uncle Ralph.   Many of us will still choose Uncle Ralph’s chili, the risk is acceptable.  The risk of aspirin use involves a slightly higher risk of bleeding.  This may occur for example in the stomach, skin (bruising) or nose.   However just because a risk can occur, doesn’t mean it will occur.  Many people take aspirin and may have only a little nuisance bruising, not enough that bothers them.  Aspirin prevents heart attacks and strokes by making the blood less sticky.  So this means that bleeding occurs more easily, but that is what it is supposed to do.  That is how blockages in the heart and brain are prevented.  So the new recommendations have carefully balanced the risks and benefits to give people solid advice based all the risks and benefits.  Getting a bunch of experts to agree is sometimes not an easy task.  It is big news when a group agrees on a new guideline.

    The guidelines do not recommend the use of aspirin in people over 80 because the benefits do not clearly out weigh the risks.  But remember not every 80 year old is the same.  Some 80 year olds are more like a 60 year old. Sometimes it’s the miles not the years.  Doing studies on people older than 80 isn’t easy, so that makes it harder to come up with good solid safe recommendations.  This is an area where the decision to use aspirin must be made between a physician and their patient.  It doesn’t mean that aspirin shouldn’t be used.

    Most men younger than 45 and women younger than 55 are relatively healthy.  They won’t have a significant benefit from aspirin use.   So there is no reason to recommend aspirin.  However there are people that despite being young may benefit from aspirin because of certain diseases. Anyone that is young but with type two diabetes or if they have already had a heart attack or stroke may benefit from aspirin.  These people should talk to their doctor or other health care provider to decide is aspirin is a good idea.

    The dose of aspirin that helps is 81mg; higher doses however are sometimes recommended.

    Annals of Internal Medicine in March 2009 (Ann Intern Med 2009;150:396-404).

    U.S. Preventive Services Task Force. Aspirin for the Prevention of Cardiovascular Disease: Recommendation Statement. AHRQ Publication No. 09-05129-EF-2, March 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/uspstf09/aspirincvd/aspcvdrs.htm

     

  • Blog post
  • 1 year ago
  • Views: 214

• My Dad Had A Heart Attack My Dad Had A Heart Attack

  • From: Julie_Stansfield_MD
  • Description:

    My Dad Had A Heart Attack

    It was many years ago.  It was his first heart attack and his last, he died.  My Dad was a surgeon, a good one many people tell me.  Since I was only 18 when he died I was only in a position to tell you he was a great Dad.  While outside his hospital room I had my first lesson on reading EKG’s.  His cardiologist was his friend.  What he wanted was dignity and his friend gave that to him, he knew he would not live.  The medical treatment of heart attacks has advanced to the point that many people survive heart attacks.  But many people don’t realize that heart disease treatment has advanced to the point that people can be treated with pills that can reverse heart damage and clean up the clogged arteries before they cause heart attacks.   One of the last big challenges of medicine has been to find people that are high risk to die from heart attacks years before they have problems.  The goal is to find these people, treat them and help them change their lives.

     There are things people can’t change about their risks but there are many things that can be changed.  For me it is a harsh reality that I am at high risk only because of my father.  But my kids don’t need to lose me, like I lost my Dad.  Yes I’m busy, exercise is a little boring, but I make time to exercise.  The data is clear, since I don’t smoke, exercise is the most critical tool I have to live a longer good life.  This is information I try and share with all of my patients.  Prevention of heart attacks is a personal and professional battle I feel passionately about.

    You can age well remember, don’t smoke, exercise, choose more vegetables and fruit, choose liquid oils like canola oil and olive oil. Fish is a good choice.   Use the time you have wisely, none of us knows how much we have.

     

  • Blog post
  • 1 year ago
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• Take your pick: MI or CVA Take your pick: MI or CVA

  • From: Cindy_Sears_RN_CDE
  • Description:

     

     

    Take your pick: MI or CVA

     

    What would you pick (if you HAD to pick)? A heart attack or a stroke? Once in a while, as a diabetes educator, I would ask that question of a client I was seeing.

    I much prefer people to take care of their diabetes for positive reasons, as opposed to fear. However, if that doesn’t work and I genuinely think someone is at a very high risk for suffering a heart attack or stroke, I ask them the question above.

    Of course, nearly 100% of the time, people look at me (as if I were crazy) and firmly say, “Neither!”  I remind them that they have it in their power to drastically reduce their risk of having either one of those problems by managing their diabetes well.

    Just a little fear can sometimes get the ball rolling in the direction of better diabetes management. Going blind or losing a leg to diabetes are real risks, in the same way that plane crashes are a real risk.

    Yet on only one occasion in the last 8 years did I frighten a client about losing her foot. (I could not HELP but frighten her, because my own fear for her imminent loss of her foot and her probable subsequent loss of her leg, was written all over my face.)

     However, heart attacks and strokes are the car crashes of diabetes complications. Plane crashes and car crashes are both devastating, but the risk of dying by the first is much much less than the risk of dying of the latter.

    Once in a while, a client of mine would answer my question with certainty that he would much rather have an MI, even if it killed him, than have a stroke, especially if it did not.

    Personally, I can understand that reasoning. Fortunately, it turns out that there are 4 ways you and I can cut our risk of a stroke in half. 

    It doesn’t involve any surgery or medications or trips to the rain forest to collect rare botanicals. It’s pretty simple, actually. Read the blog on “Four Ways to Have a Stroke” to find out more.

     

     

  • Blog post
  • 1 year ago
  • Views: 80
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• Do you want to cut your medica Do you want to cut your medical bills by 80%?

  • From: Julie_Stansfield_MD
  • Description:

     

    Do you want to cut your medical bills by 80%?

     

    In a country that is one of the richest in the world, it is amazing that we cannot afford our medical bills.   But the good news is 80% of all medical costs can be prevented.  This is because smoking, inactivity and obesity contribute to 80% of the huge American medical bills.  We also know that a few changes can mean real saving to individuals and companies.  Smoking inflates the national medical bills by 40%.  That’s not just cancer it is also pneumonia, asthma, heart attacks and strokes.  People can quit smoking. Just knowing how much money smoking really costs, help people stop for good.  Another 40% of all medical bills are created by sitting on the couch too much and too much good food.  Taking a walk and cutting the meal size by just a little can have a powerful effect on your medical bills.  It is easy for folks to think this is junk science. But there are many medical studies which have proven this.  You can control your medical costs. 

  • Blog post
  • 1 year ago
  • Views: 124

• Pound Wise & Penny Foolish Pound Wise & Penny Foolish

  • From: Cindy_Sears_RN_CDE
  • Description:

    Pound Wise & Penny Foolish

     

    MyHealthVillage is a portal provided by Longitude Health, Inc. One of Longitude Health’s goals is to help people take steps toward a healthier life style.

     

    Does giving people information about diet, exercise, and stress management really make a difference in preventing illness? How does lifestyle counseling compare to the effectiveness of procedures like coronary artery bypass surgery or angioplasty?

     

    In these times of limited resources, what would be the best use of our healthcare dollars? Here’s what Jane Brody had to say in a recent New York Times article.

     

    “The treatments — coronary artery bypass surgery, angioplasty and the placement of drug-coated stents — cost about $60 billion a year in the United States. Though they are not known to prevent heart attacks or coronary mortality in most patients, they are covered by insurance.”

     

     “Counseling patients about diet, exercise and stress management — which is relatively inexpensive and has been proved to be life-extending — is rarely reimbursed. In other words, procedure-oriented modern cardiology is pound wise and penny foolish.”

     

    Dr. Michael Ozner, who received the 2008 American Heart Association Humanitarian Award, was quoted in this article. He said, “If some of the billions spent on intervention were put into prevention, we’d have a much healthier America at a lower cost.”

     

    You might want to read Dr. Ozner’s new book called The Great American Heart Hoax. In the meantime, learn more about diet, exercise, and stress management at MyHealthVillage.

  • Blog post
  • 1 year ago
  • Views: 296

• Estrogens and Menopause Estrogens and Menopause

  • From: Julie_Stansfield_MD
  • Description:

     

    Are estrogens safe for treating the symptoms of menopause?

     

    Probably, yes.

     

    http://www.clevelandclinicmeded.com/online/journal/supplement/menopause/HodisAltsuppl4_08.pdf

     

    The above link is to a wonderful article that I have summarized below.

     

    In 2002 part of a study called the WHI (Women’s Health Initiative) was published.  It linked hormones to an increase in heart attacks, strokes, breast cancer and leg clots.  It also showed that hormones made bones stronger and decreased osteoporosis.  However the 2002 results applied to women that were, on average, 10 years past menopause and about 60 years old when they started hormones. Many of these numbers did not reach statistical significance, that means they could have occurred by chance alone.  That also means the “proof” that bad effects occurred was not clearly established.  Nonetheless many people were quite worried by the results.

     

    However the study was not fully completed in 2002.  Part of the study continued, the “observational trial”.  Some of these results were published in 2007 but more complete analysis of the data was published in 2008.  Those results showed that women who start hormones within 10 years of menopausal symptoms have no clear increase in heart disease.  The number of strokes are not increased. Importantly no clear increase in breast cancer was found.  (Actually no randomized study has shown in an increase in breast cancer rates from hormone use).  It is worth noting that the incidence of diabetes was reduced by hormone users, but this effect may have only occurred by chance. Also surprising was that the number of leg clots that were seen was not significantly elevated. Once again they found that hip fractures rates were reduced. Fractures were reduced by 33% in hormones users, this is a very impressive number.  No other medication can claim such  good results for bone strength.

     

    Why such different results?  It seems that younger women respond differently to hormones than older women.  Younger women that take hormones for hot flashes seem to have very few problems from hormones.  The study that was published in 2002 looked not only at older women, but at women that were also much heavier.  So it could be that weight gain in menopause increases a women’s risk for breast cancer.   But it looks like it is fairly safe to say that estrogens do not clearly cause breast cancer in young women suffering from the symptoms of menopause. 

     

    It also looks like women that start estrogen at the time of menopause and continue hormones for at least 5 years may actually decrease their risk for heart disease by at least 25 percent.  This is very important because far more women die from heart attacks than from breast cancer.  

     

    There have been many studies that support the health benefits of estrogens for women.  So many have been published that the American Association of Clinical Endocrinologists issued a position statement in 2008 supporting the use of estrogens for menopausal women less that 60 years old.  The benefits of estrogen use for these women exceeds the risks.

     

    Menopause is a real problem for many women. The hot flashes disturb their sleep and consequently cause problems with functioning the next day.  These are typically women with many responsibilities,  chronic sleep deprivation is not a recipe for an effective, happy day.  Hormones continue to have the FDA approval for the treatment of symptomatic menopause.  Scientific studies show that hormones are quite safe for this purpose.  These are prescription drugs with clear benefits and some minor risks.  A proper visit to a physician to be examined and discuss individual health is very important prior to using all prescription drugs.  Science changes rapidly.  Any single study cannot apply to all people.

     

    Are estrogens safe for treating the symptoms of menopause?

     

    Probably, yes.

     

     

    American Association of Clinical Endocrinologists (AACE) position

    statement on hormone replacement therapy (HRT) and cardiovascular

    risk. American Association of Clinical Endocrinologists Web site.

    www.aace.com/pub/pdf/guidelines/HRTCVRISKposition_

    statement.pdf. Accessed March 5, 2008.

     

     

    Heiss G, Wallace R, Anderson GL, et al, for the WHI investigators.

    Health risks and benefits 3 years after stopping randomized treatment

    with estrogen and progestin. JAMA 2008; 299:1036–1045

     

    Estrogen and progestogen use in peri- and postmenopausal women:

    March 2007 position statement of The North American Menopause

    Society. Menopause 2007; 14:168–182.

     

  • Blog post
  • 2 years ago
  • Views: 402

• Cholesterol Cholesterol

  • From: Julie_Stansfield_MD
  • Description:

     

    Cholesterol

     

    This week a study called the Jupitor trial was released.  It found that the drug Crestor reduced the risk of death from heart problems by 44% compared to people who took nothing.  The people they studied were men over 50 and women over 60. People at this age are at highest risk for heart attacks.  The unique quality of these people is that their cholesterol levels were not high enough to need cholesterol medicines.  For the medical community this is a “WOW!” study.  The reason this is important is because we know that half of all heart attacks occur in people with normal cholesterol levels.  How do we find these people?  The Jupitor study looked at CRP(C-Reactive Protein) levels.  There have been several studies that point to CRP as being useful to find these folks.  While one study is interesting, it is never enough to “prove” an idea.  Nonetheless the opportunity to reduce the risk of heart attacks by half in people is quite an opportunity. As a physician, starting today I will take a more aggressive approach with this group of people.

     

    Some of you may wonder what cholesterol really is. Cholesterol is actually an essential part of the body, but too much of certain kinds will cause a pile of trouble.  When you have your cholesterol checked the full panel will test for four kinds of cholesterol:  the total cholesterol, LDL, Triglycerides and HDL.  

     

    The LDL and Triglycerides are “bad” cholesterols.  They have been shown to increase the risk of heart attacks and strokes.  Lower numbers are best. All kinds of things will keep these numbers down.  To  name a few: high fiber, small meals, exercise, not smoking, low fat meals, limited sugar and other carbohydrates, eating mostly fruits and vegetables and many medications.  Some people are born with high bad cholesterols.  But they can still decrease their numbers with changes in how they live.  That means they can have fewer heart attacks and strokes.

     

    The HDL cholesterol is the “good” cholesterol.  Higher HDL is better. It goes up with diet,exercise, a small amount of alcohol and stopping smoking.  This cholesterol protects against heart attacks and strokes.  The HDL cholesterol can make your total high.  It is the one reason why a high total cholesterol might actually be good.

     

    The CRP test is a test which looks for inflammation.  That means we know all sorts of things will make it go up.  Even something as minor as a cold can raise this number.  Fascinating to think about it being used to look for people at  higher risk for heart attacks. The details for using this test are not fully worked out at this point.

     

    Cholesterol medicines come in many major types.  Statins like Crestor and many others have huge advantages.  They clearly can reduce the risk of heart attack and stroke.  Most people can take these medications without any problems whatsoever.  The FDA has even considered letting them be sold over the counter.  They will remain available by prescription, probably best because heart disease is serious stuff.  Better to visit with your doctor before you get into trouble.  Niacin is a vitamin that also lowers cholesterol, a good choice for some people.  Then there is the fibrate class.  These lower triglycerides  but also have other advantages.  There are a many other kinds of cholesterol medicines, but these are the major groups with many studies to support their use. 

    
    

     

  • Blog post
  • 2 years ago
  • Views: 313

• Potions Potions

  • From: Julie_Stansfield_MD
  • Description:

    Potions

    Lot of people are looking the perfect potion..  They are looking for something that can make them healthy without prescription pills and endless visits to the doctor.   Is there such a potion?  Probably not, but it might be a surprise that exercise is close to the magic potion people are looking for.  If you want a list of the diseases exercise can treat and prevent, I can give you a long list. It is a shorter list to give you a disease that doesn’t respond to exercise…none.  Okay I’ll admit broken bones may keep you from running a marathon.  But even with broken bones people get better faster with fewer complications if they don’t spend a lot of time in bed and start walking as soon as possible. Diabetes clearly can be prevented with exercise.  Exercise can clearly lower blood sugars 50 or more points with short walks.  Heart attacks, asthma, arthritis, depression, constipation, high blood pressure, stress, fibromyalgia..... you get the idea.

     

     

             So can exercising really save you money too?.  Studies that look at healthy women in their mid 40’s that start exercising find that within five years the savings start.  The healthy exercising women saved $4,500 dollars a year in health care costs. The previously healthy non-exercising women spent a lot more on health care. What better excuse to buy a good pair of shoes?

     

            Exercise is a powerful potion.  Is it a love potion?  Yes it is in many ways.  Many studies show that men that develop problems with their love life can have problems with blood flow to their delicate regions (G rated audiences can read too).  These changes can be reversed and prevented with daily exercise.  I can hear those laces getting tied now.

     

  • Blog post
  • 2 years ago
  • Views: 342

• 1/4 cup of anything 1/4 cup of anything

  • From: Jan_Swaney_MD
  • Description:

    I am a SNACKER and especially love the crunchy stuff, so in truth, 1/4 cup of anything is not easy and I have to be very aware of what I'm moving from hand to mouth.

    My main strategy is to have a snacking plan that keeps snack attacks at bay, making a ginormous trail mix binge less likely. I diversify my snacking plan, kind of like a mutual fund approach to investing, and rely mainly on fruits/vegetables or low-fat dairy products to stave off snack attacks. I hold the trail mix in reserv

  • 2 years ago
  • Views: 0
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