TVHC Blog

Teton Valley Health Care's blog

Health ABCs from a PA-C: Cholesterol 101

It’s health fair season, and I know many of you will have your discounted lab draws done this week at Teton Valley Hospital. One of your options for those draws is blood chemistry profile. With this test you’ll get a good overview picture of your kidney and liver health, blood count and lipid profile. The lipid panel means you’ll get a measure of your HDL (high-density cholesterol), LDL (low-density cholesterol) and triglyceride levels. But what does this mean to you?

Let’s start with the basics. Cholesterol is a waxy, fat-like substance found in your body and many foods. Your body needs it to build healthy cells and function properly. Too much cholesterol can accumulate in your body and cause plaques on your arteries. These plaques can block blood flow causing a heart attack or stroke.

We monitor two main types of cholesterol through blood work. LDL, “bad cholesterol” makes up the majority of the body’s cholesterol. LDL is known as “bad” cholesterol because having high levels can lead to a buildup in the arteries and result in heart disease. HDL, “good cholesterol” absorbs LDL and other cholesterol molecules and carries it back to the liver, which flushes it from the body. High levels of HDL, or “good” cholesterol, reduce the risk of heart disease and stroke.

Here is a list of appropriate blood levels:

Desirable Cholesterol Levels
Total cholesterol Less than 200 mg/dL
LDL (“bad” cholesterol) Less than 100 mg/dL*
HDL (“good” cholesterol) 40 mg/dL or higher
Triglycerides Less than 150 mg/dL

 

Treatment options for high cholesterol first start with TLC (therapeutic lifestyle changes). The first and most important lifestyle modification we encourage is to maintain a healthy weight. The important thing about weight loss is understanding it isn’t about short-term dietary changes. It’s about a lifestyle that includes healthy eating, regular physical activity, and balancing the number of calories you consume with the number of calories your body uses. Fewer calories in than calories expended is the way to lose weight. To better understand how many calories you need for your body and health concerns, see your primary care provider.  AHA graphic physical activity

Increasing your physical exercise is another lifestyle modification essential to maintaining a healthy heart and keeping your weight stable which in turns prevents chronic illness. Studies have shown that 30 minutes of aerobic activity five times a week is beneficial as primary prevention of heart disease. It is also important to try to maintain your target heart rate while exercising. This can be calculated by counting your pulse for 10 seconds and multiply by 6 to find your beats per minute. You want to stay between 50 to 85 percent of your maximum heart rate. This range is your target heart rate. Your maximum heart rate is 220 minus your age. If you are taking blood pressure medications, your target heart rate may be different, and you should consult your doctor before beginning a new exercise program.

Another way to control high cholesterol is with medications. Statins are a commonly prescribed medication with great value. They have proven to reduce risk of heart attacks and strokes. These medications are essential for people with cholesterol resistant to TLC and/or people with moderate to high levels of cholesterol.

An alternative therapy for people with mild high cholesterol is Red Yeast Rice. Red yeast rice (RYR) is the product of yeast (Monascuspurpureus) grown on rice. It is a dietary staple in some Asian countries. It contains the same compound found in statins, (HMG-CoA) reductase inhibitor. Studies have shown this product to be effective for treatment of hyperlipidemia (high cholesterol). More specifically, decreases in total cholesterol (TC), LDL cholesterol (LDL-C), and triglycerides (TG) have been noted. Consult with your primary care provider to see if this therapy may be beneficial to you.

Hopefully this gives you a better understanding of cholestrol in general and how you can work to keep your cholesterol levels within normal ranges.

Don’t forget that TVHC’s discounted lab draws run now through Saturday, September 13. Remember to fast for 8-10 hours prior to your draw if you plan to get the blood chemistry profile (which includes lipids). You can have your results read at our annual Harvest Health Fair Saturday, September 27 at Driggs Elementary. I’ll be there and I hope to see you at this important community event!

Anna Gunderson, PA-C is a nationally certified Physician Assistant. She works at the Driggs and Victor Health Clinics and is currently accepting new patients. Call (208) 354-2302 to make an appointment or visit tvhcare.org for more information on the services offered at Teton Valley Health Care.

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Health ABCs from a PA-C: The latest BEAT on high blood pressure

High blood pressure is a common medical concern. It’s often referred to as “the silent killer” because it causes much damage to the heart before symptoms are felt. Luckily, it’s easy to diagnose with regular wellness checks. Annual wellness exams are generally covered by insurance, too.

What is normal?

In a normally healthy person, high blood pressure (hypertension) is defined as > 140 (systolic value)/ 90 (diastolic value) from two random readings. Mild hypertension is defined as systolic value of 140-159 and diastolic value of 90-99.

Systolic pressure measures the peak pressure in the arteries when the ventricles contract, and diastolic pressure measures the minimum amount of pressure in the arteries when the ventricles are filling with blood. Both numbers are important, and any elevation in either number is used to diagnose hypertension.

Action steps

If you have mild hypertension, you may wonder if you should start prescription therapy. Evidence shows that treating mild hypertension reduces your risk for a heart attack in the future. But you have options to try before starting one of the many pharmaceuticals.

  1. Yoga has shown to improve blood pressure if practiced regularly once daily for 6-12 months.
  2. Daily meditation for at least 20 minutes has shown to reduce blood pressure.
  3. Garlic has a modest effect on your blood pressure and can be found in pill form.
  4. Fish Oil lowers triglycerides, which improves blood vessel health, which in turn reduces cardiovascular risk.

Consult with your provider to see what therapy is best for you.

Monitoring your blood pressure is an important aspect of staying healthy. Everyone should have at least one general wellness check (which screens for medical problems such as high blood pressure) with a provider annually.

With the enactment of the Affordable Care Act, most insurers are now required to cover an annual wellness exam. Check with your insurer to confirm you benefits prior to making an appointment.

Anna Gunderson, PA-C is a nationally certified Physician Assistant. She works at the Driggs and Victor Health Clinics and is currently accepting new patients. Call (208) 354-2302 to make an appointment or visit tvhcare.org for more information on the services offered at Teton Valley Health Care.

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Good Choice, Bad Choice: Fālyər

Failure (fāl yǝr) noun

1. Lack of success synonyms: nonfulfillment, defeat, foundering, debacle

2. Informal: flop, megaflop, dud, ne’er do well, dud, busted flush

I’ve been quiet on the blog lately and usually when I’m quiet, it’s because something has happened that must be processed through my 5 phases of Realization:

  1. Disbelief
  2. Inner scolding
  3. Rationalization aka Flimsy Excuse-making
  4. Acceptance along with inner scolding
  5. Realization = moving forward, along with occasional bursts of inner scolding

The reality is this: I did not meet my wellness goal of lowering my BMI. In fact, I’ve stayed exactly the same in terms of BMI.

  1. Ms. Disbelief says, I can’t believe 12 months have gone by!
  2. If I’d shown some willpower, I’d be in great shape today says the Scolder.
  3. At least my BMI didn’t get worse, according to Rationalizing Ann.
  4. It’s my own fault for not taking this seriously, now I need to commit and try again.
  5. Realization: I have the tools, I know what I need to do, I’ve learned a lot about what motivates me and now I’ll put it all together and succeed. I can’t continue to be a busted flush ne’er do well.

There’s a little trick I play on myself that’s worth about 100,000 calories. (This is top secret information.) This is what happens: Let’s pretend I’ve had a good day of exercising and eating well. I praise myself. I prowl around the kitchen, making a mental list of the locations of all of the high calorie foods. Then, I wait for my husband and teenagers to clear out. When the coast is clear, I quietly pocket a cookie, scarf a spoonful of ice cream, or chug a chocolate milk. Then I scoot off, almost smug in my knowledge that I’ve gotten away with it again!

And what exactly have I gotten away with? NOTHING. While I’ve been able to host secret hoovering sessions, the resulting pounds are visible to everyone. Somehow, eating non-healthy foods in private is similar to the belief that breaking up a cookie into small pieces reduces the caloric intake: No witnesses, no calories. It never happened folks! My capacity for magical thinking is boundless.

Over the past month, I’ve been declining unhealthy foods and replacing them with better choices. I’ve skipped the cinnamon rolls and taken the watermelon slices instead. I’ve made myself get out and walk more, do more yard work and generally be wiser about how I spend my hours. I KNOW what I need to do, I’ve LEARNED how to build and use the tools toward better health, and having that knowledge is simply not enough.

If you’ve been following my blog, you know how much I like quotes. Here’s a good one by Legouvé “To live is not to learn, but to apply.”

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  Disclaimer: This blog discusses my personal wellness goals and is in no way a soapbox to tell anyone else how to eat, exercise and/or live their lives.

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