We’re two months into the New Year, and you may have made a resolution to be healthier in 2015. Or maybe you are looking for ways to feel better. Maybe you’re tired of being tired and out of breath when you attempt simple tasks.
As a cardiologist who specializes in heart failure, I have many patients who come to my clinic with issues such as these. First, I evaluate them for heart disease. This may include laboratory tests, echocardiograms, or treadmill exercise tests. The results of these tests may lead to more invasive procedures such as angiograms or cardiothoracic surgery. Sometimes a serious cardiac or pulmonary condition is not diagnosed, yet the patients continue to have these progressive symptoms. In all cases, everyone gets the same message from me — Be Heart Smart.
To be heart smart, you have to take a serious look at what you are currently doing with your life. I focus on four areas: Sodium (salt), Calories, Smoking and Exercise. I find that all of these areas are equally hard for patients to gain control of.
Be Heart Smart
Stop. Smoking causes heart disease, pulmonary disease, and many cancers. However, you must want to stop before you can successfully quit. All the medications, classes and support groups won’t help unless you really want to stop smoking. My patients who have successfully quit have found something personal that motivated them to stop. I often ask them to name five reasons why they like to smoke, then we discuss ways they can achieve the same feeling they get from smoking with other activities.
Cut back. The first step is to educate yourself. Salt does not only come from the shaker; it is a major ingredient in all processed foods. Start reading labels and always remember salt = sodium.
Lowering your sodium intake can reduce your blood pressure, decrease water retention, and help with weight loss.
The average American consumes more than 4,000 milligrams of sodium each day.
The American Dietary Guideline recommends 2,300 mg per day.
I restrict some of my heart failure patients to less than 1,500 mg per day.
Foods high in salt:
Fast food anything
Seasoning mixes (steak, grill, etc.)
Of course, you should lose the saltshaker. I instruct many of my patients to avoid going out to restaurants until they know how to cook at home. Go back to the basics and explore a variety of herbs in your cooking: oregano, basil, rosemary, cilantro, chili powder, and many others. If you don’t know what to pick, just smell them in the grocery store; use your nose to choose. Tonight, pick three that you wouldn’t normally have used before and combine them in a chicken dish with a little olive oil and lots of your favorite fresh veggies.
Eat less. To lose weight you need to understand that it is not just a numbers game but also a metabolism game. Be honest with yourself with how much you are eating. Portion control is very important. There are many free phone-based apps now that can help you count your calories and show your progress. If you’re unsure where to start, try the DASH diet, supported by the American Heart Association. I like it because it is cheap and simple. It is not a fad diet. Rather it teaches you how to eat healthy for the rest of your life.
Exercise more. Yes, exercise does help you lose weight but only if you combine it with smart eating habits. Exercise in general is a way make you feel better and become stronger. As you age, your muscles can lose tone and strength, especially if you’ve lived a sedentary life-style. I advise my patients to “sweat” for 20 to 30 minutes a day. Choose an exercise or two you enjoy. For beginners, start out with a modest level of exertion and increase the intensity in 1-minute intervals during your exercise period – interval training.
The Key to Success
My patients who take being heart smart to heart feel better. Once on a routine, they are surprised how much more energy they have. Some have lost weight, a few have stopped smoking, and most have less shortness of breath. They admit it is not easy, but it is worth it. So talk to your doctor and get busy. Take control of your life. Be Heart Smart.
I’ve been practicing medicine in Teton Valley for more than 15 years. I’ve had the pleasure of being a family physician for many of you, and I’ve enjoyed watching your families grow. I want what’s best for you and your family, whether or not you choose me as your provider. What’s best for your family is often what’s best for mine, and when a patient asks me “what would you do if it were your child/parent/friend?” I tell them the truth.
I vaccinate. My kids are vaccinated, as are my wife and I. I recommend all my patients who are of proper age and health get immunized against several diseases that once were commonplace in the United States. The measles, mumps, rubella (MMR) vaccine is one of them. We declared measles eliminated from this country in 2000, but the incidences of disease have increased in recent years.
So far this year we have seen over 100 cases of measles spread across 14 states in this country. The majority of those (92 percent) are related to an outbreak linked to theme parks in California including DisneyLand. The 102 cases just in the month of January puts us on track for exceeding the record number of cases (644) we saw in all of 2014.
While we’ve yet to see a case of measles this year in Idaho, we still need to protect ourselves, our families and our community from it.
What’s the big deal about measles?
Measles is highly contagious.
On average, a person with measles will spread the disease to 18 other unvaccinated people, compared to an average of 2 for Ebola and less than 2 for influenza. Measles can spread even when no symptoms are present (4 days before and after a rash appears). It is spread through the air via droplets from sneezes or coughs and can linger on surfaces for up to two hours.
Measles can be deadly.
Complications from the initial viral infection of the measles can lead to hospitalization and even death. Ear infections and pneumonia are the prevailing complications, and encephalitis (inflammation of the brain) can also result. If a person with a compromised immune system comes in contact with the virus, risk is even higher.
An MMR vaccine is more than 95% effective.
The MMR vaccine is provided in two doses, one at age 12-47 months and the next when the child is 4-6 years old. It is the best defense against catching measles, mumps or rubella. You can also choose to add varicella to the vaccination, (MMRV), which vaccinates against chickenpox. While no vaccine is 100% effective, MMR and MMRV are our best options for preventing measles, mumps, rubella and chickenpox in our children and in the children who attend school and/or play with our children.
Herd immunity doesn’t work if the herd isn’t vaccinated.
The basic principle of herd immunity is that if enough people are vaccinated (immune) to a disease, those who are too young or sick to get the vaccine themselves will be protected. Some may argue that not vaccinating their child isn’t such a big deal because the majority of children and people are vaccinated. But there’s a tipping point in herd immunity where if even a small percentage of the community is not immune (unvaccinated) it puts the entire community at risk.
The takeaway here is that I hope you, like I do, will vaccinate yourself and your children against these diseases that are now making appearances in our country despite having been wiped out at one point or another.
Talk to your healthcare provider if you have questions, and understand the potential consequences to your family and to the community as a whole based on your decision to vaccinate or not.
That caught your attention. To be clear, breast cancer does not lead to an Ebola infection nor does Ebola put you at increased risk for breast cancer. However, they share the importance of monitoring yourself and being vigilant to stay well.
With Ebola, if one has traveled to certain countries and develops symptoms, they need to seek medical attention to save their life.
With breast disease, if one detects a lump or a change, it is imperative to seek medical attention to save one’s life.
Men as well as women can develop breast cancer, so men should not ignore changes.
You know your body better than anyone else, so you will be the best to detect subtle changes or irregularities. These changes will not be detectable overnight, but may arise over a period of a month. It is recommended that a particular day of the month; 1st, 15th or last day of the month be your day for self-examination. For women, it is best to schedule your self-exam several days after the last day of your menstrual cycle. It will be easiest to detect changes at that time.
Breast self-examination is easily performed by you in the shower with a liquid soap. It is important to include the entire breast, the area beneath the breast and the armpit. One should be one alert for a bloody discharge, or a different discharge and changes in the skin of the nipple. These nipple changes may be a rash, scaling or an unusual skin tag. You can visit Teton Valley Health Care’s breast health information webpage for more information about self exams and general breast health. Teton Valley Hospital can also provide you additional information with diagrams to assist you.
Mammograms are an excellent partner for breast self-examination. This partnership is critical as approximately 15% of all breast cancers are not detectable by mammography. Current recommendations for mammograms begin at age 40 and at intervals of one to two years. If one waits until that age or the next mammogram to have a lump evaluated valuable time is lost, and options may radically change. Unfortunately, many are fearful of finding a lump or that if a lump is detected a biopsy will be necessary. The sooner one finds a cancer, the more options are available. Biopsies should not be feared. Today, most biopsies are performed under local anesthesia through a nick in the skin, with minimal discomfort and a tiny scar.
It is imperative that you do not ignore a potential change you may detect during a self-exam, and that your provider listens to your concerns.
In breast cancer: earlier is better than later, smaller is better than larger, know and trust what you body tells you.