I have often asked an individual if he/she has been diagnosed with Hypertension.  If I get a strange look it usually relates to the fact that in some cases, individuals associate Hypertension with a personality trait of being “Hyper”, Anxious, Overactive.  Hypertension is the medical terminology for blood pressure that  is outside normal limits. Normal limits of Blood Pressure is 120/80.  If blood pressure increases above this level and remains higher than 140/90 for several readings, an individual may be considered mildly hypertensive.  As both upper and lower numbers increase suddenly or over a period of time, the physician may prescribe medication, suggestions for weight loss, and suggestions of lowering the sodium and salt intake in food.  Some MDs prescribe all three regimens as each one is effective for lowering blood pressure to normal limits. 

Please understand that medication may be prescribed and may not be a therapy to be discontinued.  Hypertension is controlled with medication therapy and if medication is discontinued  by you because your BP readings are in the normal range, your BP is likely to increase again.  Only the physician is trained to inform you when and if you can/cannot get off BP medication.  

On rare occasions, some individuals have a sudden sharp increase in BP levels that may be associated with symptoms of dizziness, heart rhythm changes, palpitations, and chest discomfort.  Please try to get an appointment with your doctor as soon as possible; however, if symptoms are severe and BP is higher than 180/110, seriously consider getting medical attention immediately.  Go To The ER! 

What causes Hypertension?  In most cases, the cause of high blood pressure is not known.  There may be a hereditary factor or just this tendency.  In rare cases, hypertension is associated with a kidney malfunction or kidney disease. 

What does Hypertension Cause if not Treated?  An individual with high blood pressure that is not well controlled or not controlled will develop changes in the Heart Muscle – thickening and enlargement.  The best analogy – consider a new rubber band that has a great stretch, pop, and elasticity. It can hurt you if someone smacks you with that tight rubberband.  But what happens when you keep stretching it over and over again.  The rubberband will loose its bounce and not be able to hurt your next victim.  If your heart is pumping against a great pressure in your blood vessels, over time it will get thicker, enlarge, and loose its wonderful stretch and pump feature.  Uncontrolled blood pressure can lead to an enlarged heart and congestive heart failure.  Another side effect of poorly managed blood pressure is damage to the lining of the blood vessel walls due to years of  tightness, pressure and scarring.  Hypertension will speed up vascular disease. High blood pressure is also a risk associated with Stroke.

Get your blood pressure checked routinely.  If changes occur consult your physician.  Follow his program as outlined for BP control.  Lower the sodium in your diet, exercise, loose weight, and check your blood pressure routinely to document improvement with habit changes and/or medication. 

The alternative of failing to comply is not a pretty sight – Congestive Heart Failure & Stroke just for starters!

Earlier, there had been information posted about the importance of “Knowing Your Numbers.” In this information series, data related to Cholesterol will be discussed. 

Cholesterol is the most serious culprit relating to the development of Cardiovascular Disease.  Cholesterol is a product that is made by our bodies; however too much cholesterol can lead to an accumulation of fatty substances inside the artery and arterial wall layers.   Cholesterol will be elevated if there is an inherited family condition that passes from generation to generation to cause this to occur; however what is eaten is another significant factor related to the development of high cholesterol.  Do not generalize and think that being skinny absolves an individual from high cholesterol.  There is no law that if an individual is overweight the cholesterol level is high, and the thinner framed individuals all have low cholesterol.  High cholesterol is a condition related to genetics and food sources, not just body mass. Here are other general rules re: cholesterol.  

Cholesterol levels in women will change with menopause.   As estrogen decreases there is a correlation between this decrease, a decrease in HDL or good cholesterol, and the possibility of  both the total cholesterol and the bad cholesterol, LDL, increasing.   Men generally have lower HDL cholesterol levels as compared to women and if the HDL levels of men are <35, this is considered a risk factor for heart disease.  HDL assists in the movement of LDL (bad cholesterol) into the liver.  If there are lower levels of HDL, LDL levels will increase and thicken the arterial walls. 

Do not feel SAFE, if the total cholesterol level is < 200.  Always be aware of the lipid profile results which breakdown  cholesterol results into Total Cholesterol, LDL Cholesterol, HDL Cholesterol, and ratio comparisons.  All these results will be considered in treatment options, if necessary.  Cholesterol levels should be checked as fasting levels to get the most accurate results.  A fingerstick within a couple of hours of eating will not be as accurate as a fasting level.  Be sure and review the American Heart Association guideline that is provided with this blog as it instructs readers to the recommendations for screening and the goals that are considered healthy numbers. For more information go to the following websites: www.heart.org/numbersthatcount or www.heart.org/screenings.  

There are options in the treatment of High Cholesterol.  If you have heart or vascular disease the treatment options will be recommended to maintain an LDL level of 100 and an HDL level >40.  If you do not have evidence of heart or vascular disease the optimum LDL levels are < 130; HDL levels, > 50.

Medications may be prescribed if total cholesterol levels and ratios are not healthy.  Many medications  are available in treatment of high cholesterol.  Be sure to communicate with your physician if side effects are noted.  Also, do not delay follow-up bloodwork to determine the effectiveness of medical therapy.

Regarding what to eat or not to eat, here are some facts.  If a product has “No Cholesterol”‘ however the same product is > 5GMS/Fat/Serving , this product is high in fat and needs to be limited in frequency and serving size.  Read Labels and note serving size as well as GMS of Fat/Serving. Label reading is a good tool to eating healthy.

Eat at home!  This does not mean take out,either. Fast food is full of fat! Some restaurants post calories/serving of even the healthy salads but do not be surprised of the results.  A salad may be 800-1000 calories and the dressings are full of fat, as well as the cheese, croutons, eggs, deli sliced turkey, ham etc. etc. etc!  Start preparing a menu of what will be eaten for breakfast, lunch, supper and follow.  It is easier to prepare meals at home if you are prepared to cook at home. This may be very difficult if you are busy with after school activities. So, choose an eating place that has healthy selections on the menu.  You may try Applebees, Outback, Olive Garden,  La Madelines, Subway – to name a few.  Even some Mexican eateries will provide a choice of healthier meals if you can avoid the tortilla chips and salsa before.

Avoid fatty cuts of meat.  Eat lean.  Refer to the Diet/Nutrition Guide of the Healthy Heart Numbers by the American Heart Association.  Note the serving size and equivalent comparisons for serving size with objects that you may use daily. 

Use low fat or fat free diary products. 

Eat no more than 3 servings of fats/oils per day. 

I think that information is enough to “digest” today!

The month of February is all about Heart!  The first Heart that comes to mine in February for most is a Valentine, of course!  But as a Health Care Professional, February is about Heart and Heart Health for me, a cardiovascular nurse for 39 years!  My first love in this nursing role has always been patient education, and in the month of February I will make time to promote Heart Health to the public in different venues.  The presentation this year is entitled, “Know Your Numbers.”

The numbers to know are Cholesterol, Blood Pessure, Blood Glucose, BMI (Body Mass Index), Physical Activity, Diet/Nutrition, Tobacco, and Alcohol.  I will present this info in a 3 part series beginning with Why? and What Happens When There is Neglect.  The remaining blogs will reference Important Info in Each “Number” Category. 

There is a simple answer to the question, “Why do we need to know these numbers?”

Simply, this knowledge can save your life!

Which category do you fall into?

A.  Those who do not want to have levels checked for cholesterol, sugars, and blood pressure. ”I do not want to know!”  ” I am too scared to know.” Ignorance is not Bliss! You might just scare yourself to death! These measurements are important figures in the Diagnosis of Heart Disease – the #1 Cause of Death &  Diagnosis of Stroke – the #4 Cause of Death and the  #1 Cause of Disability.   

B.  What percentage of you think and even say after you or your insurance company has paid for tests that supply these results - that no call about the results means good results!  Wrong again!  That paperwork may sit in a “loss” file or stack of papers, not intentionally, just because.  It will show up the day you return to the office for your follow-up apptmt because the staff will ask the lab to fax it again.  ” I did not get it.”  “I cannot find it.”  What does that mean if you follow-up is 3-6 months away or if your follow-up depends on your test results.  Does that sound familiar yet?  What happens if there is no follow-up?

c. The third category is the individual who feels this knowledge is Their Responsibility!  and ultimately, It Is!  Make a pest of yourself if you have too.  Get your work done and get your results!

I love my MDs.  They are personable and thorough.  I have known them and worked with them on many projects for the past 30 years. But no one is perfect, and that comment also applies to me!  I remember the time my doctor sat next to me on the examining table and read me my results of lab work.  I thought, “How sweet of him to take this time to make me feel special, sit right next to me, and share my results.  He was not holding onto the doorknob, standing just inside the door, and talking loudly.  He cared enough to sit right next to me.  I also loved the results.  I remember thinking, “ This is great.  Nothing has changed.  My numbers are as good as last year’s results.”  Guess what – after I left, I realized that the date for the blood work that we were reviewing was last year’s results! So I called and asked the staff to please get the correct and current results of my blood work to the Dr. and Me.  I also ended with, “Please make sure that they are also in my chart.” 

Another suggestion of importance – get a copy of your results for your home medical file.  This is important follow-up and also is important info to share with any other MDs as to avoid duplication of services that are costly to you and your insurance provider.   

Determine your Category – A, B, or C!  Try to move in a positive direction.

More Info to Follow on the Numbers In each Category.

C.

In the world of cardiovascular diagnostics, all of the patients that are seen for diagnostic testing on the heart and blood vessels have been referred to our lab because there is a medical condition that warrants the testing.  In other words, there is an appropriate diagnosis and symptoms that warrant testing of the heart and or blood vessels as determined by the patients’ physicians. 

In the medical market, there has been development/utilization of an array of screening tests for heart disease, stroke, measurements of calcium blockages in the arterial system, thyroid screening, gallbladder screening, diabetes screening, cholesterol screening, and echocardiography screening. 

Delta Diagnostics offers vascular screenings by way of ultrasound for the following reasons:

1. It is safe and noninvasive.  The tests that will be performed will not have an invasive component and will not deliver the capacity of radiation equivalent to 200 X Rays.

2. The equipment utilized is the same caliber as what is utilized for diagnostic testing. Quality will not be compromised because the test is a screening. Delta has been asked by Vascular/Heart Surgeons for a copy of the screening results before patients are seen. 

3. There is concentration on screening for the number one cause of Death and Disability – Heart and Stroke.

4.  These are not tests to scare individuals, but tests where results will be delivered by a cardiovascular nurse with time to discuss results and organize a suggested plan of care.   

5.  Knowledge is power.  You are in control of your health and can organize a plan of care for prevention and quality life. 

Get involved in your health.  Know your risks. View the video about the screening program.  Check back soon and learn the importance of Knowing your Numbers, Too.

I made a New Year’s Resolution to be more timely about getting to work.  I do not have to punch a time clock as I am part owner and President of our business.  There will be changes in staff this year, and I felt the need to be prompt.  I have enjoyed my mornings at home this past year because there was no need to get out of the house for early clinics and for several years, there has been no need to get kids to the bus stop. Wake up is still 5am, but I take time to relax, do household chores, serve breakfast, prepare lunch to take to the office and most importantly, take 15 mins of quiet, meditative time. However, I noticed that it was taking me longer and longer to leave the house which began to make me feel guilty.  Guilty is not good.  So I announced to my partners and staff member that my resolution for this year, 2012, is to arrive at 8AM to the office.  The first few days I became that incessant clock watcher, ruminating about my lack of efficiency, wishing my husband who is also my business partner would leave the house that I could still fit in my quiet time.  I was experiencing hot and cold flashes within a few mins which I realized was more stress related than physical changes.  I am always cold but long past hot flashes! I was breathing faster, rushing down the hall, flopping in the quiet chair only to spend time wondering if I would make it and not scanning my body and mind and releasing thoughts.   Why was I doing this to myself?!  Because of my years of teaching stress management, I realized quickly that it was OK to get to work on time but it was NOT OK to be Negatively Stressed.  I started listening to my thoughts, physical feelings, and being aware of my habits (old, bad ones.) Guess What?  It did not take me long to realize that I could still accomplish my goal and not have troubling thoughts and troubling actions. 

Within a week, I arrived at work at 8AM sharp.  The satisfaction of knowing that I can accomplish the goal and not create negative responses and thoughts in that act is a real high!  Similar to the high that I experienced at a younger age when, no matter what, I took 45 mins, 3-5 times a week, to go to the gym and still serve supper on time to our young family and hard working husband. 

I do not know “what time will tell” but I do know that I am better at body and mind scanning.  I can nip those negative responses in less than a day – not take up my life and health in that “danger” zone for longer periods of time.   

What do you do when you have learned that you consistently tried to be healthy – healthy eating, healthy blood pressure, healthy Body Mass Index, healthy activity, healthy attitude, healthy spirituality – AND your body did not cooperate!!! To be specific, you were told that you have Cerebral Vascular Disease, a small amount of plaque buildup in your carotid arteries. The looks on so many individuals’ faces can be clearly understood now.  The comments, “Well, I just do not understand.”   Let’s consider these: 

Family History - Paternal Grandfather Died at age of 54 because of Heart Attack. Dad has An Abdominal Aorta Aneurysm. Genetics – Check Yes!

Smoking – 2 Cigars in Lifetime.  Nicotine - No and No Work, Fun Environment with Second Hand Smoke. Check – No! 

Diabetes – Family History Strong on Maternal Side.  FBS checks – results – levels were increasing. Random checks now with weight loss – improving. Check – ?  Need Consistent Monitoring. 

High Blood Pressure – Controlled for last 15 years. Taking the same dose of AntiHypertensive for 20 years. Check – No!

High Cholesterol – Peaked at LDL of 182 about 6 yrs ago. Controlled, supposedly, with medication until blood work drawn 2/2011. Results not good -triglycerides& LDL high, FBS & A1C, results at upper limits of normal.  Bloodwork was drawn at 12:30pm, during day, when cortisol levels were high. Nothing before that time but black tea and one piece of dry bread at 6 AM. However when bloodwork was drawn 2 weeks later with fasting, results were fine.  What’s Up With That? Check – Yes! Not controlled well!

Weight – approaching 165 pounds at beginning of 2011 – now 151 pounds. BMI improved. Check – No! Improving.

Activity – desk job but exercise 3 days/week. Check – No; however, consider walking on days not participating in other aerobic classes or yoga for stress/mind control.  

Feelings – anger over things beyond control; guilt because it is impossible to be 2 places at one time; sadness over mom’s illness and her inability to stay well for long periods of time; loneliness because where did some of those best friends go. Check – What Were You thinking! Yes! Not Good! Negative Stress and AngerKills!

It is not difficult to discern.  The time is now to move on.

Reading some recent notes from visitors to the website, I am encouraged.  As  a nurse educator, I realized many years ago that the impact of what is being said may only reach a few individuals but every single person who hears, learns, and practices something new and healthy is more exciting as applause and a standing ovation.   Listening is difficult.  Maybe it is difficult because hearing what we want to hear is more important than what is being said!    Our minds may not be in the present.  How many are thinking days, months, years ahead?  Multitasking is a great skill? Really? Research in the future may realize that it is the silent killer.  Focus on now.  Listen. Slow down! Savor now! Merry Christmas and Happy New Year!

Delta Diagnostics is pleased to announce the release of a video which serves to educate and demonstrate the screening process offered to the public, businesses and physicians’ offices.  The video will be launched next week, December 12th.  Take the time to view the video and learn what are the goals and ideals of our organization as they relate to the Quality of our Service and the Quality of your Life.

The month of December is busy no matter how early one starts in order to finish with the celebration of Christmas and the New Year.  For some, decorations are hung by Friday after Thanksgiving, and Black Friday receives more publicity than the commemoration of a national holiday in honor of the sharing between the early settlers in America and Native Americans.  Rush, rush, rush! How do you really feel today? Where is the balance?

Individuals smoke for the following reasons:

1.  Young adults smoke to “fit in” with their peers.

2.  If an adult family member smokes, there is an acceptance of younger family members also smoking.

3.  Smoking is rebellious behavior for young adults.

4. Tobacco use is associated with maturity and sophistication.

5. Individuals will respond positively to tobacco advertising.  The tobacco industry spends $36 million dollars/day to promote use of nicotine.

6.  Use of tobacco will decrease stress and anxiety and enhance concentration, alertness and arousal.  These are the powerful addicting drug effects of nicotine.

7.  Most women will continue with nicotine habit because it is a means of avoiding weight gain. 

Any other reasons?