Feeds:
Posts
Comments

Heart Health

humanheart

You don’t have to spend a lot of money or take medication to maintain a healthy heart, just follow these guidelines:

  1. Quit smoking.  Smoking causes high blood pressure, decreases exercise tolerance, increases blood clotting, and double the odds of a heart attack.
  2. If you drink alcohol, do so in moderation. Alcohol can increase the blood pressure and in higher doses can significantly weaken heart muscle.
  3. Exercise the heart as much as you would do for any other muscle to help strengthen it and keep it healthy. 30 minutes a day of moderate intensity exercise, such as brisk walking five days a week, or 20 minutes of vigorous activity, such as jogging three days a week.  Try to make your exercise enjoyable (bring a friend or listen to music) and be persistent.
  4. Eat plenty of fiber such as fruits, nuts, whole grains and vegetables. Avoid saturated fats such as those found in most meats, chicken skin and many dairy products.  Instead, eat good fats such as olive oil, nuts, avocados and olives.
  5. Maintain a normal blood pressure. High blood pressure increases the work load on the heart and eventually will cause it to become thicker, stiffer and weaker.  This can lead to heart attacks and heart failure.
  6. Maintain as normal a weight as possible. As with hypertension, excess weight also increases the workload of the heart leading to the same end result of heart damage. Recent research shows that people who carry most of their weight around their middle (apple shaped as opposed to pear shaped), are at an even greater risk of heart disease.
  7. Controlling diabetes is important because up to three quarters of people with diabetes will die of some form of heart disease.
  8. Keep calm. Stress triggers the release of certain hormones that have an adverse effect on the heart muscle.  Studies have shown that clam and happy people have fewer heart attacks than those who are angry and discontent.  “Don’t worry – be happy”.
  9. Avoid salt as much as possible especially if you have high blood pressure. The recommended daily limit of salt is 2,300 mg. (one teaspoon). Try to avoid processed food and read food labels to steer clear of the worst offenders.
  10. Maintain levels of vitamin D. Research shows that people with low levels of vitamin D were twice as likely to have a heart attack as those who have adequate levels. The new 2010 recommended daily allowance (RDA) is 600 IU for those 1-70 years of age, and pregnant or breastfeeding women, and 800 IU for those over 71 years of age.

The above guidelines are tried and true methods of significantly improving your odds of decreasing heart disease and thereby promoting a healthier, happier, and longer life.

Colon Cancer

Colon.jpg

Cancer of the colon and rectum is the third leading cause of cancer in men and the fourth leading cause in women and is more commonly seen in the western industrialized world.

Risk factors can include: age (50 years and older), family history of colon cancer, a high fat diet, smoking, and excessive alcohol intake. Most colon cancers begin from polyps in the colon which usually start out as benign, but after time can become malignant. Therefore, timely diagnosis and removal of the polyp can help to prevent the development of colon cancer, and thereby significantly decrease the mortality of this mostly preventative cancer.

A colonoscopy exam is the current best method for detecting colon polyps. During this same procedure, the doctor can easily remove the polyp. Colonoscopy is essentially painless, is an outpatient procedure, and is a small price to pay for the possible early detection of colon cancer.

The more common symptoms of colon cancer include rectal bleeding and/or blood in the stool, a change in bowel habits, a feeling that your bowel doesn’t empty completely, weakness or fatigue, and unexplained weight loss. Any of these symptoms should get you to see your doctor as soon as possible.

Your doctor will most likely do a rectal exam (don’t be shy, as this is very important), perform a rapid chemical test of a sample of your stool to check for blood, take a blood sample to check for anemia, and most likely schedule a colonoscopy exam.

Surgery is the most common treatment for colon cancer. Chemotherapy and radiation are also often used depending on the extent and location of the cancer.

The bottom line is that colon cancer, if diagnosed early enough, has a very favorable prognosis.  If found too late after it has metastasized (spread) to other organs, it has a much poorer survival rate.

Talk to your doctor about colon cancer screening with colonoscopy and check with your health insurer about what is covered. You should begin screening if you are 50 years old or older, or if you are younger and have a family history of colon cancer.

See your doctor if you have any of the above mentioned symptoms, and if you do, don’t settle for anything less than a colonoscopy exam. Denial or delay can be a matter of life or death.

Youth Sports Injuries

football_2

Your child may be one of the estimated 50 million children participating in organized sports throughout the country. Sports programs are great in teaching the children about teamwork, competition, and providing much needed exercise.  However, statistics show that 1 in 3 of these children will be injured enough to miss a practice or a game and over a million are expected to visit an emergency room this year for a sports related injury with medical expenses costing over a billion dollars a year.

The majority of organized sports related injuries occur during practice rather than games. The top sports for injuries are football, basketball, soccer, baseball, volleyball, wrestling, cheerleading, gym, and track and field.

The most common injuries are to the head, face, fingers, knees, and ankles. The most common injury diagnoses are sprains/strains, fractures, contusions/abrasions, concussions, lacerations, and dislocations.

Concussions in particular, have received much attention recently and appropriately so. There is no longer any doubt about the short term and potential long term dangers of this injury, especially to the young developing brain. We now have very specific guidelines about when to allow a child with a head injury to return to games or practices, as well as how best to treat a child with a significant head injury/concussion.

Symptoms of a concussion are loss of consciousness no matter how brief, headache, vomiting, memory loss, and behavioral changes especially confusion and/or feeling “foggy”.  Any of these symptoms necessitate prompt medical attention.

There is also the issue of overuse injuries involving tendons, bones, and joints. This is due to playing the same sport and performing the same movements too often, too hard, and at too young an age without adequate rest and recovery.

Sports related injuries are inevitable, but there are some things that can be done to help prevent and treat injuries. Be sure your child is involved in a sports program that is properly maintained and adequately coached. Coaches should be certified in CPR and have a plan to respond to emergencies.

Make sure your child has and uses proper gear for a particular sport in order to reduce the chance of injury.

Encourage your child to perform warm up and cool down routines prior to and after sports participation. The warm up will make the body’s tissues warmer and more flexible and the cool down will loosen muscles that may have tightened during exercise.

Be sure your child has access to adequate liquids during exercise and while playing. Emphasize the importance of maintaining hydration to prevent dehydration and heat illness.

Encourage liberal use of sun screen to protect the skin from the sun’s damaging rays and help to prevent future melanoma.

Get professional help if you think your child’s injury is serious, such as when you suspect a fracture or dislocation of a joint, severe pain or swelling.

Statistics show that only 1 in 4 young athletes become elite players in high school and only 1 in 1600 high school athletes go on to professional status. Therefore the emphasis in youth sports should be in the enjoyment and long term involvement in exercise and sports. And remember to match your child’s abilities to the sport and not to push him or her too hard into a sport they may not like or be incapable of doing.

Food Poisoning

picnic

Summer is the time for picnics and social gatherings. This brings about an increased chance of food poisoning which is vomiting and/or diarrhea that comes about from eating contaminated food.  The most common form of food poisoning is from infectious organisms, such as bacteria and viruses.  When eating outside the home, these organisms can contaminate food at any point during its production,  processing, or serving. More commonly, contamination can also occur in the home. This happens because of food that is improperly handled, incorrectly cooked, or inadequately stored. The most common food culprits are chicken products, fish,  and shellfish. Another common source of food poisoning is from food that has been cooked and left unrefrigerated for too long, especially at buffets and outdoor picnics.

Steps to prevent food poisoning:

  1. Wash hands, utensils and food prep surfaces frequently and thoroughly with soap and water.
  2. Keep raw foods separate from ready to eat foods.
  3. Cook foods to a safe temperature.
  4. Refrigerate or freeze perishable foods promptly.
  5. “When in doubt-throw it out.”

Signs and symptoms of food poisoning may start within hours or up to one to two days after eating the contaminated food. The most common symptoms of food poisoning are nausea, vomiting, stomach cramps and diarrhea. The vomiting and diarrhea are the body’s way of eliminating the contaminated food.

There is no easy method to differentiate between food poisoning and common stomach flu other than if more than one person comes down with vomiting and/or diarrhea after eating a common meal, then food poisoning is the probable culprit.  Fortunately, the symptoms of either food poisoning, or of stomach flu, are usually mild and often resolve without treatment.

The best treatment for food poisoning is to let it run its course.  In most cases, once the body rids itself of the contaminated food, the symptoms improve. For this reason, anti diarrhea medicine is not recommended because it may slow down the healing process.  If diarrhea must be controlled because of travel plans or work responsibilities, then an over the counter medication, such as Immodium, may be helpful.

The main goal of treatment is to replace lost body fluids to prevent dehydration. This can be done by drinking lots of liquids, such as electrolyte drinks for adults or Pedialyte for children. A proven method to help prevent dehydration in spite of frequent vomiting is to take frequent small sips of clear liquids until vomiting stops

 

When to seek medical attention:

  1. Inability to keep any liquids down for more than 6-8 hours.
  2. No urine production for 6-8 hours.
  3. Vomiting or diarrhea lasting more than 2-3 days.
  4. Blood in vomit or diarrhea.
  5. Severe abdominal pain.

Have a safe and enjoyable summer. Bon appetit!

Drug Prices

epipen

I am absolutely shocked by the recent news of the incredible rise of prescription drug prices. Attention to this problem started with the actions of CEO Martin Shkreli of Turing Pharmaceuticals who bought the rights to manufacture a one of a kind parasite fighting drug and who then increased the price of the drug from $13.50 to $750 per pill!

Most recently in the news, we’ve heard about the increased price of the Epipen made by Mylan Drugs. The Epipen is a vial of adrenaline which can be self injected by the victim of a life threatening allergic reaction (think bee sting or peanut allergies). This is truly a life saving drug. It contains approximately one dollars worth of adrenaline. Some 5 years ago it sold for $40 and just recently jumped to around $600. (Coincidentally the CEO of the company has seen a salary increase from 2 1/2 million dollars to 18 million dollars.)

This same CEO then came out saying the company would give out coupons which would help some but not all the people who needed Epipens. And now they have developed their own generic version of the Epipen which they plan to sell for $300. Who knows what’s next. This still is a far cry from the price of a few years ago, especially for those many families that need to have on hand several Epipens to care for potential allergic emergencies, not to mention that the devices expire after one year and need to be replaced.

I find these examples of drug price gouging to be unconscionable and unsustainable. For those of us with life threatening diseases, myself included, we seem to be held hostage by the prices of our life sustaining treatments.

Years ago I felt that drug companies did a fantastic job in the research and development of all kinds of new drugs which were offered at fair prices and which helped to conquer a variety of diseases throughout the world. Now it appears they have become greedy. I am all for a free market capitalistic system as we have in the United States, but when it comes to drug companies charging as much as they possibly can, I feel they are holding patients hostage.

Unfortunately, when patients can’t afford their medications, they will often skip doctor’s appointments, tests, or procedures. They may not even fill their prescriptions or take less than directed. All of this is very unhealthy.

The government needs to step in and help to control drug prices because as of now drug companies can charge whatever they want. If it’s a life enhancing or life saving drug, there is little choice but pay the asking price.

The government has various ways to control drug prices such as allowing U.S. patients to purchase cheaper drugs from other countries such as Canada, or by encouraging the development and sales of cheaper generic drugs. We, as citizens and drug purchasers, must contact our elected officials and demand that they help to control drug prices while allowing drug companies a fair profit and enough money to continue new drug development.

Myeloma Update

terrybeth

For those of you who have followed my journey since being diagnosed with a bone marrow cancer called multiple myeloma in September of 2013, I wanted to bring you up to date. Myeloma, as of now, is still considered incurable but treatable. So, I have been on continuous chemotherapy since my diagnosis.

The most recent chemotherapy had been working well, but a recent PET scan has shown some new myeloma activity in a few of my bones. This is not unexpected for many of us dealing with multiple myeloma since relapse is common after initial treatment. I have recently begun a new chemotherapy drug with the hope that this will keep the myeloma under control for as long as possible.

This new  drug that I am now receiving, is called Daratumumab or more commonly referred to as Darzalex. It is in a new class of drugs called monoclonal antibodies, and was just approved for use this past year. It binds itself to a marker on the surface of the cancerous myeloma cell directly affecting the cell as well as enabling the body’s own  immune cells to kill the myeloma cells. As with most of the chemo drugs for myeloma, they usually only work for a period of time before losing effectiveness and then on to a new and different treatment.

In general, I feel well and am learning to live with the neuropathy of my feet as disabling as it has become. I try to push myself, by exercising as much as I am able to do, which I think is helping to make me feel better. I would recommend exercise, to the best of one’s ability, to anyone suffering a chronic disease as part of an overall treatment program.

There are, in development,  new treatments for cancer in general and for multiple myeloma in particular. One of the new and exciting directions in cancer treatment involves the use of our own immune systems to fight the disease such as the drug I am currently using. Also, the rapidly expanding field of genetics also will play a big role in diagnosing and treating cancer.

Of course those of us with cancer hope to survive long enough to benefit from the new treatments on the horizon. Hopefully, in the near future as we develop a better understanding of cancer, it will, in many cases, become a mostly preventable and curable disease.

Thank you again for your prayers and well wishes.

PS:  I would like to start a local support group for myeloma patients. If you, or someone you know would be interested in this, please contact me at valleydoctor@sbcglobal.net

Imaging

 

medical-imaging

Doctors use diagnostic medical imaging to find out the possible causes of illness, injury or pain, to help provide an accurate diagnosis. These images include X rays, CAT scans, MRIs, and ultrasound.

X-rays were the very first imaging technique and are still the most commonly used today. X-rays use radiation which produces rays that pass through the body. When striking something dense like bone the image appears white and when going through something hollow like the lungs the image appears black. Muscle and fat appear as shades of gray. Sometime a dye can be introduced into the body before the x-ray, to make certain organs stand out.

X-rays used to be developed on a type of photographic film which needed to be developed and stored. Now the x-ray images can be instantly viewed on a computer screen, eliminating the need for the old film technique. This is a landmark feature because not only are the digital images immediately available, but they can be sent instantly to another source, such as a consulting physician.

X-rays are still excellent for evaluating bones, teeth, the chest (including the lungs and heart), and swallowed opaque items such as coins and most pieces of glass. The digestive tract can be visualized using a dye, such as barium.

Computerized Axial tomography ( CAT/CT ) scans use x-rays with computers to produce 360 degree cross sectional views of the body. These views allow the physician to see details of bony structures, chest, heart and lung problems, cancers, and many other internal organs. A typical exam may take 10-30 minutes.

A CAT scanner is much larger and more complex than an x-ray machine. It is a very expensive piece of equipment and therefore more costly to the patient than an x- ray. In spite of the increased cost, CAT scans can provide the physician with much more information and diagnostic ability than can most x-rays.

CAT scans use substantially more radiation than conventional x-rays and therefore should be used only when absolutely necessary. Don’t hesitate to ask the ordering provider if the scan is absolutely necessary.

Magnetic Resonance Imaging ( MRI ) combines a very powerful magnet along with a computer and radio waves ( no radiation exposure ) to provide detailed, accurate images of bones, internal organs, soft tissue, and other internal body parts. Patients must be carefully screened to insure that they have nothing metallic in or on the body such as rings, necklaces, pace makers, metal implants and some tattoos, because of the use of the magnet.

MRIs often take at least 30 minutes or more and, as with the CAT scan, can take cross sectional images of the body area being studied. The patient needs to lie completely still inside of a large tube, which may be very difficult for a person with claustrophobia. While inside the tube, the MRI machine makes a very loud knocking sound, usually necessitating the need for wearing ear plugs. The MRI is the most expensive of all the imaging techniques.

Ultrasound uses high frequency sound waves to produce images of structures within our bodies. Like MRIs, it uses no radiation and is very safe. A small hand held device is pressed against lubricated skin and moves it around to capture the image. This exam can take from 30 minutes to an hour. Unlike the other imaging techniques, this exam can also be used in a doctor’s office or emergency room making it a very useful diagnostic tool in many circumstances.