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February 2012: Heart Attack

Is it a heart attack?

More than a million Americans have heart attacks each year. Nearly half of them die.  Why does this happen? In many cases, it’s because people don’t take action quickly enough – or at all.

A heart attack occurs when blood flow to part of the heart muscle is blocked. If blood flow isn’t restored quickly to that part of the heart muscle, it lacks nutrition and dies. That’s why it’s so important to seek medical help right away.

If you or someone you’re with may be having a heart attack, call 9-1-1 without delay. This needs to be an ambulance trip to the hospital, not a joy ride. If you get caught driving in traffic, you can lose valuable minutes. To help you visualize the urgency of the situation, think of a heart attack as a gunshot to the heart. If symptoms stop within five minutes or come and go, don’t just thank your lucky stars. Call your doctor and describe what happened. A blood vessel could be on its way toward blockage.

Cardiologists call the 60 minutes after a heart attack the “golden hour.” That’s because this is the narrow window of time when treatment can open arteries and prevent permanent heart damage. These heart specialists have two methods for doing this. They can use a clot-dissolving drug. Or, they can perform a procedure to open blocked heart arteries (angioplasty).

If treatment is so effective, why don’t people get themselves promptly to the hospital where they belong? Maybe it’s because many have a Hollywood image of a heart attack: the clutching of the chest, the unbearable pain, the dramatic collapse onto the floor.

But a heart attack can have several guises. Symptoms can begin quickly or slowly. They can be severe or mild. They may come and go. They can even vary from one time to the next. And some people may have no clear symptoms at all. These are called “silent heart attacks.” They are more common in people with diabetes.

Chest discomfort or pain may be a hallmark of heart attack. But it can feel more like pressure than pain. It may be a squeezing or heaviness, making it difficult to catch your breath. Or, you may have a feeling of fullness or indigestion, resembling heartburn.

You may have other warning signs of a heart attack, including:

  • Discomfort in one or both arms, or your back, neck, jaw, or stomach
  • Nausea, vomiting, light-headedness, or fainting
  • Sweating

So if this happen to you or someone you know, will you take the needed action? Or will you be afraid you’re being alarmist and worry that the symptoms were nothing but a case of indigestion? If so, remember this: You can’t die of embarrassment. But a heart attack can most definitely kill you.

After a heart attack, doctors often prescribe medications to prevent a second one. These work in various ways. For example, they might prevent blood clots, lower cholesterol, or lower blood pressure. Don’t stop taking these without your doctor’s okay. If you run into any problems or have any questions, we’re here to help guide you.

 

July 2011: Sun Safety

The Dangers of Tanning – Indoors or Outdoors


Ever been mistaken for Casper the Friendly Ghost? Even if you’re not quite that white, you might still value a nice tan. Many people think a little color gives them a healthier –maybe even sexier – look.

So isn’t it ironic that getting that glorious tan can actually put you at risk?

When exposed to ultraviolet (UV) radiation – whether from the sun or a tanning device – your skin reacts by producing more melanin. That’s the pigment that darkens your skin. In addition to bringing on premature wrinkling, skin spots, and a “lovely” leathery look down the road, tanning can also suppress your body’s immune system and cause eye damage or allergic reactions.

Some people even develop skin cancer from too much UV radiation. Were you one of those kids who shunned skin protection or overstayed your time in the sun? If so, you probably had a severe sunburn or two, putting you at greater risk for the deadliest form of skin cancer: melanoma.

But the sun isn’t the only culprit. Tanning devices like sunlamps used in tanning beds are more dangerous than previously thought. A few years ago, the International Agency for Research on Cancer (IARC) looked at 19 studies conducted over 25 years. It found a link between indoor tanning and two kinds of skin cancer, as well as melanoma of the eye. The risk of skin melanoma increased by 75 percent when indoor tanning began before age 35. As a result, the agency moved these devices into the highest cancer risk category: “carcinogenic to humans.”

Time to take stock of that warning. That’s especially true if you have pale skin; blond, red or light brown hair, or you or a family member has had skin cancer. Melanoma is the second most common cancer in women in their 20s. And, one in eight with melanoma die from the disease.

So, besides avoiding tanning salons, what can you do? Take precautions, whether you’re at the poolside or on the ski slopes. If you can, limit time in the sun when rays are strongest – between 10 am and 4 pm. Wear wide-brimmed hats, long sleeves, and long pants, when possible. Use a water-resistant sunscreen with a sun protection factor (SPF) of 15 or higher. Make sure it protects against all types of skin damage (called broad spectrum).

Be sure to apply sunscreen to areas of uncovered skin about 15 minutes before you go outside. And pay special attention to your nose, ears, neck, lips, and hands. Reapply, after two hours. If you have a child younger than 6 months, talk with the doctor or me before you apply sunscreen. And, check with us about any medications and cosmetics you’re using. Some make you more sensitive to UV rays.

What else? Buy sunglasses with 99 to 100 percent UV protection – even for your kids. If you’re not sure whether yours offer this protection, check with your eye care professional. Remember that you can find many of these sun protection products right here, in our store.

 

June 2011:  Osteoporosis Tied to Obesity

Bigger Bellies: Bad for Bones?

 

Do you recall reading that extra weight can protect your bones? If so, you probably thought, hey, great – at least it’s good for something.

Well, sorry, but researchers are now making somewhat of an 180-degree turn – or, at least when it comes to “spare tires.” It looks as though extra belly weight doesn’t only increase the risk of heart disease and diabetes. It may also increase your risk of osteoporosis.1 That’s the condition causing fragile, porous bones in about 10 million Americans and leading to more than 1.5 million fractures each year.

A Harvard study looked at 50 premenopausal women who had an average body mass index (BMI) of about 30, which is considered obese. It found that women who packed away more fat around their middles had lower bone mineral density, a set-up for fragile bones.

Researchers aren’t sure why this kind of fat hurts bones. But they do know that deep belly fat releases fatty acids into the liver. It also releases other substances and hormones that are hard on the heart and pancreas. It could be that similar changes are wreaking havoc with your bones, too.

Now you’ve got one more reason to let loose of those love handles. That’s especially true if you are female, 65 or older, slender, Caucasian or Asian, or you have a family history of osteoporosis. There are other osteoporosis risk factors, but ones you can mostly control:

  • You have low estrogen.
  • You eat a diet low in calcium and vitamin D.
  • Your lifestyle is lacking in physical activity.
  • You smoke or drink too much alcohol.
  • You take certain medications, such as cortisone or chemotherapy.

 

So how can you know if your belly is too big, and what can you do about it? Use a soft tape measure to check your waist. If you’re a woman and your waist measures 35 inches or more, it’s time to lose a little. (If you’re a man, that number is 40 inches or more.) Also use a BMI chart to help guide yourself into a healthy weight range (18.5–24.9).

The good news is that belly fat is often the first fat to go. That’s because it’s more metabolically active. Other steps for banishing the big belly? For example, eat more whole grains, fruits, and vegetables, which fill you up faster, combined with proteins. Eat fewer refined foods like white rice or bread, which elevate your blood sugar, often leading to a faster deposit of fat.

And, don’t forget the other side of the weight-loss equation: exercise. Extra crunches aren’t the answer, even though that might seem like a logical place to start. Instead, work up to 60 minutes of aerobic exercise like brisk walking a day, combined with regular resistance training to build calorie-burning muscles.

 

May 2011: Asthma in Infants

 

Few things are as unsettling as a sick baby, struggling to breathe – especially when it’s yours! And, figuring out the source of the problem can be a bit of a puzzle, particularly if your infant has asthma. That’s because asthma in infants can have many faces. Babies with asthma often have sudden, severe wheezing and trouble breathing, just as older children do. But asthma in infants may also show up as chronic coughing, noisy breathing, or “chest colds.”

Asthma is a chronic lung disease. It makes the airways swell, tighten, and produce too much mucus. Severe asthma attacks can require a trip to the emergency room. And, uncontrolled asthma can damage the lungs over time. So, this is not something to ignore. If your baby has unexplained respiratory symptoms, stay alert and in communication with the pediatrician. Be prepared to tell the doctor how and when symptoms get worse. This can help rule out problems and confirm a diagnosis of asthma.

If anti-asthma medications relieve any wheezing and coughing, the diagnosis is pretty clear. But in some cases, other asthma mimics need to be ruled out. These include viral infections or congenital conditions or diseases such as cystic fibrosis. If it turns out your baby does have asthma, you may be wondering what caused it and what to do next! Although no one really knows the cause, your genes may play a role. Other factors may also come into play. Some doctors think breastfeeding the first year can help prevent asthma, but the evidence doesn’t yet support this.

Keeping your baby away from common asthma triggers such as cigarette smoke, aerosol sprays, pet dander, and dust mites may lessen symptoms of asthma. If you suspect a certain food is causing an allergic reaction, this could also trigger asthma. Remove the food from your baby’s diet, and then reintroduce it, to see what happens. However, it’s hard to do very much about other common triggers, such as crying, respiratory infections, and weather changes.

Prescription anti-inflammatory medications are the other mainstay of asthma treatment for infants. Your baby may need a combination of different types of medications. Be clear about whether you should give medication continuously or only when symptoms appear. A nebulizer uses forced air to send out a mist of medication that your baby can breathe through a mask. Don’t be alarmed if it takes a little while for your baby to get used to this. If your child is a toddler, it may be possible to use an inhaler with a spacer (a small tube).

Are you concerned about trying these medications in such a small child? Remember that, along with your child’s pediatrician, I can help guide you in their safe and effective use. But whatever you do, don’t put off seeking care – even if you think your child may “outgrow” this problem. Some kids’ asthma does get better with time, but the best results come with adequate treatment.

 

April 2011: Allergies

Controlling Allergies

 

In today’s economy – where every dollar counts – budgeting can be about as painful as a root canal. So, when it comes to something like allergy control, you may feel you don’t have anything left over to spend. Still, there’s no need to suffer in silence. A few simple steps can make a big difference, while costing very little.

 

To start, think about the things you can do that are free – or practically free. For example, clear out items that might be collecting dust mites. Think extra pillows, throw rugs, or stuffed animals. Are hypoallergenic pillows and comforters or allergen-proof covers (starting around $65) too costly for you? Then keep bed linens and other items around that can be washed in hot water. And, rent a steam cleaner for about $25 a day to steamroll those nasty little allergens lurking in carpets.

 

Speaking of cleaning, dust and pollen masks and nonlatex gloves are very low-cost ways to whip through the housework (or gardening) without exposing yourself to extra allergens. Microfiber hypoallergenic cloths are specially designed to attract dust and allow you to clean without the use of chemicals. They generally cost around $1 to $2 a piece. Use a diluted bleach solution to wipe down surfaces in bathrooms and other places. And, even if you don’t have a HEPA (High Efficiency Particulate Air) vacuum cleaner, don’t forget to change your vacuum bag at least once a month. A washable rubber mat at the front door will cut back on what gets tracked in.

 

If you can spring for a portable air cleaner, make sure you find one that doesn’t produce ozone. This can make allergies worse. A good place to research these products is at the website of the Association of Home Appliance Manufacturers (AHAM) [Click Here]. Here, you can find information about all kinds air filtering technologies, from HEPA to ionization.

 

Short of buying an air cleaner, though, it might help to buy a pleated paper furnace filter with a MERV rating of 7 to 13. These capture many of the allergens HEPA filters do and cost around $10. Electrostatic filters do a similar job and cost around $15.

 

Humidity is also an important factor when trying to control allergies. You want it low enough to control dust mites, but not so low it irritates your nasal passages. A $15 hygrometer can help you see if you’re in a safer range – between 30 and 50 percent humidity. Then you can use a humidifier or dehumidifier to achieve the right level. To help keep those nasal passages clear, consider using a bulb syringe or neti pot ($15), filled with lukewarm saline.

 

Remember: Many of these products are available in our store. And, of course, don’t forget about over-the-counter (OTC) allergy medications, such as pills, eyedrops, and nasal sprays. Check with me about any prescription medications that may now be available as cheaper OCT medications. For example, a wide range of Allegra products, the best-selling antihistamine, is now available over the counter.

 

And one final note: If you or your child needs allergy shots, you may be heartened to learn this: A 10-year study showed that allergy shots reduce overall health care costs in children by one-third and prescription costs by 16 percent. A pretty sound investment.

 

March 2011:  Aspirin

Is Aspirin a Wonder Drug?

 

It’s been around for more than 100 years. It’s one of the world’s most widely used pain relievers. And, its uses just seem to keep multiplying. Is aspirin a wonder drug? For those who’ve benefited, it might seem that way.

 

The latest news of aspirin’s potential benefits has to do with breast cancer. A study of more than 4,000 women in the Nurses’ Health Study (NHS) showed a benefit for breast cancer survivors who had taken aspirin two to five times a week for a long time. They had a 50 percent lower risk of dying from breast cancer. They also had a 50 percent lower risk of their cancer spreading.[1]

 

Combined data from the NHS and another study have also shown promising results for patients with colorectal cancer. Those taking aspirin long term lowered their risk of dying from the disease by nearly 30 percent and their overall risk of dying by about 20 percent. (The study didn’t look, however, at those with advanced disease.)

 

Other types of cancer have shown similar results. What could account for such benefits? Some believe it has something to do with aspirin’s ability to lower inflammation. However, this has not yet been proven. Now, before you rush out and stock up on aspirin, know this: The American Cancer Society doesn’t recommend taking aspirin to prevent cancer. That’s because its preventive benefits are unknown and the risks often outweigh the benefits. And, if you’re being treated for cancer, it’s especially important to know that taking aspirin at the same time as radiation or chemotherapy can cause side effects.

 

Regular aspirin use has been shown to reduce the risk of heart attack, stroke, and blood flow problems. That’s why many people who’ve had a heart or stroke, or those at higher risk, take it regularly. A recent study also shows that it is effective at keeping nine out of ten coronary artery bypass grafts open after surgery. How does it help keep arteries clear? It works by affecting the blood’s clotting and keeping clots from blocking blood flow.

 

Regular aspirin use is not for everyone. Don’t take aspirin long term without first discussing it with your doctor. Side effects can include ringing in the ears, bleeding in the brain or stomach, kidney failure, or certain kinds of strokes. Regular aspirin use is a poor choice for pregnant women or those who have:

 

  • * Asthma
  • * Stomach ulcers
  • * Uncontrolled high blood pressure
  • * A bleeding disorder
  • * Heart failure
  • * Allergies to aspirin

 

If your doctor decides that aspirin is the right choice for you, you’ll need to follow his or her instructions carefully. Aspirin labels don’t contain guidelines for this type of use. If you have questions about whether the product you’ve bought contains aspirin at the right dose, be sure to stop by and discuss this with me.

 

If your doctor prescribes daily aspirin, be sure to discuss all the medications you’re taking. Also, let other health care providers know you’re taking aspirin. And, don’t stop taking it suddenly. This could increase your risk of a heart attack or stroke by triggering formation of a clot.

 

 

February 2011: Cholesterol Lowering Foods

Cholesterol-Lowering Foods: The Fabulous Five

 

You’ve been told to lower your cholesterol, a form of fat made by the liver and present in some foods. What’s your first thought? If you’re like many people, you may think first about what you need to stop eating. But did you know that adding certain foods to your diet may do as much to improve your cholesterol as medication? These foods are so effective that the Food and Drug Administration (FDA) says they can carry the health claim for managing cholesterol.

 

Here are the fabulous five foods.

 

1. Soluble fiber. Sometimes called roughage, soluble fiber reduces low-density lipoprotein (LDL) – the “bad” cholesterol. Soluble fiber is the portion of plant products that pushes food through the digestive system. It seems to lower cholesterol levels by reducing its absorption in the intestines. Aim for 10 grams or more a day. Examples of soluble fiber include:

 

  • * Oatmeal
  • * Fruit
  • * Kidney beans
  • * Psyllium
  • * Barley

 

2. Nuts. Rich in polyunsaturated fatty acids, many kinds of nuts reduce cholesterol and help keep blood vessels healthy and elastic. Aim for a handful each day or about 1.5 ounces. Remember that nuts are high in calories, so more isn’t better. Being overweight increases your risk of heart disease. To keep fats to a minimum, make substitutions. For example, add nuts to salads instead of cheese or meat. Examples of nuts to include in your diet are:

 

  • * Walnuts
  • * Almonds
  • * Peanuts
  • * Pecans
  • * Pine nuts
  • * Pistachios
  • * Hazelnuts

 

3. Fish. Fatty fish is high in omega-3 fatty acids, which helps lower cholesterol and reduce blood pressure and the risk of blood clots. Aim for two servings of fish each week. You can also take an omega-3 or fish oil supplement or eat ground flaxseed or canola oil.

 

Examples of fish high in omega-3 fatty acids are:

 

  • * Mackerel
  • * Lake trout
  • * Salmon
  • * Albacore tuna
  • * Sardines
  • * Herring

 

4. Olive oil. Many people think all oil is bad. But it’s not quite that simple. Olive oil packs a powerful punch that lowers “bad” cholesterol, but doesn’t touch the “good” kind, high-density lipoprotein (HDL) cholesterol. Extra-virgin olive oil may have the best effects. Aim for 2 tablespoons of olive oil each day. You can use olive oil to sauté foods, baste meat, or as a salad dressing when mixed with vinegar.

 

5. Fortified foods. Some foods are now fortified with plant sterols or stanols. These are substances that block the absorption of cholesterol. Aim for 2 grams a day of plant sterols. That’s equal to two 8-ounce servings of juice or about 15 grams of enriched spreads a day. Examples of the kinds of foods fortified with these substances are:

 

  • * Margarines
  • * Low-fat spreads
  • * Orange juice
  • * Yogurt drinks

 

Of course, it’s important to add all this advice to the old standard: Eat less of saturated fats, including meats and some oils, and try to eliminate trans fats. Trans fats still show up in some baked goods like cakes, cookies, and crackers. They raise LDL and lower HDL. And remember: Exercise and weight control are two other pieces of the cholesterol-control puzzle.

 

January 2011: Nutrition

Nutrition 101

 

You’ve probably heard it all before. Maybe the advice has even been so drilled into your head that it’s simply become background noise: Eat your veggies. Choose whole grains. Banish the trans fats…. Et cetera, et cetera. Well, it may all be old news, but the age-old mantra is still true: “You are what you eat.” So, here’s a brief nutrition review, along with a couple of tips on how to begin making changes.

 

These are the basics of a healthy eating plan:

 

  • * Look for a rainbow of fruits and veggies. If you choose a variety of colors, you’ll get a variety of nutrients – go for orange veggies and dark leafy greens, for example, along with dry beans and peas such as kidney beans, split peas, or lentils. And for the most benefits, choose whole fruits, not juice. Shoot for 5 to 6 servings each day.
  • * Got milk? Aim for 3 servings. A serving is 1 cup of milk or yogurt, 2 cups of cottage cheese, or 1½ ounces of cheese. If you’re lactose intolerant, look for beverages that are free of milk products but are fortified with calcium. Make low-fat and nonfat choices most often.
  • * Eat the “whole” thing. Choose whole-grain breads, rice, cereals, crackers or pasta. Three ounces is a good daily goal.
  • * Be lean (not mean). Choose 5 ½ to 6 ounces of lean meats and poultry but mix up your protein choices. If you’re a diehard carnivore, remember that protein is found in plants, too. Include fish, nuts, seeds, and beans in your meal plans.
  • * Go easy on the extras. The Nutrition Facts label is your friend! Look for foods low in saturated fats, salt (sodium), and added sugars. Nix the trans fats altogether.

 

Not many of us are great at keeping track of calories and serving sizes. Check out this nifty, new online calculator that does it for you: [Click Here]. Type in the name of a food you want more information about. With one click of your mouse, you’ll see what food group it falls into, how much a serving size is, and how many calories are in a serving. You can also compare it with another similar food. For example, if you’re wondering how your cereals stack up with one another, you can quickly find out. You might be surprised to learn that homemade granola has three times the calories of Grape-Nuts.

 

Now, I’m the first to admit that making dietary changes isn’t easy. Rather than trying to change everything at once, choose one change to start with. For example, try adding one more serving of veggies a day. Or, start eating breakfast if you aren’t already. Or switch from snacks with empty calories (soda) to nutrient-rich snacks (an apple with peanut butter). Focus on how much better you feel and how your food choices can improve your overall health.

 

If you’ve made diet changes and are still troubled by weight gain, talk with our pharmacy staff. Perhaps a medication could be causing the problem. Your doctor may be able to change your prescription.

 

For more information, visit Healthmart’s Wellness Library, where you’ll find a wealth of information about nutrition – from a guide to organic foods to a look at senior nutrition.