National Nurse Practitioner Week

Did you know that a nurse practitioner (NP) can examine, diagnose, prescribe, treat, counsel and educate you on healthcare needs?  NPs are different from other healthcare providers – they focus on the whole person when treating specific health problems and they educate their patients on the effects those problems will have on them, their loved ones and their communities.  NPs have been providing primary care in the U.S. for more than 40 years.  They are graduates of master’s, post-master’s or doctoral NP programs, with advanced clinical preparation to provide primary, acute, and chronic care to patients of all ages and walks of life.  NPs partner with their patients, assisting them in making better lifestyle and healthcare decisions.  That’s our mission at Heartstrong LLC, a healthcare education and consulting business run by two board certified nurse practitioners.  The main focus of Heartstrong is to PREVENT future health problems by helping people identify their risk factors and develop an individualized plan to make healthy lifestyle changes.  Prevention of disease is the foundation of both medicine and nursing and this is where NPs excel.

If you are interested in finding a NP in your area go to www.npfinder.com on the American Academy of Nurse Practitioners website.  If you are interested in learning more about how Heartstrong NPs can help you visit www.heart-strong.com

There are over 147,000 nurse practitioners practicing in the United States today.  The week of November 8^th through the 14^th is National Nurse Practitioner Week.

Are You Ready for American Diabetes Month?

November is American Diabetes Month, devoted to increasing awareness about diabetes and educating people about the prevention and  treatment of diabetes.  We all need to pay attention to this increasing epidemic. 

Some alarming facts about diabetes:

1 in 3 American children born this year will develop diabetes if they follow the typical American diet and lifestyle.

Every 20 seconds someone is diagnosed with diabetes.

Diabetes is the #1 cause of blindness in adults.

Diabetes is one of the strongest risk factors for heart disease and stroke in both men and women.  Adults with diabetes are at a 2 to 6 times higher risk of having a heart attack.

The American Diabetes Association has just released some great new educational videos covering a multitude of diabetes lifestyle and management tips.  Go to www.libertymedical.com to view free.

Also during the month of November help get the message out there to both adults and kids about the risks associated with diabetes, prevention tips and the importance of appropriate management. 

Why should you get involved?  Someone you know either has diabetes or is at risk to develop diabetes (maybe even you).

Two of the most important things to do to prevent diabetes:

1)      Maintain a healthy weight AND waist (men’s waist circumference should be less than 40 inches and women’s waist circumference should be less than 35 inches)

2)      Get a moderate amount of exercise daily

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can control their  risk factors to prevent a heart attack, stroke and diabetes.  Also include info for women with diabetes – how to control your risk factors to prevent heart disease.

 “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009. For more info visit www.heart-strong.com

Heartstrong Website Update

Hello,

Our main website http://www.heart-strong.com/ has just been updated. Would love to hear your comments and suggestions (it’s a work in progress).

THANKS

Is Smoking Worse for Women?

Two recent small studies revealed that women may be more vulnerable to the carcinogens and other dangerous substances in cigarette smoke.  In these studies, women who smoked were diagnosed at a younger age with lung cancer and COPD (chronic obstructive pulmonary disease) than men who smoked.  The women even smoked LESS than the men in the studies. In 2000, more women died from COPD as compared to men according to Dr. DeMeo, assistant professor of medicine at Harvard Medical School and Brigham and Women’s Hospital in Boston.

 However, Dr. Thun, the emeritus director of epidemiology at the American Cancer Society believes the risks of developing lung cancer is similar in men and women, smokers and non-smokers, but the type of cancer differs.

The bottom line is that smoking is known to be a major contributor to lung cancer and COPD. Thun adds that if smokers quit before the age of 50, they can avoid most of the risk of developing these illnesses.

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can stop smoking, help control their cholesterol and other risk factors to prevent a heart attack, stroke and diabetes. “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009. For more info visit www.heart-strong.com

Heart Healthy Vitamins and Supplements (Part 2)

Fibromyalgia: First steps after a diagnosis

from the Chronic Pain Health Center

The days and weeks after you’re first diagnosed with fibromyalgia can be a whirlwind of emotions. You may feel anxious about what’s to come, angry that you have a chronic illness, sad that your lifestyle might have to change—or even happy to finally have a diagnosis! Here are some things you can do to feel more prepared and supported.

Coordinate your health care team
Chances are you’ll have multiple health care providers (HCPs)—possibly working at separate facilities—treating your fibromyalgia. These can include a primary care doctor, rheumatologist/neurologist, pain care specialist (i.e., anesthesiologist, physical medicine specialist), psychologist and physical therapist, some of whom you may see more often than others. Coordinating with your health care team may help ensure you get the best treatment.

Make a contact list of all your HCPs to distribute to each of them, and request that they coordinate with each other on your care and share information as needed. Take the time to connect using email if possible, phone if necessary—whatever it takes to keep your team informed and united.

Consider a “whole patient” approach
Fibromyalgia will likely affect many areas of your life, and unfortunately there’s no “one thing” that will make you feel better. Many experts agree that a “whole patient” approach—one that encompasses mind, body and environment—is the best way to treat and manage the condition.

A “whole patient” approach usually encompasses many areas of influence and types of treatment. Your HCPs may work to help you develop an exercise routine; teach you meditation, visualization or other relaxation techniques; craft a healthy diet; find a balance of appropriate medications and/or supplements; use massage or physical therapy to help with your pain and mobility; and much more.

Adopt pain management strategies
There are many approaches to pain management. Your HCP will likely review several different options with you as you work together to find a combination that gives you support and relief. While many pain management strategies may start with medication, they may expand to include other approaches such as relaxation techniques. For example, relaxation training with biofeedback techniques can teach you to identify pain centers and neutralize them with techniques like deep breathing, visualization or meditation. Conventional treatments such as heating pads and cold packs, as well as warm baths, can help relax both your mind and your body while reducing pain.

Learn about medications
While complementary therapies may offer relief, there are also medications available to treat fibromyalgia. In recent years, the U.S. Food and Drug Administration (FDA) has approved three medications specifically for the management of fibromyalgia.

Your HCP may also suggest other medication options to help manage pain and address any additional issues you may experience.

If you’re juggling a variety of medications, you can use tools like daily/weekly pill organizers—or high-tech tools—to stay organized and ensure you’re taking medications correctly.

Ease into exercise
If you’re exhausted and hurting, it may be hard to get excited about exercising or any physical activity. You might be surprised to learn, however, that many HCPs recommend low-impact exercises like gentle swimming, walking, cycling, and tai chi to help ease pain and fatigue—and this can also help to raise your spirits. Stretching can help keep you limber. It’s important to remember that easing into exercise may have ups, downs and plateaus—so cut yourself some slack. And, be sure to discuss any exercise goals with your HCP before starting. 

Keep thorough medical records
Maintaining accurate, organized medical records can play a big role in minimizing the stress that can come with a chronic illness. Organized records will make it easier to speak with your insurance company or Medicare/Medicaid; help you remember what treatments you received, and when; and enable you to chart your long-term progress.

So dig out that shoebox of paperwork from under your bed and start organizing! You may choose to sort your records by service date, HCP or facility location; some people prefer paper, while others like to create accompanying digital records (like spreadsheets) to track expenses. Determine the system that best fits your personal style and stick with it.

Manage personal relationships
Fibromyalgia can have a significant impact on your personal relationships with family and friends. You need a good support system, a team to cheer you on when things are tough and to keep your attitude positive.

Just like other big life events, diagnosis with a chronic illness like fibromyalgia may bring out the best—and worst—in the people around you. As you share your experience with friends and family, take the time to strengthen bonds with those who show empathy and patience…and don’t be afraid to build healthy boundaries that protect you from those who don’t respect your experience and needs. Over time you’ll create a team that motivates and supports you, through good times and bad.

A chronic pain condition can be a struggle to manage. But, in so many ways, the outlook for people with fibromyalgia has never been better.  Today, experts understand better how to diagnose, treat, and manage fibromyalgia symptoms. Together, you and your health care team can develop a strategy that works best for you.

References

Arthritis Foundation. Fibromyalgia Treatments. Accessed on September 8, 2009. http://www.arthritis.org/disease-center.php?disease_id=10&df=treatments.

National Fibromyalgia Association. Treatments. Accessed on September 8, 2009. http://www.fmaware.org/site/PageServer?pagename=fibromyalgia_treated.

Mannerkorpi, K. Physical exercise in fibromyalgia and related syndromes. Best Practice & Research Clinical Rheumatology. 2003: 17(4). 629-647.

Henriksson KG. Fibromyalgia–from syndrome to disease. Overview of pathogenetic mechanisms. J Rehabil Med. 2003;89-94.

© 2009 HealthyWomen All rights reserved. Reprinted with permission from HealthyWomen. 1-877-986-9472 (tollfree). On the Web at: www.HealthyWomen.org.

Dance Fever

from HealthyWomen’s e-newsletter, HealthyWomen Take 10

If dancing is a rare activity for you, one you take part in only at the occasional wedding reception (if then!), then it’s time to get in touch with your inner Debbie Allen.

Dancing, like walking or cycling, is a great no-cost or low-cost way to build aerobic fitness, improve balance and strengthen your muscles at any age. And you don’t have to wait for a special event or find a partner to enjoy dance’s benefits.

You can even pick dance as your main physical activity. Research presented at the 2009 annual meeting of the American College of Sports Medicine showed that dancing gives even formerly inactive people a good workout. Beginners in a tango class logged about 20 percent of their recommended daily steps by participating in the twice-a-week program.

The fun factor of dancing helps encourage you to stick with the activity. Many people find dancing more enjoyable than spending time in a gym on traditional exercise equipment. Dance classes provide social connections that help improve mood and build feelings of well-being. There are dance groups for all activity levels—from energetic salsa to walk-speed square dancing.

Groups specializing in line dancing are especially good if you don’t have a regular dance partner, but many classes are set up to make sure that everyone dances, regardless of whether you come alone or not.  

To get started with dancing for fitness:

• Borrow dance DVDs from your local library and try them at home.
• Participate in a community dance class through your local adult school or recreation center.
• Alternate dance sessions with walks or jogs you may already be taking.
• Wear comfortable shoes and loose clothing.
• Bring water and a face towel for comfort.

And get ready to smile. Dancing increases social contact, improves self-esteem and encourages new friendships.

References

Bremer Z. “Dance as a Form of Exercise.” British Journal of General Practice. 2007;57(535):166.

Verghese J. “Cognitive and Mobility Profile of Older Social Dancers.” Journal of the American Geriatric Society. 2006;54(8):1241-4.

American College of Sports Medicine. “Salsa or Tango Toward Health.” http://www.acsm.org/AM/Template.cfm?Section=Home_Page&CONTENTID=12877&TEMPLATE=/CM/ContentDisplay.cfm. Accessed May 29, 2009.

© 2009 HealthyWomen All rights reserved. Reprinted with permission from HealthyWomen. 1-877-986-9472 (tollfree). On the Web at: www.HealthyWomen.org.

Super Obese More Likely to Diet After Weight-Loss Surgery

Just how safe is bariatric (weight-loss) surgery?

Obese people usually undergo weight-loss surgery to prevent health problems related to increased body fat.  A study published in the October 2009 issue of Archive of Surgery found that morbidly obese patients and those with chronic health problems were more likely to die after weight-loss surgery.  This study followed 856 men and women for one year after surgery.  A total of 54 people died, 1.3% within 30 days of surgery and 3.4% within a year.  Thirty of the 54 deaths occurred in people who were super obese (morbidly obese).  Super obesity was defined as a BMI of 40 or greater, normal BMI is < 25.  BMI is a weight measurement based on height and weight.  (To determine your BMI visit http://heart-strong.com/calculators.html)

 The researchers suggest that the higher death rate in morbidly obese patients may be due to the increased risk of wound complications, blood clotting and increased procedural complexity related to excess abdominal fat.  The benefits and risks or bariatric surgery must be closely evaluated, especially in people who are morbidly obese or who have congestive heart failure, COPD or complicated diabetes.

 For more heart healthy info visit www.heart-strong.com

Stressful Childhood Can Lead to Earlier Death

Poverty, smoking and long-term bullying during childhood have previously been reported to adversely impact health.  In this study The Centers for Disease Control and Prevention followed over 17,000 men and women to evaluate the impact of childhood stress on future health problems.  People who reported verbal abuse, physical abuse, sexual abuse, having a battered mother, having a family member incarcerated, living with a family member who abuses drugs or alcohol, living with mentally ill person, or having parents separated or divorced during childhood were more likely to die prematurely.  Those who reported 6 or more of the negative childhood experiences were 1 ½ times more likely to die prematurely than those who reported none.  People with bad childhood experiences died at about age 61 compared to 79 years of age for people who didn’t have negative experiences as children.

 It is important for adult guardians to recognize and try to alleviate these childhood stressors.  Further research is also needed in this area.

Premature Heart Disease Common in Indians and South Asians

Heart disease is the number one killer of men and women in the United States.  The prevalence of heart disease varies among ethnic groups.  Immigrants from India (South Asia) have a four times greater risk of developing heart disease than other Americans.  Indians are also more likely to develop premature heart disease, have heart attacks at an earlier age and develop diffuse disease due to a genetic predisposition and a multitude of lifestyle risk factors.  This includes both vegetarians and non-vegetarians.

 Genetic risk factors include: high lipoprotein (a) levels, elevated triglyceride levels and lower levels of less protective HDL (healthy) cholesterol.  Indians are also more prone to have abdominal obesity, diabetes, sedentary lifestyles and diets high in fat and starches which can increase the risk of developing heart disease.  The traditional Indian diet includes deep-fried foods (re-use of vegetable oil when cooking), coconut milk, roti, naan and other white breads, white rice, paneer (cheese), whole milk and high fat yogurt.

 Even though Indians have a strong genetic risk for heart disease they can lower their risk by making healthy lifestyle changes. 

 Below are some tips that may help reduce the risk of heart disease:

• Avoid deep frying, try to broil, bake, steam instead
• Use low fat milk and dairy products
• Increase fruit and vegetable and fiber intake
• Use olive oil or canola oil, do not re-use cooking oil
• Avoid ghee (clarified butter)
• Increase intake of fish, nuts
• Decrease intake of starches like white rice, roti, white potatoes and naan
• Avoid eating all or majority of carbohydrates at one meal, do not skip meals
• Increase activity level (walking 30 minutes a day counts as exercise)
• Weight loss (lose abdominal fat, waist circumference goal men <36 inches, women <32 inches)

 Lipoprotein (a) is a sub-class of LDL (Bad) cholesterol, when levels are elevated in the blood the risk for heart disease and stroke are increased.  Elevated lipoprotein (a) levels are associated with premature heart disease and have little to do with diet or lifestyle, they are usually hereditary.  All Indians/South Asians should have a lipoprotein (a) level checked at least once in their lifetime, preferably when they are younger since it is a marker of premature heart disease.

“Take Charge: A Woman’s Guide to a Healthier Heart” discusses how women can help control their cholesterol and other risk factors to prevent a heart attack, stroke and diabetes. “Take Charge: A Man’s Roadmap to a Healthier Heart” is due to be released Fall 2009. For more info visit www.heart-strong.com