Carotid Artery Stenting vs Carotid Artery Surgery: Is there a Difference?


If you have a carotid stenosis you could be at an increased risk for a stroke. Carotid artery surgery (carotid endarterectomy) has been the treatment of choice for many years.  Carotid artery stenting is a less invasive option.  But for many years a controversy has existed – which is the better treatment? Carotid Endarterectomy or Carotid Stenting???

The CREST (Carotid Revascularization Endarterectomy Vs Stenting Trial) was devised specifically to answer this question and the results were presented recently at the 2010 International Stroke Conference.  Over 2,500 patients were enrolled in this trial from 117 US and Canadian sites.  So what did the study show???

There was no significant difference in the risk of stroke, heart attack or death during the procedure and no difference in stroke during the 2.5 year follow-up period.

People over 69 years of age had better outcomes with surgery and people younger than 69 had better outcomes with stenting.

There was no difference in outcomes among men and women or symptomatic and asymptomatic patients.

Dr Wesley Moore who was a co-principal investigator in this study stated that stroke rates were lower with carotid surgery but when heart attacks were added to the adverse outcomes the results of the two procedures became similar.

What must be remembered is that only the most experienced physicians and hospitals were included in this study.  So in order to receive the same benefits and low rate of adverse outcomes with either procedure you need to make sure you undergo a procedure at a hospital with a physician who is well experienced.

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Sleep Apnea Can Kill You – Severe Sleep Apnea Increases Overall Mortality


 The National Heart Lung and Blood Institute estimates that 12 million adults in the U.S. have sleep apnea.  Unfortunately most people with sleep apnea are unaware – undiagnosed and untreated. 

 People with sleep apnea stop breathing while they are sleeping.  In severe sleep apnea a person’s airway is blocked and they stop breathing for 20 to 30 seconds and this causes the person to wake up abruptly.  Other signs and symptoms of sleep apnea included: excessive snoring, waking up with a headache, waking up and still feeling tired, and excessive daytime fatigue.

Sleep apnea does not permit the body to rest and instead causes stress on the heart.  High blood pressure is very common in people with sleep apnea and the risk of heart attack and stroke is higher in people with sleep apnea.

 A recent study from John Hopkins University of 6,400 middle-aged men and women over 8 years found that people with major sleep apnea were 46% more likely to die from any cause.  People with mild sleep apnea were not at a higher risk.

The most effective treatments for sleep apnea are:
Weight loss (if overweight)
Nasal CPAP mask (keeps the airways open during sleep and allows normal breathing)
Surgery (may include tonsil removal)
Mouth guard

 If you suspect you have sleep apnea you should talk to your healthcare provider about having a sleep study.  With proper treatment your risk for heart disease and strokes can be reduced and blood pressure normalized.

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Back to Nature: Take Your Workout Outdoors


Exercise equipment fills Tami Hart’s garage, gathering dust. Tami also ignores the 24-hour fitness room she could use for free at her workplace.

It’s not that the Payette, Idaho, woman has given up on physical activity. “There’s just something about walking on a treadmill or riding a stationary bike that is totally unappealing and uninspiring,” she says. Instead, you’ll find her exercising outside, year-round, even in snow and icy wind.

“I need to feel some connection with the outdoors and experience nature as I’m exercising,” says Hart, a 47-year-old sales manager and mother of three, whose fitness routine includes Nordic walking and mountain biking. 

Holly Frew feels the same way. She spends her workdays inside, sitting at a desk. At the end of a long day, she ties on her sneakers and heads outdoors near her Atlanta, Georgia, home to run—just for the fun of it.

“When I’m running outside, I feel such freedom and release,” says Frew, who is 29. “I’m in tune with nature … I get in this zone, feeling like I can run forever.”

By contrast, when she runs indoors, “I feel like a hamster on a wheel. All I can do is wonder when it will be over!”

“The monotony and confinement (of indoor exercise) leaves me mentally unmotivated,” Frew adds. “I quickly become physically exhausted.”

Natural revival

There’s good scientific reason why Hart and Frew feel such a difference between outdoor and indoor exercising. It starts with how we pay attention to the world around us and function within it, explains Andrea Faber Taylor, PhD, a researcher in the Landscape and Human Health Laboratory of the University of Illinois at Urbana-Champaign.

During most of our waking hours, we use our directed-attention ability, which helps us stay on task, take an exam or drive in heavy traffic. Directed attention—while useful for success in many life functions—demands concentrated effort. It leaves us feeling mentally fatigued and even stressed, Dr. Faber Taylor says.

By contrast, being in natural settings triggers involuntary attention. We use this when watching a flickering campfire or the moving water of a stream. Involuntary attention is easier on the mind, helping to rebuild and renew directed-attention strength.

“When people exercise outdoors in nature, they are not only exercising their body, but likely restoring attention and receiving physiological stress-reduction benefits. It’s a whole-body effect versus just the physical,” says Dr. Faber Taylor. Among her research findings: that walking in a park setting for 20 minutes improved the attention performance of children with attention deficits, compared to walking in more built settings. Similarly, a University of Michigan study released in 2008 showed that walking in natural environments or even simply looking at pictures of nature scenes restored the cognitive functioning of a group of college students.

Combining nature and physical activity—a phenomenon called “green exercise” by researchers at the University of Essex in England—produces a positive effect on physical and emotional health. Green exercise has been shown to significantly improve self-esteem and mood, reduce blood pressure and burn calories.

Those benefits contribute to why women who walk, run, dance, do yoga, bike, weight train or do other sports outdoors are so committed to the open air.

“I will walk in rain, shine, snow, deerflies biting or anything else,” says three-mile-a-day walker Sally Berry, 48, a travel consultant from Canandaigua, New York. “I get to notice things no one else does—the first birds back in the spring, a heron in a creek or the first tree to start changing color in the fall.”

Although some nature exercisers do go inside when the weather becomes too challenging, most return outdoors as soon as they can.

Taking it outside

We all know women who love going to the gym. They enjoy the fitness equipment, trainers and classes within those walls. Others work out at home, preferring the privacy and convenience they find there.

Yet green exercise has appealing advantages: it’s often cheaper and easier than a gym or fitness club, usually provides a better visual and sensory experience than being inside and may be more easily adapted to your changing interests and needs. What’s more, exercising in a natural environment—rather than indoors on a treadmill—produces higher levels of positive emotions, with less tension and stress, and encourages you to exercise longer.

“Whether I’m surrounded by nature in the woods or running through the city, just being outside gives me a huge boost of energy,” says Esther Steinfeld, a 25-year-old from Houston. Being in a gym “makes it so much easier to stop,” she adds.

The psychological effect of being in the open air is as important to Steinfeld as the physical benefits. “Running outside doesn’t necessarily solve my problems, it just helps me put them in perspective. It’s like my mind is a tangled ball of yarn, and after I’m done, it’s one long strand.”

Outdoor classes are now springing up around the United States, bridging the gap between gyms and green exercise. Fitness instructor Paula Dunwoody, who taught step aerobics and other traditional indoor classes for 12 years, now runs her own fresh-air exercise sessions in Olney, Maryland. Participants (nearly all are women) in Out-n-About Outdoor Fitness classes use body weight, resistance tubes and exercise balls to work out in public parks, playgrounds, on trails and even on Dunwoody’s own property. “I knew how being outside affected me mentally and was excited to take my work outside,” she says.

At the Morris Arboretum of the University of Pennsylvania in Philadelphia, groups of walkers take part in regularly scheduled “wellness walks” from October through March. “It’s a time when people don’t get out as much as usual. They have a safe place to walk, the air is clean and the views are gorgeous … but the focus is to keep moving,” says volunteer walk leader Elaine Bell.

A daily dose of nature, gained in as little as a 10-minute walk, is important for the health of adults and children alike, Dr. Faber Taylor believes. “We need to raise the priority of getting into nature,” she says.

Breathing easier

Maybe outdoor exercising sounds lovely to you, but you’re worried that being in nature will trigger your allergies, asthma or other breathing problems. Talk with your health care provider about coordinating your activity interests with your health condition. Then consider these suggestions to help make exercising outdoors like a breath of fresh air for your body and spirits:

  • If you have asthma, use your medications before exercising, in the manner prescribed by your physician. Do a five- to 10-minute warm-up. With the right treatment and management plan, people with exercise-induced asthma can participate safely in exercise, according to the Asthma and Allergy Foundation of America.
  • Walking is a good exercise choice over activities that cause you to breathe faster, such as running or soccer.
    • Higher ozone and pollutant levels can cause breathing problems, so check levels before exercising outdoors. Many online and print weather forecasts now report air-quality levels:
      1. 0 to 50 is good;
      2. 50 to 100 is not harmful, but could cause breathing problems for some people with asthma;
      3. above 100 is unhealthy if you have lung or heart disease and other conditions;
      4. above 150 is unhealthy for everyone.
  • Exercise in the early morning or early evening, when pollution levels are lower.
  • If you have breathing problems, avoid exercising outdoors in very cold weather.

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A Fitness Program for You and Your Dog


“If your dog is overweight – neither of you are getting enough exercise!”

Your pet’s state of health is usually a mirror of your own.  So if you and your beloved canine are leading a sedentary lifestyle, it might be time for a change that can benefit you both. Regular exercise helps humans and canines maintain muscle mass and improve cardiovascular function, both keys to health, wellness, functionality and longevity. 

Exercise and good nutrition go hand-in-hand.

¨       A humane/canine fitness partnership should be viewed as a preventive measure, begun as early as possible in your dog’s life.  “Use it or lose it” applies; physical exercise preserves muscle mass.

¨       But it’s never too late:  even if exercise isn’t a regular part of your (and your pet’s) routine, it should be added immediately.  Even a brisk 20-minute walk daily will have an impact.

¨       The ideal fitness program consists of a brisk walk/run on variable terrain, with some incline and decline (hill climbing and descent is good resistance training for muscles.)

¨       Play such as tug of war (being careful of the dog’s teeth and gums, and never pulling too hard so as not to put strain on the neck, especially in smaller breeds) or catch and fetch on a slight incline are also good ways to vary the routine (but if your animal is older or has hip weakness be sure the incline is not very steep).

¨       Remember that just as with your pet’s diet; you are in charge.  For both of you to be active, you must be the proactive one.   You set the pace to challenge your animal to a certain extent, but must also know its limits and play within that.  Note that some breeds will keep on playing to please, even if they are exhausted.

¨       Always finish the workout with a special but healthy food treat.

According to the experts at Weider Pet Health (, exercise is an innate need for dogs, and owners who engage in more physical activity to address this need automatically enjoy better health themselves.

So what are you waiting for?  Turn that computer off and go take your dog for a walk….

Tips to Achieve Your Five Impossible Fitness Goals


We all make empty resolutions to ourselves. “This year, I’m going to run my first marathon,” “Next month, I’m going to shave a minute off my mile,” “One day, I’m going to climb Mt. Kilimanjaro” We sprinkle ambitious goals into conversations with friends at dinner parties and with colleagues at work. However, it seems these deeds are much more easily said than done. Year after year our ambitious to-do lists remain unchecked and we become less and less motivated to see them through to the end.

Tara Zimliki, creator of Tara ’s Boot Camp, is one health expert who has helped many people achieve a range of fitness goals. Whether overcoming weight-loss challenges, running their first marathons, or improving their overall health, Tara has coached her clients through their most difficult fitness endeavors. Along the way, she has taught them to live by the credo that taking on a personal fitness milestone is just as much a physical feat as it is a mental one.

Maintain achievable mini-goals.

Impossible Fitness Goal: Break the Yo-Yo Diet Cycle

  • Easy Solution: Consult a Good Personal Trainer

o        Sometimes we need a little one-on-one attention to get us to the goal weight we desire. “People are often unsuccessful because they try to fit into the mold of what they think they should be doing, instead of trying something tailored to personal preference,” Tara warns. Some of us may be turned off by the cost of personal trainers and health experts, but many people don’t realize these sessions need not last forever.

o        Think of a personal training session as an investment. Once you have the knowledge and guidance that can only come from a certified health professional, you will have the tools to defeat your waistline woes once and for all.

Impossible Fitness Goal: Lose Those Last Five-Ten Pounds

  • Easy Solution: Enter a Weight-Loss Contest
    • The most important thing to do when getting rid of those last few unwanted pounds is to stay motivated. What better way to do so than with a little competition? Join a weight-loss competition or start one with friends and family in order to get you through a diet slump.
    • Studies show support from a partner or buddy will increase your chance for successful weight loss. If there’s a prize involved, the cash incentive will give you that extra push to see this objective to the end. You’ll lose those nagging pounds easily – no contest!

Impossible Fitness Goal: Run Your First Marathon

  • Easy Solution: Start Training Early
    • Tara says, “The most important thing about training for a marathon is to start early.” Race day is the culmination of months of training and preparation. However, don’t be discouraged by the commitment you are about to make.
    • The Internet offers online workout-building devices and nutrition calculators to help you set a realistic training program. By creating a personalized training guide, you know exactly how much time you need to get race-day ready. There are thousands of marathons each year, so don’t feel rushed to get this lofty goal checked off your list. You will make it happen in due time!

 Impossible Fitness Goal: Break a Personal Record

  • Easy Solution: Take a Break!
    • Competing in a 5K, 10K, marathon, or triathlon is a feat in itself, but breaking a previous race time is a glorious accomplishment. A faster time is concrete proof of all your hard work and dedication, regardless of whether or not you won the race.
    • In order to beat a personal record at your next competition, keep track of your progress daily, including on off-days, and take breaks often. “The worst thing you can do before race day is to burn yourself out,” Tara warns. When monitoring her clients’ progress, Tara has found that runners at a 10 minute/mile pace tend to lose about 15 seconds when they walk for one minute. This means that for every minute run, the runner only has to run 5 seconds faster. This break also gives the runner time to recover and regain his or her strength. For veteran competitors, running at a slower pace, rather than walking, can have similar effects on your race time.

 Impossible Fitness Goal: Bounce Back From an Injury or Hiatus  

  • Easy Solution: Alternate Between Different Types of Workouts
    • Re-starting your old fitness regimen can be more difficult than it was the first time around. The fear of a repeat injury or being unable to complete a desired work-out can be daunting.
    • During the first few weeks back of releasing your pent-up physical and emotional energy, there is a danger of overdoing it. Tara recommends working out differently than you are used to. “Biking or swimming can be great alternatives to running and weight-lifting, for example,” she says. Trying a new fitness program will not only force you to start slow, but will help keep your body sturdy when you decide to return to your normal work-out.


Evaluate your goals in terms of the joy and fulfillment they will bring you once they are completed. No matter how big or small, each milestone will make you stronger in body and mind. When beginning your next fitness task, keep these expert tips in mind and before you know it, you’ll be scaling Mt. Everest. Good luck!

Tara is a Certified Personal Trainer through The American Council on Exercise (ACE), and a Boot Camp Instructor. She has competed and trained with top athletes at the University of South Carolina where she was awarded a full cross-country scholarship. Tara has a B.A. from Rutgers University and specializes in fat loss and nutrition
Tara has completed 15 Marathons and hundreds of races worldwide. In 2008, Tara placed in the top 500 women for the NYC Marathon. Tara ’s practices what she preaches in all aspects of fitness and health and for this reason she is a trusted trainer that produces results.  For more information, please visit

Fibroid Awareness Week



Fibroid tumors are benign (non-cancerous) growths that appear on the muscular wall of the uterus. They range in size from microscopic to masses that fill the entire abdominal cavity, in some cases, as large as a five month pregnancy.  Uterine fibroids can affect women of all ages, but are most common in women ages 40 to 50.

 What symptoms should you be alert for?

While not cancerous, uterine fibroids can cause problems. Depending on size, location and number of fibroids, common symptoms include:

  • Pelvic pain and pressure
  • Excessive bleeding, including prolonged periods and passage of clots, which can lead to anemia.
  • Abdominal swelling
  • Pressure on the bladder, leading to frequent urination
  • Pressure on the bowel, leading to constipation and bloating
  • Infertility

The Fibroid Treatment Collective (FTC) (, has launched an annual observance called Fibroid Awareness Week scheduled this year for April 19th – 23rd, which is dedicated to education about fibroids that affect upwards of 50 percent of all women.  Several special events will highlight the week, including a Fibroid Treatment Seminar on Wednesday, April 21 in Pasadena at 6:00 p.m. PST and a national Fibroid Treatment Webinar, Friday, April 23 at 5 p.m., PST.  Both are free, and reservations can be made at

“We felt the best way to reach out to almost half the women around the world who may have symptoms of fibroids was through an annual educational observance and to disseminate accurate and timely information about diagnosis and treatment,” said Bruce McLucas, MD, founder of the Collective and a board certified obstetrician and gynecologist.  “The Fibroid Treatment Collective was founded 12 years ago to educate women about fibroids and various treatment options,” he added.

Concern for the high number of unnecessary hysterectomies and dissatisfaction with other treatment outcomes led Dr. McLucas to become a non-surgical treatment advocate.  His goal, and the mission of FTC, is to ensure women with fibroids know all the options when it comes to treatment.   FTC advocates embolization as a safe alternative to other fibroid treatments.

In gynecology, embolization was used to reduce bleeding during uterine surgery. Founding members of the Fibroid Treatment Collective noticed another important effect. It shrank fibroids. The promise of an effective, non-invasive treatment led to research, trials and medical acceptance.  Today more than several hundred thousand women world-wide have found relief with this safe, simple procedure.  The Fibroid Treatment Collective performed the very first fibroid embolization in America, and has perfected the procedure with thousands of successful treatments to date. 
Women interested in learning more about Fibroid Awareness Week can join a national live chat Monday through Friday from 9 a.m. – 5 p.m. PST at

Internet Support Group for Women with Heart Disease


When you’ve been diagnosed with heart disease, you may instantly feel completely alone. The feeling is, of course, totally illogical when you consider that heart disease is the most common health ailment among women. So while you’re hardly alone, sometimes it is hard to be completely logical when you are going through a major life change. In August 2009, a study published by the American Psychosomatic Society found that there was a direct correlation between loneliness and coronary heart disease, which can mean that women with existing heart disease could be at increased risk of future heart-related complications, along with depression and anxiety. Your world has been completely turned upside-down and you are suddenly juggling multiple prescription medications, dietary restrictions and extreme fatigue, and it may feel like there is no one out there who truly understands you anymore.

Luckily, in our networked society, there are many ways that you can connect with other women who are dealing with the same heart health issues. They may be around the corner or halfway around the world, but are really only as far away as the click of a mouse. Check out WomenHeart’s online community and support network Inspire <> to connect with other women living with heart disease. Community members can share stories, post journal entries and participate in discussions with other women with similar heart conditions or who have had similar treatments.

 A 2007 study in Great Britain showed that heart patients who were given access to information and communication via the Internet were more likely to participate in healthy behaviors.