Archive for February, 2014
WHAT to KNOW and DO ABOUT STROKE
PRINCETON FAMILY CARE
What is a stroke?
A stroke occurs when blood flow to the brain is interrupted, which results in brain cells in the immediate area beginning to diet due to lack of oxygen and nutrients needed to function.
What are the different forms of a stroke?
1) Ischemic stroke – occurs when a blood vessel supplying the brain becomes blocked
2) Hemorrhagic stroke – occurs when bleeding present into or around the brain
What are the symptoms of a stroke?
Symptoms of a stroke happen quickly, and include
1) Sudden numbness or weakness of face, arm, or leg (especially on one side of the body)
2) Sudden confusion, trouble speaking, or understanding speech
3) Sudden trouble with vision in one or both eyes
4) Sudden trouble walking, dizziness, loss of balance or coordination, sudden severe headache with no known cause
How are strokes treated?
Ischemic strokes are the most common type of stroke, can be treated with a drug called t-PA, which dissolves blood clots and blocks blood flow to the brain. The window of opportunity to start treating stroke is THREE hours. It is important to be evaluated and receive treatment within 60 minutes.
What is the benefit of the treatment?
Studies show patients who received t-PA within three hours of start of stroke symptoms were at least 30% more likely to recover with little or no disability after three months
How can I prevent a stroke?
One can prevent a stroke by controlling risk factors, which include high blood pressure (hypertension), diabetes mellitus, high cholesterol (hyperlipidemia), and staying active, quit smoking, and controlling heart disease
WHAT ARE TRIGLYCERIDES?
Triglycerides are the form of fat, which your body stores when you eat more calories that you use during your daily activities.
WHY IS IT IMPORTANT TO HAVE NORMAL TRIGLYCERIDES, LDL VALUES?
Deposits of cholesterol on the inside walls of your arteries occurs from too much LDL cholesterol and triglycerides in your bloodstream. These deposits are termed PLAQUES, and narrow the opening of the artery so less blood can flow to the tissues. This is called ATHEROSCLEROSIS.
WHAT IS HDL CHOLESTEROL?
HDL cholesterol (aka “good fat”) takes the bad cholesterol out of your blood and keeps those fats from building up in your arteries.
HOW ARE FATS IN BLOODSTREAM MEASURED?
A simple blood test, called a fasting lipoprotein profile, is ordered to measure the levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides.
WHAT ARE MY GOAL VALUES?
Everyone has slightly different target values, based upon risk factors for heart disease, but an example of goals are noted in the chart below
WHAT IS THE TREATMENT OF HYPERLIPIDEMIA?
The first step is therapeutic lifestyle change, which includes a healthy diet and exercise. Losing 5-10% of your body weight can improve your overall health, and reduce your risks for cardiovascular disease. Quitting smoking is recommended, as smoking lowers good HDL levels and causes harm to blood vessel walls.
WHAT MEDICATIONS ARE USED TO TREAT HIGH CHOLESTEROL?
Four types of medications are typically used to lower blood lipid levels
1) Statins – block liver enzymes your body uses to make cholesterol and consequently primarily lower LDL cholesterol
2) Fibrates – raises HDL chol and lowers triglyceride levels
3) Niacin – slows the liver production of blood fats, very effective to raise HDL
4) Bile acid sequestrants – help body get rid of cholesterol
5) Omega-3 fatty acids – prescription omega 3s are FDA approved and help reduce triglyceride levels
The aim of the Princeton Family Care is to provide timely basic medical information for clinicians, allied health professionals, and the public. The contents of this Web site are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Web site. The information does not mention brand names, nor does it endorse any particular products.
PRINCETON FAMILY CARE
WHAT ARE SIGNS AND SYMPTOMS OF LOW POTASSIUM?
Fatigue, irritability, and high blood pressure
WHAT ARE SIGNS AND SYMPTOMS OF HIGH POTASSIUM?
Nausea, vomiting, and in some cases cardiac arrest
WHAT IS THE CURRENT PERCENT DAILY VALUE OF POTASSIUM?
WHO IS AT RISK FOR POTASSIUM DEFICIENCY?
- Long distance athletes
- People taking certain medications, esp diuretics (including Lasix or Thiazides)
- People suffering from eating disorders – Anorexics or bulemics
WHAT ARE SOME DIETARY SOURCES OF POTASSIUM?
- Dark, Leafy Greens
- White Beans
- Baked Potato with skin
- Dried Apricots
- Mushrooms, white
- Baked Acorn Squash
WHAT ARE HEALTH BENEFITS OF POTASSIUM?
Osteoporosis prevention, by increasing bone density
Reduced risk of stroke, by decreasing blood pressure
FACTS ABOUT THE FLU
PRINCETON FAMILY CARE
When is flu season?
Flu Season is usually from October through May each year. The influenza virus is contagious from the day before symptoms start and up to seven days after getting sick
What are the symptoms of the flu?
Severe, sudden onset, Fever, Headache, Bodyaches, Fatigue, Cough, Chills, occasional upper resp sxs (sneezing, nasal congestion, sore throat)
How long does the flu last?
Symptoms usually resolve within two weeks, but can last longer. Antivirals can be given within 48 hours of symptom onset, and can decrease duration of flu symptoms
Can flu related illnesses be serious?
The Center for Disease Control (CDC) reports about 200,000 Americans with flu related illnesses are admitted to the hospital each year. About 3000 to 49000 people die from these flu illnesses.
How can I reduce my chances of getting the flu?
A yearly seasonal flu vaccine is the best way to reduce chances you will get the flu. It takes about two weeks for the vaccine to completely take effect. Flu vaccines are recommended for most people 6 months of age and older. Individuals at higher risk for the flu have a stronger indication for the flu vaccine and those include, people with long term chronic medical conditions, nursing home residents, pregnant women, children younger than 5 yo and adults older than 65 yo.
What are the different kinds of flu vaccines?
FLU SHOT – Inactivated (killed) flu shot into the muscle or skin, Available in Intramuscular or Intradermal versions, Types of vaccines include Trivalent (made of 3 viruses) and the new Quadrivalent (made of 4 viruses) version
NASAL SPRAY – live, weakened vaccine given as a nasal spray
Can I get any version of the flu vaccine?
Certain individuals should get the inactivated version of the flu vaccine, the shot. These include individuals younger than 2 yo, people with chronic health conditions, such as Multiple sclerosis, Crohn’s Disease, Ulcerative Colitis, or Lupus, those on medications that weaken the immune system, such as methotrexate.
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DEPRESSION AND ANGER
PRINCETON FAMILY CARE
Are depression and anger linked together?
Anger is a really important component of depression, especially in Men
What are the negative risks of anger to your health?
Anger increases the likelihood of high blood pressure and stroke, and can contribute to heart disease, lung problems, migraines, back pain.
What are some coping mechanisms when feeling angry, depressed, scare, confused, anxious?
1) Identify your feeling and try and analyze what may have triggered it
2) Accept the emotion – Feelings need to be felt to be resolved
3) Press pause – anger management advice often emphasizes taking a deep breath counting to 10, taking a walk, listening to music, or similar methods for putting your emotion on hold.
4) Distract yourself
5) Find your happy place
6) Journal your feelings
Who is affected by depression?
About 8% of adults every year suffer from depression
What are the different types of depression?
1) Major Depressive Disorder – combination of symptoms that interfere with a person’s ability to work, sleep, study, eat, enjoy activities
2) Dysthymia – two years or longer of sadness, which prevents one from feeling well, but may not interfere with day to day functioning
3) Postpartum Depression – if new mother develops a major depressive episode within one month of delivery
4) Seasonal Affective Disorder (SAD) – onset of depressive illness during winter, when there is less sunlight
5) Bipolar Disorder (Manic-Depressive illness) – cycling mood changes from extreme highs to lows
6) Psychotic Depression – severe depression with some psychosis, break with reality, hallucinations, delusions
What are signs and symptoms of depression:
Emotional signs: persistent sad, anxious, or empty feelings, feelings of hopelessness or negativity, feelings of guilt, worthlessness, irritability, restlessness, loss of interest in once pleasurable hobbies or activities
Physical: chest pain, fatigue, headaches, pain in back or muscles, weight loss or gain, digestive issues
What is the treatment for depression?
Combination of medication and/or psychological counseling, along with good social support
CELIAC DISEASE: MYTHS AND FACTS
PRINCETON FAMILY CARE
What is Celiac disease?
Celiac disease is an autoimmune disorder triggered by gluten in one’s diet. It is estimated that one percent of the US population (about three million Americans) has celiac disease. In this condition, one’s small intestine loses the ability to absorb nutrients due to damage caused by dietary sources containing gluten.
What are the symptoms of Celiac disease?
Classic symptoms of Celiac disease include abdominal pain, distension, diarrhea and constipation. It affects both children and adults. However, older children and adults often experience different symptoms, including delayed puberty, behavioral problems, iron deficiency, osteopenia/osteoporosis, hepatitis, arthritis, infertility, migraines, seizures, and neuropathy.
Is there a genetic link for Celiac disease?
Celiac disease has been strongly associated to two genes, HLA-DQ-2 and HLA-DQ-8, which are associated with an estimated risk of 36 to 53 percent of developing this immune-mediated disease. Due to this genetic link, it is recommended that parents and siblings of individuals diagnosed with celiac disease be tested, regardless of whether patient has any current symptoms.
How do you diagnose Celiac disease?
The diagnosis of celiac disease starts with blood screening, including antiendomysial antibody (EMA) or anti-tissue transglutaminase (tTG) and the determination of total serum IgA level. The gold standard for diagnosing Celiac disease is an EGD (esophagogastroduodenoscopy) with multiple biopsies of the duodenum and jejunum.
What is the treatment of Celiac disease?
The treatment for celiac disease is a strict, zero-tolerance gluten free diet, which is the avoidance of wheat and wheat by-products. Referral to dietitian/nutritionist is the key to proper management of this condition.