Thursday, August 21, 2008
Smoking
Smoking-related diseases claim close to 500,000 American lives each year.
Smoking costs the United States nearly $100 billion each year in health-care costs and lost productivity. It is directly responsible for 87 percent of lung cancer cases and causes most cases of emphysema and chronic bronchitis.
Why Quit?
After one year off cigarettes, the excess risk of coronary heart disease caused by smoking is reduced by half. After 15 years of abstinence, the risk is similar to that for people who've never smoked.
In 5 to 15 years, the risk of stroke for ex-smokers returns to the level of those who've never smoked.
Male smokers who quit between ages 35 to 39 add an average of 5 years to their lives. Female quitters in this age group add 3 years. Men and women who quit at ages 65 to 69 increase their life expectancy by 1 year.
But there are also many other great benefits of quitting smoking you might not think about, like:
Your food will taste better
You will have more energy
Your breath, hair, and clothes won't smell like smoke anymore
You will feel more in control, now that you're no longer dependent on cigarettes
You can save up to $1,500 per year or more (for a pack-a-day smoker)
Most smokers say they want to quit. With good smoking cessation programs, 20 to 40 percent of participants are able to quit smoking and stay off cigarettes for at least one year.
Will this be the year that you kick the habit?
Obesity
America is one of the richest, countries in the world, yet Americans are some of the unhealthiest people in the world. Even though we live in a country with great economic power and unsurpassed technology, we also live in a country - and state - plagued with obesity.
· Nationally, Obesity has reached epidemic proportions
· Louisiana ranks 4th highest in the U.S. in obesity rates
· 63% of Louisiana adults are obese or overweight
· 17% of Louisiana children or overweight, and an equal amount are estimated to be at risk for overweight
· Since 1990, obesity rate increased from 12.3% to 30.8% of the population, contributing to the United Health Foundation ranking of Louisiana as 50th for 2006
· Obesity & overweight are associated with increased risk for costly chronic diseases, such as diabetes, heart, vascular, and venous disease, osteoarthritis and some cancers
· Obese adults have a 36% higher average annual medical expenditure than adults at normal weight
· Children are being diagnosed with adult diseases (type 2 diabetes)
What can be done?
· Lifestyle changes: Reduce caloric intake, increase exercise and activity
· Some may be candidates for weight reduction surgery by an experienced, board-certified bariatric surgeon
We must make a change Louisiana. The future of our state and the future of our country are dependent on it.
· Nationally, Obesity has reached epidemic proportions
· Louisiana ranks 4th highest in the U.S. in obesity rates
· 63% of Louisiana adults are obese or overweight
· 17% of Louisiana children or overweight, and an equal amount are estimated to be at risk for overweight
· Since 1990, obesity rate increased from 12.3% to 30.8% of the population, contributing to the United Health Foundation ranking of Louisiana as 50th for 2006
· Obesity & overweight are associated with increased risk for costly chronic diseases, such as diabetes, heart, vascular, and venous disease, osteoarthritis and some cancers
· Obese adults have a 36% higher average annual medical expenditure than adults at normal weight
· Children are being diagnosed with adult diseases (type 2 diabetes)
What can be done?
· Lifestyle changes: Reduce caloric intake, increase exercise and activity
· Some may be candidates for weight reduction surgery by an experienced, board-certified bariatric surgeon
We must make a change Louisiana. The future of our state and the future of our country are dependent on it.
Cardiovascular Disease
What is Cardiovascular Disease?
A systemic inflammatory process that results in hardening of the arteries due to calcium deposition in the inner lining of the vessel that restricts blood flow to the downstream organ. Also refers to a separate process resulting in aneurysm formation of blood vessels – a weakening of the blood vessel wall causing dilation that may cause arterial rupture
Who is affected by Cardiovascular Disease?
Anyone may be affected!
What are the risk factors for developing PVD?
Hypertension
Diabetes
A systemic inflammatory process that results in hardening of the arteries due to calcium deposition in the inner lining of the vessel that restricts blood flow to the downstream organ. Also refers to a separate process resulting in aneurysm formation of blood vessels – a weakening of the blood vessel wall causing dilation that may cause arterial rupture
Who is affected by Cardiovascular Disease?
Anyone may be affected!
What are the risk factors for developing PVD?
Hypertension
Diabetes
- PAD is five times more common in patients with diabetes mellitus then without.
30% of patients with diabetes mellitus have PAD and their risk of major limb loss is dramatic. - Major limb amputation rate is FOUR TIMES HIGHER in patients with DM and PAD than with PAD alone
Elevated Cholesterol
Smoking
- Patients who smoke >15 cigarettes daily have a NINE-FOLD increase in risk of leg pain due to artery blockage
Genetics
- African-Americans Have the Same Risk as a Caucasian 20 year Pack A-Day Smoker for Developing Peripheral Arterial Disease
What are the signs and symptoms of Cardiovascular Disease?
Depends on the blood vessel affected
Legs – cramping with walking, ulcers, amputation
Neck – stroke
Kidney – renal failure, high blood pressure
Heart – Chest pain, heart attacks
More than half of patients with Cardiovascular Disease involving the peripheral arteries are asymptomatic.
Only about 30-40% of people Peripheral Cardiovascular disease patients have noticeable symptoms.
Even among patients with symptomatic disease, more than half of these patients may present with “atypical symptoms” including pain on exertion associated with reduced ambulatory activity and quality of life.
5 to 10% of patients with Peripheral Cardiovascular disease have are at risk for limb loss due to poor blood flow
Regardless of whether a patient has “symptoms” or not, those with Peripheral Cardiovascular Disease are at high risk of morbidity and mortality – usually from the effects of heart attacks or stokes.
Cardiovascular Disease and African-Americans
African American patients were nearly twice more likely to undergo leg amputations than white or other-race amputees.
African American adults are 50% more likely to have a stroke
African American men are 60% more likely to die from a stroke
African Americans stroke survivors are more likely to become disabled and have difficulty with activities of daily living
Southerners fare worse after stroke:
29% higher death rate for white men living in the South than white men not living in the South
For black men the stroke death rate in the south was 51% higher than the death rate in other regions.
Deep Venous Thrombosis
Deep vein thrombosis (DVT) is a blood clot that forms in a vein deep in the body. Most deep vein blood clots occur in the lower leg or thigh. They also can occur in other parts of the body.
Complications from DVT contribute to 200,000 deaths each year in the US –more than AIDS and breast cancer combined.
A blood clot in a deep vein can break off, travel through the bloodstream to the lungs, and block blood flow. This condition is called pulmonary embolism (PE) - a very serious condition that can cause death.
Blood clots can form in your body's deep veins when:
Damage occurs to a vein's inner lining
Blood flow is sluggish or slow
Your blood is thicker or more likely to clot than usual
Many factors increase your risk for DVT:
Recent surgery
Birth Control
Long periods of inactivity
Obesity
Only about half the people with DVT have symptoms. They include swelling of the leg or along a vein in the leg, pain or tenderness, increased warmth in the area of the leg that's swollen or in pain, and discoloration.
DVT’s are diagnosed based on your medical history, a physical exam, and the results from tests. We will identify your risk factors and rule out other causes for your symptoms.
The treatment centers on medications that thin the blood, thus allow the body to dissolve the clots. Other treatments include filters to catch blood clots and compression stockings that prevent blood from pooling and clotting. Centers of excellence have newer technology that may remove the clot to provide relief from future difficulties related to leg swelling and skin discoloration.
You can take steps to prevent DVT. See your doctor regularly. Follow your treatment plan as your doctor prescribes, stay active if possible, and exercise your lower leg muscles during long trips.
Contact your doctor or vascular specialist at once if you have any symptoms of DVT or PE.
Complications from DVT contribute to 200,000 deaths each year in the US –more than AIDS and breast cancer combined.
A blood clot in a deep vein can break off, travel through the bloodstream to the lungs, and block blood flow. This condition is called pulmonary embolism (PE) - a very serious condition that can cause death.
Blood clots can form in your body's deep veins when:
Damage occurs to a vein's inner lining
Blood flow is sluggish or slow
Your blood is thicker or more likely to clot than usual
Many factors increase your risk for DVT:
Recent surgery
Birth Control
Long periods of inactivity
Obesity
Only about half the people with DVT have symptoms. They include swelling of the leg or along a vein in the leg, pain or tenderness, increased warmth in the area of the leg that's swollen or in pain, and discoloration.
DVT’s are diagnosed based on your medical history, a physical exam, and the results from tests. We will identify your risk factors and rule out other causes for your symptoms.
The treatment centers on medications that thin the blood, thus allow the body to dissolve the clots. Other treatments include filters to catch blood clots and compression stockings that prevent blood from pooling and clotting. Centers of excellence have newer technology that may remove the clot to provide relief from future difficulties related to leg swelling and skin discoloration.
You can take steps to prevent DVT. See your doctor regularly. Follow your treatment plan as your doctor prescribes, stay active if possible, and exercise your lower leg muscles during long trips.
Contact your doctor or vascular specialist at once if you have any symptoms of DVT or PE.
Varicose Veins
Approximately 25 million Americans have varicose veins. For some, they're simply a cosmetic concern. But for many others, varicose veins can cause significant pain and discomfort. Sometimes they even lead to more serious problems. Exercise does not cause varicose veins. In fact, exercise may help prevent the problem, while excessive sitting or standing is more likely to aggravate it.
The underlying cause is malfunction of the valves in the veins that normally allow blood to flow only toward your heart. If the valves are defective, blood may pool in the veins, causing them to dilate and become varicose (meaning twisted and swollen).
Most varicose veins develop in the legs near the surface of the skin; they are more common in women than in men.
Factors that may contribute to their development include an inherited tendency to defective valves, increased pressure in the veins during pregnancy, obesity and past episodes of clots in the veins (thrombophlebitis). Fortunately, treatment usually doesn't mean a hospital stay or a long, uncomfortable recovery. New and less invasive techniques generally allow varicose veins to be dealt with on an outpatient basis.
Arteries carry blood from your heart to the rest of your body tissues. Veins return blood from your body to your heart so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against the natural effect of gravity. This is accomplished with the help of muscle contractions in your lower legs (which act as pumps), and elastic vein walls with tiny one-way valves in the veins. The valves open as blood flows toward your heart and close to stop blood from flowing backwards.
As you get older, though, your veins can lose elasticity, causing them to stretch and balloon out. When that happens, the one-way valves may not function properly. Blood that should be moving toward your heart may flow backward, stretching the walls of the veins that may then become visible as varicose veins (varicose comes from the Latin root varix for "twisted"). Varicose veins usually appear between ages 30 and 70 and progressively get worse. Frequently they're hereditary. Women are more likely than men to have them, in part because female hormones tend to relax vein walls. Other contributing factors can include pregnancy, illness, injury and being overweight.
You may have symptoms even before varicose veins appear. Symptoms can include an achy or heavy feeling in your legs and burning, throbbing, muscle cramping and swelling in your lower legs. Prolonged sitting or standing tends to make your legs feel worse. Bulging varicose veins are often accompanied by itching around the vein. In more advanced stages, open sores (ulcers) may develop around the ankle area. Ulcers represent a severe form of vascular disease and require immediate attention. In addition, any sudden leg swelling that may or may not be accompanied by pain and redness warrants urgent medical attention, as it may indicate a blood clot.
Unfortunately, once varicose veins start, they don't get better on their own.
The best advice if you have them (even small ones), or suspect you have them, is see your vascular specialist. Your doctor may first recommend that you wear compression stockings. In addition, lifestyle recommendations might include:
Exercise — Get your legs moving. Walking is a great way to encourage blood circulation in your legs. Your doctor can recommend an appropriate activity level for you.
Weight control — Shedding excess pounds takes unnecessary pressure off your veins.
Watching what you wear — Avoid high heels. Low-heeled shoes work calf muscles more, which is better for veins.
Elevating your legs — Take three or four 10- to 15-minute breaks daily to elevate your legs above the level of your heart (for example, by lying down with your legs resting on three or four pillows) as well as elevating your legs at night while sleeping.
Avoiding long periods of sitting or standing — Make a point of changing your position frequently to encourage blood flow. Wearing of compression hose to assist in returning the blood to the heart and decrease the pressure in varicose veins.
If these methods fail to bring relief of symptoms, newer methods of treating the refluxing greater saphenous vein (large vein in the inner part of your leg) have been very effective. Unlike vein stripping, these methods are relatively painless, done as an outpatient, and result in practically no downtime. Using either a laser probe or a radiofrequency ablation probe, the vein can be collapsed resulting in complete resolution of symptoms in many cases. In addition, bulging varicosities will also resolve once the main refluxing saphenous vein is treated producing much cosmetic improvement.
The underlying cause is malfunction of the valves in the veins that normally allow blood to flow only toward your heart. If the valves are defective, blood may pool in the veins, causing them to dilate and become varicose (meaning twisted and swollen).
Most varicose veins develop in the legs near the surface of the skin; they are more common in women than in men.
Factors that may contribute to their development include an inherited tendency to defective valves, increased pressure in the veins during pregnancy, obesity and past episodes of clots in the veins (thrombophlebitis). Fortunately, treatment usually doesn't mean a hospital stay or a long, uncomfortable recovery. New and less invasive techniques generally allow varicose veins to be dealt with on an outpatient basis.
Arteries carry blood from your heart to the rest of your body tissues. Veins return blood from your body to your heart so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against the natural effect of gravity. This is accomplished with the help of muscle contractions in your lower legs (which act as pumps), and elastic vein walls with tiny one-way valves in the veins. The valves open as blood flows toward your heart and close to stop blood from flowing backwards.
As you get older, though, your veins can lose elasticity, causing them to stretch and balloon out. When that happens, the one-way valves may not function properly. Blood that should be moving toward your heart may flow backward, stretching the walls of the veins that may then become visible as varicose veins (varicose comes from the Latin root varix for "twisted"). Varicose veins usually appear between ages 30 and 70 and progressively get worse. Frequently they're hereditary. Women are more likely than men to have them, in part because female hormones tend to relax vein walls. Other contributing factors can include pregnancy, illness, injury and being overweight.
You may have symptoms even before varicose veins appear. Symptoms can include an achy or heavy feeling in your legs and burning, throbbing, muscle cramping and swelling in your lower legs. Prolonged sitting or standing tends to make your legs feel worse. Bulging varicose veins are often accompanied by itching around the vein. In more advanced stages, open sores (ulcers) may develop around the ankle area. Ulcers represent a severe form of vascular disease and require immediate attention. In addition, any sudden leg swelling that may or may not be accompanied by pain and redness warrants urgent medical attention, as it may indicate a blood clot.
Unfortunately, once varicose veins start, they don't get better on their own.
The best advice if you have them (even small ones), or suspect you have them, is see your vascular specialist. Your doctor may first recommend that you wear compression stockings. In addition, lifestyle recommendations might include:
Exercise — Get your legs moving. Walking is a great way to encourage blood circulation in your legs. Your doctor can recommend an appropriate activity level for you.
Weight control — Shedding excess pounds takes unnecessary pressure off your veins.
Watching what you wear — Avoid high heels. Low-heeled shoes work calf muscles more, which is better for veins.
Elevating your legs — Take three or four 10- to 15-minute breaks daily to elevate your legs above the level of your heart (for example, by lying down with your legs resting on three or four pillows) as well as elevating your legs at night while sleeping.
Avoiding long periods of sitting or standing — Make a point of changing your position frequently to encourage blood flow. Wearing of compression hose to assist in returning the blood to the heart and decrease the pressure in varicose veins.
If these methods fail to bring relief of symptoms, newer methods of treating the refluxing greater saphenous vein (large vein in the inner part of your leg) have been very effective. Unlike vein stripping, these methods are relatively painless, done as an outpatient, and result in practically no downtime. Using either a laser probe or a radiofrequency ablation probe, the vein can be collapsed resulting in complete resolution of symptoms in many cases. In addition, bulging varicosities will also resolve once the main refluxing saphenous vein is treated producing much cosmetic improvement.
Carotid Artery Disease and Stroke
Every 45 seconds, someone suffers a stroke in the United States. It is the third leading cause of death behind heart disease and cancer. As our population ages, more individuals will be at risk for suffering a stroke. 2/3 of stokes are due to complications of hypertension, which is an elevation in blood pressure. 1/3 is due to peripheral vascular disease (arterial blockages) that forms in the main blood vessels that carry blood to the brain. These blood vessels are known as the carotid arteries. For this reason, control of blood pressure and surveillance for carotid artery blockage are the most effective means of avoiding stroke.
Blood is delivered from the heart to the brain through four arteries: two carotid arteries in the front of your neck, and two smaller vertebral arteries in the back. You can feel the carotid arteries by pressing gently on either side of your windpipe. When you feel your pulse, those are the carotid arteries. Atherosclerosis occurs when fat and cholesterol deposits (“plaque”) build up in your arteries. Plaque that develops in the carotid arteries slows the flow of blood to the brain.
There are three ways this can lead to a stroke:
1. The plaque can severely narrow the arteries
2. A blood clot can become wedged in the artery
3. Plaque from the carotid arteries can break off and block a smaller artery in the brain
Carotid arterial blockages may result in the brain not receiving enough oxygen; this can cause death or permanent disability. There are specific risk factors for the development of carotid disease. These risk factors are the same as those that lead to development of coronary artery disease: high blood pressure, diabetes, high levels of “bad cholesterol”, smoking, family history of coronary or carotid artery disease and lack of exercise.
Carotid artery disease often has no symptoms. But a transient ischemic attack (TIA, sometimes called a “mini- stroke”) is a warning that you might soon have a stroke. These are temporary episodes of stroke –like symptoms, which may last a few minutes or a few hours.
Symptoms of TIA (or stroke) include:
1. Weakness, paralysis, numbness or tingling on one side of your arm, leg or face
2. Loss of eyesight or blurry eyesight, even for a short time period
3. Sudden slurred speech
There are several tools for diagnosing carotid artery disease. Your doctor may be clued that carotid disease is developing by using a stethoscope during a normal checkup. But this method can produce false negatives, meaning you may have the disease even if your doctor does not detect it. Doppler ultrasound imaging uses sound waves to check blood flow and measure artery thickness and is the least expensive, noninvasive method of confirming the diagnosis. Magnetic Resonance Angiography uses magnetic fields to generate a picture of your arteries. Digital Subtraction Angiography, a way to x-ray the carotid artery has for years and continues to be the most accurate method of confirming the extent of disease present in the carotid arteries.
Treatment options for carotid artery disease include lifestyle changes, medication, surgery and endovascular angioplasty and stenting. Quitting smoking, lowering the amount of cholesterol and salt in your diet, exercising and losing weight help reduce the likelihood of developing peripheral arterial disease. There are also procedures to open your arteries. Vascular surgeons (specialists) have managed both the medical and surgical disorders related to peripheral vascular disease and have traditionally cared for those with carotid artery disease and thus are the physicians with the most experience in managing carotid disease. If you have carotid artery disease or fear that you may have had symptoms related to carotid disease, it is vital that you seek care with your primary physician or vascular specialist. Since every case is unique, it is important that your physician is skilled in every option regarding the treatment of carotid disease – medical, surgical and endovascular.
Friday, August 8, 2008
Welcome To The Medical Moment Blog!
Citadel Broadcasting together with Vascular Specialty Associates (my practice) welcomes you to the medical moment blog where we encourage you to leave questions and comments regarding various common ailments. Our aim is to educate and help everyone lead a healthier - and thus happier lifestyle. Cardiovascular disease is a leading cause of death and disability in the U.S. and is largely preventable by personal choices. We will give you the facts, let you share some opinions, and have fun while we're at it! Remember, the choice made today determines the life that you'll lead tomorrow...
Subscribe to:
Posts (Atom)
