All in a Day's Work....

I was having my initial rounds in the ward with my nurse aide. We came to our muslim patient with a DNR status. The room was filled with people. Patient's family and relatives were surrounding him and already mourning. Accessing the patient to do some assessment is quite difficult. However, I managed to reach the patient. I could only see a portion of his face and upper right arm. I grabbed a hand and pressed the fingertips to elicit pain. I checked for any reaction such as withdrawal, movement or any facial expression but could not find any, so, I pressed harder. Momentarily, requested the person standing in front of me who apparently was blocking my view to move aside. While continuously pressing the fingertip, I got a better view of the patient and to the owner of fingertip I was pressing. To my uttermost surprise, the fingertip I was holding is of the patient's wife. Dumbstruck for a moment. I could only watch her reaction. Boy...she had the ugliest facial grimace I ever saw! Immediately, we ended our visit and went to our nurse station as fast as we could. Shutting the door behind us my nurse aide and I burst into rage of laughter. Lesson learned: go back to the basics..clear first the area.

Is Being an Alcoholic Hereditary?

Children raised in a home in which a parent has a problem with alcohol have double the risk of becoming alcoholics themselves. There are various reasons for this unhappy fact. Research shows an inherited or genetic influence that increases the chances of becoming an alcoholic. The stress of living in a home troubled with alcoholism further increases the likelihood of children becoming problem drinkers themselves. Additionally, children of alcoholics often have poor self-image and esteem, and have greater difficulty in facing the stresses of daily living. When circumstances become difficult and problems arise, there is a greater likelihood of turning to alcohol as an escape.

Prevention is greater than cure -- stay away from alcohol!

Body mass index

Your weight matters, but it has to be considered in the context of how tall you are. Body mass index takes the two numbers into account. Like waist circumference, BMI is an indirect measure of risk, but a higher measure correlates with greater risk. The catch, however, is that it is not always entirely accurate. A person in excellent condition who has a lot of muscle mass may have a high BMI.

Too much excess weight is associated with diabetes, heart disease and stroke, some cancers, sleep apnea, osteoarthritis, fatty liver disease, and complications in pregnancy.

Bottom line: People with BMIs less than 18.5 are underweight. Target BMI range is between 18.5 and 24.9. Overweight is considered between 25 and 30, and a BMI above 30 puts you in the obese category.

(credits to YahooNews)

Empty Sweets

Refined sugars make up around 21 percent of the calories most people eat -- more than 30 teaspoonfuls per day. Much of this sugar is well hidden in food and beverages. To reduce the sugar in your diet, start by substituting naturally sweet foods for sugared snacks.

Reducing the Sugar in Your Diet

Sugar contains no nutrients or fiber. It's high in calories and can crowd more nutritious foods out of your diet. If Sugar has a grip on you, here are three simple tips to help you reduce your dependence without eliminating sweet treats altogether.

1. Indulge Less Frequently

    How often do you eat desserts or sweet snacks? You may choose one.

          * 1-4 times/week

          * 1-2 times/day

          * 3-4 times/day

          * More than 4 times/day

   If you answered more than once a day you would benefit from reserving treats for special times.

2. Eat Smaller Servings

   When you do eat sweets and sugared foods, learn to savor small portions. Eat slowly, and make your portion last. You can train yourself to be satisfied with a smaller serving.

3. Make the Low-sugar Choice

   Choose low-sugar alternatives when shopping. It's not always easy to tell how much sugar a product contains, because sugar can be disguised as fructose, sucrose, corn syrup, and other ingredients. When possible, however, buy products you know are low in sugar.

Your Turn

Think of some ways you can reduce the amount of sugar you are eating. You may list them on a sheet of paper.

Your Challenge

Try a fruit smoothie. Also, observe how many sweets and other sugary foods you are eating and then cut back to a healthier level.

Is alcohol less harmful to women than to men?

Alcohol's Effect to Both Genders

A question was raised, "I have heard that alcohol is less harmful to women than to men. Is this true?"
The answer is NO, this is not the case. When alcohol is taken in to the body, it is absorbed and carried to every organ in the body. Alcohol tends to dissolve in the body's water stores (in various cells). Women have less water relative to their body weight than men. If the female drinks the same quantity of alcohol as a male over the same time period, the female will have more alcohol in the bloodstream than the male. This will result in more rapid and severe intoxication in the female.

The main chemical enzyme that breaks down alcohol in the body is called alcohol dehydrogenase. Females process less alcohol through this mechanism than do males. This further increases the harmful effects of alcohol in women as compared to men.

Alcohol has also been shown to increase the risk of breast cancer in women, even when small quantities of alcohol are consumed daily (one-half to one and one-half glasses per day). The risk of breast cancer is further increased if one is taking oral contraception or hormone replacement therapy as well as regular alcohol.

Another significant problem is that pregnant women never drink alone. Alcohol present in the blood of the mother will eventually get to the baby developing in her womb. This can cause permanent damage to the child. It has not yet been determined what level of alcohol, if any, would be safe in pregnancy.

Again, prevention is better than cure. Alcohol should be avoided.

Waist circumference

While not a direct measure of heart disease, a high waist circumference tracks with increased risk for high blood pressure, high cholesterol, and diabetes—all of which have a direct impact on heart health. And the bigger the belly, the heavier one tends to be. Obesity, of course, is a well-known risk factor for a range of diseases, including heart disease.

Importantly, a higher waist circumference indicates distribution of fat around the abdomen and packing fat around vital organs, which research has indicated is more dangerous than carrying weight in the thighs or buttocks. Be sure you're measuring properly. The correct waist circumference measurement is taken by wrapping a measuring tape around the natural waist at the belly button, not around the hips.

Bottom line: Men should have a waist circumference of less than 40 inches. The figure for women is less than 35 inches.


(credits to YahooNews)

Cigarettes

A 2009 study of Norwegians found that heavy smokers—those who puff at least 20 cigarettes per day—were 2.5 times more likely to die over a 30-year period than nonsmokers. But the cardiovascular risks associated with smoking aren't just seen in chain smokers.

The more nuanced message that doesn't always get across is the risk that the occasional smoker is exposed to. Even 10 minutes of secondhand smoke exposure may affect cardiovascular function. Just because you might not smoke a pack a day or even a week doesn't mean you're in the clear. "There is no safe level of exposure" to tobacco smoke, says Yancy.

Bottom line To protect against heart disease (not to mention cancer, stroke, and reproductive problems), the goal is to smoke exactly zero cigarettes.

(credits to YahooNews)

Exercise

You've heard it a thousand times over, and the message stays the same: Regular, heart-thumping exercise offers a multitude of health benefits, particularly for cardiovascular fitness. Perhaps clinicians (and health writers) keep bashing us over the head with that fact because of the eye-popping number of American adults who reported getting zero vigorous activity in a 2008 Centers of Disease Control and Prevention survey: 59 percent.

Bottom line: For a clean bill of health, the major health associations (including the AHA and the American College of Sports Medicine) suggest a minimum of 150 minutes of moderate-intensity physical activity each week—say, brisk walking that boosts your heart rate. This translates into 30 minutes of exercise on five days of the week. Twice-weekly strength training of eight to 10 exercises, up to 12 reps each, is also on their to-do list.

Whiteson at NYU Langone Medical Center suggests that those who don't have heart disease should bump that recommendation up to 60 minutes a day, five days a week of vigorous activity, where you're breathing pretty heavily and sweating. But he offers a concession: "You can break it up" into, say, three 20-minute sessions per day, since "the effect of aerobic exercise is cumulative." He also thinks those without heart disease should do strength training thrice weekly. Individuals with heart disease should always discuss a new exercise regimen with a doctor first, he says.

(credits to YahooNews)

Hours of sleep per night

An overcaffeinated America seems to perpetually crave more shut-eye. And evidence is cropping up to suggest that a poor night's sleep is not only felt the next day but could have implications for one's heart over the long term. It is well established that sleep apnea, which results in numerous interruptions to breathing while asleep, is associated with stroke and coronary artery disease.

The reason is not clear, says Whiteson, but it's been hypothesized that people with disrupted sleep breathing have higher blood pressure overall because they don't get the restorative sleep that normally allows blood pressure to go down and gives the cardiovascular system a break during slumber. And a study in the Journal of the American Medical Association showed that middle-aged people who got five hours of shut-eye or less a night had a greater risk of developing coronary artery disease than those who got eight hours. The clue was the beginnings of calcium buildup in their arteries, found by CT scanning long before the disease process would normally be picked up.

Bottom line: Get eight hours of sleep per night. Making it happen isn't easy, we know.


(credits to YahooNews)

Is Your Heart Broken?

Resting heart rate

How hard does your heart have to work—and how fast does it have to pump—to get oxygen-rich blood throughout your body? A lower number suggests your cardiovascular system is more efficient at doing this. Thus, a highly trained athlete can have a resting heart rate in the 40s, says Whiteson.

And while the research is still emerging on what one's resting heart rate predicts about heart disease risk, a picture is beginning to take shape. "There is certain evidence to support [the idea that] a higher resting heart rate is associated with heart disease," especially ischemic heart disease, he says, which involves reduced blood flow (and oxygen) getting to heart arteries and the heart muscle. This effect seems to be more pronounced in women than in men, but a study in the Journal of Epidemiology and Community Health suggested that in women up to the age of 70, every 10-beats-per-minute increase in resting heart rate boosted the risk of dying from ischemic heart disease by 18 percent. In men, the risk was increased by 10 percent for every extra 10 beats per minute, and age didn't have an impact. The study also found that women who got high levels of physical activity were able to reduce their risk of death considerably, compared with those who did little or no activity. The same effect was not found in men, but the researchers suggest the results may have been skewed because men tend to overestimate how much exercise they get.

Bottom line: A normal resting heart rate is between 60 and 100 beats per minute. Check yours by finding your wrist's pulse, counting the beats in a 15-second period, then multiplying by four.


(Credits to YahooNews)

Is Your Heart Broken?

Sugar intake

It's not just the savory flavors that'll get you; sweets, too, can ultimately become a cause for concern, says the American Heart Association. Like salt, sugar creeps into the processed foods that make up much of the American diet, and sweetened beverages—soda, juices, and sports drinks—are especially loaded with the stuff. Here's some disturbing math for you: A 12-ounce can of soda has about 8 teaspoons (or 33 grams) of added sugars, totaling about 130 calories. (A gram of sugar translates into 4 calories.)

A can of Coke or Pepsi, then, basically takes you to the AHA's new upper limit on the recommended amount of added sugar Americans should ingest on a daily basis. The association's primary concern is the number of excess calories that added sugars sneak into our diets and pile onto our waistlines, which can contribute to metabolic changes that increase the chances of developing a host of diseases.

Bottom line: According to the AHA, women should get no more than 100 calories per day of added sugars and men should stop at 150 calories per day.


(credits to YahooNews)

Is Your Heart Broken

Salt intake

Some experts say that the pervasive use of sodium in the America diet is wreaking havoc on our cardiovascular systems. "Sodium causes retention of fluid within the circulation, and if you're sodium-sensitive, it expands your blood volume and can contribute to high blood pressure, stroke, and other heart disease," explains Clyde Yancy, medical director of the Baylor Heart and Vascular Institute at Baylor University Medical Center in Dallas and spokesman for the American Heart Association.

A report in the New England Journal of Medicine suggested that if Americans reduced daily salt intake by 3 grams, we could significantly lower the annual number of new cases of coronary heart disease (by between 60,000 and 120,000), stroke (by 32,000 to 66,000), heart attack (by 54,000 to 99,000), and even the number of deaths from any cause (by 44,000 to 92,000). The paper's authors noted previous research that showed the average American man consumes 10.4 grams of salt daily, while the average American woman gets 7.3 grams.

Bottom line: The AHA recommends Americans limit salt intake to 1.5 grams daily. Be wary: Sodium creeps in via unexpected sources, and it's not so much the salt shaker on our table that's to blame. Research suggests we get as much as 80 percent of our daily salt intake from processed foods.


(credits to YahooNews)

Is Your Heart Broken?

Alcohol intake

Those fond of tipple may be dismayed, but the science on alcohol as an agent to promote heart health is just not definitive. "If you have heart disease, alcohol plays no role in your medicine cabinet; if [you do] not, alcohol is not the right way to reduce your risk," says Jonathan Whiteson, director of the Cardiovascular Rehabilitation Program at New York University Langone Medical Center. Some research has suggested that drinking red wine may increase one's HDL, or "good" cholesterol, but Whiteson notes that the boost is minimal. "Exercise [offers] a better increase in HDL," he says.

While he's not against a drink in a social setting, it's certainly not something folks—especially those with heart disease—should engage in with the idea that it will offer a heart benefit, says Whiteson. In fact, medications' effectiveness can be either hampered or heightened by alcohol, sometimes to a dangerous extent. (Common herbal supplements can interact with heart drugs, too). And drinking too much can lead to high blood pressure or increased blood levels of triglycerides, a type of fat.

Bottom line: The American Heart Association suggests that otherwise healthy individuals who drink should do so in moderation. That is defined as one to two drinks per day for men and one drink per day for women. And be careful with that pour: The AHA defines a drink as one 12-ounce beer, a 4 ounce glass of wine, 1.5 ounce of 80-proof spirits, or 1 ounce of 100-proof spirits.


(credits to YahooNews)

Blood Pressure

Blood Pressure Facts

This one is critical to heart health. According to the National Heart Lung and Blood Institute, 1 in 3 Americans have high blood pressure. When a nurse wraps the cuff around your arm, she's taking a reading of the force on the walls of your arteries, which is subject to fluctuating pressure as the heart beats to push blood through your body. The trouble is, high blood pressure doesn't have any telltale symptoms, so a person might be living with hypertension unknowingly. Over the long haul, elevated blood pressure can damage organs and fuel a cascade of problems.

Action to lower blood pressure can include medications, but diet and exercise can really beat those numbers back into submission. The DASH diet (Dietary Approaches to Stop Hypertension)—high in veggies, fruit, fish, and whole grains but low in red meat fat and sugar—has been shown to lower blood pressure significantly. And research has suggested that the DASH diet packs an especially powerful wallop when people simultaneously work to reduce salt intake, a known blood pressure booster.

Bottom line: "The only number that really matters is 120 over 80," which is the cutoff for a normal blood pressure reading, says Yancy. The more one's blood pressure surpasses that level, the more damage to the vascular system, heart, and kidneys. The top number is called systolic blood pressure and is the measure of pressure while the heart beats. The bottom number is called diastolic and is the measure of pressure between heart beats. A reading above 120/80 but below 140/90 is considered prehypertension; anything above that is high blood pressure. Both require attention and steps to bring the blood pressure back under control.