Thursday, February 22, 2018

IpadAndIphoneRVAJanFeb2018click here for the latest digital edition of OurHealth magazine

Featured Stories

The Bridge to Better Health Starts With Primary Care - Part VI

Written by  Geri Aston

As you travel along life’s journey, it can be fun to step back and take a look at how far you’ve come. That holds true in the journey toward better health as well.  

Working with your primary care doctor to make healthy lifestyle adjustments pays off in both the short and the long term. The path to health lasts a lifetime, but it’s important to pause for a moment now and then to reflect on and celebrate your accomplishments along the way.

This article, the sixth in a year-long OurHealth series about primary care, will examine ways that your lifestyle changes can benefit your health so that you can give yourself a much-deserved pat on the back and keep the momentum going.

Give yourself “props” for losing weight

Eating right and shedding extra weight are often part of the plan to improve one’s health. That’s because being overweight or obese plays a major role in many chronic conditions, including heart disease, diabetes, arthritis, and sleep disorders. Even if you haven’t reached your weight-loss goal, every pound that you drop improves your health. That’s an accomplishment well-worth celebrating.
Losing as little as 5 to 10 percent of your weight can reduce your cholesterol levels, decrease your risk of developing type 2 diabetes, and lower your blood pressure.

Cholesterol is a big deal because high levels of “bad” cholesterol, known as low-density lipoprotein (LDL), can build up in the walls of your arteries, forming a plaque that makes the arteries hard and narrow. If the plaque tears or ruptures, a blood clot could form, blocking blood flow or breaking loose and plugging an artery. If the blood flow to part of your heart stops, that’s a heart attack. If a clot blocks blood flow to part of your brain, it’s a stroke.

Decreasing your risk of developing type 2 diabetes is also a major accomplishment because the disease can cause so many health problems. In type 2 diabetes, the pancreas loses its ability to produce enough insulin to properly control the blood sugar, called glucose, which powers the body’s cells. Over time, high blood sugar will damage your nerves and blood vessels, which can lead to heart disease, stroke, kidney disease, blindness, dental disease, and even amputations.

High blood pressure also hurts your blood vessels. It can make your artery walls stiff and create the plaque that can lead to heart attacks or strokes. The narrowing of arteries caused by plaque, furthermore, can also cause kidney failure, dementia, eye damage, and even problems having sex, says the Mayo Clinic.

The strain on your heart from high blood pressure, moreover, can cause your heart to weaken and work less efficiently. Eventually, your heart will begin to wear out — a condition known as heart failure.

High blood pressure also can cause aneurysms, says the Mayo Clinic. This happens when the constant pressure of blood moving through a weakened artery causes part of its wall to bulge out. If that bulge ruptures, it causes internal bleeding, which can be deadly.

That’s not all, though — in fact, losing weight offers many other reasons to celebrate as well. It reduces the chances that you’ll get osteoarthritis arthritis, which is caused by wear and tear on the joints, and it can ease the condition if you already have it.

Additionally, extra pounds put extra stress on weight-bearing joints like the knees and hips. When you walk across level ground, the force on your knees equals one-and-a-half times your body weight, says Harvard Medical School’s HEALTHbeat. That means that a 200-pound man will put 300 pounds of pressure on his knees with each step.

As if that wasn’t enough, the force on each knee increases to two to three times your body weight when you go up and down stairs and four to five times your body weight when you squat to tie a shoelace or to pick up something from the floor — so shedding a few pounds can go a long way toward reducing the pressure on your joints and protecting them.

It also can help you get a good night’s sleep. The risk of developing sleep apnea is four times higher for people who are obese than for people of normal weight, says the Mayo Clinic. Sleep apnea is a potentially serious disorder in which your breathing repeatedly stops and starts while sleeping. Signs of sleep apnea include snoring loudly and feeling tired even after a full night's sleep.

The good news is that weight loss helps reduce the severity of obstructive sleep apnea, the most common type of the disorder.

Collecting the rewards of exercise

Physical activity is part of healthy living. If you’ve worked it into your daily or weekly routine, you’re helping your body in ways that you might not even realize. You should give yourself credit for that.

We all know that exercise helps us to lose weight, but did you know that it can also benefit your brain? Exercise can improve memory and thinking, reduce the risk of depression and dementia, and improve your mood.

Additionally, exercise lowers the risk of developing heart disease, high blood pressure, stroke and type 2 diabetes. Studies have also found that physical activity can reduce the chances of developing colon, breast and endometrial cancers, says the National Cancer Institute.

Regular exercise helps to keep bones, muscles and joints healthy. Even though exercising might seem like the last thing that people with arthritis should do, it actually helps them by increasing their strength and flexibility and reducing their joint pain, notes the Mayo Clinic. If you have arthritis, you should work with your doctor to figure out what types of exercises are best for you.
For seniors, exercise and physical activity improve endurance, strength, balance and flexibility, says the National Institutes of Health (NIH). These benefits can help you stay strong and fit enough to perform your daily activities and maintain your independence.

As people age, they run the risk of developing osteoporosis, a condition that could weaken their bones to the point where they easily break. Doing weight-bearing exercises three to four times per week helps to prevent osteoporosis, says the NIH.
Want to sleep better? Exercise plays a role there, too. Regular physical activity can help you fall asleep faster and deepen your sleep, says the Mayo Clinic.

Not unexpectedly, finally, people who exercise have more energy in general. That’s because exercise and physical activity deliver oxygen and nutrients to your tissues and help your heart work more efficiently, says the Mayo Clinic. When your heart and lungs work better, you have more energy to go about your daily life.

Health buzz from kicking the habit

Smoking is a hard habit to break, thanks to nicotine’s addictive properties. If you’ve quit the habit or never taken up smoking, your body is reaping enormous benefits.

It’s common knowledge that smoking causes lung cancer, but it also increases the chances of getting many more types of cancer — like cancers of the blood, bladder, cervix, colon, esophagus, kidneys, larynx, liver, mouth, nose, rectum, throat and uterus, says the NIH. Over time, your decision to quit will help reduce your risk of developing all of these.

After you stop smoking, furthermore, you begin to breathe more easily and your smoker’s cough starts to go away. But why? The answer is that our lungs are made of tubes that branch out into small sacs. Smoking causes these sacs to lose their elasticity, which prevents them from taking in as much oxygen. That’s why smokers feel short of breath, a condition called emphysema.

Normally, the lungs protect themselves with a thin layer of mucus and by moving toxic particles out with small hairs, called cilia. Smoking makes the cilia move slower and struggle to remove harmful particles, explains the Quit Smoking Community. The lungs become irritated from the toxins and collect more mucous, and this triggers smoker’s cough. Over time, smoker’s cough can lead to chronic bronchitis, in which the lining of the tubes in your lungs swells and restricts breathing.

The combination of emphysema and chronic bronchitis is called chronic obstructive pulmonary disease (COPD). About 20 to 30 percent of chronic smokers may develop COPD, says the Mayo Clinic. When you quit smoking, your lungs’ sacs and cilia begin to heal, which is why you will start to breathe easier and cough less.

Additionally, smoking causes harm all over the body that you might not be able to see. It increases the risk of developing heart disease, strokes, type 2 diabetes and vision problems as well as fertility problems in women and impotence in men, says the Mayo Clinic. Smoking is also associated with an increased risk of developing inflammation of the gums and serious gum infections that could destroy the support system for teeth. Finally, women who smoke during pregnancy have a higher risk of miscarriage, early delivery, babies with lower birth weights, and sudden infant death syndrome in their newborns.

By quitting smoking, you’re lowering your risk of developing all of these serious problems. You’re also improving your looks. The chemicals in tobacco smoke can change the structure of your skin, causing premature aging and wrinkles, says the Mayo Clinic. Smoking also yellows your teeth, fingers and fingernails. Quitting smoking begins to reverse these effects, letting you start to look much healthier.

Drinking less and living better

The saying “everything in moderation” applies to alcohol. A little alcohol isn’t likely to cause harm, but a lot of alcohol consumed in one sitting or over time can cause life-altering or life-ending damage.

The dangers of driving drunk are obvious — you could injure or kill yourself or others due to your weakened thinking skills and muscle control. Getting drunk, however, also increases your chances of drowning, being a victim of or committing a crime, accidental injury, and having unprotected sex or becoming the victim of sexual abuse or date rape, says the Mayo Clinic.

When we think of the long-term harm caused by alcohol abuse, we usually think of liver damage. The liver breaks down alcohol so that it can be removed from the body. Drinking more alcohol than the liver can process damages it over time. This damage comes in the form of three types of liver disease.

Alcoholic fatty liver disease, first of all, means that you have too much fat in your liver. It’s the earliest stage of alcohol-related liver disease, says the American Liver Foundation. The damage can be reversed at this point if the person stops drinking alcohol.

Alcoholic hepatitis, secondly, means that there are fat deposits in the liver, plus inflammation and mild scarring. Up to 35 percent of heavy drinkers develop alcoholic hepatitis, the foundation says. Mild alcoholic hepatitis can be reversed by giving up alcohol. Severe alcoholic hepatitis can occur suddenly and lead to liver failure and death.

Alcoholic cirrhosis is the most advanced type of alcohol-caused liver injury. It means that the liver has severe scarring. Between 10 and 20 percent of heavy drinkers develop cirrhosis, the foundation says. Cirrhosis can’t be reversed by giving up alcohol, but doing so could improve the symptoms and prevent more damage from occurring.

Additionally, heavy drinking can increase the risk of developing some cancers, including cancers of the breast, mouth, throat and esophagus. It can cause stomach, heart, pancreas and eye problems, says the Mayo Clinic. Drinking while pregnant can cause a miscarriage or permanent brain damage and other problems in an unborn child.

If you don’t drink or only drink in moderation, you’re protecting yourself and those around you from these dangers. That’s one more accomplishment worth celebrating!

Quit smoking & begin healing

  • 20 Minutes After Quitting
    • Your heart rate drops to a normal level.
  • 12 Hours After Quitting
    • The carbon monoxide level in your blood drops to normal.
  • 48 Hours After Quitting
    • Your sense of smell and taste begin to return to normal.
  • 2 Weeks to 3 Months After Quitting
    • Your risk of having a heart attack begins to drop.
    • Your lung function begins to improve.
  • 1 to 9 Months After Quitting
    • Your coughing and shortness of breath decrease.
  • 1 Year After Quitting
    • Your added risk of coronary heart disease is half that of a smoker's.
  • 5 to 15 Years After Quitting
    • Your risk of having a stroke is reduced to the same as a nonsmoker’s.
    • Your risk of getting cancer of the mouth, throat, or esophagus is half that of a smoker's.
  • 10 Years After Quitting
    • Your risk of dying from lung cancer is about half that of a smoker’s.
    • Your risk of getting bladder cancer is half that of a smoker’s.
    • Your risk of getting cancer of the cervix, larynx, kidney or pancreas decreases.
  • 15 Years After Quitting
    • Your risk of developing coronary heart disease is the same as that of a nonsmoker.

Sources: American Lung Association and QuitDay

How much alcohol is too much?

Reasonable zone

Moderate drinking: Up to one drink per day for women of all ages and men older than age 65; up to two drinks per day for men age 65 and younger. One drink means:

  • Beer: 12 fluid ounces (355 milliliters)
  • Wine: 5 fluid ounces (148 milliliters)
  • Hard liquor (80 proof): 1.5 fluid ounces (44 milliliters)

Danger zone

Heavy drinking: More than three drinks on any day or more than seven drinks per week for all women and men older than age 65; more than four drinks on any day or more than 14 drinks per week for men age 65 and younger.

Binge drinking: Four or more drinks within two hours for women and five or more drinks within two hours for men.

Source: Mayo Clinic

When a person reduces his/her “bad” cholesterol, how does this positively impact his/her health?

“The foundation of health creation is nutrition, exercise, sleep hygiene and mindfulness. By adopting a diet that is rich in plants, avoiding refined and processed foods and consuming fewer calories an individual will experience less inflammation, reduced “bad” cholesterol levels and normalization of insulin resistance. And this leads to the reduction in cardiovascular events and better health overall.”
Shaival Kapadia, MD, FACC
Bon Secours

How does quitting smoking improve a person’s lung capacity, e.g., when you quit smoking, how soon does the body begin to realize the short-term and long-term improvement to the lungs?

“Within two days after quitting smoking, abnormalities in heart rate and blood pressure may show improvement; carbon monoxide levels in the body decrease; risk of coronary artery disease starts to decline; and the ability to taste and smell begins to improve. Quit smoking today and experience more long-term health benefits, in particular increased life expectancy.”
Vicki Latham-Solomon, MD
Bon Secours Canal Crossing Internal Medicine

How does reaching an ideal weight reduce the negative impact on joints?

"Let's look at weight and your knees. When you walk across level ground, the force on your knees is the equivalent of 1½ times your body weight. That means a 200-pound man will put 300 pounds of pressure on his knees with each step. Add an incline, and the pressure is even greater: the force on each knee is two to three times your body weight when you go up and down stairs, and four to five times your body weight when you squat to tie a shoelace or pick up an item you dropped.
Losing a few pounds can go a long way toward reducing the pressure on your knees — and protecting them. For example, research has proven that a sustained 10- to 15-pound weight loss in obese young people can translate to a much lower risk of osteoarthritis later in life."
Vivek Sharma, MD
Colonial Orthopaedics

How does being physically healthy help improve a women’s chances for conception?

“A woman's chances for conception depends greatly on her ovulatory function. Ovulation can be affected by extremes in weight-by being either underweight or overweight. Utilizing proper nutrition and exercise to maintain a healthy weight can help regulate ovulation. Furthermore, avoiding alcohol and tobacco products can improve one's chance for conception.”
Kenley Neuman, DO, FACOG
Virginia Physicians for Women

Maintaining good musculoskeletal health throughout life makes a huge difference in long-term health. The most important healthy habits to keep for good musculoskeletal health, are:

  1. Wearing a seatbelt every time you drive or ride in a car.
  2. Keeping body weight close to the ideal body weight.
  3. Exercising in moderation on a regular basis.

Stephen Kates, MD
Professor and Chair, The John Cardea Chair of Orthopaedics
VCU Health

Does maintaining a healthy sleep regimen effect overall long-term wellness?

“Technically, sleep can be described as a naturally recurring, reversible state of suspended consciousness. Sleep is absolutely necessary for survival. It is a time of rejuvenation, growth and the consolidation of learning. To perform optimally physically and/or mentally a person needs sufficient sleep.”
Michael Polsky, MD, CPI
Pulmonary Associates of Richmond, Inc.


Expert Contributors:
Shaival Kapadia, MD, FACC with Bon Secours in Richmond
Stephen Kates, MD with VCU Health in Richmond
Vicki Latham-Solomon, MD with Bon Secours Canal Crossing Internal Medicine in Richmond
Kenley Neuman, DO, FACOG with Virginia Physicians for Women in Richmond
Michael Polsky, MD, CPI with Pulmonary Associates of Richmond, Inc. in Richmond
Vivek Sharma, MD with Colonial Orthopaedics in Colonial Heights and Chester