Aspirin and your Heart

Aspirin is an anti-inflammatory and anti-platelet drug, and is used to treat pain, fever, blood clots, heart attacks, and strokes.

The benefits of taking aspirin daily include if you:

Have had a heart attack or chest pain

Had open heart surgery

Had coronary angioplasty

Had a stroke or TIA (Transient Ischemic Attack)

Have peripheral vascular disease (PVD)

Have heart rhythm problems, such as atrial fibrillation (A.Fib)

Risks of taking aspirin every day include minor bleeding or bruising, worsening of asthma, upset stomach, or allergic reaction. Children should not be given aspirin due to the risk of Reye’s syndrome (rapidly progressive brain dysfunction).  Contraindications for use of aspirin include allergies to NSAID’s, peptic ulcers, GERD or gastritis, hemophilia, kidney disease, and gout.

There are 2 forms of aspirin you can take. Please ask your doctor which is best for you. The first type is called non-enteric coated.  This means the aspirin does not have a protective coating that keeps your stomach from being upset, but is best to take when having active chest pain.  This type comes in a chewable form.  The enteric coated aspirin has the protective covering that keeps your stomach safe.  This type cannot be chewed or crushed.  Do not take any aspirin with alcohol as it increase chance of bleeding and stomach distress.

Please seek immediate medical attention if you have an allergic reaction, stools are black or bloody, vomit or cough up blood, there if blood is in your urine or you feel shortness of breath.

 

Information obtained from Elsevier Interactive Patient Education, Elsevier Inc. (2017).

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The Importance of Vitamin D

Vitamin D is very important because it helps your body metabolize calcium and phosphorous (muscle, bone, and dental health), thought to support your immune system; prevent diabetes and multiple sclerosis, and functions of the heart. When there is not enough vitamin D you have Vitamin D Deficiency.

You can get vitamin D from milk, and other dairy foods, a Vitamin D supplement, and being in the sun.   When you have a severe deficiency of Vitamin D your bones can become soft.  In adults this is called osteomalacia, and in children rickets.  Research is showing vitamin D supplements can prevent multiple sclerosis (MS) or keep symptoms of it from worsening. They have found the farther away a person lives from the equator the greater the chance they will have MS.

Deficiency can be caused by a poor intake of foods having vitamin D, not enough sun exposure, digestive disorders that cause poor absorption of vitamin D, such as Crohn disease, pancreatitis, and cystic fibrosis. Deficiencies can also be caused by being overweight, having stomach or small intestine surgery, and having kidney or liver disease. Breast fed babies are also at risk for deficiency.

Those at greatest risk are the elderly, those who do not expose themselves to the sun, those with broken bones, those with osteoporosis, those who have a disease of condition that prevents proper absorption of vitamin D, dark skinned people, those on steroid and seizure medications, and those who are overweight.

Symptoms include bone, and muscle pain. Frequency of falls, bone fractures, abdominal pain, nausea, vomiting, and constipation. Deficiency can be diagnosed by a blood test.  Test results differ in males and female.  The optimal range for Women is 18-78 pg/ml, and Males 18-64 pg/ml per the 1,25-dihydroxyvitamin D test.  For the 25-hydroxy D test 20-30ng/ml indicates insufficiency, while less than 20 ng/ml is deficiency.  Over 30ng/ml is considered optimal for this test.  High levels of Vitamin D can be seen in those over taking supplements, hyperparathyroidism, high calcium levels, kidney stones, sarcoidosis and kidney disease.

Treatment includes improving diet with foods that contain vitamin D (fortified dairy, cereal, juice, fish, and eggs), Infant formula, and dietary supplements of vitamin D and calcium. Exposure to sunlight is important, but use caution to prevent sunburn or if you are at risk for skin cancers. Using a tanning bed is not recommended. If found to be deficient the treatment for an adult is typically vitamin D 50,000 IU three times a week for three months and then a daily over the counter daily use of up to 4,000 IU once daily. For healthy individuals that have normal vitamin D levels, daily International Units or IU’s recommended are as follows:

Infants: 400 IU once daily

Children (>1 year old): 600 IU once daily

Adults: 600 IU once daily

Elderly: 800 IU once daily

Pregnant and breast feeding: 600 IU once daily

Each of these is to be taken with your largest meal of the day for the best chance of absorption.

Talk to your primary care physician to get tested.

Lyme Disease

Lyme disease is an infection caused by bacteria called Borrelia burgdorferi. An infected tick transmits the bacteria to its victims by biting.  The tick must be attached to your skin for 36 hours or more for transmission of bacteria to take place.

A circular rash surrounding the tick bite is the first sign of infection, and can appear up to 30 days after tick removal. Additional symptoms include flu-like symptoms, fatigue, headache, chills and fever, generalized body aches, joint pain, and swollen lymph glands.

States with the most frequent exposure to these ticks are the New England, Mid-Atlantic States, and the Midwest. These ticks are often found on deer and like wooded, grassy areas. Lab tests can confirm diagnosis but must be several weeks into the infection so the body has time to develop antibodies.

Treatment of choice is an antibiotic, which may have to be taken for several weeks. The most common antibiotics used are amoxicillin, and cefuroxime. Treatment is more effective if started early. If the infection is serious, IV antibiotics may be needed.  Reinfection is possible with another tick bite by an infected tick. If left untreated, neurological problems can develop, including meningitis, and heart rhythm disturbance.

To prevent a tick from attaching itself to your skin wear clothes that covers your skin. Spray your skin and clothes with an insect spray that contains 20-30% DEET.  Try to stay away from wooded, grassy areas.  Check yourself and your pets for ticks when you return indoors. If you find a tick remove it with tweezers near the head.

Make sure you seek medical attention if you start having symptoms after a tick bite, you have an irregular heartbeat, nerve pain, and your face feels numb.

 

Tick Bites!

Ticks are parasites that live outside of the body and feed on blood. They are typically found in grassy wooded areas.  Ticks prefer to live in warm and humid environments.  They transmit infections into other living creatures as well as humans of at least 12 types.  The risk of developing an illness related to tick bites depends on

  1. The type of tick. Investigate what ticks are in your area.
  2. The time of the year
  3. How long it was attached. Ticks should be removed quickly to prevent illness’s associated with tick bites.
  4. Geographic location

Removing a tick

Use very fine tweezers, and grab the tick close to the skin and the ticks head. Do not grab the tick by its body. Pull gently upward until the tick releases itself. Avoid twisting and squeezing, as you want to prevent the head from coming off the body of the tick.  This can cause germs to enter your body and result in illness.  Once removed, wash the bite site with soap and water, and apply an antibacterial ointment or cream to prevent skin infection.

Do not try to remove tick with matches, petroleum jelly, or finger nail police. They will not remove the tick and may increase chance of fluids entering your body.

An evaluation between 2-4 hours is recommended if a sudden onset of hives, rash, itching or swelling occurs in areas outside of the original tick bite or if there has been a history of allergic reactions to tick bites in the past. An evaluation within 24 hours is recommended if  you are unable or unwilling to remove the tick, and the tick head imbedded in the skin, redness, pain, swelling, drainage or heat at the tick site (may be a sign of infection), or rash or flulike symptoms develop 2-4 weeks after a tick bite.

Polycystic Ovarian Syndrome (PCOS) in a Nutshell!

PCOS is a range of symptoms caused by an increase in hormone (estrogen and progesterone) imbalance in women. When one hormone is out of balance then another is triggered to be out of balance. The ovaries are stimulated to grow small cysts and release male hormones called androgens known as testosterone. Also, there is an increase in insulin levels in the blood, but the body has difficulty using it, and that is call resistance.  This causes the body’s blood sugars to go up and may result in diabetes.

Symptoms include irregular or no periods, heavy periods, increase in body and facial hair, acne, thinning hair on the scalp, pelvic pain, difficulty getting pregnant, patches of thick, dark skin, and metabolic syndrome, elevated insulin and insulin resistance.

Causes have been attributed to genetic and environmental but are mostly unknown. Risks include obesity, sedentary lifestyle, and family history.

Treatment- There is no cure, but methods to provide relief to sufferers include,

  1. Involves lifestyle changes- weight loss and exercise. Eating healthier foods. To lower insulin resistance
  2. Birth Control- regulates periods, reduce hair growth, and acne
  3. Metformin helps ovulation to become more normal
  4. Restoration of Fertility- need to see a fertility specialist

Complications include increased risk for: endometrial hyperplasia, endometrial cancer, insulin resistance, diabetes, hypertension, Depression/Anxiety, dyslipidemia(a disorder of lipid metabolism), cholesterol and triglyceride levels, heart disease of the arteries of the heart, stroke, weight gain, miscarriage, non-alcoholic fatty liver, and patches of dark skin under arms, groin, and back of neck.

Make sure you follow up with your primary care physician or gynecologist yearly.

How to Stop Self Sabotage in 16 Steps!

  1. Listen to yourself and notice any self-doubting. Why do you do stop yourself from reaching your dreams and goals? What are you afraid of?
  2. Do you feel you don’t deserve it? That you don’t deserve the body or happiness that you desire. You might feel comfortable right now, because that is what you know, but you are still unhappy. YOU NEED TO BELIEVE YOU DESERVE IT.
  1. Are you scared to be thin? Do you feel out of your comfort zone?, and how things will be different?. You have to claim what you want out of your life. You have to define how you want to live your life.
  1. Don’t compare yourself to other people
  2. Life isn’t perfect. Don’t be negative or beat yourself up when you slip up. If your frustrated then reset your goal.
  3. Surround yourself with positive supportive people.
  4. S- specific aim or goalA-attainable goals that are reachableT-timely. Give yourself a time frame for when you want this goal reached.
  5. R-realistic- there may be times of failure as well as celebration
  6. M-measureable short and long term goals
  7. Be proud of small wins.
  8. Portion control
  9. Eating the right foods
  10. Eat every 2-3 hours to keep your metabolism going
  11. Keep a food diary
  12. Stock foods that are healthy only
  13. Read food labels
  14. Disciplined is developed by being disciplined. It takes time and practice. It is always hard at first, but the more you do it, the easier it gets.
  15. Think of losing weight in the long term
  16. Key: PATIENCE, CONSISTENCY, & PERSISTENCE

Dehydration!

Dehydration occurs when you use or lose more fluids than you are taking into your body. This results in your body not being able to perform its usual functions that require proper fluid intake.  If you don’t replace these fluids, you become dehydrated.  We lose water and salt daily through vapor from breathing, sweat, urine, and stool.

Causes include poor fluid intake due to illness or mouth sores, or nausea, intense physical activity,

hot weather, severe diarrhea or vomiting, fever, sweating, poor fluid intake with increased activity and hot weather, and increased urination due to a medical condition such as diabetes or medications.

Symptoms

Mild to Moderate symptoms include dry, sticky mouth, thirst, decrease in urination, fatigue,

no wet diapers for at least 3 hours, few or no tears when crying, dry skin, headache, constipation, dizziness, and muscle cramps.

Severe symptoms are considered a medical emergency. If you experience great thirst, are irritable or confused, feel weak, have a very dry mouth, little or no urination or sweating, eyes look sunken in, a

low blood pressure, rapid heart, rapid breathing, tenting of skin, fever, fainting, and a swollen tongue, you need immediate medical attention.

Complications of dehydration include heat exhaustion or heat stroke, swelling of the brain, seizures, low blood volume shock (Hypovolemic Shock), kidney failure, coma and death.

Treatment for kids includes small frequent sips of rehydrating solutions, such as Pedialyte, popsicles, and water.  In adults, Gatorade, PowerAde, water, and ice chips are effective.  Additionally, wearing

loose clothes, air conditioning, fans, cool wet towels, spray bottle with water, avoid alcohol, caffeine.

You can also break up exposure to heat by spending 10-20 min in heat then going inside to get cool.

Milk, caffeinated drinks, fruit juices and gelatins don’t relieve dehydration and can worsen diarrhea.

Heat Exhaustion!

When it is hot outside your body cools itself by sweating. Your body cools as the sweat evaporates from your skin.  But if you are overexposed to heat or are doing strenuous physical activity your body loses its ability to cool itself properly.  This is called heat exhaustion. This can be caused by loss of water and electrolytes through sweating as a result of hot, sunny, humid weather, and physical exertion in that weather.  Elderly and children are at greater risk due their body’s inability to regulate body temperature, and lack of cool air. Drugs, such as, ecstasy, cocaine and amphetamines, can cause rapid rise in body temp.

Symptoms of heat exhaustion include, nausea, dizziness, irritability, headache, thirst, weakness, high body temperature, excessive sweating, decreased urine output, confusion, vomiting, muscle cramps, which is related to low blood sodium and potassium.

Heat exhaustion can occur in the elderly because they are less likely to drink enough fluids or sense significant changes in temperature. Heat exhaustion in kids can occur as babies and young kids are very sensitive to extreme heat.  Keep cool and hydrated. Don’t leave them in the car, even with the window open.

Treatment- When the temp is over 91 you need to take precautions

  1. Go to a cool area
  2. Remove layers of clothes
  3. Fanning and wet towels
  4. Dizzy may be related to low BP, so lay down and put your feet up
  5. Drink water or sport drink, and sip slowly
  6. If you have continuous vomiting get medical attention immediately

Heat exhaustion can progress to heat stroke, which is a medical emergency.

Heat Stroke (Sun Stroke) occurs when there is a high body temp of 103 or higher. It is considered hyperthermia without fever.  Symptoms include hot, red, dry or moist skin, rapid and strong pulse, and loss of consciousness.  Call 911, move person to cool area, cool person down with cool cloths or bath, DO NOT GIVE FLUIDS.

Those at risk for heat stroke are those wearing dark, heavy, padded clothes, and over dressing, has a high percentage of body fat, dehydration, Fever, beta blockers (cardiac medication), antipsychotic medication, alcohol and caffeine.

The most important thing to remember is to not wait until you are thirsty to drink fluids.

Managing your Sunburn!

Sunburn is radiation burn due to overexposure to Ultraviolet (UV) radiation mostly from the sun or sun tanning.  Too much exposure can be dangerous, but a lesser amount of exposure would lead to a tan.  Sunburns are considered a superficial burn.  Extreme burns can result in hospitalizations. Sunburns can occur in less than 15 min.  Some medications can create greater sensitivity to UV radiation, such as, antibiotics, birth control pills, and tranquilizers.

Suntan is a result of slight to moderate exposure that causes a release of melanin, a protective pigment that is the skin’s natural defense against overexposure.  Suntans are viewed as exotic and desirable.  Repeated extreme exposure over time can lead to damage to your DNA and skin tumors, dry wrinkled skin, dark spots, and freckles.

Those with the greatest risk for skin burns are those with fair skin, living or on vacation somewhere sunny or at a high altitude, work outdoors, and participate in outdoor recreation.

UV Index is the risk of getting sunburn at a specific location and time of day, such as:

  1. Time of Day 10 AM-4 PM- sun’s rays are at their strongest
  2. You can even get burn on cloudy days
  3. Reflective surfaces, such as, snow, ice, water, and concrete
  4. The position of the sun, which is greatest late spring and early summer
  5. The higher the altitude the greater the risk of a sunburn.
  6. Proximity to the equator- closer you are to the tropical regions of the planet 50% greater chance of getting sunburn.
  7. Incidence and severity of sunburns have increased worldwide because of damage to the ozone layer of the planet due to ozone depletion.Complications include skin cancers (Melanoma, basal-cell carcinoma, squamous cell carcinoma), and sunburn to the corneas of your eyes.
  8. Appearance of sunburns include red skin that feels hot is caused by the increase of blood to the area to heal the burn. Also there is pain, fatigue, dizziness, swelling, itching, and peeling skin, rash, nausea, fever, and chills. Fluid filled blisters that can burst and become infected. After exposure, skin may turn red from 30 min to 2-6 hours. Worst of the pain is 6-48 hours after exposure. The burn continues to progress for 1 to 3 days. Skin peeling can last about 3-8 days.

Prevention is the Key:  use hats/caps, clothes that cover arms and legs, and use wraparound sunglasses.

Moderate sun tanning without burning can prevent sunburn. A diet rich in vitamin C, and E can help reduce the amount o sunburn.  Beta-carotene (Vitamin A) helps protect against sunburn.  Protect your skin with sunscreen or sunblock.  The higher the SPF the less the DNA damage is to the skin.  Sunscreen helps prevent some forms of skin cancers. Apply 30 min before exposure and 30 min after exposure, and any time you get wet.

Treatment options include

  1. Pain medication- ibuprofen, naproxen
  2. Corticosteroids- for itching
  3. Cool the skin- cool compresses, cool shower
  4. Moisturizer- aloe vera, hydrocortisone cream
  5. Don’t break blisters- it is a protective layer, and breaking it will slow healing. If it breaks clean with soap and water and apply antibacterial cream and cover with a wet dressing.
  6. Drink plenty of water
  7. Avoid further sunlight
  8. Products that contain benzocaine can irritate the burn and cause allergic reaction.