HealthyLife Articles

Tag: management

  • Polypharmacy: What To Know

    MEDICAL NEWS

    Wooden spoon filled with variety of pills.

    Medications improve the quality of life for many people. When you have a medical condition, the right medication can make all the difference.

    Polypharmacy refers to the use of multiple medications, generally in the range of 5-10 each day. It is common in older adults; however, anyone who struggles with more than one chronic condition may be at risk.

    While taking medication to protect your health is essential, you should be aware of the danger associated with polypharmacy and how to prevent it.

    The danger of polypharmacy

    Every drug is studied to make sure it is safe and effective to treat the condition it is used for. But, once you start mixing multiple medications together, the side effects may be less known and hard to predict.

    Anyone taking more than five medications is at risk for:

    *  Adverse drug reactions

    *  Balance issues

    *  Cognitive impairment

    *  Harmful drug interactions

    *  Drug-disease interactions

    Taking a lot of different medications also creates a burden on you, the patient, to manage and keep track of everything you are taking.

    Ways to decrease your risk

    *  Keep an updated list of all your medications. Take it with you to every doctor’s appointment. If you see multiple doctors, this is especially critical.

    *  Talk to the pharmacist every time you are prescribed a new medication. Make sure to show them your medication list so they can check for any drug interactions.

    *  If possible, fill all your prescriptions at one pharmacy.

    *  Don’t stop taking a medication on your own. Always talk to your doctor if you are concerned about the amount of medicine you are taking.

    Questions to ask your doctor

    Your doctor is your best resource to decrease your risk of polypharmacy. Always review your medications with them at each visit and ask detailed questions. Here are some questions to ask:

    *  Is there one medication that could help with multiple conditions?

    *  Do the benefits of the drug outweigh the risks?

    *  Should I keep taking a medicine that doesn’t seem to be working?

    *  Can the dosage be adjusted to decrease the risk of side effects?

    *  Could a new symptom be a side effect of my medication?

    © American Institute for Preventive Medicine

  • Gestational Diabetes

    Pregnancy & Prenatal Care

    A pregnant woman can have diabetes. If she didn’t have it before the pregnancy, it’s called gestational diabetes. (Gestational refers to pregnancy.) It can begin any time during pregnancy. It usually begins in the last half, though. It goes away after the baby is born. But the woman has a greater risk of getting diabetes later.

    Symptoms

    *  Feeling very tired

    *  Rapid weight gain

    *  Feeling very thirsty

    *  Having to pass urine often

    Also, a sign for gestational diabetes is when the baby gets too big during the pregnancy.

    All pregnant women should be screened for diabetes. Screening happens through urine and blood tests. Those are part of routine prenatal health care visits.

    Causes

    Any pregnant woman can develop gestational diabetes. But risk factors may be:

    *  Obesity before pregnancy

    *  High blood pressure before pregnancy

    *  Having a baby that weighed more than 9 pounds at birth in the past

    *  Having a stillbirth in the past

    *  Having a child with a birth defect in the past

    *  Being older than 25

    *  Being pregnant with more than one baby

    Treatment

    Special problems can be avoided with treatment. Without treatment, the baby can get too big. The mother may not be able to have a vaginal birth. Other problems are preeclampsia and preterm birth. Preterm birth is when the baby is born 3 or more weeks before the due date. There can also be delivery problems. But a woman with gestational diabetes can have a healthy baby. She needs proper medical care, though.

    Blood sugar must be controlled. This is done through:

    *  Special diet from the health care provider

    *  Exercises from the health care provider

    *  Insulin shots, in some cases, when diet and exercise are not enough. Insulin is a hormone. Among other things, it keeps blood sugar from getting too high. The provider teaches how to do the shots. The provider teaches the mother how to check her own blood sugar. It is important to do what the provider requests.

    *  Having prenatal visits more often. The provider checks the mother’s daily blood sugar record. Tests are done to see how the baby is doing.

    *  Extra care at delivery

    {Note: The baby should be checked for low blood sugar a day or so after birth.}

    Questions to Ask

    Self-Care / Prevention

    If you get diabetes during pregnancy:

    *  Follow the diet and exercise plan your health care provider or dietitian gives you.

    *  Drink at least 8 to 10 cups of fluids a day. Drink enough for your thirst. Limit ones with a lot of sugar. Examples: all kinds of sodas, fruit drinks and juices.

    *  Get plenty of rest when you feel tired.

    *  If you are told to do so, test your blood sugar levels at home. Your health care provider will tell you how. Keep a daily record of the results.

    *  After you have your baby, get your blood sugar checked when your doctor tells you to.

    {Note: Some pregnant women need to give themselves insulin shots at home. If your provider says you need to, you will be shown how. Be sure to give the insulin correctly. It’s an important way of taking care of yourself and your baby.}

    Prenatal Self-Care book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • High Blood Pressure

    Heart & Circulation Problems

    The medical name for high blood pressure is hypertension (hy-puhr-TEHN-shun). High blood pressure (HBP) is when blood moves through the arteries at a higher pressure than normal. The heart strains to pump blood through the arteries.

    Signs & Symptoms

    High blood pressure (HBP) is a “silent disease.” Often there are no signs or symptoms. A lot of adults with HBP do not know they have it. So, get your blood pressure checked at each doctor’s office visit, at least every 2 years, or as often as your doctor advises. When blood pressure is 180 or higher (top number) or 120 or higher (bottom number), these signs of a hypertensive crisis may occur:

    *  Severe chest pain

    *  Severe headache with confusion and blurred vision

    *  Severe anxiety

    *  Shortness of breath

    Blood pressure is measured with 2 numbers. The first (top) number measures systolic pressure. This is the maximum pressure against the artery walls while the heart is pumping blood. The second (bottom) number measures diastolic pressure. This is the pressure between heartbeats when the heart refills. The results are given as systolic over diastolic pressure, such as 120/80 millimeters of mercury (mm Hg).

    Tips When You Have Your BP Measured

    *  Don’t drink coffee or smoke 30 minutes before having your BP read. (Don’t smoke at all!)

    *  Go to the bathroom before you get it checked.

    *  Before the test, sit for 5 minutes.

    *  Wear short sleeves so your arm is exposed.

    *  When you get tested: Sit; keep your back and arm supported; and keep your arm at heart level.

    *  An average of 2 readings from BP tests taken at least 5 minutes apart should be done.

    Causes, Risk Factors & Care

    The exact cause is not known.

    Risk factors include:

    *  Family history of HBP

    *  Aging. More than half of older adults have HBP.

    *  Smoking cigarettes

    *  Race. African Americans are more likely to have HBP than Caucasians.

    *  Gender. Men are more likely to have HBP than women (until women reach menopause).

    *  Being inactive. Obesity. Sleep apnea.

    *  Drinking too much alcohol

    *  Too much sodium intake in some persons

    *  Emotional distress

    High blood pressure could be caused by another medical problem or be a side effect of some medicines. This is called secondary hypertension. This can usually be reversed when the problem is treated.

    Diagnosis

    Blood pressure readings tell if your blood pressure is high. A health care professional measures blood pressure during an office visit with a manual or automated device called a sphygmomanometer (sfig’-mo-ma-nom-e-ter). The numbers on the gauge measure your blood pressure in millimeters of mercury (mm Hg).

    You should get 2 or more readings at different times. To confirm a diagnosis of HBP, your doctor may have you wear a device that records your blood pressure every 20-30 minutes over a period of 24 to 48 hours. This is called ambulatory blood pressure monitoring (ABPM).

    Note: Sometimes just being at the doctor’s office is enough to raise some people’s blood pressure. This is called “white-coat hypertension.” If you think this affects you, tell your doctor. You may be advised to check your blood pressure with a home testing device. Your doctor may have you wear a device that records your blood pressure for 24 hours. This will give accurate readings of your blood pressure.

    Health Problems Related to HBP

    High blood pressure plays a major role in these health problems:

    *  Stroke. Dementia. Brain damage.

    *  Heart disease. A person with HBP is 5 times more likely to have a heart attack than a person without HBP. It can also cause the heart to enlarge. This could cause (congestive) heart failure.

    *  Chronic kidney disease

    *  Kidney failure

    *  Vision loss. This includes blindness.

    Why is ambulatory blood pressure monitoring (ABPM) done?

    During an office visit, a short-term rise in blood pressure can be due to:

    *  Emotions or stress

    *  Pain or physical activity

    *  Caffeine or nicotine

    *  “White-coat hypertension.” With this, just being at a doctor’s office or in the presence of medical staff is enough to raise blood pressure.

    Getting blood pressure readings over 1-2 days during normal activity and sleep gives a more accurate measurement of your blood pressure.

    Self-Care / Prevention

    For blood pressure control, follow a healthy lifestyle.

    *  Get your blood pressure checked at each office visit, at least every 2 years, or as often as your doctor advises.

    *  Get to and/or stay at a healthy weight. Aim for a body mass index (BMI) between 18.5 and 24.9. Find your BMI using the table below or from:www.nhlbisupport.com/bmi.

    *  Don’t smoke. If you smoke, quit.

    *  Limit alcohol to 2 drinks or less a day if you are male and 1 drink or less a day if you are female or age 65 or older.

    *  Limit caffeine.

    *  Exercise. Try to do at least 60 minutes a day.

    *  Learn to handle stress. Take classes. Learn relaxation techniques, etc.

    *  Take medicine as prescribed. Tell your doctor if you have any side effects, such as dizziness, faintness, or a dry cough without having a cold. Don’t stop taking your prescribed medicine or change the dose(s) unless your doctor tells you to.

    *  Talk to your doctor or pharmacist before you take antihistamines and decongestants. Discuss all prescribed and over-the-counter medicines with your doctor and pharmacist before you take them to avoid harmful drug interactions. Find out about drug and food interactions, too. Ask if grapefruit juice can cause harmful effects with the medicine(s) you take.

    *  Keep track of your blood pressure using a home testing device. Do this if advised by your doctor.

    Medical Care

    High blood pressure usually lasts a lifetime, but can be treated and controlled. If you are diagnosed with high blood pressure, follow your doctor’s advice. Medical treatment includes:

    *  A physical exam and lab tests. These check for damage to your heart, kidneys, and other organs. They also identify risk factors you have for heart, kidney, and other diseases. Your treatment plan is based on your needs.

    *  Follow-up blood pressure checks and other tests as needed.

    *  Healthy lifestyle changes.

    *  Medications. Most persons need more than 1 medicine to treat high blood pressure.

    Your doctor will decide if and what medication(s) you need. This is based on your blood pressure level, age, race, other conditions you have, heart disease risk factors, etc. Common medicines used to treat HBP are:

    *  Diuretics (water pills)

    *  Calcium channel blockers

    *  ACE inhibitors

    *  Angiotensin II receptor blockers

    *  Beta-blockers

    *  Alpha blockers. Alpha-beta blockers.

    *  Nervous system inhibitors

    *  Vasodilators

    Reasons to Get Medical Care

    *  You have signs or symptoms of a hypertensive crisis. Get medical care right away.

    *  You need to schedule office visit appointments to get your blood pressure checked. Do this as often as your doctor advises.

    *  You have adverse side effects from taking medicine(s) to lower blood pressure. Examples are:

    – You feel lightheaded or dizzy.

    – You feel weak, sleepy, and/or drowsy.

    – Your heart races.

    – You get a skin rash.

    Resources

    American Heart Association

    800.242.8721

    www.heart.org

    National Heart, Lung, and Blood Institute

    www.nhlbi.nih.gov

    High Blood Pressure brochure by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • High Blood Pressure 2

    Pregnancy & Prenatal Care

    A blood pressure reading concerns the blood in the arteries. The top number in the reading is the systolic pressure. That’s the pressure when the heart muscle contracts. The bottom number is the diastolic pressure. That’s the pressure when the heart muscle relaxes.

    An example of a blood pressure reading is 120/80. This is measured in millimeters of mercury (mm Hg). A blood pressure reading should be taken before pregnancy or at its start. This is called a baseline blood pressure. The baseline reading shows what is normal for that woman. During the first several months of pregnancy, blood pressure may drop a little. It often rises slightly later in the pregnancy. That’s because of the extra work the mother’s body is doing. A slight rise is normal then. High blood pressure in pregnancy is when there is an increase of 30 or more in the systolic pressure (top number). An increase of 15 or more in the diastolic pressure (bottom number) is also a sign of high blood pressure.

    Causes

    Preeclampsia

    A common cause of high blood pressure in pregnancy is preeclampsia. This used to be called toxemia. Three things usually come with preeclampsia:

    *  High blood pressure

    *  Swelling of the face, hands, fingers, or feet

    *  Protein in the urine

    Other symptoms of preeclampsia are:

    *  Sudden weight gain or gaining more than 2 pounds a week

    *  Headaches

    *  Vision problems like spots before the eyes or blurry vision

    *  Pain in upper belly

    *  Severe indigestion that doesn’t go away

    Preeclampsia affects about 7 out of 100 pregnant women. It happens most often during a first pregnancy, but can occur again, especially with a new partner. And, it only happens during pregnancy. It goes away after delivery. Preeclampsia can lead to eclampsia. That’s when convulsions also occur. Eclampsia can result in a coma for the mother.

    Risk Factors

    The cause of preeclampsia is not known. High blood pressure does not have to be present before pregnancy. The things listed below may increase the risk for preeclampsia:

    *  First pregnancy or first pregnancy with a new partner

    *  Chronic high blood pressure or kidney disease

    *  Diabetes or lupus before the pregnancy

    *  Being overweight

    *  Being African American

    *  Pregnancy before age 20 or after age 35

    *  Being pregnant with more than one baby

    *  Preeclampsia in a past pregnancy or in a mother or sister

    Pregnancy Induced Hypertension (PIH)

    High blood pressure can develop during pregnancy without other symptoms. This is called pregnancy induced hypertension (PIH). This type of high blood pressure often happens after the 20th week. After delivery, blood pressure usually goes back to normal.

    Treatment

    High blood pressure and preeclampsia can range from mild to severe. They can be treated with medical help and home care. But if serious symptoms are present, medicine and/or hospital care may be needed. The health care provider may induce labor (bring on labor). Or a Cesarean section (C-section) may be done.

    When blood pressure remains high, not enough blood reaches the placenta. The fetus doesn’t get enough oxygen and nutrients. That can cause:

    *  Growth problems for the fetus

    *  Placenta abruptio.

    *  A baby that is born preterm, that has mental problems, is underweight, or stillborn

    Questions to Ask

    Self-Care

    *  Get a lot of rest. Sleep 8 to 12 hours at night. Take 2 naps during the day, if you can. When you sleep or rest, lie on your left side, as much as you can. This helps blood flow to the placenta. When you tire of lying on your left side, lie on your right side.

    *  Take medicine for high blood pressure as prescribed. If told to do so, take regular blood pressure readings at home. Ask your health care provider how to get a home test kit.

    *  Follow your health care provider’s advice about exercise.

    *  Do things to relax. Examples: listen to soft music, put your feet up, take a nap. Watch a TV show that makes you laugh. Put your hand on your belly to feel your baby move.

    *  Don’t take any medicine without your health care provider’s okay. That includes cold or sinus medicines and antacids.

    Prenatal Self-Care book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Irritable Bowel Syndrome (Ibs)

    Abdominal & Urinary Conditions

    Image of women sitting holding stomach in pain.

    Irritable bowel syndrome (IBS) is a problem that mostly affects the bowel (the large intestine) and is not caused by any other bowel disease. It can be painful, does not damage the colon or lead to other health problems.

    Signs & Symptoms

    *  Gas, bloating, pain, or discomfort in the abdomen.

    *  Chronic diarrhea, constipation (or both).

    *  Mucus in the stool.

    Causes

    The cause is not known. A person with IBS has an extra sensitive colon. Muscles in the intestines go into spasm, causing symptoms.

    Treatment

    Changes in eating habits, stress relief, and medications treat IBS.

    Questions to Ask

    Self-Care / Prevention

    *  Don’t smoke. If you smoke, quit. Avoid secondhand smoke.

    *  Maintain a healthy diet. Lose weight if you are overweight.

    *  Avoid constipation. Don’t strain to pass stool.

    *  Exercise to keep abdominal muscles strong. Follow your doctor’s advice.

    *  When you do sit ups, keep your knees bent and your feet flat on the floor.

    *  Follow proper lifting techniques.

    *  Wear a weight lifting belt to support the back when lifting.

    *  Wear a truss. This is a device that holds a hernia in place.

    *  For mild pain, take an over-the-counter medicine for pain. If even mild pain lasts longer than a week, see your doctor.

    Resources

    National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

    www.niddk.nih.gov

    Healthier at Home book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Nausea And Vomiting

    Pregnancy & Prenatal Care

    Nausea is when you feel like throwing up. Vomiting is when you do throw up. They are both signs of morning sickness. It is usually due to changes in hormones. Low blood sugar levels also cause it.

    Despite its name, morning sickness can happen any time of day. It can even happen in the evening. Morning sickness usually begins around the 6th week. For most women, it ends after the first trimester. For some, it lasts longer. For a few, it can last the whole pregnancy.

    Upset stomach and throwing up can also be caused by:

    *  A virus in the intestines. Diarrhea can go along with this.

    *  Spoiled food

    *  Eating or drinking too much

    Questions to Ask

    Self-Care / Prevention

    *  Keep crackers or dry cereal by your bed. Eat a few crackers or a handful of dry cereal in bed. Do this before you lift your head up in the morning.

    *  Get up and out of bed slowly. If you can, sit in bed for a half-hour before you get up.

    *  Use these tips to keep your blood sugar from getting too low:

    – Eat small regular meals and snacks through the day. Focus on foods high in carbohydrates. Examples: whole grain breads and cereals, potatoes, pasta. More examples: rice, beans and other legumes, vegetables, fruits.

    – Have a good source of protein at each meal. Examples: low-fat milk, yogurt, low-fat cheese, dry beans, dry peas.

    – Have a snack before you go to bed at night. Have one if you wake up at night.

    – Avoid foods with high sugar content.

    – Don’t drink alcohol.

    *  Don’t smoke.

    *  Don’t eat fried or greasy foods. These foods have a lot of fat. Fat stays in the stomach for a long time. This can lead to nausea.

    *  Don’t eat spicy foods.

    *  Don’t take any medicine without your health care provider’s okay.

    *  Take your prenatal vitamins (vitamin pills) with meals. This helps prevent stomach upset. Your doctor may prescribe PremesisRx®. This is a vitamin that helps nausea.

    *  Ask your health care provider about taking ginger and in what form.

    *  Write down the times when your stomach is upset and when you throw up. These may happen only after you eat certain foods. Or they may happen with certain smells. Once you know what they are, you can avoid them.

    *  Stay away from smoke and smoky rooms. Even stay away from cooking smells.

    *  Get plenty of rest.

    *  Discuss any home remedies with your health care provider. Do this to make sure they are safe.

    *  Ask your health care provider about a relief band. That’s a wrist band that helps with an upset stomach and throwing up.

    *  If the Self-Care Tips bring no relief, call your health care provider. He or she can prescribe medicines. Sometimes, IV fluids are needed.

    *  To get rid of cooking smells and odors:

    – Open the windows.

    – Run fans in the house. Use the exhaust fan on the stove.

    – Use a portable air cleaner or air purifier.

    Prenatal Self-Care book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Go Red To Manage Pain

    SELF-CARE CORNER

    Image of cherry juice.

    Tart cherries may help reduce chronic inflammation, especially for the millions of Americans suffering from joint pain and arthritis, according to research from Oregon Health & Science University. The researchers suggest tart cherries have the “highest anti-inflammatory content of any food” and can help people with osteoarthritis manage their disease.

    In a study of women ages 40 to 70 with inflammatory osteoarthritis, the researchers found that drinking tart cherry juice twice daily for three weeks led to significant reductions in important inflammation markers-especially for women who had the highest inflammation levels at the start of the study.

    Often thought of as “wear-and-tear” arthritis, osteoarthritis is the most common type of arthritis. Athletes are often at a greater risk for developing the condition, given their excessive joint use that can cause a breakdown in cartilage and lead to pain and injury, according to the Arthritis Foundation.

    Along with providing the fruit’s bright red color, the antioxidant compounds in tart cherries-called anthocyanins-have been specifically linked to high antioxidant capacity and reduced inflammation, at levels comparable to some well-known pain medications.

    Available every day of the year in dried, frozen, and juice forms, tart cherries are a versatile ingredient to include in any training or inflammation-fighting diet.

    © American Institute for Preventive Medicine

  • The Lowdown On High Blood Pressure

    MEDICAL NEWS

    Image of women having her blood pressure checked.

    Because 1 in 3 American adults suffers from high blood pressure, regular and accurate blood pressure checks are important for correctly diagnosing and treating hypertension (the medical term for high blood pressure).

    Dr. Robert Zelis, a cardiologist at Penn State Milton S. Hershey Medical Center, says there are three groups of people who may want to consider checking blood pressure on their own, in addition to having it measured at their annual physical exam.

    *  The first is those with so-called “white-coat hypertension.” These are patients who get so worked up about being in a doctor’s office that their readings will always be high there.

    *  The second is those who already take medication to control their blood pressure and need to monitor how it’s working.

    *  The third is those who suffer from chronic conditions such as diabetes or high cholesterol or who have risk factors such as obesity, smoking, or a strong family history of hypertension.

    Whether a blood pressure check is done at the doctor’s office or at home, it’s important to follow the same procedure:

    *  Make sure the blood pressure cuff is large enough and easy to use.

    *  Sit in a chair with a straight back, with both feet flat on the floor. Your legs should not be crossed.

    *  Make sure your arm is supported on something such as a table or armrest.

    *  Don’t take a measurement with the cuff placed on top of clothing. Bare skin is best.

    *  Wait 30 seconds after sitting down before you take your measurement.

    *  Take a second reading 30 seconds after you have finished the first to confirm your initial results.

    *  Take the measurements at the same time of day.

    *  Record your results to spot patterns.

    © American Institute for Preventive Medicine