Category: Stroke

Diagnosis: Diabetes

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Diagnosis: Diabetes

A diagnosis of diabetes can be a scary thing, but with life-style changes the condition can be improved, or even reversed. Patients do not need to face years of fear, guilt, and drugs.

Diabetes is a scary diagnosis. Make some life style changes and change the prognosis.

Diagnosis: Diabetes

By D.S. Mitchell

A Public Health Emergency

One in ten Americans is living with Type 2 diabetes; that’s approximately 38 millions people. Some might call that a public health emergency. With diabetes comes other life altering diseases; cardio-vascular disease, kidney failure (dialysis), stroke, neuropathy, blindness, and lower limb amputation.

Medical Treatment

Many diagnosed diabetics are on high doses of injectable insulin and multiple oral anti-diabetic medications. Insulin is a hormone that transports sugar out of the blood and into the body’s cells. With diabetes the body can’t manufacture the hormone (Type 1-sometimes called childhood diabetes) or the more common Type 2 diabetes, where the body becomes resistant to insulin’s effects. In both cases, insulin injections are the standard fallback treatment.

Change Your Tactics

It doesn’t have to be this way. Instead of accepting the “inevitable” some patients decide to implement strategic behavioral tactics that have shown to improve the condition and even reverse it. Said more simply, if you’ve been diagnosed with diabetes, you can turn it around. What follows are seven behaviors that can make a difference in your life and your battle with diabetes.

  1. Lose Weight: Do not under estimate the impact of gaining, (or losing), even a few pounds. The physiology of diabetes causes the body to ineffectively regulate blood sugar levels because at the heart of diabetes is “insulin resistance.” With insulin resistance the pancreas is forced to manufacture more and more insulin in an effort to transport sugar from the blood to the cells. What is often misunderstood is that insulin whether manufactured in the body or taken as a medication promotes fat storage and weight gain. It becomes a vicious circle, gain a few pounds and the weight gain will force the body to produce more insulin which in turn causes more weight gain-and so it goes. The good news, however, is that even a 10% weight loss can improve insulin sensitivity by 60%.
  2. Keep Up Your Fluid Intake: Hydration is a pretty big deal, don’t ignore it. With dehydration comes a concentration of sugar in the blood.  Studies show that patients who drink less than a half liter of water per day increased their risk of elevated blood sugar compared with those who drank more. Water, milk, herbal tea all work. Caution for coffee lovers; caffeine is dehydrating, limit the intake to a maximum of three cups per day.
  3. Stay Vaccinated: Many believe that COVID is behind us. Well, for folks with immune suppression, over the age of sixty, obesity, and diabetes the threat remains serious. In fact, studies indicate that COVID damages the pancreas and causes system wide inflammation, which in turn increases insulin resistance. New studies link COVID to new cases of diabetes. If you are in one of the high risk groups get vaccinated and stay boosted. Vaccinations lead to milder cases of the disease which should indirectly result in decreased COVID impact on pre-existing diabetics.
  4. Increase Protein Intake: Protein at every meal, not just dinner. Protein maintains muscle and contributes to blood sugar regulation. Fill your plate with fish, white meat chicken, lean cuts of beef and plant based protein sources such as beans, nuts, quinoa.
  5. Bite-sized Bits of Activity: “Exercise snacking” means spreading short bursts of activity throughout the day. A fifteen minute walk, two or three times per day, may do more to help control blood sugar than one long workout. Remember the 10,000 steps recommendation? In that study there was a link between exercise and improved diabetes control. The goal is to mix various types of exercise. Schedule exercise periods for yourself each day. You might start the day with a fifteen minutes block of strength training, using weights, resistance bands and body-weight moves. Mid-morning do fifteen minutes of aerobic activity such as fast walking, swimming, jogging, or tennis. After lunch try fifteen minutes of stretching which improves joint flexibility, balance, and reduces chances of injury.
  6. Read Labels: Do not focus on sugars, but rather read labels for the “Total Carbohydrate.” This term incorporates both naturally occurring sugars and those added. Women should aim for 30-45 grams of total carbs per meal, and men 60 to 75. A typical reaction after hearing a diabetes diagnosis is to eliminate sugar and carbs. Such behavior can result in nutritional deficiencies, fatigue, and dangerously low blood sugars. Consider talking to a Registered Dietitian and setting up a realistic eating plan. Many insurance plans pay for such training. Ignorance is not helpful, your quality of life depends on understanding how you can best help yourself.
  7. Finally: Losing weight, changing eating patterns, and exercising, are things that a newly diagnosed diabetic, or a long time diagnosed diabetic can do to reverse the disease. However, even with all those interventions, there may still be times when insulin and other diabetic medications have a role to play. Pregnancy is such a situation. Pregnancy frequently elevates the expectant mom’s typical blood sugars, just proving insulin has a secure place in the treatment of diabetes.

 

3 Gremlins Facing Health Care In The U.S.

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3 Gremlins Facing Health Care In The U.S.

Americans are taking too many prescription meds

3 Gremlins Facing Health Care In The U.S.

By D. S. Mitchell

On The Front Line

Writing for www.CalamityPolitics.com allows me a grass root platform to discuss health care, and every other area of our political spectrum, for that matter. It does not give me the right to say anything I want about the issues. With that said, I have ground level experience in health care. Because of that experience and exposure to trench warfare in hospital health care I have strong opinions. Client care and results need to be discussed and evaluated for effectiveness. I have a passionate interest in health care, and in this area, I believe my street level experience gives me the right to discuss the issues. Bringing common sense thinking to health care should always be welcomed. I am an RN, and have worked for 38 years in hospitals in Oregon, Washington, California and Nevada.

The Sickest

My two primary areas of specialty are Crisis Psychiatry and Cardiac Intensive Care. Whether the issues are mental, behavioral, or cardiac emergency, many of the issues facing the caregiver, and the client are the same. Despite the obvious differences in the front line needs of the clients, both of these populations are often the sickest in the hospital. One thing I know, is that the health of the American citizen should not be decided by a politician in Washington, D.C. Sadly, that’s where this battle always shows its ugly underbelly.

Gremlin 1: Big Pharma

Suitcases Of Medications

For the first twenty-five years of my career, when I admitted a patient that came to the unit with a suitcase of medications, I believed it was because they were incredibly ill. Like physicians I had been trained to believe in  pharmaceuticals.  Once I was an old nurse, my thinking transformed into, the patient is sick because they are taking so many prescribed medications. I can hear the protests from the audience now. Don’t believe me, just read the labels. These are chemicals and they are toxic and poisonous.

Side Effects

Truthfully, every pill has the potential to cause side effects, some known and some unknown.   When a person complains to his doctor that he is uncomfortable due to the side effects of the medication he is taking, his doctor writes him another prescription to help deal with the side effects.  The patient has pain so his doctor writes him a prescription for an analgesic. When he complains that the pain medication makes him constipated, he is given a prescription.  You can see where this is headed, right?

Advertising Medications

In America, television is the best friend of the pharmaceutical industry.  Constant television marketing has convinced viewers that there is a pill that will fix anything and everything. Unfortunately, many Americans now believe that there is a pill that will make everything in their life better.  Health care policy makers need to take this issue very seriously. I realize drug manufacturers want to make a profit, but I also believe constant repetition creates a need that previously did not exist.

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Atrial Fibrillation and Stroke Risk

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ATRIAL FIBRILLATION AND STROKE RISK

 Assessing stroke risk in patients is an important part of managing Atrial Fibrillation.

Atrial Fibrillation and Stroke Risk

A-fib can lead to blood clots in the upper chambers of the heart increasing the risk of having a stroke fivefold.

 

By D.S. Mitchell

Costco Connection

I am a Costco member and as such I get a copy of the Costco Connection magazine every month. The publication is full of useful information. In the February 2023 issue, I found a great article by Andrea Downing Peck, on the dangers of atrial fibrillation, a very dangerous heart rhythm disorder. I’m a retired RN and I’m always looking for information that will help people recognize symptoms of dangerous health conditions.

Kareem Abdul-Jabbar

Recently, I have seen numerous public service announcements made by NBA basketball legend Kareem Abdul-Jabbar who tells us that he suffers from atrial fibrillation. Well Kareem is not alone; an estimated 2.7 million American live with atrial fibrillation (a-fib). A-fib is the most common sustained heart rhythm disorder seen by doctors.

What Is A-Fib?

A-fib is an irregular, disorganized heart rhythm where the heart’s upper chambers (the atria) no longer beat in coordination with the lower chambers (the ventricles). The rate is usually more rapid than would normally be expected for the level of activity being engaged in.  A-fib is extremely dangerous because the rhythm commonly causes blood clots and blood clots cause strokes. Patients may experience a-fib without symptoms, but when symptoms do appear they may include chest discomfort, light-headedness, palpitations, shortness of breath, and fatigue. If left untreated it can be deadly.

Common Victims

The risk for a-fib increases after age 65. Several medical conditions also increase the risk of developing a-fib whether you are young or old: High blood pressure, Sleep apnea, Obesity, Heart failure, Diabetes, Overactive thyroid, Pericarditis, and coronary artery disease.

Triggers

Lots of studies and research have been done over the last fifty years to discover how to prevent heart disease. Researchers have known that the risk of coronary disease increases with predictable lifestyle factors. Now much of that research is telling us that those same factors and prevention strategies are most likely relevant to heart rhythm disturbances such as a-fib.

Alcohol vs Caffeine

Caffeine has been suspected as a trigger in patients who experience intermittent a-fib. Intermittent a-fib is defined as a temporary episode of the disorder that starts suddenly but resolves quickly without medical interventions, usually within 24 hours. The studies clearly indicate that caffeine does not appear to increase episodes of a-fib, but alcohol did frequently act as a trigger. Drinking more than one alcoholic beverage per day is clearly a trigger for the disorder.

More Than One Trigger

Smoking, sleeplessness, dehydration, stress, obesity, high blood pressure, and sedentary lifestyle are factors that seem to trigger a-fib events. The caveat here, as with many things, it is often a combination of several factors that trigger the event. Over the next several decades the prevalence of a-fib is expected to increase significantly. It’s the combination of these co-morbidities that increase the risk of a-fib.

The Answer

There’s an epidemic of obesity, Type 2 diabetes, inactivity, and alcohol abuse, in the United States. According to experts, we need the population to move, lose weight, drink less alcohol, and as practitioners, doctors need to aggressively treat diabetes and high blood pressure.

Treatment

 Treatments can vary. Medication or surgical intervention, in some cases, may be required. Medications are used to control heart rate and rhythm. Anti-coagulants are used to prevent clotting. A cardioversion is sometimes used as an emergency intervention. A catheter ablation is a procedure used to permanently restore the heart’s proper electrical currents.  There is also for some patients an implant called the Watchman that offers an alternative to blood thinners.

Outcomes

It is important to educate the public about a-fib and other heart rhythm disorders. It is important that if an individual is experiencing symptoms, they should contact their physician as soon as possible to diagnose the problem and above all prevent stroke.

 

May Is Stroke Awareness Month

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May Is Stroke Awareness Month

May is Stroke Awareness Month. Learn the varying risks, types, causes and symptoms of stroke

May Is Stroke Awareness Month

If you are experiencing acute stroke symptoms remember time is critical, every minute treatment is delayed can result in irreparable brain damage. DO NOT CALL your friends and family to ask advice, CALL 9-1-1 immediately.

By D. S. Mitchell

No Longer Just For Seniors

Strokes are not just a health concern for the elderly. Strokes can happen to anyone of any age from infancy through adulthood, most however do occur after the age of 60. Alarming statistics however indicate that over the last 15 years younger Americans, in their 20s, 30s, 40s, and 50’s are suffering strokes at increasing  numbers.

Celebrity Strokes

Recent headline grabbing stroke victims include entertainer Jamie Foxx (55), politician John Fetterman (53), musician *Kid Cudi (32) and influencer Hailey Bieber (25).  The reasons are many, some genetic, but mostly the experts are pointing at lifestyle choices; unaddressed high blood pressure, high cholesterol, obesity, Type 2 diabetes, stress, cigarette smoking, alcohol abuse, and *drug use (Kid Cudi admitted a two week cocaine binge before checking into rehab and subsequently suffering a stroke). Of those factors poor food choices and lack of exercise are probably the most common factors for younger stroke victims.

What Exactly Is A Stroke?

A stroke is quite simply a sudden loss of brain function. The two direct causes of stroke occur when a blood vessel is blocked (ischemic stroke) or when a blood vessel ruptures (hemorrhagic stroke). Onset of symptoms is usually sudden. Symptoms can include weakness or loss of sensation, frequently to only one side of the body, confusion, difficulty speaking, blurred vision, loss of balance and coordination, and headache.

FAST

FAST is the acronym used to teach people how to recognize dangerous stroke symptoms.

  • Facial droop (one sided)
  • Arm or leg weakness
  • Speech slurred or difficult
  • Time is of the essence if you are experiencing any of the above symptoms call 9-1-1.

DO NOT ATTEMPT TO DRIVE YOURSELF TO THE HOSPITAL, you might end up killing yourself and someone else in a collision. Call 9-1-1. When you call 9-1-1 you will not only get an ambulance with all the necessary emergency equipment onboard along with trained EMTs, but the 9-1-1 call also triggers actions at the nearest hospital where professionals will be preparing for appropriate testing and treatment.

Treatment Options

Treatment may include the removal of a single blood clot or multiple clots. Procedures such as angioplasty, stents, or medications such as blood thinners, to prevent further clots from forming may be used. The residual damage from a stroke may take weeks or months of physical and speech therapy to strengthen affected areas. Thankfully due to research and the development of new treatments for strokes there are better outcomes.  Having a stroke doesn’t mean your life is over, you can still have a meaningful and productive life.