Bryan Health Provider Health Blog
To bring you the latest in health news, we will have occasional blog posts on health topics from a variety of members of our medical community.
What is sudden cardiac arrest?
By Michael Kutayli, MD
Sudden Cardiac Arrest (SCA) occurs when the heart suddenly stops pumping blood. It is not a heart attack, which causes damage to the heart muscle when a blocked blood vessel in the heart prevents blood from reaching the heart muscle. A heart attack usually has warning signs such as chest pain and shortness of breath with exertion.
SCA, however, may occur with no warning symptoms. It is the result of an electrical problem in the heart, which causes the heart to just quiver or stop beating. When the heart stops pumping blood, loss of consciousness occurs and death can result within a few minutes. A shock to the heart, either external or internal, is needed to restore the electrical activity in the heart. External shocks are given with an automated external defibrillator (AED). Internal shocks come from an implanted cardiac defibrillator (ICD). Since it takes time to bring a defibrillator to someone in cardiac arrest many die before they can get to a hospital.
How can you reduce your risk of SCA? You can start by determining your risk factors for SCA.
Risk factors include:
A previous heart attack
Weak heart muscle with a low ejection fraction
Family history of SCA
Unexplained loss of consciousness with exertion
High blood pressure, high cholesterol, diabetes, tobacco abuse, obesity and/or family history of heart disease (i.e., risk factors for a heart attack)
The ejection fraction (EF) is the percentage of the blood pumped out of the left ventricle with each heart beat. A normal EF is 50 to 75 percent. An ejection fraction of 35 percent or less means you are at greater risk for SCA. Your EF can be determined by various tests; usually by having an echocardiogram (ECHO) or heart catheterization.
Other test may be done to determine your risk of SCA. An electrocardiogram (EKG or ECG) records the electrical signals from your heart and can show evidence of a heart attack or rate and rhythm abnormalities. Holter monitors and event monitors record heart rhythms over a period of time. Cardiac stress tests and cardiac catheterizations look for evidence of blocked coronary arteries and estimate the ejection fraction. An electrophysiology study looks for abnormal rhythms.
You can help reduce your risk of SCA by leading a healthy lifestyle. This includes regular exercise, maintaining a normal weight, eating less fat (especially saturated fats), limiting salt in your diet, limiting alcohol consumption, and quitting smoking.
Medications prescribed by your healthcare provider can help to improve blood pressure, control arrhythmias and help to improve the heart function. An internal defibrillator (ICD) may be recommended if you are at high risk for SCA. The ICD monitors the heart rhythm and can use electronic signals to disrupt life-threatening arrhythmias. A catheter ablation procedure can destroy electrical pathways in the heart which are causing arrhythmias.
For more information on SCA and your ejection fraction:
- Schedule an EF (ejection fraction) screening on November 10. To schedule an appointment between 7:15 a.m.-4 p.m., call 402-481-5121. Cost of the screening is $40.
What is palliative care?
By Lisa Mansur, MD, FCCP
Medical Director of Palliative Care
Bryan Medical Center
Perhaps you've heard the term and wondered, what is palliative care? How can in benefit me or a loved one?
Palliative care is big picture medicine. The word palliative means "to cloak or surround." Often palliative care is confused with hospice care. Hospice care is an important arm of palliative care that provides care during the last weeks to months of life. Palliative care, on the other hand, is for patients who are chronically ill, recurrently in the hospital, progressively debilitated, or even some patients that are suddenly and catastrophically ill.
It used to be that patients had very little time from being given a terminal diagnosis until death. Today, patients have an average of 30 months from the time of a terminal diagnosis until death. The care a patient receives during that time requires a team of primary doctors, subspecialists, nurse practitioners, nurses, social workers, nutrition specialists, therapists and spiritual leaders. The palliative team facilitates the communication between the host of care providers, the patient, and their family.
After defining the goals and expectations that the patient and their family have, the medical team and the palliative team focus on measures of restoration and palliation that provide day-to-day comfort, dignity and quality for the patient.
The palliative team uses medical information, recommendations of physicians and the palliative performance scale to help the patient understand where they have been medically, where they are currently and what to expect medically in the near future. This evaluation assists with the education of the patient and family and it empowers them to make better medical decisions.
Palliative care also is involved in developing and implementing a plan for symptom control. The palliative team addresses symptoms including shortness of breath, pain, confusion, swallowing difficulties, nausea, weakness, anxiety and suffering.
Many studies have recently shown the benefit of applying palliative care alongside restorative care in our patients. These benefits include longer life with more comfort, patient and family satisfaction, and reduced medical expenditures.
With over 25 percent of the Medicare dollar being spent in the final WEEK of life, it is definitely time to make sure that medical therapies are done FOR the benefit of the patient. Upon receiving information about interventions and options that includes expected outcomes, patients overwhelmingly desire only the therapies that contribute to comfort and quality.
So, how do you access palliative care?
Palliative care can be provided by all physicians and caregivers in any setting. A patient and their family should request a focus by the medical team on the goals, expectations and definitions of quality given by the patient. Once this discussion is initiated, each medical decision will be informed by and will focus on the patient's desires. This is empowering and it leads to higher quality care.
See article from Journeys: Palliative Care Relieves Suffering
June 1, 2011
Superfoods: What's all the fuss about Acai?
By Katie Walz
If you have watched TV, read magazines, surfed the Internet or read food labels at the grocery store in the past few years, chances are you've seen mentions of the acai berry. You may be wondering, does it really promote weight loss, prevent cancer, and cure baldness? Where do I get some, how are they eaten, and what do they taste like?
And how do you pronounce "acai" anyway?
While you can't believe everything you read about these berries, it is true that they do have some impressive nutritional qualities. Natives of Northern Brazil have had the acai (pronounced a-sigh-EE) berry as part of their diet for hundreds of years for its healing and wellness powers. Recently, science has discovered exactly why these berries have been hailed as a super fruit since ancient times.
What really sets the acai berry apart from other berries is their antioxidant level, which is crucial to strengthening the body's ability to fight aging and disease. Studies have revealed that these berries have 10 times the antioxidant power of grapes and twice the antioxidants of blueberries!
These berries also can play a role in supporting a healthier cardiovascular system. Rich in essential fatty acid and omegas, acai helps support a healthy cholesterol profile. Acai's generous amounts of monounsaturated fatty acids can help lower LDL (bad) cholesterol levels, while maintaining HDL (good) cholesterol levels.
The acai berry also plays an important role in improving visual and neurological function, cartilage formation, muscular health, bone mineralization, endurance, and may even delay the onset of diabetes. They are an excellent source of fiber, which aids in digestive function and plays an important role in colon cancer prevention.
There is no doubt that these berries are beneficial to your health, but are they appealing to your taste buds?
Acai berries produce a unique tropical fruit flavor with a vibrant taste of berries and chocolate. They look similar to a blueberry or small grape. The acai berry is mostly composed of nut and must be carefully processed before they can be eaten. Therefore, these berries are usually found in the more convenient juice or capsule form.
Although acai berries may not be available in your local supermarket, you can find them in health food markets, specialty food shops, and on the Internet.
If you are looking for practical ideas for how you can incorporate superfoods including acai into your regular diet, join me on Thursday, June 9 at 7 p.m. for an hour-long cooking class at Bryan LifePointe. Recipes and samples will be provided. The cost is $10 per person. You must register by June 7. Register online or by calling (402) 481-6300. Space is limited, so register soon!
Tanning: is it really that bad for you?
By Rodney S.W. Basler, MD
South Lincoln Dermatology
Despite the efforts of cancer societies and dermatologists, most Americans still equate a summer tan with attractiveness and health. Unfortunately, research clearly indicates that long-term, indiscriminate exposure to sunlight is a cause of:
In fact, the latest evidence confirms a direct relationship between sun exposure and lethal malignant melanoma. In the short term, tanning may make you look young and fit, but over time it will leave you wrinkled, scarred, and possibly DEAD.
With this body of evidence in mind, protective measures and moderation must be advised for all who enjoy outdoor activities during the sunny days of spring and summer.
Sunlight has the greatest proportion of wavelengths within the sunburn spectrum during the hours when the rays travel the shortest distance through the atmosphere, which is between 10 a.m. and 2 p.m.
A simple suggestion is to limit your sun exposure to early morning and late afternoon. Avoid sunlight during the hours on either side of noon, when the rays within the spectrum are more intense.
For those who wish to continue basking in direct, mid-day sun at the side of a pool, the best solution is to apply of one of the newer sunscreens, which contain ingredients that protect against UVA and UVB wavelengths. These preparations provide significant protection while allowing some minimal pigment darkening.
Sunscreens should deliver an SPF of a minimum of 15, with SPF 30 now recommended by the American Academy of Dermatology. The lotion should be applied 20-30 minutes before sun exposure, and importantly, reapplied every two to four hours, especially when perspiration or water emersion are factors.
The ultimate recommendation for sunscreens is this: USE THEM - THEY WORK!
Be smart, for your health's sake, and enjoy the summer!
Article from our health library:Summer Safety Tips
Is depression affecting you?
By David Miers, PhD
Manager, Bryan Mental Health Services
More than 20 million Americans are diagnosed with depression each year. According to the National Institute of Mental Health, this illness affects more people than any other mental health condition. However, the World Health Organization reports that less than 25 percent of individuals with depression receive adequate treatment. People fail to recognize depression or refuse to get help. Sometimes this is due to the beliefs that depression is not serious or seeking treatment is a sign of weakness.
Depression is a serious medical condition and if left untreated, can lead to other mental health disorders such as alcohol and substance abuse, and higher rates of suicide.
Everyone gets down from time to time but depression is more than just the "blues." It is important to have an understanding of the signs and symptoms of depression.
Depression can occur in anyone, any age, and any race or ethnic group. It can vary in intensity and duration, even disappearing entirely only to reoccur later.
Common Symptoms of depression include:
- Depressed mood (e.g. feeling sad or empty)
- Lack of interest in previously enjoyable activities
- Significant weight loss or gain, or decrease or increase in appetite
- Insomnia or sleeping too much
- Agitation, restlessness, irritability
- Fatigue or loss of energy
- Feelings of worthlessness, hopelessness, or guilt
- Inability to think or concentrate, or indecisiveness
- Persistent physical symptoms that do not respond to treatment (such as headaches, chronic pain, and digestive disorders)
- Recurrent thoughts of death, recurrent suicidal ideation, suicide attempt or plan for completing suicide
When several symptoms of depression occur at the same time, last longer than two weeks, and interfere with ordinary functioning, seek professional treatment from a physician or qualified mental health professional.
The good news is that depression is very treatable, with 80-90 percent of people returning to usual daily activities and feelings. The most common forms of treatment for depression include antidepressant medication, psychotherapy, or a combination of the two.
If you or someone you know is suffering from the symptoms of depression, seek help. Bryan Health has free, confidential depression and bipolar screenings available here. Identifying you may have a problem is the first step toward finding your way back to a healthier, happier life.