Coronary artery disease treatments and prevention

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Coronary artery disease (CAD) is a condition where plaque filled with cholesterol deposits in the blood vessels of the heart. As a result, your heart does not get enough blood flow and oxygen, which leads to a variety of conditions ranging from angina to heart attacks. The biggest risk factors for developing CAD are smoking, diabetes and family history. Hypertension, high cholesterol levels and poor lifestyle habits, like lack of exercise and an unhealthy diet, are also risk factors.

The best treatment of CAD is prevention. Quit smoking, control your diabetes, blood pressure and cholesterol levels. You want your LDL (bad cholesterol) to be low, and you want your HDL (good cholesterol) to be high. This can be achieved with diet, exercise and medications.

 

Symptoms of CAD can be vague. Chest pain is the most common symptom, but it can also present as jaw pain, neck pain, arm pain, back pain, shortness of breath or fatigue. Early recognition is key. Contrary to popular belief, women over 55-years-old carry a higher risk than men of the same age. The risk in younger men is higher than in older men.

There are various ways to treat CAD. Medications, lifestyle changes like quitting smoking, controlling your diabetes, blood pressure and cholesterol levels, as well as stents or bypass surgery. A stent is a device that looks like the spring of a ballpoint pen, which keeps arteries open. These are life-saving in situations of a heart attack. Nowadays, open heart bypass surgeries are reserved for extensive blockages in multiple areas of the heart, and/or when the blockage is in a critical part of the heart, which is not suitable for a stent.

The latest in stent technology is bioabsorbable stents, which disappear after their job of keeping the arteries open is done. These are currently being used by myself and other Michigan Heart physicians. If you have questions about CAD, please talk to your primary care physician or cardiologist.

 

 

Blood Pressure Machines

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If you think you have high blood pressure and want to check your blood pressure often, those free machines at local pharmacies are tempting. But just how accurate are they?

There are two types of blood pressure monitors. The first is the one you’re probably most familiar with, manual blood pressure monitors. These consist of an arm cuff, squeeze bulb, gauge and a stethoscope. This is most likely what your doctor or nurse practitioner uses when you go into the office for a visit.

 

There are also automatic monitors, much like the one in your local pharmacy and home usage. These are powered by batteries, usually a pump, and have a cuff that attaches to your upper arm. These monitors are easier to use. The only monitors that are recommended are upper arm models and wrist models should not be used. The machine at your local pharmacy may be tempting, but according to a study from The Journal of Family Practice, the machines at local pharmacies aren’t calibrated as often as they should be. It’s also possible the cuff won’t fit you, meaning your reading isn’t accurate.

If you want to monitor your blood pressure at home, you should purchase an automatic upper arm model for about $60-80. Models that have been shown to be accurate are made by Omron and HoMedics. Be sure to place the cuff on your arm and sit for 3-5 minutes to obtain an accurate reading. If you do not rest before the readings, the measurements will be TOO HIGH. Also, remember that blood pressure is very variable and you will see some high and some low readings, which is normal. Write down the readings and share these with your physician.

This article was originally published on December 15, 2014, and was updated on February 2, 2017.

Five ways to beat the winter blues

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Winter can be a rough time for many. The days are short, temperatures are low and sometimes it’s a struggle to get out of bed. Here are five ways to help lift your spirits and help you feel happier.

1. Utilize light. People with seasonal affective disorder (SAD) (a form of depression that begins as weather gets cold and days get shorter, and fades as the weather warms up) may feel depressed, irritable and have trouble waking in the morning, especially when it’s still dark out. Studies show that a dawn simulator, which causes the lights in your room to gradually brighten over a set period of time, can serve as an antidepressant and make it easier to get out of bed. Additionally, sitting next to a light box (10,000 lux) for 30 minutes per day can be as effective as antidepressant medication.

2. Listen to music. Does an upbeat song ever make you feel happy? A 2013 study from the University of Missouri confirms listening to upbeat music can significantly improve your mood in both the short term and long term.

3. Stay active. A 2005 study from Harvard suggests exercising every day for about 30 minutes improves symptoms of mild to moderate depression.

4. Eat smarter. Certain foods, like fresh fruits and omega-3 fatty foods, can help boost your mood, whereas carb-heavy and caffeine-heavy foods can impact your mood negatively. There are plenty of seasonal produce available in the winter like cranberries, oranges, winter squash and kale.

5. Laugh. Laughter helps stimulate processes in your brain that counter depression symptoms and blood pressure. Your local library should have plenty of comedy movies and TV shows to help you laugh.

Five Winter Activities that Double as Exercise

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This time of year is primed for turkey, pumpkin pie and cookies. We often spend as much time baking cookies as we do shoveling snow. So how do you work in a workout? Good news! Some common winter activities can double as workouts. So gather the family and be prepared to work up a good sweat:

Shoveling snow. This necessary evil in winter can help you burn more than 250 calories an hour. Just make sure you’re lifting with your knees, not your back, and using an ergonomic shovel to minimize stress on your back.

Sledding. Remember how tired you got as a kid running up the hill with your sled in hand? Try it as an adult. You’re guaranteed to have fun heading down the hill at top speeds, and if you last for 30 minutes you’ll burn about 200 calories.

Ice skating. You don’t have to be as skilled as Nancy Kerrigan or as agile as Brian Boitano. Just 30 minutes of light skating will burn upwards of 200 calories.

Playing in the snow. Building a snowman, snow angels and snowball fights have always been winter classics, but did you know they also help you burn calories? If you play in the snow for at least an hour you can burn between 200-350 calories.

Skiing and snowboarding. If you’re looking for a more intense workout, while still being outside in the snow, skiing and snowboarding is your best bet. Depending on your fitness level, and your skills, you can burn upwards of 300 calories per hour.

Make sure to bundle up, stay hydrated and have fun.

This article was originally published on December 20, 2014, and was updated on December 12, 2016.

Urgent Care Vs. Emergency Room

We’ve all been there as patients; sick on the weekend, trip and twist an ankle. What do you do if your primary care doctor is gone for the day or weekend?

Non-life-threatening emergencies can be treated at an urgent care. If you’re having a life-threatening emergency such as chest pain or a serious head injury, a trip to the emergency room is in order.

What is considered an emergency?

  • severe chest pain or difficulty breathing
  • compound fracture (bone protrudes through skin)
  • convulsions, seizures or loss of consciousness
  • fever in newborn younger than 3 months old
  • deep knife or gunshot wounds
  • moderate to severe burns covering a large area of the body
  • poisoning
  • severe head, neck or back injury
  • pregnancy-related problems
  • severe abdominal pain
  • signs of a heart attack (chest pain lasting longer than two minutes)
  • signs of stroke (loss of vision, sudden numbness, weakness, slurred speech)
  • suicidal or homicidal feelings

What is considered a non-life-threatening urgent medical condition?

  • accidents and falls resulting in extremity or minor head injury
  • sprains and strains
  • back pain
  • breathing difficulties (mild to moderate asthma)
  • bleeding/cuts (requiring sutures)
  • eye irritation and redness
  • fever or flu
  • vomiting, diarrhea or dehydration
  • severe sore throat or cough
  • minor broken bones and fractures (fingers, toes)
  • skin rashes and infections
  • urinary tract infections
  • mild to moderate allergic reactions
  • seasonal allergies
  • headaches

If you’re in doubt, get it checked out. Sometimes you may feel fine after a trip or fall, but could/will feel worse the next day when inflammation and pain set in.

IHA Call Center Triage Nurses and Office Triage Nurses can be utilized to assist in decision making on where to go. Call us first: 734.995.2950

IHA has three urgent care locations and one after hours location, all open after normal work hours and on the weekends, with slightly altered hours on holidays. Click here for a comprehensive service list for our locations.

Locations

IHA After Hours Care – Brighton

IHA Urgent Care – Domino’s Farms

IHA Urgent Care – Livingston

IHA Urgent Care – WestArbor

This article was originally published on September 29, 2014, and was updated on November 18, 2016.

Recipe: Herb Roasted Butternut Squash with Pecans

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Together with St. Joseph Mercy Ann Arbor’s Executive Chef, Ryan Kendall, we’re bringing you a delicious and healthy side dish that would be perfect for Thanksgiving, or any time of the year: Herb Roasted Butternut Squash with Pecans.

Butternut squash are rich in antioxidants, low in fat, high in dietary fiber, with significant amounts of potassium and vitamin B6. With a one-cup serving, you get nearly half the daily recommended dose of vitamin C!

To choose a butternut squash, look for one that’s unblemished and seems heavy with a matte skin. Uncut butternut squash can be stored in a cool, dry place (not the refrigerator) for up to three months.

When you’re ready to cook the Herb Roasted Butternut Squash with Pecans, you’ll need to gather the following ingredients and materials:

large knife
spoon
wide vegetable peeler
cookie sheet
mixing bowl
sheet pan
3 large butternut squash
2 tbsp extra virgin olive oil
1 tbsp paprika
½ tsp kosher salt
¼ tsp black pepper
1 tsp fresh parsley
1 tsp fresh sage
1 tsp fresh thyme
1 tsp fresh rosemary
½ cup chopped pecans
¼ cup agave nectar

Preheat the oven to 350 degrees

Start by cutting off the top and bottom ends to make them both flat. Then cut the squash lengthwise into halves. The seeds will be in the bottom, use a spoon to scrape them out and discard.

Using a vegetable peeler, peel each half. Usually a downward motion, away from you, is the easiest. Slice the halves into ½” to 1” chunks, as uniformed in size as possible.

On a separate tray, spread out the pecans and toast in the oven for 5 minutes.

In a large mixing bowl, toss squash with olive oil and add herbs and seasonings. Coat pieces will.

Place squash on sprayed or oiled sheet pan in the oven and roast for 25-45 minutes (depending on the size of your squash pieces) until tender.

Remove from sheet pan and place in serving dish. Toss lightly with pecans and drizzle with agave nectar. Serve warm.

This article was originally published on November 21, 2014, and was updated on October 27, 2016.

Flu Vaccine Updates

 

We strongly encourage you and your family be vaccinated! For ease of convenience, we’re offering all flu shots to be scheduled online, or by calling your office directly. When scheduling them online, please schedule one person per appointment time. If you have questions or concerns, please contact your physician’s office.

 

 

Peripheral artery disease and IHA’s outpatient endovascular center

Peripheral artery disease (PAD) is a blood disease of the legs, where plaque builds up in the arteries.

Plaque is made up of fat, cholesterol, calcium and other substances in the blood. When you develop PAD your extremities, usually your legs, don’t receive enough blood flow, which causes symptoms such as leg pain or calf cramping when walking. You have a higher chance of contracting PAD if you have diabetes and/or smoke.

 

Most cases of PAD are treatable, although in very serious cases, PAD can lead to leg amputation. At IHA Vascular & Endovascular Specialists, we have an outpatient center equipped to perform the most up-to-date procedures for PAD, if it’s necessary. We try non-surgical options first, such as a medication and lifestyle changes, and work our way toward surgery if it’s needed.

In our outpatient endovascular center, we can perform many minimally-invasive procedures, which will allow the patient to avoid the hospital. We also strive to perform minimally-invasive procedures, which allows the patient less downtime and a faster recovery.

If you have leg pain when you walk or climb stairs, talk to your doctor. Some older adults associate leg pain with the aging process; however the cause of pain could be PAD.

This article was originally published on April 7, 2016, and was updated on September 19, 2016.

Making Halloween safe and inclusive for kids with allergies

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When a child has food allergies, Halloween can be a scary time. The small candy wrappers often do not contain lists of ingredient, making it nearly impossible to make sure your little one is eating a treat that’s safe for them. When your child has an egg, milk, nut or soy allergy, how do you make sure they’re safe and can have a fun Halloween experience?

The Food Allergy Research & Education (FARE) organization started the Teal Pumpkin Project, which encourages people to place a teal painted pumpkin outside their door if they’re offering non-food treats, such as stickers or small toys, to trick-or-treaters.

It’s a small step to make sure all children can be a part of the fun on Halloween, and it allows the parent to know their children will be safe without a bag full of candy they may or may not be able to eat safely.

If you’re interested in participating, it’s very simple! Place a teal painted pumpkin outside your door to let trick-or-treaters and their parents know you have non-food items, and pass them out like you normally would. Some kids may ask for them knowing they can’t have dairy, soy or nuts. It’s best to keep the non-food treats in a separate bowl or container, so extra safety from cross-contamination. FARE has printable materials available for you to display to let others know there are non-food items available at your home.

This article was originally published on September 30, 2015, and was updated on September 7, 2016.

All about menstrual cups

For years, women have relied on pads or tampons during their period. But, recently menstrual cups have become more popular and more widely available.
A menstrual cup is a flexible cup that is designed for use inside the vagina during your period to collect the menstrual blood. Menstrual cups are usually made of medical grade silicone, but some can be made from latex.

You can use a cup throughout your entire cycle, some users only need to empty it once every 12 hours, and some empty it more often on their heavier days.

A menstrual cup is a more expensive up-front purchase than a box of tampons or pads, however it can last for up to ten years, providing you with a significant cost-savings, and less waste. You also get more time between changes.

It’s also surprisingly easy to use. If you currently use tampons, or have used a diaphragm, you should have little trouble learning to use a cup. It folds up to a size similar to a tampon for insertion. When properly inserted, the wearer shouldn’t feel it at all, much like using a tampon.

There are some potential drawbacks to using a cup. Some women aren’t comfortable inserting them or have fit problems. That’s OK! A menstrual cup isn’t for everyone, but it’s an alternative for women looking for something different.

If you have any questions about a menstrual cup, ask during your next routine gynecological exam. Your provider can help you determine if you should give a menstrual cup a try and can help alleviate any concerns you may have.