Tag Archives: Blood flow

High Blood Pressure (Hypertension)

Introduction

hypertension-34

Hypertension (aka high blood pressure) is called the silent killer. It’s common for me to see someone who thought they were ‘fine’ drop dead from its effects, never knowing it was about to happen and not having been aware of the warning signs and risk factors.

In lay terms, your heart is just a muscular pump pushing blood (containing oxygen and nutrients) around the body keeping stuff alive. The more you poison that pump (by ingesting unhealthy foods and inhaling other toxins) and strain the muscle by adding weight and clogging its vessels so it has to pump against more force (by being obese, not exercising and engaging in other unhealthy behaviors), the more likely that muscle is to strain until it gives out. Once it does, blood isn’t delivering what’s needed to your vital organs, and that’s when bad stuff happens.
hypertension

Organs Placed at Risk by High Blood Pressure

The vital organs in question and those bad effects include the following:
• The heart itself (no blood flow and no oxygen = heart attack; when the heart’s not strong enough to pump blood around the body = congestive heart failure)
• The blood vessels, especially the heart’s main offshoot, the aorta (too much strain = aneurysm, an outpouching from the main tubular system, stealing valuable blood from the rest of the body)
• The brain (no blood flow and no oxygen = stroke; aneursyms also occur in the brain)
• The kidneys (not enough blood flow or adequate enough function to clear the toxins from the kidney = renal failure)
• The eyes (poor blood flow and/or diseased eye blood vessels leads to vision loss)

blood_pressure_5_treat-img_1280x720-jpg

 

The Bottom Line on Hypertension

The heart is a muscle best thought of as a machine. Here’s three easy things you can do to reduce your risks.
• Get off your rump. Any exercise helps to get your heart pumping and blood flowing; strive for 20” three times a week at the very least.
• Close your mouth. Everything in moderation is cool, but introduce some fruits and vegetables into your life.
• Lose the salt shaker. At least taste your food first. It’s likely the food was already prepared with salt.

Did I mention to stop smoking? Any questions?

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

End of Life Decision Making

Introduction

This Straight, No Chaser post addresses considerations related to end of life decision making.

Having this conversation when death is staring you or a loved one in the face is not the most ideal situation. Do you have a living will? Do you know what advance directives are? Have you assigned a healthcare power of attorney? For the overwhelming majority of you who do not, I hope to turn those answers to “Yes.”

I’m not talking about anyone’s fictitious “death panels.” What I’m describing are the legal tools at your disposal that enable you to control the circumstances surrounding your death. It needs to sink in: at any age your life could be at risk, and at any age you could die. When your life is threatened, if you have specific desires, someone will need comply with decisions you have made. It could happen today. You need protect yourself – now. You’re much more protected having declared your interests and desires than not. Read on.

Advanced Directives

AdvanceDirective

Simply put, advance directives should result after a thoughtful conversation between you and your loved one(s) and subsequently with your healthcare provider. Advance directives document your preferences on what specific decisions should and shouldn’t be made in an effort to save your life or allow your life to end. Here are some of the decisions covered by advanced directives. They don’t all have to be addressed. You may just include the ones of interest to you, leaving discretion to your physicians and/or family just as may have occurred, say, when you weren’t in a coma.

Items to Consider

  • Do you care to be intubated? The use of breathing tubes to either protect your airway or breathe for you when you’re unable to is a big deal. The decision to accept or forego this might be an immediately life-prolonging or life-ending decision.
  • Do you care to have advanced cardiac life support in the event that your heart either stops or is unstable? As with intubation, there’s an immediacy to this decision that’s better addressed in a moment of quiet reflection than in the emotion of crisis.
  • Do you want transfusions of blood or other blood products? Some religions have strong declarations on the topic. If you haven’t made your decision not to receive blood known in a legal document, and you are unable to express that decision in a life or death situation, physicians will try to save your life with an infusion. They will not adhere to your choice, because they won’t know what it is. That scenario doesn’t have to happen.
  • Do you want “every possible thing done for you,” or might there be a limit in the face of perceived medical futility (i.e., minimal chance of any success)? Basically, this question gets at whether you’d like to go in peace or in a blaze of resuscitative glory and heroic effort.
    • If you’re in the midst of a terminal illness and/or are comatose with no perceptible chance of recovery, will you want medicines and treatments (such as dialysis to remove toxins from your body) to ease pain and suffering, or will you want to be allowed to die?
    • Will you want the medical staff to feed you if you can’t feed yourself?
    • Will you want to donate your organs?

endoflifedeath

As you can see, these are serious questions to consider. I’d hope you’d agree they are worthy of conversation well in advance of a tragedy. In our next post, I’ll discuss some related logistical considerations around end-of–life care and decision-making. I hope this has you thinking and planning on having important conversations.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: High Blood Pressure (Hypertension)

hypertension-34

High blood pressure is called the silent killer. It’s common for me to see someone who thought they were ‘fine’ drop dead from its effects, never knowing it was about to happen and not having been aware of the warning signs and risk factors.
In lay terms, your heart is just a muscular pump pushing blood (containing oxygen and nutrients) around the body keeping stuff alive. The more you poison that pump (by ingesting unhealthy foods and inhaling other toxins) and strain the muscle by adding weight and clogging its vessels so it has to pump against more force (by being obese, not exercising and engaging in other unhealthy behaviors), the more likely that muscle is to strain until it gives out. Once it does, blood isn’t delivering what’s needed to your vital organs, and that’s when bad stuff happens.
bloodpressureThe vital organs in question and those bad effects include the following:
• The heart itself (no blood flow and no oxygen = heart attack; when the heart’s not strong enough to pump blood around the body = congestive heart failure)
• The blood vessels, especially the heart’s main offshoot, the aorta (too much strain = aneurysm, an outpouching from the main tubular system, stealing valuable blood from the rest of the body)
• The brain (no blood flow and no oxygen = stroke; aneursyms also occur in the brain)
• The kidneys (not enough blood flow or adequate enough function to clear the toxins from the kidney = renal failure)
• The eyes (poor blood flow and/or diseased eye blood vessels leads to vision loss)

blood_pressure_5_treat-img_1280x720-jpg

Bottom line: The heart is a muscle best thought of as a machine. Here’s three easy things you can do to reduce your risks.
• Get off your butt. Any exercise helps to get your heart pumping and blood flowing; strive for 20” three times a week at the very least.
• Close your mouth. Everything in moderation is cool, but introduce some fruits and vegetables into your life.
• Lose the salt shaker. At least taste your food first. It’s likely the food was already prepared with salt.
Did I mention stop smoking? Any questions?
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: End of Life Decision Making

end-of-life_tcm7-91616

Having this conversation when death is staring you or a loved one in the face is not the most ideal situation. Do you have a living will? Do you know what advance directives are? Have you assigned a healthcare power of attorney? For the overwhelming majority of you who do not, I hope to turn those answers to “Yes.”
I’m not talking about anyone’s fictitious “death panels.” What I’m describing are the legal tools at your disposal that enable you to control the circumstances surrounding your death. It needs to sink in: at any age your life could be at risk, and at any age you could die. When your life is threatened, if you have specific desires, you’ll need someone comply with decisions. It could happen today. You need to be protected now. You’re much more protected having declared your interests and desires than not. Read on.

AdvanceDirective

Simply put, advance directives should result after a thoughtful conversation between you and your loved one(s) and subsequently with your healthcare provider. Advance directives document your preferences on what specific decisions should and shouldn’t be made in an effort to save your life or allow your life to end. Here are some of the decisions that can be covered by advanced directives. They don’t all have to be addressed. You may just include the ones of interest to you, leaving discretion to your physicians and/or family just as may have occurred, say, when you weren’t in a coma.

  • Do you care to be intubated? The use of breathing tubes to either protect your airway or breathe for you when you’re unable to is a big deal. The decision to accept or forego this might be an immediately life-prolonging or life-ending decision.
  • Do you care to have advanced cardiac life support in the event that your heart either stops or is unstable? As with intubation, there’s an immediacy to this decision that’s better addressed in a moment of quiet reflection than in the emotion of crisis.
  • Do you want transfusions of blood or other blood products? Some religions have strong declarations on the topic. If you haven’t made your decision not to receive blood known in a legal document, and you are unable to express that decision in a life or death situation, physicians will try to save your life with an infusion. They will not adhere to your choice, because they won’t know what it is. That scenario doesn’t have to happen.
  • Do you want “every possible thing done for you,” or might there be a limit in the face of perceived medical futility (i.e., minimal chance of any success)? Basically, this question gets at whether you’d like to go in peace or in a blaze of resuscitative glory and heroic effort.
    • If you’re in the midst of a terminal illness and/or are comatose with no perceptible chance of recovery, will you want medicines and treatments (such as dialysis to remove toxins from your body) to ease pain and suffering, or will you want to be allowed to die?
    • Will you want the medical staff to feed you if you can’t feed yourself?
    • Will you want to donate your organs?

endoflifedeath

As you can see, these are serious questions to consider, and I’d hope you’d agree they are worthy of conversation well in advance of a tragedy. In my next post, I’ll discuss some related logistical considerations around end-of–life care and decision-making. I hope this has gotten you to thinking and planning on having important conversations.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: High Blood Pressure (Hypertension)

hypertension-34

High blood pressure is called the silent killer. It’s common for me to see someone who thought they were ‘fine’ drop dead from its effects, never knowing it was about to happen and not having been aware of the warning signs and risk factors.
In lay terms, your heart is just a muscular pump pushing blood (containing oxygen and nutrients) around the body keeping stuff alive. The more you poison that pump (by ingesting unhealthy foods and inhaling other toxins) and strain the muscle by adding weight and clogging its vessels so it has to pump against more force (by being obese, not exercising and engaging in other unhealthy behaviors), the more likely that muscle is to strain until it gives out. Once it does, blood isn’t delivering what’s needed to your vital organs, and that’s when bad stuff happens.
bloodpressureThe vital organs in question and those bad effects include the following:
• The heart itself (no blood flow and no oxygen = heart attack; when the heart’s not strong enough to pump blood around the body = congestive heart failure)
• The blood vessels, especially the heart’s main offshoot, the aorta (too much strain = aneurysm, an outpouching from the main tubular system, stealing valuable blood from the rest of the body)
• The brain (no blood flow and no oxygen = stroke; aneursyms also occur in the brain)
• The kidneys (not enough blood flow or adequate enough function to clear the toxins from the kidney = renal failure)
• The eyes (poor blood flow and/or diseased eye blood vessels leads to vision loss)

blood_pressure_5_treat-img_1280x720-jpg

Bottom line: The heart is a muscle best thought of as a machine. Here’s three easy things you can do to reduce your risks.
• Get off your butt. Any exercise helps to get your heart pumping and blood flowing; strive for 20” three times a week at the very least.
• Close your mouth. Everything in moderation is cool, but introduce some fruits and vegetables into your life.
• Lose the salt shaker. At least taste your food first. It’s likely the food was already prepared with salt.
Did I mention stop smoking? Any questions?
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: End of Life Decision Making

end-of-life_tcm7-91616

Having this conversation when death is staring you or a loved one in the face is not the most ideal situation. Do you have a living will? Do you know what advance directives are? Have you assigned a healthcare power of attorney? For the overwhelming majority of you who do not, I hope to turn those answers to “Yes.”
I’m not talking about anyone’s fictitious “death panels.” What I’m describing are the legal tools at your disposal that enable you to control the circumstances surrounding your death. It needs to sink in: at any age your life could be at risk, and at any age you could die. When your life is threatened, if you have specific desires, you’ll need someone comply with decisions. It could happen today. You need to be protected now. You’re much more protected having declared your interests and desires than not. Read on.

AdvanceDirective

Simply put, advance directives should result after a thoughtful conversation between you and your loved one(s) and subsequently with your healthcare provider. Advance directives document your preferences on what specific decisions should and shouldn’t be made in an effort to save your life or allow your life to end. Here are some of the decisions that can be covered by advanced directives. They don’t all have to be addressed. You may just include the ones of interest to you, leaving discretion to your physicians and/or family just as may have occurred, say, when you weren’t in a coma.

  • Do you care to be intubated? The use of breathing tubes to either protect your airway or breathe for you when you’re unable to is a big deal. The decision to accept or forego this might be an immediately life-prolonging or life-ending decision.
  • Do you care to have advanced cardiac life support in the event that your heart either stops or is unstable? As with intubation, there’s an immediacy to this decision that’s better addressed in a moment of quiet reflection than in the emotion of crisis.
  • Do you want transfusions of blood or other blood products? Some religions have strong declarations on the topic. If you haven’t made your decision not to receive blood known in a legal document, and you are unable to express that decision in a life or death situation, physicians will try to save your life with an infusion. They will not adhere to your choice, because they won’t know what it is. That scenario doesn’t have to happen.
  • Do you want “every possible thing done for you,” or might there be a limit in the face of perceived medical futility (i.e., minimal chance of any success)? Basically, this question gets at whether you’d like to go in peace or in a blaze of resuscitative glory and heroic effort.
  • If you’re in the midst of a terminal illness and/or are comatose with no perceptible chance of recovery, will you want medicines and treatments (such as dialysis to remove toxins from your body) to ease pain and suffering, or will you want to be allowed to die?
  • Will you want the medical staff to feed you if you can’t feed yourself?
  • Will you want to donate your organs?

endoflifedeath

As you can see, these are serious questions to consider, and I’d hope you’d agree they are worthy of conversation well in advance of a tragedy. In my next post, I’ll discuss some related logistical considerations around end-of–life care and decision-making. I hope this has gotten you to thinking and planning on having important conversations.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: End of Life Decision Making

end-of-life_tcm7-91616

Having this conversation when death is staring you or a loved one in the face is not the most ideal situation. Do you have a living will? Do you know what advance directives are? Have you assigned a healthcare power of attorney? For the overwhelming majority of you who do not, I hope to turn those answers to “Yes.”
I’m not talking about anyone’s fictitious “death panels.” What I’m describing are the legal tools at your disposal that enable you to control the circumstances surrounding your death. It needs to sink in: at any age your life could be at risk, and at any age you could die. When your life is threatened, if you have specific desires, you’ll need someone comply with decisions. It could happen today. You need to be protected now. You’re much more protected having declared your interests and desires than not. Read on.

AdvanceDirective

Simply put, advance directives should result after a thoughtful conversation between you and your loved one(s) and subsequently with your healthcare provider. Advance directives document your preferences on what specific decisions should and shouldn’t be made in an effort to save your life or allow your life to end. Here are some of the decisions that can be covered by advanced directives. They don’t all have to be addressed. You may just include the ones of interest to you, leaving discretion to your physicians and/or family just as may have occurred, say, when you weren’t in a coma.

  • Do you care to be intubated? The use of breathing tubes to either protect your airway or breathe for you when you’re unable to is a big deal. The decision to accept or forego this might be an immediately life-prolonging or life-ending decision.
  • Do you care to have advanced cardiac life support in the event that your heart either stops or is unstable? As with intubation, there’s an immediacy to this decision that’s better addressed in a moment of quiet reflection than in the emotion of crisis.
  • Do you want transfusions of blood or other blood products? Some religions have strong declarations on the topic. If you haven’t made your decision not to receive blood known in a legal document, and you are unable to express that decision in a life or death situation, physicians will try to save your life with an infusion. They will not adhere to your choice, because they won’t know what it is. That scenario doesn’t have to happen.
  • Do you want “every possible thing done for you,” or might there be a limit in the face of perceived medical futility (i.e., minimal chance of any success)? Basically, this question gets at whether you’d like to go in peace or in a blaze of resuscitative glory and heroic effort.
  • If you’re in the midst of a terminal illness and/or are comatose with no perceptible chance of recovery, will you want medicines and treatments (such as dialysis to remove toxins from your body) to ease pain and suffering, or will you want to be allowed to die?
  • Will you want the medical staff to feed you if you can’t feed yourself?
  • Will you want to donate your organs?

endoflifedeath

As you can see, these are serious questions to consider, and I’d hope you’d agree they are worthy of conversation well in advance of a tragedy. In my next post, I’ll discuss some related logistical considerations around end-of–life care and decision-making. I hope this has gotten you to thinking and planning on having important conversations.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: End of Life Decision Making

AdvanceDirective

Do you have a living will? Do you know what advance directives are? Have you assigned a healthcare power of attorney? For the overwhelming majority of you who do not, I hope to turn those answers to “Yes.” I’m not talking about anyone’s fictitious “death panels.” What I’m describing are the legal tools at your disposal that enable you to control the circumstances surrounding your death. Please understand that at any age your life could be at risk, you could die, and you could need someone comply with decisions; as such, you need to be protected now. You’re much more protected having declared your interests and desires than not. Read on.
Simply put, advance directives should result after a thoughtful conversation between you and your loved one(s) and, subsequently, with your healthcare provider. Advance directives document your preferences on what specific decisions should and shouldn’t be made in an effort to save your life or allow your life to end. Here are some of the decisions that can be covered by advanced directives. They don’t all have to be addressed. You may just include the ones of interest to you, leaving discretion to your physicians and/or family just as may have occurred, say, when you weren’t in a coma.

  • Do you care to be intubated? The use of breathing tubes to either protect your airway or breathe for you when you’re unable to is a big deal. The decision to accept or forego this might be an immediately life-prolonging or life-ending decision.
  • Do you care to have advanced cardiac life support in the event that your heart either stops or is unstable? As with intubation, there’s an immediacy to this decision that’s better addressed in a moment of quiet reflection than in the emotion of crisis.
  • Do you want transfusions of blood or other blood products? Some religions have strong declarations on the topic. If you haven’t made your decision not to receive blood known in a legal document and you are unable to express that decision in a life or death situation, physicians will try to save your life with an infusion. They will not adhere to your choice, because they won’t know what it is. That doesn’t have to happen.
  • Do you want “every possible thing done for you,” or might there be a limit in the face of perceived medical futility (i.e., minimal chance of any success)? Basically, this question gets at whether you’d like to go in peace or in a blaze of resuscitative glory and heroic effort.
  • If you’re in the midst of a terminal illness and/or are comatose with no perceptible chance of recovery, will you want medicines and treatments (such as dialysis to remove toxins from your body) to ease pain and suffering or will you want to be allowed to expire?
  • Will you want the medical staff to feed you if you can’t feed yourself?
  • Will you want to donate your organs?

As you can see, these are serious questions to consider, and I’d hope you’d agree they are worthy of conversation well in advance of a tragedy. In my next post, I’ll discuss some related logistical considerations around end-of–life care and decision-making. I hope this has gotten you to thinking and planning on having important conversations.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Skin Problems of Diabetics, Part 1

diabetes_foot_problems_s12_ulcers

If you are diabetic or caring for a diabetic, one of the things you’ve likely noticed is that the skin doesn’t always seem to look, feel or perform normally. Perhaps the first thing I’d want you to know as a means of understanding what’s going on is this combination of facts: the skin is the body’s largest organ and diabetics have issues with blood flow. Given all the area needing blood flow, it stands to reason that diabetics invariably would have skin problems.
On a practical level, appreciate that infections are the most common cause of death in diabetics. Even a small cut or scratch in this population can lead to loss of a limb if unrecognized and left untreated. Unfortunately, amputations among diabetics  happens all too often. Is it preventable? With 100% confidence, yes. You can sufficiently reduce your risk of this ever happening. That said, there’s a reality that approximately 1/3 of all diabetes will have some type of skin problem, ranging from eczema and other localized itching problems to infections, abscesses, and gangrene.
By now you are likely wondering two things: How does this happen, and how can I prevent/help this?
First, diabetics suffer from frequent and excessive urination from those high blood glucose levels. This can lead to dehydration. Dehydrated skin is dry, red and has a waxy appearance. It becomes cracked, itchy, easily injured, harder to heal and easier to infect. Remember how diabetics have problems with poor blood circulation? That reduces the bodies’ ability to fight infections. So the first course of action for diabetics (beyond understanding the risks) is to be diligent in preventing infection.
I will dedicate a separate post to give you all the knowledge you need to prevent diabetic cuts, scratches and skin infections or to have them treated. In the meantime, the same rules apply to diabetics as they do to everyone else: an ounce of prevention is worth a pound of care. Diet and exercise can stave off the day when you’re fighting for your life because of a diabetic foot ulcer.
Click here for an explanation of basic facts about diabetes.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: High Blood Pressure

bp_chartbloodpressure
High blood pressure is called the silent killer. It’s common for me to see someone who thought they were ‘fine’ drop dead from its effects, never knowing it was about to happen and not having been aware of the warning signs and risk factors.
In lay terms, your heart is just a muscular pump pushing blood (containing oxygen and nutrients) around the body keeping stuff alive. The more you poison that pump (by ingesting unhealthy foods and inhaling other toxins) and strain the muscle by adding weight and clogging its vessels so it has to pump against more force (by being obese, not exercising and engaging in other unhealthy behaviors), the more likely that muscle is to strain until it gives out. Once it does, blood isn’t delivering what’s needed to your vital organs, and that’s when bad stuff happens.
The vital organs in question and those bad effects include the following:
• The heart itself (no blood flow and no oxygen = heart attack; when the heart’s not strong enough to pump blood around the body = congestive heart failure)
• The blood vessels, especially the heart’s main offshoot, the aorta (too much strain = aneurysm, an outpouching from the main tubular system, stealing valuable blood from the rest of the body)
• The brain (no blood flow and no oxygen = stroke; aneursyms also occur in the brain)
• The kidneys (not enough blood flow or adequate enough function to clear the toxins from the kidney = renal failure)
• The eyes (poor blood flow and/or diseased eye blood vessels leads to vision loss)
Bottom line: The heart is a muscle best thought of as a machine. Here’s three easy things you can do to reduce your risks.
Get off your butt. Any exercise helps to get your heart pumping and blood flowing; strive for 20” three times a week at the very least.
Close your mouth. Everything in moderation is cool, but introduce some fruits and vegetables into your life.
Lose the salt shaker. At least taste your food first. It’s likely the food was already prepared with salt.
Did I mention stop smoking? Any questions?
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: End of Life Decision Making

AdvanceDirective
Do you have a living will? Do you know what advance directives are? Have you assigned a healthcare power of attorney? For the overwhelming majority of you who do not, I hope to turn those answers to “Yes.” I’m not talking about anyone’s fictitious “death panels.” What I’m describing are the legal tools at your disposal that enable you to control the circumstances surrounding your death. Please understand that at any age your life could be at risk, you could die, and you could need someone comply with decisions; as such, you need to be protected now. You’re much more protected having declared your interests and desires than not. Read on.
Simply put, advance directives should result after a thoughtful conversation between you and your loved one(s) and, subsequently, with your healthcare provider. Advance directives document your preferences on what specific decisions should and shouldn’t be made in an effort to save your life or allow your life to end. Here are some of the decisions that can be covered by advanced directives. They don’t all have to be addressed. You may just include the ones of interest to you, leaving discretion to your physicians and/or family just as may have occurred, say, when you weren’t in a coma.

  • Do you care to be intubated? The use of breathing tubes to either protect your airway or breathe for you when you’re unable to is a big deal. The decision to accept or forego this might be an immediately life-prolonging or life-ending decision.
  • Do you care to have advanced cardiac life support in the event that your heart either stops or is unstable? As with intubation, there’s an immediacy to this decision that’s better addressed in a moment of quiet reflection than in the emotion of crisis.
  • Do you want transfusions of blood or other blood products? Some religions have strong declarations on the topic. If you haven’t made your decision not to receive blood known in a legal document and you are unable to express that decision in a life or death situation, physicians will try to save your life with an infusion. They will not adhere to your choice, because they won’t know what it is. That doesn’t have to happen.
  • Do you want “every possible thing done for you,” or might there be a limit in the face of perceived medical futility (i.e., minimal chance of any success)? Basically, this question gets at whether you’d like to go in peace or in a blaze of resuscitative glory and heroic effort.
  • If you’re in the midst of a terminal illness and/or are comatose with no perceptible chance of recovery, will you want medicines and treatments (such as dialysis to remove toxins from your body) to ease pain and suffering or will you want to be allowed to expire?
  • Will you want the medical staff to feed you if you can’t feed yourself?
  • Will you want to donate your organs?

As you can see, these are serious questions to consider, and I’d hope you’d agree they are worthy of conversation well in advance of a tragedy. In my next post, I’ll discuss some related logistical considerations around end-of–life care and decision-making. I hope this has gotten you to thinking and planning on having important conversations.

Straight, No Chaser: This is Specifically For the Faint of Heart

faint
Don’t faints seem mysterious?  It’s as if your computer crashed and had to reboot.  Although we never seemingly figure out why computers are so crazy, fainting (syncope) is reducible to a common denominator: something causes a decrease in blood flow to your brain.  Recall that oxygen and other needed nutrients are carried in blood, so even a temporary stoppage or shortage of blood flow shuts things down.  Now extrapolate that to strokes and comas, which are often due to serious and prolonged causes of blockage to the blood vessels supplying the brain.  This is a prime example of why good blood flow and good health are so important.  The brain is a highly efficient, oxygen and energy-guzzling organ.  Shut it down for even a few seconds, and bad things start to happen.  Consider fainting a warning sign.
I’m going to start by offering some Quick Tips to help if you find yourself around someone who has fainted.  Then, I will get into the weeds of why these things happen for those interested.  I’m doing this so you can check these and determine where your risks may be.

  • Call 911.  Make sure the person is still breathing and has a pulse.  If not, start CPR.
  • Loosen clothing, especially around the neck.
  • Elevate the legs above the level of the chest.
  • If the fainter vomited, turn him/her to the side to help avoid choking and food going down the airway (aspiration).
  • A diabetic may have been given instructions to eat or drink something if s/he feels as if s/he is going to faint.  If you know this, a faint would be a good time to administer any glucose gel or supplies advised by a physician.  Prompt treatment of low blood sugar reactions is a life-saver.  Discuss and coordinate how you can perform this effort on behalf of your friends and family with their physicians.
  • If it’s possible that the faint is part of some heat emergency (heat exhaustion or heat stroke), follow these steps to save a life (click here).

Actually, faints are caused by all kinds of medical problems.  I list a few notable causes below, but whether the front end difficulty is with the heart pumping, the nerves conducting, or the content of oxygen or energy being delivered, the end result is the same.

  • Decreased nerve tone (vasovagal syncope): This is the most common cause of faints, and contrary to what you might think, it happens more often in kids and young adults than in the elderly.  Understand that your nerves actually regulate blood flow (analogous to a train conductor telling the heart to speed up or pump harder or not).  Changes in nerve tone can result in errant signals being sent, transiently resulting in low flow.
  • Diseases and conditions that affect the nervous system and/or ability to regulate blood pressure: Alcoholism, dehydration, diabetes and malnutrition are conditions that may depress the nervous system.  Alternatively, coughing, having a bowel movement (especially if straining) and urination may abnormally stimulate the system.  In the elderly and those bedridden, simply standing can cause fainting due to difficulty regulating blood pressure.  In this case, standing causes a sharp drop in blood pressure.
  • Anemia: A deficiency in blood cells can lead to a deficiency in oxygen delivery to the brain.
  • Arrhythmias (irregular heart beats): Inefficiency in your heartbeat leads to unstable delivery of blood to the brain.
  • Low blood sugar (hypoglycemia): Low energy states can deplete the body of what it needs to operate effectively, leading to low blood flow.
  • Medications (especially those treating high blood pressure): anything that lowers the heart’s ability to vigorously pump blood around the body can leave the brain inadequately supplied, leading to a blackout.  Let’s include illicit drugs and alcohol in this category.
  • Panic attacks: Hyperventilation caused by anxiety and panic upset the balance between oxygen and carbon dioxide in the brain, which can lead to fainting spells.
  • Seizures: Here’s a chicken and egg scenario.  A prolonged faint can lead to a seizure, and seizures lead to periods of unconsciousness, during and after the seizure.  The lack of oxygen is a common denominator.