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Heart Disease

Heart disease affects an estimated 62 million Americans, more than any other illness. Laurie Anderson RN FNP MSN is here to share information and advice on heart disease, its symptoms, treatments, and prevention.

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Saturday, September 22, 2007

Fleas, Books, and Heart Disease (or Why I've Been Missing)
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Time flies doesn't it? I hate it when my favorite bloggers don't post for weeks at a time, and then here I am, more than two weeks since my last entry. Sorry about that. I've been dealing with my dog, two cats and my house, which have had major flea infestation. What a pain to clean, bomb, spray, and clean again. My two adult cats have had two baths apiece in a many weeks, a first for both of them! As a result of the first encounter between cats and water I had to go on antibiotics for a paronychia, given to me by a cat's nail sliding under the side edge of mine. Ouch!

Word to the wise-if you are given a prescription for Augmentin, a very good antibiotic for skin infections, take it with food. Otherwise you're likely to spend a few hours hugging the bowl as we say...it was not a pretty sight at 3 AM.

In the mean time I have become reacquainted with a site I really enjoy called Book Crossings. If you are a reader you'll love this site. Users log on and register books in their collection that they are willing to give away. Once registered the book is given a Book Crossing ID number ("BCID") from which it can be tracked. Once you have registered a book you release it into the wild, and then you wait for someone to find it and to read it. Hopefully then will then go to the site and make a note about both what they thought about the book, and whether or not they have re-released it into the wild. Books have disappeared for years, only to pop back up in another part of the country, or the world! The site is free and is supported by people spending money to purchase Book Crossing items such as bookmarks and bookplates, but you can also participate without these purchases. If you're a book person, check out www.brookcrossings.com It's really cool!

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A new study has once again supported that diabetes is a strong risk factor for heart disease. Whether one considers people with angina or a heart attack, the rate of death from heart disease is higher for people living with diabetes. One example from this study is that 8.5% of people with diabetes who have a severe heart attack will die from that event within a month, compared to only 5.4% of those who don't have diabetes.

Dr. Elliott Antman, the study's author, is a senior investigator at Boston's Brigham and Women's Hospital. He points out that despite many advances in cardiac care, individuals with diabetes don't enjoy the same level of benefit in terms of health outcomes. His study used data on more than 62,00 people enrolled in 11 clinical trials that evaluated treatments for acute coronary syndrome (ACS); 17% of these study enrollees had diabetes. Antman states that his study points to a need for "aggressive strategies to manage the diabetic population," who present with ACS. This means researching what therapies are the most effective for diabetic patients.

Dr. Larry C. Deeb, president of medicine and science for the American Diabetes Association and a clinical professor of pediatrics at the University of Florida, responded to the report, stating that he was not surprised at the outcome. "Everyone in his right mind has known that people with diabetes have been dying more regularly than people without diabetes," Deeb said. He agreed with Antman's summary that more effort is needed to understand the links between diabetes and heart disease treatment.

He noted that the study did not ask an important question, which is, "what is the effect of diabetes control on heart disease outcomes?" As a person who spends considerable time and energy helping people with diabetes to find strategies to control their blood sugars and other heart disease risk factors, I agree with Dr. Deeb that this is an interesting question indeed. (This study was reported in the Journal of the American Medical Association, Aug 15, 2007).

Until next time (sooner than later), take care!

~Laurie

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Posted by: Laurie Anderson, RNP at 10:05 AM

Thursday, September 06, 2007

Life's Lessons
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I wrote a long blog a few days ago about a someone that I recently cared for in the ED. I have "stewed" about the story for several days because I am always fearful that an individual will realize that they were the topic of my blog. I try very hard to make the description different enough that no one could be identified, especially to themselves, but somehow I am never quite satisfied.

So today I realized that I needed to do something about my inertia, because a good point was being missed by not publishing this blog entry. Since my original post was written I have had several other situations arise that help to make my point. So here are the short and "you can't possibly ID" the patients stories that will still communicate my original idea.

A previously healthy young man came to the ED after a series of events that encouraged me to do a "CAT" scan of a portion of his body. It turned out that he had a very serious tumor that was likely cancer, but he would be left waiting for further tests to know for sure if it was cancer, and what his chances of survival were, if any. Frankly it did not look good for him.

Today in my state they are looking for the driver of a car who hit two little boys and left the scene. One boy was killed; the other is in critical condition in the children's hospital.

This afternoon a very young person arrived in the ED having a large heart attack. It is likely that this individual will also die because of the extent of the heart damage, and tonight there is a family sitting at that bedside watching machines maintain life.

Life can change in an instant; my job proves it to me all too often. Think about that before you spend one more day wasting your energy on anger at a loved one or worrying about things over which you have no control. Smile. Be kind. Tell someone you love them. Drive with care and attention. Take care of yourself.

Be well, Laurie

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Posted by: Laurie Anderson, RNP at 10:16 PM

Saturday, September 01, 2007

More on The Topic of Health Insurance
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This is a nod to Dr. K of WebMD's "Mad About Medicine" blog. I appreciate his timely and thoughtful comments and suggest that if you are truly interested in this topic you also read his blog, which has three sequential entries on various aspects of this problem.

I realize that I presented only a passionate view that is motivated by my position as a health care provider; it makes me crazy that people can't obtain basic health care because of a lack of insurance and lack of community resources to care for the uninsured. There are many reasons that we are in the mess we're in with health insurance. My plea is that as the country with the most and best resources and the presumed ability for its citizens to influence decision-making, let us not go another year without finding a way to ensure equality of health care for all.

Laurie

Posted by: Laurie Anderson, RNP at 10:01 AM

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