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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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Monday, December 31, 2007

Happy New Year!
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On Christmas Eve I met a 29 year old woman who has 5 children ranging in age between 2 1/2 months and 10 years old. Whew! Makes me tired just thinking about it.

We got talking, and she told me that she had to tell her children that she is their Santa Claus. She said, "they wanted a whole lot of stuff for Christmas like game systems and electronic toys that I can't even afford. It would be one thing if they appreciated it, but if they were broken in a day, they wouldn't care." Then she got a big smile on her face, and she told me, "they are really looking forward to Christmas though, because we are going to bake cookies and make hot chocolate." Makes my eyes well up just remembering her smile and her obvious love for her children.

New Year's eve is a time of taking stock and making resolutions. This year, my goal is to love my child like that.

Happy New Year to one and all! Laurie

Posted by: Laurie Anderson, RNP at 4:18 PM

Monday, December 17, 2007

You Can be Fat and Fit (and Live Longer!)
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Men and women who are judged fit on a treadmill test but who are overweight or obese have a lower risk of death than those of appropriate weight but have low fitness levels.

In a study published in the Journal of The American Medical Association researcher and exercise physiologist Steven Blair of the University of South Carolina tracked 2,600 people over age 60 years to determine how physical fitness and body fat affected their death rates over a period of 12 years. Blair found that those in the lowest 5th of fitness levels were four times more likely to die than those in the top 5th of fitness levels. This level of fitness provided protection against death whether an individual was of normal weight, overweight, or obese.

Blair thinks his findings are important because people in the US and many other countries are increasingly inactive and obesity rates are high, and at the same time many of these countries populations are aging. "We should not ignore obesity," Blair said. "But what happens all too often is we focus nearly exclusively on obesity and forget the activity and fitness part."

Blair's team assessed participants' fitness using a treadmill test, seeing how long they could walk while the treadmill's workout increased in intensity. They measured body mass index (BMI) a figure that is calculated from a person's height and weight, as well as waist circumference and percent body fat. Their results showed that even a small effort to improve fitness levels provides a health benefit and that people who are sedentary now don't need to take drastic steps in exercise frequency or intensity to make gains. "If you're overweight or obese and you're sedentary and unfit and you start taking three 10-minute walks a day and you do that at least five days a week, you're not going to lose an enormous amount of weight," Blair said. "You're going to still be heavy. But you're going to be much healthier if you do that," Blair said. Blair also recommends healthy eating patterns, including lots of fruit, vegetables, and whole grains.

According to the Centers for Disease Control (CDC), more than 1/3 of the US adult population is obese; obesity is a major risk factor for cardiovascular disease (CVD), some types of cancer, and type 2 diabetes. The CDC has also found that more than 1/2 of adults in the US do not participate in regular physical activity. Exercise can cut your risk of dying from CVD, as well as lowering your risk of stroke, colon cancer, hypertension, and type 2 diabetes.

It's important for all of us to find ways to become more active. I think that I have suggested this before, but if you're looking for last minute holiday gifts then purchase a pedometer for someone you love who needs to be more active. Ask them to get one for you and set up a little friendly competition. In fact, I am going to make a point of dusting mine off and putting it on every day. Then I'll do my best to get in those 10,000 steps most days of the week, and every few days I'll log them in here in the blog. Who wants to see if they can walk more than me in a week? It will do us both good!

Take care, Laurie

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Posted by: Laurie Anderson, RNP at 1:34 PM

Friday, December 07, 2007

4 Early Signs of Ovarian Cancer
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Off the "Heart" Track, But Important to Me

I've been meaning to write about ovarian cancer warning signs for some time, because too many people think that the symptoms are too vague to recognize, leading too many women to overlook symptoms that could signal this frequently deadly cancer.

Recently I came across references to a set of common symptoms that may suggest that ovarian cancer is present. These symptoms should be promptly discussed with a woman's health care provider. An expert panel, including individuals from the American Cancer Society, the Gynecologic Cancer Foundation, and the Society of Gynecologic Oncologists have published the following list of concerning symptoms:
  • Bloating of the abdomen (anywhere between the bottom of the ribs and the area between the hip bones {pelvis}, from side to side).
  • Pelvic or abdominal pain.
  • Trouble eating or feeling full quickly (also known as early satiety).
  • Urinary symptoms as might also be experienced with bladder infection, such as urinating more frequently, having to go urgently, or having pain with urination.
I actually make the point about the urinary symptoms because it highlights one of the potential problem with this list; they actually describe symptoms that could be attributed to many things, some of which are of no consequence.

Last year a patient in my primary care practice developed vaginal bleeding, even though it had been several years since her last menstrual period and we considered her to be post menopausal. She neglected to mention this bleeding for a while because a member of her family had told her that sometimes this "just happens." When she did tell me she also mentioned feeling full quickly while eating and some abdominal pain. My first thought was that she might have endometrial cancer, a cancer of the lining of the uterus, which commonly causes bleeding after menopause. Fortunately the uterine biopsy that we did was negative, but the nearly simultaneous ultrasound showed an ill-defined mass in her abdomen that prevented us from seeing her right ovary. We had accidentally found ovarian cancer together. She had surgery to remove her ovaries, uterus, and the grapefruit-sized tumor, and more than a year later she remains free of cancer.

Many women aren't so lucky. The abdomen is a fairly large open area (called a "potential space" because of its capacity) with the ability to stretch to accommodate a fairly large growth before it is noticed. This is because there are few nerve endings to pick up pain signals until a tumor is pressing against other organs that have these pain sensors. Once a tumor is this large, it will often have already spread to other organs, such as the stomach, liver and intestines.

The American Cancer Society estimates there will be 22,430 new cases of ovarian cancer in 2007 in the United States. While 93% of women diagnosed with early stage ovarian cancer will survive more than 5 years and many of them will be cured, only 19% of ovarian cancers are found at the early stage before they have spread to other organs. This results in ovarian cancer being the 5th leading cause of cancer death among women and it accounts for more deaths than any other cancer of the female reproduction system.

The important thing for women to know is that they can really help their health care providers to detect ovarian cancer at an early stage, if they are suspicious about a certain pattern of symptoms. If you develop any of the symptoms described above, pay careful attention to their persistence, especially beyond an episode of treatment. Take those urinary symptoms for example. If you see your health care provider for symptoms that might be associated with a bladder infection and it is either not that, or it seems to be but you don't get better despite the right treatment, this warrants further investigation. Now think about bloating and abdominal pain. Many women have these symptoms with their menstrual cycles, but if your period comes and goes, and by the third week you are still feeling bloated or having pain, it needs to be evaluated further. Feeling full early into eating a meal is a big trigger for me. If I hear this complaint from a woman I consider ovarian cancer at the top of my list of potential diagnoses; you should too. If you have any family history of ovarian cancer you should really be on the lookout, and question early on if you have symptoms of concern.

Because ovarian cancer symptoms can be vague or mimic so many other things, it pays to be persistent if you are concerned. If you are not taken seriously seek a second opinion, preferably with an OB-GYN surgeon who is familiar with female cancers. Let your local medical community members think you are little nuts because you keep complaining about your symptoms until someone listens. If you are wrong - so what! If you are right, the life you save will be yours.

For more information:

Ovarian Cancer Symptoms May Begin Months Before Diagnosis
Hope for Earlier Detection?

Take care,

~Laurie

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Posted by: Laurie Anderson, RNP at 7:03 AM

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