Know Your Numbers

Authors: Alan Gatz, MD and Kendria Holt-Rogers, MD, UMC Primary Care Physicians

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Today,  many people are aware of the need to focus on the effect of risk factors and life choices on overall health and wellness. Health professionals speak to patients about cholesterol, blood sugar, blood pressure, BMI (body-mass index), and hemoglobin A1c, but many individuals become overwhelmed and do not totally understand all of the information as presented.

Here’s a condensed and simplified description of the above mentioned health determinants.

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Cholesterol

This term actually should be changed to lipids, which includes the entire family of proteins sub-divided into three major subcategories:

  1. LDL (low density lipoprotein) cholesterol
  2. HDL (high-density lipoprotein) cholesterol, and
  3. Triglycerides (TG).

The two numbers the majority of people need to remember are their LDL and HDL levels.

A simple way to understand the concept of reducing heart and vascular disease is to keep the low low and the high high. LDL level above 150 mg% increases the risk of developing blood vessel blockage while HDL above 50 mg% helps protect against the development of this problem.

High triglycerides also can affect a person’s health including development of pancreatic disease.  Any intervention – including lifestyle changes and medications –  that will improve the overall cholesterol readings will also improve the total TG.

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Interventions to improve the cholesterol numbers and reduce risk of cardiac disease:

  • Exercise – 30-45 minutes 3 times per week
  • Diet – increase fiber, reduce fat and sugar
  • Weight loss – even 5 pounds will affect the level
  • Medication – effective but comes with risk of side effects

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Blood sugar (Glucose)

Important in the proper functioning of most all body systems, if the blood level is too high, many of the major organs can be damaged irrevocably, most notably the heart, kidneys, circulatory system and eyes. Normally, people think of getting a blood sugar reading by having their finger lanced to obtain a drop of blood.  This “spot” reading will give an idea of current glucose level but the Hemoglobin A1c (Hgb A1c) is much better at allowing us to determine average blood sugar level over several weeks.

Without getting too scientific, the higher the average blood sugar, the higher the level of Hgb A1c.  In general we strive to get the level below 7%.

Ways to improve Hgb A1c :

  • Take your medications as prescribed
  • Prescribed exercise program
  • Improve diet and control your weight

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Body Mass Index

This number is determined by a patient’s height and weight.

The ideal BMI is between 18.5 and 25.  Below 18.5 is considered underweight with 25-30 being overweight.

Those individuals above 30 are classified obese.  The importance of BMI lies with the effects of stress on the heart, circulatory system, joints, muscles and metabolism.  Severe obesity with BMI greater than 36 increases the individual’s risk for hypertension, myocardial infarction (heart attack), stroke, diabetes, degenerative arthritis, decreased independence.  Obviously we cannot affect the BMI by growing taller but anything we can do to reduce weight will improve the BMI.

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Blood Pressure

The measurement of blood pressure is important in determining the stress the heart experiences pumping the blood through the thousands (approximately 60K) of miles of blood vessels in the body. Like a body builder the heart, if faced with greater weight (pressure), will grow to meet the challenge.  But, also like the body builder, there can be too much growth (the heart becomes muscle bound) which results in the heart failing to “lift the weight”. The result is heart failure which many times causes permanent disability and death. 

We don’t have the time or space to discuss the effects of blood pressure on the kidneys,  but suffice it to say untreated blood pressure is a leading cause of kidney failure and need for dialysis.

Remember these numbers – Systolic 135, Diastolic 80. 

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If your readings fall above these numbers you should seriously consider speaking with your health care provider about intervention.

Interventions to improve blood pressure:

  • Reduce weight
  • Reduce alcohol intake
  • Reduce salt in the diet
  • Exercise with emphasis on aerobic activity
  • Adequate rest – sleep 6-8 hours/night
  • Stress reduction – yoga, meditation, therapeutic massage

Hopefully, this primer will help you manage your health with greater confidence and purpose.

Dr. Gatz and Dr. Rogers look forward to being your partner in wellness. To schedule an appointment, call the clinic at 504-962-6120. Visit www.umcno.org/primary-care to learn more about UMC’s Primary Care Center and its services.

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Colon Cancer: When & Why You Should Start Screening

Author: Guy Orangio, MD,  FACS, FASCRS, UMC Colorectal Cancer Surgeon

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Colorectal cancer is the fourth most commonly occurring cancer and the second leading cause of cancer deaths in the United States, with over 56,000 people expected to die from this disease each year. However, this cancer is preventable and curable when detected and treated early.

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March is Colorectal Cancer Awareness Month, a perfect time to learn more about  this disease and when and why to get screened. Because there are often no symptoms when it is first developing, colorectal cancer can only be caught early through regular screening.

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Most colon cancers start as non-cancerous growths called polyps. If we are able to find these polyps while they are still non-cancerous, we remove them and the cancer may be prevented. Major surgery can usually be avoided.

STAGES

Screening programs begin by classification of risk based on personal, family and medical history. People who are at increased risk may need earlier and more frequent screening depending upon the recommendation of their healthcare provider.

The American Society of Colon and Rectal Surgeons (ASCRS), which is dedicated to advancing the treatment of patients with diseases affecting the colon, rectum and anus, supports the following colorectal cancer screening guidelines:

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Recommendations Screening People at Average Risk

  • Men and women at average risk should have screening for colorectal cancer and adenomatous polyps beginning at age 50 years.
  • A colonoscopy (a test that allows the physician to look directly at the lining of the entire colon and rectum) every 10 years or a barium enema (x-ray of the colon) every 5 to 10 years are acceptable alternatives. •

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Recommendations for Screening People at Increased Risk

  • People at increased risk of colorectal cancer or adenomatous polyps include those with first-degree relative (parent, sibling or child) with colon cancer or adenomatous polyps diagnosed before 60 years
  • People with two first-degree relatives who were diagnosed at any age, should have screening colonoscopy starting at age 40 years — or ten years younger than the earliest diagnosis in their family — and then repeat every five years.
  • People with a first-degree relative with colon cancer or adenomatous polyp diagnosed at age greater than 60 years or two second degree relatives with colorectal cancer should be advised to be screened as average risk persons beginning at age 40 years
  • People with one second-degree relative (grandparent, aunt or uncle) or a third-degree relative (great-grandparent or cousin) with colorectal cancer should be screened as average risk persons

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Prevention Tips

In addition to timely and regular screening for colorectal cancer, people may be able to lower their risk of getting the disease by:

  • Avoiding foods that are high in fat.
  • Eating plenty of vegetables, fruits and other high-fiber foods.
  • Exercising regularly and maintaining a normal body weight.
  • Not smoking and drinking alcohol only in moderation.

 

For information on the Comprehensive Colorectal Cancer Program at UMC, click here.

 

About Dr. Orangio

Guy Orangio

Guy Orangio, MD, is a board-certified colorectal surgeon at UMC and an Association Professor of Clinical Surgery at LSU Health New Orleans.

 

Out With the Old: Why It’s Important for Seniors to Get Moving

Author: Maryann Vicari, UMC Physical Therapist

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How do we age well and gracefully? This question has been on the mind of human beings for ages. We have all been searching, to some extent, for the fountain of youth or a way to slow down the aging process. Unfortunately, that fountain has yet to be discovered, and no scientist has come up with a formula that will keep time from aging the body.

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Nevertheless, there is some good news. We, as humans, can improve our aging process and increase the number of “healthy” years by doing something that humans have been doing for centuries – MOVE! That’s right, moving the body is one of the best ways to age well and to help reduce the risk of developing heart disease, diabetes and obesity, which are a few of the main causes of death and poor aging among older adults.

Evidence has shown that regular physical activity is safe for healthy and even frail older adults (ages 65 and older). 

This physical activity can range from low intensity walking to more vigorous sports and resistance exercises, depending on the individual’s preference and physical ability.  Basically, for older adults, some form of physical activity is better than nothing at all or a predominantly sedentary lifestyle.

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According to the Centers for Disease Control (CDC), older adults need at least 2.5 hours of moderate intensity aerobic activity (think brisk walking) every week, which is about 30 minutes a day, and muscle-strengthening activities on two or more days a week that work all major muscle groups (legs, hip, back, abdomen, chest, shoulders, and arms).

This may sound like a lot, but please do not be discouraged; you don’t have to start here.  If you have never worked out before or have been inactive for some time, you can safely work your way up to this point by joining a local wellness center or YMCA.  There, you can find trained professionals that can help you work towards your goal of achieving a healthy and physically active lifestyle.  As always, you should consult your physician before beginning any sort of exercise routine, especially if this is new to you or if you have a pre-existing heart or metabolic disease, such as diabetes and hypertension.

To make an appointment for a consultation with one of our primary care physicians, click here.

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Keep this in mind: If you want to improve your health or if you want to maintain the level of health you have for years to come, your best bet is get or stay as active as you can.  The more active you are as you age the less likely you will be to develop debilitating diseases, which can only work as catalysts to age you beyond your years.

So, get out there and move your bones!

 

References:

https://www.cdc.gov/physicalactivity/basics/older_adults/index.htm

McPhee, J., et al.  Physical activity in older age: perspectives for healthy aging and frailty.  Biogerontology. (2016). 17: 567 – 580.