Pain Care: Prevention Before Treatment

Author: Harry J. Gould, III, MD, PhD

GettyImages-857090084.jpg

When a patient says, “Doctor, it hurts when I do this,” the immediate thought in response to the implied request is “Don’t do that.”  Unfortunately, in today’s society, this seems to be the best and most effective advice that a physician can provide for their patients in pain.

GettyImages-896469402.jpg

The United States is in the midst of what the Centers for Disease Control describes as “The worst public health crisis in American history.”

There are reports, almost daily, to enlighten us about the fact that the over-prescribing of prescription painkillers has led to countless overdose deaths and serious consequences associated with misuse, abuse, addiction, and diversion that plague society in epidemic proportions.

GettyImages-998493028.jpg

As a result, there has been a strong push by the community and regulatory agencies to limit the prescribing and dispensing of opioid analgesics across the board, while paying little attention to the underlying cause.

Pain is often under-treated or over-treated, but mostly it is poorly treated.

The system’s response has precipitated a reluctance on the part of many physicians to provide pain care for many in need, further exacerbating the primary cause of the problem.

A frequent response is to change clinical focus and redirect efforts to offer one-dimensional assessment and management that relies on interventional modalities.  Unfortunately, not all patients are identical and interventions, if ordered inappropriately or too often, can be costly and have problems of their own.

The observations and policies have mandated change and have heightened the efforts of healthcare providers to find ways to “do no harm” in their efforts to help those in need.

How then can we improve pain care and overall quality of life?  Perhaps it is time to return to basics.

As a starting point, we should consider some important truths about pain.

GettyImages-175917145.jpg

The Truth About Pain

  • Pain is subjective and is different for everyone based on culture, situation, experience, genetics, age and gender.
  • Pain is a modality that is essential for survival. It warns us of present and potential tissue injury so that we can respond and minimize damage.
  • The most important reason that chronic pain is so debilitating is less the uncomfortable sensation that is experienced and more the fact that pain robs us of our ability to control of own lives. Unfortunately, many chronic pain conditions are present for a lifetime.  Thus, the realistic goal should be to minimize the effect of the underlying condition causing the pain and reclaim control of our lives rather than to eliminate pain.

Too often, patients surrender responsibility for controlling their pain to friends, physicians, physicians, drugs or procedures.

GettyImages-901669282.jpg

Taking Responsibility for Your Pain

As a patient, it is essential for you to take responsibility for your pain and to participate in your own care. This process can begin by considering and implementing some obvious positive behavior changes that can maximize pain control and minimize both physical and fiscal cost.

Things You Can Do to Control Pain

  • Eat a regular healthy diet, avoiding excess, with a goal to optimize body mass index (BMI).
  • Exercise daily — regular activity from baseline to 30-60 min/day tailored to the patient’s ability to tolerate activity without a backward slide. “No pain, no gain” is not always the best approach.
  • Be sure to get enough restorative sleep.
  • Balance life experiences and schedule time for yourself that allows for participation in hobbies and enjoyable leisure activities.
  • Be aware of habitual activities and positions that add undo ergonomic stress, e.g., poor posture, wearing high heels, wearing shoes that lack adequate support, sleeping on an old or non-supportive mattress or pillow, using inadequately supportive chairs and car seats. Tailor work and living environments to minimize but not necessarily eliminate stressors and eliminate high-risk conditions.
  • Learn and take advantage of alternative forms of coping and pain control, e.g., meditation, guided imagery, self-hypnosis and relaxation.

GettyImages-901219888.jpg

With proper perspective and attention to basics, one is likely to realize improved general conditioning that enhances:

  • Healing and the immune system’s ability to fight off infection and disease
  • Improved cardiovascular, pulmonary and gastrointestinal health
  • Reduced stress
  • Improved mental health
  • Increased sense of self and well-being and an overall improved quality of life
  • Reduction in pain at any level

GettyImages-478807474.jpg

 

When setbacks occur, first consider the use of topical heat, cooling or massage and prudent physical activity to improve strength, range of motion and endurance and seek counsel for a comprehensive pain assessment early when the basics have not provided adequate results.

Suicide Prevention: Know the Signs and Where to Get Help

Author: David Fein, MD, Medical Director of  Behavioral Health Emergency Room Services

Suicide rates have been on the rise, now standing as the 10th leading cause of death in the U.S. and the 2nd leading cause of death in teens. Now more than ever, it’s critical to know the signs that might indicate a person is considering suicide, where to go for help, and how to provide appropriate support and interventions.

Worried man.jpg

Risk Factors

While there are known risk factors for suicide, such as being older, male, or single, there are additional risk factors to be mindful of as well. These include dramatic changes in behavior, such as getting one’s affairs in order, giving away possessions, increasing substance use, and expressing feelings of being trapped, a sense of hopelessness, or the belief that there is no purpose or meaning to life.

Lonely woman.jpg

Many suicides occur during moments of extreme anxiety and hopelessness about the future. In fact, interviews of people who attempted suicide reveal that, oftentimes, they experienced profound regret about their decision almost immediately.

We should strive to never let temporary feelings of hopelessness drive us or a loved one to a permanent act like suicide. If you feel you are trapped with no way out and think the only solution is death, know that many resources are available to help you through the crisis.

Call center.jpg

Where to Find Help

Each parish has a community mental health center and a mobile crisis unit that are available 24/7 to provide support for people in a behavioral health crisis. Calling the crisis unit does not necessarily mean you will be brought to the E.R. They are there to provide support to you – sometimes over the phone, sometimes in person.

Metropolitan Human Services District serves Orleans, St Bernard, and Plaquemines parishes. Call (504) 568-3130 for their clinic, and (504) 826-2675 for their mobile crisis unit. Jefferson Parish Human Services Authority serves Jefferson Parish. Call (504) 838-5257 for their clinic and (504) 832-5123 for their mobile crisis unit.

If a friend or loved one is in crisis and unwilling to seek help, another option is an Order of Protective Custody, which is signed off by the parish’s coroner and gives the police legal authority to bring the person to the hospital for an evaluation. To  request for an Order of Protective Custody in Orleans Parish,  call (504) 658-9660; in Jefferson Parish, call (504) 365-9100; in St. Tammany Parish, call (985) 781-1150.  

There are also national services such as the Suicide Hotline (1-800-273-8255) and the National Alliance on Mental Illness (NAMI) (1-800-950-6264) which also has a Crisis Text Line (just text NAMI to 741-741). As always, emergency rooms and 911 are available 24/7 in case of an emergency.

Dr. Fein is an Assistant Professor of Psychiatry and Associate Director of the LSU-Ochsner Psychiatry Residency Training Program, LSU Health New Orleans School of Medicine.

Continue reading

Essential Immunizations for Adults

GettyImages-669938250.jpg

You want to pass on certain things like family traditions, a grandmother’s quilt or dad’s love of books—but no one wants to pass on a serious illness. Take charge of your health and help protect those around you by asking about vaccines at your next doctor’s visit.

GettyImages-863504394.jpg

Vaccines

Vaccinating our children is commonplace in the United States. But many adults don’t know which vaccines they need, and even fewer are fully vaccinated. Every year, thousands of adults in the U.S. become needlessly ill from infectious diseases. Many adults are hospitalized and some even die from diseases that could be prevented by vaccines.

Not only can vaccine-preventable diseases make you very sick, but if you get sick, you may risk spreading certain diseases to others. That’s a risk most of us do not want to take.

GettyImages-951541842.jpg

Babies, older adults and people with weakened immune systems (like those undergoing cancer treatment) are especially vulnerable to infectious diseases. They are also more likely to have severe illness and complications if they do get sick.

You can help protect your health and the health of your loved ones by getting your recommended vaccines.

GettyImages-693058384.jpg

The good news is that getting vaccinated is easier than you think. Adults can get vaccinated at their primary care doctor’s office, pharmacies, workplaces, health clinics and health departments.

Most health insurance plans cover the cost of recommended vaccines—a call to your insurance provider can give you the details.

GettyImages-650006104.jpg

What vaccines do you need?

All adults should get:

  • Annual flu vaccine to protect against seasonal flu
  • Td/Tdap to protect against tetanus, diphtheria and pertussis (whooping cough)

Some additional vaccines you may need (depending on your age, health conditions and other factors) include:

  • Hepatitis A
  • Hepatitis B
  • Human Papillomavirus (HPV)
  • Meningococcal
  • Pneumococcal
  • Shingles

GettyImages-846489690.jpg

Traveling overseas?

There may be additional vaccines you need depending on the location. Find out here. 

GettyImages-519833420.jpg

Still not sure what vaccines you may need?

Take this short quiz.

Summertime Skincare

Author: Brian D. Lee, MD, UMC Dermatologist and Kelly R. Stewart Chairman of the LSU Health Sciences Center New Orleans Department of Dermatology

GettyImages-950778134.jpg
The warmth of summer sunshine draws many people outdoors to participate in a variety of activities during these beautiful days.

It’s important to protect your skin from the damaging potential of sunlight.

This article focuses on the simple steps necessary to avoid sun damage and maximize your fun in the sun.

The Truth about Tanning

GettyImages-78461169.jpg
First thing’s first: There is no such thing as a healthy tan. Tanned skin is simply an indication of damaged skin. People who tan dramatically increase their risk of developing skin cancer and destroying the elasticity of the skin, causing sagging, leather-like skin that will make them look much older than their actual age.

GettyImages-838282218 (1).jpg

Artificial sun tanners afford no protection against the harmful rays of the sun and may give one a false sense of protection. People with dark skin need to wear sunblocks because their darker natural skin color does not afford them enough protection.

The Damaging Effects of the Sun

GettyImages-984020088.jpg
The damaging effects of the sun includes the induction of:

  • Skin cancers
  • Premature aged appearance
  • Sun induced eye diseases including eye cancers, and increased risk of cataracts and glaucoma.

Protecting Yourself and Your Children

To protect oneself from the sun, sunblocks, sunglasses, and sun protective clothing must be used.

GettyImages-679896548.jpg

Children less than 6 months of age should not use sun blocks because of concerns regarding their absorption of the sunblock ingredients. They should wear loose fitting, long sleeve shirts and pants, wear a hat of tightly knit material (when held up to light there should be darkness inside cap) and sunglasses where are labelled to protect against the two types of sun rays: UVA and UVB.

GettyImages-804253762.jpg
Everyone should limit their outdoor exposure between 10:00 a.m. and 2:00 p.m. Shade areas may contain 80% of non-shaded areas. It is best to be inside at the peak sunlight intensity hours.

Sunscreen

GettyImages-986665996.jpg

Sunblock should be of a SPF of 30 or greater and the container should also indicate 100% blockage of UVA sunlight.

One ounce of sunblock (a small jigger) is necessary to rub into the skin 20 to 30 minutes prior to sun exposure to allow sunblock absorption. Spray sunblocks should be sprayed onto the hands and rubbed into the skin to avoid eye exposure.

GettyImages-853808618.jpg
There are two types of sun blocks: physical and chemical. Physical sun blocks contain zinc oxide and titanium dioxide and protect by causing reflection the harmful rays. These are excellent products which eliminate the risk of allergic reactions to ingredients in chemical sun blocks. They are available in lotions, gels and sprays.  Most sun blocks sold are chemical sun blocks.

While the potential for allergic reaction (rashes/itching) is very rare, the possibility exists. When shopping for chemical sunblocks read the ingredient label and look for a product that contains avobenzone and does not contain oxybenzone. Oxybenzone may have a possible link to the production of hormone imbalances (low testosterone). Clear spray sunblocks are favorites of men for applying to their skin. Perspiration, degradation and swimming eliminate the sunblocks, so application every 2 hours is recommended.

Grab your sunblock, sun glasses and a hat and have a wonderful day at the beach!

Sun-Safety-Tips_Infographic.jpg

Is HIV How you ID?

Author: Lauren Richey, MD, MPH, FIDSA, UMC Internal Medicine and Infectious Disease Specialist and LSU Health Sciences Center Associate Professor of Medicine

GettyImages-881076458.jpg

Human Immunodeficiency Virus (HIV) is an infection that can cause serious damage to your body and immune system if not treated; however you can be without symptoms for many years. The lack of symptoms makes people think they are healthy, and, as a result, they often do not seek out or request testing.

Young Couple #1.jpg

It is important to find out about the infection early because there are simple, effective treatments which can keep you healthy and prevent any damage to your immune system.

The only way to know if you have HIV is to get tested.

How Do I Get HIV?

GettyImages-919439074.jpg

HIV can be transmitted through:

  • sexual fluids during sexual activity,
  • mother to child during birth,
  • breast feeding, and
  • blood.

Blood transmission can occur through blood transfusions and the use of intravenous (IV) drugs.

HIV Test.jpg

How is HIV/AIDS Diagnosed?

As mentioned before, early HIV infection often causes no symptoms, and must be detected by testing a person’s blood for the presence of antibodies — disease-fighting proteins — against HIV. These HIV antibodies generally do not reach levels high enough to detect by standard blood tests until 1 to 3 months following infection, and may take as long as 6 months to do so.

People exposed to HIV should be tested for HIV infection as soon as they think they may have been exposed to HIV.

When a person is highly likely to be infected with HIV and, yet, antibody tests are negative, a test for the presence of HIV itself in the blood is used. Repeated antibody testing at a later date, when antibodies to HIV are more likely to have developed, is often recommended.

Who Should Get Tested?  Everyone! 

Woman alone.jpg

There are a lot of misconceptions about HIV and how it is transmitted but anyone, regardless of race, sex, gender, sexual orientation, or educational level, who has had sex should be tested.

The Centers for Disease Control and Prevention (CDC) recommend that everyone between the ages of 13 and 64 gets tested for HIV at least once as part of routine health care. About 1 in 7 people in the United States who have HIV don’t know they have it.

GettyImages-821194010.jpg

People at higher risk should get tested more often. Sexually active gay and bisexual men may benefit from more frequent testing (for example, every 3 to 6 months).

GettyImages-942572812.jpg

If you’re pregnant, talk to your healthcare provider about getting tested for HIV and other ways to protect you and your child from getting HIV.

What are My Options for HIV/AIDS Treatment?

As with many other conditions, early detection offers more choices for treatment. Today, there are medical treatments that not only can slow down the rate at which HIV weakens the immune system, but  may keep HIV in check so that the individual has a chance to live a normal life span.

Middle Aged Man.jpg

Unfortunately, there is no cure for an HIV infection.

Talk with your healthcare provider for more information regarding various drug therapies for the treatment of HIV/AIDS.

Where Can I Get Tested?

We offer testing at University Medical Center New Orleans in the Infectious Disease Center (ACB building, Clinic 4C). There is also routine HIV testing in our Emergency Department. So if a medical condition or any risk of exposure to HIV brings you to the ED, you can get tested!

To find other testing centers near you, you can enter your zip code into: gettested.cdc.gov.  Other places include your primary medical doctor, OB/GYN doctor, or at a community testing event.

How Can I Protect Myself Against Acquiring HIV?

GettyImages-861329562.jpg

  1. Use Condoms: Using condoms during sexual encounters is one of the simplest ways to prevent HIV transmission.
  2. Take PreP (pre-exposure prophylaxis): PreP involves taking a daily medicine to prevent HIV acquisition and is very effective.
  3. Use Clean Needles: If you inject drugs, using clean needles, and never sharing needles, is another way to prevent HIV transmission.
  4. Talk to Your Partner: Before having sex for the first time with a new partner, you and your partner should talk about your sexual and drug-use history, disclose your HIV status, and consider getting tested for HIV and learning the results.

Where Can I get PreP? Where Can I Receive Treatment for HIV?

GettyImages-940000898.jpg

The HOP (HIV Outpatient Program) clinic nested in the Infectious Disease Center of the ACB building Clinic 4C provides both comprehensive HIV care and PreP.

Call (504) 702-4344 to make an appointment or to refer a patient. 

Click here for more HIV Resources.

About the Author

richeylauren-infdis.jpg

Dr. Lauren Richey, MD,MPH, FIDSA is an Internal Medicine and Infectious Disease specialist in New Orleans, Louisiana. She has more than 11 years of diverse experience with HIV and other infectious diseases.

 

 

The Lasting Impact of Sudden Impact

Author: Natalie Moll, Student and Sudden Impact Graduate

GettyImages-481633290.jpg

Driving is the first freedom teenagers often experience.

Unfortunately, motor vehicle crashes are the number one killer of teens.

When I was 16 years-old I had my first Sudden Impact experience, and since then, I have never viewed driving the same.

What is Sudden Impact?

Sudden Impact Logo.png

Sudden Impact is an interactive program that educates high school sophomores about the dangers of driving impaired, driving without a seat belt, and distracted driving. It is facilitated by the Injury Prevention Program for UMC’s Level 1 Trauma Center and by the Louisiana State Police.

The program also offers mock crashes and mock trials to further educate teenagers on the consequences of reckless driving. It has a big reach. Since the program’s inception 20 years ago, it has been expanded to 16 additional hospital host sites in 9 regions of Louisiana. It is in more than 120 schools.

The Presentation

On day one of Sudden Impact, we were presented a slide show filled with information on the risks of driving without seat belts and driving impaired (at the time, distracted driving wasn’t a large part of the program).

Distracted Driving Stats.jpg

I remember we took an anonymous test before the start of the presentation that asked questions such as:

  • How often do you wear your seat belt?
  • Would you or have you gotten behind the wheel after having a drink?

GettyImages-664449652.jpg

Then, we heard from three speakers — a woman from the Trauma Prevention Team, a state trooper, and a woman who had been injured because of a drunk driver — that really ingrained three lessons I still think of when I get behind the wheel:

  1. Sometimes bad things happen to good people.
  2. 100 percent of crashes are preventable.
  3. Seat belts save lives.

Following our three speakers, we took an anonymous post-test that asked the same questions as the previous one. However, when compared to the pre-test, we noticed a 22% increase in responses that aligned with safer driving habits.

For example, one of the questions asked: How often will you wear a seat belt while in a car? During the pre-test, only 64% of students answered “always,” but for the post-test, 97% of students answered “always.”

The Mock Crash

About a year later, I had my second Sudden Impact experience. It was the mock car crash, which stressed the consequences of motor vehicle crashes as a result of impaired driving, distracted driving, and not using seat belts…along with everything that happens next — EMS arrival, the trip to the hospital, the family being notified…the list goes on. While the presentation I went through the year before was eye-opening, the only way to describe the mock crash is INTENSE.

Mock Crash.jpg

Sudden Impact set up a crash in our faculty parking lot in the morning, and while I knew there was going to be an assembly, I never thought I would have to witness girls I knew hanging out of cars screaming in agony. Although it’s all fake, it’s chilling how real it feels. Watching a classmate being loaded into a coroner’s van while her mother is crying is an image that will forever with me. It reminded me that I have to make the conscious decision to think about the consequences of my actions, especially when driving.

GettyImages-865339342.jpg

The Injury Prevention Team also returns to some schools three years after the first presentation for an anonymous survey for high school seniors that asks about the effectiveness of the overall program.

97% of the seniors said they felt that Sudden Impact kept them from driving impaired, driving distracted and not using their seat belts as well as practicing safer driving habits.

The Impact

I’m a college junior now, and I practice safer habits when I’m driving or riding in a car because of the Sudden Impact program. It gave me a true perspective of the dangers that come with driving. I think it was important that I learned the risks of reckless driving the same time I was learning the rules of the road, and it was important for me to hear it from those three speakers. I paid more attention to the things they were saying because they were the ones saying it.

Now, I never get in a car without using the seat belt or while impaired, and I never have to remind my friends who went through the program with me to do the same. It’s because we all understand the consequences of our potential actions…and that may not be the case had we not experienced Sudden Impact.

Don't Drink and Drive.jpg

Remember: 100% of all motor vehicle crashes are preventable. Drive safely, and remember the impact you have while on the road.

 

About the Author: Natalie Moll

DSC_7917.jpg

Natalie Moll is a junior at Louisiana State University in Baton Rouge. She is majoring in mass communication with a concentration in public relations and a minor in sociology. Natalie is also a founding member of the Omega chapter of Alpha Delta Pi, where she serves as Sisterhood Chair.

Open Up: The Truth About Oral Cancer

Author: Rohan Walvekar, MD, Co-Director of ENT Services at UMC

GettyImages-495809266.jpg

Oral cancer will be responsible for over 10,000 deaths and will affect over 50,000 people in the United States in 2018.

These numbers may surprise you, because, in general, oral cancers are not thought of as commonly occurring; however, Louisiana is one of the states with highest incidence of oral and pharyngeal cancers in the United States.

What is the rate of these cancers in Louisiana?

map.jpg

April honors Oral Cancer Awareness, and is a good time to learn about the signs, symptoms and treatment of oral cancer, as well as the importance of early detection.

What are oral cancers and why should we care about these cancers?

GettyImages-517269459.jpg

Oral cancers are cancers that affect parts of our mouth such as the gums, tongue or palate. They are most commonly caused by tobacco use and alcohol consumption. There is a new threat called Human Papilloma Virus (HPV-16) that can also cause certain types of oral and oropharyngeal cancers.

These cancers are important because they have a devastating effect on a person’s ability to communicate with the world around them by affecting speech and swallowing, breathing and appearance; treatment, which is most commonly involves surgical removal, may also have an serious impact on these functions that are so vital to us.

GettyImages-693070662.jpg

Surgical management is the ideal treatment for oral cancers but comes with the possibility of a disfiguring operation (e.g. removal of jaw bone or tongue affecting appearance or speech) and loss of function.

Early detection of oral cancer plays a vital role improving quality of life and function by limiting extent of surgery and consequently side effects of treatment.

In addition, it’s important to note that early-stage tumors (i.e. tumors detected at an earlier stage of the disease) have better chances of cure (5-year disease-free survival: 60-80 percent) as compared to cancers diagnosed when they are too large or advanced (5-year disease-free survival rates: 30-40 percent).

Unlike other types of cancers that may miss detection until they are too advanced; oral cancers can be diagnosed earlier with inspection and a biopsy – both of which can be easily done during an oral cavity examination by an expert in the clinic or at a cancer-screening event.

GettyImages-514771081.jpg

Patients who notice a sore, ulcer or growth in the mouth that has not responded to treatment or a lump in the neck (oral cancers can spread to lymph nodes in the neck) that does not go away either after treatment or spontaneously in 2-3 weeks, should get check by an oral cavity expert such as an ENT surgeon or Head & Neck Cancer Surgeon.

The slogan that the Head Neck Cancer Alliance (OHANCAW) promotes –“All you have to do is open your mouth” is a testament to how a simple cancer screening can save lives and improve outcomes for oral cancer patients who are diagnosed early.

Get screened – promote screening – save lives!

GettyImages-898328226.jpg

Click here to learn more about our Cancer Services and future screenings.

To make an appointment with an ENT, visit our website here. 

About Dr. Walvekar

100511.jpg

Rohan R. Walvekar, MD, earned his doctoral degree from the University of Mumbai. After graduating in 1998, he completed a residency in Otolaryngology and Head Neck Surgery at the TN Medical College & BYL Nair Charitable Hospital, Mumbai, India, with triple honors. Subsequently, he completed two head neck surgery fellowships, and trained at at the Tata Memorial Hospital, Mumbai, which is India’s most prestigious cancer institute, catering to over 5000 new head neck cancer registrations a year. After completing an Advanced Head Neck Oncologic Surgery fellowship at the University of Pittsburgh, he became an Assistant Professor in Head Neck Surgery within the Department of Otolaryngology Head Neck Surgery at the University of Pittsburgh/VA Medical Center, prior to joining the LSU Health Sciences Center in July 2008. His clinical interests are head neck surgery and salivary endoscopy. His research interests include evaluating prognostic markers and clinical outcomes of head and neck cancer therapy and treatment of salivary gland disorders.

The Link Between Diet, Obesity and Cancer

GettyImages-693280398.jpg

A diet that includes plenty of fruits, vegetables and good sources of protein are important for good health, but did you know that what you eat can also affect your risk for cancer?

GettyImages-672689852.jpg

The good news is that diet and obesity are things that can be controlled through healthful choices and a greater understanding of how our bodies process certain foods.

The link between cancer and diet is the topic of the UMC Cancer Center’s next Breast Health Lunch Lecture, presented by Adam Riker, MD., F.A.C.S. Dr. Riker is an LSU Health New Orleans surgical oncologist and Oncology Service Line Director at UMC.

28699154_2003528203020812_5890471297964610745_o.jpg

The free lecture takes place from 12 – 1 p.m. in the UMC Conference Center, on the first floor of UMC, 2000 Canal Street. Lunch will be provided, and a Q&A will follow.

During the lecture Dr. Riker will share a wealth of information, including the basics of cancer, how many people develop cancer, and most importantly, why people develop cancer.

GettyImages-852114758.jpg

According to the World Cancer Research Fund, one of the biggest risk factors for cancer is being overweight or obese. Eating food that is high in fat or sugar can lead to weight gain, and there is strong evidence that being overweight or obese increases the risk of 11 cancers.

GettyImages-656948420.jpg

Dr. Riker’s lecture will explore why having too much sugar in our diets is not only dangerous, but potentially deadly, the effects of wheat, flour, gluten and process foods (most of which contain flour and wheat) on our overall health, the effects of dairy consumption and the most common pesticide/herbicide in the U.S. food chain and its impact on the vast majority of food consumed in the U.S.

GettyImages-929020348.jpg

In the second half of his lecture, Dr. Riker will drill down on how our body processes food, especially sugar and wheat. Sugar is linked to insulin resistance, weight gain, high blood pressure, heart disease, diabetes and cancer. Gluten, a protein in wheat, has been linked to a number of ailments, including inflammation, intestinal disorders and autoimmune disorders.

GettyImages-478656090.jpg

He will discuss the dietary guidelines in the food pyramid and affect on childhood and adult obesity.

The Standard American Diet

1970: 2,077 calories

1990: 2,343 calories

2010: 2,590 calories

Additionally, “I’ll focus upon the striking increase in obesity and diabetes (and other health problems) as a result of the U.S diet and then discuss what we can do about it, in order to live a healthy, happy, fulfilled and cancer-free lifestyle,” Dr. Riker said.

GettyImages-596804694.jpg

Know Your Numbers

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

GettyImages-649184074.jpg

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.

GettyImages-687013434.jpg

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.

GettyImages-599995238.jpg

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

GettyImages-610573056.jpg

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

GettyImages-859587780.jpg

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.

GettyImages-653909098.jpg

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. 

GettyImages-518124848.jpg

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.

GettyImages-667855148.jpg

Colon Cancer: When & Why You Should Start Screening

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

Male Patient Being Reassured By Doctor In Hospital Room

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.

second

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.

Nurse Showing Patient Test Results On Digital Tablet

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:

iStock-617758648.jpg

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. •

Affectionate African American couple

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

screening

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.