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Do you know your blood pressure numbers? Dr. Michael Bloch explains how maintaining healthy numbers are important for good quality of life and increasing longevity. High blood pressure, or hypertension, affects 85 million Americans – that’s one in three people. Left untreated, it can lead to serious and sometimes life-threatening health concerns such as vision loss, kidney disease, heart failure, heart attack and stroke. But what is it, exactly, what makes it go up and why is that increase in pressure so dangerous? All About Blood Pressure In order to function properly, your body requires a continual supply of oxygen rich blood, which is goes to organs and tissues via blood vessels called arteries. Your beating heart produces the force (or pressure) your vessels require to move blood. This is your blood pressure. Your blood pressure numbers reflect two forces at work – the pressure created as blood is pumped throughout the body (systolic) and the pressure when your heart is at rest in between beats (diastolic). A normal, healthy reading shows a systolic level at 120 or below over a diastolic level of 80 or less: 120/80. An increase in pressure occurs slowly over time, straining the circulatory system and forcing the heart, blood vessels and tissues to work harder. This friction damages blood vessel walls and lets plaque buildup from LDL cholesterol, setting the stage for hardening of the arteries. As more and more plaque builds up, your blood vessels narrow, further raising blood pressure, damaging the circulatory system and increasing your risk of serious health conditions. The Silent Killer High blood pressure is known as a “silent killer,” as most people with it have no symptoms. In fact, one in six of those affected don’t even know they have the condition. That’s why it’s so important to know your numbers. The only way to find out if you have high blood pressure is to have it measured, either by a health professional or using a home monitor. If your numbers are high, there are things you can do to help lower it – it is treatable, but not curable. You can manage it with medications and lifestyle changes including: Adhering to the Mediterranean diet Decreasing sodium intake Avoiding excessive alcohol consumption Increasing exercise and activity levels Losing weight Prevention and Genetics Even better? High blood pressure doesn’t just happen. You can prevent the condition altogether. How? Know your numbers and know your risk. Look at your family medical history. Genetics certainly increases the risk of it, but those same lifestyle choices that can improve poor blood pressure can also prevent you from developing it. So if your numbers are good, keep them that way – eat well, move your body, maintain a healthy weight and drink alcohol in moderation.

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Did you know an estimated 1.9 million neurons and 14 billion synapses are lost per minute during a stroke? That’s why every second counts. Anyone can have a stroke, but your chances increase if you have certain risk factors. That’s why the best way to protect yourself or your loved ones from a stroke is to know the risks and how to manage them. You can make changes to your lifestyle to lower your risk of stroke by asking yourself the following questions: 1. Is my blood pressure normal? High blood pressure is the leading cause of stroke and the most important controllable risk factor. If you’ve had a stroke, lowering your blood pressure can help prevent future strokes. 2. Can I quit smoking? Smoking damages blood vessels, clogs arteries and raises blood pressure — doubling your risk of stroke. If you want to reduce your risk of stroke and heart attack, quitting smoking is the first step — and Renown can help you with this. Learn more: Renown Health Quit Tobacco Program. 3. Do I make time to exercise 30 minutes a day? Many studies link consistent exercise habits with lower stroke risk. Also, being overweight contributes to high cholesterol, high blood pressure, heart disease and diabetes, all increasing your stroke risk. You don’t need to run a marathon — just commit to making time to move each day. 4. Do I regularly eat processed food and sugar? Eating less cholesterol and fat, especially saturated and trans fats, may reduce the fatty deposits (plaque) in your arteries. Also, eating five or more servings of fruits and vegetables per day may reduce your stroke risk. If you are diabetic, follow recommendations to get your diabetes under control.

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Stroke is unfortunately common, with 1 in 5 American women experiencing it each year. When it comes to a stroke the phrase “time is brain” speaks to the urgency of getting rapid care. In fact, a woman may lose nearly 2 million neurons per minute of oxygen loss to the brain. The Renown Health Comprehensive Stroke Center experts share the importance of timely treatment and how stroke symptoms can differ in women. Women and Stroke – Surprising Symptoms  Each year stroke affects more women than men. Even more concerning, women are less likely to recover from a stroke. The following non-traditional, less common, warning signs can be common in women: Hiccups with chest pain Sudden disorientation, drowsiness, confusion or a general altered mental status Nausea or vomiting A sudden headache that feels like the ‘worst headache of your life’ Unusual chest pain (especially with hiccups) Body numbness or weakness, such as an arm or leg suddenly ‘falling asleep’ Fainting or loss of consciousness Stroke Diagnosis The first step is neuroimaging by CT scan. This allows for rapid identification of any bleed, and also assists in determining candidacy for the early clot busting medication. MRI brain imaging is much higher resolution, and can better determine the core stroke size, assisting in prognosis and recovery. Since strokes have several different origins, an inpatient workup is essential to determine the underlying cause. Whether the stroke is secondary to plaque in the large vessels, clots being thrown in the setting of atrial fibrillation (an abnormal heart rhythm), or small vessel disease from years of uncontrolled vascular risk factors (high blood pressure, smoking, high cholesterol, diabetes), determining the cause is essential to implementing a management plan to reduce risk for further strokes. Quick Treatment for Stroke is Key Early recognition of stroke symptoms and seeking prompt attention is paramount. There are interventions that can be instituted to minimize the stroke and increase likelihood of recovery, but only if a patient presents to the hospital early. A clot busting medication, called tPA, can be given to patients with stroke if given within 4-5 hours from time of onset. Renown Regional Health Center is designated as a Comprehensive Stroke Center, the highest level of stroke certification available. To earn the designation of comprehensive stroke center, a hospital has to meet stringent requirements, including biannual on-site evaluations. This includes care for ischemic stroke patients (lack of blood flow), hemorrhagic stroke patients (bleeds), and determining the underlying cause to guide secondary stroke management prevention. Stroke Symptoms Remember “B.E.F.A.S.T.” to recognize the symptoms of a stroke below: B – Balance Being off balance or dizzy, is common. E – Eyes An eyesight change such as blurring or double vision may occur. F – Face droop One side of the face, or lip, droops A – Arm weakness Does one arm drift down? S – Speech Talking may slur or sound strange. T – Time Time to call 911. Call an ambulance immediately if you or anyone else, experiences any of these symptoms.

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Without a doubt, taking medications can not only be expensive, but also confusing. In the United States, generic prescriptions are widely used, with 9 out of 10 people choosing them over a name brand. Pharmacists are a great resource to help us understand the benefits and side effects of any medication. We asked Adam Porath, PharmD, Vice President of Pharmacy at Renown Health, to answer some common questions about generic drugs. What is a generic drug? A generic drug has the same active ingredients of brand-name drugs. Brand-name drugs have a patent (special license) protecting them from competition to help the drug company recover research and development costs. When the patent expires other manufacturers are able to seek approval for a generic drug. However, the color, shape and inactive elements may be different. Per the U.S. Food & Drug Administration (FDA), a generic medicine works in the same way and provides the same clinical benefit as its brand-name version. Why do they cost less? Generic drug makers do not have the expense of costly development, research, animal and human clinical trials, marketing and advertising. This savings is passed on to the public. Also after a patent expires, several companies will compete on a generic version of a drug, further driving down prices.

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It seemed like a normal Wednesday, except Kimi Woolsey was feeling really stressed. On Sept. 4, 2019 she was rushing to get ready for an appointment when suddenly, she could not feel her legs. Kimi immediately knew something was wrong and called out to her fiancé, Paul, for help. After seeing a bright light in her right eye, she felt a severe, sharp pain in her head traveling down into her leg. Paul quickly called 911, the EMT’s arrived and her stroke survival journey began. At first the medical team thought she had a complicated migraine, but one of them suspected a stroke. On the way to the hospital Kimi felt numbness and her face drooping, then instantly, no pain. For a moment she thought she was dying, going from pain to numbness and realizing she couldn’t move or speak. Kimi didn’t know she was having another massive stroke in transit. Each year nearly 800,000 people in the U.S. suffer a stroke, or “brain attack” – that’s one every 40 seconds. Of those, about 75% occur in people over age 65. However, at only 45 years old, Kimi is proof that a stroke can happen at any age. Stroke Survival Begins for Kimi Upon arriving at the emergency department of Renown Regional Medical Center the Certified Comprehensive Stroke Center team went into action. Kimi received a brain MRI, then was wheeled into surgery for a thrombectomy (clot removal). She was in the intensive care unit for 11 days. She remembers someone telling her, “Generally people don’t survive this magnitude of stroke.” And a doctor saying, “You are here for a reason.” Kimi’s comeback journey began with the comprehensive care team at Renown Rehabilitation Hospital. “Literally I had the best day of my life that first day there…I was so happy because I couldn’t imagine being in a safer place with people that literally live for you,” she recalls. During her 41 days there, her biggest milestone was being able to get out of bed and walk. For Kimi the support she felt at the rehab hospital was key to her progress, ”I still feel loved and appreciated and they’re rooting for me still and I can feel it.” Although she left the rehab hospital on Oct. 18, 2019, she is still working on improving the left side of her body. Currently Kimi works with therapists in outpatient physical rehabilitation sessions, continuing to see improvement in both her hand and leg. Her advice to those currently in a rehab hospital setting is, “Stay as long as you can to get the most out of it and push, push, push.” Kimi’s Stroke Survival as a Warrior “Having a stroke is not for the faint of heart,” says Kimi. She experienced despair and felt discouraged. Many days she would ask herself, “Why am I here?” Today she proudly calls herself a stroke warrior and refuses to be a victim of her stroke. Alongside her tenacious spirit, Kimi actively helps others on their stroke survival journey. Before her stroke she never dreamed of starting a non-profit foundation. Now, each day you’ll find her texting inspiration to others, offering advice and connecting with other struggling stroke survivors on her Facebook page, Stroke Warrior Recovery Coach. Her goal is to become the person she needed to talk to after her stroke; she currently coaches several stroke survivors. “Stroke survivors need to know that they aren’t alone. Mental support and encouragement are so important for each person’s stroke journey,” Kimi said. Along with the physical changes, Kimi feels the stroke magnified her empathy. “I was always in a hurry in my life. People didn’t go fast enough for me – on the road, at the grocery store, in a line. Now I have more patience with myself and others." Kimi realizes most people cannot wrap their brain around the concept of a stroke. In fact, the brain fog, physical challenges and frustration are hard to explain… unless you’ve experienced them. “You need to find your tribe,” she explains. “I have a passion for helping people through this process.” Most of all, she encourages people to keep going and never stop. After her stroke, Kimi has a greater appreciation for her family, health and life. She is one of the patients featured in the current “Fight The Good Fight” trauma and physical rehab advertising campaign. “I wake up every day and fight,” she asserts. “Each day you have to fight for your recovery and fight for yourself.”

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There are some important numbers to know when it comes to good health. Learn more and receive a free blood pressure check at a primary care open house Feb. 27 at Renown Medical Group – Double R. Know Your Numbers Adults are pretty good at knowing and memorizing numbers — from passwords and PINs to addresses and phone numbers. But what about the numbers that could help save your life? Heart disease remains the leading cause of death in the U.S., with 633,842 deaths attributed to the disease in 2016, according to the National Center for Health Statistics. The American Heart Association lists the vital numbers you need to monitor to help prevent heart disease as blood pressure, total cholesterol, blood sugar and body mass index (BMI). With these numbers, your doctor can assess your risk of developing heart issues such as atherosclerosis, which can lead to other serious heart conditions. Atherosclerosis is a condition wherein plaque builds up in the arteries — the blood vessels that transport oxygen-rich blood to cells, the heart and other organs. These fatty deposits clog the arteries, inhibiting blood flow and reducing the amount of much-needed oxygen the body receives. These blockages can lead to angina, coronary heart disease, peripheral artery disease and even heart attack or stroke. But knowing your numbers and keeping them in healthy ranges can mitigate your risk of atherosclerosis and other heart conditions. First things first: Make an appointment with your healthcare provider to see how you’re doing. Learn your numbers and discuss how they may increase your personal risk of heart disease: Total Cholesterol Because cholesterol contributes to the buildup of plaque, keeping your numbers in check means keeping your arteries free of blockages. Check LDL (bad) cholesterol and HDL (good) cholesterol. Your body needs low levels of LDL, but not enough good cholesterol in your system can also increase risk. You can maintain healthy numbers by staying physically active and consuming a heart-healthy diet low in cholesterol and sodium. Statins, the class of drugs used to reduce LDL cholesterol, have proven so effective that the U.S. Preventive Service Task Force recommended in November that all adults older than 40 with one or more risk factors consider taking them. Blood Pressure High blood pressure places undue strain on your heart and arteries to move blood and oxygen throughout the body. And a heart that’s working too hard can lead to stroke, heart attack and heart failure. High blood pressure cannot be cured, but it can be managed by eating a heart-healthy diet low in alcohol, staying active and maintaining a healthy weight. Blood sugar Given that the body converts most of the food we eat into glucose, or blood sugar, for energy, adding sugar to the diet can raise blood sugar to unhealthy levels and damage the heart, increasing risk of cardiovascular disease and obesity. Opt for foods that are low in fat and added sugars and, instead, get your sweets in naturally occurring foods. Let added sugars be a treat and not the norm. Body Mass Index (BMI) Your BMI is used to determine whether you’re at a healthy weight. If you’re carrying extra pounds, the heart has to work harder, which increases risk of heart disease. Losing those pounds and maintaining a healthy weight reduces the burden on your heart and blood vessels and improves your blood pressure and cholesterol levels. So eat a heart-healthy diet and get active — even if you simply walk for 30 minutes a day. Because no symptoms indicate that you have poor cholesterol numbers, high blood pressure or high blood sugar levels, getting screened and learning your numbers is vital. Your doctor can determine what healthy levels look like for you individually and work with you to develop a plan for staying in optimum ranges. That plan will include heart-healthy eating, exercise, abstaining from smoking and, in some cases, medication. It’s up to you to stick with that plan between doctor visits. Do it for yourself, but consider making a pact for a more heart-healthy, active life with a buddy. Research shows people stick with exercise plans longer when they have a partner. This article also appeared in the Reno Gazette-Journal’s Health Source Aug. 27.

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When you’re too sick to go to work but not sick enough for a doctor’s visit, over-the-counter medicines are a welcome relief to help alleviate that fever, runny nose or allergies. But because those medicines aren’t signed off on or managed by your doctor and pharmacist, you must be especially mindful of what you put into your body. Whenever you pop a pill, you want to ensure you’re taking the correct dosage, waiting the right amount of time before taking another dose and not mixing certain medicines. Too Much Tylenol/Acetaminophen Tylenol — or acetaminophen — is a popular pain reliever for many, but too much can be bad for your liver. “Our bodies have a finite ability to metabolize Tylenol,” says Andy Wright, clinical pharmacist at Renown Rehabilitation Hospital. “When too much builds up in the liver, it becomes toxic. In patients with medical conditions like cirrhosis of the liver or hepatitis, this could be disastrous.” Remember, acetaminophen is in more than just Tylenol and generic pain relievers. You may also see acetaminophen in flu, cold and cough medicines, like Nyquil, and some prescription medications including Norco and Percocet. Keep a list of the medications you take, and limit daily acetaminophen use to 3,000 mg per day. When you’re scanning medicine bottle contents, remember acetaminophen is also referred to as APAP, AC, acetam or paracetamol. Mixing Painkillers When you’re dealing with pain and not getting any relief, taking a different medication may seem like the easy solution. Maybe you take some Aleve — a form of naproxen — for a headache, but it isn’t working, so you switch to Motrin, an over-the-counter form of ibuprofen. Not a smart idea. Ibuprofen and naproxen along with aspirin are known as nonsteroidal anti-inflammatory drugs (NSAIDS). Because these medicines work in similar ways, they should never be combined or used in larger doses or more frequently than directed. Otherwise your risk of side effects can increase, which range from mild nausea to severe gastrointestinal bleeding.  It’s also important to consider your family history when taking NSAIDs because, “recent studies have shown NSAIDs may have greater cardiovascular risks for people taking blood thinners or those with hypertension,” explains Andy. “A good example is ibuprofen: It has a relatively low gastrointestinal bleed risk while it has a moderate to high cardiovascular risk. The opposite is true for naproxen.” Rather than experimenting with multiple medicines, figure out which drug works best for you. You may find muscle soreness improves with aspirin, whereas when a headache hits, naproxen is best. Keep in mind that these medications aren’t always best for everyone in the family. “Aspirin in children and teens is not recommended unless under the supervision of a doctor,” Andy says. And pregnant and lactating women should generally avoid NSAIDS due to risk of birth defects and bleeding. “In both of these cases, acetaminophen or Tylenol are preferred but only if approved by an OB/GYN.” Fighting Allergies Over-the-counter antihistamines like Claritin, Zyrtec and Allegra have made fighting itchy eyes and runny noses a little easier. But these daily medicines — when taken inappropriately or in the wrong combinations — can also have an adverse effect. Similar to acetaminophen, you need to watch for antihistamines in other products. Sleep aids — like Tylenol PM and Unisom — commonly use an antihistamine known as diphenhydramine, which may increase your risk of overdose. “Combining antihistamines, or overdosing, can cause many adverse effects including dry mouth, blurred vision — even arrhythmias,” Andy says. “Only take these medications on their own.” If you’re still struggling with symptoms, you can talk to your doctor about adding an over-the-counter nasal steroid.  Andy confirms the importance of closely following the directions listed on antihistamine (and all medicine) bottles. He has seen extended release nasal decongestants cause significant arrhythmias requiring medical care after a patient took the medicine with warm fluids. “The decongestant in question is designed to slowly release, but it can dissolve suddenly in the presence of warm liquids like coffee,” Andy explains. “This can cause the pill to deliver 12 to 24 hours of medication all at once.” Taking an Antidiarrheal with Calcium Calcium supplements and antidiarrheal medicines are another harmful combination. Calcium firms up your stool, but if taken with an antidiarrheal, can cause severe constipation. If you need to take an antidiarrheal, take a break from your calcium for a few days until you’re back to normal. Another consideration when taking calcium supplements or calcium-based antacids is gas. “I’ve had several patients report cases of excessive gas using Tums or calcium carbonate-based supplements.” Andy suggests instead “trying Maalox or Mylanta for indigestion and Citracal as a supplement.” Talk with Your Doctor or Pharmacist About Your Medications If over-the-counter drugs aren’t providing the relief you need, it’s time to see your doctor. And remember, for your safety it is important to keep your doctor and pharmacist up-to-date with any medications — prescribed or over-the-counter — that you are taking.

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