Posts filed under ‘WEALTH’
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High Blood Pressure: The Facts
What is high blood pressure, or hypertension?
You are considered to have HTN if your BP is > 140/90 and prehypertensive if your BP is between 120/80-140/90.
What should my blood pressure be?
I’d like it to be 120/80 or lower.
What do these readings mean?
Blood pressure is the pressure of the blood against the walls of the arteries.
- The higher (systolic) number represents the pressure while the heart contracts to pump blood to the body
- The lower (diastolic) number represents the pressure when the heart relaxes between beats.
How do I know if I have high blood pressure?
HTN is considered a “silent killer” because most people do not know that their BP is elevated. Some people may experience flushing, dizziness, headaches, or visual changes when their BP is high. The best way to see if you have HTN is to check your BP at home when you do not feel anxious. Take it once daily for a week at various times and average the total readings.
Is it dangerous for my BP to get too low?
There is no specific number at which blood pressure is considered too low. Most doctors consider chronically low blood pressure dangerous only if it causes noticeable signs and symptoms such as dizziness or fainting. I have patients who have always run in the 90s/60s and that is normal for them.
My BP has always naturally been high. I don’t need to lower it…
I nag you about your BP because studies indicate that there is a true and direct correlation between untreated high blood pressure and risk of stroke and heart disease.
How can I eat to reduce my BP?
Follow the DASH diet. Click on this link to access more information about this
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
Exercise for at least 30 minutes per day most days of the week, and consume a low salt diet.
How much salt should I consume in my diet?
You should be getting less than 2300mg sodium per day if you don’t have HTN. This is equivalent to 1 tsp of salt per day. If you are African American or have a history of HTN, then you sodium allowance is 1500mg or less than 1 tsp salt/day. I prefer that you use natural salt or sea salt as common table salt has added chemicals and table salt is heated to over 1200 degrees Fahrenheit altering the natural chemical structure of the salt which could cause health problems. Better yet, don’t add salt to your diet and try to eat foods in their natural states.
What are the best BP cuffs?
Obviously the one that gives you the best reading 
Seriously though, I recommend to my patients Omron cuffs for their reliability. The A&D Medical Lifesource cuffs are also well reviewed. For those who find the upper arm cuffs difficult to use, I recommend the Omron HEM 650 wrist monitor as it is generally accurate.
Can I check my BP at a grocery store or pharmacy?
Many supermarkets and drugstores offer free blood pressure monitors for public use. But these machines are used continually and can get seriously out of calibration, so the value of the readings taken using those is limited.
Cholesterol: The Good, The Bad, And The Ugly
What Is Cholesterol?
Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body’s cells. It’s normal to have cholesterol because it is used for producing cell membranes and some hormones, and serves other needed bodily functions. But too much cholesterol in the blood is a major risk for coronary heart disease (which leads to heart attacks) and for strokes.
Cholesterol comes from two sources: your body and food. Your liver and other cells in your body make about 75 percent of blood cholesterol. The other 25 percent comes from the foods you eat.
How Do I Interpret My Lipid Profile?
Cholesterol can’t dissolve in the blood. It has to be transported to and from the cells by carriers called lipoproteins. Low-density lipoprotein, or LDL, is known as “bad” cholesterol. High-density lipoprotein, or HDL, is known as “good” cholesterol. These two types of lipids, along with triglycerides make up your total cholesterol count.
LDL (Bad) Cholesterol
When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed your organs such as the heart and brain. It can form plaque, a thick, hard deposit that can narrow the arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, a heart attack or stroke can result.
HDL (good) Cholesterol
Approximately one-fourth to one-third of blood cholesterol is carried by high-density lipoprotein (HDL). HDL cholesterol is known as “good” cholesterol, because high levels of HDL seem to protect against heart attack. Low levels of HDL (less than 40 mg/dL) also increase the risk of heart disease. HDL carries cholesterol away from the arteries and back to the liver, where it’s passed from the body. Some experts believe that HDL removes excess cholesterol from arterial plaque, slowing its buildup.
Triglycerides
Triglyceride is a form of fat made in the body. Elevated triglycerides can be due to being overweight/obesity, physical inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates (60 percent of total calories or more). People with high triglycerides often have a high total cholesterol level, including a high LDL (bad) level and a low HDL (good) level. Many people with heart disease and/or diabetes also have high triglyceride levels. People with high triglycerides also tend to carry more of their fat around their middle.
What Should My Cholesterol Be?
The following guidelines are from the American Heart Association:
| Initial classification based on total cholesterol and HDL cholesterol |
| Total Cholesterol Level | Category |
| Less than 200 mg/dL | Desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk. |
| 200 to 239 mg/dL | Borderline high |
| 240 mg/dL and above | High blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL. |
| HDL Cholesterol Level | Category |
| Less than 40 mg/dL (for men) Less than 50 mg/dL (for women) |
Low HDL cholesterol. A major risk factor for heart disease. |
| 60 mg/dL and above | High HDL cholesterol. An HDL of 60 mg/dL and above is considered protective against heart disease. |
If your total cholesterol is 200 mg/dL or more, or your HDL cholesterol is less than 40 mg/dL (for men) and less than 50 mg/dL (for women), you need to have a lipoprotein profile done to determine your LDL cholesterol and triglyceride levels. If your cholesterol is high or you have other risk factors, your healthcare provider will likely want to monitor your cholesterol more closely. Follow your provider’s advice about how often to have your cholesterol tested. He or she will set appropriate management goals based on your LDL cholesterol level and other risk factors.
| LDL Cholesterol Level | Category |
| Less than 100 mg/dL | Optimal |
| 100 to 129 mg/dL | Near or above optimal |
| 130 to 159 mg/dL | Borderline high |
| 160 to 189 mg/dL | High |
| 190 mg/dL and above | Very high |
Your LDL cholesterol goal depends on how many other risk factors you have.†
- If you don’t have coronary heart disease or diabetes and have one or no risk factors, your LDL goal is less than 160 mg/dL.
- If you don’t have coronary heart disease or diabetes and have two or more risk factors, your LDL goal is less than 130 mg/dL.
- If you do have coronary heart disease or diabetes, your LDL goal is less than 100 mg/dL and closer to 70.
Triglyceride is the most common type of fat in the body. Many people who have heart disease or diabetes have high triglyceride levels. Normal triglyceride levels vary by age and sex. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol seems to speed up atherosclerosis (the buildup of fatty deposits in artery walls). Atherosclerosis increases the risk for heart attack and stroke.
| Triglyceride Level | Category |
| Less than 150 mg/dL | Normal |
| 150–199 mg/dL | Borderline high |
| 200–499 mg/dL | High |
| 500 mg/dL and above | Very high |
† Electronic 10-year risk calculators are available at http://hp2010.nhlbihin.net/atpiii/calculator.asp?usertype=pub.
How Much Cholesterol Should I Eat Per Day?
Someone with normal LDL cholesterol should have less than 300mg of total cholesterol per day, and someone with high LDL or who is on a cholesterol lowering medication should get less than 200mg per day.
You can go to the following link to get a report on personalized cholesterol treatment options based on your profile. http://www.americanheart.org/presenter.jhtml?identifier=3000416
What Can I Do To Lower My Cholesterol?
Some cholesterol is made by your body. The food you eat is responsible for the rest. Food products from animals contain cholesterol — including meats, poultry, shellfish, eggs, butter, cheese and whole or 2 percent milk. And any type of food can also contain saturated fats and trans fats, which cause your body to make more cholesterol.
The American Heart Association recommends that you keep your intake of total fat to between 25 percent and 35 percent, your saturated fat consumption to less than 7 percent and your intake of trans fat to less than 1 percent of your total daily calories.
At the same time, limit your intake of cholesterol from food to less than 300 mg per day. People with high LDL (bad) blood cholesterol levels or who are taking cholesterol medication should consume less than 200 mg of cholesterol per day.
Eat at least 25 to 30 grams of dietary fiber each day — preferably from whole grains, fruits, vegetables and legumes.
To combat high blood pressure and for overall cardiovascular health, limit sodium to 2,300 mg or less ( 1 tsp or less) per day. Some people — African Americans, middle-aged and older adults, and people with high blood pressure — need less than 1,500 mg per day. And if you drink alcohol, do so in moderation (no more than one drink a day for women, no more than two for men).
But a heart-healthy diet isn’t just about what you shouldn’t eat. It also means eating a diet rich in vegetables and fruits, with whole grains, high-fiber foods, lean meats and poultry, fish at least twice a week, and fat-free or 1 percent fat dairy products. Also, the diet should be low in saturated fat, trans fat and cholesterol.
By learning to make smart choices — whether you’re cooking at home or eating out — you can enjoy flavorful foods while you manage your cholesterol.
For those of you who need some help in planning and preparing healthy meals, you may want to check out meal planning sites on the web. Here is a good site that I recommend to my patients: Healthy Menu Planning
You’ve Put Me On A Cholesterol Lowering Drug, Now What?
We will check your liver every 3 months for at least the next year then determine the frequency of testing. You should continue to take this every day and follow a low cholesterol diet. I want to see your LDL below 100 for sure and as low as 70 if you have multiple risk factors (high blood pressure, diabetes, previous heart disease). You still need to incorporate exercise and a low cholesterol diet into your daily regimen. A drug can only do so much…
How long do I need to take my statin drug? Can I just go off it when my cholesterol goes down?
No, studies have shown that statin therapy taken continuously can reduce the long term risk of developing heart disease if you don’t have it and preventing another heart attack/or increasing plaque build up in the coronary arteries if you already have known heart disease.
I’ve Heard So Much Bad News About Statins. Aren’t These Drugs Dangerous?
Here’s the scoop on statins: If 1,000 people take statins for a year, about 51 will report minor muscle pain. But if 1,000 people take a placebo, about 49 will report such pain. That means that statins are responsible for minor muscle pain in just 2 out of 1,000 people per year. Similarly, statins are responsible for serious muscle pain (called myopathy, severe enough to stop use of the drug) even less often—in about 5 out of 100,000 users per year. Finally, the drugs cause a potentially fatal muscle disorder (rhabdomyolysis) in 1 or 2 out of 100,000 users per year. To put this in perspective, it’s estimated that statins prevent more than 1,500 heart attacks and strokes per 100,000 users each year.
Time Savers For The Time Lacking
As a busy professional working mom, I have had to learn a few things about setting priorities and doing things to save me time NOW and not LATER. Of course, I still have much to learn here as the box of mail in my office lays shamefully hidden in the corner, the medical journals and flyers on CMEs and the newest medical gadgets overflowing. It is the same scenario every day as I walk into my office: Me with a pang of guilt and almost panic as I survey the ever-growing pile knowing that I could easily dump everything into the trash but there is still this part of me that thinks “wait, I might need to know the six signs of rare osteosarcoma should it come walking into my exam room once in the next thirty years” or “hey, I should be reading about phantom limb pain in my spare time (ha ha I laugh internally, this longstanding joke with myself since the kids were born).” So the journals and letters and other fascinating pieces of scientific knowledge stay in the corner due to my fear of needing them in the future and the ever present realization that bringing home another bag of mail would bring the total count of scattered plastic bags in the house to seventeen. My husband would be far from happy..
So I digress…like I mentioned before, it is important to let go of nonproductive activities (do not try to sort mail in big box when you know you won’t throw anything away in the end, it’s best just to leave it sitting there), and learn to set priorities.
1. Start with “A-priority” tasks; is it the best use of your time?
2. Fight procrastination; do it now if it’s important.
3. Subdivide large, tough tasks into smaller, easily accomplished parts.
4. Eastablish a quiet hour, even though it requires will power and may not always work.
5. Learn to say “no” when you’ve got something important to do.
6. Learn to delegate. (Lina, anyone?)
7. Accumulate similar tasks and do them all at one time.
8. Minimize routine tasks; spend only the time they deserve. Shorten low-value interruptions. Throw away junk mail and other low-value paperwork. Delegate, shorten or defer indefinitely the C-priority tasks i.e. medical journals–I’m just kidding here folks, I do keep up on new findings
9. AVOID PERFECTIONISM. Remember the 80/20 maldistribution rule.
10. Avoid over-commitment. Be realistic about what you can do in the time you have.
11. Do difficult things quickly; waiting doesn’t make them easier.
12. Try to handle paper only once.
OK, now for the exercise part. Many of you hear me nagging you about exercise and how important it is. You’ve stomped your feet indignantly at the thought of 10,000 steps per day, and I’ve seen the horror cross many a face when I mention waking up earlier to exercise. Exercise is fabulous for heart protection, stress reduction, immune boosting, mood elevation, pain relief, insomnia, weight loss, dementia prevention, the list goes on. I do understand that you may feel too tired at the end of the day to exercise, or you may feel that you don’t have time to do it. Here’s what I do when I only have 10-20 minutes to spare for exercise. I put in Tony Horton’s 10 Minute Trainer and ta-dah it’s done. You get the same cardiovascular benefits of 3 10 minute work-outs throughout the day as doing it all at once. So, you may not have half hour blocks, but I’m sure you can find ten minutes to spare!
As for eating, I have found another time saver here as well. There is a wonderful program on the web that helps you save time by meal planning for you. It’s called Menu Planning Central and includes healthy menus, family friendly menus and vegetarian menus. Not only do you save time by planning ahead, but you save money when grocery shopping. I was trying to get by with the microwaveable Trader Joe’s foods, but who can blame the children for spitting up food when they’ve had the same lasagna, penne pasta with tomato sauce, rosemary chicken and wild rice in rotation for the past 5 months (I kid you not). Meals are simple to prepare and are healthy as well. Check it out here:
I hope you find the above ideas helpful for you in your crazy lives. There will never be more than 24 hours in a day, so we just have to figure out how to get everything done with the time we have. Now, go out and live!
Don’t Buy A Franchise Until You Hear This
http://www.bestrecessionproofjob.com?site=MyOwn7&t=franchisevid
Looking to buy a franchise? The best franchise business opportunity may involve less work, start-up, and headache than you think.
What Is WEALTH?
I have decided to start a new blog site to discuss a topic that interests me: The concept of true WEALTH. People immediately jump to the conclusion that wealth equal money, but that is only one sixth of the equation. Being rich does not make you WEALTHY. I will briefly summarize what true WEALTH entails, and will explore each topic in detail with future blog posts.
W: Winning portfolio
E: Entrepreneurship
A: Abundance mentality
L: Letting go
T: Tribe building
H: Health optimization
You may be wondering why you should listen to me or what qualifications do I have to be teaching YOU about WEALTH. I do not have an MBA. I am not a certified financial advisor. I am a physician who has been a business owner as well as an employee. I have spent the last decade interacting with thousands of people, and have developed the skills needed to guide patients toward their fitness goals. I have observed in a majority of patients that having the desire to be healthy does not always translate into the ability to achieve great health. I have found that the only way for people to become healthy is to provide them with the knowledge of how their bodies work and give them the tools to treat themselves.
The same can be true of becoming financially wealthy. The only way that you can learn to grow rich is to understand money and learn how to manage it yourself. It is amazing to me that we hand over our hard-earned money to complete strangers to manage when we’d never do the same to our children. If you are interested in wealth creation, you must first respect each and every dollar you make.
Treat money as if it were an extension of you, as if it were your child—if you know how it’s made, if you know where it is at all times, if you can take the time to nurture and invest in it, then and only then will you see it transform from a single dollar into astounding wealth.
You may also be asking yourself why I chose to mix my two interests, that of wealth creation and that of health. My question to you is how could I not? In the last few years, I have watched our economy’s recession play out in my exam rooms. I have treated stress, anxiety, insomnia, depression, high blood pressure, weight gain, and much more because of money or the lack thereof. I have witnessed couples separating because of money. I have had dozens of patients who couldn’t afford to see me because they lost their jobs and health insurance. I have used compassion, prescription medications, and acupuncture in my practice, but these doctor “tools” cannot save people from foreclosure or from losing their jobs. My words of “exercise will help your pain” cannot bring more time to the lives of stressed-out patients with pain who cannot find the time to balance their work and personal life.
I hope to provide you, my readers or patients, with the tools necessary to create abundance in your lives. Whether it take the form of money, spiritual or personal growth, a sense of vitality and happiness, or your ability to spread this wealth to others I do not know, but it is my purpose to leave an imprint outside of the exam room and to change the meaning of health than that which can only be “seen.”
