Not So Silent Killer – The Spiraling Effects of Heart Disease Among African Americans

For decades, heart disease has cut a wide swath through the health and well-being of American society. Over 70 million Americans are living with a form of heart disease, and it is the most likely cause of death. Statistics for African Americans are particularly dire. Of 5 million individuals diagnosed with heart disease, 725,000 are African American, with an estimated increase of 900,000 expected by the end of the decade. Although risk factors are identical across racial groups, blacks present multiple factors and symptoms are likely to be more advanced and aggressive. In 2003, American Heart Association statistics showed an alarming 41% of black males and 44.7% black females had cardiovascular disease compared to 34.3% and 32% of white respectively. The harsh social and economic realities of African American life have exacerbated the onslaught of the disease, towards which we are seemingly predisposed. Despite this, blacks remain the most underrepresented and under served population in research studies, clinical trials and treatment. Black women, who have the highest risk factors, remain the lowest on the healthcare ladder for diagnosis and life-saving tests and treatment and are 69% more likely to die from a heart attack or stroke than white women. Grim health outcomes notwithstanding, it is possible to reverse medical predictions to achieve and maintain optimum health through education and positive lifestyle changes.

Risk Factors
The risk factors for heart disease are as follows: hypertension; family history; cigarette smoking; diabetes; obesity; high blood cholesterol and physical inactivity. Previously, increasing age and gender were determining factors; though this is no longer true as the disease has been diagnosed at increasing younger ages. Each year, 40,000 more women than men suffer strokes and women account for 51% of the total heart disease. Secondary risk factors are high levels of triglyceride, the most common type of fat in the body which accelerates to high cholesterol and diabetes; excessive alcohol in-take and previous heart attack or stroke.

Risk factors and symptoms tend to be higher and more destructive in blacks. For example, a black, female diabetic, with attendant factors of obesity and a sedentary lifestyle, may be so far advanced that a limb may need to be amputated. Dr. Malcolm Taylor, MD, Assistant Clinical Professor for University Medical Center, in Mississippi, Director of the Congestive Heart Failure Clinic at St. Dominic-Jackson Memorial Hospital and former President of the Association of the Black Cardiologists explains, “Diabetes is not only a disease involving glucose, it also causes premature aging of the blood vessels. That’s why the number one cause of death for diabetics is cardiovascular diseases.” The virulence of the risk factors have led researchers and genetic scientists to explore the existence of intrinsic biological determinants or a human genome that make blacks more naturally predisposed susceptible to certain chronic illness such, genes for salt retention that causes hypertension and another for that exacerbates diabetes.

The prevalence of hypertension in African Americans is the highest in the world and plays a significant role in cardiovascular complications. Clinical Director of the Hypertension and Vascular Biology and Head of the Hypertension Division of Cardiology at the University of Maryland School of Medicine in Baltimore, Maryland and a founding member of the Association of Black Cardiologist, Dr. Elijah Saunders asserts that one African-American dies as a result of high blood pressure every hour in the US, which is nearly twice as often as whites. “Blacks also develop high blood pressure at younger ages than whites and suffer more damage to their organs as a result of the disease.” The pressure of stressful life experiences negatively impacts cardio vascular health. In today’s fast-paced, competitive environment, a number of external components contribute to elevated blood pressure including social-economic factors such as career pressure, lack of or underemployment, substandard living conditions and racism. In addition, lack of adequate healthcare and shoddy management of chronic illnesses paves the way for long-term heart failure. Stress stimulators often trigger the development of calcification which causes injury to the cells. The accumulated calcium becomes a marker for aththerosclerosis, a thickening and hardening of artery walls which eventually blocks the arteries.

The culture of eating, not to nourish but to fuel the body, is a particular egregious contributor to cardiovascular disease, which relates to the arteries and vessels within the cardiac system. While many Americans are aware that poor nutrition and lifestyle are not conducive to optimal health, cultural practices are difficult to break. Fried and starchy foods, heavy salt intake, dairy, unsaturated fats and high cholesterol meals – staples of traditional African American cuisine – are major causes of aththerosclerosis. Over time, the accumulation of hard-to-process foods particles creates a blockage in the vessels which eventually compromises the arterial walls. Americans’ increasing corpulence and ever-expanding waist line also weighs heavily. Lisa Jubilee, nutritionist and co-founder of Living Proof, Nutrition and Fitness Center in New York City says, “We’re observing the phenomenon of the skinny, fat person who looks great dressed up and doesn’t weigh much, but have substantial fat deposits stored in their midsection causing an apple shape.” The abdominal fat causes heart disease by pressing into the internal organs and decreasing the oxygen supply to various parts of the body.

Yo-yo dieting is also vicious enemy to the heart and the body’s metabolic system. The shock of food deprivation and supply places substantial stress on the body and hinders its ability to lose weight naturally. Jubilee explains, “Your body doesn’t care if you’re trying to lose weight or build muscle, its main focus is survival. Therefore it will try to find nutrients however it can, even it means metabolizing muscle which will then cause atrophy.” Gradually, vacillating dieting habits weakens the heart muscles and leaves other organs susceptible to cardiovascular disease.

What to Look For: Symptoms and Signs
The body sends a number of signals to the individual to bring about life-saving change. One of the most flagrant signals is a transit ischemic attack (TIA) or “mini stroke.” Dr. Donna Mendes, Chief of Vascular Surgery at St. Luke’s Roosevelt, Uptown in New York City, Clinical Professor of Surgery at the College of Physicians & Surgeons, and the first African American female to become board certified in the specialty of peripheral vascular surgery explains, “A TIA occurs when the blood vessel in the brain develops an ulcer caused by high cholesterol. Plaque forms around the crater which eventually breaks off and makes its way through the blood stream towards the brain. The portion of the brain impacted will suddenly experience decreased blood flow, resulting in a TIA.” The part of the body controlled by that portion of the brain becomes impaired, lasting from a few minutes to twenty-four hours. For example, while combing the hair the comb may fall from a person’s hand. Other indicators include loss of sensation on one side of the body, loss of vision, motor function or intermittent pain in the calf after walking, which results from decreased oxygen and blood flow. Peripheral artery disease is also a major element in the development of heart disease. It affects arteries which emanate from the heart, which, when damaged, causes stroke, gangrene or amputation of the lower extremities.

Despite exhaustive studies of heart disease in Caucasians, scientists have only recently begun to study the presentation of the disease in African Americans. Dr. Taylor asserts, “Blacks still receive less cardiovascular care, even for acute symptoms, are less likely to receive EKGs, cardiac testing, bypass surgery or even an aspirin.” Historically considered a man’s disease, women present much milder, vague symptoms than male counterparts, which are often missed by both primary physicians and cardiologists. Because they do not the display the heart clutching, Hollywood version of an attack most associated with heart failure, they are often misdiagnosed or under-treated despite the existence of one or more risk factors. After weeks of persistent breathlessness and vague sense of physical unease, Joan Connell, then 42, an accounting professional at Ziff Davis Publishing, went to the emergency room convinced she was having a heart attack. Despite being an overweight smoker who had been physically inactive for years, she was sent home. A week later she returned with a second heart attack and was rushed into emergency bypass surgery which revealed four blocked arteries.

This year, the National Institutes of Health released the Women’s Ischemic Syndrome Evaluation study (WISE) to address the discrepancy in symptoms between men and women and to assist physicians in identifying and treating the illness in women. Symptoms in men include angina (chest pain), pressure or discomfort in the chest or a tingling sensation in the arm of on one side of the body. Women, however, experience a broader constellation of symptoms over a prolonged period of time. Dr. Patrice Desvigne-Nickens, MD, Head of the Cardiovascular Medicine Scientific Research Group at the National Heart Lung and Blood Institute in Bethesda, Maryland explains, “In the presence of one or more pertinent risk factors, women present a wider set of symptoms for cardiac ischemia which results in heart attack. These symptoms include fatigue; shortness of breath; feelings of indigestion and ill health; palpitations; neck, shoulder and upper back pain; nausea; vomiting; sweating and lightheadedness.”

Connell says that Black women’s superwoman syndrome is detrimental to women’s health and receiving proper care. “We are often over-stressed from working two jobs, taking care of family and juggling multiple responsibilities, the last thing we have time for is taking care of ourselves.” According to Dr. Desvigne-Nickens treatment is time-sensitive therefore the level of damage and the expeditious delivery of treatment plays a significant part in determining the severity of the damage and if the patient survives the attack. Self-care is not selfish. Dr. Desvigne-Nickens says, “Doctors must pay close attention in order to discern symptoms and then order the appropriate test. Women must feel empowered to act quickly to get the necessary treatment.”

Treatment: Cutting Edge Technology, Medication, Protection and Testing
Take heart. Over the years scientists and pharmaceutical companies have developed sophisticated treatment methods, dose-appropriate medications and minimally invasive techniques which have proved effective in the treatment of heart disease. Often EKGs fail to accurately show measure heart defects. Imaging studies have revolutionized how doctors view – and treat – vessel and organ damage.

· Angiography or arteriogram – a procedure that uses X-ray and a special dye to see inside the arteries, veins and heart chambers to detect narrowing or blockage of the vessels. Other forms of angiographies which correspond with various parts of the body include renal, aortic and coronary.
· Carotid Ultrasound – illustrates blood flow and the narrowing of the blood vessels.
· Cardiac Scanning (CT) – examines how well the arteries diffuse blood
· Ankle Brachial Index – predicts the presence and the severity of peripheral artery disease. The patient’s blood pressure is first taken at rest in the arm and in the foot and again several minutes later. A reading under one indicates narrowing of the blood vessel. DR. Mendes also suggests checking the pulse in the groin, behind the knees and in the leg.
· Stress tests – used to determine the amount of stress the heart can manage before developing either an abnormal rhythm or evidence of ischemia. One of the more popular, the treadmill test provides information on how the heart responds to exertion and involves walking on a treadmill or pedaling a stationary bike at varying levels of difficulty, while electrocardiogram, heart rate and blood pressure are monitored.

How to Stop Heartburn – Simple Ways to Heal Heartburn and Acid Reflux

If you suffer from Heartburn or acid reflux, you must read this book. Anil Minocha and Christine Adamec explain Heartburn, its causes and treatment in a very simple and comprehensive manner. Use of medical terminology, though unavoidable, has been kept to a minimum and the authors have invested a lot of effort and style in directly addressing the reader. Reading the book, it felt like having a one on one consultation with your doctor. Having suffered in the past from heartburn, I wish I had discovered and read this book some few years ago. In my view, anyone who decides to read this rare and compelling book, will gain these benefits;

o Good understanding of the conditions, heartburn and gastroesophageal reflux disease (GERD), which is commonly called acid reflux. The authors have painstakingly explained the conditions, making them painless for the reader to understand.

o You will also understand the causes of heartburn and acid reflux. After reading this book, you will start to challenge if not all, some of your own held beliefs about the causes of the condition.

o Understand how the disease is diagnosed. Not many physicians do get the diagnosis right at the first attempt. Despite that you may find the symptoms of heartburn sometimes frightening, uncomfortable and challenging, in most cases, doctors will fail to administer you with the right treatment. Most doctors tend to prescribe less effective over-the-counter antacid medications. In this book, you will learn and understand your diagnosis better.

o Imagine those frustrating moments when you spent so much money on antacids but yet the symptoms would not go away. When you read, “How to Stop Heartburn: Simple Ways to Heal Heartburn and Acid Reflux”, you will understand that antacid medication are not always the best long-term solutions for resolving the causes of heartburn. The authors have also brought to your attention the dangers of self-medication and the consequences of failing to seek early medical advice.

o You should be relieved to know that heartburn and acid reflux can be treated. There are many advanced medications available for treating heartburn, GERD or acid reflux. This is revealed in the book.

o Treatment of heartburn does not only require medication, you also need to make changes to your lifestyle. In the book, the authors explored how best you can learn to understand your lifestyle and to make changes to help you overcome the condition.

o You will also gain good information on other forms of treatment such as alternative remedies for heartburn. Heartburn during pregnancy, infancy and childhood are also explained.

o Lastly, apart from enhancing your understanding of heartburn and acid reflux, the authors have also included in the book very useful tools such as a food diary, which you can complete to identify the triggers of your heart burn and stop it right in its tracks.

All About Hemorrhoids – Their Treatment And Prevention

Hemorrhoids, also known as piles, are the dilatation, the stretching beyond normal dimensions of radicles of rectal veins inside the anal canal. In this instance a radicle is the smallest branch of a blood vein. Veins are weak compared to arteries due to their thin walls, therefore veins can become strained and twisted with any great back pressure. Veins have one-way valves to prevent back flow. The three rectal veins are named accordingly superior, middle and inferior rectal veins. Obstructions or pressure increase in these veins cause hemorrhoids.

Piles, or hemorrhoids, come in two types, internal and external. External hemorrhoids are outside the anus and are skin covered. Their color may be brown or black. Because nerves are so abundant in the anal area an external hemorrhoid is extremely painful.

The second type, internal hemorrhoids are in the interior of the anal canal, internal to the anus. They are purple or red and have a mucous membrane covering. They are usually painless. It isn’t unusual for a person to have both external and internal hemorrhoids at the same time.

Conditions that can lead hemorrhoids –

Hemorrhoids, a familial disease, tend to occur among members of a family, is sometimes blamed on heredity. The only animals that get hemorrhoids are those that stand on two legs. Most likely this is due to rectal vein congestion because of the pull of gravity. People who are chronically constipated often have piles problems. Resisting the urge to move your bowels at your body’s signal can bring about constipation and then hemorrhoids.

A high intake of meat, chicken, shrimp, spicy foods and more lead to hemorrhoids. The people least likely to get piles are those who have a high percentage of vegetables and fibrous food in their diet. Some women get hemorrhoids during pregnancy because of the uterus compressing the rectal veins. Rectal cancerous lesions might bring about hemorrhoids through obstructing blood flow.

Symptoms and indications of hemorrhoids –

With external hemorrhoids a protuberance can be seen and felt around the anus. There will be pain and discomfort in the anal area. While straining to expel a stool the pain will be worse.

Early on, internal hemorrhoids can’t be felt. Subsequently, in progression of the disease, the hemorrhoids will protrude as a stool is expelled and then retreat by themselves. When the condition worsens the protruded hemorrhoids won’t go back.

Bleeding isn’t unusual for either type hemorrhoid. However, when an internal hemorrhoid is retracted it could bleed internally, into the rectum. Bleeding occurs in splashes while pushing to expel a stool. In some cases the bleeding may be quite profuse. With both types of hemorrhoids there may be a mucus discharge and it will itch around the anus.

Other things brought about through hemorrhoids –

Hemorrhoids can become infected and the infection spreading to deeper veins and producing septicemia. Septicemia is blood poisoning caused by pathogenic microorganisms and their toxic products in the bloodstream.

Thrombosed hemorrhoids are not considered dangerous, however, they do cause considerable pain and swelling because they affect the nerve endings located in the anal skin. They’re first noticed as an acute extremely painful swelling at the anus. Thrombosis is the formation of a blood clot inside a blood vessel that obstructs the flow of blood. It occurs because of high pressure on the veins during excessive straining efforts. It’s rare to see thrombosis of an internal hemorrhoid.

Fibrosis usually follows thrombosis and is more common with external hemorrhoids than the internal type. Initially fibrosis is like a bump but with repeated friction of stool expulsion it will develop a stem like connecting part.

Suppuration is very rare and comes about because of infection of a thrombosed hemorrhoid. It’s accompanied by throbbing pain and swelling at the perianal region. An abscess with discharge of pus isn’t unusual.

Gangrene can develop when the tissues in the hemorrhoids and the adjoining skin die because of loss of blood supply. That occurs only when the arterial supply of the hemorrhoid is somehow or the other constricted.

Treatment of hemorrhoids –

Hemorrhoids are usually first treated based on the symptoms observed. Mild cases can be treated with over the counter medications, usually some type of cream or ointment. Moderately severe cases will respond to prescribed medications containing hydrocortisone acetate and pramoxine hydrochloride. Constipation should, of course be treated. If the medicines such as creams, ointments and foams are not producing results then the following treatments might be considered.

A thrombosed external hemorrhoid, one that has developed a blood clot, can be removed by cutting after administering local anaesthesia. The area is cut into using a scalpel and the clot is removed. There is nearly instant relief of the sharp pain. However, a dull ache may continue. Sitz baths, over-the-counter pain medications and the use of a rubber or air rubber donut may help with the pain.

Sclerosant injection can reduce hemorrhoid size. Sclerotherapy is a procedure used to treat blood vessels or blood vessel malformations. A medicine is injected into the vessels, which makes them shrink. This procedure is also used to treat varicose veins.

Rubber band ligation around the base of hemorrhoids is an useful outpatient treatment for second-degree internal hemorrhoids. The surgeon places a couple of tight rubber bands around the base of the hemorrhoidal vein which will cause it to lose its blood supply. The hemorrhoid will then shrivel and die within 2 to 7 days. The shriveled hemorrhoid and band will fall off during normal bowel movements.There may be some discomfort for a couple of days days after the procedure and a minor amount of bleeding may be experienced.

Cryosurgery has fallen out of favor as a treatment for hemorrhoids. The procedure consists of freezing and destroying internal or external hemorrhoids with a cryoprobe, which uses nitrous oxide or liquid nitrogen as freezing agents. The hemorrhoids are either directly frozen ligated first. In either case, local anaesthesia is usually used to deaden the pain.

Cryosurgery is more painful than other medical surgeries. And in addition, the patient will have an open wound for as long as a couple of weeks after surgery which can become infected. Moreover, patients can have an abnormal rectal discharge or foul odor which may require the use of absorbent pads.

Anal dilatation, or stretching of the anal canal, is no longer a method of choice for hemorrhoid treatment. The high incidence of fecal incontinence is, perhaps, the most objectionable side effect. Additionally, anal stretching can increase the rate of flatus incontinence. However, it may still be considered to help help younger women and en with overly tight sphincters who otherwise would have needed surgery. It may also helpful with strangulated and thrombosed prolapsed hemorrhoids.

Hemorrhoidectomy is the removal of hemorrhoids through surgery. It is done under general anesthesia and usually in a out patient surgery center. The surgery is performed with a scalpel, a tool that uses electricity (cautery pencil), or a laser. Hemorrhoidectomy is used primary only in severe cases for both internal and external hemorrhoids. It is significant post operative pain and usually it requires two to four weeks for recovery.

Prevention of hemorrhoids –

Diet and habits are the primary means of preventing hemorrhoids. Your diet should include plenty of of fruits and vegetables and fibrous food. Go easy on meats and shellfish. Eat when hungry, of course, but try to keep regular eating times. Make water your prime liquid intake, and drink plenty of it. Be regular in your bowel movements and do take something, food or medicine to treat constipation.

Holistic and Natural Health Education

Natural health courses are gaining popularity among those that are looking for comprehensive education in holistic health and healing. To become a holistic healer it is very important to attend a well – known and recognized natural health college. In holistic health courses students learn about the holistic and non-invasive health approaches for disease prevention and wellness-optimization.

If you want a career in holistic healing you can get a holistic degree by pursuing education through an alternative medicine school. Unlike modern medication, holistic healing is basically used as a subsequent treatment along with the traditional medicine and cures the disease without any side effect that is why a large number of students have started exploring holistic healing courses and other ways to earn a holistic degree and become a specialized holistic leader.

For those who are unable to attain a regular holistic degree from a full time alternative medicine college, there is a chance to attain it through a reputed distance learning natural medicine university. It is always advisable for a student to check his requirements and discuss the same with the distance learning holistic health college.

A holistic degree can be earned upon a completion of an educational program in holistic health sciences. Taking admission in a renowned alternative medical college is the first step towards making a bright career in holistic medicine. The syllabus include an in – depth study of various subjects such as mind-body-spirit medicines, homeopathy, naturopathy, various massage therapies, oriental medicines and various other subjects.

The holistic doctors that have earned their degrees are permitted to work in various natural pharmacies, interactive medical clinics, other similar medical practices and can open their personal clinics. Along with an interesting career and peace of mind, the professional knowledge of natural healing can also provide complete financial stability. Like all other degree programs alternative therapy courses also provide the students with great opportunities of employment, personal and professional growth so that you may help yourself financially and cure others.

What to Look for in a Home Health Care Provider

Anyone in need of home health care deserves non-medical care or in home medical care that is compassionate whether the patient is a child, adult or elder. Home health care services are provided anywhere except for in nursing homes or a hospital. These services may even be provided at an assisted living facility, a school, apartment or house.

As far as care plans go, there are a wide variety of personal care and nursing services that are not just available, they are tailored for the needs of each individual recipient. Customized care plans and follow up assessments should be provided by a registered nurse.

Nursing Supervision and Case Management

The care that is provided by personal care assistants and home health aides is typically supervised by a registered nurse. One of these registered nurses should be on call at all times in order to assist the caregivers as well as to provide medical training and oversight and to implement the plans of care.

Elder or Adult Care

Are you aware of the fact that 75% of the health care costs in the US are incurred by only 12% of Americans? These people generally have some type of chronic illness. The benefits of this type of individualized home care include much more than just being able to keep someone at home for their illness as opposed to being institutionalized or put in a long term care facility. As far as cost goes, home care visits are roughly only 10% of what a single day in the hospital will cost.

Additionally, home health care has a track record that has been proven when it comes to things such as reducing readmissions to the hospital, expensive visits to the emergency room and in managing chronic illnesses. In addition, there is scientific evidence that has proven that patients are able to heal faster when they are in their own homes. Both morbidity and mortality rates are reduced in patients who take advantage of home health care. In fact, 90% of seniors facing long term care in nursing homes prefer to stay home and get the services of a home health care provider.

Private Elder Care Coordination, Planning and Management

This involves both advising and then assisting families when it comes to determining the necessities of an aging adult. These caregivers are able to navigate many of the long term type of care resources that are available in your area. The goal here is to educate and inform the family of what the options are and them to assist them with the implementation of their decision. Typically this is done by an RN who has been certified and specially trained in the area of geriatrics who can provide:

The services of being a liaison for family members who may live a great distance away
Educating and advocating for the patient
Assisting with paperwork and forms that are related to insurance, medical assistant and Medicare
Screening, arranging for and then monitoring any in home help or options for institutional or residential care options
Care planning that is tailored to the patient