Good News – Bad News

Posted by Steven Reinberg, HealthDay Reporter

While progress is being made in reducing the number of stroke deaths, it seems that more people who experience these brain attacks have significant stroke risk factors, a new study reveals.

The rates of high blood pressure, diabetes, abnormal cholesterol, smoking and drug abuse have all been on the rise in stroke patients over recent years, the study authors said.

The study included over 900,000 people hospitalized for stroke between 2004 and 2014. Each year, prevalence of high blood pressure went up by 1 percent, diabetes rose by 2 percent, high cholesterol went up by 7 percent, smoking increased by 5 percent, and drug abuse jumped 7 percent, the researchers found.

“The risk of dying from a stroke has declined significantly, while at the same time the risk factors are increasing,” said researcher Dr. Ralph Sacco. He’s a professor of neurology at the University of Miami Miller School of Medicine.

“We are not exactly sure why these increases are occurring,” Sacco said.

It’s possible that doctors are getting better at diagnosing risk factors. Or certain lifestyle factors may play a role, Sacco suggested. These include obesity, lack of exercise, poor diet and smoking.

The increase of drug abuse among younger patients is especially concerning, he added.

Although the increases in risk factors were seen in all racial and ethnic groups, increases in high blood pressure among blacks and diabetes among Hispanics stood out, Sacco noted.

He stressed that patients need to know their blood pressure, blood sugar and cholesterol levels. “There are great medications that can be used to treat those conditions,” Sacco said.

“We need to go further in controlling risk factors, like diet and exercise,” he advised.
According to Dr. Salman Azhar, director of stroke at Lenox Hill Hospital in New York City, “The challenge now is to prevent strokes, and if they have had a stroke, trying to prevent a second stroke. This is where the importance of these risk factors comes in.”

The responsibility to reduce risk factors lies with patients, but also with the community, he continued.

“It’s up to communities to provide access to better food and places to exercise. We have a responsibility as a community and a health system,” Azhar said.

The 922,000 people included in the study had been hospitalized for an ischemic stroke, which is caused by a blocked blood vessel in the brain. These are the most common types of stroke.

The number of stroke patients who had one or more risk factors increased from 88 percent in 2004 to 95 percent in 2014, the findings showed.

For hospitalized stroke patients during the 10-year study period, high cholesterol rates more than doubled, from 29 percent to 59 percent, and the rate of diabetes went from 31 percent to 38 percent.

In addition, high blood pressure rates increased from 73 percent to 84 percent, and the prevalence of drug abuse doubled from 1.4 percent to 2.8 percent. Also, kidney failure increased each year by 13 percent, and plaque buildup in the carotid (neck) arteries rose by 6 percent each year, the investigators found.

Dr. David Katz is director of the Yale-Griffin Prevention Research Center in Derby, Conn. He said the improvement in stroke survival “suggests we are relying on advances in treatment while neglecting prevention.”

Katz, who is also president of the American College of Lifestyle Medicine, said, “Treating disease is never as good as preserving health and vitality. This study is a precautionary tale of the questionable and costly choices we seem to be making as a culture.”

The report was published online Oct. 11 in the journal Neurology.

Copyright © 2017 HealthDay. All rights reserved.

How Did I Do at University of Portland?

 

 

 

 

First thing: I spoke THREE times in one day; I have never done that before!  This was another milestone for me.

I love the University of Portland because I can deliver the same speech, varies ways, to test certain things out.  But THIS time, I delivered the SAME speech, the same way, to all three groups to see if there was any variation in the way certain people view my presentation.

You would think if I didn’t do anything different, all threes groups would behave the same way.   WRONG!  Each of the three groups behaved differently!

To me, I was blown away. How could three groups be so different?I gauge the groups by the laugh I get at the beginning.  If they don’t laugh, I know it will be a tough group.

All three group responded the same way to my questions before I ask before the speech.  I thought if I started with these questions, I would urge them to listen.

I worked up to my first laugh:

I was a young, healthy, active, non-smoking, non-drinking- mostly non- drinking – normal cholesterol man,….. just like this guy! (point, Laugh)

 

 

 

 

 

There were no laughs!   I looked at Jill, thinking I didn’t say my line write.  Nope…I said it correctly!  So I continued on, with maybe a chuckle  or two at a few points. Then at the end, they asked a bunch of questions!  Were they the same group that heard my talk?

Then I had the second group.  They REALLY loved the picture!  I had to wait before I could continue because they were laughing so much!  When the end came, they didn’t ask ANY questions…but they stated to thank me…and we had to give another book to someone who didn’t look like she was paying attention but she was actually moved by my talk!

The third group had a few chuckles.  They asked a few questions at the end.  You never know what kind of impact you will have on a group until the very end of the talk, when they are leaving the room.

It must be tough being a stand up comic!

Stroke at 30??

Stroke at 30-something: You Can Come Back.  The Right Attitude, Therapy and Caregiver Support is Vital to Successful Rehabilitation

Stroke survivor Jessica “Jess” McNair can joke about it now—one of the reasons, in fact, she is convinced that it’s her sense of humor that helped her recover from a series of strokes this year. At 32 years old, Jessica experienced what doctors described as “cascades of multiple strokes” resulting from irregularly formed arteries in her neck. The event left the San Rafael, Calif., resident unable to walk, talk or care for herself.  The prognosis was bleak and Jess’ team of doctors predicted she had a five percent chance of living.  Her road to recovery started with a grueling schedule of occupational, speech, and physical therapy.

“I had overwhelming amounts of denial from the very beginning,” said Jess describing her first reaction to the news given to her at the hospital. Although Jess was preparing to move to London and bartending to save money, she doesn’t see herself as a victim: “I consider myself strangely pessimistic in an optimistic way.”

This is where Jess’ older sister Kate comes in.

The Caregiver’s Life is Changed

No individual or family is ever prepared to fulfill the role of a full-time caregiver. Looking back, Kate recalls that both her and Jess were overwhelmed with emotion. “We were both crying, but immediately started joking,” says Kate who feels that maintaining a good sense of humor is a necessary coping skill for everyone – but especially for stroke survivors. “When I walked into the hospital I told her that there are other ways to get a day off – you don’t have to have a stroke!”

A fulltime sales professional, wife, and expectant mother at the time, Kate knew early on that she had to deal with the situation personally. The then 34 year-old recalls the vagueness of the doctors and nurses in answering her questions, which emphasized how important it was for her to take control of the situation. Shouldering the responsibility of work and the physical demands of pregnancy, Kate now had the added role of primary caregiver to her younger sister.

Thankfully, Kate was able to rely on her husband and friends who helped deal with insurance companies, meal preparation, and physical therapy.

“There was a lot of planning. We had to plan how to watch her. It was pretty scary and the frustrations were there,” Kate remembers.

When it came to working as a team, Kate recalls Jess’ determination, “She was really determined. We would make a diary and everyday have these little goals.” This helped support the efforts of her rehab.

A Great Rehab Team

For stroke survivors, rehabilitation options depend on the severity of their stroke, their level of disability, and the intensity of rehabilitation exercises they are able to endure. The goal of rehabilitation is to improve the survivor’s function so that they can regain independence and live life without relying on a caregiver.

Upon suffering a stroke and calling the ambulance herself, Jess was admitted to the Intensive Care Unit at Marin General Hospital where she had two more big strokes. She was then accepted to the rehabilitation program at California Pacific Medical Center (CPMC)—Davies Campus while she still had a tracheotomy. At the time, Jess couldn’t speak or make a noise. Through their sisterly-bond, Kate was the only person who could read her lips and understand her. “I guess you could refer to me as a vegetable at that point—I was not moving at all,” Jess points out. This marked the beginning of her three-month stay at CPMC’s inpatient rehabilitation facility, before being transferred to their outpatient program.

“I had three amazing people working with me—I call them my heroes,” referring to her occupational, physical, and speech therapists with whom she remains friends to this day. During her recovery, the skilled professionals got her standing up and walking again with assistive technology such as the EksoGT™, a wearable exoskeleton that helped train her body to walk with a proper gait, and an electronic stimulation machine that enabled her to relearn vocalization.  With these devices, both Jess and Kate noticed improvement, providing Jess the much needed confidence and motivation to continue her therapy.

A Time for Independence

Jess is still in recovery and has been able to regain some of her independence with the help of Kate and her army of “heroes.” The sisters, who will be separated in the upcoming months due to Kate relocating to Minneapolis, feel that this experience has brought them closer and made their relationship stronger.

“Before, we were close – we saw each other on an everyday basis, but now our bond has been reinforced. Silly arguments don’t seem to matter anymore,” mentions Jess.“I love her—she’s one of my most favorite people on earth. I feel like I’m abandoning her, so I’m going to miss her a lot, but I am confident in her progression,” Kate adds.

Jess is maintaining her positive attitude and currently focusing on regaining enough independence to be able to make the move to London.

To encourage others on their own personal comeback journeys, Jess and Kate recently participated in a podcast. The podcast is available through Connected Social Media, Ekso Bionics and iTunes.

To learn more about the advanced exoskeleton technology Jess used during rehab, visit Ekso Bionics.

It’s Time to Get Your Flu Shot

Posted by Steven Reinberg, HealthDay Reporter

Flu season is fast approaching, and U.S. health officials are worried that this season could be a bad one.

That’s why the U.S. Centers for Disease Control and Prevention is urging everyone 6 months and older to get a flu shot.

Why the extra concern? Australia, which experiences its flu season in summer because it’s in the southern hemisphere, has been hard hit this year. And the major culprit has been the H3N2 flu strain, which is known for causing severe disease, especially among older people.

And small clusters of H3N2 are already showing up in the United States, according to published reports.

“We don’t know what’s going to happen but there’s a chance we could have a season similar to Australia,” Dr. Daniel Jernigan, influenza chief at the CDC, told the Associated Press.

And, even when severe strains aren’t circulating, flu is an illness that needs to be taken seriously.
“Influenza is not just a few days at home with a runny nose—it can be a lot worse,” Dr. Thomas Price, secretary of the U.S. Department of Health and Human Services, said during a Thursday morning news briefing.

Flu can lead to hospitalization and death, Price said. “This is particularly true for certain groups: older adults, pregnant women, people with some long-term medical conditions and young children,” he explained.

Getting a flu shot is easy, Price said. “There are thousands of places where you can get your flu shot,” he added.

“Each flu season, flu causes millions of illnesses, hundreds of thousands of hospitalizations, and thousands and sometimes tens of thousands of deaths,” Price said.

The CDC estimates that since 2010, flu-related hospitalizations in the United States have ranged from a low of 140,000 to a high of more than 700,000. And deaths ranged from 12,000 to 56,000, depending on the year.

“These numbers are far too high, especially when we consider that there is a vaccine that can prevent a significant proportion of this disease,” Price said.

But too few children and adults get their yearly flu shot, he noted.

Among children and teens, the number who were vaccinated last year didn’t change from the year before, remaining at about 59 percent. For adults, vaccination rates increased about 1 percent, from 46 percent in 2015-2016 to 47 percent in 2016-2017.

Last year’s vaccine was 42 percent effective, which means that if you were vaccinated, you had a 42 percent lower risk of getting the flu.

But even at that low level, the CDC estimated that the vaccine prevented more than 5 million cases of flu, nearly 3 million doctors’ visits and 86,000 hospitalizations, Price said.

According to a report in the Sept. 29 issue of the CDC’s Morbidity and Mortality Weekly Report, 79 percent of health care workers got flu shots in 2016, the same as in the past three flu seasons.
Although the vaccination rate among health care workers seems high, it ranged from 92 percent of those who worked in hospitals, to 68 percent of those working in nursing homes and to 76 percent in clinics.

But Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, stressed that “100 percent of health care workers should be vaccinated.”

People who are already sick are more likely to get the flu and die from it, especially in nursing homes. Health care workers need to think of their patients and not run the risk of giving them influenza, Siegel said.

Among pregnant women, 54 percent said they were vaccinated in 2016, which is the same as the last four flu seasons, the CDC researchers reported.

It’s especially important for pregnant women to get their flu shot, Siegel said. If a pregnant woman gets the flu, it can result in her infant suffering from a birth defect, he explained.

“It’s hard to convince pregnant women that putting anything into their body is safe at a time when they have a developing infant,” Siegel said. “But that’s an emotional reaction. In reality, the risk of flu is far greater to the fetus and there’s zero risk from a flu shot.”

For this year’s flu season, about 166 million doses of vaccine will be available, Price said.

Price advised three steps to fight the flu. First, get vaccinated. Second, take measures to prevent the spread of the disease. That means staying home if you’re sick, avoiding people with the flu, washing your hands often and coughing into your arm. Third, if you get the flu, take antiviral medications, such as Tamiflu.

Copyright © 2017 HealthDay. All rights reserved.

Stop Sitting!!!

I just got this email from one of my friends at Deloitte; it maybe useful to a number of people who sit through the day…like me!

Dear Gordon –

Thanks for posting the article about “sitting too much.”  About two years ago I read several similar articles, and was disturbed when I read that “sitting is the new smoking” – meaning that sitting to much is very dangerous to our health.

As a result, I purchased a “standing desk” and “leaning stool” for my home office.  See the attached photo.  I’ve used this setup for two years, and love it.  FYI, here is the manufacturer’s website:  www.focalupright.com.

Best wishes to you, Jill, and your family.

Pete

My talk….

As I was preparing to write about my experience and ask for a reference letter, I got this note from Ken Kolosso.  I have to tell you, I was impressed with what he said, but even MORE impresses with the timing.  The event was just a week ago and I already had a reference letter!

Do you know how long it takes me to get a referral?  Not 1 week!  I have a rule: the second that a referral comes in, I will post it.

Meeting Ken’s 2 teams was an experience.

We arrived in Omaha at 11:35 PM…and still got an Uber driver (love that service). We got checked in,  jumped into bed by 1:30pm and was up at 5:30am to get ready for the trip…only 4 hours of sleep.  I don’t have to tell you this: I NEED my sleep…and so does Jill!

We got up and meet Dylan at the lobby. He arrived early; I have to admire that trait in him. Dylan, my navigator, rented a Ford Expedition so we went in style.  He set cruise control at 81 and we FLEW…for 1.5 HOURS!

We got there early…so I had time to set things up. Case in point: when they introduced me, I usually open up my speech by attempting to tie my tie. I totally blanked out and got  right into my speech. The audience didn’t know about the sequence, so that was ok.  But then I got to a slide, and couldn’t remember what I was supposed to say.  What felt like 2 minutes…was probably a few seconds; I flubbed a little. I said I would do better at the speech tomorrow.

Then, we had to wait, as the other presenters gave their talk.  During one part, I just couldn’t keep my eyes opened for a part of it; I kept dozing off.  I felt bad for the speaker; I just couldn’t help it. I wanted to say something, but he left as soon as he was done.

This time, we went to bed at 10:00pm!

We got up and met Dylan at 7:15am (again, he was early) and we made it there in record time:  28 minutes.  The speech the next day went GREAT.  A portion of Ken’s quote:

After hearing from Gordon and Jill, people will come away inspired and truly blessed.  Financial advisors will have a renewed passion and desire to share the need for disability insurance (aka income replacement insurance) when doing holistic planning for their clients.

I feel blessed to have meet Dylan and Ken; they were fantastic to deal with and I feel honored to have worked for them.

Another reference!

In September 2017, I invited Gordon and Jill Vigianno to speak to 70 of my financial advisors at our regional meeting in Nebraska.  What an impactful story we heard!  We saw and heard, firsthand, how a disability can strike at any time.  In Gordon’s case, this was a massive stroke that nearly killed him on his 51st birthday.  If it wasn’t for his disability coverage, the Viggiano’s would have been financially ruined.

Gordon and Jill have experienced great hardship and many trials since Gordon’s stroke, but their perseverance, faith and love for one another helped them conquer these great storms.  After hearing from Gordon and Jill, people will come away inspired and truly blessed.  Financial advisors will have a renewed passion and desire to share the need for disability insurance (aka income replacement insurance) when doing holistic planning for their clients.

The book they distributed following their presentation, Painful Blessings, written by Jill is outstanding.  I started reading and couldn’t put it down.  I finished it in one night!

Ken Kolosso, ChFC® , CLU® , MBA
Managing Partner
Nebraska Region
Thrivent Financial®

Take a Stand Against Sitting Too Much

Posted by Steven Reinberg, HealthDay Reporter

Days spent sitting for hours may increase your risk for an early death no matter how much you exercise, researchers say.

In a new study, people who sat the most had twice the risk of dying over a 4-year period as people who sat the least. But taking a break every 30 minutes to get up and walk around might help decrease the risk, the study authors said.

“What’s most troubling is it’s like I exercise in the morning and I think I’m good, but in addition to exercise I should also be mindful of not being sedentary for long periods throughout the day,” said lead researcher Keith Diaz. He is an associate research scientist at Columbia University Medical Center in New York City.

It’s more than exercise, Diaz said. “You have to do more. You have to move, you have to get up often and break up your sedentary habits if you want to have the lowest risk of death,” he explained.

Many people sit for up to 10 hours a day, he noted. Earlier studies that have reported a link between sitting and an early death have relied on people telling researchers how long they sat in a day. This new study, however, actually measured sitting time using a hip-mounted accelerometer that tracked movement, and correlated it with the risk of dying during the study period.

Diaz cautioned, however, that this study only shows an association between sitting and an increased risk of early death. It can’t prove that sitting causes the risk, due to the study design.
Exactly how prolonged sitting might be related to an increased risk of early death isn’t known, he added.

“There is evidence that suggests, but does not prove, that it could be about how our body handles blood sugar,” Diaz said.

“We think it’s through a kind of diabetic pathway. When our muscles are inactive, they are not using blood sugar, and we know that blood sugar can wreak terrible consequences on our body. Poor blood sugar control is thought to be one of the ways sitting increases one’s risk for heart disease or death,” he said.

Standing up from your desk and walking around for a few minutes every half hour could be an important behavioral change that might reduce the risk of premature death, Diaz suggested.  The report was published online Sept. 11 in the journal Annals of Internal Medicine.

Dr. David Alter is an associate professor of medicine at the University of Toronto. He said, “We don’t yet know what the ideal solutions are to remedy the risks associated with sedentary behavior.”
It’s not just about avoiding sedentary behavior or prolonged bouts of sedentary behavior, said Alter, who wrote an accompanying journal editorial.

“It might require a combination of exercise, light activity and frequent movement breaks,” he said.
What’s almost certain is that the solution will require folks to track their activity and inactivity, Alter said.

“Just like weight-management strategies, we will need to monitor how much time we spend sitting, moving and undertaking exercise in a much more deliberate way than we have perhaps thought previously,” Alter said.

For the study, Diaz and his colleagues reviewed data on nearly 8,000 U.S. adults 45 and older who had participated in a previous study. The participants wore a monitor that kept track of the amount of time they were seated.

The researchers found that in a 16-hour waking day, the participants sat a little more than 12 hours. The average was 11 minutes at a stretch.

Over an average follow-up of four years, 340 participants died.
Spending more time sitting for longer periods increased the risk for an early death, regardless of age, gender, race, weight or how much one exercised, the researchers found.

Those who had the lowest risk of dying were those who didn’t sit longer than 30 minutes at a stretch, the findings showed.

“If we are to sit for prolonged periods at a time—more than 30 minutes at a time, and for many hours per day—more than 12 hours per day, our risk of death is high,” Alter said.
“That risk is reduced if we exercise at least 150 minutes per week, but not entirely eliminated,” he concluded.

Copyright © 2017 HealthDay. All rights reserved.

Truth about Atrial Fibrillation

 

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The Truth about AFIB

Your heart beats more than 100,000 times every day. However, not all heartbeats are the same.

Your heart may beat abnormally—it may flutter and beat fast. If so, you might have a heart condition called atrial fibrillation or AFib. AFib is the most common heartbeat disorder but AFib can be tricky— you may have it and not even know.

Fact: Medical experts estimate that 15% of strokes are a result of untreated AFib.

During National Atrial Fibrillation Awareness Month we are raising awareness about this serious health condition and its strong connection to stroke. Don’t let AFib overwhelm you. Take control. Act.

The first step to take charge of your health is to learn more about AFib:

  • Know the Signs and Symptoms
  • Discover Treatment Options
  • Access Resources and Tools

This September don’t take your heartbeat for granted.

AFIB and Stroke

In action,

Amy Herron
Senior Coordinator, Programs