Practice “Walking Away” Now To Help Prevent Holiday Heart Attacks

By David Martin, RN, President and CEO, VeinInnovations

As reported in last week’s Live Healthy, Atlanta!, research shows the holiday season and its glad tidings also bring an increase in deadly heart attacks. Christmas, December 26, and New Year’s Day, according to one study, are the days most likely for such an event.

Last week’s column also mentioned factors involved in the spike in holiday heart attacks – lack of exercise, weight gain, the increased likelihood of drinking and eating to excess – especially salty foods that raise blood pressure – and how those, combined with cold weather and seasonal illnesses such as colds and flu, can stack up to hurt you. We touched on the emotional factors. This week we’re going to zero in on staying more “Zen” during the holidays, as less stress is good for everyone.

What makes for holiday stress?  

Heightened expectations, unmet desires of holidays past, and that human habit of comparing “our holiday extravaganza” to that of friends and family members increases strain on an already over-taxed body. If you find yourself hung up in comparing, complaining, or on the verge of an argument, substitute a healthy behavior for focusing on the negative. Take a note of a current business buzzword and put it to use: Disrupt, as in change the way things are being done. In this case,  simply disrupt the energy by walking away.

Other stressors include the rush to get to one more event, the push to make the last plane out, the discomfort of sleeping in an unfamiliar bed, or the desire to “make everything perfect.”

Practice saying “no” now so you can resist buckling under family pressure come Thanksgiving, when family or friends push you to do more than you really want to do.

Other steps you can take now to keep things merry and bright:

Start exercising now. Plug in the ear buds, get the game on your phone, and walk during halftime. Park further away at work, take the steps instead of the elevator, or walk during lunch.

Just wear the coat. And a couple of other layers. Staying warm is better for you, and your heart. A sudden shock of cold weather – after being inside – is a stressor. Ease into the cold with layers on.

Avoid sudden exertion. Getting the house ready for holiday company is not the time to suddenly leap into action. Start exercising now, so you’re “every-day fit” when you suddenly need to rake a mountain of leaves, or charge through the mall or airport with a ton of stuff in tow.

Lay off the salt and alcohol. Too much drinking can lead to atrial fibrillation, an abnormal heart rhythm in which disorganized electrical signals cause the heart’s upper chambers to contract irregularly, increasing the risk of stroke, heart attack, and heart failure.

Take a flu shot and wash your hands. Fever and infection stress the heart; avoid getting sick by getting a flu vaccination and keeping your hands clean. Also watch drinking or eating from someone else’s cup or plate.

Take a breath of fresh air. Unless there are air pollution alerts, get outside to clear your lungs. The exception: indoors and out, stay away from wood burning fires, as ultrafine airborne particles can be bad for the heart.

If you need help, ASK. Symptoms such as chest pain, dizziness, or pain in your arm or jaw should not be ignored. Heart attacks in women have a unique set of symptoms and are more likely to be fatal (one out of three women in America will die of heart attack or heart disease). Learn the warning signs: squeezing in the chest, nausea, shortness of breath, breast and arm. Call 911 for emergency help.

For more hands-on information, screenings, and to get some good exercise while you help raise money to fight heart disease, join me on Saturday, September 26, for the Atlanta Heart WalkIt’s fun and free, just sign up here.

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Plan Now To Avoid Holiday Heart Attacks (Part one of a two-part series.)

By David Martin, CEO, VeinInnovations

At last it’s the beginning of football season! Time for tailgating, barbecue and beer, soon to be followed by Halloween candy, and stuffing ourselves at Thanksgiving as the Christmas rush sets in. Before we know it, we’re in that five-week food and stress fest also known as the “Holiday Heart Attack Season.”

Seriously. The Holiday Heart Attack Season is a real phenomenon.

Research confirms this most disconcerting pattern: the holiday season and its glad tidings also bring an increase in deadly heart attacks. Christmas Day, December 26th, and New Year’s Day, studies say, are the first, second, and third most likely days, respectively, for such an event.

“We’re learning that there are certain triggers for cardiovascular events. If we can get a true handle on the seasonal variation, we could knock down death from coronary disease,” says Robert A. Kloner, MD, PhD, a researcher at Good Samaritan Hospital, and a professor at the Keck School of Medicine at the University of Southern California.

Indeed. A review of 53 million U.S. death certificates from 1973 to 2001, performed in 2004 by researchers at the University of California, San Diego, and Tufts University School of Medicine, revealed a 5% increase in deaths during the holiday season – nationwide.

“We certainly know that there are certain risk factors for coronary artery disease. There’s obviously smokinghypertension, dyslipidemia [high cholesterol], diabetes, lack of exercise, and age,” according to Dr. Kloner.

The Tufts study showed a link to colder weather, which, when you look at the origins of coronary artery disease, makes sense. The disease stems from atherosclerosis, a condition in which fatty plaques narrow the arteries to the heart. If a plaque breaks free, and a blood clot forms, a heart attack is likely to follow.

Cold Weather is Hard on the Heart

When the temperature drops, blood vessels constrict, raising blood pressure, and making blood clot more easily. As frigid temperatures increase strain on the heart, starting a running program, raking leaves, or any other physical exertion adds to the strain and may trigger a heart attack.

Many an emergency room patient in snowy climes is rushed to the hospital after an hour or two of shoveling snow.

What are other reasons for the increase in coronary artery disease deaths in December and January, over the numbers for June through September?

Looking back to the studies, and comments from Kloner, here are the likely reasons:

  • People are more likely to delay getting treatment because they don’t want to disrupt Christmas and New Year’s festivities by attracting attention to themselves.
  • People want to wait until they get home to seek treatment.
  • Out-of-town relatives wait to seek competent care.
  • Hospitals may be short-staffed on major holidays, meaning treatment is delayed, or the specialists you need are not immediately available.

Overindulgence, Slippage, and Stress

Three other factors are at play here as well: the temptation to shop, socialize, or catch another football game instead of sticking with an exercise  routine; the ease of grabbing a handful of those tasty “pigs-in-a-blanket” along with another slice or two of pizza, along with another couple of beers, lead to an increase in salt consumption, as well as the addition of a few more pounds. The additional salt, alcohol, and weight are a horrible combination, especially when you factor in the third component of holiday revelry: familial stress.

I’ll talk more about the whys of holiday stress – how to avoid it and how to survive it – in next week’s Live Healthy, Atlanta. In the meantime, one step you can take now to help avoid the Holiday Heart Attack is to start walking regularly, and register to walk with me at the Atlanta Heart Walk September 26, 2015. It’s free, fun, and a great way to get you, and your family, in line for healthier, happier holidays.

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Live Healthy, Atlanta!

By David Martin, CEO, VeinInnovations

Soft drink consumption has fallen, and with it, the trend toward obesity, especially in children, is finally declining.  Information is the key to the turnaround in America’s soft-drink fueled obesity crisis.

During the 60s, 70s, and 80s, Americans pounded down the soft drinks. According to a 2014 Bloomberg News article, in the 1970s, we doubled the amount of soda we drank. We were drinking more soda than water in the 1980s. And by 1998, when consumption peaked, we were drinking 56 gallons of soft drinks a year – the equivalent of 1.3 oil barrels’ worth for every American!

As the 90s blew by, seeing the rise of quart-sized Big Gulps and the war between Coke and Pepsi for domination in fast-food contracts made it abundantly clear that soft drinks were cultural, economic, and nutritional fuel. There was a world-wide addiction to Tab and Diet Coke. The rise and fall of Coke stock prices affected Atlanta’s employment as well as funding for everything from colleges to art exhibits.

The awareness, in the late 90s, that so much of the country seemed to have cola coursing through their veins started becoming a major health issue when research about the costs of obesity, and the rise in obesity, came to the fore.

A couple of weeks ago The New York Times ran a front-page story detailing that for the first time in several decades of American diets getting worse, and obesity rates increasing, American diets are finally changing for the better.

For the first time since the government started tracking such information 40 years ago, calorie consumption is in the midst of its first sustained decline.

According to new reports from the United States Department of Agriculture, the Centers for Disease Control, and a University of North Carolina food research analysis of  Nielsen Homescan Services data, the sharpest decline in calorie consumption is among children.

“In the most striking shift, the amount of full-calorie soda drunk by the average American has dropped 25% since the late 1990s,” writes Margot Sanger-Katz in the recent NY Times piece.

“The reversal appears to stem from people’s growing realization that they were harming health by eating and drinking too much,” the story goes on to say.

Despite the encouraging data, it doesn’t mean our obesity epidemic is over.  We’ve heard for the last several years that more than one-third of adults in Americans are thought to be obese, and that their weight puts them at an increased risk of heart attacks, diabetes, and cancer.

The good news that the upward trend toward weight gain and obesity has stopped means people are finally getting the message about calorie consumption and weight gain, according to Dr. Dariush Mozafarlan at Tufts University.

This is heralded as no less than a turning point by researchers at the University of North Carolina, who say the area with the biggest change in diet is seen is in households with children. The good news about this is that cutting sugary soft drinks out for ochildren means parents have to deny themselves, too.

The Obama Administration deserves some credit for pressuring the food industry to increase transparency about the amount of sugar and fat hiding in our foods.

With passage of the Affordable Care Act, chain restaurants, starting in 2010, were required to make a meal’s calorie content public.  School lunches were also required to become healthier.

Across the country, soda machines started disappearing from public schools . In 2006, 30% of schools banned junk and soda machines. By 2013, the number was up to 44%.

And thus we see the 25% drop in the consumption of sugary soft drinks, a heralded and sustained drop in calories consumed, evoking a scramble by the soft drink industry to figure out how to keep share of customer and profits up by selling bottled water, iced tea, and energy drinks.

Lemonade Anyone?

At the end of the day, and the end of a long hot summer, perhaps your own, homemade lemonade will be a refreshing alternative.  Here’s a recipe to make the three-ingredient drink without sugar. Stevia-improved lemonade is a refreshing, inexpensive, low-calorie alternative.

Making homemade lemonade may not be as convenient as buying a Big Gulp or can of Coke. But the calories saved, health benefits realized, and social pleasure of sharing a glass with friends could make the effort of squeezing a few lemons well worthwhile. Enjoy!

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Get one step closer to living Atlanta healthy with the Heart Walk Atlanta

By David Martin, President and CEO of VeinInnovations

Right now our friends at the American Heart Association, the Atlanta Chapter, are gearing up for one of the biggest events of the year: the Atlanta Heart Walk September 26 at Centennial Park.

The company I founded and run, VeinInnovations, will be there again this year, as we have been for the last four years, in force, to support the AHA’s work to raise awareness about the prevalence and warning signs of heart disease and stroke, and to promote walking as a natural, handy, reasonable way to increase heart health and decrease the likelihood of heart attack and stroke.

This event is wildly successful, in large part because it is a lot of fun! Last year some 15,000 people walked; this year, AHA predicts there will be between 15,000 and 18,000 walkers.

Who walks?

We all know someone whose family has been affected by heart disease. The widower whose wife’s heart attack came out of the blue, stunning family and friends with searing loss. The families watching as a loved one’s heart grows weaker with each passing day, as they hope and pray for a transplant. The parents who’ve lost children and children who’ve lost parents – to heart attack or stroke.

Family members such as each of these, and thousands more, will be walking with us September 26 to spread the word: Some heart disease can be prevented. Early diagnosis saves lives. A walk in the park is a great defense against America’s Number 1 Killer of Women.

From the American Heart Association, here are some important myths to dispel about heart disease:

Myth: Heart disease is for men, and cancer is the real threat for women

Fact: Heart disease is a killer that strikes more women than men, and is more deadly than all forms of cancer combined. While one in 31 American women dies from breast cancer each year, heart disease claims the lives of one in three. That’s roughly one death each minute; more than 1400 women die of heart disease each and every day.

Myth:Heart Disease is for old people

Fact: Heart disease affects women of all ages.  For younger women, the combination of birth control pills and smoking boosts heart disease risks by 20 percent. And while the risks do increase with age, things like overeating and a sedentary lifestyle can cause plaque to accumulate and lead to clogged arteries later in life. But even if you lead a completely healthy lifestyle, being born with an underlying heart condition can be a risk factor.

Myth: Heart disease doesn’t affect women who are fit

Fact: Even if you’re a yoga-loving, marathon-running workout fiend, your risk for heart disease isn’t completely eliminated. Factors like cholesterol, eating habits and smoking can counterbalance your other healthy habits. You can be thin and have high cholesterol. The American Heart Association recommends you start getting your cholesterol checked at age 20, or earlier, if your family has a history of heart disease. And while you’re at it, be sure to keep an eye on your blood pressure at your next check-up.

Myth: I don’t have any symptoms

Fact: Sixty-four percent of women who die suddenly of coronary heart disease had no previous symptoms. Because these symptoms vary greatly between men and women, they’re often misunderstood. Media has conditioned us to believe that the telltale sign of a heart attack is extreme chest pain. But in reality, women are somewhat more likely to experience shortness of breath, nausea/vomiting and back or jaw pain. Other symptoms women should look out for are dizziness, lightheadedness or fainting, pain in the lower chest or upper abdomen and extreme fatigue.

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Fact: Although women with a family history of heart disease are at higher risk, there’s plenty you can do to dramatically reduce it. Simply create an action plan to keep your heart healthy.

Because of healthy choices and knowing the signs, more than 670,000 of women have been saved from heart disease, and 300 fewer are dying per day.

How can you support the effort, and help the women you love?

Come walk with us! Here’s the link to register. VeinInnovations will be there, providing free screenings for the condition we treat: chronic venous insufficiency (CVI), which causes painful, hurting, restless legs, varicose and spider veins, and likely contributes to many people opting out of healthful exercise because their legs hurt. Also – let us screen your legs for CVI, as VeinInnovations surgeons and physicians and referral partners are donating $1 each (up to $250 per physician) for every adult we screen. So each adult screened represents a $6 donation to the AHA!

We’ll be joined by other health experts and scores of corporate donors who will give you breakfast, take your photos, load you up with all manner of rewards for walking, and in general cheer you on for joining us all on a beautiful September morning to remember the people we’ve lost due to heart attack and stroke, and to work toward reducing the number of heart attack and stroke victims going forward.

It’s a step worth taking. I look forward to seeing you there.

Team-VI

The VeinInnovations team at the Atlanta Heart Walk 2014.

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Frank Ferrier of VeinInnovations with fellow pledge partner Stanley Kalish of Atlanta Foot & Leg Clinic. These surgeons are joined by VeinInnovations Darrell Caudill, Lisa Perez, David Park and Alexander Park and referring physician Paul E. Cox in pledging $1 each per adult screened for chronic venous insufficiency at the Atlanta Heart Walk.

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Be Healthy, Atlanta!

By David Martin, President and CEO of VeinInnovations

When I first began writing for SaportaReport’s Thought Leadership, this blog was focused on how healthcare systems in America ran. I began the blog just as the biggest changes to the American health care system were happening; the Affordable Care Act, or Obamacare, was just beginning.

I wrote about health care exchanges, the Supreme Court case that decided the fate of the ACA, insurance and other ins and outs of healthcare delivery in the US. Over time, this column has shifted its focus to personal health. This is an organic change that I’ve decided to formalize by changing the name of this column.

Starting next week, you’ll see a new title above my posts. I’m proud to present Atlanta Healthy!  I’ll focus on the healthcare scene here in our city and on health challenges unique to our area, occasionally broadening the scope. I’ll also discuss the great possibilities for growth in Atlanta, both for healthcare practice and for the health of our citizens.

We have a lot to be proud of in Atlanta. We’re home to the Centers for Disease Control, a globally respected organization, as well as the Task Force for Global Health. In addition, Atlanta is home to the stellar Emory University and Northside hospitals, ranked as the two best hospitals in Georgia by the US News and World Report. We’re blessed with easily accessible medical facilities, including those associated with Piedmont, WellStar, and Tenet Healthcare,  and amazing emergency room care via Grady Hospital.

Atlanta is the urban center of a state that struggles with obesity. Georgia’s adult obesity rate rose by more than five percent in 10 years. This obesity rate comes with serious complications. The adult diabetes rate is more than 10 percent; hypertension affects 35 percent of adults in Georgia. We have a lot of heart attacks and strokes we can help prevent, and I will write more about that next week regarding the Atlanta Heart Walk, and my personal involvement in it. Go ahead though, and mark the date: September 26, as this will be a walk to remember!

Obesity and Exercise in Atlanta

I hope most Atlantans realize what they’ve got. Our city is bursting with opportunities and places where you can get fit. But first, let’s think about mentality. Above, I mentioned that Georgia is a state with a high rate of obesity – currently, we rank 18th in the nation. What motivates you to exercise?

Ask most people and they’ll say “weight loss” or “better health”. These are vague, long-term goals. (Don’t we all wish that one run around Chastain Park would result in losing five pounds immediately? Alas, it’s not so.)

Do you say you exercise to lose weight or have better health? Studies have shown that, if those are your reasons, you’ll spend the least amount of time exercising. An article from July’s New York Times argues for the premise of its title: Rethinking Exercise as a Source of Immediate Rewards.

The article argues that we should focus more on the immediate benefits of exercising. Yes, it’s a struggle to get yourself to yoga, the pool, or the park, but after you’ve done an hour of exercise? Worth it. How do you feel? Refreshed. Mentally sound. Less stressed.

The next time you need to exercise and aren’t really excited about the idea, give yourself a pep talk. One that’s less, “Mom had bad cholesterol. I’ve gotta exercise,” or “Admit you have a dad-bod. It’s time to lose some weight.”

Instead, think, “If I go to yoga, I will feel like a million bucks tonight.”

I tried this thought exercise the other day. It worked. The exercise provided the immediate benefits I’d gotten myself to look forward to. Go get healthy, Atlanta! Do it for short term pleasure and enjoy the long term gains.

You can start on the Atlanta Beltline, where you can enjoy a wide variety of free fitness classes.  And you can make plans to join me and my team from VeinInnovations for the Atlanta Heart Walk 2015 on September 26 at Atlanta’s Centennial Park.

Let’s Be Healthy, Atlanta. It’s a worthy endeavor for ourselves and our loved ones, who are much more likely to exercise themselves when they see us enjoying the benefits of losing the stress, and the dad-bod.

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What are we teaching our children by our reliance on mobile screens? Are we modelling “phones as pacifiers”?

By David Martin, President and CEO of VeinInnovations

We’re a digital culture and kids born in the 80s and 90s are digital natives. New technology arrives daily, it seems, and much of it vastly improves human lives.

There, however, costs to our connectivity. We carry computers in our pockets these days and we’re surrounded by screens. The amount of screen time we put in each day can have negative effects on our health.

Too much time spent with a screen can harm a child’s social, emotional, and intellectual well being. Adults aren’t immune from the negative impacts of time spent with a screen, either. Your health will take a hit from hours of sedentary pursuits. And if you have a kid at home, your modelling these bad habits will encourage theirs.  Child see; child do.

Diatribes against screen time often veer into moralizing about days past and the decline of health, intelligence, and culture due to our dependence on screens and our foregoing more active pursuits.  Look, there are a lot of people in their 50s and 60s who watched more TV than they probably should have as kids, and most of them have turned out fine. You might be one of them. Albeit the screens of the 80s and 90s were pretty simple, and couldn’t be carried around without a generator and a wagon. Television was king.

Mobile devices mean most of us carry screens with us at all times. When they’re with us, they’re hard to ignore. Think about the last time you sat down to dinner and you and your friend left your phone sitting, face up, on the table, just to make sure you didn’t miss anything. When your friend got up to use the washroom, you likely tapped your phone and browsed social media or your email. These behaviors may become new social mores. Is there harm in it? Let’s consider:

Negative Affects of Screen Time on Children and Adults

Weight Gain. You’re not burning calories when you’re seated in front of a screen. You’re not doing much of anything, in fact. Americans don’t have time to waste in front of screens, because we’re not getting enough exercise as it is. The CDC has found that less than half of all adults get the minimum recommended amount weekly exercise. (The minimum suggestion is 150 minutes.) Less than 3 in 10 high school students get 60 minutes of physical activity every day. In 2012, more than a third of kids and teens were overweight or obese. Abandon the screen for something more stimulating – your health depends on it!

Poor Performance in School. A 2010 Kaiser Family Foundation study found that eight to ten year olds spend almost eight hours a day with a variety of different media, mostly TV. The same study found that pre-teens and teenagers spend more than 11 hours a day with media, again, mostly in front of the TV. The study found that only 51% of children who were heavy media users got good grades (A’s and B’s) while 66% of light users got good grades.

Your Phone is Not a Pacifier, So Quit Using it Like One. Young kids don’t need to engage with screens. Screens may, in fact,  harm their development. The American Academy of Pediatrics encourages limited screen time for kids of all ages and recommends kids under two spend zero time with screens. The AAP writes on their Media and Children guidelines page, “Studies have shown that excessive media use can lead to attention problems, school difficulties, sleep and eating disorders, and obesity.”

Phones shouldn’t be used as pacifiers for kids. They shouldn’t be used as a pacifier for adults, either, but they are. I’ll try to stop short of moralizing, but let me give a couple examples:

  • You feel awkward at a party where you only know a few people. When your friends mingle, you reach into your pocket and check your phone instead of engaging with new people. 
  •  You’re eating dinner with your family and the phone pings. It’s 8:00 and there was a work emergency they’d call, but you check your email anyway. Then you shoot off a response that in all honestly could wait until the morning. You spend ten minutes at the table with your family, but not truly present. 

We live in a connected world, and there are many benefits this connectivity.   Working in medicine, I see what technology is doing to change and save lives. As adults, screen time limits are ours to set according to what we see fit. We just need to remember that there are costs to time spent with a screen, and these costs are not limited to a sedentary lifestyle.

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How will your loved ones be helped if end-of-life counseling is covered by Medicare?

By David Martin, President and CEO of VeinInnovations

Last week, Medicare made headlines across the nation by proposing to pay doctors for end-of-life discussions with their patients. This measure, which was originally meant to be part and parcel in the Affordable Care Act, was so controversial that it had to be dropped in order for the ACA to pass. These discussions are what then vice-presidential candidate Sarah Palin so convincingly (but erroneously) branded “death panels.”

Far from a death panel, end-of-life conversations are vital, compassionate discussions well worth having. We all die. It’s not a fact we like to focus on, but it is a part of life. How we die matters, to us and to our families. End-of-life conversations and the legal action they inspire create a clearer path to the kind of death we want. Deciding upon and making your end-of-life plans clear is a gift for your family, who will be absolved of making heart-wrenching decisions just as you are leaving them and this world behind.

We live in an age of life-saving medicine and life-extending medical procedures. These two are not the same. We can prolong death at great cost; much has been made of the fact that incredibly high healthcare spending comes in the last year and last month of life.

Let’s be realistic, because cost does matter in healthcare. The cost burden is higher in the United States than almost anywhere else on the planet. If we had incredible health outcomes – improved quality and length of life – the cost might be worth it. Alas, we do not. Unnecessary care is common, especially at the end of life when we are making decisions on behalf of loved ones whose wishes were unclear.

When we do ponder our deaths and how we would like to spend our final moments, the intensive care unit, feeding tubes and intubation, beeping machines and a cold hospital room are unlikely to be part of the fantasy. The best death is peaceful: at home, comfortable, with family and close friends surrounding your bedside. The best death remains a fantasy for far too many of us. Half of all Medicare patients spend their last days in the hospital or a nursing home.

This is not to say that a peaceful death cannot come in the hospital or nursing home. But only about 30% of adults in the United States have an advanced directive or similar document prepared. This leaves decision making at the end of life to distressed, grieving children and spouses, which is hardly the legacy or sense of family unity one wants to leave.

The majority of people would decline life-extending procedures for themselves when the end is a forgone conclusion. When we leave others in charge but don’t make our wishes clear, we’re subjected to more procedures. Our loved ones don’t want to see us go; nor do they want to see us endure more pain. Yet in the absence of a directive, they will most often choose to extend our lives.

Planning our deaths through end-of-life talks, not just with doctors but with loved ones, is not morbid. It is not unseemly to sit across from your spouse or daughter and say, “This is how I want to die.” Death is a part of life, and as played out as that platitude is, there is no better to way to describe it. How we die is a part of our lives, but also the lives of those we leave behind.

I hope Medicare will move forward with the plan to pay for end-of-life discussions. We fight so hard to have good lives, and to provide good lives for the people we love. Why should our deaths be any different?

Related:

On Brittany Maynard, Thanksgiving, and How Facing Our Mortality Head-On This “Movember” is a Leadership Gift to Our Families

http://atulgawande.com/articles/

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Food is medicine, yet very few doctors report feeling properly trained to give diet and nutrition advice, despite the increase in obesity related illness. This is changing, though slowly.

By David Martin, President and CEO of VeinInnovations

Can you imagine a trip to the doctor that ends with a prescription for apples and kale? Or trying to make out a doctor’s scrawl prescribing “Legumes three times per week”?

In the US, Americans suffer from a host of preventable lifestyle diseases – caused mainly by bad habits, a sedentary lifestyle, and poor nutrition. These lifestyle diseases include obesity, and diabetes is among the ensuing complications. Food can be medicine; a healthy diet can prevent disease. So are doctors ready to discuss nutrition with their patients?

Very few doctors report feeling properly trained to give diet and nutrition advice to their patients. There’s a knowledge gap and it’s one that’s in dire need of fixing.

The Importance of Preventing Illness and Disease  

Each year, seven out of ten deaths among Americans are caused by chronic diseases. (This includes cancer and heart disease.) Close to one of every two adults has at least one chronic illness. Many chronic illnesses are preventable. Children, too, are increasingly at risk. One in three children in America is overweight or obese. This extra weight predisposes them to chronic disease. In Hispanic and African American communities, the rates of obesity are even higher.

The Affordable Care Act calls for a National Prevention Strategy, a comprehensive plan to help increase the number of healthy Americans at every stage of life. From the CDC:

“Created by the National Prevention, Health Promotion, and Public Health Council in consultation with the public and an Advisory Group of outside experts, the Strategy recognizes that good health comes not just from receiving quality medical care but from stopping disease before it starts. Good health also comes from clean air and water, safe outdoor spaces for physical activity, safe worksites, healthy foods, violence-free environments, and healthy homes. Prevention should be woven into all aspects of our lives, including where and how we live, learn, work, and play. Everyone—businesses, educators, health care institutions, government, communities, and every single American—has a role in creating a healthier nation.”

Our focus in healthcare is more often on treating an illness after it’s occurred. But that focus must shift to the prevention of disease and illness. Shifting our focus will create healthier homes, schools, workplaces, and communities. People can live longer, more productive lives, and reduce their healthcare costs.

Nutrition, Diet, and Preventing Disease

A wholesome diet of legumes, fresh fruits and vegetables, and whole grains provides your body with essential nutrients needed to maintain wellness and fight disease. This kind of diet is preventative in itself: people who eat this way regularly have a lower incidence of major chronic diseases and especially diet-related diseases. (A study in the Journal of the American Medical Association, JAMA, showed that what we eat is the single most important factor behind premature death and disease.)

Only 25 percent of medical schools offer the 25 recommended hours of nutrition training recommended by the National Academy of Sciences. This training is not required, but it really should be. Diseases are prevented through good diet, but the majority of doctors feel unprepared to provide nutrition advice, although their patients ask them for guidance.

There are some uplifting changes afoot as students and doctors alike seek nutrition training previously not offered. Tulane University School of Medicine puts their students through a rotation with cooks and culinary students to learn about the power of food as medicine. Medical students in Chicago are taking culinary nutrition courses (for no credit!) in order to learn more about the healing and preventative nature of food.

Prescriptions for a healthy meal may not be that far off, either. A 2013 program in New York city did just that. Patients filled their prescriptions (and their bellies) at farmers’ markets across the city.

Who knows! Next time you go to the doctor, you might come back with a prescription to eat more carrots!

More resources: 

How Does Diet Impact Health?

Importance of Nutrition During Chemotheraphy

The FDA Takes Step to Remove Artificial Trans Fats in Processed Foods

National Prevention Strategy: America’s Plan for Better Health and Wellness

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Supreme Court Decision on the Affordable Care Act keeps status quo in Georgia; here’s a review of Frequently Asked Questions

By David Martin, President and CEO of VeinInnovations

What where those “four words” that could have repealed the Affordable Care Act? How many Georgians are breathing a sigh of relief over the law being upheld? How many Americans?

Last week saw the Supreme Court uphold the Affordable Care Act’s grant of tax credits to help people on individual insurance markets afford their health insurance. This impacts mostly people who don’t have insurance through work. Had the Supreme Court not upheld the law, some 500,000 Georgians who counted on the tax credits would be scrambling right now to figure out new insurance.

The whole reason the ACA was in court again was based on some messy language in the way the bill was written. In essence, all the drama was based on a technicality in the law that said people would receive subsidies through exchanges “established by the state.”  Since Georgia was one of the 37 states that opted out of creating a state-run exchange, Georgians received their subsidies via the Federal government. So their subsidies hung in balance based on poorly chosen words that did not change the intent of the law, but did give folks who’ve tried to repeal the ACA one more shot at having the judicial branch shoot it down.

Whether you’re among the half-million Georgians (16 million or so Americans)  breathing a sigh of relief or not, here are some answers to Frequently Asked Questions about the ACA.

Q: I have a pre-existing condition. How does that affect my getting insurance coverage?

A:  It’s estimated that there are between 50 and 129 million Americans with a pre-existing condition. Before the ACA passed, insurance companies could deny anyone with a pre-existing condition like diabetes, pregnancy, or a history of cancer coverage. Now they cannot.

Q: I’m not insured, but I’m also not sick. Why should I spend money each month on health insurance?

A: If you think you don’t need health insurance, let me try to sway you with some sobering financial figures. Accidents, injuries and illness don’t discriminate. They happen to everyone and usually happen without warning. A sprained ankle or broken arm can cost thousands of dollars without insurance. Treating diabetes without insurance can cost thousands of dollars each month while a pregnancy could put you in major debt before you bring your bundle of joy home. Considering what costs you could face, the monthly premium is a bargain.

Q: Where can I get more information?

A: If you want to get a better understanding of the Affordable Care Act, here are some helpful links.

The Affordable Care Act Is Working (http://www.hhs.gov/healthcare/facts/factsheets/2014/10/affordable-care-act-is-working.html)

The New Health Care Law and You

You Ask, We Answer: Demystifying The Affordable Care Act

Is the Affordable Care Act Working?

(http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html?_r=0#/)

Obamacare Facts and News

http://obamacarefacts.com/supreme-court-obamacare/

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How do our emotions affect us? There’ll be lots of talk about mental health with the release of Pixar’s newest movie Inside Out. How do you handle emotions? What are some healthy, natural ways to deal with anxiety?

By David Martin, President and CEO of VeinInnovations
 

Inside Out, the latest offering from Disney Pixar, is about the adventures of five personified emotions living inside an 11-year old girl’s head. Joy, Anger, Fear, Sadness and Disgust co-exist and interact, working together to help their girl, Riley, get through life as an adolescent who’s just moved across the country. The filmmakers consulted with scientists to get the feeling just right.

In real life, we can’t sum up our feelings on one hand. (For starters, there are six basic emotions; all of the characters listed above plus surprise.) Anxiety, an emotion that didn’t make the cut in Inside Out, is one many of us struggle with regularly.

Anxiety disorders include Post Traumatic Stress Disorder (PTSD), Obsessive-Compulsive Disorder (OCD), and Generalized Anxiety Disorder (GAD). Anxiety disorders are among the most commonly diagnosed mental illnesses in the United States. But people without anxiety disorders struggle with this unpleasant emotion, too. How do you know when to get help? And how can you effectively tackle your anxiety?

When to Go to The Doctor For Anxiety

Public speaking, job interviews, asking someone on a date, or moving to a new city are all events that might (will likely!) cause stress. It’s typical that certain specific events provoke relatively mild, brief bouts of anxiety.

If you have severe anxiety and it lasts for at least six months, it is generally considered wise to seek evaluation and treatment. Reach out to your primary care doctor first. They can rule out if other causes of anxiety, such as a medication or other illness, could be causing your symptoms. Then, if needed, they can refer you to a mental health care professional.

The stigma surrounding mental health remains and creates a barrier between people and resources that can help them feel better. This stigma stinks. Get the help you need. Encourage the people you love to get the help they need and promise to support them no matter what. Living with severe anxiety is challenging, and further, it can steal joyful moments from us.

Symptoms of Mild Anxiety and Severe Anxiety

Mild anxiety is caused by specific events. If you know your department at work is facing layoffs, you might have trouble sleeping at night until the ordeal is over. An elderly parent driving to come see you might make the hours until they get to your house a little tense. Everyone is familiar with symptoms of mild anxiety. We each seem to have our own cocktail of reactions when we’re anxious. For you, it may be a headache and a tendency to snap at others. For your sister, it may be absentmindedness and feeling sick to her stomach.

Severe anxiety is a feeling you can’t shake, even when you realize your feelings are more intense than the situation calls for. When someone with GAD is anxious, they can’t relax. They may startle easily or be unable to concentrate or fall asleep. Physical symptoms may include nausea, feeling out of breath, hot flashes, trembling, fatigue, and difficulty swallowing.

How to Treat Mild Anxiety

If you suffer from severe anxiety, talk through treatments options with your doctor. What they recommend may include medication or cognitive behavioral therapy.

There are “natural” ways to treat anxiety as well. The following techniques can help people combat mild anxiety. They can help people with severe anxiety, too!

Yoga: Enthusiasts have preached the benefits of yoga for years but their claims weren’t backed up with data. They were rather relaxed about it. In recent years, a number of good studies have pointed to practicing yoga as a good way to tame stress and anxiety. Primary evidence suggests the benefits of yoga are similar to exercise and relaxation techniques. Further, yoga involves controlled breathing, a technique that shows promise as a means of providing relief from depression. Read more about yoga’s benefits here.

Exercise: Yes, exercise. It’s good for everything, from heart disease to anxiety. Exercise has psychological and physical benefits that help reduce anxiety and improve your mood. Exercise releases pleasant brain chemicals, including endorphins. When you exercise, you reduce immune system chemicals that can worsen depression. You also raise your body temperature, which can have calming effects.

Mindfulness Meditation: Yoga and meditation are regular bedfellows and their presence on this list may make you pause and worry about hippie advice. But there’s real science backing up these practices. And if you’re struggling with anxiety, they’re worth a try. People who practice mindfulness meditation are taught to let go of regrets from the past and to let go of anxieties about the future. Techniques include visualizations to shift your attention away from thoughts that cause anxiety. Another technique is the body scan (yoga participants will be familiar with this.) The body scan asks you to lay still, flat on your back. An instructor will lead the class in relaxation, starting in your jaw, moving down to your neck, shoulders, and so forth, right down to your toes. The intent is to connect your mind and your body while preventing your thoughts from wandering. If it still sounds crazy, here’s a link to the Harvard Health Blog’s post about its benefits.

Diet: Sadly, there’s no change in diet that can eliminate anxiety. But a healthy diet can have a positive impact on your symptoms. Eating a breakfast with protein, choosing complex carbs over simple ones, drinking enough water, and avoiding caffeine, can help.

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