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Friday 16 May 2014

Know Your Blood Pressure

Every year, 17th May is dedicated to World Hypertension Day (WHD). The purpose of the WHD is to promote public awareness of hypertension and to encourage citizens of all countries to prevent and control this silent killer. 
 The WHD was first inaugurated in May 2005 and has become an annual event ever since.
The theme for 2014 is  "Know your Blood Pressure"





Everybody has and needs blood pressure. Without it, blood can't circulate through your body. And without circulating blood, your vital organs can't get the oxygen and food they need to work. That's why it's important to know about blood pressure (BP) and how to keep it in the proper range.

Your heart beats about 60 to 80 times a minute under normal conditions. Your BP rises on contractions and falls when your heart relaxes between beats. Your BP can change from minute to minute with changes in posture, exercise or sleeping.





 
What is Blood Pressure (BP)?

Two numbers are recorded when measuring your blood pressure, such as 117/78 mm Hg (millimeters of mercury). The top or larger number (systolic pressure) measures the pressure in your arteries when your heart beats. The bottom or smaller number (diastolic pressure) measures the pressure while your heart rests between beats.



Normal BP is below 120/80 mm Hg. BP of 120-139/ 80-89 is considered "prehypertension".  If you are an adult and your BP is 140/90 Hg or higher, you have high BP. If you have diabetes or kidney disease, your doctor will want your BP to be lower than 130/80 mm Hg. If your BP goes above this threshold and stays there, you have high BP.  Your doctor may take several readings over time before making a judgment about high BP.




What causes High BP?

High BP, also called hypertension, isn't nervous tension. People who have high BP don't have to be tensed, compulsive or nervous. In fact, you can have high BP and not know it. High BP usually has no symptoms. That's why it's called the "silent killer".

About 90-95 percent of the cases of high BP have no known cause. But some factors increases your chances of developing this disease. These are called risk factors.

Risk factors you can control:





  • Obesity - People with a body mass index (BMI) of 30.0 or higher are more likely to develop high BP.
  • Eating too much salt- This increases BP in some people
  • Alcohol- heavy and regular use of alcohol can increase BP dramatically.
  • Lack of exercise- An inactive lifestyle makes it easier to become overweight and increases the chance of high BP.
  • Stress- This is often mentioned as a risk factor. However, stress levels are hard to measure, and responses to stress vary from person to person.

Risk factors you can't control:


  • Race- e.g. African Americans develop high BP more often than Caucasians do, and it tends to occur earlier and be more severe.
  • Heredity- A tendency to have high BP runs in families. If your parents or other close blood relatives have it, you are more likely to develop it.
  • Age- In general, the older you get, the greater your chance of developing high BP. It occurs most often in people over age 35. Men seem to develop it most often between age 35 and 50. Women are more likely to develop it after menopause.




Can you tell when your BP is high?

No, definitely not. High BP usually has no symptoms. In fact, many people have it for years without knowing it. That's why, it's so dangerous. The only way to find out if you have this disease is to have your BP measured. 

Can high BP damage your body?

Yes! It can hurt your body in many ways. Mainly it adds to the workload of your heart and arteries. Because your heart must work harder than normal for a long time, it tends to get bigger. A slightly enlarged heart may still work well, but if it's enlarged very much, it may have a hard time meeting your body's demands.
As you grow older, your arteries will harden and become less elastic. This occurs in all people, regardless of BP. But having high BP tends to speed up this process.



High BP increases your risk of stroke. It can also damage your kidneys and eyes. Compared with people with controlled high BP, people with uncontrolled high BP are
  • three times more likely to develop coronary heart disease.
  • six times more likely to develop congestive heart failure.
  • seven times more likely to have a stroke.

If you have high BP, follow your doctor's advice. Most high BP can't be cured, but it usually can be controlled. And it's effects can be prevented or reduced- if it's treated and controlled early and kept under control.

What can be done about high BP ?

Most treatments for high BP rely on some combination of losing weight, diet, regular physical activity and medication.

Diet

A Registered Dietician could be consulted to prepare you start or follow a diet that will help to reduce blood pressure and control weight. It will include eating more fruit and vegetables, whole-grain cereals, pulses, less salty snacks, fried food and fatty meat.



Weight Reduction





Many people with high BP are also overweight. If that's true of you, your dietician can prescribe a diet for you. Often when people lose weight, their BP drops automatically. Being overweight is a risk factor for heart disease. By losing weight you'll help your BP and help yourself stay healthy in other ways too.

If you're given a diet, follow it closely, including advice about alcohol consumption. Alcoholic drinks are low in nutrients and high in calories, so if you're trying to lose weight, avoid them.




Sometimes eating less sodium can help lower BP. If this might help you, your doctor will recommend a low-salt diet. This means you'll have to...


  • Avoid salty foods such as pickles, processed foods, baked foods etc.


  •  Cut down on how much salt you use in cooking and at the table.



  • Start reading package labels regularly to learn about the sodium content of prepared foods.




  • Use different herbs and spices as seasonings and make your meal tasty.

Don't make major changes in your diet without first getting proper medical advice and once a diet has been prescribed for you, stick to it.

Physical activity




Don't be afraid to be active. Physical activity should be part of your daily routine. It helps to reduce BP and it can even help you lose weight or stay at your best weight.
Your doctor can suggest the best kind of exercise program for you. Whatever physival activity you enjoy, be it brisk walk, yoga, aerobics, swimming, running etc...do it regularly to keep your BP and weight under control.

Medication




Some people need medication to help them reduce high BP. Many drugs are available for this. Some get rid of excess fluid and salt, others open up narrowed blood vessels and still others prevent blood vessels from constricting and narrowing. 

But, please remember, don't follow your friend's or relatives prescription, you need to consult your Physician who would recommend the right drug for you. What drug is prescribed for your relative/ friend will not necessarily work for you. Please consult your doctor for the right medicine and dosage.

Medicines lower high BP in most cases. But every person reacts differently to medication. You may need a trial period before your doctor finds the best medicine for you.

Know these important points about any prescribed medication:
  • the name of the medication
  • What it's supposed to do
  • how often to take it
  • how long to take it
  • how to store it (does the medicine need to be in a cool place?)
  • if there's a specific time of day it should be taken
  • if you need to avoid foods, drinks,other medications or activites while on the drug
  • what results, reactions or side effects you might expect from the medication and what to do if you have reactions or side effects
  • what to do incase you miss a dose
  • if the medication can cause any side effects if you are pregnant
  • what to do if you get sick or have to get hospitalised
   You must also know the names and effects of all other medications  you are taking and tell your doctor about them. 

An important point to remember is which ever medicine doctor has prescribed for you to lower your BP, you have to continue and not stop taking it at your will and especially if your BP has lowered down. This has happened because of the medication. So, the treatment has to be continued over a lifetime for good results. 




Periodic check ups with your physician is a must to keep checking your BP. Depending on your readings, the medicine dose could be regulated.

What about side-effects?

Some of the drugs can affect certain functions of the body resulting in bad side-effects. Drugs that lower BP have proven effective over the years. The benefits of using them far outweigh the risk of side-effects. However, the physician usually changes the medicine when you report to him any side-effects.

How can you help yourself?



It takes a team to treat your high BP successfully. Your doctor can't do it alone, and neither can you. You've got to work together. 
Even so, you can do more than anyone else to bring your blood pressure under control and keep it there.

You can help yourself if you....
  1.  Keep appointments with your doctor - this will help everyone monitor your blood pressure program amd make any adjustments to keep your BP under control.
  2. Take prescribed BP drugs as directed- if you don't feel well after taking a medication, tell your doctor how you feel. This will help your doctor adjust your treatment to avoid those side-effects.
  3. Follow medical advice about diet and physical activity - make an effort to lose weight if it's recommended. Make changes in your lifestyle if needed.
  4. Remind yourself that as long as you and your team of health advisors work together, you can control your BP.

 Conclusion: 
High BP is a lifelong disease. It can be controlled but not cured. Once you begin to manage it and start a treatment program, maintaining a lower BP is easier. By controlling your high BP, you'll lower your risk of diseases like stroke, heart attack, heart failure and kidney disease.

You Can Do It !!





Reference: American Heart Association - Understanding and controlling your High Blood Pressure.

Monday 20 January 2014

Cranberries - small berries with big benefits !

Cranberries are low, creeping shrubs or vines up to 2 metres (7 ft) long and 5 to 20 centimetres (2 to 8 in) in height; they have slender, wiry stems that are not thickly woody and have small evergreen leaves. The flowers are dark pink, with very distinct reflexed petals, leaving the style and stamens fully exposed and pointing forward. They are pollinated by bees. 
 The fruit is a berry that is larger than the leaves of the plant; it is initially white, but turns a deep red when fully ripe. It is edible, with an acidic taste that can overwhelm its sweetness.





Cranberries are small berries but with big health benefits. They are not grown in India but are a major commercial crop in certain American states and Canadian provinces. In India, they are available in dried form or as cranberry juice.

About 95% of cranberries are processed into products such as juice drinks, sauce, and sweetened dried cranberries. The remaining are sold fresh to consumers.



Whether you use fresh cranberries or dried, both provide flavonoid antioxidants that have many health benefits. One cup fresh or ½ cup of dried cranberries equals a fruit serving and they’re a good source of vitamin C, fiber and antioxidants. Thus, they are often referred to as "Super Food". Not to mention, half a cup of cranberries contains only 25 calories.

Some of the benefits of Cranberries:


1. Berries are Nutrient and Antioxidant-Rich

Colorful berries such as strawberries, blueberries, blackberries and cranberries are considered some of the most nutrient-rich foods.  They provide nutrients like vitamin C and fiber, but they are excellent when it comes to their antioxidant capacity.  Since antioxidants help neutralize harmful free radicals, which damage our cells and DNA, they can help prevent certain chronic diseases and may help mitigate some of the effects that naturally occur as we age.
2. Cranberries Provide Unique Urinary Tract Benefits

Hundreds of studies show that regular consumption of cranberry juice or cranberry products is associated with a reduction in risk for urinary tract infections. This is thought to be due to the type of polyphenols in cranberries that prevent E. coli bacteria for sticking to the surface of the cells in the urinary tract. The specific polyphenols in cranberries are structurally different than those found in other foods, which is why cranberries are essential. Drinking a cup of cranberry juice or having a serving of dried cranberries daily is sufficient to help reduce your risk.






3. Cranberries are a Tasty Complement to Your Dishes

Dried cranberries are a great addition to your recipes—from appetizers to desserts. They’re easily added to oatmeal or yogurt; go great with grain side dishes, casseroles, on top of salads, in wraps, or baked goods.




4. Cranberries are Good for Your Mouth and Stomach

This may be surprising, but there are several scientific papers on the role of cranberries and oral health. Studies show that the unique anti-bacterial properties that help prevent against UTIs, also help prevent bacterial adherence in your mouth and stomach.  This may help protect against cavities, periodontal disease and stomach ulcers. 
  
5. Cranberries are Heart-Smart

Cranberries also provide the same heart-smart flavonoids that are commonly found in red wine and grapes. These bio-active natural plant compounds help reduce risk for cardiovascular disease by helping to reduce inflammation and inhibiting low-density lipoprotein (LDL)-oxidation and boosting the good high-density lipoprotein (HDL). Cranberries also help relax blood vessels to improve blood pressure.
 6. Cranberries are Fiber-rich

Due to high fiber in them, cranberries are associated with significantly lower risks for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increased fiber intake has also been shown to lower blood pressure and cholesterol levels, improve insulin sensitivity, and enhance weight loss for obese individuals.


7. Cranberries protect from some form of cancers

Research has shown that cranberries are beneficial in slowing tumor progression and have shown positive effects against prostate, liver, breast, ovarian, and colon cancers.





Cranberries can also be enjoyed dried or in a can, but watch out for added sugars. Check the ingredient label and make sure that the product contains cranberries only. If you choose to drink cranberry juice, it is often mixed with other fruits and added sweeteners. Look for juice with cranberries as the first ingredient.





More tips for enjoying cranberries:
  • Make a homemade trail mix with unsalted nuts, seeds and dried cranberries.



  • Include a small handful of frozen cranberries in a fruit smoothie. 
                           

  • Add dried cranberries to your oatmeal or whole grain cereal. 


  • Toss dried or fresh cranberries into your favorite muffins or cookie recipe.





Precautions

A high intake of cranberry or it's juice should not be taken by those on the blood-thinning drug 'warfarin', also known as 'coumadin'. There has been conflicting evidence on the potential for cranberries to enhance the drug's effect on the body. Several cases of increased bleeding due to suspected interactions with cranberry juice and warfarin have been reported.

Cranberry products may increase urine oxalate excretion, which could promote the formation of kidney stones. Individuals with a history of kidney stones should talk to their healthcare provider before including any forms of cranberries in their diet.









Ref:  www.medicalnewstoday.com/articles/269142.php
       Cranberry - Wikipedia, the free encyclopedia

Monday 13 January 2014

Caring For The Patient With Cancer At Home (Symptom- Diarrhea)


Diarrhea is the passage of loose or watery stools three or more times a day with or without discomfort. It happens when the water in the intestine is not being absorbed back into the body for some reason.



Sometimes diarrhea can be caused by an overflow of intestinal liquids around stool that is lodged in the intestine (impaction). Other causes can include infections, surgery, anxiety, side effects of chemotherapy, radiation therapy to the abdomen, or medicines, supplemental feedings containing large amounts of vitamins, minerals, sugar and electrolytes and tumor growth. Diarrhea caused by chemotherapy or radiation therapy may last for up to three weeks after treatment ends.





                                       

    What the Patient Can Do?
  • Try a clear liquid diet like plain water, clear soups, strained kanjis, twirls (apple), strained wheat cracks (dalia) water, plain gelatin etc. as soon as diarrhea starts or when you feel that it's going to start. Avoid acidic drinks such as tomato juice, citrus juices and fizzy soft drinks.

                                                Plain water

                                                                Clear Soup

                                            Citrus Juices
                                          
                                                        Fizzy Soft Drinks

  • Eat frequent small meals. Do not eat foods that are very hot or spicy.
  • Avoid greasy foods, bran, raw fruits and vegetables, and caffeine.

  • Avoid pastries, candies, rich desserts,jellies, preserves, and nuts.


  • Do not drink alcohol or use tobacco.


  • Avoid milk or milk products if they seem to make your diarrhea worse.
  • Be sure your diet includes foods that are high in potassium (bananas, potatoes, apricots, and coconut water). Potassium is an important mineral that you may lose if you have diarrhea.


  • Monitor the amount and frequency of your bowel movements.
  • Clean your anal area with a mild soap after each bowel movement, rinse well with warm water and pat dry.
  • Take your medicines for diarrhea as prescribed by your doctor.
  • When the diarrhea starts to improve, try eating small amounts of foods that are easy to digest, such as rice, bananas,peeled apples or stewed apples, yogurt or plain curd, mashed potatoes, low-fat cottage cheese and dry toast for a day or two. If diarrhea keeps getting better, start small, regular feeds.










        What Caregivers Can Do :

  •  See that the patient drinks about three quarts of fluids each day.




  •  Keep a record of the patient's bowel movements to help decide when the doctor should be called.
  • Check with the doctor before using any over-the-counter diarrhea medicine. Many of these contain compounds that are like aspirin, which can worsen bleeding problems. It may be better to use a prescription medicine. 
  • Check the anal area for red, scaly, broken skin. Report this to your doctor.
  • Protect the bed and chairs from being soiled by putting pads with plastic backing under the buttocks where the patient will lie down or sit.

      Call The Doctor if the Patient:
  • Has six or more loose bowel movements per day with no improvement in two days.
  • Has blood in or around anal area or in stool.
  • Loses five pounds or more after the diarrhea starts.
  • Has new abdominal pain or cramps for two days or more.


  • Does not urinate for 12 hours or more.
  • Does not drink liquids for 48 hours or more.
  • Has a fever of 100.5F or higher, taken by mouth.

  • Gets a puffy or swollen belly.
  • Has been constipated for several days and then begins to have small amounts of diarrhea or oozing of liquid stool, which could suggest an impaction (severe constipation).












Reference: Caring for the Patient with Cancer at Home - a Guide for Patients and Families   

Tuesday 1 October 2013

Caring For The Patient With Cancer At Home (Symptom- Constipation)


Constipation is one of the symptoms a patient with cancer can have. It is defined as the infrequent or difficult passage of hard feces (stools), which often causes pain and discomfort.




It could be caused due to any of the following reasons :
  • poor food and fluid intake
  • not enough movement in the bowel
  • lack of activity
  • weakness
  • ignoring the urge to have a bowel movement
  • intake of certain medicines



What To Look For :
  • small, hard bowel movements
  • leakage of soft stool that looks like diarrhea
  • stomach ache or cramps
  • passing a lot of gas or frequent belching
  • belly appears blown up or puffy.
  • no regular bowel movement within the past three days.
  • vomiting or nausea.
  • feeling of fullness or discomfort.



What The Patient Can Do :
  • Drink more fluids. Fresh fruit juices and warm or hot fluids in the morning are especially helpful. 
  • Increase the amount of fiber in the daily diet by eating foods like whole grain breads and cereals, fresh raw fruits with skins and seeds, fresh raw vegetables, fruit juices, dates, apricots, raisins, prunes, prune juice and nuts.


  • Avoid foods and drinks that cause gas such as cabbage, cauliflower, broccoli and carbonated drinks.


  • Try to avoid any foods that cause you to be constipated such as cheese, eggs, products made of refined flour such as white bread, biscuits, naans, roomali roti etc


  • Get as much light exercise as you can.


  • Do not use enemas or suppositories. Use stool softeners or laxatives only after talking with your doctor or nurse.

  • Go to the bathroom as soon as you have the urge to have a bowel movement.
  • Keep a record of your bowel movements so that problems can be noticed quickly.

What Caregivers Can Do :
  • Offer the patient prune juice, hot lemon water, or tea to help stimulate bowel movements.


  • Encourage the patient to drink extra fluids.

  • Help keep a record of the patient's bowel movements.
  • Offer high fiber foods such as whole grains breads and cereals, dried and fresh fruits, vegetables, and bran.

  • Consult the doctor before giving the patient laxatives.

Call the doctor if the patient :
  • Has not had a bowel movement in 48 hours.
  • Has blood in or around anal area or in stool.
  • Cannot move bowels within one or two days after taking a laxative.
  • Has cramps or vomiting that won't stop.







Reference: Caring for the Patient with Cancer at Home - a Guide for Patients and Families