High Blood Pressure: How Loud It Can Be

High blood pressure (HBP) is louder than you may think.  Often called the “silent killer”, hypertension has symptoms to let you know it is present.  Symptoms may include headache, dizziness, fatigue, weakness, blurred vision, seizures, unexplained anxiety, and more.  Though nonspecific these signs and symptoms do correlate with high blood pressure. If you have a family history of HBP and heart problems, it is very likely the symptoms will be present. Untreated hypertension may lead to more serious conditions like heart attacks and strokes.

When you experience symptoms suggestive of hypertension, it is important to get it checked.  This should be done by a health care professional, but can be done at home, also.  Consistent readings above 140/90 call for assessment and treatment.  A complete physical exam, complete blood tests, and EKG should be done to check for overall good health and findings that are seen with hypertension. 

On physical exam the eye exam may reveal retinopathy and artery narrowing.  This is associated with decreased vision and can proceed to blindness.  Bruits over the carotid arteries in the neck and over the abdomen area suggest vascular disease that can block the arteries off.  This can lead to strokes, chronic kidney disease, peripheral vascular disease (poor circulation in legs), sexual dysfunction and more.  Heart findings and EKG changes can show signs of heart disease that accompany hypertension.  Blood tests provide further information and can even help assess if there are secondary causes.  Your doctor correlates all the information to assess a treatment plan. 

Initial therapy includes lifestyle changes like a healthy, nutritious diet, good sleep, low stress, and exercise.  If your blood pressure reading consistently remains elevated medication may be needed.  This may be temporary or lifetime depending on your lifestyle health habits.  For example, weight loss and eating the right foods especially those known to decrease blood pressure, can totally eliminate the need for medication and its side effects that can create new chronic problems. The best part is that you will feel better, and hopefully prevent any problems from untreated high blood pressure.  Best health!

Chronic Disease: Controlling the Incurable

Chronic disease affects more people as they age. It will affect everyone at some time in their life. Over 80% of the health costs worldwide are incurred by 20% of persons with one chronic disease or more. Chronic disease is defined as any illness that lasts more than three months, and/ or is recurrent. This includes such diseases as morbid obesity, arthritis, heart disease, diabetes, depression and many more. Most primary care doctors and family physicians see more patients with chronic diseases than any other health conditions.  The initial visit of the majority of patients seen on first visit have at least two or more chronic conditions.


Chronic disease management begins first and foremost with knowing as much as you can about the diseases that affect you.  Research yields information that strengthens your knowledge base of cause, effects, and what can be done to make it better or even preventable.  There are many evidence-based treatments that work, but some may help you more than others if at all.  For example, low back pain may be helped with hot or cold therapy, massage. acupuncture, spinal alignment. epidurals. medication and more.  Your spouse benefits from cold therapy and massage which hardly helps you. Hot therapy and acupuncture improves your pain and function, but not that of your spouse.  You must find what works best for you.  Ask your doctors for different treatments other than those they order as well.


Chronic disease responds favorably to a nutritious diet.  With medication noncompliance over 50% for whatever reason, you eat daily which allows for good, healthy food. Many foods have medicinal qualities that help control disease processes while keeping the healthy parts healthier.  Cooked dry beans are the perfect example.  They can provide as much as 9 to16 grams of fiber and 15 to 25 grams of protein in one-fourth cup  (60 to 150 calories).  A 14 ounce bag can yield about eight to ten cups at a cost of less than $2. Eaten alone or in other dishes, beans have powerful potent antioxidants that overpower cellular oxidative stress of chronic disease states.  High fiber is good for so many chronic problems such as heart disease, high lipids, diabetes, hypertension and more.  As you decrease processed foods in your diet, and add more fresh food your body responds with lower blood pressure, less pain, less overall stress, and good feelings of good health!


As chronic diseases progress especially with aging, many people move less.  Less movement opens the door for more chronic disease, and worsening of any you may already have.  Daily motion is the magic potion lotion.  Movement in activities of daily living count, and exercise helps.  At least ten minutes per day helps.  At home exercise programs work and are less stressful than going out.  Fancy home gyms with exercise equipment are nice but unaffordable for many.  Sitting, standing or laying you can do arm circles, leg raises, torso twists, and more.  Walking in place also works.  This type of activity improves physical and mental status to better.


You can control chronic diseases by choosing that which helps what you have.  Controlling the incurable involves routines designed for you.  This in itself improves overall quality of life and gives positive personal satisfaction that helps mental issues that may become chronic in themselves.  Best health!

10 Money Saving Medical Tips

You are your most important asset. Saving your health saves you money. These money saving medical tips can help you do both.

• Keep your health insurance coverage. This is as important as your home and food. Cut expenses elsewhere to keep it in your budget. Let your doctor know if you do not have insurance coverage. Many offer discounts to the uninsured as do other health providers like hospitals and diagnostic centers.
• If you lose your job, get COBRA through your employer. You will have at least 18 months of coverage. You will have to pay for it. It is worth it.
• Be sure you are up to date on your health maintenance. Get in now for your physical and preventive tests (mammogram, blood tests, eye exam, shots, etc.).
• Check your medication, prescription and non-prescription. Review these with your doctor to discontinue any you really do not need, and/or can't afford. Let your doctor know if you are unable to afford any of your medication, so other options can be discussed such as drug assistance programs. Research them yourself on the Internet, and by calling or writing the drug company that makes your medication. Remember to include your non prescription medicines in your budget (like cough medicine, stool enhancers, pain relievers, etc.). Talk with your pharmacist.
• Discontinue unhealthy habits like smoking and excessive drinking. These items cost money and your health.
• If you become disabled, you can withdraw money from your IRA without paying the penalty and taxes. You may need this money to pay for present or future health costs. It may benefit you more while you are well enough to enjoy it. By the time retirement rolls around, you may not be around.
• Eat healthy small servings. Smaller portions of healthy food save your money and your health. Remember this when you eat out.
• Exercise at home. Save your money and time on that gym membership. You can reap the same and better benefits with a home exercise program with or without expensive exercise equipment. Turn on the TV and participate in the fitness shows that are best for you. Exercise DVDs and tapes are a one time expense that can be used again and again. Ride your bicycle, take a walk or jog in your neighborhood. It all counts.
• Continue your home exams like self breast exams, and self scrotal exams. You may detect something early. There is much controversy about the self breast exam, and it is no longer recommended by some. Common sense tells you that self detection is a smart thing to do.
• Save money for your health bank. As insurance companies and plans cover less, you will be paying for more for services and premiums. Keep a nest egg for health expenses.

Remember that YOU are your most important asset. Great health is true wealth!

Living with Arthritis - Keep Moving!

Arthritis is an inevitable part of the aging.  It affects 1 in 3 people worldwide. Age-related arthritis usually starts at about 40 with increasing incidence as one gets older.  The more joints it affects the more likely it may become disabling and painful.  The joints most commonly affected are the hands and feet followed by weight bearing joints like the hip and knee.  The spine is also affected causing low back pain, one of the top five reasons for doctor visits.

Arthritis, also called degenerative joint disease (DJD), is just that – degeneration of bone surfaces from years of wear and tear and or occupational overuse.  Over time joint spaces throughout the body become narrow and less mobile leading to a progressive decline in affected joints.  The narrowing of the joint spaces involves an inflammatory process.  Severe degeneration causes bone surfaces to rub against one another in places where cartilage and synovium used to be. All of this can lead to disabling pain and limited movement. 

 Symptoms of arthritis include stiffness, pain, and joint swelling.  This can lead to decreased, limited movement affecting your activities of daily living.  If arthritis worsens, it can lead to mobility issues and may require surgery.  Chronic, debilitating pain may also make all activities more difficult and less enjoyable.

Is this avoidable?  No.  Is it treatable? Yes.  Some studies postulate that cartilage damage induced by inflammatory arthritis that chondroitin sulfate may at least delay progression.  Antiflammatory medications like aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) help with inflammation and pain.  Further pain contol may be achieved with narcotics which are potentially addictive.  Dietary adjustments include increase calcium and Vitamin D.

The most beneficial treatment is movement. When it’s hard to move, efforts to move must be made to keep from moving even less.  Ironically so, when you feel like you are having a hard time moving, it’s time to keep moving!  Ask your doctor for an orthopedic doctor consult and a physical therapy evaluation for treatment.  You will be able to implement your own home exercise program. 

Best health!

Family Health: Allergy vs. Adverse Reaction

Do you know the difference between an allergy and adverse reaction?  When taking medication of any type, prescription or non-prescription, reactions from a single or multiple drugs may occur.  An allergic reaction usually involves allergy symptoms which may include difficulty breathing, hives, and itching.  Adverse reactions may include this and much more essentially indicating your body is unable to tolerate the medicine.

It is important that your health care team is aware of any reactions to medication you have taken.  When asked about allergies be sure to include adverse reactions as well.  It is also important to note any drug-drug and drug-food interactions you may have experienced.  Medication in the same drug class are often offered as alternatives. These can also be adversely tolerated.

Be aware of your medication history and include it in your medical history.  Share this with all of your healthcare providers.  This will assure that you will be unlikely to be prescribed anything that may cause an allergic or adverse reaction.  Best health!

Read and Learn for Your Health

Read what you need. Learn about what you need to maintain good health and well-being.  Health literacy is an important part of your self-care health care.  It helps promote better health and quality of life. 

Medical science progresses so rapidly!  It is impossible for health care providers to keep up with all these new developments. Be aware of treatments your doctors and healthcare team have yet to hear about or are unlikely to ever find out about.  The overwhelming amount of new health information that comes out is far too much for many to stay current on every disease and treatment.  This should not stop you the patient from finding out all you can.  The same goes for wellness.  Participating in your health care is mandatory to maintain good health, achieve wellness, and overcome illness.

There are so many different treatments and modalities that compliment traditional medicine.  As many lack training in these areas they are unable to tell the patient.  Asking your doctor is a good starting place as is telling your doctor about the things you have read about or tried that helped.  In turn this may evoke a response by your physician to find out more, and even share with other patients and colleagues who may in turn share their “new” information which your doctor can share with you.

Reading and learning are vital to good health.  Informed choices based on fact have proven to yield better health outcomes.  Best health!

Keep a Happy Heart, Be Heart Smart

A healthy heart is a cheerful heart.  Keep your heart smart and happy with this quick, easy to understand information.

Check your heart list:
___Heart and vascular exam by health care provider
___Blood pressure, pulse, weight, height
___EKG

For further evaluation, especially if symptoms are present, and/ or if there is a strong family history of heart and vascular disease see a cardiologist.

Tests may include:
___Doppler echocardiogram (checks heart valves, size, etc.)
___Stress test - nuclear, doppler or exercise (heart function)
___Heart MRI scan (artery disease)
___Interventional studies like cardiac catherization, angiogram (checks artery blockage, valve function)

Heart health habits:

1. Maintain a healthy weight.
2. Eat healthy small portions.
3. Exercise regularly - every little bit counts! Just do it regularly.
4. Keep blood pressure under control.
5. Keep stress level low.
6. Get adequate sleep.
7. Take an aspirin a day if in a high risk group. Check with your health care provider.
8. Love, laugh, and let go!

Have a happy, healthy heart! Best health and love!

J.L. Richardson, MD, family medicine, is the author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.