Let’s start with what smoking actually does to the body. Smoking harms nearly every organ of the body. Smoking causes many diseases and reduces the health of smokers in general. It primarily starts at the lungs. How?   Well think of your lung tissue with openings all over which are air sacs called alveoli. This is an anatomical structure that has the form of a hollow cavity which does the exchange of oxygen and carbon dioxide in and out of our body, when we inhale and exhale. The thing to know about this tissue is that before you start smoking the alveoli are expandable (think of it like a rubber band) allowing the person to get a good exchange of oxygen getting in the body to go to all our tissues and carbon dioxide getting out of the body (O2=oxygen being the fuel to our tissues and without it causes cellular starvation, carbon dioxide=CO2 being an acid / toxin to the human body and exhaled by the lungs).   After years of smoking the alveoli stretches out not allowing a good exchange of O2 and CO2. The sad thing for a smoker is the alveoli CANNOT REVERSE back after damage has already occurred unless you had a lung transplant with continuing to smoke, which no M.D. or health insurance would allow. More realistic would be QUIT the bad habit. The tissue doesn’t get completely better but it improves when you quit. So the pt with Emphysema has alveoli that can’t exchange oxygen and carbon dioxide from the blood like it use to at the bottom of the lungs, prior to even starting to smoke. Also, after smoking years and when diagnosed with COPD you have difficulty breathing (that is why smoking is a major cause of bronchitis or Emphysema=types of chronic obstructive pulmonary disease=COPD and it is not REVERSIBLE). Emphysema is the worst type of COPD you can get. COPD is the third leading cause of death in the U.S., and the economic burden of COPD in the U.S. in 2007 was $42.6 billion in health care costs and lost productivity. Isn’t this reason enough to stop smoking?

Emphysema is an enlargement of the air spaces distal to the terminal bronchioles, with destruction of their walls. People with emphysema have historically been known as “Pink Puffers”, due to their pink complexion.

Chronic bronchitis is defined in clinical terms as a cough with sputum production on most days for 3 months of a year, for 2 consecutive years. People with advanced COPD that have primarily chronic bronchitis were commonly referred to as “Blue Bloaters” because of the bluish color of the skin and lips (cyanosis) along with hypoxia and fluid retention.

Know when the lungs get affected in time the heart gets affected. One affects the other in time. The heart can’t live without the lungs and vice versa.

Now knowing just this you’ll understand why smoking alone can cause the so many unhealthy conditions which will be discussed in Part 2 tomorrow.  Have a great day readers!

“Erectile dysfunction (ED) is common in patients with congestive heart failure (CHF). ED reduces quality of life, and it may affect compliance, thereby impairing the success of CHF treatment. ”

American Heart Association

“In addition to relieving patient suffering, research is needed to help reduce the enormous economic and social burdens posed by chronic diseases such as osteoporosis, arthritis, diabetes, Parkinson’s and Alzheimer’s diseases, cancer, heart disease, and stroke.”

Ike Skelton (born December 20, 1931) is an American politician who was the U.S. Representative for Missouri’s 4th congressional district from 1977 to 2011).

A number of symptoms are associated with heart failure, but none is specific for the condition. Perhaps the best known symptom is short of breath (called dyspnea). In heart failure, this may result from excess fluid in the lungs. The breathing difficulties may occur at rest or during exercise. In some cases, congestion may be severe enough to interrupt or prevent you from sleeping.

-Fatigue or easy tiring is another common symptom. As the heart’s pumping capacity decreases, muscles and other tissues receive less oxygen and nutrition, which are carried in the blood. Without proper fuel (oxygen from the blood) provided by our engine (the heart), the body cannot perform as much work as it use to do (just like going from in shape to out of shape in time). The ending line is this will result into fatigue.

-Fluid accumulation will cause swelling in the feet, ankles, legs, and occasionally the abdomen (if the fluid building up in the body gets severe), what we medically call edema.   Through gravity the blood goes backwards and our body allows water to transfer in the skin to allow the fluid to go somewhere other than the bloodstream to decrease fluid overload to the heart by compensating. It body compensates since the blood is going backwards from the heart causing fluid back up. Excess fluid retained by the body will result into weight gain, which sometimes occurs fairly quickly (if you have CHF already you should always call your M.D. if you weight gain is 3lbs or more in a week, odds are high this is due to fluid building up).

-Persistent coughing is another common sign, especially coughing that regularly produces mucus or pink, blood-tinged sputum. Some people develop raspy breathing or wheezing.

-Heart failure usually goes through a slow development process, the symptoms may not appear until the condition has progressed over the years. This happens because the heart first compensates by making adjustments with the heart that delay or slow down but do not prevent, the eventual loss in pumping capacity. In time failure happens, just like a car in when it gets older over several years is starts showing one problem after another and is exchanged for a newer car; same principle with the heart in that you show signs and symptoms as your heart starts to slow down to failure and its either treat the problem or get a transplant of the organ (which is unlikely to happen).  The heart first hides the underlying process but compensates by doing this to your heart:

1- Enlargement to the muscle of the heart (causing “dilatation”) which allows more blood into the heart.

2- Thickening of muscle fibers (causing “hypertrophy”) to strengthen the heart muscle, which allows the heart to contract more forcefully and pump more blood.

3- More frequent contraction, which increases circulation.

By making these adjustments, or compensating, the heart can temporarily make up for losses in pumping ability, sometimes for years. However, compensation of the organ can only last so long, not forever (like anything in life the living thing or an object will go through a ending life process to termination). Eventually the heart cannot offset the lost ability to pump blood, and the signs of heart failure appear.

DIAGNOSIS

In many cases, physicians diagnose heart failure during a simple physical examination. Readily identifiable signs are shortness of breath, fatigue, and swollen ankles and feet. The physician also will check for the presence of risk factors, such as hypertension, obesity and a history of heart problems.

Using a stethoscope, the physician can listen to a patient breathe and identify the sounds of lung congestion. The stethoscope also picks up the abnormal heart sounds indicative of heart failure.

If one or not both symptoms or the patient’s history point to a clear cut diagnosis, the physician may recommend any of a variety of laboratory tests, including, initially, an electrocardiogram (EKG), which uses recording devices placed on the chest to evaluate the electrical activity of a patient’s heartbeat which will be affected by CHF.

Echocardiography is another means of evaluating heart function from outside the body. This works through sound waves that bounce off the heart are recorded and translated into images. The pictures can reveal abnormal heart sizes, shape, and movement. Echocardiography also can be used to calculate a patient’s ejection fraction which is a measurement of the amount of blood pumped when the heart contracts.

Another possible test is the chest x-ray, which also determines the heart’s size and shape, as well as the presence of congestion in the lungs.  The lab blood test performed is called a BNP and if elevated it further helps diagnose for the MD that the patient has CHF BUT the elevation of your BNP alone doesn’t mean you have CHF.

Tests help rule out other possible causes of symptoms. The symptoms of heart failure can result when the heart is made to work too hard, instead of from damaged muscle (like in a heart attack). Conditions that overload the heart occur rarely and include severe anemia and thyrotoxicosis (a disease resulting from an overactive thyroid gland).

Prevention of CHF:

-If not diagnosed yet your already possibly ahead. Without this diagnosis you can get started on making yourself further away from being diagnosed with this disease. How to reach this goal is through living a routine life through healthy habits practiced, healthy dieting over all, and balancing rest with exercise during the week 30-40 minutes a day or 1 hour to 1.5 hours 3 times a week and not being obese. They all would benefit the heart in not stressing it out making the heart’s function harder in doing its function. When the heart stresses out it is at risk for lacking oxygen putting it at potential for angina (heart pain) to a heart attack with over time leading toward failure of the heart. Need to learn more about what is and how to get your weight in therapeutic body mass index range through dieting of all 4 food groups, balancing exercise/rest, and knowing how the body works with all ingredients in foods including portion sizes (fats, calories, starches, carbohydrates, proteins with vitamins and minerals) to understanding how all this information takes effect in how your metabolism operates in being beneficial or against you?   Well than go to healthyusa.tsfl.com and take a peek at what we offer at such a reasonable price and more of a reachable goal with having Dr. Anderson through access of his book “Dr. A’s healthy habits” with me as your personal coach and if you want foods to eat in helping you lose weight if needed I’m there to help you with any questions you may have and even for support. To take a peek go to healthyusa.tsfl.com and see what we offer for no price and with no hacking. Join me and so many others in attempting to reach this goal. So far I have lost 22lbs. and hope to lose more.

“Your body has an amazing ability to make up for heart failure. It may do such a good job that you don’t know you have a disease. But at some point, your heart and body will no longer be able to keep up. Then fluid starts to build up in your body, and you have symptoms like feeling weak and out of breath. ”

WebMD under Heart Failure Health Center

Types of Heart Failure

The term congestive heart failure (CHF) is often used to describe all patients with heart failure. In reality, congestion=the buildup of fluids in the heart for not pumping correctly, just like pipes in a home not working properly=back up of water in the pipes, happens with CHF also to the fluids (blood) backing up in the lungs.   This is just one feature of the condition and does not occur in all patients. There are two main categories of heart failure although within each category, symptoms and effects may differ from patient to patient. The two categories are:

1-Systolic heart failure (systolic is the top number of your blood pressure=the heart at work). This occurs when the heart’s (muscle-myocardium) ability to contract (pump=being active) decreases, particularly starting on the L side of the heart where the muscle of the heart is greatest (myocardium=heart muscle). The heart cannot pump blood with enough force to push a sufficient amount out of the heart into the circulation through the aorta. The aorta is a artery (vessel) that leaves the L lower chamber of the heart (left side of the heart=highly oxygenated rich blood). Due to the heart not using enough force pushing the blood forward in the aorta this causes the blood to back up and cause it to go back up into the L lower to the L upper chamber that goes further back up into the pulmonary vein into the lungs=congestion in the lungs due to the heart failure.

2-Diastolic heart failure (diastolic is the bottom number of your blood pressure which is the pressure when the heart is at rest). This failure occurs when the heart has a problem relaxing. The heart cannot properly fill with blood because the muscle of the heart due to trying so hard to compensate over a long period of time with disease (ex. High B/P, Obesity, etc…) strains the heart in doing its function that failure finally starts that the muscle of the heart (myocardium) becomes stiff. This causes the heart to lose its ability to relax to allow proper filling of the heart in upper and lower chambers=back up of the blood.   This failure starts on the right side of the heart causing the blood to back up away from the heart and may lead this blood that is highly concentrated with carbon dioxide to accumulation especially in the feet, ankles and legs. Some patients may have lung congestion.

Doctors usually classify patients’ heart failure according to the severity of their symptoms. The table below describes the most commonly used classification system, the New York Heart Association (NYHA) Functional Classification. It places patients in one of four categories based on how much they are limited during physical activity. Here are how the classes are defined based on symptoms.

Causes of Heart Failure:

As stated, the heart loses some of its blood pumping ability as a natural consequence of aging. How- ever, a number of other factors can lead to a potentially life-threatening loss of pumping activity.

As a symptom of underlying heart disease, heart failure is closely associated with the major risk factors for coronary heart disease: smoking, high cholesterol levels, hypertension (persistent high blood pressure), diabetes= abnormal blood sugar levels, and obesity. A person can change or eliminate those risk factors and thus lower their risk of developing or aggravating their heart disease and heart failure through healthy habits performed routinely, proper dieting, and balancing rest with exercise.

Among prominent risk factors, hypertension-HTN (high blood pressure) and diabetes are PARTICULARLY IMPORTANT. Uncontrolled HTN increases the risk of heart failure by 200 %, compared to those who do not have hypertension.   Moreover, the degree of risk appears directly related to the severity of the high blood pressure.

Persons with diabetes have about a two to eight fold greater risk of heart failure than those without diabetes. Women with diabetes have a greater risk of heart failure than men with diabetes. Part of the risk comes from the diabetes association with other risk factors for heart disease such as high cholesterol or obesity or other risk factors. However, the disease process of diabetes also damages the heart muscle.

The presence of coronary disease is among the greatest risks for heart failure. Muscle damage and scarring caused by a heart attack greatly increase the risk of heart failure. Cardiac arrhythmias, or irregular heartbeats, also raise heart failure risk. Any disorder that causes abnormal swelling or thickening of the heart sets the stage for heart failure.

In some people, heart failure arises from problems with heart valves, the flap-like structures that help regulate blood flow through the heart. Infections in the heart are another source of increased risk for heart failure.

A single risk factor may be sufficient to cause heart failure, but a combination of factors dramatically increases the risk. Advanced age adds to the potential impact of any heart failure risk.

Finally, genetic abnormalities contribute to the risk for certain types of heart disease, which in turn may lead to heart failure. However, in most instances, a specific genetic link to heart failure has not been identified.

SO LIVE AS HEALTHY AS POSSIBLE IN YOUR ROUTINE HABITS, YOUR DIETING OF THE 4 FOOD GROUPS, MAINTAINING YOUR WEIGHT IN A THEREPEUTIC RANGE (look as calculating BMI online for free to find out what your weight range for your height is), and BALANCING REST WITH EXERCISE TO HELP DECREASE THE CHANCE OF GETTING HEART FAILURE. Go to healthyusa.tsfl.com to learn what Dr. Anderson through his book of “Dr. A.’s Healthy Habits” and me as your health coach could provide you within a reachable cost. To just view what can be offered to you for no price with no hacking go to healthyusa.tsfl.com and take a peek;)

“Around 1% of people under 65 years of age have heart failure, but 7% of 75-84 year olds have heart failure and this increases to 15% in people older than 85. It is the most common cause of hospitalisation in patients over 65 years of age.”

MontifioreHeartCenter

The definition of heart failure, it occurs when the heart loses its ability to pump enough blood through the body. Usually, the loss in pumping action is a symptom of an underlying heart problem, such as hypertension and CAD = coronary artery disease. The term heart failure suggests a sudden and complete stop of heart activity but actually the heart does not suddenly or abruptly stop. Instead the way it works is heart failure usually develops over time, years. The heart first compensates with the disease or illness the individual has but, just like a car, after wear and tear the heart goes into decompensating to heart failure due to the heart decline. How serious is this condition? It varies from person to person depending on factors like an individual with obesity & unhealthy versus a person in healthier condition. All people diagnosed or not diagnosed with heart failure lose a pumping capacity of the heart happens as they age but diagnosed with heart failure makes the engine of the body a challenge in doing its function properly. The pump loss is more significant in the person with heart failure and often results from a heart attack (actual scaring to the tissue=death to that tissue area) or from other diseases that can damage the heart. The severity of the condition determines the impact it has on a person’s life. At the other end, extremes, treatment often helps people lead full lives if the person follows the meds ordered by the doctor including the diet and activity/exercise the doctor orders to the patient with heart failure (compliance so important). There are different levels of heart failure but even the mildest form is a serious health problem, which must be treated. If not the pump (the heart) will just get worse in doing its function properly. To improve the chance of living longer in an individual with heart failure, patients must take care of themselves, see their physician (cardiologist) on a regular basis, and closely follow treatments (as ordered) with knowing what heart failure actually to understanding how the disease works (is the failure on the right side or left side? Which in time will effect the other side in time). In knowing what side the failure is on will make you understand what signs and symptoms to expect.  Tune in on Monday for Types of CHF and causes.  Hope you come back reading more on learning about CHF.

“Death leaves a heartache no one can heal, love leaves a memory no one can steal.”

From an Irish headstone― Richard Puz, The Carolinian

Losing someone or something (ex. house) you love or care deeply about is very painful. You may experience all kinds of difficult emotions and it may feel like the pain and sadness you’re experiencing will never let up. These are normal reactions to a significant loss. But while there is no right or wrong way to grieve, there are healthy ways to cope with the pain that, in time, can renew you and permit you to move on.

For me personally I lost a dear family member this past week and anyone out their who has had a loss recently–I can relate to what you might be feeling with providing my deepest condolences to you and know you can move on.  Like I told on the day of the funeral, to a few people, that Marian is in the next world so much happier being out of misery but it is us on earth in misery but it will heal in time like a wound.  For all people effected it will heal in varying degrees.  The other thing I stated was she has never left us, she’s with all old and new loved ones in heaven.  Those left behind on Earth she saw all the time, some a few to rarely, but will never leave us helping us get through this rough time just like my father was there in 1999 when he died of cancer and never left me.  I know she is keeping a close eye on all loved ones she had in her life.  As long as she is better off I know that its for the better which overrides any of my misery.  Being a RN over 25 years seeing so many types of patients including being a oncology nurse loss of a loved one might be easier for me in dealing with than some but trust me I still have feelings like everyone else in this world.  Marian what kills me the most is we didn’t see each other with the family a lot due primarily distance but you will be missed by many.  God has his reasons for you to leave this world and unfortunately we couldn’t do more time with each other in this world.   I am very thankful I got to meet you in my lifetime. 

Grief is a natural response to loss. It’s the emotional suffering you feel when something or someone you love is taken away. The more significant the loss, the more intense the grief will be. You may associate grief with the death of a loved one—which is often the cause of the most intense type of grief—but any loss can cause grief, including: Divorce, loss of health, loss of a job, loss of financial stability, retirement, loss of a friendship, loss of a cherished dream (ex. spouses in their own business, planning to get married that never happens, loss of a mortgage on a new home, a loss of a baby, etc…).

The more significant the loss, the more intense the grief. However, even subtle losses can lead to grief. For example, you might experience grief after moving away from home, graduating from college, changing jobs, selling your family home, or retiring from a career you loved.

Grieving is a personal and highly individual experience. How you grieve depends on many factors, including your personality and coping style, your life experience, your faith, and the nature of the loss. The grieving process takes time. Healing happens gradually; it can’t be forced or hurried—and there is no “normal” timetable for grieving.  Some people start to feel better in weeks or months. For others, the grieving process is measured in years. Whatever your grief experience, it’s important to be patient with yourself and allow the process to naturally unfold.

Dr Elisabeth Kübler-Ross pioneered methods in the support and counselling of personal trauma, grief and grieving, associated with death and dying. She also dramatically improved the understanding and practices in relation to bereavement and hospice care. This is quite aside from the validity of her theoretical work itself, on which point see the note, right.

Her ideas, notably the five stages of grief model, the model was first introduced by American Psychiatrist Elisabeth Kübler-Ross in her 1969 book, On Death and Dying, and was inspired by her work with terminally ill patients but simply a significant loss can experience these steps as well.  They are: 1.) Denial 2.) Anger 3.) Bargaining 4.) Depression 5.) Acceptance .  You go through all these steps in a loss and repeat them and not in order for all.   Contrary to popular belief, you do not have to go through each stage in order to heal.   In fact, some people resolve their grief without going through any of these stages. And if you do go through these stages of grief, you probably won’t experience them in a neat, sequential order, so don’t worry about what you “should” be feeling or which stage you’re supposed to be in.Kübler-Ross herself never intended for these stages to be a rigid framework that applies to everyone who mourns. In her last book before her death in 2004, she said of the five stages of grief: “They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grieving is as individual as our lives.”

While loss affects people in different ways, many experience the following symptoms when they’re grieving. Just remember that almost anything that you experience in the early stages of grief is normal—including feeling like you’re going crazy, feeling like you’re in a bad dream, or questioning your religious beliefs.

Symptoms of Grief:  Shock and disbelief – Right after a loss, it can be hard to accept what happened.  Sadness – Profound sadness is probably the most universally experienced.  Guilt – You may regret or feel guilty about things you did or didn’t say or do. Anger – Even if the loss was nobody’s fault, you may feel angry and resentful. If you lost a loved one, you may be angry with yourself, God, the doctors, or even the person who died for abandoning you.  You may feel injustice has been done to you.  Fear – A significant loss can trigger a host of worries and fears. You may feel anxious, helpless, or insecure. You may even have panic attacks.  You may feel fears of how do  I live without this person.  Physical Symptoms – We often think of grief as a strictly emotional process, but grief often involves physical problems, including fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia.

Coping with grief and loss is one get support.                                                         The single most important factor in healing from loss is having the support of other people. do not grieve alone. Connecting to others will help you heal.

Finding support after a loss

• Turn to friends and family members
• Draw comfort from your faith
• Join a support group – To find a bereavement support group in your area.
• Talk to a therapist or grief counselor – If your grief feels like too much to bear, call a mental health professional with experience in grief counseling.Face your feelings, express your feelings in a  tangible and creative way (I am writing about it in my blog for example).  Take care of your health (especially not on alcohol or drugs to numb the pain for it will be only temporary and unhealthy).  Don’t have people inform you how to feel and when you will be better.  Don’t tell yourself how you should feel.  This is YOUR grief no one elses and when its time to move on or that you have gotten over the grief you will know.  It is ok to be angry, ask why God did you do this to me, not understand why this took place,  laugh at moments of good time memories
• When you’re grieving, it’s more important than ever to take care of yourself. If you don’t care for yourself you can’t take care of others.  The stress of a major loss can quickly deplete your energy and emotional reserves.

• Don’t let anyone tell you how to feel, and don’t tell yourself how to feel either. Your grief is your own, and no one else can tell you when it’s time to “move on” or “get over it.” Let yourself feel whatever you feel without embarrassment or judge- ment.   It’s okay to be angry, to yell at the heavens, to cry or not to cry. It’s also okay to laugh, to find moments of joy, and to let go when you’re ready.  As time passes, these emotions should become less intense as you accept the loss and start to move forward.The sadness of losing someone you love never goes away completely, but it shouldn’t remain center stage. If the pain of the loss is so constant and severe that it keeps you from resuming your life, you may be suffering from a condition known as complicated grief .  Unable to get rid of the intense grieving loss feelings and move on with your life.  Still in intense mourning and unable to accept the death or loss you have had after a long period of time.  A loss can effect you weeks to months to a year and if you move on at that point it is therapeutically dealing with it.  Your feeling can still be present till you die but in less intensity since the occurrence of the loss.Contact a grief counselor or professional therapist if you:
• Distinguishing between grief and clinical depression isn’t always easy as they share many symptoms, but there are ways to tell the difference. Remember, grief can be a roller coaster. It involves a wide variety of emotions and a mix of good and bad days. Even when you’re in the middle of the grieving process, you will have moments of pleasure or happiness. With depression, on the other hand, the feelings of emptiness and despair are constant.
• Complicated grief

• Feel like life isn’t worth living
• Wish you had died with your loved one
• Blame yourself for the loss or for failing to prevent it
• Feel numb and disconnected from others for more than a few weeks
• Are having difficulty trusting others since your loss
• Are unable to perform your normal daily activities!
• This article was done in memory of Karen Guttridge-Foster-Saher – an old dear friend who I will never loose on earth or off.

1. Block SD. Grief and bereavement. http://www.uptodate.com /index. Accessed Aug. 31, 2012.
2. Dealing with the effects of trauma — A self-help guide. Substance Abuse and Mental Health Services. http://store.samhsa.gov/shin/content//SMA-3717/SMA-3717.pdf. Accessed Aug. 31, 2012.
3. Holtslander L, et al. An inner struggle for hope: Insights from the diaries of bereaved family caregivers. International Journal of Palliative Nursing. 2008;14:478.
4. Vale-Taylor P. “We will remember them”: A mixed-method study to explore which post-funeral remembrance activities are most significant and important to bereaved people living with loss, and why those particular activities are chosen. Palliative Medicine. 2009;23:537.
5. Benkel I, et al. Managing grief and relationship roles influence which forms of social support the bereaved needs. American Journal of Hospice and Palliative Medicine. 2009;26:241.
6. Reminders of trauma: Anniversaries. United States Department of Veterans Affairs. http://www.ptsd.va.gov/public/pages/anniversary-reactions.asp. Accessed Aug. 31, 2012.

Article is all from the Mayo clinic Nov 2012