“I think one’s feelings waste themselves in words; they ought all to be distilled into actions which bring results.”

Florence Nightingale

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.

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.

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;)

CHF part 2 tomorrow and learn what the signs and symptoms with how its diagnosed, how its treated with tips on the disease (most importantly prevention).

“Cholesterol helps your body build new cells, insulate nerves, and produce hormones. Normally, the liver makes all the cholesterol the body needs. But cholesterol also enters your body from food, such as animal-based foods like milk, eggs, and meat. Too much cholesterol in your body is a risk factor for heart disease.  When there is too much cholesterol in your blood, it builds up in the walls of your arteries, causing a process called atherosclerosis, a form of heart disease.”

WEB MD

What is heart disease?

Heart disease occurs when the arteries that supply blood to the heart are clogged. Deposits of fat and cholesterol prevent the blood from flowing as it should. If the blood supply is completely blocked, you are in danger of having a heart attack.

What is cholesterol?

Cholesterol forms in the liver. It is a waxy substance that has many important functions in the body. It is part of various hormones, the makeup of the walls of your body’s cells, a component of bile, and many other purposes. How the body processes it is very complex. It joins with a protein and forms a package called lipoprotein. These lipoproteins carry cholesterol through the blood.

Foods of animal origin contain cholesterol. These foods include eggs, dairy products, shellfish, and meat. Foods of plant origin-fruits, grains, and cereals—do not contain cholesterol.

How is cholesterol measured?

Cholesterol is measured in metric system units. The LDL’s (low density lipoproteins) have the bad cholesterol. LDL’s are the main source of blockage in the arteries. HDL’s (high density lipoproteins) have the good cholesterol. HDL’s help keep cholesterol from building up in the wall of the arteries.

A total cholesterol level less than 200mg/dl is considered good. It represents the least risk of heart disease. Above that, your level is borderline high. If you are above 200 your level of cholesterol is high.

Why is my cholesterol so high?

Some cholesterol is essential to many body processes. However, problems can develop when there is too much cholesterol.

Your cholesterol level is high because of the amount of cholesterol and fat in the food you eat. It’s also affected by how quickly your body makes LDL cholesterol and disposes of it. The following factors determine whether your LDL level is high or low:

-Heredity –Your Diet –Your weight –Your exercise program –Your age & sex –Other medical conditions you may have, such as diabetes.

How can I control these factors?

1-You can’t do much about heredity, age, sex (non-modifiable factors – meaning you have no control on these factors to keep cholesterol low).

2-You can do a lot through diet. To lower cholesterol, limit your daily calories from fat to 30 percent should be saturated fat and not more than one third from polyunsaturated fat. At least one third of the total fat calories should be from mono-saturated fat. Weight loss helps to lower LDL’s and raise HDL’s.

3-Physical Exercise can also do a lot in lowering cholesterol. It can help in lowering LDL’s and raise the HDL’s.

4-Some women find that estrogen replacement following menopause lowers cholesterol.

5-You should take care of other medical problems like diabetes as best as you can.

6-Medications are a very important part of treating high cholesterol. Studies have shown that your life span can be improved by taking mediations if you have high cholesterol.

What else can you do?

You should lower a high LDL cholesterol level whether you have heart disease or not. Our doctor may prescribe medication to help you do this. He or she can provide information about low fat food plans. You can also get specific food listings for fat and cholesterol.

You must do most of te work, though. For the same number of calories, you can develop a food plan that includes enough food with lower fat and cholesterol. This type of plan will satisfy your hunger and be enjoyable, as well.

FOR MORE INFORMATION:

National Heart Lung and Blood Institute

P.O. Box 30105

Bethesda, MD 20824-0105

“First excessive insulin raises the level of bad cholesterol in the blood – the LDL version. At the same time it decreases the level of “good” cholesterol – the HDL variety. “

www.diabetes-information-network.com/heart–disease.htm

There are several stages involved in the development of heart disease. Unfortunately having too much insulin in your blood is involved in each and every stage.

Stage 1: First excessive insulin raises the level of bad cholesterol in the blood – the LDL version. At the same time it decreases the level of “good” cholesterol – the HDL variety.

Then it goes on to increase the level of triglycerides in the blood – yet another risk factor for heart disease. Excessive insulin also causes your blood to clot more quickly which increases your risk of stroke.

Though your kidneys are not insulin sensitive, when your insulin level is elevated it indirectly causes your kidneys to retain salt and fluid which further increases your blood pressure.

Stage 2:In this stage excessive insulin increases cellular proliferation which damages the lining of your blood vessels. This increases the blood vessels vulnerability and sets the stage for even more blood vessel damage.　　

Stage 3: In this third stage insulin plays a different role. There are two very different kinds of LDL cholesterol. “Pattern A” LDL cholesterol is light, floats on water and represents no particular threat to the human body. But “Pattern B” LDL is a smaller particle, much more dense form that’s intimately involved in the heart disease process. That’s because it’s this denser form that attaches itself to the blood vessel lining to form artery-clogging plaques. Excessive insulin increases this more dangerous form of LDL. It’s this kind of LDL that forms the “fatty streak” plaques that are the hallmark of early heart disease.　

Stage 4: Excessive insulin promotes the conversion of specialized cells called microphages in your blood into foam cells which further promotes the formation of dangerous plaques.　

Stage 5: Before the plaque becomes dangerous it must be oxidized by free radicals. Once again insulin plays a role by increasing the level of dangerous tissue-damaging free radicals in your blood. The smaller dense LDL particles that excessive insulin promotes are more subject to free radical oxidation.　

Stage 6: This damage to your blood vessel lining triggers an inflammatory response which contributes to the vicious cycle. Excessive insulin boosts inflammation throughout the body including within the lining of blood vessels. Many medical researchers feel that inflammation plays a major role in heart disease and excessive insulin plays a major role in generating it. In addition, studies have shown that this increased level of inflammation can directly damage brain neurons. (The C-reactive blood test measures the level of inflammation in your body. Today more and more doctors are using the test in recognition of the key role inflammation plays in so many different diseases.)　

Stage 7: As the plaque builds over the years, it eventually restricts the flow of blood causing either chest pain or other symptoms in other parts of your body. If the blood vessels feeding the brain become restricted, your brain function will inevitably be affected.

In numerous studies where insulin was injected into the blood vessels of lab animals, it was found that thick artery clogging plaques accumulated just downstream from the injection sites.

Stage 8: Excessive insulin also directly stimulates the central nervous system raising blood pressure which further increases the risk of a heart attack or stroke. At this stage you may experience TIAs (transient　 ischemic attacks) which are small strokes that damage small areas of your brain. Damage caused by TIAs are commonly found in the brains of deceased Alzheimer’s patients.

Stage 9: Excessive insulin causes the body to increase it’s excretion of magnesium which causes a magnesium deficiency which can then trigger arterial spasms that can directly cause a heart attack. If a heart attack doesn’t get you, remember that excessive insulin has already increased the blood’s tendency to clot. A blood clot can easily form at the site of the spasm and travel to other areas of the body such as the lungs where it can cause a fatal embolism.　

Stage 10: You’re officially diagnosed as having heart disease and if that isn’t bad enough this diagnosis dramatically increases your risk of dementia and premature death.

After reading the above it should come as no shock that studies have found that fatal heart attacks are three times more likely after a high carbohydrate meal than after a high fat/protein meal!

“Causes of epilepsy vary by age of the person. Some people with no clear cause of epilepsy may have a genetic cause. But what’s true for every age is that the cause is unknown for about half of everyone with epilepsy.”

Epilepsy Foundation

Diagnosis of Epilepsy

The history of the person is the most valuable component of the workup of that individual with possible epilepsy.

The routine diagnostic tooling to see if someone has this disease is a EEG which is the major diagnostic test.  EEG takes short samples of brain wave activity with 26 wires to the scalp recording amplified brain waves from the superficial regions of the brain by means of scalp electrodes.

Laboratory studies are done to rule out various causes for seizures.  Routine blood and urine studies are often done for baseline information.  Electrolytes and blood chemistries will be evaluated to identify possible metabolic causes for seizures.

Neuropsychological testing may be done in the evaluation of persons presenting with seizures.  The purpose of neuropsychological testing is to determine if there is brain dysfunction and to determine if the pattern of change in brain function is indicative of a destructive lesion.  Neuropsychological testing involves evaluation of cognitive functions and personality and emotional traits.

Medical Management

The major medical treatment for epilepsy is antiepileptic medications.  Epileptic seizures can be controlled in 50 to 95% of cases with this form of treatment depending on seizure type and compliance of the individual taking their medications.

Those taking medications for epilepsy know if a single first line  drug is not effective a second first lin drug is added but the noneffective drug is tapered off while the second first line drug is given.  Know during this time frame there is a risk for seizure activity so practice safety (ex. do not drive).

In some cases there is surgery:  those with intractable seizures is the epileptic focus may be possible.  In some cases partial complex seizures are the common seizure treated by surgery.  The focus of this seizure type has often been found in the anterior temporal and inferior frontal regions of the brain cortex.

There are other treatments as well.

Care of an individual during a Seizure

The care of a person in a seizure should focus primarily on maintaining a safe environment.  The seizure that has greatest risk for causing injury and even fatality is the generalized tonic/clonic (grand mal), although there is a potential for injury with any seizure that involves alteration of consciousness.

The 2 major goals for care during a seizure are protection from injury and prevention of aspiration.  The person’s head should be cradled if on the floor to prevent banging of the head.  At no time should the person be restraint when having a seizure.  The person should be turned to their side to allow the tongue to fall away from the airway and allow drainage of the excessive saliva that accumulates to drain out of the mouth during the seizure.  You should stay with the person till the seizure stops and note the behavior mentally and physically the person exhibits while having the seizure and how long it lasts.  Immediately call 911 (especially if this is the first seizure the person ever had) or call the neurologist of the individual to have the him or her be evaluated ASAP.

“About 1 in 100 people in the United States may have an unprovoked seizure once in life. However, a solitary seizure doesn’t mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis.”

MAYO CLINIC

Most people with epilepsy are otherwise healthy; as long as it is controlled like most other diseases.  A seizure is a physical manifestation of paroxysmal and abnormal electrical firing of neurons in the brain.  Think of it as numerous voltage (hyperexcitability of neurons) going throughout the brain meaning brain waves going in all directions with the brain saying its too much activity causing the brain to go into a seizure.

When the seizure occurs there is a decrease in oxygen since the brain isn’t capable to send messages during the seizure.  If the seizure continues to repeat one right after another the person is in status epilepticus and if the seizures doesn’t stop the person can lead to a neuronal death;  like John Travolta’s son who died of this.

The term seizure disorder may refer to any number of conditions that result in such a paroxysmal electrical discharge.  These conditons could be metabolic or structural in nature.   Epilepsy is the term for those who have a second seizure that occurs spontaneously and without preceding metabolic or structural cause for the occurrence.  Epilepsy is a chronic disorder that requires antiepileptic drug therapy; usually thorough out life.

Etiology of Epilepsy is generally a sign of underlying pathology involving the brain.  It may be the first sign of nervous system disease (ex. Brain tumor), or it may be a sign of a systemic or metabolic derangement.

Metabolic and Systemic Causes of Seizures:

a.) Electrolyte Imbalance=Acidosis, heavy metal poisoning, Hypocalcemia, Hypocapnea, Hypoglycemia, Hypoxia, Sodium-Potassium imbalance, Systemic  diseases (liver, renal failure, etc…) Toxemia of pregnancy, and water intoxication.

b.) Infections like meningitis, encephalitis, brain abcess.

c.) Withdrawal of sedative-hypnotic drugs=Alcohol, Antiepileptic drugs, Barbiturates, Benzodiazepines.

d.) Iatrogenic drug overdose=Theopylline, Penicillin.

Other causes of epilepsy can be Trauma, Heredity.

Structural causes of epilepsy:

Head trauma/Degenerative Disease like Alzheimer’s or Creutfeldz-Jacob or Huntington’s Chorea or Multiple Sclerosis or Pick’s Disease. There is also tumors or genetic disease or Stroke or Infections or Febrile seizures.

Types of seizures

I-Partial seizures (seizures beginning local)

1-simple partial seizures-(the person is conscious and not impaired).  With motor symptoms, autonomic symptoms and even psychic symptoms.

Check in this weekend to find out about how epilepsy is diagnosed with medical management and care of a person while having a seizure.  See you tomorrow. 😉

2.)-Complex partial seizures-(the person is with impairment of consciousness)

II-Generalized seizures-(bilaterally symmetrical and without local onset).

3.) Tonic clonic seizures – Grand Mal