DR. E

I humbly apologize for not having a new entry for the past couple of weeks. I’ve been focusing on my health. Sometimes we doctors can get so consumed with work that we don’t take time to tend to our health. I recently got a wake up call. The silent killer was knocking on my door. Yeah, hypertension, and it almost got in and took my life. Today, as we focus on hypertension, I will share with you the experience that has changed my outlook on my personal health.

Two weeks ago I woke up carrying out my daily routine. I felt great. No headache, no blurred vision, no chest pain, no signs or symptoms to suggest that my blood pressure (BP) was elevated. As I was walking in the house, something inside me said “take your blood pressure”. Listening to that inner voice I took my BP. To my surprise it was 180/140. “This could not be right”, I thought. My sphygmomanometer (manual device used to take blood pressure) was brand new. I went to the nearby clinic and the doctor there took it and immediately told me that she is referring me to the hospital. I consulted with a colleague and he too urged me to go directly to the hospital.

When I arrived at the hospital, an EKG was done and medication was administered to lower my blood pressure. There I was still in shock and even though my pride didn’t allow me to show it, I was scared. How could this happen to me? I’m a doctor, I should be on top of these things! I realized that I was not on top of my health. Over the past couple of years I gained a lot of weight and I was not exercising. My excuse was always -“ I’m too busy”. Being too busy could have cost me my life. My grandmother always used to say, “No one ever killed work, work killed them.”

Since my emergency hypertensive crisis, I’ve been placed on medication and I have changed my diet and I am in the gym. Lost 5 lbs already! I was walking around with a dangerously high BP and I didn’t know. I was asymptomatic (had no signs or symptoms). This makes hypertension a silent killer . When was the last time you took your blood pressure? Or have you been diagnosed as being hypertensive and you are not taking your medication because you feel good. Or maybe you took your BP and it’s normal (120/80). It’s only normal because it was being controlled with your medication and when you stop taking your pills it will go right back up. I could have been dead but I got a chance now to change my lifestyle to a healthy one. Let’s all do the same. Let’s take a closer look at hypertension.

Let’s Meet the disease

High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.

Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

You can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.

High blood pressure generally develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.

How do I know if I have high blood pressure?

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.

A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms aren’t specific and usually don’t occur until high blood pressure has reached a severe or life-threatening stage.

When should you see your doctor?

You’ll likely have your blood pressure taken as part of a routine doctor’s appointment.

Ask your doctor for a blood pressure reading at least every two years starting at age 18. If you’re age 40 or older, or you’re 18 to 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year.

Blood pressure generally should be checked in both arms to determine if there’s a difference. It’s important to use an appropriate-sized arm cuff.

Your doctor will likely recommend more frequent readings if you’ve already been diagnosed with high blood pressure or have other risk factors for cardiovascular disease. Children age 3 and older will usually have blood pressure measured as a part of their yearly checkups.

If you don’t regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community-like the local clinics.

Risk factors

High blood pressure has many risk factors, including:

Age. The risk of high blood pressure increases as you age. Until about age 64, high blood pressure is more common in men. Women are more likely to develop high blood pressure after age 65.
Race. High blood pressure is particularly common among people of African heritage, often developing at an earlier age than it does in whites. Serious complications, such as stroke, heart attack and kidney failure, also are more common in people of African heritage.
Family history. High blood pressure tends to run in families.
Being overweight or obese. The more you weigh the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
Not being physically active. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.
Using tobacco. Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow and increase your risk of heart disease. Secondhand smoke also can increase your heart disease risk.
Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. If you don’t get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood.
Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having more than one drink a day for women and more than two drinks a day for men may affect your blood pressure.If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and two drinks a day for men. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
Stress. High levels of stress can lead to a temporary increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.
Certain chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure, such as kidney disease, diabetes and sleep apnea.

Sometimes pregnancy contributes to high blood pressure, as well.

Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits, such as an unhealthy diet, obesity and lack of exercise, contribute to high blood pressure.

Complications

The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage.

Uncontrolled high blood pressure can lead to complications including:

Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
Aneurysm. Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
Heart failure. To pump blood against the higher pressure in your vessels, the heart has to work harder. This causes the walls of the heart’s pumping chamber to thicken (left ventricular hypertrophy). Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body’s needs, which can lead to heart failure.
Weakened and narrowed blood vessels in your kidneys. This can prevent these organs from functioning normally.
Thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
Metabolic syndrome. This syndrome is a cluster of disorders of your body’s metabolism, including increased waist circumference; high triglycerides; low high-density lipoprotein (HDL) cholesterol, the “good” cholesterol; high blood pressure and high insulin levels. These conditions make you more likely to develop diabetes, heart disease and stroke.
Trouble with memory or understanding. Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people with high blood pressure.
Dementia. Narrowed or blocked arteries can limit blood flow to the brain, leading to a certain type of dementia (vascular dementia). A stroke that interrupts blood flow to the brain also can cause vascular dementia.

Let’s not allow this non-communicable disease to creep around our lives. Get your BP checked regularly and if your doctor diagnoses you with hypertension. Change your lifestyle and live a long healthy life. Knowledge is power. Let’s have power over our health .

God Bless you all,

Dr. E

Hope everyone is having a great morning! Today let’s take a look at breast self-examination, for breast awareness.

This is an inspection of your breasts that you do on your own. To help increase your breast awareness, you use your eyes and hands to determine if there are any changes to the look and feel of your breasts.

If you notice new breast changes, discuss these with your doctor. Though most breast changes detected during a self-exam for breast awareness have benign causes, some changes may signal something serious, such as breast cancer.

Most medical organizations don’t recommend routine breast self-exams as a part of breast cancer screening. That’s because breast self-exams haven’t been shown to be effective in detecting cancer or improving survival for women who have breast cancer.

Still, doctors believe there is value in women being familiar with their own breasts, so they understand what’s normal and promptly report changes.

Why it’s done?

A breast self-exam that you do for breast awareness helps you understand the normal look and feel of your breasts. If you notice a change in your breasts that seems abnormal or if you notice one breast is different when compared with the other, you can report it to your doctor.

There are many conditions that can cause changes in your breasts, including breast cancer.

Although the breast self-exam technique isn’t always a reliable way to detect breast cancer, a significant number of women report that the first sign of their breast cancer was a new breast lump they discovered on their own. For this reason, doctors recommend being familiar with the normal consistency of your breasts.

Risks

A breast self-exam for breast awareness is a safe way to become familiar with the normal look and feel of your breasts.

However, yes in my opinion, I think there are some limitations and risks, including:

Anxiety caused by finding a lump.

Most of the changes or lumps women find in their breasts aren’t cancerous. Still, finding something suspicious in your breast can make you anxious about what it may mean. You may endure several days of worry until you can see your doctor.

Additional tests and procedures may be necessary to check out lumps or changes. If you discover a suspicious lump, you may end up having imaging test such as a diagnostic mammogram or a breast ultrasound, or a procedure to remove breast tissue for examination (biopsy). If it turns out the lump was noncancerous (benign), you might feel that you’ve undergone an invasive procedure unnecessarily.

Overestimating the benefits of self-exams.

A breast self-exam isn’t a substitute for a breast exam by your doctor (clinical breast exam) or a screening mammogram. Becoming familiar with the normal look and feel of your breasts can supplement breast cancer screening, but can’t replace it.

Discuss the benefits and limitations of being familiar with the consistency of your breasts with your doctor.

Breast Self Examination — What to look for during breast examination

How you do I prepare Dr. E?

To prepare for your breast self-exam for breast awareness:

Ask your doctor for a demonstration. Before you begin breast self-exams for breast awareness, you may find it helpful to discuss the instructions and technique with your doctor.

If you menstruate, choose a time in your cycle when your breasts are least tender. Your hormone levels fluctuate each month during your menstrual cycle, which causes changes in breast tissue. Swelling begins to decrease when your period starts. The best time to perform a self-exam for breast awareness is usually the week after your period ends.

What you can expect ?

Begin with a visual examination of your breasts

Sit or stand shirtless and braless in front of a mirror with your arms at your sides. To inspect your breasts visually, do the following:

Face forward and look for puckering, dimpling, or changes in size, shape or symmetry.
Check to see if your nipples are turned in (inverted).
Inspect your breasts with your hands pressed down on your hips.
Inspect your breasts with your arms raised overhead and the palms of your hands pressed together.
Lift your breasts to see if ridges along the bottom are symmetrical.
If you have a vision impairment that makes it difficult for you to visually inspect your breasts, ask a trusted friend or a family member to help you.

Next, use your hands to examine your breasts.

Common ways to perform the manual part of the breast exam include:

Lying down. Choose a bed or other flat surface to lie down on your back. When lying down, breast tissue spreads out, making it thinner and easier to feel.

In the shower. Lather your fingers and breasts with soap to help your fingers glide more smoothly over your skin.

When examining your breasts, some general tips to keep in mind include:

Use the pads of your fingers.

Use the pads, not the very tips, of your three middle fingers for the exam. If you have difficulty feeling with your finger pads, use another part of your hand that is more sensitive, such as your palm or the backs of your fingers.

Use different pressure levels. Your goal is to feel different depths of the breast by using different levels of pressure to feel all the breast tissue. Use light pressure to feel the tissue closest to the skin, medium pressure to feel a little deeper, and firm pressure to feel the tissue closest to the chest and ribs. Be sure to use each pressure level before moving on to the next spot. If you’re not sure how hard to press, talk with your doctor .

Take your time. Don’t rush. It may take several minutes to carefully examine your breasts.

Follow a pattern. Use a methodical technique to ensure you examine your entire breast. For instance, imagine the face of a clock over your breast or the slices of a pie. Begin near your collarbone and examine that section, moving your fingers toward your nipple. Then move your fingers to the next section.

If you have a disability that makes it difficult to examine your breasts using this technique, you likely can still conduct a breast self-exam. Ask your doctor to show you ways you can examine your breasts.

Results: What’s normal ?

Many women find lumps or changes in their breasts, since some of these are normal changes that occur at various points in the menstrual cycles.

Finding a change or lump in your breast is not a reason to panic. Breasts often feel different in different places. A firm ridge along the bottom of each breast is normal, for instance. The look and feel of your breasts will change as you age.

When to contact your doctor

Make an appointment with your doctor if you notice:

A hard lump or knot near your underarm.
Changes in the way your breasts look or feel, including thickening or prominent fullness that is different from the surrounding tissue .
Dimples, puckers, bulges or ridges on the skin of your breast
A recent change in a nipple to become pushed in (inverted) instead of sticking out.
Redness, warmth, swelling or pain
Itching, scales, sores or rashes
Bloody nipple discharge

Your doctor may recommend additional tests and procedures to investigate breast changes, including a clinical breast exam, mammogram and ultrasound.

That’s all for today ! Knowledge is power let’s continue to have power over our health! God Bless you all!

Dr. E

Lifestyle Changes after Hypertension