|
Monthly Matters:
Monitoring Your Blood Pressure
High blood
pressure or “hypertension” is a very common condition. It has
historically been called the silent killer because those who have it
generally have no symptoms until they suffer a heart attack,
congestive heart failure, a stroke, kidney failure, blindness, or
other consequence of longstanding hypertension. Thus, those with
high blood pressure should manage it like any other chronic
condition – they should have a high level of knowledge about it and
they should monitor it at home. They should work closely with us to
assure that it is optimally managed. We last discussed high blood
pressure in our April 2007 Health Matters. In this section, we want
to talk about the importance of your home blood pressure monitoring.
Home blood pressure monitoring is convenient
and inexpensive, and we recommend that every individual with
hypertension or pre-hypertension purchase a home monitor. Home blood
pressure readings are critical in monitoring the effectiveness of
blood pressure management. Your frequent checks of your blood
pressure provide us with more frequent and accurate information than
our own infrequent measurements of your blood pressure, which are
usually limited to those times when you are in our office. While we
try hard to make visits to our office low stress, people naturally
feel nervous when they are in the doctor’s office. Medical studies
have shown that home blood pressure readings are generally lower
than blood pressure readings taken in the clinic, which would
indicate that home blood pressure readings may be a better predictor
of an individuals risk for cardiovascular disease (heart attacks,
strokes, kidney failure, etc) than clinic readings.
What Blood Pressure Numbers Mean
Your blood pressure is literally a measure of
the pressure inside of your arteries. It also measures how hard your
heart has to pump. Like any pipe, if the pressure inside is too high
for a long time, then you have an increased risk that the pipe will
rupture. Likewise, if a pump (your heart) has to pump against a high
pressure for a long time, then it is more likely that the pump (your
heart) will wear out early.
The top number of a blood pressure reading is
called the “systolic” pressure – it is the pressure while the heart
pumps. The bottom number is called the “diastolic” pressure – it is
the pressure between heartbeats. Both the systolic and the diastolic
pressures are important.
The classification of high blood pressure is
relatively simple and shown below. If one of the measures – either
the systolic or the diastolic – is consistently elevated, then you
have hypertension.
|
Classification |
Systolic Blood Pressure |
Diastolic Blood Pressure |
|
Normal blood pressure |
120 or less |
80 or less |
|
Pre-hypertension |
120 to 139 |
80 to 89 |
|
Hypertension |
140 or above |
90 or above |
If you have high blood pressure, then our
treatment goal is to get your blood pressure back into the normal
range – that would be <130/80. Fortunately, we have many very good
blood pressure medications to choose from.
Taking Your Blood Pressure
Good electronic automated blood pressure cuffs
for home use can be purchased at most pharmacies and over the
Internet for about $80. If you have any questions about the
available monitors, you can ask your pharmacist for assistance.
Reputable brands include Microlife, Lifesource, A&D, Omron, and
other. Both upper arm and wrist monitors are available although we
suggest the upper arm variety as they are more accurate. When you
have a cuff, make sure that you are familiar with its proper use.
Again, your pharmacist can assist you or you can bring it in to one
of our offices and we’ll help you out.
Those with pre-hypertension or well treated
hypertension should measure their blood pressure weekly and then
send the readings to us about twice a year. If your blood pressure
is not adequately controlled or if we are changing your blood
pressure medications, then we advise you to monitor your blood
pressure twice daily and report the results to us weekly until we
have you on the medications necessary for adequate control.
You should check your blood pressure readings
both in the early morning and the evening. Take three consecutive
readings about one minute apart and record the average. You should
sit quietly and relax in a comfortable chair for several minutes
prior to doing the measurement. The blood pressure cuff should be
put directly on the skin of your upper arm – in other words, you
should not put the cuff over clothing. You should do the measurement
either before exercise or you should wait for thirty minutes after
you have exercised because exercise generally lowers the blood
pressure. Caffeine and smoking can elevate your blood pressure, so
wait for several hours after ingesting them before testing your
blood pressure.
Reducing Your Blood Pressure
In addition to medications for high blood
pressure, you can make several dietary and lifestyle changes to
decrease your blood pressure. Daily exercise is most critical, along
with reducing your intake of sodium (salt). Many prepackaged foods
and almost all fast food contain very high levels of salt. They
should be avoided. Weight reduction for those who are overweight and
smoking cessation for those who smoke are also very important.
Because blood pressure is largely determined
by genetics, even those with really good lifestyle habits may not be
able to bring their blood pressure under control. However, these
changes – exercise, dietary and weight management – are very helpful
in minimizing the long term consequence of hypertension. And, home
blood pressure monitoring is a key component of good blood pressure
control.
Family Matters: Treating Sunburns
A sunburn can sneak up on you and your child,
especially after a long day at the beach or park. With a sunburn,
the skin frequently seems fine during the day of sun exposure but
then gradually becomes painful and hot several hours later. Serious
sunburns can even bring on symptoms of feeling ill such as fevers,
chills and sweats, and itching.
When a sunburn occurs, the only thing you can
do is to treat the symptoms and be mindful to prevent sunburn in the
future by using adequate sunscreen. If you or your child get a
sunburn, the following tips may help:
-
Stay in the shade until the sunburn is healed. Any
additional sun exposure will only increase the severity of the burn
and increase the pain.
-
Take a cool (not cold) bath, or gently apply cool, wet
compresses to the skin to help alleviate pain and heat.
- Apply pure aloe vera gel (available in most
pharmacies) to any sunburned areas. It's excellent for relieving
sunburn pain and for helping skin to heal more quickly.
-
Take a pain reliever like acetaminophen or ibuprofen
and spray on over-the-counter "after-sun" pain relievers. Do not,
however, give aspirin to children or teens.
-
Apply moisturizing cream to re-hydrate the skin.
-
For the most severely burned areas, apply a thin layer
of 1% hydrocortisone cream.
-
Do not use petroleum-based products, because they
prevent excess heat and sweat from escaping.
-
Avoid first-aid products that contain benzocaine,
which may cause skin irritation or allergy.
-
If the sunburn is severe and blisters develop, give us
a call at 503-292-9560 so that we can help you. Avoid disturbing the
blisters as they could become infected.
Burned skin typically begins to peel about a
week after the sunburn. Try to avoid scratching or peeling off loose
skin because skin underneath the sunburn is vulnerable to infection.
Don’t forget that cumulative sun exposure is
associated with an increased risk of skin cancer. While almost
everyone enjoys the sun and being tanned, sunscreen is the best way
to avoid sunburns and reduce the risk of skin cancer later in life.
Biofeedback: The Power of Mind Over Body
Mind over body... we've all heard that before,
and while we have a vague sense of its promise, we are generally not
sure how to take advantage of it. Wouldn't it be nice to be able to
make yourself feel better by using such a mind-body connection to
address certain health problems?
The mind-body connection is undoubtedly
present, but modern science still doesn't understand it well.
Despite that lack of knowledge, there are techniques that use
mind-body feedback to produce positive mental and physical responses
in certain situations. Biofeedback is one of those mind-body
techniques.
Biofeedback is a technique that can be taught.
It relies on the use of relaxation techniques and the monitoring of
the body's response to those techniques using various monitoring
procedures and equipment. Individuals are taught to relax while
tracking things like brain activity, blood pressure, muscle tension,
and heart rate. Using these techniques, you can learn to recognize
and control bodily responses that cause certain problems.
Biofeedback can be used to help treat a wide
range of conditions including:
-
Asthma
-
Back pain
-
Headaches
-
High blood pressure
-
Hot flashes
-
Incontinence
-
Irritable bowel syndrome
-
Migraine headaches
-
Nausea and vomiting associated with chemotherapy
-
Panic Attacks
-
Tension Headaches
In fact, medical studies support biofeedback's
use in these conditions - in other words, there are good clinical
studies that demonstrate a positive benefit when biofeedback is used
in these situations. The success of biofeedback is very person
dependent - different people respond differently, and some
individuals are able to learn how to control their body's response
to these conditions much more effectively than others.
Biofeedback Training
We talk about "training" because biofeedback is
a technique that is taught to individuals who can then apply it when
needed at home, at work, or when traveling. Biofeedback training is
available from several different types of trainers such as physical
therapists and psychologists. A typical session lasts 30 to 60
minutes and requires practicing the techniques at home.
When you begin a biofeedback session, the
trainer will apply electrical sensors to different parts of your
body. These sensors monitor your physiologic responses to
stress--for instance, how your muscles contract when you have a
tension headache. They then feed the information back to you via
visual and audio cues. Given this feedback, you'll start to
associate your body's unique response--pain in the case of tension
headaches--with certain physical changes, such as your muscles
tensing.
Once you begin to recognize that your
headache, for instance, is the result of tense muscles or at least
it is significantly worsened by tense muscles, you can learn how to
make positive physical changes in your body to alleviate some of the
pain. This may include relaxing those specific muscles when you find
yourself physically or mentally stressed. Your eventual goal is to
be able produce these positive responses on your own, at any time
and place and without the help of the feedback technology.
There are several different techniques
available for your therapist to choose from in gathering information
about your body's responses. Your particular health issues and goals
will help to determine which one is right for you. The options
include: Electromyogram (EMG): An EMG uses electrodes
or other types of sensors to measure muscle tension. By making you
aware of muscle tension, you can learn to recognize and control the
tension. EMG is normally used to promote the relaxation of muscles
involved in backaches, headaches, neck pain and grinding your teeth.
An EMG may also be used for patients with illnesses whose symptoms
tend to worsen under stress, such as asthma.
Temperature
biofeedback: Your temperature can be monitored using sensors
attached to your fingers or feet. Body temperature frequently drops
when someone is under stress, so it can be monitored and used to
prompt you to begin relaxation techniques as a means of responding
to the stress. Temperature biofeedback can help treat certain
circulatory disorders and it can help to reduce the frequency of
migraines.
Galvanic skin
response training: These sensors measure the amount of perspiration
on your skin, which alerts you to anxiety. This can be helpful in
treating phobias, anxiety, stuttering and other emotional disorders.
Electroencephalogram
(EEG): An EEG monitors the activity of brain waves linked to
different mental states, such as wakefulness, relaxation, calmness,
light sleep and deep sleep.
If you decide to try biofeedback, we can help
you get started by referring you for training. Additional
information can be found on the Association for Applied
Psychophysiology and Biofeedback website at
www.aapb.org and the Biofeedback Certification Institute of
America's website at
www.bcia.org which can be used to search for certified trainers.
You do not have to be certified to be able to train in this
technique.
If you seek out such training, be sure to ask
the therapist for references. Find out the therapist's other areas
of professional expertise, and whether he or she has experience
treating the specific problem for which you are seeking help. And,
it's always a good idea to check to see whether your health insurer
will cover the cost of treatment, as many plans have differing
benefit levels.
Biofeedback may appeal to you because it can
help you respond positively to certain health problems while
reducing your need for medications. We think it has value because it
helps put you in greater charge of your body using measurable
feedback to monitor and learn about how your body responds to
certain situations. In upcoming issues of Health Matters, we'll
explore the mind-body connection of hypnosis and we'll discuss
acupuncture, an ancient and often effective Chinese technique for
managing various conditions. Both modalities of treatment have shown
positive results, and yet scientists still cannot fully explain why
these treatments are effective.
Transformation: Liquid Calories – Go Easy!
The Transformation program at GreenField Health is a lifestyle and
weight management program. There have been scores of participants
over the three years of its existence and their experience has led
to the development of “The Seventeen Habits of Successful Weight-
Appropriate People.” Each month in Health Matters, we have been
sharing one of these habits with you and discussing its benefits.
The recommendation for this month is to consume liquid calories
judiciously. Carbonated sodas have no nutritional value and are full
of sugar. A typical can of Coke, Pepsi or Sprite contains 10
teaspoons of sugar! Diet sodas may not have the calories, but
studies have shown that substituting diet sodas for the regular kind
has no impact on weight loss. People who are used to the sweet taste
of sodas (either from sugar or artificial sweeteners) consume more
calories and crave sweets more than those who do not.
Fruit juices are often heavily sweetened as well. The fiber in the
fruit is removed and sugar added so the nutritional value of fruit
juice is much less than that of the original fruit.
The last liquid to discuss is alcohol. When it comes to weight
management, the less alcohol we take in, the better. Not only does
it have calories without any nutritional value, but studies have
shown that those who drink alcohol with their meals eat 30-50% more
than when they eat without alcohol. Our food choices are not as
healthy and our sensation of satiety is blunted when we drink
alcohol. So, moderation in all things is advisable.
Office Notes
For the first time in many years, we missed
getting Health Matters to you on time last month. We hope you’ve
enjoyed this combined June – July issue, and we’ll be back to you on
schedule in August.
As always, if there is anything at all that we
can do for you, please call us at 503.292.9560 or email us at the
links found below. Happy Summer!
Sincerely,
Your GreenField Team
Amanda Clark, MA, your Health Coordinator (email)
Angie Ashburn, CMA, your Health Coordinator
(email)
Beth Davis, your Benefits Coordinator and
Biller
(email)
Chuck Kilo, MD
(email)
Cindy King, your Benefits Coordinator and Biller
(email)
Connie Turner, MA, your Health Coordinator
(email)
Cynthia Ferrier, MD
(email)
Dana Lee, MA, your Clinical Supervisor (email)
David Hays, MD
(email)
David Shute, MD (email)
Desi Lowder, CMA, your Health Coordinator (email)
Elizabeth Hays, MD
(email)
Eric Murray, MD
(email)
Jill Arena, your COO
(email)
Joel Swartzmiller, your IT Manager
(email)
Justine Stephens, MA, your Health Coordinator (email)
Kristin Walker, your Program and Executive Assistant
(email)
Lea Robinson, your Administrative Assistant
(email)
Maria Soutavong, MA, your Health Coordinator
(email)
Meena Mital, MD
(email)
Pam Mockenhaupt, CMA, your Health Coordinator and Biller
(email)
Paula Koeller, MD
(email)
Samantha Charles, your Clinic Administrator
(email)
Todd Canon, MD,
(email)
--------------------------
GreenField Health System
9427 SW Barnes Road, Suite 590
Portland, OR 97225
Phone: 503.292.9560
Fax: 503.292.9510
Web:
http://www.GreenFieldHealth.com
questions, concerns, comments always
appreciated:
questions@GreenFieldHealth.com
© 2003-2008 GreenField Health
|