Monthly Archives: October 2016

Are you at risk for stroke?

Written by Rebecca Budde, SIU School of Medicine

On average, someone in the United States has a stroke every 40 seconds; every 4 minutes, someone dies from one.

While some risk factors are out of your hands, you do have control over several of them. “Taking the risk factors you can control out of your life, can reduce the risk of stroke and other health problems significantly,” says SIU family medicine physician Dr. Rachel Rahmen. “Many of these preventable risk factors are related to each other, and taking control of one often leads to better results in other areas.”

Here are the risk factors you can control to help reduce your stroke risk:

High Blood Pressure (Hypertension)
This is a major risk, according to the American Stroke Association. Hypertension is roughly defined as blood pressures over 140/90 (normal is 120/80). Adopting healthy lifestyle habits to lower blood pressure can go a long way to prevent a stroke.

Smoking
After high blood pressure, smoking is the single greatest contributor to stroke. The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system in many ways. The use of oral birth control combined with cigarette smoking greatly increases stroke risk in women.

Physical Inactivity and/or Obesity
You’ve heard it before, but being a couch potato or being overweight/obese contributes to numerous preventable illnesses, including stroke. Since 1980, the prevalence of obesity in adults has doubled. In children, it’s tripled. With obesity comes higher blood pressure (remember, it’s the number one risk factor for stroke). Managing your weight will help lower your risk of stroke (along with diabetes, heart disease, and many others).

Diet
You’ve heard this one, too. A diet rich in fruits and vegetables is good for your waistline and reduces your risk of stroke. Lowering sodium intake and increasing potassium intake can lower blood pressure. Eating saturated fat, trans fat and cholesterol can raise blood cholesterol levels and your risk of stroke.

Type 2 Diabetes
Diabetes increases your risk of vascular diseases (atherosclerosis). People living with diabetes also may have difficulty keeping their blood pressure stable, have high blood cholesterol, suffer from peripheral artery disease and be overweight.  While diabetes is treatable, the presence of the disease still increases your risk of stroke.

Peripheral artery disease is the narrowing of blood vessels carrying blood to leg and arm muscles. It’s caused by fatty buildups of plaque in artery walls. This leads to a higher risk of carotid artery disease, which also raises the risk of stroke.­

Atrial Fibrillation
An estimated 2.3 million Americans have chronic atrial fibrillation —when a heart beats irregularly, quivering instead of beating. This affects the atria or upper chambers of the heart where blood can pool and clot. If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, it can cause a stroke. Atrial fibrillation can often be controlled with medication.

Other Heart Diseases
Those with coronary heart disease or heart failure have a higher risk that those with hearts that work normally.

Asymptomatic Carotid Stenosis
The carotid artery is the large artery you can feel on the side of your neck. Atherosclerosis, the build up of plaque, narrows the carotid artery causing carotid artery stenosis.

Drug Abuse
Studies have shown that recreational street drugs such as cocaine, amphetamines and others are associated with increased risk of stroke and heart attacks.

Alcohol Abuse
Like smoking, alcohol abuse can lead to multiple medical complications, including stroke.

Resources are available to help you take charge of your health. Talk with your doctor about how you can lower your risk of stroke. SIU School of Medicine has numerous programs in place for patients interested in quitting smoking, better diabetes management and weight loss programs. People of any age can have a stroke. Stop a stroke before it starts.

To make an appointment with a primary care provider who can help you reduce your risk, call SIU’s Center for Family and Community Medicine at 217-545-8000.

Copyright © SIU School of Medicine, Springfield, Illinois

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See signs of stroke? Act FAST

Written by Rebecca Budde, SIU School of Medicine

Each year about 795,000 Americans have a stroke and every four minutes someone dies of stroke, according to the Centers for Disease Control and Prevention.

So, what exactly is a stroke?

A stroke is damage to the brain, caused by a blood clot blocking the blood supply to the brain or when a blood vessel in the brain bursts, says Dr. Jatin Patel, a family medicine physician at the SIU School of Medicine’s Center for Family Medicine.

How do I know if someone is having a stroke and what do I do?

If someone you know has symptoms of stroke, get them to the emergency room immediately.

Look for the FAST warning signs of a stroke.

  • Face drooping – One side of the face may droop or go numb. Ask the person to smile, then check to see if the smile is uneven.
  • Arm weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence like “I like chicken soup.” Ask the person to stick out his tongue, if the tongue is crooked, does it go to one side or the other?
  • Time – to call 9-11!

If the person has difficulty doing any of these simple tasks, call 9-1-1 immediately and describe the symptoms to the dispatcher, or take the person to the emergency room quickly. The sooner the person is treated, the better the outcome.

How are strokes treated?

According to Dr. Patel, a stroke caused by a blood clot can be treated with a strong blood thinner, tPA or tissue plasminogen activator. If the stroke is treated within the first three hours after it happens, it can help improve the outcomes of patients fairly well.

Next up: steps you can take to prevent a stroke.

Copyright © SIU School of Medicine, Springfield, Illinois

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4 flu vaccine myths you should know

Written by Laura Bottom, SIU School of Medicine, Center for Family Medicine14194682140_63181e5377_c

Warm, summer nights are coming to an end, kids are back in school and the flu vaccine is one poke away. The Center for Disease Control and Prevention (CDC) and SIU Center for Family and Community Medicine recommend anyone 6 months and older to get a seasonal flu vaccine.

Myth 1: The flu vaccine can give you the flu.

Flu vaccines are currently engineered in two ways. One way uses an inactivate virus, resulting in a non-infectious vaccine.  The second way is with no flu virus at all, which is the case for recombinant influenza vaccine. Common side effects of the vaccines include low-grade fever, headache and muscle aches. Side effects at the injection spot can include soreness, redness, tenderness or swelling.

Myth 2: It is better to get the flu instead of the flu vaccine.

The flu virus can lead to very serious complications resulting in hospitalization or even death. “The flu can be extremely harmful especially in young children, older adults, pregnant women and people with certain chronic health conditions including asthma, heart disease and diabetes,” says Family and Community Medicine Chief Resident Dr. Safiya McNeese. “This vaccine helps to protect your body against the flu virus. Getting the flu vaccine is a much safer choice than risking serious illness.”

Myth 3: It is not necessary to get a flu vaccine every year.

“It is recommended that those who are 6 months and older get a flu vaccine every year,” Dr. McNeese says.Over time, the vaccination becomes less effective, leaving you less protected. Annual vaccination is important for the best protection from the flu virus.

Myth 4: I should wait to get vaccinated so immunity lasts 224214775_d93b5c728c_bthroughout the flu season.

The CDC recommends people get vaccinated as soon as it becomes available. After being vaccinated, it can take about two weeks for antibodies that help protect your body against the flu virus to develop. It is best to get vaccinated BEFORE the flu virus is spread throughout your community, but it is never too late to get vaccinated.

Call you doctor’s office today to schedule a flu vaccination. Or call 545-8000 and ask for SIU Center for Family Medicine. Our team of doctors will care for your whole family through flu season and beyond.

Copyright ©SIU School of Medicine, Springfield, Illinois

 

Stop using opioids to treat chronic pain

Written by Lauren Murphy, SIU School of Medicine

EV401-024SIU internist Dr. Rexanne Caga-anan regularly sees new patients asking for refills of their narcotics. “I see it at a very alarming rate,” says Dr. Caga-anan. “Depending on how the patient is, it can either be a very long or a very short interview, but either way, it’s a very difficult conversation to have.”

Patients can become dependent on opioids in just 7 days. That’s why Dr. Caga-anan highly recommends that physicians limit opioid prescriptions to 3 days for acute pain. Patients on prescription opioids must also sign a pain management contract. Under the contract, patients must agree to take the prescription as prescribed and not to share their prescription or take any illicit drugs. The clinic regularly checks patients’ urine to ensure they’re compliant with the pain contract.

“For so long, patients have been under the impression that when they’re in pain, they need a narcotic,” explains Dr. Caga-anan, who lists just 3 instances in which prescription opioids are appropriate:

  1. Active cancer treatment
  2. Palliative or end of life care
  3. Acute, short-term pain following an injury or surgery

Dr. Caga-anan and the CDC agree: Opioid therapy should play no role in chronic pain management.

According to the CDC, evidence to support opioid therapy for chronic pain remains “limited, with insufficient evidence to determine long-term benefits versus no opioid therapy.” Evidence does suggest serious harms that appear to be dose-dependent: constipation, arrhythmia, drowsiness, nausea and vomiting.

For patients who have been prescribed opioids to treat chronic pain for years, Dr. Caga-anan warns, patients may not know they have a problem.

“Usually a lot of these patients have been on prescription opioids for decades,” Dr. Caga-anan shares. “It usually starts with a very simple complaint, like a sprained ankle, a trip to the ER where they were given narcotics, and for some reason, nobody took the time to wean them off. It’s very easy to become dependent on these medications.”

Opioids should never be the first line of treatment, says Dr. Caga-anan, who recommends first treating pain with over-the-counter pain relievers like acetaminophen or anti-inflammatory agents such as ibuprofen. “It is very important that we seek to identify the etiology of the pain, so that we can address it directly,” Dr. Caga-anan explains. To treat neuropathic pain, for example, physicians can prescribe pregabalin or gabapentin. Antidepressants can also play a role in pain management.

neckpain“Patients may benefit from physical therapy, conservative management such as hot/cold compresses, topical agents, or even behavioral or cognitive therapy to help manage their pain,” explains Dr. Caga-anan, who adds that in some cases, surgery may be appropriate. “We can involve other specialists to help us with pain management, if indicated.”

Suspect you or a loved one may have a problem? Speak with your SIU physician about counseling and treatment options. Make an appointment by calling 217-545-8000.

Copyright SIU School of Medicine, Springfield, Illinois