Sometimes health emergencies are quite preventable. Learn how you can be proactive about your health by first controlling your risk factors.
When it comes to taking your health seriously, it’s easy to just wait until something bad happens. You’re having a heart attack, so you rush to the emergency room. Or you find a lump, so you go to the doctor.
But oftentimes, many health emergencies can be prevented. It’s all about controlling your risk factors – such as diabetes, obesity, hypertension and high cholesterol – before matters escalate. To do this, you need to prioritize your annual checkups with medical professionals, even if you think you’re perfectly healthy.
Learn how you can take control of your health by facing your risk factors head-on.
When Delia Perez was pregnant with her second child, she discovered some unfortunate news during a doctor’s visit. She had developed gestational diabetes, meaning her blood sugar levels were high and could potentially affect her own health and that of her baby.
Out of love for Juan Carlos, her then-unborn son, Perez worked hard to manage her diabetes. After giving birth, she assumed it was gone.
It was fortunate, though shocking, when she came across a free glucose screening at the YWCA in Elgin. Even though she wasn’t pregnant anymore, her blood sugar levels were still abnormally high.
“I didn’t know what to do; I didn’t know where to begin,” Perez says. “I just thought about my children and how I want to live longer for them.”
Perez learned that women who experience gestational diabetes have a 50 percent chance of developing Type 2 diabetes later on in life. So, she signed up for a diabetes management class at the YWCA in partnership with Advocate Sherman Hospital, in Elgin.
That’s where she learned how to take care of herself. She learned about menu planning – not necessarily what to eat, since she still eats the same foods, but how to cook her foods healthily.
She learned about foot care, since damaged nerves can be a side effect of diabetes and oftentimes, diabetic patients may not notice blisters or cuts on their feet. She learned about stress management, overcoming obstacles when going to see a doctor, and a host of other topics related to managing her diabetes.
“One thing a lot of people don’t realize is all the work that goes into diabetes management,” says Kate Olson, a registered dietitian at Advocate Sherman Hospital and a certified diabetes educator. “It’s a constant and lifelong process. Diabetes is also a progressive disease, so over time the same management strategy doesn’t work forever. You constantly have to work on it.
So, I think having access to support and education is essential to be successful.”
All types of diabetes involve a dysfunction of the body when absorbing sugar from the bloodstream, Olson explains. Type 1 is an autoimmune condition where the body destroys the cells in the pancreas that make insulin, meaning a person with Type 1 diabetes has to give themselves insulin in order to survive. This is the less-common form, Olson says, as only about 5 percent of diabetics have this type.
Type 2 diabetes is more common, and it’s oftentimes linked to genetic predisposition and lifestyle choices, Olson adds. Though it can develop in children, Type 2 diabetes is more common in adults, especially in African-American, Hispanic and American-Indian populations. It can be managed through healthy lifestyle choices and a variety of medications.
“If a person has poorly controlled blood sugars, it can increase the risk of damage to the body, including damage to blood vessels in the eyes, the kidneys and the nerves,” Olson says. “It can significantly increase the risk for cardiovascular disease, and if the blood sugars are uncontrolled, it can also lead to diabetic ketoacidosis, which can be fatal if not treated.”
Diabetics typically don’t have any symptoms at first, which is why it’s important to have regular checkups with a doctor to catch the diabetes early on, Olson says.
However, many people who are uninsured or underinsured aren’t necessarily going to see a primary care doctor, says Paola Velasquez, a coordinator of multicultural services who helps teach Advocate Sherman Hospital’s diabetes self-management class.
“That’s why we started offering glucose screenings in the community about three or four years ago,” Velasquez says. “We partnered with churches, Laundromats, flea markets, and we just allowed the community to trust us and become familiar with us. Then, about two years ago we started offering the self-management class so we could teach people how to care for themselves.”
Since Elgin’s population is 45 percent Hispanic, Advocate Sherman Hospital offers the program in Spanish. It’s six sessions over the course of six weeks for people who are diabetic, pre-diabetic, have a family history of diabetes, or live with someone who has diabetes.
When Perez started taking the class, her A1c – her average blood sugar level over a three-month time period – was 9 percent (see chart at left). After the class, when Perez followed up with her doctor, her A1c was down to 5 percent.
“I’ve learned so much about how to take care of myself,” Perez says.
Editor’s Note: Delia Perez’s comments were translated from Spanish to English.
The statistics are undeniable. Nationwide, obesity rates are a problem.
“If you compare the numbers, the rate of obesity in the United States was 13 percent in the 1960s and now it’s close to 37 percent,” says Dr. Amir Heydari, medical director of Northwestern Medicine Huntley Hospital’s surgery department and surgical medical director of the hospital’s weight-loss surgery program. “It’s not just being obese or overweight that’s an issue. It’s all the comorbidities that come with it.”
Comorbidities include, but are not limited to, cardiovascular disease, heart failure, hypertension, diabetes and stroke. Women have higher instances of breast cancer, while men have higher instances of colon cancer, Heydari says. And, while alcohol used to be the most common reason for liver failure in the United States, it’s not anymore.
“It’s actually obesity now,” Heydari says. “A lot of medical problems have a direct or indirect relation with the disease of morbid obesity. That’s why it’s necessary to offer procedures – minimally invasive surgeries – to patients as an option.”
Since 2002, Northwestern Medicine Huntley Hospital and its predecessor, Centegra Health System, have provided minimally invasive weight-loss surgery as an option to patients, and the program continues to grow. High volumes of patients undergo weight-loss surgery through the program, which is Metabolic Bariatric Surgery Accredited, the highest accreditation a hospital can get.
During his residency, Heydari trained under Dr. Edward Mason, who’s known as the father of weight-loss surgery. But Heydari wasn’t always interested in performing the procedures he learned.
“Initially, I didn’t think weight-loss surgery should be performed in a community hospital,” he admits. “It wasn’t until we started doing laparoscopic minimally invasive surgery in 2002 that I became interested. Those days, the only surgery I would offer was the gastric bypass and then lap bands, but now there are multiple types of surgeries that we do.”
Patients are educated about every option, Heydari says. Oftentimes, patients are referred to Northwestern’s weight-loss surgery program by their physician, but sometimes, patients hear about the program on their own and call the hospital for more information.
If the patient is interested in weight-loss surgery, they’re required to attend a seminar. Patients with disabilities are allowed to forgo the seminar in lieu of viewing the information at home.
“The reason we do all of these things is because we want them to get educated from the beginning,” Heydari says.
After filling out paperwork, patients must continue to participate in educational programming to learn about the multiple surgeries offered. Laparoscopic vertical sleeve gastrectomy is the most common surgery, in which about 80 percent of the stomach is removed. The second most common surgery is laparoscopic Roux-en-Y gastric bypass, in which the surgeon makes a small pouch at the top of the stomach to receive food. More surgeries are offered, including revisional surgeries for patients who experience complications from weight-loss procedures they underwent years ago. Non-surgical options are also discussed.
Patients have consultations with Heydari about all of the options, and furthermore undergo a psychological evaluation.
“We do that because this is a change – a good change – and we have to make sure people can adapt to changes in their lifestyle,” Heydari says.
During the whole process, patients take in about six hours of educational programming. They’re also strongly advised to participate in a support group to build further connections.
“We want them to feel supported from the very beginning,” Heydari says. “By the time they have surgery, it will be at least two months, and sometimes even seven months or so, since they came to the first seminar. It’s a long process. Anyone who says to a weight-loss surgery patient ‘Oh, you took the easy route,’ is wrong.”
Heydari says more than 20 million Americans can benefit from weight-loss surgery. But last year in the United States only about 200,000 surgeries were done.
“We should be getting a lot more,” Heydari says. “Part of it is misinformation and ignorance, part of it is that patients are fearful. But I believe, as medical care providers, we are here to be a patient’s advocate. Weight-loss surgery is truly a wonderful treatment for a patient’s comorbidities. Studies show that people who have surgeries in these programs have better results and fewer complications.”
Simply put, hypertension is a sustained elevation in your blood pressure. If left uncontrolled, the long-term excessive pressure against your artery walls can be a gateway to experiencing heart attacks, strokes and other complications.
“It’s a whole-body disease, since your blood vessels travel to every part of your organs,” says Dr. Arthur Hong, a family physician at Northwest Community Healthcare Medical Group in Palatine. “That means hypertension can affect pretty much any organ in your body.”
Since there are rarely symptoms of high blood pressure, patients can be unaware of when they’re in a life-threatening stage of hypertension. That’s why it’s crucial to attend routine medical appointments.
Your primary care doctor can easily check your blood pressure during a routine visit. Many pharmacies also have blood pressure cuffs for visitors to use. Your systolic pressure (the top number in a blood pressure reading) represents the pressure in your blood vessels when your heart is beating, while your diastolic pressure (the bottom number) represents the pressure in your blood vessels when your heart relaxes. See the chart on the following page to understand your blood pressure reading.
“I think it’s really important for people to get a primary care doctor,” Hong says. “Sometimes people don’t really think about it until they have issues, or until they get a lot older. But really, regardless of what age you’re at, seeing a primary care physician is an important part of preventative health.”
Hong says multiple readings are required to have an accurate understanding of a person’s blood pressure. For those who have hypertension, lifestyle changes are critical.
Developing a plan with your physician is a great place to start, Hong adds.
“High blood pressure doesn’t just come out of nowhere,” he says. “Your family history plays a role, but so does your lifestyle. Focusing on maintaining a healthy weight, a healthy diet with low-sodium intake, and regular exercise is important. Medications can also come into play, but living a healthy lifestyle is the goal.”
Lowering High Cholesterol
Cholesterol sometimes gets a “bad rap,” but healthy levels are necessary for the body to function.
“Cholesterol is a fat that’s the basic raw material and building block that lets the body build new cells and repair itself,” says Dr. David S. Bromet, director of invasive and interventional cardiology at AMITA Health Saint Joseph Hospital-Elgin. “Cholesterol is, in fact, so important to us that we can get it from two sources.”
First, your body gets cholesterol from the food you eat, Bromet explains. Second, your body manufactures cholesterol, specifically in the liver.
But too much of a good thing can become a problem.
“Normally, cholesterol floats around in the bloodstream and is picked up by the cells of the body through special receptors, or “antennae,” on the individual cells when they need to use it,” Bromet says. “If there is too much cholesterol in the bloodstream, however, that cholesterol has no place to go and will get deposited in the blood vessel walls. I say in and not on the vessel walls because it is carried into our thick-walled blood vessels – specifically called arteries – and the cholesterol builds up there.”
These buildups in the vessel walls are called plaques. Eventually, if the plaques get big enough, they can start deforming the inner opening of the tube, or “lumen,” of the artery and narrow the space that blood needs to flow through. This narrowing can lead to heart attacks, strokes and peripheral vascular disease (reduced blood flow to the limbs).
“The plaques can do this by limiting the flow of blood to the heart, brain, legs, kidneys – really any spot in the body,” Bromet explains. “The body needs blood and oxygen to do its job, and if it can’t get it because the plumbing is clogged, it doesn’t work properly and we feel poorly.”
Bromet says it’s reasonable for patients in their late teens and 20s to start keeping tabs on their cholesterol levels. Simple blood tests can be part of basic checkups with a physician.
“There was a really good American Heart Association campaign about 10 years ago that had the catchy slogan of ‘Know Your Numbers,’” Bromet says. “I liked that health campaign because it urged people to know what their cholesterol levels were, their blood pressure, their weight/body mass index, etc. Newer campaigns seem less focused on the numbers, but they are always a good place to start.”
It’s especially pertinent to “know your numbers” if you have a family history of high cholesterol, heart attacks, vascular disease or strokes, Bromet adds.
“As a profession, cardiologists believe that if we could address high cholesterol in our patients starting when they are 20 to 50 years old, we would be much better at preventing vascular complications when people are 50 to 100 years old.”
The first step to managing your cholesterol is maintaining a healthy diet and exercise regimen, Bromet says. Beyond that, there are multiple types of cholesterol-lowering medicines.
“But the news is even better,” Bromet says. “We have multiple studies now that show if we reduce cholesterol levels enough, people can actually unclog their blood vessels. It’s not too late if you have blockages in your vessels. If we get aggressive in lowering your cholesterol, in 18 to 24 months your body can start to remove the buildup in the vessel walls. I would advise patients to see their physicians and know their cholesterol numbers. You can prevent blockages from forming, and even reverse blockages that are there.”