Category Archives: patient education

Clean fuel, patient education

How Non-Medical Treatment Affects Hypertension Severity

Recently, I kicked around this idea of explaining the importance of non-medical treatments such as diet and exercise for hypertension, though it is applicable to other problems like diabetes.  You can see my prior post about the proper diet to address high blood pressure here.

4 tiers of medical severity or hypertension

Tier 4:  These patients have permanent end organ damage-permanent uncontrolled hypertension (elevated blood pressure), severe chronic kidney disease on hemodialysis, strokes, and congestive heart failure.

Tier 3: Uncontrolled hypertension or high blood pressure (or other  medical problem such as diabetes) are present requiring steady escalation of medications with no end in sight.

Tier 2:  These patients have stable controlled hypertension or medical problem requiring stable medication dosing without decrease.

Tier 1:  Stable controlled hypertension or medical problem without any use of medical therapy

Fine points about this diagram

Every patient with any chronic medical problem from high blood pressure and diabetes to rheumatoid arthritis fits into this continuum.  No one wants to be in tier 4, the worst level.   Long-term complications at this are permanent.  The best we can do is hope to contain it, and the original problem still remains unstable.

Those in tier 3 are frequently unaware of when and how they entered into tier 4 until it is much too late.  These patients are unstable and really not much better than tier 4.

Tier 2 is a good place and is all you can expect from a doctor’s effort, but medications are required.

No one, and I do mean no one, achieves tier 1 without sacrifice and significant change, and many are happy at tier 2.  But if non-medical control of hypertension and diabetes is a goal, then profound changes are necessary.   Yes, the appropriate medicine combination delivers you into tier 2.    Non-medical treatments of hypertension through exercise and diet (clean fuel or whole food plant based diet) are necessary to reduce any tier, but especially for achieving tier 1.

In conclusion, taking medications only gets you to tier 2 if the correct medicine is found.  Tier one is only achieved through extensive lifestyle changes.   I discussed diet and hypertension in prior posts, but I still emphasize a marriage of a DASH diet (8-9 servings of fruits and vegetables daily),  clean fuel and aerobic exercise to achieve with a  tier 1 results.  More to come later.

 

And lastly I want to apologize.  I have had internal medicine board duties and extracurricular work-related activities keeping me away from addressing this blog.  My goal is to at least do a monthly entry and weekly if I can get it.  Feel free to contact me by email if you have questions or concerns.  You can also comment.  Do not forget to like or comment on facebook as well.

 

Dirty Fuel, patient education, Weight Loss

3 Ways to Flatten (get off) Soda

The quintessential soda

I discussed diet with a patient today when I realized I failed to mention soda consumption. For the purposes of this article, soda and sweetened tea are synonymous.  Soda is a dirty fuel.  There are several articles mentioning health risks associated with carbonated soda, but not benefits.  For those who do not know, soda contributes to weight gain, obesity, high blood pressure, diabetes, and cavities.  Rather than go into these risks, the objective of this article is to describe ways to stop soda consumption.

Strategy 1:  Drink a full glass of water before soda or sweetened tea

I grew up drinking Coca-cola, and I could easily drink at least 3-5 cans a day.  I stopped drinking soda and sweetened tea in college, and I found this strategy worked very well.  When thirsty, I easily down 1-2 glasses or cans of soda rapidly.  Whereas, drinking a glass of water beforehand rapidly quenched my thirst.  I was apt to drink only half or less than 1 soda.  Water is the most efficient source of hydration so you get more bang for your buck.  Notably, if you desire to supercharge soda discontinuation, then drink two glasses of water before reaching for that soda/sweetened tea and see the result.

Strategy 2:  Reduce soda or sweetened tea intake by 1 glass or can per day

For many, if you can get someone to think about making small changes, then a series of changes eventually becomes large moves.  Therefore, small moves matter.  One leap is all that is necessary for many before an avalanche of changes.   If you have a level of commitment, then small changes take you places.  One must have resolve.  For example, you can drink a glass of  sweetened tea or soda three times daily with meals.  I challenge patients to consider exchanging one sweetened drink for water for one meal.   Small changes plant seeds of success.

Strategy 3: Cold Turkey

There is nothing like straight quitting.  NOTHING! If one is angry, determined, and has grit, then cold turkey is possible.  Commit every single day as if it is the first day.  Understand that soda is absolutely evil.  The only way to make that leap is to understand who made the soda and what it stands for.   They do not stand for me, and quite possibly you as well.  Now I have veered into political/economic commentary here, but I conjure these things for my own motivation.  It may help you as well.

Another way is to consider soda and like an illegal drug.  It is addictive.  I have never heard anyone say I will  do one crack rock today, or one line of heroine this morning at 8am before work and not another one for 24 hours.  Your health is serious business.

Feel free to leave any more suggestions on quitting soda in the comment section.  Let me know if you disagree as well.

patient education

4 Strategies to Avoid Ear-Related Doctor Visits

Ear problems  are something I see at least 1-2 times weekly, so I felt inspired to post a primer on how to handle common issues at home before calling the doctor.

  1. Avoid using  Q-tips or cotton swabs.   Q-tip use is common and effective.  However, Q-tips can compress cerumen or wax in your ear leading to hearing loss.  Compressed wax is deep into the canal and usually overlies the tympanic membrane or eardrum.  Moreover, it is very dry  and difficult to remove either at home or in the doctor’s office.  You can apply Debrox or Murine ear drops inside the ear for 10  minutes daily for 5 days to soften the wax to where it is easily removed, but your hearing may be compromised for that time period.

2.  Avoid using sharp objects (i.e. tooth picks, needles or pins) in the ear.  The canal and eardrum are delicate and puncture is possible.

3.  Use alcohol or peroxide to avoid swimmer’s ear.  Patients frequently come in the office with ear infections after swimming in a pool.  One way to avoid it is to use Auro over-the-counter ear drops in each ear after swimming.  An even cheaper way is to mix hydrogen peroxide  with lukewarm water at a 1:1 ratio (mix together 1 tablespoon of each in a small dish) and place a few drops  in one ear and wait at least 2 minutes. Then follow the same instructions for the other ear.

4.  Wash ears at home to prevent hearing loss due to dry compacted wax/cerumen.  Dry compacted wax is the most common ear issue I see.  I experience the same problem.  Use either olive oil,  or over-the-counter Debrox or Murine ear drops to soften earwax.  I prefer Debrox.  Lie down one side and drop a 2-3 Debrox drops into the opposite ear, and continue to lay on the unaffected side for at least 15 minutes.  Then turn over and allow the Debrox to drain out of one side while placing more ear drops into the opposite ear and wait another 15 minutes.  Once finished, fill a bulb syringe with lukewarm water.  Bulb syringes come in an ear care kit sold in pharmacies and supermarkets.  Then gently flush the affected ear out 1-2 times while using a towel under the ear to catch the water.  Turn over and follow the same instructions for the other ear.    Perform this process once weekly.  Afterward, you may hear a roaring sound in the ear, and that means water remains in the ear canal putting you at risk for ear infections.  To resolve the issue, combine rubbing alcohol and water at a  1:3 ratio and apply a few drops into the affected ear. (1:3 ratio means you will combine a 1/3rd cup of rubbing alcohol with a 2/3rd cup of lukewarm water)   Avoid alcohol if your ear hurts or bleeds.  Drain the ear on a towel 2 minutes after using the solution and the roaring will resolve within an hour.  The combined liquid readily evaporates anything left behind.

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