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Thursday, August 17, 2017

The Roving Reporter : The Heart Attack and Depression Link

 By Jennifer J. Brown, PhD
Almost nowhere is the mind-body connection more apparent than in the link between depression and heart attack.

Heart-Attack-Depression-Image-1Mental health and heart health are intimately connected when it comes to your heart. Heart disease is consistently the No.1 killer in the United States, according to the Centers for Disease Control and Prevention (CDC). Each year, about 715,000 Americans have a heart attack. And 190,000 of these are repeat heart attacks. Those who have heart attacks are more likely to become depressed, and people with depression have higher rates of heart attacks.

Current Depression and Heart Attack

Heart-Attack-Depression-Image-2One in 10 American adults surveyed by Gallup said they currently have depression or are on depression treatment. Whether or not they have had a heart attack dramatically increased their depression risk:

8 percent is the current depression rate for people who have never had a heart attack.
17 percent is the rate for people who have had a heart attack.
Heart Attack and Lifetime Depression Risk

Heart-Attack-Depression
Almost one in five U.S. adults surveyed said they had been diagnosed with depression at some point. Lifelong rates of depression rose much higher for those who had experienced a heart attack:




The Roving Reporter

Sunday, August 13, 2017

The Roving Reporter : 3 Heart-Disease Treatment Breakthroughs That Are Changing Lives


By Steven Nissen, MD, Special to Everyday Health

Nearly 27 million people in the United States have heart disease. It remains the leading cause of death for both U.S. men and women. However, during the last several years, there have been some truly significant advances in heart disease treatment that are now moving quickly toward widespread availability.

After a decade of failed efforts at developing new heart drugs, two important therapeutic breakthroughs are nearing FDA approval in 2015. These overdue advancements have the potential to change the practice of medicine. They can help patients who have not benefited adequately from existing therapies.

1. A Better Drug for Heart Failure

Congestive heart failure is a common disorder characterized by a failure of the heart muscle to forcefully pump blood to the body’s tissues. Heart attacks, high blood pressure, or diseases that weaken the heart muscle are common causes. Patients often have severe shortness of breath or fatigue that limits their ability to enjoy life. This disorder is the most common reason for hospital admission among Medicare patients.

In a large clinical trial, known as Paradigm-HF, the new drug LCZ696 was used to treat heart failure, and it was highly effective. It achieved a substantial 20-percent reduction in death or repeat hospitalization compared with the best currently available therapies. Although the benefits of a reduction in deaths are self-evident, the importance of reducing readmission to the hospital should not be underestimated. Currently, 20 percent or more of patients hospitalized for heart failure are re-admitted within 30 days. This represents a significant burden for patients and the healthcare system.

LCZ696 will probably be approved this year, providing a new, promising option for the 5.7 million Americans with heart failure.

2. New Treatment for High Cholesterol

The second innovative drug therapy is known as a PSCK9 inhibitor. This class of drugs has moved from discovery to the clinic more rapidly than any cardiovascular advancement in recent memory.

The single most important risk factor for developing coronary heart disease is an elevated level of “bad” cholesterol, also known as LDL-C. Currently, the best available drugs for reducing cholesterol, statins, have been shown to lower the risk of heart attack or stroke up to 35 percent.

Statins have been available for more than 25 years and have been enormously successful at reducing the burden of heart disease. Unfortunately, some patients cannot tolerate statins or can’t take large enough dosages to adequately reduce cholesterol levels. In other cases, LDL-C is very high due to an underlying genetic cause, and even the most powerful statins cannot reduce it to safe levels.

PSCK9 inhibitors have been shown to reduce bad LDL-C by as much as 50 percent to 70 percent and demonstrated few, if any, adverse effects. Although these drugs are given by injection every two weeks or once a month, they are injected through very small needles that produce little or no pain. Patients can easily self-inject these drugs using an automated injector.

This new class of drugs appears to be well tolerated even in patients who cannot take statins due to adverse effects. The FDA is considering applications from two pharmaceutical companies for drug approval in 2015.

3. Less Invasive Surgery for Heart Valve Disease

In 2011, the FDA approved a new procedure to treat heart valve disease without a major surgical operation, known as TAVR, or transcatheter aortic valve replacement. This device is approved for patients who need an aortic valve replacement, but who are too high risk for standard open-heart surgery.

This new approach is an important advance for patients who are too ill to withstand an open-chest procedure or for older patients. In the United States, patients currently undergoing TAVR typically include people with lung or kidney disease who would be less likely to tolerate major heart surgery to replace the aortic valve. TAVR was initially performed only at large academic medical centers. It is now moving gradually toward mainstream treatment throughout the world.

A catheter (small hollow tube) is placed in the groin (femoral artery) and guided into the heart chambers using advanced imaging techniques. Through this catheter, a collapsed tissue heart valve is guided into position and placed directly inside the diseased aortic valve. Once the new valve correctly positioned, a balloon is inflated to deploy the valve, incredibly, without opening the patient’s chest.

Currently TAVR is being performed at more than 350 hospitals in the United States.

Although heart disease remains the No. 1 cause of death in the United States, these treatment breakthroughs and other developments offer new hope to patients, providing long-awaited advances that are already making a difference.

Steven Nissen, MD, is the Chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute, in Cleveland, Ohio. He has more than 35 years experience as a physician and is world-renowned for his work as a cardiologist, patient advocate, and researcher.



The Roving Reporter

Maxy sez: Foods That Help and Hurt Type 2 Diabetes

By Jan Sheehan Reviewed by Lindsey Marcellin, MD, MPH

A diabetes-friendly diet is one key to effectively managing the disease. Read on to find which foods to eat, and which ones to avoid.

Healthy eating is one of the best ways to manage type 2 diabetes. Because this type of diabetes is strongly linked to excess weight, cutting calories and following the right kind of diabetes diet will go a long way toward improving your health.

One of the most important aspects of good nutrition when you have type 2 diabetes is eating meals with the right mix of carbohydrates, proteins, and fats to keep blood sugars as normal as possible throughout the day. The next step is choosing among the foods and beverages that can give you an extra edge in managing type 2 diabetes, says dietitian Beth Reardon, MS, RD, an integrative nutritionist and food researcher at Duke University Integrative Medicine in Durham, N.C.

Eat Pre-Germinated Brown Rice and Fiber

White rice has long been known to be a bad food for diabetes. Like most "white" foods, it causes blood sugar spikes. However, adding healthy whole grains and fiber to a diabetes diet may reduce the risk of complications, such as diabetic neuropathy, which is nerve damage resulting from high blood sugars. Researchers at the Medical College of Georgia found that a diet rich in pre-germinated brown rice protected animals with diabetes from this common complication. To make pre-germinated rice, you soak the rice in warm water overnight before cooking. This stimulates the rice to germinate, producing tiny shoots that are invisible, but contain chemical complexes that appear to be protective against neuropathy.

This rice is also packed with fiber, an important component for diabetes management. “Because fiber takes a long time to digest, sugars are released slowly,” Reardon says. “That helps keep blood sugar levels steady and prevents glucose spikes.”

Another way to add fiber to your diet is through beans. A recent study published in Nutrition Journal found that beans and rice eaten together prevent the blood sugar spikes caused by white rice alone.

Add Oranges and Spinach to Your Diabetes Diet

In a recent study of men and women ages 40 to 75, those with the most vitamin C in their bodies had the lowest incidence of type 2 diabetes. Oranges and orange juice are one of the best sources of vitamin C, Reardon says. Other foods with generous amounts of vitamin C are grapefruit, strawberries, and tomatoes. (If you are on a statin drug for high cholesterol, check with your doctor or pharmacist before eating grapefruit or drinking grapefruit juice, as it can cause dangerously increased levels of atorvastatin, lovastatin, and simvastatin.)

When it comes to leafy greens, just one cup of spinach contains 40 percent of your daily value of magnesium, a mineral that can help regulate blood sugar levels — important because people with type 2 diabetes frequently have low levels of magnesium. To get more of this magnesium-rich green veggie into your diet, substitute spinach for lettuce on sandwiches and in salads, Reardon suggests. Not a big fan of spinach? Nuts, beans, and low-fat diary products are also good sources of magnesium.

Drink Low-Fat Milk

Milk is loaded with calcium and vitamin D. This double whammy of essential nutrients may help in your quest to keep type 2 diabetes under control. In a 20-year study of almost 84,000 women, those who consumed the most calcium and vitamin D gained the most protection from type 2 diabetes. Just be sure it’s low- or nonfat — skim or 1 percent milk will control your intake of saturated fats and help prevent weight gain.

Spice Up Your Diabetes Diet

Several studies have documented that cinnamon can lower blood sugar levels. But for an even bigger punch of diabetes protection, sprinkle cinnamon in your morning coffee. Coffee consumption has been associated better type 2 diabetes management, possibly due to its antioxidant properties. Having both cinnamon and coffee can give you double the ammunition to fight type 2 diabetes.

A hearty bowl of curry could also help control your type 2 diabetes. That’s because turmeric, a spice used in curry, can help prevent the inflammation associated with type 2 diabetes. “Turmeric contains a chemical called curcumin, which is a natural anti-inflammatory that works as well as some anti-inflammatory drugs,” Reardon says. Curry typically contains a heaping helping of turmeric, but you can spice up other dishes with turmeric as well.

It’s just as important to steer clear of foods that can make managing type 2 diabetes more difficult, or at least eat them sparingly. First and foremost, don’t feast on foods that are high on the glycemic index (GI), which is a system that ranks foods by how they affect blood sugar. High GI foods, such as white rice, doughnuts, soda, and white bread, can cause glucose levels to skyrocket. The same goes for sweets and desserts. “Because these foods are high in carbohydrates, they can cause blood sugar levels to go up considerably,” Reardon says.

That doesn’t mean you can never have a slice of pie or a few cookies. Just be smart about eating foods that can make controlling your type 2 diabetes more challenging. Having a piece of cake with a low-carb meal (such as baked chicken and broccoli) won’t raise glucose levels as much as cake after a big pasta meal.

It’s also wise to watch your saturated fat intake when you are living with diabetes. Fatty cuts of meat and full-fat dairy raise cholesterol and promote inflammation throughout the body in both healthy people and people with type 2 diabetes. But recent research found that the effects of this inflammation may be more damaging for people with the disease. And because diabetics already have an increased risk of heart disease, consuming saturated fat in moderation is especially important. Studies have also shown that fatty foods may increase insulin resistance in women with diabetes.

Managing type 2 diabetes involves paying careful attention to what you eat. If you start with a base of good-for-you foods, building a healthy diet will be that much easier.

Wednesday, August 9, 2017

The Roving Reporter : Is It Healthy to Use a Vibrator?

Bringing a vibrator into the bedroom can rev your sex life, boost your bond, and more.
Curious about using a vibrator? You’re not alone. Many women turn to vibrators to achieve the big O. In fact, a study published in July 2009 in the Journal of Sexual Medicine found that 53 percent of women ages 18 to 60 have used a vibrator, and one-quarter of them have used it in the past month. Plus, those who use a vibrator regularly were more easily aroused and better able to become lubricated and achieve an orgasm.

So should you try using a vibrator? Absolutely. Here’s why it’s healthy, and how to incorporate it into your sex life — solo and with a partner.

Why It’s Healthy to Use a Vibrator

The benefits of using the battery-operated device abound. If you choose to try it solo, you can discover what turns you on without feeling any pressure or expectations from your partner, says Kristin Zeising, PsyD, a psychologist and sex therapist in San Diego. She recommends experimenting with it all over your body to discover erogenous zones you may not know about. Finding out what feels good will help you give your partner more guidance and make sex more pleasurable.

Incorporating a vibrator into your sexual repertoire can also boost your bond with your mate. “Anything that brings more pleasure to your sex life can help your relationship,” says Zeising. Plus, opening up a conversation about sex toys can foster better communication with your partner in general.
The benefits of using the battery-operated device abound. If you choose to try it solo, you can discover what turns you on without feeling any pressure or expectations from your partner, says Kristin Zeising, PsyD, a psychologist and sex therapist in San Diego. She recommends experimenting with it all over your body to discover erogenous zones you may not know about. Finding out what feels good will help you give your partner more guidance and make sex more pleasurable.

Incorporating a vibrator into your sexual repertoire can also boost your bond with your mate. “Anything that brings more pleasure to your sex life can help your relationship,” says Zeising. Plus, opening up a conversation about sex toys can foster better communication with your partner in general.

How to Bring a Vibrator Into the Bedroom Think again. According to another study published in July 2009 in the Journal of Sexual Medicine, 45 percent of men have used a vibrator, and most said they did so with their female partner. What’s more, men who used vibrators had better erectile function and were more satisfied during sex than those who didn’t.

So how can you bring up the conversation with your partner? Zeising recommends suggesting it as a way to add to the fun you’re already having. Reassure your partner that your desire to use a vibrator has nothing to do with his performance. “Remind him that he’s the one who turns you on and that the vibrator is just a tool to help you along the way,” says Zeising. And remember: You don’t have to use it during every sexual  encounter .
Think your mate will be opposed to using a vibrator? Think again..


When you’re both ready, go shopping for a vibrator together so you can find one that you’re both comfortable with. Then, play around with it to figure out what feels good, suggests Zeising. Use it on yourself or each other — and don’t be afraid to let your partner take the lead.


Thanks for stopping by ---See you in the funny papers. 

The Roving Reporter


Sunday, August 6, 2017

Chicken Salad with Grapes, Honey, Almonds, and Broccoli

Time   :20 Minutes       Makes 4 to 6 servings

2     large eggs, lightly beaten
 6   (4-oz.) chicken cutlets, 1/4 to 1/2 inch thick 
1-1/2    cups seasoned breadcrumbs
 1/2     cup apple cider vinegar  2 tablespoons honey
 1    tablespoon Dijon mustard
 1/2     teaspoon kosher salt 
4    teaspoon freshly ground black pepper
 1/2     cup olive oil 
1 (5-oz.)     package spring lettuce mix 
3     cups broccoli florets 
1/2    cup halved seedless red grapes 
1/2    cup halved seedless green grapes 1/2 cup sliced honey-roasted almonds

1 .  Preheat oven to 425°. Whisk together eggs and 3 Tbsp. water in a small bowl. Dip chicken in egg mixture, and dredge in breadcrumbs, pressing firmly to adhere. Place on an aluminum foil-lined baking sheet. Bake 15 minutes or until chicken is brown and done.

 2 .  Meanwhile, whisk together vinegar, honey, Dijon mustard, salt, pepper, and olive oil. Toss together lettuce, broccoli, red grapes, and green grapes; season with salt and pepper. Top with chicken and sliced almonds; serve with vinaigrette.
Heart Healthy

Maxy sez:: Suicide and Diabetes: What Caregivers Should Know

When emotional health and diabetes collide, suicide is a real risk. Learn how to help your loved ones avoid this tragic choice.
By Madeline R. Vann, MP    Medically Reviewed by Farrokh Sohrabi, MD

As many as one in five people with diabetes think about suicide, some on a daily basis. People considering suicide don't always advertise their plans, but those with diabetes might be doing so by neglecting their diabetes management. A statewide study of patients in Texas revealed that depression and diabetes led to poor diabetes control. And although no in-depth research into diabetes and suicide exists, the study authors suggest that one sign of worsening emotional health might be giving up on the hard work of controlling diabetes.

Also of great concern, according to a study published in The Primary Care Companion to the Journal of Clinical Psychiatry, are data that suggest that people with diabetes might go so far as to commit insulin suicide, intentionally overdosing with the very medication that can help them achieve and maintain blood sugar control.

Emotional Health and Diabetes: Depression and Suicide

The connection point between diabetes and suicide is depression. About 16 percent of the general population experience depression, but the percentage is nearly doubled among those with diabetes. To better understand depression and diabetes, family medicine expert David Katerndahl, MD, and colleagues at the University of Texas Health Science Center at San Antonio looked at diabetes control and depression symptoms among 106 patients over the course of five years.
Though their research did not address suicide risk specifically, Dr. Katerndahl said, "I looked at the results from our question about how frequently patients thought about suicide over the past two weeks and found that 20 percent had thought about suicide and 6 percent thought about it daily." The results of the study show a link between depression, poor compliance with diabetes treatment, and a lower qualify of life .

"Diabetes and depression is a toxic combination," said psychologist Susan Guzman, PhD, director of clinical services for the Diabetes Behavioral Institute in San Diego. "Mortality rates in people who have both are about 2.5 times the rates in people with either or neither."

Decades of Diabetes Leading to Depression

Ed Cook, a San Diego resident, was diagnosed with diabetes 38 years ago. For much of the time, the government administrator and, after retirement, entrepreneur felt life was balanced despite his illness. But as Cook, now 66, gradually lost his vision and then his driver's license, his business, and most recently, one toe to amputation, depression infiltrated his life. A religious person, he struggled against thoughts of suicide and sought help from Guzman.

"The complications led me to severe depression," Cook admitted. He entered treatment, which included anti-depressants for a time, and he now regularly attends both therapy and support groups. "It helps to know I am not alone," he said. "Diabetes is not the end of the world."

But Cook also acknowledges that his battle is not over. Periodically, he still feels some despair as he continues to face the screenings and health assessments, such as vascular checkups, that are intended to catch complications before they do too much damage. Still, through prayer and therapy, he said, he's come to see that even now he has a role and a purpose. "I try to be an encouragement to people," he said.

This shift in attention is part of the treatment process, noted Guzman. At their worst, people with depression and diabetes may feel like a collection of flawed body parts under the thumb of the illness. But as the depression subsides, they can see that they are more than just the label and experience of diabetes.

Suicide by Insulin
Complicating the issue is the ability of people with diabetes to commit suicide using the very same tools that keep them alive. At one point, Cook floated the idea of an intentional insulin overdose to Guzman, but she pointed out that it's a permanent solution to a temporary problem, not to mention risking severe side effects from the overdose if you survive it.

How widespread is insulin suicide? According to research published in the Journal of Clinical Psychiatry, an analysis of overdose-related calls to a poison center suggested that 95 percent of insulin overdoses were deliberate. But Guzman noted that this is an area that needs more study.

Katerndahl understands how life with diabetes can look grim to patients, especially if they have seen older relatives living with some of the more severe complications of diabetes. But he said it's also important to remember that modern medicine offers many more options for disease management than the diabetes programs older relatives were following decades ago.

How Caregivers Can Help: Tips for Preventing Suicide

As a caregiver, it can be hard to tell when a loved one's blue mood turns to depression and potentially to thoughts of suicide, but often there are clues. "More than half of the time, people who complete suicide have talked about it," said Guzman.

Here are suggested actions to take:
Note any changes in self-care. Katerndahl's research supports what other studies have shown: Depression correlates with poor diabetes management compliance. If someone used to be on top of diabetes control but now makes less effort, talk to the person or the person's doctor about what's going on.
Know the risk factors for suicide. There are many risk factors for suicide, including recent unemployment, childhood traumas, social isolation, family conflict, and personality traits such as aggression, impulsivity, or shame. For people with diabetes, experiencing severe complications that require amputations or the loss of independence can also be risk factors.

Encourage substance abuse treatment. Alcohol and substance abuse both increase the risk for suicide, warned Guzman. If your loved one is struggling with an addiction in addition to diabetes and depression, investigate treatment options.
Don't argue. You have to take any talk of suicide seriously, which means getting help, not debating the matter. Trying to reason with someone who's depressed and considering suicide won't help, said Guzman. Avoid saying things like, "But you have so much to live for." Instead, sympathize with the person's concerns and offer the hope that depression treatment could ease suffering. From his own experience, Cook said that even at his worst, the people in his life who were positive and encouraging were like a lifeline.
Suggest depression screening. Doctors can (and should, argues Katerndahl) provide depression screening tools to but you can also find them online. Encourage your loved one to complete one.
Call the doctor. If you are very concerned and your loved one can't or won't get help, calling the doctor is an option. Privacy laws prevent doctors from discussing a patient's status with you, but they don't prevent you from sharing your concerns with the doctor, who might be able to find a solution.
Remove weapons. Taking away guns, knives, and even prescription medications may be necessary if you feel suicide is imminent. Limiting access to insulin might be necessary for severely depressed insulin-dependent people, with family members or doctors taking over responsibility for giving insulin.action. "Don't sit on it. You're better off talking to the patient or the physician and, if it turns out your wrong, that's fine. You don't want to end up second-guessing yourself." Your care and insistence could make the difference in your loved one's life. "Getting treated for depression was a godsend," said Cook.
"Look for any kind of warning signs," said Katerndahl, and take 
control.

Friday, July 28, 2017

Woman’s Children Make A Bizarre Prediction At Their Father’s Funeral That Actually Comes True

Losing someone close to you is likely the single most difficult experience you can go through. This feeling is multiplied infinitely if the person you’ve lost is a spouse or a child.

It’s only natural for people to look for ways to cope during the grieving process. Occasionally, survivors claim to receive messages from the one they’ve lost.

When Dechia Gerald received the news that her husband Matthew, a police officer, had been killed in the line of duty, she was rightfully devastated. Then, her daughter made a strange prediction at his funeral that left Dechia dumbfounded…


Everyone knows that police officers risk their lives on daily basis to enforce the laws that have been put in order. This is especially apparent to the spouses of these brave heroes. So when Dechia husband Matthew had been killed in the line of duty, she was Gerald of Baton Rouge, Louisiana received the call that her stunned.
In addition to his wife, Matthew left behind two young daughters. Despite the tragedy, Dechia remained strong for her girls.


While the family was grieving at Matthew’s funeral, her eldest daughter made a strange comment that completely startled her — she predicted that Dechia was pregnant with another child. Initially, she wrote this off as her daughter’s way of dealing with the grief of her loss. Not long after, though, her youngest daughter made the same remark…
While Dechia didn’t think much of the prediction at first, she still decided it would be best to take a pregnancy test. Surprisingly, it turned out that her daughters were correct, and she was, in fact, in the very early stages of pregnancy! She was shocked, to say the least

Dechia gave birth nine months later to a healthy baby boy, whom she named Falyn Matthew Gerald. In their time of grief, her friends and family members couldn’t help but feel as if her husband had been reborn through their youngest child. It was truly a miracle...
When Dechia lost Matthew, she began wearing his wedding band on a necklace as a way to keep him with her at all times. Friends and family stood in awe after Falyn reached up and placed his finger through the ring on her neck the first time that he laid on her chest to cuddle.
“We all feel his daddy with us,” Tish, Matthew’s mother said in an interview. “Very bittersweet, just more than I can express. Just touches my heart more than I can express. It’s like having him all over again.”


Now, every day with her three children is a reminder of Dechia’s late husband Matthew. “I can just feel his presence. I don’t have to worry about the anxiety or worry where’s he’s at or what he’s doing because at this moment, he’s here with us,” she said.

That is some serious intuition. Their story is certainly heartbreaking, though luckily, they’ve found a new way to cope with their loss.


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Howdy friends and readers...I am back just as sassy as ever . I was away due to circumstances beyond my control , I will fill you in . Maxy sez  will  continue and  I want to  give a shout out to Trudy in Laramie Wyoming for stating her first diabetic group  and being a mentor to five people in her group .