1 Concierge Update Winter 2008 email@example.com 616-284-8880 February is Heart Health Month: Keep your heart healthy by following these guidelines suggested by our mmpc cardiologist, Dr. Berkompas: 1. Exercise every day. Despite your hectic schedule, it can really make a difference in your heart health. It is important to make exercise a priority and schedule it into your daily routine. 2. Eat breakfast. When you eat a healthy breakfast each morning, your mind and body win! It’s important for energy and metabolism. Eat a breakfast of whole grain cereal with skim milk or low fat soy milk and a serving of fruit. You will think and feel better. Did you know that people who eat a healthy breakfast each day are thinner than people who do not? 3. Make sure that you’re getting lots of fruits and vegetables. A great way to consume the necessary fiber and antioxidants that your body requires, fruits and vegetables are also low in fat when prepared simply. In addition to breakfast, lunch, and dinner, raw fruits and vegetables are great for snacks. Ten servings of fruits and vegetables will set you on a healthy track to keep you feeling your best. 4. Make the effort to prepare healthy meals. Aside from cutting back on the obvious offenders like too much fat, you should also look at the types of tools and techniques you use. Consider the use of a roasting pan with a rack so the fat can drain to the bottom of the pan. Flexible silicone bakeware is useful because it eliminates the need to grease the pan. If you’re looking for ways to increase flavor but reduce fat, use fresh herbs. Use heart healthy margarine instead of butter in your recipes. Egg substitutes are an excellent replacement for eggs in a recipe, and low fat dairy products may be used as substitutes as well. Also, limit your salt intake. Finally, consider using soup stock instead of fat for basting. 5. Limit your portion sizes. Try to eat smaller portions. A deck of 2 cards, or the size of a fist is a serving of meat, fish, or poultry. Take a look at the recommended serving size on the USDA MyPyramid Food Guidance System: (www.mypyramid.gov). Get out a measuring cup or a food scale and practice measuring some of your favorite foods onto a plate, so you can see how much (or how little!) a ½ cup or 3- ounce serving is. 6. Get 7-8 hours of sleep each night. Adequate sleep is linked to lower levels of heart disease, type 2 diabetes, and obesity. It also helps relieve stress. level may not be enough to bring your lipid levels into a healthy range. Lifestyle changes such as eating less saturated fats, increasing activity, quitting smoking and controlling blood sugar levels are still the foundation to lipid control. These lifestyle changes have most likely improved your cholesterol and triglyceride levels. Adding medication will improve the lipid levels further and decrease your risk for heart disease. Different classes of lipid-lowering medications work in different ways to improve your lipid levels. Overall these medications decrease the body's ability to produce cholesterol and triglycerides. The medications also help the body remove cholesterol and triglycerides from the blood. Your health care provider will work with you to decide which medication is right for you. The choice is based in part upon which lipid values are increased and any other illnesses you may have. There are four classes of medications used to treat abnormal lipid levels. They include statins, bile acid sequestrants, nicotinic acid and fibric acid derivatives. These medications are usually used separately. Sometimes, more than one medication is used at the same time. This is done when one class of medicine does not adequately control the lipid level or if there are two different abnormal lipid levels. Types of Lipid Medication Statins hinder with the body’s ability to make cholesterol. Statins also increase the body's ability to breakdown LDL cholesterol. This results in lower LDL cholesterol levels in the blood. National Wear Red DayOne in four American women dies of heart disease, and most fail to make the connection between risk factors, such as high blood pressure and high cholesterol, and their personal risk of developing heart disease. Only 20% of women consider heart disease to be their biggest health risk, yet almost 3 million women have had a heart attack. Many women still do not take heart disease seriously. To raise awareness and help those around you take action to prevent heart disease in women, you can participate in National Wear Red Day on February 1, 2008. Medications to Improve Your Lipid Levels. Don't feel discouraged if your cholesterol and triglyceride levels are not at a healthy level even though you've tried a meal plan lower in saturated fats and you've increased your activity level. Changes in your meal plan and activity 3 Because statins are so effective in safely lowering the LDL cholesterol, they are often the first choice of medications to lower the LDL cholesterol. Statins do other good things too, including raising HDL cholesterol (“good” cholesterol) levels and lowering triglycerides. Bile acid sequestrants Bile acids are digestive chemicals partially made up of cholesterol. Normally they can be reused by the body. Bile acid sequestrants bind with bile acids before they can be reused. The bound bile acids are then excreted in the feces. Remember, bile acids are partially made up of cholesterol. As bile acids are removed, cholesterol is also removed. Nicotinic acid (niacin) Nicotinic acid, or niacin, can help to improve all lipid levels. Niacin is a vitamin that limits the body’s ability to make lipoproteins. These are particles that carry cholesterol and triglycerides in the blood. Fibric acid derivatives The major effect of fibric acid derivatives is to lower triglycerides. They help lower the production of fat particles that carry triglycerides through the blood. They also help the body break down fats that would otherwise raise triglyceride levels. Fibric acid derivatives can also increase HDL cholesterol (“good” cholesterol) levels by 10% to 35%. The LDL cholesterol (“bad” cholesterol) lowering effects of fibric acid derivatives range from 5% to 20%. Occasionally, however, the LDL cholesterol level may increase. Combination therapy As mentioned previously, different lipidlowering agents are used together. This is known as combination therapy, and is used when one type of medicine isn’t enough. Recently, medicines have been developed that combine two classes of lipid-lowering medication into one pill. One such medicine combines a statin with another agent that blocks the absorption of cholesterol in the intestines. Source: Report of the National Cholesterol Education Program (NCEP) Expert Panel on: Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). NIH publication # 02-5215. September 2002. MMPC Vascular Screening: mmpc vascular office is once again offering a Vascular Screening Day on January 25, 2008. Screening for aneurysms in the abdomen, and blockages in the neck and legs. These are simple ultrasounds of the abdomen and carotid arteries, along with circulation testing on the legs. These tests are being offered at $40.00 each test OR $100.00 for all three testsA savings of $20.00. Payment is due at time of service. To schedule your appointment, you may call our vascular office at 459-8700 or call your Concierge office at 284-8880 and we will be happy to arrange a time for you. 4 CT Coronary Calcium Scoring Coronary artery disease, also know as arteriosclerosis is a build up of plaque on the arterial wall slowing the flow of blood to the heart muscle. After time, calcium will be added to the plaque. It is this calcified plaque that a CT Coronary Calcium Scoring exam identifies. This score helps your physician determine your current risk for a heart attack and helps devise a preventative plan for you. Typically, patients are diagnosed with coronary artery disease when they have already shown symptoms (chest pain, fatigue, shortness of breath), responded abnormally to stress testing or undergone cardiac angiography. This means the opportunity for prevention is lost and the patient may have already suffered irreversible consequences or a cardiac event. CT Coronary Calcium Scoring can detect coronary arteriosclerosis in its earliest stages. Early detection allows for positive lifestyle changes that will help minimize further progression of coronary artery disease for preventative treatment and aid. The test is recommended for asymptomatic men age 40-70 and asymptomatic women age 55-70 who have the following risk factors: High blood pressure, Diabetes, High cholesterol, Family history of heart disease, Smoking, Sedentary lifestyle, Overweight by 20% or more, and Highstress lifestyle. The test is performed using CT (CAT Scan) technology. There is no preparation and it only takes about 15 minutes. The radiation exposure during the exam is very minimal and comparable to the radiation received during a conventional x-ray. To schedule an appointment, or ask questions, you may call your Concierge office (616-284-8880) or call the Cardiovascular office direct at (616-9744567). This test is not covered by insurance and payment of $200.00 is due at time of service. If you have an acute medical issue, remember to call us before noon to be guaranteed an appointment that same day!! Meet the Staff: Karen Hirdes, Clinical/Clerical Assistant, MA- medical assistant, SBS- site billing specialist Personal: Karen is a native Grand Rapids resident. She has been married to her husband, Corey, for 2 ½ years. She enjoys downhill skiing, exercising, and reading. 5 Professional: Karen has been employed with mmpc for 12 years. She has both her Associates Degree in Medical Assisting and a Bachlors Degree in Healthcare Administration from Davenport University. Karen also has a billing certification through mmpc. She has experience working in many specialty offices. Please inform us, or have your family inform us if you are admitted to the hospital. If you have the need to be transported by ambulance, please ask to be taken to Spectrum- Butterworth hospital. Cindy, and our mmpc physicians are able to follow your care at Butterworth.