Patient Education

NCMA Pulmonologist shares insights on new study associated with living with asthma

Northern California Medical Associations’ (NCMA) Dr. James M. Steele M.D. talks about the latest study on asthma and the necessity of managing symptoms to help keep down costs.

Northern California Medical Associations’ (NCMA) Dr. James M. Steele M.D. talks about the latest study on asthma and the necessity of managing symptoms to help keep down costs.

Researchers from the Centers for Disease Control and Prevention recently analyzed data from the Medical Expenditure Panel Survey to discover the financial toll asthma has on sufferers and their families. More than 213,000 respondents participated over a six-year period with 10,237 people identified with treated asthma. According to the results of the survey about 15.4 million people in the U.S. undergo treatment for asthma each year with annual costs in the $82 billion range. Those who suffer from asthma spend about $3,266 every year on medical care. Around 3,168 deaths are attributed annually to asthma.

“This survey clearly shows the impact asthma has on patients and society as well,” says Dr. James Marco Steele, NCMA Pulmonologist. “The best way to keep medical expenses down for asthma patients is to have an active treatment plan in place and to avoid triggers. Taking asthma medication as prescribed and using the quick-acting meds when needed will help to keep attacks in check for most patients.”

Understanding Asthma

Asthma is a disease that affects the lungs causing recurring episodes of wheezing, breathlessness and chest tightness. Asthma patients also frequently experience nighttime and early morning coughing episodes. During an asthma attack the airways in the lungs swell and shrink. This means that less air can get in and out of the lungs. The situation becomes all the worse when mucous clogs up the airways, restricting the ability to breathe even more. An asthma attack can be scary and stressful for the person having an attack. Asthma triggers can include:

  • pollen, mold, dust mites, cockroaches, pet dander
  • smoke, air pollution, chemicals and strong odors
  • aspirin, acetaminophen and other medications
  • weather conditions
  • exercise, physical activity
  • emotional stress

Chronic health problems can also exacerbate the symptoms of asthma such as obesity, obstructive sleep apnea, acid reflux, stress and depression. Colds and sinus infections can also worsen asthma symptoms.

“As with most pulmonary issues, asthma can be a challenge for patients to deal with, but many people live completely normal lives with the condition, as long as it’s properly managed with the help of a healthcare provider,” explained Dr. Steele. “Our goal with asthma patients is to have a good treatment plan in place and to provide adequate education and support, so that the patient can resume a normal and active life.”

Treating Asthma

In addition to avoiding allergens that trigger asthma symptoms, drug therapies can also help. As mentioned previously, severe attacks are best deal with by having an emergency action plan in place. A healthcare provider may also recommend using a peak flow meter to monitor the asthma. A peak flow meter is a small handheld device that measures how much air the patient is able to push out through the lungs. By tracking airflow, changes can be made to the treatment plan that may include additional behavioral or environmental changes, or possibly an alternative asthma medication.

Untreated asthma can have adverse effects on a person’s life. In addition to wheezing and coughing, asthma symptoms can cause time lost from work or school, inability to participate in activities, and occasional visits to the hospital. The best way to manage attacks and get back to a more active life is to consult with a physician. “Asthma may not be curable, but with the help of a team of knowledgeable healthcare providers, symptoms can be managed, and flare-ups reduced,” said Dr. Steele.

About Dr. Steel

NCMA Pulmonologist James Marco Steele, MD, provides diagnostics, treatment, and management of the full spectrum of pulmonary diseases including asthma. Dr. Steele is Board Certified in Sleep Medicine, Pulmonary Medicine, Internal Medicine, and Critical Care by the American Board of Internal Medicine (ABIM). Dr. Steele offers his expertise in the following areas: sleep disorders, critical care medicine, pulmonary hypertension, adult cystic fibrosis, clinical research, and special procedures that encompass a wide range of diagnostic and interventional pulmonary medicine. For more information visit the ncmahealth.com website or call (707) 525-3786.  

 

 

 

Research highlights connection between sleep loss and weight gain

Sleep loss increases the risk of obesity through a combination of effects on energy metabolism. This research, presented at the European Congress of Endocrinology in Lisbon, will highlight how disrupted sleep patterns, a common feature of modern living, can predispose to weight gain, by affecting people’s appetite and responses to food and exercise.

In the 24/7 culture of the modern world, an increasing number of people report routine reduced quality of sleep and several studies have correlated sleep deprivation with weight gain. The underlying cause of increased obesity risk from sleep disruption is unclear but may relate to changes in appetite, metabolism, motivation, physical activity or a combination of factors.

Dr Christian Benedict from Uppsala University, Sweden and his group have conducted a number of human studies to investigate how sleep loss may affect energy metabolism. These human studies have measured and imaged behavioural, physiological and biochemical responses to food following acute sleep deprivation. The behavioural data reveal that metabolically healthy, sleep-deprived human subjects prefer larger food portions, seek more calories, exhibit signs of increased food-related impulsivity, experience more pleasure from food, and expend less energy.

The group’s physiological studies indicate that sleep loss shifts the hormonal balance from hormones that promote fullness (satiety), such as GLP-1, to those that promote hunger, such as ghrelin. Sleep restriction also increased levels of endocannabinoids, which is known to have appetite-promoting effects. Further work from Dr Benedict’s team shows that acute sleep loss alters the balance of gut bacteria, which has been widely implicated as key for maintaining a healthy metabolism. The same study also found reduced sensitivity to insulin after sleep loss.

Dr Christian Benedict remarks, “Since perturbed sleep is such a common feature of modern life, these studies show it is no surprise that metabolic disorders, such as obesity are also on the rise.”

Although Dr Benedict’s work has shed light on how short periods of sleep loss can affect energy metabolism, longer-term studies are needed to validate these findings. The group are now investigating longer-term effects and also whether extending sleep in habitual short sleepers can restore these alterations in appetite and energy metabolism.

Dr Christian Benedict says, “My studies suggest that sleep loss favours weight gain in humans. It may also be concluded that improving sleep could be a promising lifestyle intervention to reduce the risk of future weight gain.”

North Coast Sleep Centers with Dr. James Marco Steele

NCMA Pulmonologist James Marco Steele, MD, provides diagnostics, treatment, and management of the full spectrum of pulmonary diseases. Dr. Steele is Board Certified in Sleep Medicine, Pulmonary Medicine, Internal Medicine, and Critical Care by the American Board of Internal Medicine (ABIM). Dr. Steele offers his expertise in the following areas: sleep disorders, critical care medicine, pulmonary hypertension, adult cystic fibrosis, clinical research, and special procedures that encompass a wide range of diagnostic and interventional pulmonary medicine.


Story Source:

Materials provided by European Society of EndocrinologyNote: Content may be edited for style and length.


Read this article on Sciencedaily: European Society of Endocrinology. “Sleep loss affects your waistline.” ScienceDaily. ScienceDaily, 22 May 2017. <www.sciencedaily.com/releases/2017/05/170522081109.htm>.

Who Needs a Cardiac Electrophysiologist?

A clinical cardiac electrophysiologist, or cardiac EP, specializes in treating rhythm problems of the heart. A cardiac EP is a cardiologist who completes 3 years of extra training beyond that required for board certification in cardiology to specialize in problems of the heart and blood vessels.

NCMA Bedi photo

Dr. Ashwani Bedi is board certified in cardiac electrophysiology, cardiovascular disease and internal medicine. He brings specialty expertise in all aspects of cardiac electrophysiology including SVT and VT ablations, atrial fibrillation ablations, pacing (including BiV pacing) and defibrillation as well as intracardiac echocardiography. Dr. Bedi was the recipient of the Health Care Hero Award and received multiple WOW designations at Deaconess Hospital in Evansville, Indiana. He has a professional interest in cardiac ablations, prevention and awareness of sudden cardiac death in communities and has been actively involved in cardiac screening for college athletes.

Common reasons to see an electrophysiologist

A cardiac EP can diagnose and treat conditions such as Atrial fibrillation (an irregular, fast heart rhythm in the upper chambers of the heart), Bradycardia (a heartbeat that is too slow), Tachycardia (a heartbeat that is too fast), Ventricular tachycardia ( a particularly dangerous type of very fast heartbeat), Supraventricular tachycardia (characterized by a sudden, very fast heartbeat), Ventricular fibrillation (dangerous fluttering of the heart muscle that doesn’t let it pump blood and can be fatal), sudden cardiac arrest (the heart suddenly stops beating), Long QT syndrome  (a disorder of the heart that can cause sudden arrhythmias) Wolff-Parkinson-White (WPW) syndrome (a condition that causes episodes of a fast heartbeat  caused by an extra electrical pathway in the heart), other arrhythmias (Arrhythmias can be caused by pregnancy, medicine interactions, or metabolic problems)

What is Arrhythmia

In a normal, healthy heart, the upper chambers (the atria) and lower chambers (the ventricles) work together, alternately contracting and relaxing to pump blood. Sometimes the rhythm changes, resulting in an irregular heartbeat — it may becomes too fast (more than 100 beats per minute) or too slow (fewer than 60 beats per minute). Sometimes arrhythmia is caused by an injury from a heart attack. It can also happen in patients who are recovering from heart surgery, have coronary artery disease or valve disorders.

Arrhythmia can also be caused by an imbalance of sodium or potassium, or be the result of  stress. An electrophysiologist can order special tests to confirm arrhythmia and to determine its cause. Once identified, arrhythmia can be treated in a number of way including;

  • lifestyle changes
  • medications
  • invasive therapies if necessary

If medications and lifestyle changes don’t correct the problem, an electrophysiologist may consider catheter ablation. With this procedure a thin tube is inserted into a blood vessel in the groin. A wire is put through this catheter and sent up to the heart. A small part of the heart that is causing arrhythmia is destroyed with radiofrequency energy, restoring normal heart function.

Electrophysiologists work to understand what is causing the disease and and using their vast knowledge and available resources, they work to develop new strategies for treating the condition. They help people with irregular heartbeats manage their condition, and work as a team with other physicians and healthcare providers so patients receive the best care possible.

For more information about the full range of services offered by Northern California Medical Associates, visit the NCMA Health website. To make an appointment with Dr. Bedi, call (707) 573-6199


FountainGrove Cardiology
3536 Mendocino Ave. Suite 200
Santa Rosa, CA 95403
(707) 573-6166 Main Number
(707) 573-6199 Scheduling
Fax: (707) 573-6165

NCMA’s Diabetes Center Receives Prestigious AADE Accreditation

Northern California Medical Associates announces that the NCMA diabetes center under the leadership of Chief Endocrinologist Dr. Yuichiro D. Nakai, M.D. has achieved AADE accreditation through the American Association of Diabetes Educators education program.

Education, an important element of staying healthy with diabetes

Northern California Medical Associates announces that the NCMA diabetes center under the leadership of Chief Endocrinologist Dr. Yuichiro D. Nakai, M.D. has achieved AADE accreditation through the American Association of Diabetes Educators education program. Patients who have diabetes know how challenging it can be to manage the disease. In addition to constantly monitoring the condition and taking medication, reducing the risk for complications is part of the daily routine. Healthy eating, physical activity and managing symptoms while focusing on prevention may seem overwhelming for patients newly diagnosed with diabetes, this is where diabetes education steps in and helps to keep a patient on track.

As a member of the healthcare team, a diabetes educator focuses on making living with diabetes easier. They work with each patient individually to develop a personalized plan to stay healthy, while providing the tools and ongoing support to put that plan into action and make it a routine part of life.

“Most patients will never be “cured” of diabetes,” explains Dr. Nakai, NCMA endocrinologist Diabetes Center Medical Director. “Over their lifetime, most will have and live with multiple diabetes complications (medical, psychological, social, financial, etc.). As a chronic disease requiring both lifestyle and medication therapy, at some point, most will “burn out” on dealing with diabetes daily for at least some period of time.

“One crucial concept in diabetes care is goal-setting and management which comes with the understanding that most patients will experience a greater, cumulative lifetime benefit from setting aggressive goals for their diabetes management early in their diagnosis, rather than waiting to make lifestyle changes until symptoms become a real problem. This means that patients need to be educated in goal setting and promoting safe, yet aggressive early therapies for the disease. This in turn will lead to a lifetime of not only managed diabetes, but a longer, healthier life overall.”

The Educational Guidelines

Diabetes education is now a recognized part of diabetes care and is covered by Medicare and most health insurance plans when it is offered through an accredited diabetes education program such as the newly AACE/ACE accredited NCMA Diabetes Center, which has met vigorous criteria set by the U.S. Department of Health & Human Services.

The AACE/ACE guidelines contain specific processes to assist in choosing therapy of which Dr. Naiki’s recommendations include:

  • Remember that lifestyle modifications first addressed back in 1916 still work and that aggressive lifestyle changes can outperform adding an individual diabetes drug without lifestyle change.
  • Discuss what are likely to be changing individualized diabetes goals over time and provide specific suggested changes to get to those goals. If unable to do so personally due to time or other constraints, refer patients for diabetes and nutritional education.
  • Recognize that most drugs will have benefits and side effects within days so in most circumstances adjustments can be made rapidly. The exceptions that take a little longer for full dose effect include TZDs, weekly incretins and new, longer-acting basal insulins.
  • Scheduled, short-interval, one- to three-month follow-up appointments to specifically address success and side effects of medications may help keep the focus on diabetes and help minimize therapeutic inertia.
  • Try to identify when patients are not ready or able to intensify glucose control early in visits, and then redirect time/effort to other long-term diabetes-related concerns such as foot exams, pushing patients to schedule eye exams, and addressing lipid or blood pressure goals.
  • Refer to an endocrinologist or diabetes specialist when a patient is not meeting individualized goals.

About NCMA Diabetes Center

The NCMA Diabetes Center is under the leadership of Chief Endocrinologist and Diabetes Center Medical Director, Yuichiro D. Nakai, M.D. and offers a multidisciplinary team approach to treatment with diabetic nurse specialist Naya Barretto, FNP-BC, MPH, RN and Jennifer Logan, R.D., C.D.E.

Recognizing that education is the key to prevention as well as proper management of diabetes, NCMA Diabetes Center offers workshops to cover all aspects of diabetes care including diabetic weight management, nutrition, safe exercise for diabetics, glucose meter use, insulin use, carbohydrate exchanges/ carbohydrate counting. One-on-one patient diabetes education and nutritional visits are also offered.

To learn more or to schedule an appointment call 707-578-7530.

High Blood Pressure Substantially Reduced with Low Salt Diet

Low-salt, heart-healthy dash diet as effective as drugs for some adults with high blood pressure
A study of more than 400 adults with prehypertension, or stage 1 high blood pressure, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowers systolic blood pressure — the top number in a blood pressure test — especially in people with higher baseline systolic readings.

A study of more than 400 adults with prehypertension, or stage 1 high blood pressure, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowers systolic blood pressure — the top number in a blood pressure test — especially in people with higher baseline systolic readings.

Results of the randomized clinical trial of the dietary combination, conducted by researchers at the Johns Hopkins University School of Medicine, were published in the Nov. 12 issue of Journal of the American College of Cardiology.

“Our results add to the evidence that dietary interventions are as effective as — or more effective than — antihypertensive drugs in those at highest risk for high blood pressure, and should be a routine first-line treatment option for such individuals,” says Stephen Juraschek, M.D., an adjunct assistant professor at Johns Hopkins and an instructor of medicine at Harvard Medical School.

The Dietary Approaches to Stop Hypertension (DASH) diet, long promoted by the National Heart, Lung, and Blood Institute and the American Heart Association, is rich in fruits, vegetables and whole grains, along with low-fat or fat-free dairy, fish, poultry, beans, seeds and nuts.

While both low-sodium and DASH diets have long been known to prevent or lower high blood pressure, Juraschek says the new study was designed to examine the effects of combining the two diets in adults with early or modest forms of high blood pressure — those considered to be at greatest risk for developing more severe forms of hypertension known to increase the likelihood of stroke, kidney disease, heart attacks and heart failure.

For the study, investigators tested and followed 412 adults, including 234 women, ranging in age from 23 to 76 years and with a systolic blood pressure of 120-159 mm Hg and a diastolic blood pressure between 80-95 mm Hg (i.e., prehypertension or stage 1 hypertension). Fifty-seven percent of the participants were African-American.

At the start of the study, none of the participants was taking antihypertensive drugs or insulin, none had a prior diagnosis of or current heart disease, renal insufficiency, poorly controlled cholesterol levels or diabetes.

Investigators put all participants on the DASH diet or a control diet for 12 weeks. The control diet was similar to that of a normal American diet based on the average macronutrient and micronutrient profile of the U.S. population.

All participants were also fed 50 (low), 100 (medium) or 150 (high) mmol/day of sodium in random order over four-week periods. Fifty mmol/day is equivalent to 1,150 mg of sodium. A teaspoon of salt is equal to 2,400 mg of sodium. A diet that includes 100 mmol/day of salt is equivalent to 2,300 mg of sodium — or nearly a teaspoon of salt. This is the maximum level of sodium intake recommended by the U.S. Food and Drug Administration (FDA) and is thought to reduce the risk for heart disease and stroke.

At the time of the study, according to the National Health and Nutrition Examination Survey, Americans consumed about 150 mmol/day of sodium, which is considered by the FDA to be harmful and may increase a person’s risk for high blood pressure, heart disease and stroke.

Participants were sorted into four groups based on their baseline systolic blood pressure: 120-129, 130-139, 140-149 and 150 or greater baseline systolic blood pressure.

After four weeks, the investigators found that the group with 150 or greater baseline systolic blood pressure on just the DASH diet had an average of 11 mm Hg reduction in systolic blood pressure compared to a 4 mm Hg reduction in those solely on the DASH diet, but whose baseline systolic pressures were less than 130.

When the researchers combined the DASH diet with the low-sodium diet and compared participants’ blood pressures to those on the high-sodium control diet, they found that the group with less than 130 systolic blood pressure at baseline had a 5 mm Hg reduction in systolic blood pressure; the group with 130-139 mm Hg baseline systolic blood pressure had a 7 mm Hg reduction; and the group with baseline systolic blood pressure between 140-149 had a 10 mm Hg reduction.

Most surprisingly, say the researchers, a participant who had a baseline systolic blood pressure of 150 or greater and was consuming the combination low-sodium/DASH diet had an average reduction of 21 mm Hg in systolic blood pressure compared to the high-sodium control diet.

“This is outstanding, it’s huge,” says Juraschek, because it suggests that those at highest risk for serious hypertension achieve the greatest benefit from the combination diet.

To put the potential impact of the findings into context, Juraschek says, the FDA requires any new antihypertensive agent submitted for approval to lower systolic blood pressure by 3-4 mm Hg. Most established medications on the market, such as ACE inhibitors, beta-blockers, or calcium channel blockers, on average reduce systolic blood pressure by 10-15 mm Hg.

“What we’re observing from the combined dietary intervention is a reduction in systolic blood pressure as high as, if not greater than, that achieved with prescription drugs,” says senior study author Lawrence Appel, M.D., M.P.H., professor of medicine at the Johns Hopkins University School of Medicine. “It’s an important message to patients that they can get a lot of mileage out of adhering to a healthy and low-sodium diet.”

The researchers caution that the study did not address effects in people with systolic blood pressure of 160 or greater or in persons with prior cardiovascular disease or medication treated diabetes. Further studies with larger sample sizes are needed to investigate the impact of the low-sodium/DASH diet on these populations.


Journal Reference:

  1. Stephen P. Juraschek, Edgar R. Miller, Connie M. Weaver, Lawrence J. Appel. Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure. Journal of the American College of Cardiology, 2017; DOI: 10.1016/j.jacc.2017.10.011

Read this article on science daily: Johns Hopkins Medicine. “Low-salt, heart-healthy dash diet as effective as drugs for some adults with high blood pressure.” ScienceDaily. ScienceDaily, 22 November 2017. www.sciencedaily.com/releases/2017/11/171122131412.htm.


About NCMA Cardiology

From cardiac catheterization to open-heart surgery, from electrophysiology to rehabilitation and prevention, the Northern California Medical Associates (NCMA) Cardiovascular Services team is dedicated to delivering the highest quality care and the best patient results.  Our professional staff not only maintains its commitment to our patients’ health and well-being but to maintaining a tradition of excellence and expertise in our practice of the most current, innovative treatments in cardiovascular medicine.

The Cardiovascular Services team is comprised of highly skilled physicians, specialists, nurses, and other healthcare professionals dedicated to our patients’ health care needs. Since 1975, the group has focused on sub specialization within cardiovascular health to provide services by the most highly trained and experienced physicians and staff.

NCMA’s services are extensive in the specialties and communities we serve. We provide cardiac care in three counties, with 11 offices, located in Santa Rosa, Petaluma, Sonoma, Fort Bragg, Mendocino, Ukiah, and Lakeport.

When you join NCMA Cardiovascular Services, you enter into a health care partnership that will last you throughout your life.

Find a location near you: www.ncmahealth.com/ncma-services/cardiology

New study reveals: Regret is lasting for many men who undergo traditional prostate cancer treatments

HIFU, an FDA approved precise and targeted therapy for the treatment of prostate cancer, is one of the most exciting new treatments available today.

Responding to a recent review of patient comments spanning two decades Dr. Michael Lazar of California HIFU talks about the importance of informing prostate cancer patients about all available treatment options.

A recent study revealed this month that as they get older, some men who have undergone treatment for prostate cancer come to regret the treatment decisions they made. This study reviewed the survey results of 934 men conducted at intervals of one, two, five, and 15 years after they were treated for prostate cancer. Most of the men (89%) were treated with surgery or radiation. Ultimately, 14.6% of the entire group expressed some regret over treatment results (16.6% of the radiation-treated men, 15% of the surgically-treated men, and 8.2% of the men treated conservatively).

“Luckily today there are more treatment options for men with prostate cancer,” says Santa Rosa Urologist Dr. Michael Lazar, MD of California HIFU. “It is interesting to see that most of the regret expressed by these patients has to do with loss of quality of life due to side effects from treatment including; loss of sexual function, related bowel issues and urinary incontinence. These are the same side effects I hear my patients express concern about as well. This is another reason why new treatments such as HIFU can be a great option for men who have been diagnosed in the early stages, when long term side effects of more radical treatments can potentially be avoided.”

The study results also revealed that regret increased over time, suggesting that when initial concerns over surviving prostate cancer fade, the life altering consequences of treatment become more obvious. Regrets spiked among men who felt they hadn’t been adequately counseled by their physicians before pursuing a particular treatment option, and also among men who were overwhelmed by constantly fluctuating levels of prostate-specific antigen, a blood test used to monitor cancer’s possible return.

“It is imperative that men who are diagnosed with prostate cancer have the tools they need in advance, to help them make an informed decision,” explains Dr. Lazar. “Information is more available now than it was 15 or 20 years ago, and it is easier for cancer patients to educate themselves. It is still important for the doctor to have a comprehensive knowledge of current treatment options, and to share that information openly with the patient. This is the best way to avoid regret.”

Prostate Cancer Treatment Options

There are many prostate cancer treatment options available today. Prostate cancer is usually managed with active surveillance, radiation therapy, surgery to remove the cancerous gland, freezing (cryotherapy), or high intensity focused ultrasound (HIFU). Hormonal therapy is used to only to control cancer that has spread beyond the prostate, or for very elderly patients with a limited life expectancy.

After many years of poor response rates to the usual chemotherapy medicines, an explosion of new therapies are becoming available, specifically for the treatment of prostate cancer. This includes medicines that kill tumor cells directly, stimulate the man’s immune system to attack the tumor, and prevention of the tumor from growing a blood supply, to name just a few. These therapies are for cancers that have spread beyond the prostate and are not treatable with Radiation, Surgery, Freezing, or HIFU.

HIFU: Non-invasive Treatment for Prostate Cancer

HIFU, an FDA approved precise and targeted therapy for the treatment of prostate cancer, is one of the most exciting new treatments available today. It is one of the few that actually reduces the risk of complications caused by surgery and radiation. HIFU uses ultrasound energy, or sound waves, to target and destroy only specific areas of tissue and during the procedure, the sound waves pass through healthy tissue without causing damage. At the focal point of the sound waves (similar to a magnifying glass focusing the rays of the sun to burn a leaf), the tissue temperature is elevated only high enough to destroy the targeted tissue.

“Although recommendations are that men opt to wait and watch when diagnosed with prostate cancer, HIFU is a treatment that is most effective for men who have early stage, localized prostate cancer that has not spread or metastasized outside the prostate,” explains Dr. Lazar.

About Dr. Lazar

Dr. Lazar is part of Northern California Medical Associates (NCMA) and operates California HIFU in Santa Rosa. He is the medical director of HIFU Prostate Services, LLC, a leading provider of minimally-invasive prostate cancer treatments using High Intensity Focused Ultrasound (HIFU). Dr. Lazar is also a clinical partner with HPS with the HIFU San Francisco Surgery Center of Excellence, a state-of-the-art facility that is convenient to hotels and the airport.  For more information about Dr. Lazar, HIFU treatment for prostate cancer visit the HIFU website or to make an appointment call: (707) 546-5553.

 

NCMA cardiologist shares insight on a new study linking high blood pressure to common heart valve disorder

NCMA cardiologist Dr. Noel Santo Domino discusses the latest findings pointing to a clear link between high blood pressure and a life-threatening condition that may be preventable in some cases.

Mitral regurgitation is a term that describes a medical situation where blood backflows into the heart resulting in symptoms such as shortness of breath, tiredness, dizziness and chest pain. “It is generally more common in older adults and can lead to death,” explains Dr. Noel Santo Domingo, MD NCMA cardiologist.

A new study, published in the journal PLOS Medicine, detailed the heart history of 5.5 million adults over 10 years. Researchers discovered that those who were diagnosed with higher blood pressure in early life have a significantly greater risk of developing mitral regurgitation later in life. Mitral regurgitation is a condition which makes the heart less efficient at pumping blood throughout the body and can lead to heart failure in severe cases.

Dr. Noel Santo-Domingo

Mitral regurgitation is a term that describes a medical situation where blood backflows into the heart resulting in symptoms such as shortness of breath, tiredness, dizziness and chest pain. “It is generally more common in older adults and can lead to death,” explains Dr. Noel Santo Domingo, MD NCMA cardiologist.

The crux of this study indicates that mitral regurgitation may in fact, be preventable in patients who are diagnosed early with high blood pressure. “If this is the case, then as cardiologists it becomes our task to encourage those patients that are presenting with high blood pressure to take measures to adopt healthier lifestyle habits – thereby greatly reducing the chance that they will ever develop this deadly and debilitating disease.”

The deadly consequences of mitral valve regurgitation

Mitral valve regurgitation often progresses slowly and is accompanied in the early stages by very mild symptoms. A patient may have no symptoms for years, even decades. Depending on how advanced the disease is when diagnosed, signs and symptoms of mitral valve regurgitation can include:

  • Heart murmur
  • Shortness of breath (dyspnea), especially with exertion or when at rest
  • Fatigue, especially during times of increased activity
  • Heart palpitations (experienced as rapid, fluttering heartbeat)
  • Swollen feet or ankles

A diagnosis of mitral valve regurgitation sometimes happens only after a doctor discovers a heart murmur. In other patients the problem develops quickly and in these cases, the patient may experience a sudden onset and exhibit severe signs and symptoms. In the medical community, mitral regurgitation has been largely considered a degenerative disorder, viewed as resulting from a weakening of the valve over time due to ‘wear and tear’. When viewed as a degenerative disorder doctors generally focus on treatment such as surgery to repair or replace the valve — rather than prevention.

“This new study is exciting and provides hope for many of our patients,” said Dr. Santo Domingo. “It also suggests additional research is needed to determine whether lowering blood pressure — through exercise, diet or blood pressure-lowering drugs – will in fact reduce the risk of the disorder occurring. In the meantime, advising patients who already exhibit signs of high blood pressure to take measures to improve their health will only lead to better outcomes in the long run.”

The deadly ramifications of HBP

High blood pressure (HBP or hypertension) is often called the “silent killer” in that symptoms are very subtle and not always detectible in an otherwise healthy person. In this way it quietly damages blood vessels and leads to chronic health conditions. While there is no absolute cure, medications prescribed by a cardiologist can help, and choosing to pursue healthier lifestyle changes can not only enhance quality of life, it will help to reduce the overall risk of developing heart disease and related symptoms such as stroke, kidney disease and more.

The American Heart Association recommends taking these steps to manage high blood pressure naturally:

  • Eat a well-balanced, low-salt diet
  • Limit alcohol consumption
  • Adopt a routine that includes regular physical activity
  • Maintain a healthy weight
  • Take prescription medications properly
  • Monitor your heart health and know your blood pressure

The best way to find out if a person’s blood pressure is in a healthy or unhealthy range is to get it checked.

About the NCMA Cardiology Team

From cardiac catheterization to open-heart surgery, from electrophysiology to rehabilitation and prevention, the Northern California Medical Associates (NCMA) Cardiovascular Services team is dedicated to delivering the highest quality care and the best patient results. The NCMA Cardiology staff not only maintains its commitment to patients’ health and well-being but also maintains a tradition of excellence and expertise in its practice of the most current, innovative treatments in cardiovascular medicine. To learn more, visit the cardiology section of the NCMA website.

 

 

Today’s Top Doctor Feature: Yuichiro D. Nakai, MD and Dr. Jack Waxman MD

Northern California Medical Associates’ Endocrinologist Dr. Yuichiro D. Nakai, MD and Rheumatologist Dr. Jack Waxman were recently selected as 2017 top physicians in their respective specialties by Sonoma Magazine’s Top Doctors survey.

Sonoma Magazine’s Top Doctor survey was submitted to Sonoma County doctors who were then asked which medical specialist they would most often recommend to a loved one, and more than 300 professionals emerged as top docs in 50 categories of medicine.


About Dr. Nakai

NCMA’s Yuichiro D. Nakai, MD, and his Endocrinology Division in Santa Rosa diagnose and treat hormone-related health conditions by identifying imbalances in the hormone glands of your body system. Through discussion, examination and careful laboratory testing, they work hard to provide comprehensive treatment options for conditions. Dr. Nakai also oversees the NCMA Diabetes Center. To learn more about the Diabetes Center or to schedule an appointment call (707) 578-7530.


About Dr. Waxman

Dr. Jack Waxman of NCMA’s FountainGrove Rheumatology is an expert rheumatologist who is able to provide patients with diagnostics, treatment and management of a full spectrum of rheumatologic health conditions. In addition to general rheumatologic medicine services, treatment of arthritic diseases and fibromyalgia, vasculitis, connective tissue diseases, osteoporosis, bone density scanning and infusion therapy is also available. To learn more call (707) 573-6942 to make an appointment today.

 

NCMA Otolaryngologist Dr. David Quenelle, MD: The connection between antidepressants and tinnitus

Dr. Quenelle discusses the new study by Oregon Health & Science University that reveals why prescription antidepressants may aggravate tinnitus symptoms

People of all ages experience symptoms of hearing loss, including tinnitus and these symptoms can sometimes lead to serious social problems and depression. Researchers at OHSU presented findings this month on a study focused on understanding why a common antidepressant medication may worsen tinnitus symptoms in some patients. Published in the journal Cell Reports, researchers focused on the neuromodulator ‘serotonin’, which is largely considered to be responsible for maintaining mood and social behavior, sleep, memory, appetite and digestion. This study discovered that neurons of the brain known as fusiform cells become hyperactive and hypersensitive to stimuli when exposed to antidepressants that work to elevate serotonin; a situation which may compound symptoms in people who suffer from both depression and tinnitus.

People most at risk of experiencing an increase in tinnitus symptoms are those who take the type of antidepressant classified as selective serotonin reuptake inhibitors (SSRI) which works in the brain by boosting the level of serotonin specifically.

“We have known for some time that prescription medications can damage inner ear hair cells and cause tinnitus,” explains Dr. David Quenelle of Santa Rosa Head & Neck. “Culprits include non-prescription medications like aspirin and acetaminophen taken at high doses. Prescription medication such as certain diuretics and antibiotics are also known to cause or aggravate tinnitus, so it’s not surprising that anti-depressants can also be added to the list.”

Tinnitus in a nutshell

According to the American Tinnitus Association more than 50 million Americans deal with tinnitus every day, often to a debilitating degree, making it one of the most common health conditions in the U.S. More than 20 million people struggle with chronic tinnitus, and 2 million of those report extreme and debilitating symptoms. Veterans are the fastest growing segment of the population suffering from severe tinnitus reportedly affecting more than 900,000 people.

Tinnitus is commonly associated with hearing loss. Onset can stem from a variety of known and unknown causes, including but not limited to neurological damage, excessive ear wax, ear infections, and nasal allergies. The primary symptom of tinnitus is the perception of a persistent buzzing or ringing sound within the ear, not associated with external auditory stimuli.

“Symptoms of tinnitus can be perceived in a range from mild to severe for those who have the condition,” says Dr. Quenelle. “Ironically for some people, it can also lead to depression, making it all the more important that physicians treating patients for depression also screen for hearing loss or tinnitus before prescribing medication.”

Severity of Symptoms

Tinnitus is a medical condition that can have negative consequences on a patient’s overall health and well-being. Even moderate symptoms can interfere with a person’s ability to work and socialize. Most commonly reported symptoms include:

  • Anxiety & Depression
  • A sense of feeling distressed
  • Mood swings
  • Poor concentration
  • Problems sleeping
  • Pain (tinnitus accompanied by hyperacusis)

There may be no medical cures for tinnitus yet, but there are proven devices and treatments that can significantly reduce the symptoms including; hearing aids, biofeedback, electrical stimulation, relaxation therapy, counseling, habituation therapies, tinnitus maskers and hypnosis.

About SRHN Hearing Center

People of all ages experience symptoms of hearing loss, including tinnitus and these symptoms can sometimes lead to serious social problems and depression. SRHN’s Hearing Center’s team of board certified otolaryngologists and experienced audiologists is devoted to finding the best, personalized hearing solutions and providing comprehensive care for all hearing and balance needs. To learn more visit our website or call (707) 523-7025.

 

 

The Hearing Center SRHN

 

Just a Few Extra Pounds Has Big Consequences on Heart Health

NCMA Cardiology expert Dr. Thomas Dunlap on the importance of maintaining healthy weight over time as new study reveals hazards associated with heart health and minimal weight gain.

NCMA Cardiology expert Dr. Thomas Dunlap on the importance of maintaining healthy weight over time as new study reveals hazards associated with heart health and minimal weight gain.Researchers now say that gaining just a small amount of weight can have a negative impact on the structure and function of the heart muscle over time, increasing long-term risk of heart failure. The study tracked a group of 1,262 adults (average age 44) who were originally free from heart disease and other conditions that put them at high risk for heart disease for seven years. Participants underwent MRIs scans of their hearts and multiple body fat measurements at the start of the study and then again seven years later. Scientists discovered that even a five percent weight gain led to an increased risk of thickening and enlargement of the left ventricle.

“We’ve known for some time now that patients who carry extra pounds are much more likely to develop heart disease,” says NCMA cardiologist Dr. Thomas Dunlap. “This study helps to stress the importance of maintaining optimal weight and points out the need to be persistent with an exercise program that will help keep the pounds off.”

One bit of good news from the study was revealed by those who actually lost weight. The participants of that group were more likely to exhibit decreases in heart muscle thickness, resulting in lower risk of heart disease.

“It’s important to take steps to improve heart health before a problem arises,” says Dr. Dunlap. “If maintaining weight at optimal levels can decrease a person’s chances of developing heart disease over time, then making lifestyle choices to improve cardiovascular health will also improve quality of life, while lowering the risk for heart disease. Once symptoms begin to manifest, walking back the clock to earlier levels of cardio health is not always easy, or in some cases; even possible.”

Heart Disease is Serious Business

According to the American Heart Association more than 5 million people in the United States suffer from heart failure, less than 50 percent of those with heart failure live a full five years following diagnosis. The deadly duo of heart disease and stroke are among the most prevalent and costly health complications today. Heart disease or stroke wreak havoc on people’s lives measured in increased medical bills, lost wages and decreased quality of living.

  • 1.5 million heart attacks and strokes occur every year in the United States
  • 800,000 deaths occur from heart disease each year, a total of 1 in every 3 deaths – about the same number as die from cancer, respiratory disease and accidents – combined
  • 150,000 of deaths from heart disease occur in people under age 65
  • $320 billion in health care costs and lost productivity were attributed to heart disease and stroke in 2011

The top five ways to get a handle on heart disease include; managing high blood pressure (talk to your doctor), take up a daily routine of physical activity (at least 20 minutes per day), make an effort to eat whole foods (avoid processed alternatives), avoid excess salt and quit smoking. 

About NCMA Cardiology Services

From cardiac catheterization to open-heart surgery, from electrophysiology to rehabilitation and prevention, the NCMA’s Cardiovascular Services team is dedicated to delivering the highest quality care and the best patient results. The professional staff not only maintains its commitment to patients’ health and well-being but maintains a tradition of excellence and expertise in the practice of the most current, innovative treatments in cardiovascular medicine. For more information, visit the NCMA website.