Thursday, February 15, 2018

7 tips for a healthy heart

Author: Dr. Martha Whyte, regional medical director for Region 7

According to the American Heart Association, in 2015, almost 13,000 Louisiana residents died of heart disease or stroke. Having high blood pressure puts you at high risk for cardiovascular disease, and managing high blood pressure is a lifelong commitment.

More than 29 Louisianans die from heart disease every day, making it the state’s number one killer. Louisiana also ranks fourth in the nation for stroke death rates.

Heart disease is usually caused when plaque builds up in the walls of the arteries. The build-up narrows the arteries, making it hard for blood to flow through. Sometimes, blood clots form, completely stopping blood flood. This can cause a stroke.

High blood pressure, or hypertension, increases your heart’s workload by quietly damaging your blood vessels and arteries over time. It is the leading cause of stroke.

One in every three adults has high blood pressure, and only about half of them have their blood pressure controlled which could lead to costly health complications, including heart attack and stroke. Many are unaware of their hypertension, as it frequently causes no symptoms, even when extremely elevated.

Get Screened

Blood pressure screening and treatment reduces the risk of heart disease, heart attacks, and stroke. This, in turn, has a positive impact on reducing the overall cost of healthcare.

On average, a heart attack costs $94,500 in the first year of treatment and $74,000 every year after. Strokes are even more expensive; $122,000 in the first year and $75,000 every year after.

In Louisiana, Medicaid expansion has made it possible for thousands to see doctors resulting in early diagnoses and treatment that has saved lives. And as shown above, there is a corresponding savings to the health care system when the focus changes from treatment to prevention.

Reduce Your Risk

There are a number of ways that you can stay healthy and lower your risk of having a heart attack or stroke or suffering from heart disease.

At the top of the list is eating a healthy diet, but eating health doesn’t mean sacrificing the foods and flavors you love. You can modify your diet in a way that will have your heart pumping for joy by:
  • Eating more poultry, fish, nuts and beets and less red meat. When purchasing meat, choose a lean cut and limit portion size.
  • Choosing low-fat or fat-free dairy products
  • Picking fresh or frozen fruits and vegetables instead of canned and processed fruits and vegetables, which contain added salt and sugar.
  • Selecting breads, pasta and other carbohydrate-rich foods that are made from whole grains.
  • Switching from butter to olive, canola, soybean, peanut, corn or safflower oils for cooking.
  • Choosing low-sodium foods whenever possible. Using herbs and spices to flavor foods instead of salt.
  • Cutting back on foods and beverages with added sugars. For example, eat fruits instead of drinking fruit juices.
  • Modifying your favorite recipes so that they contain less fat and calories.
A link that may help guide your choices is

Maintaining a healthy weight can also lower your risk for heart disease. Being overweight or obese can increase your risk for heart disease. To determine whether your weight is in a health range, doctors often calculate a number called the body mass index. Doctors sometimes also use waist and hip measurements to measure a person’s excess body fat.

If you know your weight and height, you can calculate your BMI with the Centers for Disease Control and Prevention’s Assessing Your Weight website.

Exercising regularly can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends that adults should engage in moderate-intensity exercise for at least 30 minutes on most days of the week.

For more information, see the CDC’s Nutrition and Physical Activity Program website.

Don’t smoke. Cigarette smoking greatly increases your risk for heart disease. So, if you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.

Limit alcohol use. Drinking too much can cause high blood pressure. It can also add calories and cause weight gain. 

Reduce stress and get plenty of sleep: Both of these are important to reduce your risk for obesity and high blood pressure.  If you are stressed and not sleeping adequately, you tend to drink, eat and stress more! Exercise, take time to decompress before you got to bed by reading or listening to music, no television when trying to sleep, and let your doctor know if you are unable to accomplish your goals. 

Seeing your primary care physician regularly is also an important step is protecting yourself from heart disease. Many other diseases, such as Diabetes, can also contribute to heart disease development. High blood sugar can lead to damage to your blood vessels and nerves to your heart leading to risk of stroke and heart attack.  Seeing your doctor for all regular screenings, such as cholesterol and blood sugar, will help lower your risk for damage to your heart and other vital organs.

For more information on the prevention and management of heart disease and stroke, visit Well-Ahead Louisiana’s resources page to increase awareness of hypertensions among patients and implement quality improvement processes.

Thursday, February 8, 2018

Vaccines are Important for Adults

Author: Dr. Frank Welch, Medical Director, Immunization Program

You may remember trips to the doctors to get your immunizations throughout your childhood, but you may not realize that you need vaccines throughout your adult life as well. Vaccines are still important for your good health and are one of the safest ways to protect it.

One of the greatest technological developments in history, immunizations are so effective at preventing and eradicating disease that many Americans have never seen a single case of mass killers of the past, such as smallpox and polio. However, despite their effectiveness, more than 40,000 American adults die each year from diseases that can be inexpensively and effectively prevented by immunization. Infants, older adults, and people with weakened immune systems are especially vulnerable to vaccine preventable diseases.

Working with your body’s natural defenses, vaccines lower your chances of getting sick and spreading certain diseases. Side effects from immunizations are usually mild and go away on their own, and severe side effects are rare.

Some of the most common adult vaccines are for the flu and tetanus. A flu shot is recommended every year and your Td/Tdap shot should be boosted every 10 years. This shot protects against tetanus, diphtheria, and Whopping Cough. Click here for more information about different adult vaccines.

Despite concerted efforts to promote annual influenza vaccination in older adults, persistent knowledge gaps exist regarding the burden of disease and the risk of flu and related complications, especially for people age 65 and older.  

That said, awareness of the consequences of vaccine-preventable disease influences vaccination behavior. Rates of herpes zoster (Shingles) vaccination increased among people who witnessed friends or family members experience the disease, particularly if severe.

Vaccine protection wanes over time, and there are a number of other risk factors that could heighten your chances of getting sick. Your age, job, lifestyle, travel, and health conditions are all factors that could determine the vaccines you need as an adult. Check with your doctor about your current immunizations during your annual check-up.

In addition to the preventing the flu, immunizations prevent serious diseases, such as, pneumonia, tetanus, pertussis (Whopping Cough), Herpes Zoster (Shingles), Human Papilloma Virus, Hepatitis A and B.

Adults can get vaccines at doctors’ officers, pharmacies, Urgent Care facilities, federally qualified health centers, and parish health units.

Uninsured and underinsured adults are eligible for vaccination at parish health units. Most health insurance plans cover the cost of recommend vaccines. Check with your insurance provider for details and for a list of vaccine providers.

Don’t wait until you know someone who’s ill. Protect your health and the health of those around you by getting the recommended vaccines based on your age and health conditions.

To see a list of vaccines you may need, take the Louisiana Department of Health’s Adolescent and Adult Immunization quiz.

For more information on immunizations, click here.

Monday, February 5, 2018

Debunking the Flu Vaccine Misconceptions

Author: Dr. Frank Welch, Medical Director, Immunization Program

Being vaccinated against the flu, particularly in active seasons like this one, is the best way to protect yourself and those around you against getting sick. However, the talk of vaccines also brings all the misconceptions about vaccines back to the surface.

The flu vaccine remains the safest and most effective way to protect yourself and those around you from the flu. In the most severe seasons, the flu causes approximately 700 deaths and nearly 8,000 hospitalizations each year in Louisiana. The 2017/18 flu season is on pace to meet and possibly exceed those statistics.

The Louisiana Department of Health has actively been promoting the flu shot for the past several weeks. Although the response for this responsible public health/flu prevention tactic has been overwhelmingly positive, some people still talk nonsense and spread misinformation. Here are the answers to a few of the many myths and misconceptions about the flu  vaccines that have appeared on our social media pages.

If I take the flu shot, I will get the flu.

Many people fear that they will get the flu if they are given the flu vaccine, but it is absolutely impossible for the flu shot to give you the flu. Flu vaccines given with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been ‘inactivated’ and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). The most common side effects from the influenza shot are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur.

The shot isn’t effective in preventing the virus.

The flu shot is not perfect, but it does protect against, and minimize many complications of the flu.
There are many different flu viruses and they are constantly changing. Because of this, the composition of the U.S. flu vaccines is reviewed annually and updated as needed. According to the Centers for Disease Control and Prevention, flu vaccines protect against the three or four viruses that research suggests will be most common. For 2017-18, three-component vaccines are recommended to contain protections against:
  • ·        H1N1
  • ·        H3N2
  • ·        B/Victoria lineage virus

There are also four-component vaccines that protect against a second lineage of B viruses.

I got the flu shot and I still got the flu.

It’s possible to get sick with the flu even if you have been vaccinated. This is possible for a few reasons.

·        You may have been exposed to a flu virus shortly before getting vaccinated or during the period (two weeks after vaccination antibodies that provide protection develop in the body) that it takes to gain protection after getting vaccinated, resulting in you becoming ill with the flu before the vaccine begins to protect you.

·        You may have been exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. The flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.

·        Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, the flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.

·        You may be sick with a virus or bacteria that is not the flu. These other germs circulate more in the winter along with the flu virus and are sometimes confused with the flu.

The vaccine is only 10 percent effective.

The 10 percent vaccine effectiveness figure was an interim estimate of the vaccine’s benefit against one flu virus (H3N2) that circulated in Australia during its most recent flu season. In the United States last season, overall vaccine effectiveness against all circulating flu viruses was 39 percent. Estimates of the flu vaccine’s effectiveness against circulating flu viruses in the United States this season will be available later in the season but are expected to be significantly higher than 10 percent, and more likely in the 35-60% effectiveness range.

The flu shot is not safe for pregnant women or newborns.

With rare exception, an annual flu vaccine for everyone six months of age and older, including pregnant women and people with medical conditions. Vaccine providers should be aware of the approved age indications of the vaccine they are using and of any precautions. People getting vaccinated should also be screened for allergies as those with severe allergic reactions should not be vaccinated.

For a complete list of those who should speak with their doctor before getting vaccinated, refer to this list.

The mercury in vaccines causes autism.

There is no evidence that vaccines cause autism. Thimerosal, a mercury-based preservative, is used in trace amounts in vials that contain more than one dose of a vaccine to prevent germs, bacteria and/or fungi from contaminating the vaccine. Multi-dose flu vaccines contain thimerosal. However, scientific research does not show a connection between thimerosal and autism, and it has shown to be safe when used in vaccines.

Measles, mumps and rubella vaccines do not and have never contained thimerosal. Varicella, inactivated polio, and pneumococcal conjugate vaccines have also never contained thimerosal.
Flu vaccines are available in both thimerosal-containing and thimerosal-free versions.

For a complete list of vaccines and their thimerosal content, click here.

The Louisiana Department of Health recommends that everyone who has not received a flu vaccination to do so as it is the best way for you to protect yourself, your family, and the people around you. For more information on the flu, visit

Monday, January 29, 2018

Tips to Keep Your Super Bowl Party’s Meal Safe

Author: David J. Holcombe, M.D., M.S.A., Regional Medical Director, Region 6 (Alexandria Region)

It’s almost time for the Super Bowl, and like all big events, that means it’s time for a party. And where there’s a party, there’s plenty of food. And since most of us don’t serve large meals often, there’s a greater potential for food contamination. The Louisiana Department of Health warns it’s important to be wary of food borne illnesses and take precautions to keep yourself and all of your party-goers healthy this Super Bowl Sunday.

Food borne illnesses are frequent, affecting well over 48 million people in the U.S. each year. Such illnesses are also a significant cause of sickness and result in over 128,000 hospitalizations and 3,000 deaths annually as reported by the CDC. The older and sicker (or younger) the patient, the more likely they are to have a tragic outcome.

In addition to Salmonella, other illnesses related to food include E.coli, Shigella, Hepatitis A, Listeria and Norovirus. These are all common causes of food poisoning, sickening millions of people annually in the U.S.

Food borne illnesses are caused by a great number of agents including viruses, bacteria, vibrios and others. Sometimes it is a situation where the food itself contains the toxins, while at other times the illness is caused the growth of the bacteria (such as Salmonella) within an infected person. In any case, the symptoms usually include fever, nausea, vomiting, abdominal pain and diarrhea, sometimes explosive and even bloody.

Protect Yourself
As you prepare your Super Bowl meal, the goal is to keep germs from finding their way into your food. To keep your foods safe during preparation and as you serve items, put these tips in your playbook. This will ensure that a case of food poisoning doesn’t put a damper on your party.
  • Don’t leave food in a hot car.
  • Keep your kitchen clean, especially cutting boards, sponges and knives.
  • Make sure your refrigerator is 40 degrees and your freezer is zero.
  • Cook red meat to 160 and poultry to 180 degrees F.
  • Never leave perishable foods out of the refrigerator for more than TWO HOURS.
  • Keep cold party foods on ice.
  • Heat leftovers to 165 degrees and keep them above 140 F.
  • Put hot foods into small units for rapid cooling.
  • If it looks strange or smells strange, throw it out.
  • Wash your hands before, during and after food preparation.

The Top 10 Causes of Food Poisoning
Viruses, especially noroviruses, cause about 63 percent of all cases.  Noroviruses are the culprits in the infamous cruise ship outbreaks of diarrhea and are also responsible for the periodic closures of some Louisiana oyster beds. It requires very few viruses to cause an infection and the transmission potential is staggering, often affected an entire cruise ship in a matter of days. Noroviruses can also spread through an entire nursing home or other institution in a very short time.

Next is Salmonella, causing about 20,500 infections occurring every year in Louisiana with nearly all caused by food-borne transmission. Salmonella, like Escherichia coli, Shigella, Listeria and Campylobacter (all also among the top 10 culprits), invades the intestinal wall and causes significant fever, abdominal pain and diarrhea. Symptoms are preceded by an incubation period lasting anywhere between six hours to three days, with symptoms lasting up to week. Poultry products (including the annual holiday turkey) are particular culprits since up to 90 percent of chicken carcasses are contaminated with Campylobacter and around 20 percent with Salmonella and Listeria. Turkeys and chickens share similar germs (as do some reptiles).

Other agents include Clostridium perfringens (as was identified in the recent Louisiana incident), Staphylococcus aureus and Bacillus cereus. All three of these produce toxins, the former after being ingested and the latter two prior to being ingested. In other words, with Staph and Bacillus, the poison is already in the food before you take a bite, while Clostridium perfringens produces it in your gut. In any case, victims get sick in a few hours after eating the food, often prepared and stored under improper conditions for that Super Bowl shindig, but usually get better within a few days.

Rounding out the top 10 are Vibrio parahaemolyticus and its close cousin, Vibrio vulnificus, both saltwater organisms. Vibrio Parahaemolyticus (causing about 45,000 cases a year) is often associated with partially cooked shrimp, and can cause an unpleasant episode of diarrhea.

Vibrio vulnificus is found in raw oysters, another holiday favorite and causes about 100 cases a year. While most people can eat oysters with relative impunity, those with severe liver disease run a life threatening risk with Vibrio vulnificus.

Thursday, January 25, 2018

Louisiana Dept. of Health Secretary Rebekah Gee: Sen. Sharon Hewitt prescribes wrong approach to fixing Medicaid

Author: Dr. Rebekah Gee, MD, MPH, secretary of the Louisiana Department of Health

Gov. John Bel. Edwards and I have long believed in smart, innovative policies that engage Medicaid recipients in their communities, either through job opportunities, volunteering or skill improvement and education. We believe that a healthier workforce is a more productive workforce. I know business leaders agree. Once we improve people’s health, we can better expect them to engage in their communities in a productive manner.

Recently, state Sen. Sharon Hewitt offered suggestions for the state’s Medicaid expansion. Unfortunately, despite her admirable interest in evidence-based policy, she prescribes the wrong approach to inspiring work opportunities for the people of Louisiana.