Live Well Wednesday

Maintaining a Healthy Heart

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At Compass Community Health Care Center we are dedicated to providing the best health care possible. We are listening to our patients, families, and community with their health concerns and questions. Watch for #LiveWellWednesday posts each Wednesday evening, which focus on giving you the information and tips you need to understand current health care concerns and topics.

Today’s topic is Maintaining a Healthy Heart, by Paul (PJ) Adkins, Compass Community Health Care Center Family Nurse Practitioner.

In honor of February being Heart Health Month, we will be highlighting heart health issues and topics all this month during our #LiveWellWednesday posts. Be sure to check back each Wednesday in February for more information from Compass Community Health Care Center Family Nurse Practitioner, Paul Adkins.

Heart health should not only be a topic of concern for February, but year round. I would like to encourage all of you to begin making small changes in your lifestyle to make heart health a priority.

Atherosclerotic heart disease is an accumulation of cholesterol deposits and plaques inside the coronary arteries. Theses plaques can limit blood flow resulting in a heart attack or stroke.  Smokers can develop coronary disease in tiny vessels that are not able to be stented or intervened upon with angioplasty.  Coronary microvascular heart disease causes chronic chest pain and recurrent shortness of breath and  is more common in women than men, but cigarette smoking is typically the main cause of disease in the tiny coronary vessels.  I encourage all smokers to quit and many resources are available to help people quit.

Routine medical provider visits should be made or kept for check-ups and screenings to set health goals to prevent heart disease. EKG’s, blood pressure check, cholesterol check, screening for diabetes, and physical assessment of your heart sounds are important screenings for all adults.

Exercise should be part of your daily routine. Walking fifteen to twenty minutes continuously everyday is a reasonable goal. Thirty minutes of exercise five days a week is  now recommended.

Your diet and cooking routines should incorporate using less salt, less saturated fats, lower carbohydrates, and lean meats. Foods to limit are red meat, full-fat dairy products, deep-fried foods, bakery products, packaged snacks, chips, cookies, and margarines.

Medications should be taken as prescribed; especially medications for high blood pressure, diabetes, and high cholesterol.

Smoking cessation should be a key focus of heart health as well since it can greatly reduce your risk for heart attack or stroke.

The blood pressure goal should be less than 130/80 mmHg if you are 60 years old or less and less than 140/90 if you are greater than 60 years old.

A lower A1C will lower your risk of heart disease. Diabetics should aim for an A1C less than 6.5 while non-diabetics should aim for an A1C less than 6.0.

Everyone should be aware of there cholesterol numbers as elevated cholesterol increases your heart disease risk. Total cholesterol should be less than 200, HDL(good cholesterol) should be greater than 40, LDL (bad cholesterol) should be less than 130 in patients without coronary disease and less than 70 in patients with coronary disease, triglyceride levels should be less than 150.

Medications like aspirin, plavix, brilinta, and effient are important trio continue taking after cardiac stents are placed as they help keep the stents from clotting off. Patients should not stop these medications without talking to their cardiologist first.  Cholesterol and blood pressure medications are crucial in maintaining heart health in those patients with coronary disease and help prevent coronary disease in those with known risk factors.  Risk factors include smoking, high cholesterol, strong family history, diabetes, obesity, and sedentary lifestyle.  Maintaining a healthy weight is important as obesity can lead to metabolic syndrome processes like high blood pressure, diabetes, and high cholesterol which greatly increase your risk for developing heart disease. Getting good quality sleep on a routine basis will help keep your heart healthy as sleep deprivation leads to other medical issues. Regular dentist check-ups and cleanings are important as dental abscesses can result in heart valve infections.  Poor dental hygiene is also known to lead to diabetes.  Limit your stress and stay active. Daily fitness trackers like Fitbits can help you assess your steps and daily activity.

We look forward to seeing you at your next appointment or as a new patient to discuss your heart health, setting health goals, and developing a game plan to keep your heart healthy. You owe it to your heart to at least have a yearly check-up with screenings.

For additional information on this topic check out the American Heart Association at www.heart.org or to schedule an appointment with one of our providers, please contact our office 740-355-7102.

#LiveWellWednesday                 #CompassCares

Live Well Wednesday

Endocarditis

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At Compass Community Health Care Center we are dedicated to providing the best health care possible. We are listening to our patients, families, and community with their health concerns and questions. Watch for #LiveWellWednesday posts each Wednesday evening, which focus on giving you the information and tips you need to understand current health care concerns and topics.

Today’s topic is Endocarditis, by Paul (PJ) Adkins, Compass Community Health Care Center Family Nurse Practitioner.

In honor of February being Heart Health Month, we will be highlighting heart health issues and topics all this month during our #LiveWellWednesday posts. Be sure to check back each Wednesday in February for more information from Compass Community Health Care Center Family Nurse Practitioner, Paul Adkins.

Today’s article is about bacterial endocarditis which is an infection of the heart’s endocardial surface and typically involves an infected heart valve.  Infection or vegetation on more than one of the valves can sometimes occur as well.  A fever is the most common patient symptom.  Some other common symptoms include chills, night sweats, cough, pleuritic chest pain, shortness of breath, malaise, headache, joint pain, and weight loss.  A murmur is often heard in patients with endocarditis as well.  Two common risk factors for endocarditis are untreated dental abscesses and intravenous drug use.  Patients who are immunosuppressed and patients with indwelling central venous catheters are at an increased risk for endocarditis too.  Patients with prosthetic joint replacements and those with valve replacements are also at an increased risk.  Many patients with predisposed risk factors like joint replacements and moderate murmurs may need to take antibiotics prophylactically prior to having dental work done.

Endocarditis is an infection that can result in other problems like valvular insufficiency, heart failure, stroke, sepsis, septic emboli, and other infections throughout the body.  Staphylococcus and streptococcus organisms are two common bugs that can cause endocarditis.  However, other atypical organisms can lead to infection of the heart’s endocardial surface as well.  Lab findings consistent with endocarditis can often include an elevated white blood count, an elevated sedimentation rate, an elevated C reactive protein, anemia and positive blood cultures.  EKGs can reveal heart block or conduction delays with endocarditis.  Chest xrays can help rule out heart failure.  Surface echocardiograms are often the first test that clearly identifies that endocarditis exists by allowing visualization of the heart valves.  A transesophageal echocardiogram (TEE) is often done if there are suspicious findings on a regular surface echo because a TEE can allow for better visualization of the heart valves.  In some cases, cardiac MRI is even performed for better visualization of the heart.  The aortic valve and mitral valve are routinely the most common valves that are involved, but the pulmonic and bicuspid valves can sometimes become infected.

The mainstay treatment for bacterial endocarditis is long term intravenous antibiotic therapy.  Six weeks of antibiotics through a PICC line is often recommended and follow up with an infectious disease physician and cardiologist is incorporated in the plan of care.  A repeat TTE, blood cultures, and blood work will often be performed after the antibiotic course has been completed.  Patients with complicated infections who do not improve or worsen clinically may end up needing valve replacement surgery.  Patients who develop sepsis and become critically ill from bacterial endocarditis can develop multi-system organ failure and even die.  Valvular disorders can remain years after the infection resolves in some patients along with long standing heart failure.

Patients should seek medical care right away if they have had a fever that lasts many days or if they have developed any of the symptoms mentioned above.  Prevention of endocarditis should involve routine dental checkups, avoiding intravenous drug use, seeking care for any signs of infection, and routine health maintenance with well checkups.  Take good care of your heart and maintain a healthy lifestyle.  Prevention and maintenance can go a long way in helping you stay healthy and potentially avoid heart problems.

For additional information on this topic check out the American Heart Association at www.heart.org or to schedule an appointment with one of our providers, please contact our office 740-355-7102.

#LiveWellWednesday                 #CompassCares

Live Well Wednesday

Defining Heart Failure

PJ THP_2550_pp.JPGAt Compass Community Health Care Center we are dedicated to providing the best health care possible. We are listening to our patients, families, and community with their health concerns and questions. Watch for #LiveWellWednesday posts each Wednesday evening, which focus on giving you the information and tips you need to understand current health care concerns and topics.

Today’s topic is Defining Heart Failure, by Paul (PJ) Adkins, Compass Community Health Care Center Family Nurse Practitioner.

In honor of February being Heart Health Month, we will be highlighting heart health issues and topics all this month during our #LiveWellWednesday posts. Be sure to check back each Wednesday in February for more information from Compass Community Health Care Center Family Nurse Practitioner, Paul Adkins.

Heart failure is a very common condition that we routinely see in primary care.  Today’s article will define the symptoms, causes, and treatment options involved in heart failure.  Common symptoms of heart failure include shortness of breath with exertion, weight gain, lower extremity swelling, abdominal swelling, inability to lie completely flat without getting short of breath, fatigue, and sometimes a chronic dry cough.  These symptoms of heart failure can be caused by a multitude of clinical problems.  Some of the problems that can result in heart failure commonly include ischemia or blockage from coronary artery disease, heart attacks, viruses resulting in viral cardiomyopathy, stress of pregnancy in some cases, valve disorders, certain chemotherapy agents, untreated hypertension,  severe untreated sleep apnea, prolonged stress (broken heart syndrome), and sepsis or shock.  Any insult that renders the left ventricle to become weaker can result in heart failure.  The importance of taking care of yourself is in your heart’s best interest.

The left ventricle is essentially the main pumping chamber of the heart.  The left ventricle’s squeezing  function is measured through an ultrasound called an echocardiogram to assess the ejection fraction.  A normal ejection fraction should be greater than 55%, so a reduced ejection fraction indicates a weak pump.  Systolic heart failure is defined as an ejection fraction less than 55%.  The left ventricle can also become enlarged (dilated) and stiff resulting in diastolic dysfunction and diastolic heart failure. In patients with diastolic dysfunction, the left ventricle has decreased or impaired relaxation abilities.  The impaired relaxation can result in a decrease of blood filling.  The left ventricle can only pump what it fills up with, so a decrease in filling means a decrease in the amount of blood pumped with each squeeze.  Congestive heart failure refers to being “congested” with fluid overload which is a common in severe systolic heart failure.

Treatment options for heart failure commonly begin with low salt diet as salt causes people to retain water, fluid restrictions or fluid balance, heart healthy diet, exercise, adequate sleep and taking medications as scheduled.  Weighing yourself everyday is also important as gaining more than 3 pounds a day or more than 5 pounds in a week can be a sign of fluid overload.  Inability to lie flat without becoming increasingly short of breath and lower extremity swelling are also indicates of fluid overload.  ACE inhibitors like Lisinopril and angiotension receptor blockers like losartan are commonly used to help treat heart failure. Beta blocker medications are also commonly used.  These medicines help the heart squeeze and relax.  In some cases, maintaining medication therapy can improve a person’s ejection fraction over time and that can be reassessed with an ultrasound.  Diuretics or water pills like Lasix or aldactone are often used for patients who are fluid overloaded.  A balance of the correct salt intake, such as less than 4gm of sodium a day is important.  Adherence to medication therapy is equally important and monitoring your symptoms should not be overlooked.

Patients with advanced heart failure often require inotropic agents via IV to help improve their hearts pumping function.  These medications include dobutamine and milrinone.  Recurrent admissions to the hospital and IV Lasix or bumex is often used to assist with getting the excess fluid off.  Kidney function and electrolytes like potassium and magnesium have to be monitored closely when patients are on aggressive diuretic medications.  Ultrafiltration is a process that is also sometimes used to remove salt and water.  This process is similar to dialysis, but does not require a permanent dialysis catheter.  Left ventricular assist devices (LVADS) or heart transplants are the last resort options in those with end stage heart failure.
For additional information on this topic check out the American Heart Association at www.heart.org or to schedule an appointment with one of our providers, please contact our office 740-355-7102.                  #LiveWellWednesday #CompassCares

Live Well Wednesday

Hope for Cervical Health

Megan Whisman.jpgAt Compass Community Health Care Center we are dedicated to providing the best health care possible. We are listening to our patients, families, and community with their health concerns and questions. Watch for #LiveWellWednesday posts each Wednesday evening, which focus on giving you the information and tips you need to understand current health care concerns and topics.

Today’s topic is Hope for Cervical Health by Megan Whisman, Compass Community Health Care Center Family Nurse Practitioner.

In honor of January being Cervical Health Awareness month, we will be highlighting women’s health issues and topics all this month during our #LiveWellWednesday posts. Be sure to check back each Wednesday in January for more information from Compass Community Health Care Center Family Nurse Practitioner, Megan Whisman.

To wrap up our series on Cervical Health Awareness Month, Compass Community Health Care Center would like you to know that’s so much you can do to prevent cervical cancer.

HPV (human papillomavirus) is a very common infection that spreads through sexual activity. About 79 million Americans currently have HPV, but many people with HPV don’t know they are even infected. HPV is also the main cause of cervical cancer. Each year, more than 12,000 women in the United States get cervical cancer.

The good news?
• The HPV vaccine (shot) can prevent HPV.
• Cervical cancer can often be prevented with regular screening tests (called Pap tests) and follow-up care.
• In honor of National Cervical Health Awareness Month Compass Community Health Care Center, encourages:
• Women to start getting regular Pap tests at age 21
• Parents make sure pre-teens get the HPV vaccine at age 11 or 12
• Teens and young adults also need to get the HPV vaccine if they didn’t get it as pre-teens. Women up to age 26 and men up to age 21 can still get the vaccine.
• Thanks to the health care reform law, you and your family members may be able to get these services at no cost to you. Check with your insurance company to learn more.
• Taking small steps can help keep you safe and healthy, make your appointment today to get your annual exam.

For more information on cervical cancer visit:

https://www.cdc.gov/…/res…/features/CervicalCancer/index.htm

https://www.cancer.gov/types/cervical

News & Events

Ed Hughes Retiring After 27 Years

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Ed Hughes, CEO of Compass Community Health Care Center, is retiring after 27 years of dedicated service. Ed is passionate about people and the love he has for his community is endless. We wish him the best of luck and will cherish the impact he has had on the many lives he touched.

If you look up the word “fixture” in the dictionary, it has two different definitions – “something securely, and usually permanently, attached or appended, as to a house, apartment building, etc.” or “a person or thing long established in the same place or position.” One would be hard pressed to not find Ed Hughes, Executive Director of Compass Community Health Care in either of those definitions.

Continue to the full Portsmouth Daily Times article by clicking here.

 

News & Events

Operation Gratitude 2016, A Huge Success

large-group-photoThank you to our community volunteers for joining us to honor our area veterans!  We were able to provide food bags for 100 local veterans.

It takes a community to make a project successful and Compass Community Health utilized that model when they honored area veterans Friday. Volunteers from many local organizations including RSVP, Compass Community Health, the Ohio Valley Chapter of the Red Cross, Ohio State University Extension Office, Shawnee State University’s Rotaract Club, Kathleen Young Southeastern Ohio liaison for Governor John Kasich’s Office, Congressman Bill Johnson, Pleasant Green Baptist Church, United States Daughters of 1812, the Portsmouth City Health Department, ADAHMS Board, Community Action Organization, Potters House Food Pantry and others, distributed donated food items to more than 115 local veterans in honor of Veterans Day.

For full Portsmouth Daily Times article click here.