L.J. Rohan

L.J. Rohan

Certified Gerontologist

Women and Heart Disease, The Facts May Surprise You Part I

January 27, 2020

“Cardiovascular disease is the number one cause of death for men and women in this country,” says Jennifer Haythe, MD, Director of Cardio-Obstetrics, an internist at NYPH/Columbia and co-director of the Women’s Center for Cardiovascular Health at Columbia.”

Before I went back to school, I wouldn’t have known this fact: My first thought, especially for women, would have been cancer, and therein lies a big part of the problem. A 2017 survey conducted by the Women’s Heart Alliance interviewed 1,011 U.S. women aged 25-60 years and collected physician survey data from 200 primary care physicians and 100 cardiologists, as well. The goal of the surveys was “to determine knowledge, attitudes and beliefs regarding heart disease in women.” The results mirrored my own thinking.

Let’s separate the various strands of this knotty problem. First, the researchers found that 45% of women twenty-five to sixty, and 35% percent of women fifty to sixty– that included me—were unaware that heart disease annually kills 500,000 women in the U.S. Add to that, another 15.2 million women, worldwide, who die from the disease every year. Even more surprising– only 13% of Americans know how great a woman’s risk is for developing heart disease. That percentage of awareness falls even more in women with lower levels of education and income, and women of color.

 The next shocking fact: 71% of women almost never discussed heart health with their physicians, assuming their doctors would ask if there were a problem. To further curl your hair, physicians often didn’t or don’t, discuss cardiovascular disease with their female patients because in spending only 17.5 minutes per patient, according to studies, either the patient had a more immediate health issue, or she didn’t fully report her symptoms. This reflects a wholesale lack of interest (or knowledge) in making prevention a priority before a woman experiences symptoms, or worse, has a cardiac incident.

We all have seen someone in a TV show or movie pretending to have a heart attack (usually a man). He clutches his chest, his breath becomes short and shallow, his eyes bug out, and he makes some dramatic yelp as he falls onto the floor, or into a chair, if he’s lucky.

Realistically, heart attacks come in several different flavors and their symptoms vary. Let’s begin with maybe the most dangerous —The Silent Heart Attack.

The symptoms of a silent heart attack can be subtle, and often dismissed as sudden fatigue, nausea, or shortness of breath that occur when exercising or just out and about. Those symptoms disappear when resting, according to cardiologist Suzanne Steinbaum, MD, director of Women’s Heart Health at Lenox Hill Hospital in New York City.

Additionally or differently, especially in women, there might be nontraditional signs like unexplained fatigue, pain or discomfort in the throat, neck, or jaw, or what seems like heartburn — symptoms so mild, they’re barely noticed, or that go completely unnoticed during times of heightened stress.

 The damage from these silent attacks is usually only discovered accidentally while testing a woman’s heart for other reasons. If we have had a silent heart attack, we are 3x more likely to die from heart disease.

One might also experience the following heart attack symptoms:

  • Feeling very full, as though you have eaten a large meal, even if you haven’t eaten recently
  • Followed by feelings of indigestion and a large person sitting on your chest
  • Ribs tightening and becoming short of breath
  • Pain in your right shoulder and arm (not left, as many believe)
  • Pain in the front of your neck and up into your jaw

I suggest you memorize all possible heart attack symptoms. Make a copy and keep it on your phone or pin it on your fridge. I have!

In Part Two of this discussion, I will talk about some empowering choices we can make to keep a heart attack a thing of fiction.

Until next time…Be Vibrant!

Read More

Who Will Care for Us Seniors?

January 20, 2020

Recently, an article appeared in the national press highlighting the shortage of geriatric medical doctors, called Geriatricians, who specialize in the diseases of older people– folks typically sixty-five and over, who suffer from a variety of diseases. Thoughtful friends sent me the article, several asking for my opinion. Today, I would like to offer my opinion in print.

First the really good news: according to the federal model, 70% of people over sixty-five do not see a geriatrician. The 30% who do often fall into the over eighty-five category and suffer from three or more chronic conditions. These statistics tell me that there are millions of fairly healthy seniors out there, and research backs this up. I find these numbers very encouraging, and believe these folks are more aware of healthy practices, and so take better care of themselves. That’s where gerontologists like me, and some MDs, come in because we promote ways to keep the aging body and mind healthy and free of disease. Prevention and retention are the most important words when it comes to getting older. Every time I put fingers to the keyboard my dominant thought is, how can I offer advice, or highlight research, which will help prevent decline and retain or enhance our precious facilities for our entire lives?

The truth is it’s easier to add things, whether they be supplements, healing foods, better self-care, regular sleep, and exercise, and greater attention to filling our lives with joy, especially when we are still quite healthy and mobile, than to fight our way back to health after developing a chronic condition. This, I believe is the future of the best practice of healthcare: preventative choices we can add into our day and so develop deep reserves which will keep us healthy and vibrant as we get older.

Should we need health care professionals, I love the action Dr. Mary Tinetti, Chief of Geriatrics at the Yale School of Medicine endorses by having “geriatricians to serve as ‘a small, elite work force’ who help train whole institutions in the specifics of care for older adults.” These other fields include nurse-practitioners, PAs, and pharmacists, all who become the foot soldiers for geriatricians. This extension of knowledge and care through different avenues will, I hope, serve those 30% well, as these medical professionals add their expertise to that of the geriatric specialists.

Why I like this idea so much stems from the unacceptable stereotype: ageism. The more fields (and the many people in those fields) that embrace and deal with aging, the less ageism will exist. My hope is that one day soon the general public will view aging issues without prejudice, but rather like pediatrics, just another part of human healthcare. With the help of those 70% of seniors who are doing well, the sea change is coming.

Until next time…Be Vibrant!

Summary: January 20, 2020—Geriatricians and Gerontologists

A shortage of geriatric medical doctors, called Geriatricians, who specialize in the diseases of older folks may exist, but the good news is that 70% of seniors do not require specialized care. Trained nurse practitioners, PAs, and pharmacists, can become the foot soldiers for geriatricians. This extension of knowledge and care through different avenues will, I hope, serve all seniors, as these medical professionals add their expertise to that of the geriatric specialists, hopefully decreasing ageism prejudice.

Read More

Downsizing

January 13, 2020

Like many of you, I am guessing, I set aside January (and into February) to get organized both inside and out. Recently, I came across a very interesting book, The Upside of Downsizing: Getting to Enough by Dr. Sara Hart, PhD.

 An issue many of us are facing, or will be in the not too distant future, is moving from the home where we lived the second chapter of our lives (age 30-60+), and where we may have reared our family, and loved many pets. I am not quite there yet, having just turned 60, but I have begun to give it some serious thought. What my husband and I decided to do is to pretend we are moving on December 31, 2020, and go through our house, basement to attic, and get rid of anything and everything that no longer serves us. At the point we do decide to move, the stress of cleaning out and decluttering will not be added to the stress of finding a new home and physically moving. I also think this new dawning decade is a good time to open every cabinet and closet, and take stock. Next, tossing things attached to old energy, will invite fresh energy to revitalize our home and ourselves.

Dr. Hart makes a brilliant opening suggestion: Start decluttering a place that will be easiest for you to clear out and “begin there so you have some ‘wins’ and also keep your energy and spirits up.” I could not agree with her more, so for the Rohans’ that means starting in the laundry room where cleaning supplies, plant stuff, nails, screws, and all manner of hardware, and some strange odds and ends have found their way there.

I found Dr. Hart’s approach, her gentle encouragement, and her honestly at the difficulty she encountered within herself as she parted with beloved heirlooms, refreshing. She spends time talking about the emotional response we might feel at getting rid of a lifetime of objects we love. This is a woman bearing her soul in what can be one of the most painful processes we experience in our life. She constantly asks, ‘How will I know when I have enough?’ I like this question, and along with the mantra of the younger declutter queen, Marie Kondo, I am asking, “Does this bring me joy?” which is helping immensely to clarify my true feeling toward the object I am holding in my hand. This second question actually makes parting with things easier. I can tap into how I really feel about an item, and put it in the give-away pile, even if my mother spent a million hours creating it.

You may be wondering why I am talking about this topic? Because, as we get older, research confirms and seniors agree that downsizing may ramp up the fear of losing control over our lives; possibly creating a downward spiral into feelings of despondency and depression. Cortisol levels become and stay elevated when we feel out of control, allowing illnesses and diseases to take hold easier and hammer us, sometimes all the way into the ground. Exerting control over our lives lowers our cortisol levels and gives us a greater sense of well-being, hence, my idea of decluttering because I want to, way before I have to, so I feel empowered by taking control of my clutter and stuff and deciding thoughtfully to let it go. With our world so fraught with serious issues at the moment, many which I feel helpless to influence, going through and getting rid of some of my accumulated objects gives me a reassuring sense of at least having control over my little patch of the world, and hopefully, making it a better and more serene spot for me and my family.

Read More

Is Your Cruisin' Causing You Bruisin'

January 6, 2020

As I get older, one thing that truly bothers me is how much more easily my skin bruises. Every time my upper arm so much as taps the corner of a cabinet door, or my thigh grazes the edge of a hard chair, I used to end up with a big ol’ purple bruise that could take weeks, even months, to heal. Both these calamities, plus the times I drop something on the top of my foot, like a pot lid, or a book, prompts a wardrobe re-think so the bruise doesn’t show. For someone who is a bit of a klutz, any notions or potions which could shorten the healing time get my full attention.

Those of us in post-menopause suffer the effects of these slight dings to a far greater extent than any other age group. The main reason is the loss of our protective armor of hormones, which, in this case, literally gives our skin an armor-like invincibility to these minor collisions. Without estrogen and progesterone to keep it thick and supple, our skin thins, and becomes much drier. The fat cells in our skin also shrink. Adding to the list of reasons to stay out of the sun and use sunscreen when we are in the sun: ultraviolet light breaks down our collagen and the elastin in our skin. Our blood flow also decreases as we age, and the capillaries—the blood vessels closer to the surface of our skin, become more fragile and can be broken easier, which leads to bruising. Regular exercise can help keep our blood pumping strong, creating a variety of chemical reactions that keep the blood vessel walls stronger than those of non-exercisers. Vitamins C and D, when taken in adequate amounts, help keep these vessels in good shape, as does the spice Turmeric. Talk with your DIFM (Dietitian in Integrative and Functional Medicine), or RDN (Registered Dietitian Nutritionist), about adding these to your regime, if you aren’t taking them already.

These are some of the internal tools to help with bruising, but what can we do when we bang into something and know we are in for a plum- colored spot? After sifting through all the best science, I find it confirms what has become my lickety-split response, I call it my AIE: Arnica gel and Arnica homeopathic tablets* (more on this in a moment), Ice, and Elevation. Here is the scenario: I slam one of my body parts into a non-yielding inanimate something. Ouch! I immediately pop some homeopathic Arnica tablets under my tongue (I am so convinced this works, I carry them in my purse at all times). Next I grab an ice pack from the freezer, if at home, or if I am out I get some ice in a plastic bag, or even a cloth napkin, and ice and elevate the area for twenty minutes. If I am at home, I also apply a nice layer of Arnica gel to the area before I put on the ice pack. If out and about, the Arnica tablets will suffice until I get home and can apply the gel. It is hard to describe my elation the next day when the area is either virtually free of any discoloration, or the discoloration is so slight I don’t have to worry about what I wear. It is important to take the tablets and/or apply the gel once every few hours for the first twenty-four hours, then continue for a few days with the gel, if there is any sign of the mishap.

Now to talk a bit more about Arnica. Several studies in both the US and the UK find applying topical Arnica gel at 20% strength can significantly reduce bruising. A 2016 study published in American Journal of Therapeutics, found that both Arnica gel and homeopathic tablets reduced swelling, inflammation, and bruising without causing issues by interacting with other allopathic or pharmaceutical drugs being taken. Of course, it is always necessary to speak with your nutritional expert before taking homeopathic tablets. While the gel seems to be safe in all cases—just ask. So when next you bang a tender spot, you might give this remedy a try!

Until next time…Be Vibrant!

*“Homeopathy is a medical system based on the belief that the body can cure itself. Those who practice it use tiny amounts of natural substances, like plants and minerals. Homoeopathists believe these stimulate the healing process. It was developed in the late 1700s in Germany. It’s common in many European countries, but it’s not quite as popular in the United States.”

“Though oral homeopathic Arnica is believed to help with bruising, it’s listed as a poisonous plant by the FDA and considered unsafe for oral ingestion. Homeopathy remedies are so diluted that it’s unlikely poisoning will happen. In homeopathy, there’s a belief that the dilution makes the remedy more effective because of how it works on an atomic level. The FDA hasn’t approved any homeopathy remedies such as Arnica, and hasn’t evaluated any remedy for effectiveness or safety. According to the Memorial Sloane Kettering Cancer Center, you should avoid ingesting Arnica if you’re pregnant or breastfeeding, as it can harm the fetus or baby. You also shouldn’t ingest Arnica if you’re on Warfarin (Coumadin) or any blood-thinning medication.”

Healthline.com

Read More

Fourth Quarter Blog Recap

December 30, 2019

October 7, 2019—Straight Answers on Breast Cancer

Claudia Harsh, MD, an expert in the field of women’s medicine, answers questions about the connection between menopause and breast cancer.

October 14, 2019—Great Answers on Breast Cancer Prevention

Once again Dr. Harsh offers thoughtful answers to some of the most pressing questions women have regarding breast cancer.

October 21, 2019—Ninety-Nine Bottles of Beer on the Wall

Two glasses of wine a day may lead to a greater chance of contracting breast cancer, especially in women with a family history of the disease. The good news? Exercise lowers the odds!

October 28, 2019 Foods as Prevention in Stopping Breast Cancer

Regular, focused exercise is the number one breast cancer risk reducer, but making friends with vegetables and cutting back on red meat and processed foods come in second and third.

November 4, 2019 Keeping Your Balance

Keeping your balance throughout your life is an empowering –and do-able goal.

November 11, 2019–Great Remedies For Winter Illnesses

Cold and flu season is one time where non-pharmaceutical remedies excel at bolstering the immune system to efficiently squash symptoms before they evolve into a serious illness. Adding more Vitamin C, D, and zinc to your daily regimen strengthens your immune system and may help you avoid that nasty cold.

November 18, 2019: Raising Our Awareness to Help Prevent 

Exercise, proper diet and rest, social connections, and lowered stress all play huge roles in lowering one’s propensity for developing Alzheimer’s. Learning to play an instrument shows promise, as well.

November 25, 2019 A Gratitude Attitude is Where It’s At

Embracing gratitude makes people physically, socially, and psychologically healthier. Grateful people feel less stress, less anxiety, greater life satisfaction, and better sleep—especially in combination with my Gratitude Meditation: https://apps.apple.com/us/app/gratitude-meditation/id461484572

December 2, 2019–Great Remedies for Winter Illnesses

 Herbs and dietary supplements — one area where non-pharmaceutical remedies excel at bolstering the immune system to efficiently squash symptoms before they evolve into a serious illness. The qualities of Vitamin C, zinc, and Vitamin D are covered in this post.

December 9, 2019–Get Hygge, Be Happier!

Hygge, pronounced “hoo-gah” is a Danish term defined as “a quality of coziness and comfortable conviviality that engenders a feeling of contentment or well-being.” (The Little Book of Hygge).  This superior Scandinavian practice has no direct translation in English, but “cozy and comfy” comes close. Find time, especially during busy holiday seasons, to recharge, reflect, reorient, and revive, in other words, find time to hygge!

December 16, 2019—Some Ideas for Bringing In 2020

The year 2020 seems especially auspicious, being the sequential year of the century, and the beginning of a new decade.  I offer a winning, triple-play suggestion to bring in the New Year—combining exercise, a personal commitment to oneself, and being fully present.

December 23, 2019—A Plan for 2020

Regular exercise boosts our testosterone, lengthens our telomeres, and helps our adrenals make more estrogen. These actions allow our brains to fire on all fronts and our memory banks to stay as crisp as a cracker. They also give us a greater sense of well-being, help us feel less irritable and more balanced, and contribute to our sexual comfort and desire. Move it to keep it should be our theme for 2020!

December 30, 2019—Fourth Quarter Recap

Read More