September is Atrial Fibrillation (AF) Awareness Month, which reminds us that even in the midst of the pandemic, cardiovascular and other diseases progress unabated. As a result, we welcome this opportunity to review some of the important approved developments in AF therapeutics and assess their validity when subjected to scientific scrutiny.
Potential complications of both surgery (carotid endarterectomy or CEA) and conventional stenting (accessed from the groin) for stroke prevention in patients with carotid artery disease occur during or after the procedures. Studies have shown a higher risk of stroke during conventional stenting as compared to surgery and a higher risk of heart attack and wound complication with surgery as compared to conventional stenting.
Heart South Vascular Institute at Heart South Cardiovascular Group, has successfully performed its first radial to peripheral intervention, and is one of the earliest adopters of this new technology in the area.
Obesity is a growing disease both in the US and around the world. It is a major cause of many diseases including diabetes, hypertension, heart disease, cancer, cerebrovascular disease and stroke, gastroesophageal reflux disease, bone and joint damage and respiratory disorders. It also places individuals at increased risk of developing serious complications from COVID-19.
Approximately every 40 seconds someone in the United States has a stroke and roughly every four minutes someone dies of a stroke. It causes about one in 20 deaths annually – making it the fifth-leading cause of death – and the primary reason for long-term disability. Moreover, Alabama has the second-highest stroke mortality rate in the United States, behind Mississippi, according to the Centers for Disease Control and Prevention (CDC). This high incidence of stroke has earned Alabama a spot in the stroke belt, dubbed so by the medical community.
The Brookwood Baptist system recently incorporated state-of-the art Cardiac Magnetic Resonance (CMR) imaging for diagnosis patients with complex cardiovascular conditions. The technique allows for the acquisition of three-dimensional multi-planar moving images of the heart, blood vessels and associated organs without the need for ionizing radiation in about one 15-minute session.
Observed annually on the fourth Tuesday in March, Diabetes Alert Day is a wake-up call to inform the American public about the seriousness of diabetes – an illness that affects millions of Americans of all ages, particularly when diabetes is left undiagnosed or untreated. This year, Diabetes Alert Day falls on March 24, and it’s especially imperative that the people of Alabama take note considering our state has among the highest prevalence of diabetes in the United States.
Valentine’s Day was last month, and as usual, stores were filled with candy hearts while customers snapped up flowers and greeting cards. With Valentine’s Day now in the rear view mirror, while thinking about the holiday, I realized that we tend to overlook the opportunities we have every day to genuinely impact someone else. I found myself wondering how I could turn the seasonal attempts to show someone appreciation into a day-to-day routine. If I carried this mentality with me throughout the year, what downstream effects would follow? How would this impact not only my personal life, but my career and the culture of my organization?
Over the last four decades, there has been a tremendous reduction in mortality of patients with cardiovascular diseases. This applies to the entire spectrum of disease, including patients with acute myocardial infarction, heart failure, atrial fibrillation and arrhythmia.
We live in a three-dimensional world, where many physicians and surgeons diagnose, treat and operate on patients using flat images, but that is not the case at Children’s of Alabama. Seven years ago, I helped open Children’s first 3-D laboratory, which provides cutting-edge technology through advanced visualization. We help our medical staff provide a clearer, less invasive and more realistic view of joints and organs. With this type of information, doctors can also give patient families a clearer vision and understanding of their child’s condition.
Managing medical waste is not for the faint of heart - and neither is managing a medical office. Your facility’s staff must adhere to strict, sometimes time-consuming medical waste guidelines and regulations while providing the highest level of patient care. You must protect the health of your patients, your employees, and the environment. Following best practices in health care delivery, medical waste management, and medical office management can streamline processes and help ensure the best delivery of service in each area.
Transcatheter aortic valve replacement, or TAVR, is a minimally invasive alternative to open heart surgery for patients who require replacement of their aortic valve due to severe aortic stenosis. Although previously available only to patients at high or intermediate surgical risk, in August the Food and Drug Administration approved both of the latest-generation TAVR valves for use in patients at low surgical risk. This is a large group of patients who are typically younger and/or more active than those at higher risk. Until now these patients' only option was open heart surgery.
Arrhythmias are abnormal heart rhythms that are often under recognized cardiac problems and can lead to dangerous consequences if ignored or not treated appropriately. Typical symptoms can mimic those of other cardiac conditions like a heart attack, and often include palpitations (abnormal sensation in the chest, feeling like your heart is racing or beating abnormal). Sometimes symptoms may be associated with chest discomfort, shortness of breath at rest or with exertion, dizziness, near passing out or passing out, and/or fatigue.
The Apple Watch and other wearables are now able to monitor your heart rhythm. The Apple watch can detect irregular heart rhythms, and if it does so five times, it will prompt you to record your rhythm. In that way, it can also be used to diagnose atrial fibrillation.
The numbers tell the story.
Atrial fibrillation (AFIB), a condition in which the heart fires so rapidly that the upper chambers quiver instead of beating in a normal rhythmic pattern, is the now most common arrhythmia condition worldwide and is recognized as a global health problem with its burden of morbidity and mortality resulting from embolic stroke. AFIB is expected to double by 2030.
Peripheral arterial disease, or PAD, is a disease process in which plaque buildup causes the arteries to narrow, resulting in reduced blood flow to the limbs. This can lead to a variety of medical emergencies: Claudication, stroke, uncontrolled hypertension, and possibly amputation.
In 2012, Transcatheter Aortic Valve Replacement (TAVR) became commercially available in the US to treat high-risk patients with severe aortic stenosis. It offered effective, minimally invasive, and often lifesaving treatment to tens of thousands of patients who previously had no option for aortic valve replacement surgery.
I work with Chris Heck, MD an orthopaedic spine surgeon. We have developed an interest in treating osteoporosis, as a result of patients with have seen with broken bones.
Peripheral angioplasty is a minimally invasive procedure that can be performed now in an outpatient setting under local anesthesia for the treatment of peripheral artery disease (PAD). Medical technology has played a significant role in furthering this trend. PAD is a common circulatory problem in which the narrowed arteries reduce blood flow in the legs causing leg pain, numbness and/or discoloration.
A 2016 report from the Centers for Disease Control and Prevention (CDC) found that 20 percent of Medicare participants 65 or older don’t take their blood pressure medicine as directed.1 Additionally, 20-30 percent of prescriptions for chronic health conditions are never filled and roughly 50 percent are not taken as recommended.1
Venous ulcers of the lower extremities can be a frustrating disease process for clinicians. Do I send them to wound care center (WCC), do I need to order specific studies, are they venous or arterial?
Atrial Fibrillation (AF) is the most common abnormal heart rhythm which can cause adverse clinical outcomes such as stroke and heart failure. An estimated 2.7 to 6.1 million people have AF in the United States. As the prevalence of AF increases with increasing age, with an aging population, prevalence of AF is expected to double in the next 2-3 decades. People above the age of 40 years have a 1 in 4 chance of developing AF in their lifetime. Patients with AF are 6-7 times more likely than general population to suffer from a stroke.
I find it intriguing that physicians are one of the only professionals who pledge an oath before practicing their craft. Other notable “oath” moments in our country focus mainly on Nationalism and Service (Military, Law Enforcement, Public Servants and Naturalization among others). How different might some professionals behave, if included in their daily duties, was the acknowledgement that they are working under an assumed set of values and principles that help guide their tasks? For CERTIFIED FINANCIAL PLANNER™ professionals this exists, not in an oath form however; but within principles expressing ethical and professional ideals.
One of the greatest challenges facing the healthcare industry isn’t a political issue, it’s a geographic issue. What if I told you that approximately 50 million Americans (17 percent of the total population of the US) have limited access to high quality healthcare because they live in rural communities? Rural healthcare has a unique set of challenges including not only geographic but also economic and lifestyle factors.
Over 10 million people in the Unites States and over 200 million worldwide have peripheral arterial disease (PAD).1 Critical limb ischemia (CLI), defined as ischemic rest pain or tissue loss resulting from arterial insufficiency, affects approximately 1% of the adult population, or 10% of patients with PAD.2 Further increasing the impact of CLI is the poor prognosis it carries. Major amputation occurs in 33-67% of patients with ischemic tissue loss at 4 years.3,4 Mortality at 2 years in CLI patients is as high as 40%, and appears to be even higher in those with tissue loss. The vast majority of these deaths are due to cardiac events, cardiovascular disease, and cancer, rather than PAD.4,5
Where are the old (and not so good) days when a patient with myocardial infarction was staying in hospital bed for a week?
"I believe it was divine intervention that I was sent to Aspire Physical Recovery Center at Cahaba River. The therapy team brought me back to myself."
Mitral valve regurgitation has been described as a very common cardiac valvular abnormality which is under recognized and under treated even in industrialized countries
More than 10 million people in the United States are affected by Peripheral Artery Disease (PAD). About one in every twenty Americans over the age of 50 has PAD. Smokers are four times more likely to develop the condition. Peripheral Artery Disease is a strong indicator for potential heart attack and stroke. Most people are aware of coronary artery disease but few know the symptoms of vascular disease. The most common symptom of PAD in the lower extremities is a painful muscle cramping in the hips, thighs and calves when walking or exercising. Other symptoms to be aware of are leg numbness, skin discoloration of the legs or toes & loss of hair on the lower legs.
Are you sleeping well? One in three Americans suffer from sleep-related issues. If you or someone you know suffers from a sleep disorder, there has never been a better time to find a solution. Lack of good sleep can be detrimental to one’s quality of life in many aspects. Untreated sleep disorders make it difficult to control other health conditions such as migraines, anxiety, depression, pain, and more. Poor sleep due to a disorder such as sleep apnea can also have negative effects on your social life, as you are too tired to participate in social activities. People who snore could also interrupt the sleep of their bed-partners! Finally, sleep issues can lead to poor concentration, job performance, and lack of productivity.
In 2012, I read this article that made me question much of what I thought I knew about my profession of serving clients as a guide for their financial decisions. The designation following my name for which I had worked so hard at obtaining? Good, but not enough. The incredible technology –from complex financial forecasting to automated investment management? Lacking.
Almost everyone has seen the ads for the new anticoagulants at this point. However, many Americans still remain in the dark regarding what atrial fibrillation (Afib) is and it’s potentially devastating consequences. Despite increasing efforts to improve the awareness for atrial fibrillation, many still do not know it’s signs and symptoms or that it is a progressive disease. Afib is the most common arrhythmia in the world affecting 3-6 million Americans with projections of up to 16 million by the year 2050.
2018 marks 23 years since Children’s of Alabama entered the primary care market, expanding our footprint and brand awareness outside of our main campus on Birmingham’s Southside and strengthening our relationship with doctors who care for kids.
In the past few years, when we discussed patient satisfaction it pertained only to patient surveys and results. Some managers believe surveys are utilized by specialties, such as, plastic surgery who primarily practice on a cash basis. Consumerism is here to stay! Cost and quality will create a level playing field in healthcare. When working with a practice, I love to sit in the waiting room to see operations from the patient’s point of view. I also search the specialty online to review the competition and the effectiveness of the practice’s website; I may also see online reviews.
In a world of rapidly accelerating technology, our lives have become a 24hr sprint of endless tasks to be completed within a certain timeframe. Doctor offices are inundated with patients many young in age presenting symptoms such as high blood pressure, racing heartbeat, headaches, chest pain, random sweats, insomnia, and gastrointestinal problems. With the increased volume of patients and the demanding time constraints experienced in physician offices, these physical symptoms are often treated individually. The physician may prescribe medication, make recommendations on possible lifestyle changes, yet the symptoms remain. Effective treatment has to go deeper. These patients could be simply suffering from stress or they could be dealing with a more problematic subset of mood disorders: Anxiety Disorders.
Peripheral artery disease is a widespread and vastly underdiagnosed disease, affecting nearly 12 million Americans, mostly those over the age of 50, though the incidence increases with age. The most common symptom of peripheral arterial disease is claudication, which is pain, fatigue or aching in the legs when someone attempts to walk. This is due to the poor blood flow to the muscles in the legs. Beyond simply the discomfort in the legs, we know that having peripheral vascular disease makes one much more likely to have poor cardiovascular outcomes. Among patients with symptomatic peripheral arterial disease, more than 10% will have a stroke, heart attack, or die from a cardiovascular cause within two years. And when we look longer term, the statistics are even more sobering. For patients with symptomatic peripheral arterial disease, their mortality rate is 25% at 5 years and 50% at 10 years. When looking at patients with critical limb ischemia (those who have pain at rest or wounds on their feet), the numbers are even worse: they have a mortality rate of 50% at 5 years and 90% at 10 years.
Just because you’re getting older doesn’t mean that it’s too late to get in shape. In fact, research shows that older people who have never exercised can still benefit from physical conditioning. By starting a regular exercise program, you can help prevent coronary artery disease, high blood pressure, stroke, diabetes, depression and some cancer. Physical fitness reduces the effects of osteoporosis and arthritis — two conditions which can severely limit an older person’s lifestyle. Being in good shape physically can help you remain independent as you age and improve the quality of your life.
As we finalize 2017 participation in the Merit Based Incentive Program, most of us focused on improved performance in quality since the category carried the highest weight of 60%. Those who had previous success in Meaningful Use found the Advancing Care category easy to address. The Practice Improvement category is new and somewhat vague, but many practices were already performing tasks that qualified as an improvement activity. It is important to document the approach to improvement and track success because this category is subject to audit in the future.
Approximately 12 million Americans suffer from peripheral artery disease (PAD), yet general awareness of the disease is at 25%. Patients over the age of 50 with a history of smoking, high cholesterol, diabetes, hypertension, and heart disease are at the greatest risk. A staggering 50% of PAD patients have unrecognized symptoms that may progress directly to severe disease.
Venous reflux in the lower extremity is when blood from the foot which should travel towards the heart reverses downwards due to gravity.
Sleep is a very important activity, that we often take for granted. It is especially important in children as it allows for proper neurological development. One disorder that is more and more common is sleep apnea, or interrupted sleep from breathing issues. We generally associate sleep apnea and distressed breathing while sleeping with adults, but it does occur with children - actually in 3-5% of children.
Most people are aware that atherosclerosis can cause blockages in the coronary arteries, resulting in chest pain or heart attack, or in the carotid arteries, precipitating a stroke. But atherosclerosis can lead to another serious but often under-diagnosed condition: peripheral arterial disease (PAD). Defined as atherosclerotic obstruction of the arteries to the lower extremities, PAD causes leg pain and is associated with other cardiovascular disease. Although lower extremity PAD affects an estimated 12 to 20 million people in the United States, only four to five million of them are experiencing symptoms.
Bang, bang, bang! If you experience your heart banging against your chest or skipping beats you may be experiencing an arrhythmia. An arrhythmia is an irregular rate or rhythm of the heartbeat, where your heart can beat too fast or slow. Most commonly, this is caused by atrial fibrillation (AFib), when disorganized electrical signals cause the heart’s chambers not to beat in sync or fibrillate. Millions of Americans are affected by this disease and the number increases each year. AFib is the most common abnormal heart rhythm in America.
Birmingham Heart Clinic physicians are now utilizing a new approach to reduce atrial fibrillation stroke risk and eliminate the need for blood thinners over time.
A family medicine doctor is someone you can always feel comfortable voicing your concerns to and leave an appointment feeling as though you were really listened to. They will help you to become an informed and active member of your healthcare decision-making process.
Physicians Giving Back with Lee Irvin, M.D.
You probably don’t know Lee Irvin, M.D., of Mobile, and he’s fine with that. He’s the kind of gentleman you’d love to hang out with and have a drink or dinner with…swap stories with. But it’s easy to see that his medical mission over the last couple of years wears heavy on his heart.
Social Security Disability under Title II of the Social Security Act*
Surveys have shown that most Americans know little about Social Security law and the vital benefits it provides. By far, the least understood Social Security benefit is Social Security Disability Insurance (SSDI). This lack of knowledge has been measured through objective testing in various academic studies. Anecdotally, I know this to be true based on recurring questions and comments I have received from the public and clients alike over the last several decades of my work as a social security disability attorney.
As we women age, we do not always know what is coming next. We think we do, but we may not. We all know the stereotypical changes that happen with menopause, and of course, chronic diseases such as diabetes, heart disease, etc. that can occur with age. I can tell you that many women in their late 40s to late 70s are not expecting pain with intercourse, vaginal pain and discomfort, or both. It is honestly a surprise. And not a good one at that. It can make a healthy sexual relationship go sour very quickly, which not only hurts the woman’s quality of life, but her partner’s as well. This can affect the relationship as a whole, and both parties’ overall health, which can then lead to other medical issues. In our practice, we traditionally have treated men for erectile dysfunction and other sexual issues, but we understand that female sexual health is important as well.
Early detection of coronary artery disease is a signiﬁcant problem. One third of deaths after 35 are secondary to cardiovascular disease. One half of middle aged men and one third of middle aged women will develop coronary artery disease. Currently our ability to detect early disease is limited. By the time symptoms occur there is usually 70% obstruction of the coronary artery. Data from autopsies on Korean War casualties indicate initial signs of development of coronary plaque in the early 20’s of age. Theoretically it would seem appropriate to begin prevention therapy as soon as possible but who should get it? Obviously, the patients with known vascular disease and equivalents such as diabetes would need this therapy. Those without established disease need an estimate of their risk.
Are you sleepy? We would like to introduce you to our Sleep Center here at Medical West!
Have you ever said?:
• I have been told that I snore
• I suddenly wake up gasping for air during the night
• I have been told that I stop breathing while sleeping
• I feel tired during the day even though I slept all night
• I have high blood pressure
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