Learning More About Narcolepsy

Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy fall asleep without warning, anywhere, anytime. When they awaken, they may feel refreshed, but eventually get sleepy again. Narcolepsy can drastically affect a person’s quality of life and can result in physical harm to themselves or others.

 There are two forms of narcolepsy: Type 1 narcolepsy is when sudden attacks of sleep are accompanied by a loss of muscle tone.  Type 2 narcolepsy occurs with no loss in muscle tone.

In addition to sudden attacks of sleep, some of the signs and symptoms of narcolepsy include:

  • Decreased alertness and focus – Excessive daytime sleepiness makes it difficult for individuals to concentrate and fully function.
  • Sudden loss of muscle tone – This condition, called cataplexy can cause a number of physical changes, from slurred speech to complete weakness of most muscles, and may last up to a few minutes.
  • Sleep paralysis – People with narcolepsy often experience a temporary inability to move or speak while falling asleep or upon waking. These episodes are usually brief, lasting a few seconds or minutes.
  • Hallucinations – Hallucinations may occur while sleeping or while awake. These hallucinations may be particularly vivid and frightening because the person experiencing them may believe they are reality.

Narcolepsy symptoms typically begin anywhere between ten and thirty years of age. Symptoms may worsen for the first few years and then continue for life. People with narcolepsy may also have other sleep disorders, such as obstructive sleep apnea, restless leg syndrome and even insomnia.

While the exact cause of narcolepsy is unknown, research has revealed that people with type 1 narcolepsy have low levels of the chemical hypocretin, which is an important neurochemical in your brain that helps regulate wakefulness and REM sleep. Those with a family history of narcolepsy have a greater risk of developing it.

Unfortunately, there is no cure for narcolepsy however medications and lifestyle changes can help manage the symptoms.  It is recommended that you see a doctor if you experience excessive daytime sleepiness that disrupts your personal life.

Jamaica Hospital’s Sleep Center treats individuals with a wide variety of sleep disorders. Please call 718-206-5916 to schedule an appointment.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Anemia

Anemia is defined as having a lack of healthy red blood cells to carry adequate amounts of oxygen to the body’s tissues. It is one of the most common blood conditions in the United States, affecting almost 6% of the population.

There are three main causes of anemia. They include:

  • A decrease in red blood cell production
  • An increase in red blood cell destruction
  • Blood loss

There are several factors that may lead to a decrease in red cell production, here a few:

  • Not having enough iron, folate or vitamin B-12 in our diets
  • Hypothyroidism
  • Bone marrow or stem cell problems

Factors that can lead to an increase in red blood cell destruction are:

  • Infections
  • Severe hypertension
  • Toxins produced by advanced liver or kidney disease
  • Genetic disorders such as sickle cell disease  or thalassemia

Blood loss can be the result of an injury; it can also occur for other reasons such as heavy menstrual periods or gastrointestinal disorders such as inflammatory bowel disease.  

Some people are more at risk than others for developing anemia. Those who have an increased risk are:

  • Women who have heavy periods
  • Women who are pregnant and are not taking prenatal vitamins that include iron and folic acid
  • Older adults
  • Individuals with a family history of anemia
  • Individuals living with chronic conditions such as diabetes, hypertension or kidney disease
  • Individuals with a diet that lacks sufficient iron, vitamin B-12 or folate

The signs and symptoms of anemia can be mild or severe depending on the cause, they may include:

  • Headaches
  • Fatigue
  • Weakness
  • Shortness of breath
  • Chest pain
  • Irregular heartbeats
  • Dizziness or lightheadedness
  • Cold hands and feet

It is recommended that you see a doctor if any of these symptoms persist.  During your appointment, your doctor may perform a physical examination and ask questions about your diet as well as family and medical history.  A physical examination may be conducted and a series of tests ordered to determine a diagnosis.

Treatment for anemia depends on the cause. A patient’s treatment plan can involve making changes to their diet, and taking supplements. Prescription medications, chemotherapy, blood transfusions or marrow transplants may be needed in other instances

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Anxiety

The American Psychological Association defines anxiety as, “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.”

Experiencing anxiety occasionally is normal; however, if this feeling occurs frequently, and gets worse over time it may be an indication of an anxiety disorder.

Anxiety disorders are the most common form of mental health disorders. Nearly 30% of adults living in the United States are affected at some point in their lives. 

There are four main types of anxiety disorder, including:

  • Generalized anxiety disorder
  • Social anxiety disorder (social phobia)
  • Specific phobias
  • Separation anxiety disorder

It is important to note that it is possible to have one or more anxiety disorder.

The causes of anxiety disorders are not fully understood; however, there are certain risk factors believed to contribute to developing them.  General risk factors include:

  • Exposure to negative or stressful life events in early childhood or adulthood
  • A family history of anxiety disorders or other mental illnesses
  • Having certain health conditions such as heart arrhythmias or thyroid problems
  • Taking certain medications that can aggravate symptoms

For those living with any type of anxiety disorder, feelings of excessive worry, fear, apprehension or nervousness are often difficult to control and can interfere with daily activities. These feelings can also lead to physical symptoms such as:

  • An increased heart rate
  • Trouble concentrating
  • Gastrointestinal problems
  • Sweating
  • Hyperventilating
  • Having difficulty sleeping
  • Fatigue

If you are finding it difficult to control anxiety, and symptoms are affecting your health or ability to live a normal life, please seek help.  A mental health specialist can conduct a psychological evaluation to help determine a diagnosis. A physical exam may also be recommended to rule out any underlying medical conditions.

Treatment for anxiety disorders can include psychotherapy or medications.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

COPD

Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory lung disease that makes breathing difficult. It is caused by damage to the lungs over a prolonged period of time and is usually attributed to smoking.

COPD can result in serious, long-term disability and is the third leading cause of death in the United States.

The symptoms of COPD typically present when there is significant damage to the lung. They may include:

  • Shortness of breath
  • Chronic cough
  • Frequent respiratory infections
  • Wheezing
  • Swelling of the feet, ankles or legs

Those most at risk of developing COPD are individuals who:

• Are over age 40 and currently smoke or smoked at some point

• Worked or lived around chemicals or fumes

• Have certain genetic conditions

• Have asthma

If you think you have COPD, you should:

• Talk with your healthcare provider about your symptoms

• Request a breathing test, known as a spirometry

• Quit smoking! If you need help, ask your doctor

• Avoid pollutants or fumes that can irritate your lungs

COPD can lead to other health complications such as heart problems, lung cancer, or high blood pressure in the arteries that bring blood to your lungs.

While you can’t undo the damage COPD has caused to your lungs, there are steps you can take to prevent the condition from getting worse, this includes avoiding factors that can irritate lungs, taking medications as directed, enrolling in a pulmonary rehabilitation program, and receiving annual flu and pneumonia vaccines.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Information About Depression

Depression is a mood disorder that makes you feel constant sadness or lack of interest in life.  It can affect how a person feels, thinks and behaves. It can lead to a variety of emotional and physical problems. Those living with depression have trouble doing normal day-to-day activities, and sometimes may feel as if life isn’t worth living.

While everyone experiences feelings of sadness at some point in their life, those with clinical depression have prolonged periods of feeling helpless, hopeless, and worthless. These feelings are not always tied to a specific incident and can last for many days to weeks. Depression can occur in children, adolescents and adults. Although someone can experience depression only once in their life, most who suffer with depression experience recurring episodes.

Some of the symptoms of depression include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

There is no known singular cause for depression. Instead, health professionals point to a combination of contributing factors including a person’s brain structure and chemistry. Hormone and genetics are also believed to play a role.

Help is available for those with depression. A mental health professional can conduct an evaluation and outline a course of treatment based on the patient’s individual needs. Treatment may include:

  • Medications – These can include a combination of antidepressants, mood stabilizers, antipsychotic, anti-anxiety or stimulant medications
  • Psychotherapy – Talking to a mental health professional on a regular basis about your depression and other issues can help treat the symptoms.
  • Electroconvulsive therapy – This brain stimulation therapy passes electric currents through your brain to help your neurotransmitters work better.
  • Transcranial magnetic stimulation – This treatment uses a coil to send magnetic pulses through your brain to help stimulate nerve cells that regulate mood.

Some with depression may experience thoughts of hurting themselves or others. If someone you know is depressed and you think they may hurt themselves or attempt suicide, call 911immediately.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

The Facts About Ear Infections

An ear infection is an infection of the middle ear, the air-filled space behind the eardrum. Children are most likely to develop ear infections, but adults can get them too.

Ear infections are commonly associated with colds or the flu because the middle ear is connected to the upper respiratory tract by a tiny channel known as the Eustachian tube. Germs that are growing in the nose or sinus cavities can climb up the Eustachian tube and enter the middle ear to start growing.

The most common symptoms associated with ear infections in children include:

  • Ear pain, especially when lying down
  • Tugging or pulling at an ear
  • Trouble sleeping
  • Crying more than usual
  • Trouble hearing or responding to sounds
  • Loss of balance
  • Fever of 100 F (38 C) or higher
  • Drainage of fluid from the ear

Ear pain, difficulty hearing and drainage of fluid from the ear are the most common symptoms in adults.

While anyone can develop an ear infection, there are multiple factors that can increase your chances of developing one, including:

  • Age – Children between the ages of 6 months and 2 years are more susceptible to ear infections because of the size and shape of their Eustachian tubes and because their immune systems are still developing.
  • Group child care – Children cared for in group settings are more likely to get colds and ear infections than are children who stay home.
  • Bottle feeding – Babies who drink from a bottle, especially while lying down, tend to have more ear infections than do babies who are breast-fed.
  • Seasonal factors. Ear infections are most common during the fall and winter. People with seasonal allergies may have a greater risk of ear infections when pollen counts are high.
  • Poor air quality. Exposure to tobacco smoke or high levels of air pollution can increase the risk of ear infections.

Because ear infections often clear up on their own, treatment may begin with managing pain and monitoring symptoms. When they don’t however, antibiotics can be used to clear the infection. Some people are prone to having multiple ear infections. This can cause hearing problems and other serious complications.

It is important to see your doctor when:

  • The patient is less than six months old
  • Symptoms last more than a day
  • Pain is severe
  • There is a discharge of fluid

Most ear infections don’t cause long-term complications, but if someone develops them repeatedly, they can lead to complications including impaired hearing, speech or development delays and spread of infection to nearby tissue.

The best ways to reduce the risk of developing an ear infection include practicing good hand hygiene and social distancing to avoid contracting the common cold, the flu or other viruses and bacterial infections that can lead to them. Other tips include breast-feeding your baby and avoiding secondhand smoke.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Anorexia

Anorexia nervosa-often used interchangeably with anorexia, is an eating disorder and psychological condition characterized by having a distorted body image (believing one is much heavier than they are), and the intense fear of gaining weight or becoming obese.  

The exact cause for anorexia nervosa is unknown; however, there are several environmental, biological and psychological factors believed to contribute to its development.

Individuals with anorexia nervosa aim to maintain a low body weight that is abnormal for their height and age. This is typically achieved by practicing unhealthy weight loss habits such as:

  • Exercising excessively
  • Severely restricting the amount of food consumed
  • Vomiting after eating
  • Misusing, diuretics, laxatives or diet aides

The symptoms of anorexia nervosa can be physical, emotional or behavioral, and may vary from person to person.

Physical symptoms can include:

  • Extreme weight loss
  • Severe loss of muscle mass
  • Fatigue
  • Thinning hair or hair that breaks easily
  • Fainting or dizziness
  • Infertility
  • Lanugo- soft, downy hair that covers the body

Emotional and behavioral symptoms may include:

  • An unhealthy preoccupation with food
  • Excessive concern about  being overweight
  • Adopting eating rituals such as chewing food and spitting it out
  • Lying about food intake
  • Avoiding eating in public
  • Repeated weighing or measuring of the body
  • Social withdrawal

Most individuals with anorexia nervosa hesitate to seek help because their desire to stay thin often outweighs their concerns for being healthy. However, anorexia nervosa can be life-threatening, so it is important that they receive the immediate care of physicians and mental health experts to help with overcoming this condition.

The diagnosis of anorexia nervosa generally includes physical exams, lab tests and psychological evaluations.  Treatment is often administered by a team of healthcare professionals who are experienced in dealing with eating disorders such as a primary care doctor, dietitian and psychologist.  A care plan may include medication, psychotherapy and nutrition education.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Important Information About Hypertension

According to the American Heart Association, hypertension is the medical term for high blood pressure.  It is defined an adult as blood pressure that is greater than or equal to 140 mm systolic and 90 mm diastolic. Hypertension directly increases the risk of coronary heart disease and stroke.

When the heart beats, it generates a force exerted against artery walls, known as blood pressure. Blood pressure is measured by testing the force needed to stop blood from flowing through the arteries, away from the heart. When a blood pressure test is performed, a test result will yield two numbers. The first number is known as the systolic number. It measures the pressure when the heart beats. The second number, known as the diastolic number, measures the pressure between heart beats, when the heart is at rest. A normal blood pressure for a healthy adult is 120/80.

Hypertension, also known as high blood pressure, is a serious condition that affects approximately one quarter of all Americans. Hypertension is commonly known as the “silent killer” because of the lack of any noticeable symptoms.  If not treated, hypertension can lead to many more serious conditions that can ultimately prove fatal.

Diagnosing and treating hypertension is very important because it can lead to a number of other diseases, such as heart disease, stroke, and kidney failure.

Everyone is susceptible to developing hypertension, but some groups are at greater risk than others. Those most at risk are:

                • People with a history of hypertension in their family

  • Overweight people

                • African Americans

                • Elderly people

You are also at a higher risk to develop hypertension if you:

                • Smoke

                • Drink alcohol frequently

                • Are pregnant or on birth control pills

                • On a high-salt diet

                • Are an inactive person

If you have hypertension, there are ways of controlling your condition. The following lifestyle changes can be added to reduce your risk:

  • Exercise Regularly – Aerobic exercise for 15 to 45 minutes, three to four times a week, every week is recommended by doctors. Swimming, walking, jogging, riding a bike, and dancing are all excellent forms of aerobic exercise.
  • Eat healthy – Avoid foods with high salt and high fat content. Doctors suggest eating more fruit, vegetables, chicken, fish, pasta, and low-fat dairy products.           
  • Control Alcohol – Limit alcohol consumption. 
  • Stop Smoking – If you are serious about controlling hypertension, you must stop smoking.

In some more serious cases, doctors will prescribe medication to help control hypertension. The best prevention is to see a doctor and have a blood pressure check-up at least once a year.

Before beginning a diet or exercise program, consult your physician.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Learn The Facts About Diabetes

Diabetes is a treatable, but not curable, disease in which the body either develops a resistance to insulin or cannot successfully use all the foods it takes in because of a defect in the production of insulin. Insulin is a hormone created in the pancreas, an organ found near the stomach. It acts as a key to allowing glucose into our cells. Glucose is created during digestion and is needed as a fuel for the body to perform many activities.

Scientists are not certain why diabetes affects some people and not others, but there is strong evidence that heredity, diet, activity level, and ethnicity play an important role.

Diabetes is the leading cause of blindness, kidney disease, nerve damage, and non-traumatic amputations, and the fourth leading cause of death in the United States. It is essential to be under the regular care of a physician when diagnosed with the disease, as diabetics have an increased risk of heart disease and stroke and are also prone to infection and slow-healing wounds.

What Are The Risk Factors For Diabetes?

  • You are at risk of developing diabetes if you:
  • Are overweight
  • Are over the age of 45
  • Have poor dietary habits
  • Do not exercise regularly
  • Are a woman who has experienced gestational diabetes
  • Are a woman who has delivered a baby weighing more than nine pounds at birth
  • Are of African American decent
  • Are of Hispanic decent
  • Have a family history of diabetes

What Are The Types Of Diabetes?

Type I
Type I is also called insulin dependent diabetes because the body does not produce insulin in sufficient quantities, if at all. In this form of diabetes, people are required to take insulin every day by injection. It is seen mostly in children and young adults, though not exclusively. It affects 10% of the diabetic population.

Type II
This more common form of the disease affects the greatest number of people.  Almost 90% of people with diabetes have this type. Type II has also been called the non-insulin dependent form of the disease because it can often, though not always, be managed without taking insulin. Many people do well with oral medications, strict diets, exercise, and close monitoring by a physician.

Gestational Diabetes
This form of the disease can develop during pregnancy. It will often go away after the pregnancy is completed. It is believed to be caused by the hormonal changes that take place during pregnancy. It is a risk factor for developing the disease later in life.

 Some common symptoms of diabetes include:

  • Frequent urination
  • Constant thirst
  • Dramatic weight loss
  • Constant hunger
  • Tingling or numbness in the feet or hands   
  • Blurred vision
  • Frequent feeling of fatigue

It is important to discuss any symptoms with your physician as soon as they are noticed. The above lists some warning signs and they all need not be present. Further testing is necessary to make an accurate diagnosis.

Diabetes isn’t necessarily painful, and that is why it is often not diagnosed until major symptoms develop.

Depending on the type of diabetes and its severity, treatment plans will vary and must be tailored to the individual’s specific needs. Medications include daily injections of insulin and/or oral agents, strict diet, regular glucose monitoring, an exercise plan, and regular medical examinations.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Learn More About Cholesterol

Cholesterol is a necessary component of the cells in the body. It is found in large quantities in nerve tissue, the brain, skin, adrenal glands, and liver. Cholesterol is a soft, fat-like substance found in the bloodstream along with the circulating fats called lipids. Cholesterol is not able to dissolve in blood and in order to be transported it must be united with a type of

Low Density Lipoprotein (LDL) is known as bad cholesterol when found in large quantities. It contains more cholesterol than protein and helps transport cholesterol to the cells. When the LDL level is high, excess cholesterol will accumulate in the blood vessels and lead to  complications.

High Density Lipoprotein (HDL) is known as good cholesterol because it contains more protein than other cholesterol. This form of lipoprotein helps transport excess cholesterol away from the cells, therefore, it is better to have more HDL’s and fewer LDL’s in the bloodstream.

When there is too much cholesterol circulating in the blood, it leads to a disease called hypercholesterolemia. This elevated level of cholesterol in the blood will eventually lead to the formation of fatty deposits of plaque on the lining of blood vessels. When this happens, blood vessels become narrowed and hardened by these deposits. This condition is called atherosclerosis and it can lead to the formation of blood clots in these now narrowed blood vessels. When blood vessels become narrowed, it makes it difficult for blood to reach parts of the body and can eventually cause serious damage.  It is believed that atherosclerosis causes more deaths due to heart attacks than any other disease.

A diet high in cholesterol can lead to stroke, heart disease, atherosclerosis, and possibly death. Many of the great tasting foods that we eat every day contain high amounts of cholesterol. Foods that are high in cholesterol include red meat, egg yolks, whole milk, cheese, ice cream, butter, fried foods, cake, and cookies. Foods that are prepared with high amounts of saturated fats such as palm or coconut oil also lead to high cholesterol levels.

Foods that are low in cholesterol and high in fiber are a smarter choice. These include fresh leafy vegetables, peas, dried beans, and whole grains. A healthy diet is one that contains less red meat and more fish and poultry. Taking the skin off poultry makes it even healthier to eat.

Other factors that can lead to high cholesterol include smoking, obesity, and a family history of heart disease.

The American Heart Association says that when the level of cholesterol rises above 200 milligrams per deciliter of blood, there is a significant increase in the risk of having a heart attack. High cholesterol can vary from person to person but is generally defined as above 240 mg/dl.

The body has the ability to produce approximately 1,000 milligrams of cholesterol daily from the carbohydrates and fats that we eat. Therefore, it is not necessary to eat foods that are high in cholesterol in order to meet the body’s needs. In fact, the American Heart Association recommends that you limit your daily intake of cholesterol to no more than 300 milligrams per day. The daily diet should contain no more than 30% fat and only a third of this fat should be saturated.

Exercise and a healthy diet are two ways that you can lower your cholesterol. It is important to always consult a physician before starting any diet or exercise plan. Stress management is also very helpful in reducing the risk of heart disease, heart attack, and stroke. In many cases where cholesterol levels are not being controlled, it may be necessary for a physician to prescribe medication to help lower it.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.