Know your devices medical alarm options!

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UnknownThere are a number of medical alarm options out there that target the elderly and disabled population. You should know that there are also devices that do not go directly to a monitoring center and instead directly dial 911. These are typically cellular and VoIP systems.

With cellular systems, they are not directly tied to a specific address because they are mobile and can go anywhere. This means you would have to rely on either the person using the device to know exactly where they are OR the phone giving 100% accurate GPS coordinates. This can be an issue in rural areas due to poor cellular service, and also in heavily populated areas such as an apartment complex or high rise building. Current technology only provides latitude and longitude without altitude.

If you use a device that is monitored by an alarm company they should preemptively solicit valuable information from you that would be available to pass to the 911 dispatcher should the need arise. This will allow responders to have a better location and nature of the incident if the patient is unable to talk or can’t be heard for any reasons.

Understand how your device works and make sure that they will be able to provide help when you need it most. The worst time to find out if your device will get you help is the moment when you need the help. A few questions and a little research can help in making the right decision.

Source credit: Grand Traverse 911

 

Congestive Heart Failure and Cardiac Rehabilitation

Cardiac Rehab programs now open to heart failure patients

 

Many who could benefit from attending cardiac rehabilitation didn’t have a coverable diagnosis. Yes they had significant heart disease with congestive heart failure, but were not covered to attend rehabilitation. For many years I assisted in fighting to get this coverage. It is wonderful to see it finally here. This opens access to many patients who would benefit from exercise, lifestyle intervention, education, prevention and managing of their chronic heart disease.

Chest Pain isn’t always from the heart

Causes of chest pain

Frequently people consult about experiencing chest pain. I know through training all chest pain is supposed to be referred to the emergency room for evaluation, but realistically many including myself am able recognize symptoms come from many different causes and may have different care needs. The emergency need for consultation is due the fact that many people will deny their symptoms are from a cardiac cause, delaying treatment and thus have pretty extensive heart damage or death. Evaluation thus is helpful in determining the cause.   When one gets evaluated there are many different areas of anatomy where the cause may be from.

 

Here is a list of many different causes for chest pain:

  • the chest wall including the ribs, the muscles, and the skin;

Possibilities: A rib in poor alignment, shingles, pulled muscle, cartilage between the ribs being inflamed,

  • the back including the spine, the nerves, and the back muscles;

Vertebra alignment, pinched nerve, shingles,

  • the lung, the pleura (the lining of the lung), or the trachea;

Recent cold/cough, bronchitis, blood clot, pulmonary embolism, pleurisy, pnumothorax – collapsed lung,

  • the heart including the pericardium (the sac that surrounds the heart);

Pericarditis, aortic dissection, angina, heart attack, blood clot

  • the aorta; aortic dissection
  • the esophagus;  Acid reflux, narrowed esophagus, regurgitation
  • the diaphragm, the flat muscle that separates the chest and abdominal cavities; 
  • referred pain from the abdominal cavity including organs like the stomach, gallbladder, and pancreas, as well as irritation from the underside of the diaphragm due to infection, bleeding or other types of fluid.

Gastric bleeding, septicemia, blood infections, gastric ulcers,

 

The symptoms of heart attack  for men or women.

Heart-Attack

 

references:

http://www.medicinenet.com/chest_pain/article.htm#what_are_the_sources_of_chest_pain

Congestive Heart Failure Patients finally Get Cardiac Rehabilitation

Congestive Heart Failure Patients finally Get Cardiac Rehabilitation

This is great news. I worked for many years petitioning our Congress and Senate to urge CMS to cover Cardiac Rehabilitation services for Congestive Heart Failure patients. There is a large subset of patients who can be much better served and monitored through cardiac rehabilitation to prevent readmissions. Congratulations to the AACVPR for helping attain this coverage from CMS, that is a very big deal.

 

 

 

WASHINGTON — Medicare has proposed covering cardiac rehabilitation services for patients with chronic heart failure 4 years after saying there was little evidence to support doing so.

The proposed coverage decision would expand access to rehab for a wider range of heart patients. Medicare currently covers rehab only for patients who have had an acute MI in the preceding year, coronary artery bypass surgery, heart or heart-lung transplant, or other major events.

The Centers for Medicare and Medicaid Services (CMS) came to the determination after reviewing literature on the rehab service from 2006 to August 2013. It announced the decision online late last week.

“Since chronic heart failure often results from coronary artery disease and hypertension, evidence on behavioral interventions in the treatment of these conditions provide additional supportive evidence,” the agency wrote. “With the accumulated evidence that supports the benefits of the individual components of cardiac rehabilitation programs, the evidence is sufficient to determine that participation in these multi-component programs improves health outcomes for Medicare beneficiaries with chronic heart failure.”

The agency is seeking public comments on the proposed decision and will post a final determination later.

Under the proposal, the agency would pay for rehab services — exercise, behavioral risk factor reduction, health education, and personal counseling — for patients with left ventricular ejection fraction of 35% or less and New York Heart Association class II to IV symptoms with at least 6 weeks of heart failure therapy.

The American Heart Association praised the CMS announcement.

“We are gratified that the agency recognized the evidence that pointed to the need for this expansion, and look forward to the day when this coverage will enable millions of heart failure patients to reap the benefits of cardiac rehabilitation,” AHA President Mariell Jessup, MD, said in a statement.

The AHA, along with the American College of Cardiology, the American Association of Cardiovascular and Pulmonary Rehabilitation, and the Heart Failure Society of America had asked CMS to consider adding CHF for coverage of cardiac rehab.

The CMS decision follows a study of nearly 2,300 patients that showed that aerobic exercise is safe for heart failure patients and effectively improves clinical outcomes. The patient population CMS is including is effectively the same as that in the trial, Ileana Pina, MD, professor at Albert Einstein College of Medicine in the Bronx, N.Y., told MedPage Today in a phone interview.

“Even though we knew all the good things exercise can do, a lot of physicians were not recommending it because the patients would have to pay out of pocket to go to a cardiac rehab program,” Pina, vice chair of the clinical cardiology council at the AHA, said.

She said many patients without this rehab option end up going to skilled nursing facilities because of their condition.

Roughly 17% of those age 65 and older have heart failure, according to CMS.

Tweak you Week! Make your day HARDER!

This is too good not to share. I found this posted by Carolyn Thomas on  http://myheartsisters.org/  She is a wonderful advocate on women and heart disease. This is a 4 minute video on a movement to “Make your day HARDER” due to our generation of sitting. I think of my children as I watch this, are we subjecting are youth to heart disease? We have better knowledge of the effects of smoking and have worked hard to improve diet, however they spend the majority of their youth sitting. Sure they are involved in sports but the vast percentage of the time our children sit. How do we go about changing this to ensure they have a  healthy future?

http://www.youtube.com/watch?v=whPuRLil4c0

http://www.youtube.com/watch?v=whPuRLil4c0

 

 

How Exercise Improves Heart Health: Must Compare to Medications

I couldn’t agree more, or write it any better than this post by Dr. Mercola on the benefits of Exercise for the Heart Health. I especially like the discussion about how it should be compared to medication studies. I have regularly heard at Cardiac Rehabilitation conferences about the benefits of exercise can be similar or better to the use of stents for treating heart disease.

How Exercise Improves your Heart Health

By Dr. Mercola

Did you know that exercise is one of the safest, most effective ways to prevent and treat chronic diseases such as heart disease?

This common-sense advice was again confirmed in a meta-review conducted by researchers at Harvard University and Stanford University,1 which compared the effectiveness of exercise versus drug interventions on mortality outcomes for four common conditions:

  • Diabetes
  • Coronary heart disease
  • Heart failure
  • Stroke

After reviewing 305 randomized controlled trials, which included nearly 339,300 people, they found “no statistically detectable differences” between physical activity and medications for prediabetes and heart disease.

Exercise was also found to be more effective than drugs after you’ve had a stroke. The only time drugs beat exercise was for the recovery from heart failure, in which case diuretic medicines produced a better outcome.

The drugs assessed in the studies included:

  • Statins and beta blockers for coronary heart disease
  • Diuretics and beta blockers for heart failure
  • Anticoagulants and antiplatelets for stroke

Exercise Should Be Included as Comparison in Drug Development Studies

The featured review is a potent reminder of the power of simple lifestyle changes, as well as the shortcomings of the drug paradigm. If you’re interested in living a longer, healthier life, nothing will beat proper diet and exercise.

Exercise is in fact so potent, the researchers suggested that drug companies ought to be required to include it for comparison when conducting clinical trials for new drugs! As reported by Bloomberg:2

“The analysis adds to evidence showing the benefit of non-medical approaches to disease through behavior and lifestyle changes.

Given the cost of drug treatment, regulators should consider requiring pharmaceutical companies to include exercise as a comparator in clinical trials of new medicines, according to authors Huseyin Naci of Harvard and John Ioannidis of Stanford.

‘In cases where drug options provide only modest benefit, patients deserve to understand the relative impact that physical activity might have on their condition,’ Naci and Ioannidis said in the published paper. In the meantime, ‘exercise interventions should therefore be considered as a viable alternative to, or, alongside, drug therapy.’”

There are glimmers of hope that change is possible, slow and begrudging as it may be. Dean Ornish, founder of the Preventive Medicine Research Institute, spent 16 years proving that a vegetarian diet along with exercise and stress management is more effective than conventional care for the treatment of heart disease.

And, as of January 2011, Medicare actually began covering the Ornish Spectrum—Reversing Heart Disease program,3 under the benefit category of “intensive cardiac rehabilitation.”

How Exercise Benefits Your Heart and Health

Heart disease and cancer are two of the top killers of Americans, and exercise can effectively help prevent the onset of both, primarily by normalizing your insulin and leptin levels.

Other beneficial biochemical changes also occur during exercise, including alterations in more than 20 different metabolites. Some of these compounds help you burn calories and fat, while others help stabilize your blood sugar, among other things.

In a nutshell, being a healthy weight and exercising regularly creates a healthy feedback loop that optimizes and helps maintain healthy glucose, insulin and leptin levels through optimization of insulin and leptin receptor sensitivity.

And, as I’ve mentioned before, insulin and leptin resistance—primarily driven by excessive consumption of refined sugars and grains along with lack of exercise—are the underlying factors of nearly all chronic disease that can take years off your life.

Previous research has shown that exercise alone can reduce your risk of cardiovascular disease by a factor of three.4 However, endurance-type exercise, such as marathon running, can actually damage your heart and increase your cardiovascular risk by a factor of seven…

Research5 by Dr. Arthur Siegel, director of Internal Medicine at Harvard’s McLean Hospital found that long-distance running leads to high levels of inflammation that can trigger cardiac events. Another 2006 study6 found that non-elite marathon runners experienced decreased right ventricular systolic function, again caused by an increase in inflammation and a decrease in blood flow.

All in all, such findings are a powerful lesson that excessive cardio may actually be counterproductive. In the featured review, the types of exercise, frequency, intensity and duration varied widely across the included studies, which made it impossible to ascertain the specifics of what was most or least effective for the prevention and treatment of disease.

However, it was clear that exercise in general is comparable to many of the drugs used for heart disease, heart failure, and stroke. That said, other research has clearly demonstrated that short bursts of intense activity is safer and more effective than conventional cardio—for your heart, general health, weight loss, and overall fitness.  One of the easiest ways to exercise is simply by performing body weight exercises.

Are You Exercising Effectively and Efficiently?

The answer is to exercise correctly and appropriately, and making certain you have adequate recovery, which can be as important as the exercise itself. There is in fact overwhelming evidence indicating that conventional cardio or long-distance running is one of the worst forms of exercise there is. Not only have other studies confirmed the disturbing findings above, but they’ve also concluded it’s one of the least efficient forms of exercise. Research emerging over the past several years has given us a deeper understanding of what your body requires in terms of exercise.

High-intensity interval training, which requires but a fraction of the time compared to conventional cardio, has been shown to be FAR more efficient, and more effective. This type of physical activity mimics the movements of our hunter-gatherer ancestors, which included short bursts of high-intensity activities, but not long-distance running. This, researchers say, is what your body is hard-wired for. Basically, by exercising in short bursts, followed by periods of recovery, you recreate exactly what your body needs for optimum health. Twice-weekly sessions, which require no more than 20 minutes from start to finish, can help you:

  • Lower your body fat
  • Improve your muscle tone
  • Boost your energy and libido
  • Improve athletic speed and performance

This type of exercise will also naturally increase your body’s production of human growth hormone (HGH)—a synergistic, foundational biochemical underpinning that promotes muscle and effectively burns excessive fat. It also plays an important part in promoting overall health and longevity. Conventional cardio will NOT boost your HGH level.

Interval Training—A Much Better Cardio Workout

Most people still think that in order to improve your cardiovascular fitness, endurance training is a must. But this is actually not true. Quite the contrary. According to fitness expert Phil Campbell, getting cardiovascular benefits actually requires working ALL your muscle fibers and their associated energy systems. Interestingly enough, this cannot be achieved with traditional cardio, and here’s why: Your body has three types of muscle fibers: slow, fast, and super-fast twitch muscles, and your heart has two different metabolic processes:

  • The aerobic, which requires oxygen for fuel
  • The anaerobic, which does not require any oxygen

Slow twitch muscles are the red muscles, which are activated by traditional strength training and cardio exercises. The fast and super-fast twitch muscles are white muscle fibers, which are only activated during high intensity interval exercises or sprints. Activating the fast and super-fast muscles is also what causes the production of therapeutic levels of growth hormone, as mentioned earlier. Many athletes spend $1,000 a month on HGH injections, which carry certain health risks, but there’s really no need for that. With Peak Fitness exercises and the use of the Power Plate, you can increase your levels of HGH to healthy young normal’s.

Now, traditional cardio exercises work primarily the aerobic process, associated with your red, slow-twitch muscles. High-intensity interval training, on the other hand, work both your aerobic AND your anaerobic processes, which is what you need for optimal cardiovascular benefit. Quite simply, if you don’t actively engage and strengthen all three muscle fiber types and energy systems, then you’re not going to work both processes of your heart muscle. Many mistakenly believe that cardio works out your heart muscle, but what you’re really working is your slow twitch muscle fibers, associated with the aerobic process only. You’re not effectively engaging the anaerobic process of your heart…

Demonstration of an Effective High Intensity Interval Session

In the case of high intensity exercises, less is more, as you can get all the benefits you need in just a 20-minute session performed twice to three times a week. It’s inadvisable to do them more than three times a week. If you do, you may actually do more harm than good—similar to running marathons. Because while your body needs regular amounts of stress like exercise to stay healthy, it also needs ample recuperation, and if you give it more than you can handle your health will actually begin to deteriorate. As a general rule, as you dial up the intensity, you can dial back on the frequency. While the entire workout is only 20 minutes, 75 percent of that time is warming up, recovering or cooling down. You’re really only working out intensely for four minutes:

  • Warm up for three minutes
  • Exercise as hard and fast as you can for 30 seconds. You should feel like you couldn’t possibly go on another few seconds
  • Recover at a slow to moderate pace for 90 seconds
  • Repeat the high intensity exercise and recovery 7 more times

For Optimal Health, Add Variety to Your Fitness Routine

While high intensity interval exercises accomplish greater benefits in a fraction of the time compared to slow, endurance-type exercises like jogging, I don’t recommend limiting yourself to that alone. Of equal, if not greater importance, is to avoid being too sedentary in general. Compelling research now tells us that prolonged sitting can have a tremendously detrimental impact on your health even if you exercise regularly. The reason for this is because your body needs to interact with gravity in order to function optimally. Therefore, make sure to get out of your chair every 10 minutes or so, as suggested below.

Ideally, to truly optimize all aspects of your health, you’d be wise to design a well-rounded fitness program that incorporates a variety of different exercises. Without variety, your body will quickly adapt, so as a general rule, as soon as an exercise becomes easy to complete, you’ll want to increase the intensity and/or try another exercise to keep it challenging. I recommend incorporating the following types of exercise into your program:

  1. Interval (Anaerobic) Training: This is when you alternate short bursts of high-intensity exercise with gentle recovery periods.
  2. Strength Training: Rounding out your exercise program with a 1-set strength training routine will ensure that you’re really optimizing the possible health benefits of a regular exercise program. You can also “up” the intensity by slowing it down. For more information about using super slow weight training as a form of high intensity interval exercise, please see my interview with Dr. Doug McGuff.
  3. Avoid Sitting for More Than 10 Minutes. This is not intuitively obvious but emerging evidence clearly shows that even highly fit people who exceed the expert exercise recommendations are headed for premature death if they sit for long periods of time. My interview with NASA scientist Dr. Joan Vernikos goes into great detail why this is so, and what you can do about it. Personally, I usually set my timer for 10 minutes while sitting, and then stand up and do one legged squats, jump squats or lunges when the timer goes off. The key is that you need to be moving all day long, even in non-exercise activities.
  4. Core Exercises: Your body has 29 core muscles located mostly in your back, abdomen and pelvis. This group of muscles provides the foundation for movement throughout your entire body, and strengthening them can help protect and support your back, make your spine and body less prone to injury and help you gain greater balance and stability.

Foundation Training, created by Dr. Eric Goodman, is an integral first step of a larger program he calls “Modern Moveology,” which consists of a catalog of exercises. Postural exercises such as those taught in Foundation Training are critical not just for properly supporting your frame during daily activities, they also retrain your body so you can safely perform high-intensity exercises without risking injury. Exercise programs like Pilates and yoga are also great for strengthening your core muscles, as are specific exercises you can learn from a personal trainer.

  1. Stretching: My favorite type of stretching is active isolated stretches developed by Aaron Mattes. With Active Isolated Stretching, you hold each stretch for only two seconds, which works with your body’s natural physiological makeup to improve circulation and increase the elasticity of muscle joints. This technique also allows your body to repair itself and prepare for daily activity. You can also use devices like the Power Plate to help you stretch.

Exercise Tips for Those with Chronic Health Problems

Remember that even if you’re chronically ill, exercise can be a potent ally. That said, if you have a chronic disease, you will of course need to tailor your exercise routine to your individual scenario, taking into account your stamina and current health. For example, you may at times need to exercise at a lower intensity, or for shorter durations, but do make a concerted effort to keep yourself moving. Just listen to your body and if you feel you need a break, take time to rest. But even exercising for just a few minutes a day is better than not exercising at all.

In the event you are suffering from a severely compromised immune system, you may want to exercise in your home instead of visiting a public gym. But remember that exercise will ultimately help to boost your immune system, so it’s very important to continue with your program, even if you suffer from chronic illness.

Exercise Is More Effective Than Potent Medicines

The take-home message here is that one of the best forms of exercise to protect your heart is short bursts of exertion, followed by periods of rest. By exercising in this way, you recreate exactly what your body needs for optimum health. Heart attacks, for example, don’t happen because your heart lacks endurance. They happen during times of stress, when your heart needs more energy and pumping capacity, but doesn’t have it. So rather than stressing your heart with excessively long periods of cardio, give interval training a try.

During any type of exercise, as long as you listen to your body, you shouldn’t run into the problem of exerting yourself excessively. And, with interval training, even if you are out of shape you simply will be unable to train very hard, as lactic acid will quickly build up in your muscles and prevent you from stressing your heart too much.

Most importantly, the featured review is a powerful message to anyone considering taking a medication to address risk factors and lower your risk of heart disease. There’s simply no evidence suggesting that statins or beta blockers are any more effective than exercise, which means you can forgo all the side effects and exorbitant expense associated with such drugs.

Remember what these Harvard and Stanford University researchers concluded after reviewing 305 studies comparing exercise versus drug treatment: “[E]xercise interventions should… be considered as a viable alternative to, or, alongside, drug therapy.”What could possibly be more empowering than that?