Heart failure is a chronic, progressive condition that starts slowly and
gets worse over time. Many people don’t realize they are experiencing
heart failure because the symptoms can be similar to normal aging.
Heart failure is a chronic, progressive condition that starts slowly and
gets worse over time. Many people don’t realize they are
experiencing heart failure because the symptoms can be similar to normal
aging. Heart failure is the result of the heart’s muscle gradually
losing the ability to pump enough blood to supply the body’s needs.
This can happen for a variety of reasons including injury to the heart
muscle from a heart attack or high blood pressure. Generally, the heart
either becomes weak and unable to pump blood or it may become stiff and
unable to fill with blood. Both conditions ultimately lead to retention of
extra fluid which is referred to as congestion. This is why a
person’s experiencing the symptoms of heart failure are referred to
as having congestive heart failure.
How Common is Heart Failure?
Heart failure is a growing problem in the United States. It is estimated
that there are nearly 6.5 million Americans over the age of 20 who are
dealing with heart failure. A major killer, heart failure can directly
account for about 8.5% of all heart disease deaths in the United States
and is a contributor in about 36% of all cardiovascular disease deaths.
Risk Factors
Having read thus far, you may be asking yourself, am I at risk for heart
failure? Heart failure can occur at any age, but most people are at a
greater risk as they get older.
Here are some other risk factors to be aware of:
- High blood pressure
- coronary artery disease
- Heart attack
- Damage to the heart valves of history of a heart murmur
- Enlarged heart
- Congenital heart disease
- Family history of enlarged heart
- Diabetes
- Obesity
- Sleep apnea
- Severe lung disease
Symptoms
The symptoms of heart failure are often dismissed as part of the normal
aging process. Extra fluid or congestion is the primary factor in the
symptoms of heart failure. Symptoms can occur over a period of time or
they may all occur at once.
- Shortness of breath with simple activities
- Trouble breathing when resting or lying down
- Waking up breathless at night
- Needing more than two pillows to sleep
- Tiring easy
- Frequent coughing
- Coughing that produces a pink or bloody mucus
- Dry, hacking cough when lying flat in bed
- Swelling of feet, ankles or legs
- Increased need to urinate at night
- Swelling of the abdomen
- Lack of appetite and nausea
- Fatigue
- Cold legs and arms
- Difficulty concentrating
Diagnosis
Heart failure is diagnosed by your healthcare provider based on your signs
and symptoms, a physical examination and through special tests designed to
measure heart function. Your provider may order an echocardiogram, or
“echo”, which is an ultrasound of the heart to measure
ejection fraction, the thickness of the heart wall and the flow of blood
through your heart valves.
Treatment
If heart failure is detected and treated early, you can continue to live
an active lifestyle. Your healthcare provider will work with you to
determine your best course of treatments. Treatments can include
medication, devices and lifestyle changes such as quitting smoking,
changing your diet and increasing exercise.
Living with Heart Failure
Heart failure is a very serious and life-changing disease, but with
appropriate management and lifestyle changes, you can maintain quality of
life for a long period of time. The key is to educate yourself on your
condition. Knowledge is power! It is also important for you to meet
regularly with your healthcare provider, take your medications as
directed, adhere to dietary recommendations and exercise as directed.
Finally, you will weigh yourself daily. Large changes in weight may be an
indication that you may need to adjust your treatment plan. Following
these step and the advice of your healthcare provider gives you the best
chance possible to stay one step ahead of heart failure.
Ann has been caring for heart failure patients since starting in
cardiology in 2001, assisting patients with diagnosis and treatment in
both outpatient, inpatient and infusion clinic settings. Ann was also a
co-author of a book chapter on heart failure and has spoken nationally on
this topic to other healthcare providers and patients. Ann offers
cardiology clinics at both the Kimball and Pine Bluffs clinics.
The Basics of Breast Reduction
MARCH 6, 2020 BY DR. WILLIAM WYATT
Having excessively large breasts is a serious medical issue for many
women. I frequently meet with patients who come to me with back and neck
pain, complaining of difficulty performing common physical activities and
emotional distress due to their large breasts. Making the decision
to have breast reduction surgery is a serious one, but many of my patients
they tell me it “was the best decision I have ever made”.
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Having excessively large breasts is a serious medical issue for many
women. I frequently meet with patients who come to me with back and neck
pain, complaining of difficulty performing common physical activities
and emotional distress due to their large breasts. Making the decision
to have breast reduction surgery is a serious one, but many of my
patients they tell me it “was the best decision I have ever
made”.
What is breast reduction surgery?
Breast reduction is a surgical procedure to remove excess fat, granular
tissue, breast tissue and skin to achieve a breast size more in
proportion with a patient’s body and to alleviate the discomfort
associated with excessively large breasts.
What are the risks of breast reduction?
As with any surgery, there are risks of complication such as infection,
bleeding, blood clots, skin loss, loss of nipple sensation and
unfavorable scarring. Patients considering a breast reduction surgery
should discuss possible complications and concerns with their plastic
surgeon before having breast reduction surgery.
Who is a candidate for breast reduction?
Patients who may be a candidate for breast reduction surgery:
- Are physically healthy
- Have realistic expectations
- Don’t smoke
- Are bothered by feeling that their breasts are too large
- Have breasts that limit their physical activity
-
Experience back, neck and shoulder pain caused by the weight of their
breasts
- Have shoulder indentations from bra straps
- Have skin irritation beneath the breast crease
-
Have failed other conservative treatment measures such as physical
therapy, chiropractic care, support bras and NSAIDs
What should be expected during recovery from breast
reduction?
Breast reduction surgery is most often preformed as an outpatient
procedure at a hospital or surgical center. When the procedure is
completed, dressings or bandages are applied to the incisions. An
elastic bandage or support bra may be worn to minimize swelling and
support the breasts as they heal. The physician and their staff will
provide all post-operative wound care and answer any questions that
arise. Patients are sore and tired for a few days after surgery and
should plan on 1-2 weeks down time before gradually returning to full
activity levels. A full recovery can take up to 6 to 8 weeks.
Next steps?
If you are considering breast reduction surgery, it is worth your time
to discuss your issues with a board-certified plastic surgeon.
Dr. Wyatt is a board-certified plastic and reconstructive surgeon,
board-certified hand surgeon and board-certified general surgeon with
over 30 years of experience. He is affiliated with Kimball Health
Services and sees patients in Kimball, Nebraska and Pine Bluffs,
Wyoming. For an appointment at either location, call (308) 235-1953.
References
American Society of Plastic Surgeons - Reconstructive Procedure/Breast
Reduction.
https://www.plasticsurgery.org/reconstructive-procedures/breast-reduction
Do I Really Need an Antibiotic to Get Well?
FEBRUARY 28, 2020
BY HOLLY DOBRINSKI, FNPC
Many people this time of year get sore throats, ear aches, coughs, and
other various symptoms and seek medical care. Unfortunately, according to
the CDC (Centers for Disease Control and Prevention) at least 2.8 million
people get an antibiotic-resistant infection, and more than 35,000 people
die from them each year.
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Many people this time of year get sore throats, ear aches, coughs, and
other various symptoms and seek medical care. Unfortunately, according
to the CDC (Centers for Disease Control and Prevention) at least 2.8
million people get an antibiotic-resistant infection, and more than
35,000 people die from them each year. We are going to briefly discuss
ways as a patient you can help in the fight against resistant bacteria
and help protect yourself and your family.
Antibiotic resistance does NOT mean that one’s body is resistant
to antibiotics, but instead means that the bacteria (or microbe in case
of fungus) has changed in a way that it is no longer going to be killed
by an antibiotic (or antifungal in the case of fungus).
There are many examples of ways that antibiotic resistance threatens
modern medicine and our current abilities to care for patients.
According to the CDC, at least 1.7 million adults develop sepsis each
year and need emergently treated with effective antibiotics in order to
save their lives. Many surgical patients also require antibiotics before
and after surgery to prevent or treat infections. There are also chronic
conditions, like diabetes, kidney failure and dialysis patients, organ
transplant patients, and cancer patients on chemotherapy, that
predispose patients to developing infections that require antibiotics or
they could die. This is millions of people across the US that have needs
that warrant the use of effective antibiotics every day (CDC, 2019)
Healthy habits can help protect you from infections and stop germs from
spreading. These habits include keeping current on all recommended
vaccinations, keeping your hands washed and clean, keeping any wounds
clean, and keeping your chronic health conditions, like diabetes, under
good control.
Antibiotics save lives daily for both animals and humans, however, they
don’t always come without side effects and as mentioned,
resistance the more they are used. Antibiotics do NOT work on viruses
(like colds or flu). If you or your animals become ill, talk to your
health care provider or veterinarian regarding the need for antibiotics.
Do not assume that just because there is a sore throat or sinus
congestion, that you NEED an antibiotic or that you will be given one.
Also know that antibiotic resistance is a worldwide issue. Make sure you
report to your health care provider if you have traveled out of the
country or received care in another country (CDC, 2019)
8 ways to be antibiotic aware
-
Antibiotics save lives, but are not always the answer when you are
sick.
- Antibiotics do NOT work on viruses.
-
Antibiotics are only needed for treating certain infections caused by
bacteria.
- An antibiotic will NOT make you feel better if you have a virus
- Anytime antibiotics are used, they can cause side effects.
- Taking antibiotics creates resistant bacteria.
-
If you need antibiotics, take them exactly as prescribed (and finish
them, no left overs).
- Stay healthy: cover coughs, wash hands, and get vaccinated.
Click to view tip sheets on determining if you really
need an antibiotic or not
and
how to protect yourself. When in doubt, check with your health care provider. We are always
willing to help!
Holly Dobrinski is a family nurse practitioner and primary health
provider at the Kimball Health Services Clinic in Kimball. For an
appointment, call (308) 235-1966.
References
Centers for Disease Control and Prevention (CDC)
Antibiotic/Antimicrobial Resistance. November 5, 2019.
https://www.cdc.gov/drugresistance/index.html
Centers for Disease Control and Prevention (CDC) Antibiotic Resistance:
5 Things to know. July 2, 2019.
https://www.cdc.gov/drugresistance/about/5-things-to-know.html
Centers for Disease Control and Prevention (CDC) About Antibiotic
Resistance. November 4, 2019.
Silent Killer
FEBRUARY 19, 2020
BY DR. JAMES BROOMFIELD, MD
High blood pressure affects nearly half of all American adults. Many
people with high blood pressure don’t even know they have it
because it is often a symptomless “silent killer.” When left
untreated, the damage that high blood pressure does to the circulatory
system is a significant contributing factor to heart attack, stroke and
other health threats.
See More
High blood pressure affects nearly half of all American adults. Many
people with high blood pressure don’t even know they have it
because it is often a symptomless “silent killer.” When
left untreated, the damage that high blood pressure does to the
circulatory system is a significant contributing factor to heart
attack, stroke and other health threats.
High blood pressure occurs when the force of blood flowing through
your blood vessels is consistently too high. Blood pressure is
recorded as two numbers:
-
Systolic blood pressure – (the first number) – how much
pressure your blood is exerting against your artery walls when your
heart beats
-
Diastolic blood pressure (the second number) – how much
pressure your blood is exerting against your artery walls while the
heart is resting between beats
There are five blood pressure ranges as recognized by the American
Heart Association. They are:
- Normal – 120/80 mm Hg or less
-
Elevated – Readings consistently range from 120-129 systolic
and less than 80 mm
-
Hypertension Stage 1 – Readings consistently ranges from
130-139 systolic or 80-89 mm Hg diastolic
-
Hypertension Stage 2 – Readings consistently ranges at 140/90
mm Hg or higher
-
Hypertensive crisis – Blood pressure readings that exceed
180/120 mm Hg require medical attention*
High blood pressure develops slowly over time and can be related to
many causes. The only sure way to know if you have high blood pressure
is to have your blood pressure checked regularly. If you have been
diagnosed with high blood pressure, here are some solutions to help
you work with your provider to get your blood pressure under control.
- Ask about your blood pressure at your annual check up
-
Know your numbers – know what your blood pressure should be
-
Become a tracker – keep a log of your blood pressure levels
-
Be flexible – it may take time to get to your blood pressure
goal
-
Know yourself – be aware of barriers to better health and talk
to your provider about them
Dr. Broomfield has been practicing medicine in rural settings for over
25 years. Like the country doctors before him, Dr. Broomfield is
committed to providing quality family health care to his patients, no
matter where they are. He even makes the occasional house call.
Board-certified in family medicine, he joined the Kimball Health
Services medical staff as our medical director and chief of staff in
September, 2013. He sees patients in the Kimball Health Services
Clinic and Pine Bluffs Health Clinic. He also offers a skin care
specialty clinic at each facility twice a month.
*If your blood pressure is higher than 180/120 mm Hg and you are
experiencing signs of possible organ damage such as chest pain,
shortness of breath, back pain, numbness/weakness, change in vision or
difficulty speaking, do not wait to see if your pressure comes down on
its own. Call 911.
Your Heart Skips a Beat, is it Love or Atrial Fibrillation?
FEBRUARY 12, 2020
BY ANN ANDERSON, FNP-C
It is once again that time of the year---Valentine’s Day.
It’s a time when our hearts flutter or skip a beat because of the
love we have for somebody…but what if that skipped, irregular
heart beat is a sign of something more serious...atrial fibrillation?
See More
It is once again that time of the year---Valentine’s Day.
It’s a time when our hearts flutter or skip a beat because of
the love we have for somebody…but what if that skipped,
irregular heart beat is a sign of something more serious...atrial
fibrillation?
What is atrial fibrillation?
Normally, your heart contracts and relaxes to a regular beat. Certain
cells in your heart make electric signals that cause the heart to
contract and pump blood. In atrial fibrillation (AFib), the
heart’s two small upper chambers (atria) don’t beat the
way they should. Instead of beating in a normal pattern, the atria
beat irregularly and too fast, quivering like a bowl of gelatin. It is
estimated that at least 2.7 million Americans are living with atrial
fibrillation, or AFib.
The cause of atrial fibrillation is not always known, however it can
be the result of uncontrolled high blood pressure, coronary artery
disease or a complication from heart surgery. No matter the cause, the
most serious risk is that it can lead to other medical problems
including:
- Stroke
- Heart failure
- Chronic fatigue
- Additional heart rhythm problems
- Inconsistent blood supply
Who is at risk for atrial fibrillation?
Anyone can develop atrial fibrillation, but typically people who have
one or more of the following conditions are at greater risk of AFib:
- Advanced age
- High blood pressure
- Underlying heart disease
- Drinking alcohol
- Family history
- Sleep apnea
- Athletes
-
Other chronic conditions – thyroid problems, diabetes, asthma
What are the symptoms of atrial fibrillation?
People with atrial fibrillation may not have any symptoms and their
condition is only detectable upon physical examination. Still others
may experience one or more of the following symptoms:
- General fatigue
- Rapid and irregular heartbeat
- Fluttering or “thumping” in the chest
- Dizziness
- Shortness of breath and anxiety
- Weakness
- Faintness or confusion
- Fatigue when exercising
- Sweating
- Chest pain or pressure*
How is atrial fibrillation treated?
Treatment of atrial fibrillation begins with a proper diagnosis
through an in-depth examination from your healthcare provider. After a
diagnosis, treatment goals will include restoring normal heart
rhythms, reducing heart rate, preventing blood clots, managing stroke
risk factors and preventing heart failure.
You can live with AFib. While nothing in life is guaranteed, you and
your healthcare provider can work together to reduce your risk of
stroke and other complications from AFib.
For more detailed information on atrial fibrillation, visit the
American Heart Association website.
https://www.heart.org/en/health-topics/atrial-fibrillation
Ann Anderson, FNP has focused on the practice of general cardiology
for nearly 20 years. She is a board-certified ANCC family nurse
practitioner and is a certified cardiac device specialist with the
International Board of Heart Rhythm Examinations. Joining the Kimball
Health Services team in 2016, Ann sees family practice patients at the
Pine Bluffs Health Clinic and offers cardiology clinics at both the
Kimball and Pine Bluffs clinics.
*Chest pain or pressure is a medical emergency. You may be having a
heart attack. Call 911 immediately.
What is a Board-Certified Hand Surgeon?
FEBRUARY 4, 2020
BY DR. WILLIAM WYATT, MD, FACS
Take a look at your hands. They are a marvel of nature; made up of
bones, joints, ligament, tendons, muscles, nerves, skin and blood
vessels which all must work together to do the most delicate of
tasks. So much of what you do every day depends on your
ability to use your hands – opening a door, drinking your morning
coffee, tying your child’s shoes, working at a computer, driving
and so much more.
See More
Take a look at your hands. They are a marvel of nature; made up
of bones, joints, ligament, tendons, muscles, nerves, skin and blood
vessels which all must work together to do the most delicate of
tasks. So much of what you do every day depends on your
ability to use your hands – opening a door, drinking your
morning coffee, tying your child’s shoes, working at a computer,
driving and so much more.
Just like other parts of your body your hands can be affected by
disease, birth defects and traumatic injury, and when something goes
wrong, it can be debilitating. Physicians who treat problems of the
hand are known as hand surgeons. A board-certified hand surgeon
receives specialized training in treatment of the hand. This training
is above and beyond the training they receive as a plastic surgeon,
orthopedic surgeon or in general surgery. Physicians spend a full year
in this specialized additional training in the area of hand surgery
and must pass a rigorous certification examination in order to receive
board certification from the American Society of Surgery of the Hand.
Conditions treated by a board-certified hand surgeon can include
problems of the elbow, arm and shoulder. Other conditions include:
- Carpal tunnel syndrome
- Tennis elbow
- Wrist pain
- Traumatic injuries to the hand, wrist and forearm
- Trigger finger
- Arthritis
- Nerve and tendon injury
- Birth defects
Hand surgeons do not have to treat all problems with surgery. They
often recommend non-surgical treatments such as medication, splints,
therapy and injections.
If you are experiencing any sort of pain or discomfort or have
suffered an injury to your hands, wrists or arms, it is worth your
time to discuss your issues with a board-certified hand surgeon.
Dr. Wyatt is a board-certified plastic and reconstructive surgeon,
board-certified hand surgeon and board-certified general surgeon with
over 30 years of experience. He is affiliated with Kimball Health
Services and sees patients in Kimball, Nebraska and Pine Bluffs,
Wyoming. For an appointment at either location, call (308) 235-1953.