Coconut Oil, not healthy after all ?

The American Heart Association just recently released a warning against using coconut oil to cook with. When I saw this I was personally shocked. A few years ago I was following the Paleo diet and they told us to cook with nothing but coconut oil. And yes, we did see weight loss plus it gave the foods we cooked a nice flavor as well. My husband and I slowly stopped using coconut oil just because it has always been more expensive then the others. The American Heart Association conducted trials which showed that seven out of seven trials of people consuming coconut oil had an increase in their LDL cholesterol. LDL is low-density lipoprotein also known as the “bad” cholesterol. LDL causes the increase of atherosclerotic plaques and increases chances of heart disease such as coronary artery disease.

As a healthcare provider I know it will be a challenge changing the mindsets of those who have been cooking with coconut oil for years and have always heard the previous rave of health benefits. Checking lipid panels on patients annually and now asking them if they cook with coconut oil can be an identifier and cause if they have elevated LDLs. The American Heart Association advises that it is still safe to use on skin and hair but to avoid consuming it. I have already seen many people on social media discrediting the AHA with this new warning, so we must remember education is key when caring for patients to prevent disease and negative outcomes.

Figure 1. Fats: the Good, the Bad, and the Ugly.

Palpitations

Have you ever had the sensation of your heart skipping a beat ? Well that may have been a palpitation you felt. There are many causes for palpitations that we will discuss. These causes include: hyperthyroidism, hypocalcemia (low calcium levels in the blood), hypoglycemia (low blood sugar), anemia, hypertension, infection, anxiety attacks, causative agents (caffeine, alcohol, nicotine, recreational drugs, stimulants, stress, exercise, over the counter weight control medications), and mitral valve prolapse.

When a patient comes in complaining of palpitations as a healthcare provider we must run all of these differential diagnoses through our mind. We must complete a detailed history and physical to find the causative agent or refer to cardiology if all signs point to cardiac origin. If the patient is complaining of palpitations along with chest pain, we must defer them to the emergency room immediately to rule out life threatening cardiac issues.

Of course if the identified cause can easily be solved by lifestyle changes such as reducing caffeine intake, we must educate our patients on lifestyle changes. Palpitations is a condition we as healthcare providers should not take lightly and must adequately work-up each patient for. If you are experiencing palpitations, contact your healthcare provider immediately to be evaluated.

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Hypertension (High Blood Pressure)

Hypertension is known as the “silent killer”. A person rarely has any symptoms of hypertension and can live with it for years without knowing. The effects of long term high blood pressure can be life-threatening. The outcomes from hypertension can be stroke, myocardial infarction (heart attack), and it can damage organs such as the kidneys leading to renal failure. It is highly important to be routinely screened for hypertension and to manage it appropriately to prevent these outcomes.

The Eighth Joint National Committee guidelines on hypertension express that adults over the age of 60 must strive for a blood pressure goal of less than 150/90 mm Hg. For adults aged 30 – 59 and those with diabetes and chronic kidney disease, the panel recommends a goal of less than 140/90 mm Hg.

The first line of treatment for hypertension would be lifestyle modifications. This includes: exercise, healthy diet, and restricting sodium intake. High levels of sodium causes fluid to be retained in the body which increases blood volume thus increasing blood pressure. If lifestyle modifications do not work then it is time to move to medications.

The healthcare provider has various medication options for the hypertensive patient.

These include:

  • ACE inhibitors – Ex: Lisinopril, Benzapril,
  • ARBs – Ex: Losartan, Valsartan
  • Calcium Channel Blocker – Ex: Amlodipine, Verapamil, Diltiazem
  • Thiazide-type Diuretics – Ex: Hydrochlorothiazide, Metolazone

In the black population it is recommended to initiate hypertensive medication therapy with a calcium channel blocker and a thiazide-type diuretic.

If blood pressure is not controlled with one medication, a second class can be added. It is not recommended for an ACE inhibitor and an ARB to be used in conjunction. If two medications cannot control the blood pressure then a third class can be added. If blood pressure goal is still not being attained then referral to a hypertensive specialist is recommended.All about hypertension or high blood pressure #hypertension #highbloodpressure:

The Compound Effect by Darren Hardy

The Compound Effect is a book I had to read for my Healthcare Economics class. I have to say this book is probably one of the best at laying out the blueprint on how to be successful. If you haven’t read it yet, I highly suggest you do. I finished it in one day, it was that captivating and motivating. It gives you the steps you need to take to be successful not just in your career but in life, finance and relationships. What it boils down to is if everyday you make small positive changes then over time it will result in a drastic change or outcome. An example is saving for retirement at an early age. Over time you keep saving and saving, once you hit retirement you have a reliable source of money. If you never made that decision to save for retirement then you perhaps cannot travel the world or live comfortably as those that did. I am including the link to this book in case you decide to read it, it is also available on Kindle.

https://www.amazon.com/Compound-Effect-Darren-Hardy/dp/159315724X/ref=sr_1_1?ie=UTF8&qid=1492911214&sr=8-1&keywords=the+compound+effect

First Trimester

Well I am almost 9 weeks pregnant and boy does pregnancy take a toll on the body. I have been feeling super tired, taking long naps during the day. I have been throwing up at night time after dinner which I think is related to acid reflux. Many people say the second trimester is when you start feeling better, I cannot wait ! Oh! Also it’s like an overwhelming feeling of nausea/hunger just comes at random times. Like the type of hunger as if you didn’t eat in days. As soon as that feeling comes over the only thing that will help is eating carbs ASAP! I am still trying to stay active even though I feel like a zombie sometimes and also trying to stay positive through the whole journey. Pregnancy comes with a lot of changes not just physically but emotionally and mentally as well. It helps to have an amazing support system! Also this picture I include pretty much sums it up !

First Trimester Feelings:

 

Healthy Recipes

Having a hard time figuring out what eating healthy looks like ? Trust me, I have been there and still struggle with trying to find new ways to incorporate healthy meals into my families diet. For the longest time eating healthy to me meant meal prepping. This at which I was truly HORRIBLE at. Yea I would be motivated the day I cooked for hours cooking 10-15 chicken breasts, baking sweet potatoes and cooking some broccoli. I would have all of our to-go containers in the fridge ready to eat. Thing was after 2 days I didn’t want to eat the same meal again and that’s where we began to go downhill eating out and deviating from our meal plan. Since multiple failed attempts at meal prepping now I try to research new healthy recipes that incorporate different flavors and vegetables giving more of a feeling of variety. I am going to include multiple links to many of my favorite recipes I have tried below. Please give a try and do some research and share your recipes !

One Pan Southwestern Chicken and Rice

Quick & Healthy Dinner: 20 Minute Honey Garlic Shrimp

http://www.simplyrecipes.com/recipes/avocado_chicken_salad/

Crispy Baked Lemon Parmesan Chicken

Healthy Buffalo Cauliflower Bites Recipe

Pregnancy and Exercise

Staying active when pregnant has many key benefits. These benefits include: strengthening your body for childbirth, improving your mood, helping with sleep, boosting energy, easing back pain and many other aches, and reducing your risk of complications such as developing gestational diabetes or needing to have a c-section. I just recently found out I am pregnant and I intend in staying as active as I can through the pregnancy. Currently I practice yoga and go to the gym with my husband 3-4 times a week. People must understand as well that though there are some exercise restrictions such as avoiding contact sports and doing sit-ups, most exercise is considered safe. Yoga, swimming, walking, dancing, biking, and even weight lifting are considered safe if your healthcare provider agrees. I may post in the upcoming weeks with the progress of my pregnancy and how my body will be changing.

Exercise during pregnancy is associated with multiple health benefits for both you and your baby, and is safe for most women from the time of conception to delivery. Staying active while pregnant can help prepare your body physically for labor and delivery, as well as boost your mood and energy levels. Exercising regularly will also help you lose weight and recover faster following the birth of your baby.:

Clostridium Difficile AKA C.Diff

Working in a hospital setting I have seen numerous patients with C.Diff infections. What is C.Diff you ask ? Well it is an infection by a bacteria that we can commonly come in contact daily. The Clostridium Difficile bacteria can be found in bathrooms, foods, hospital settings, and more. Usually our bodies defense in our gut keeps this bacteria at a level where it can do no harm to us. This level can be disrupted when someone takes antibiotics which kill the good bacteria in our intestines. This killing off of the good bacteria allows the C.Diff bacteria to multiply and take over. Symptoms of this infection include: DIARRHEA, fever, and stomach pains. Many healthcare professionals along with me will tell you this diarrhea has a very strong smell.

Ways to prevent the spread of this bacteria include: HAND WASHING! Healthcare professionals who care for these patients must follow contact precautions (gown and gloves). Any visitors for a patient with this infection must also follow contact precautions. Avoiding over-prescribing antibiotics for viral infections. The most important of these is hand washing.

The treatment for this infection is Oral Vancomycin and IV Flagyl.c_diff_infection_preview_660px.gif (659×1175):

 

Education as Prevention

This semester in my Nurse Practitioner courses we started our first clinical experience. I have been completing my hours in a primary care office where we mostly encounter the Hispanic population. Being from a Hispanic family my self I knew the importance of educating my patients extensively as I had done with my parents and family members. Education is the number one best thing you can do for your patient in preventing disease. An example was my parents would eat white rice everyday for dinner. And not a small portion, I am talking about a full plate of white rice. I explained to them the lack of nutritional value in white rice and how it increases blood sugar. They continued to eat it everyday because they were set in their ways. Recently my mother had labs done and it showed her blood sugar was borderline, the physician educated her again on her diet and how to prevent the progression to diabetes. Slowly but surely, with my advise constantly being given they have ceased to consume white rice and have replaced it with fresh vegetables and salads. Now her blood sugar levels are in normal range and she saw the true benefit of education and diet modification in preventing a disease.

When seeing a patient remember, EDUCATION EDUCATION EDUCATION! Many patients do not want to be thrown another medication to cover up their problem when there is a solution to it that can be given by you through educating them!Cost/Benefits and importance of patient education #infographic #healthcare www.pfh.org Find us on Twitter and Facebook!:

Bedside Handoff Report

Bedside handoff is an essential component when it comes to nursing care. What I have observed with even working in the clinical setting is that bedside handoff is not being strictly implemented or done by any nurses during shift change. Report is still being given at the nurses station which leads to incorrect information, sentinel events and also excluding the patient from their own care.

The Joint Commission reported that about 70% of sentinel events were due to lack of communication during handoff report (Riesenberg, Leitzsch & Cunningham, 2010). What this tells us is that there has to be a change implemented to improve patient care and outcomes. Educating healthcare professionals on the importance of bedside handoff I believe will make this transition smoother.

Bedside handoff allows the nurses to look at the patient and check for important things such as lines, IV drips and rates, skin issues, and also allows the patient to have a say in their own care. As healthcare professionals it is our job to provide safe and effective care while also providing quality service to our patients. Practicing bedside handoff will increase patient satisfaction and raise hospital survey scores.

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Reference:

Riesenberg, L. A., Leitzsch, J., & Cunningham, J. M. (2010). Nursing handoffs: a systematic review of the literature. The American Journal Of Nursing, 110(4), 24-34. doi: 10.1097/01.NAJ.0000370154.79857.09