HRM Health May/June - Get Healthy and Shape Up, Kidney Care to prevent Dialysis, and Healthy Habits for your eyes


Summer Shape Up

Get heart healthy this season with these food and exercise tips.

Many of us have long since broken New Year’s resolutions to eat right, exercise more and lose weight. Spring and summer are great times to reboot those resolutions and get heart healthy. Bonus—losing weight will not only boost your heart health but also will improve your kidney and eye health (see pages 46 and 48) and improve your overall condition.

If you’ve been anchoring the couch all winter, the warm weather may inspire you to get moving. Even if you were in great shape just a few years ago, don’t go out too fast, says Kristin Thompson, athletic training coordinator for Bon Secours Hampton Roads.

“People remember what shape they were in before they had children or before something else happened, and it’s frustrating,” Thompson says. “It takes so little to de-condition, and it’s so much work to get back to where you were. We tell people to set realistic expectations. Your goal may be to run in one of the many 5Ks and other races offered in Hampton Roads. You wouldn’t want to sign up the week before.”

Swing your legs off the couch and start with a 20-minute walk after dinner. The second week, increase your distance or go the same distance at a faster pace, Thompson says. Summer also is a great time to dust off your old bicycle. You can even rent a bike at many area parks. “For someone just starting out, cycling is a lot easier than running or walking,” Thompson says. “Swimming also is a great form of exercise too. Get in the pool with the kids.” Speaking of kids or grandkids, get outside and play catch, baseball or football—“ anything that gets you moving,” Thompson says. Walk around the park or the zoo and you may have so much fun you’ll forget you’re exercising. You can also incorporate exercise into your daily routine by parking at the far end of the parking lot wherever you go to add steps to your day.

As exercise becomes more a part of your life, you’ll want to move faster and boost the intensity to increase your heart rate. “When your heart rate goes up, you’ll improve your cardio-vascular health and get a whole slew of other benefits,” Thompson says. All that exercise is bound to make you hungry, but don’t reach for the chips and cookies. Instead, go for seasonal vegetables, lean meats and fruit, says Sheila A. Bailey, a registered dietitian with Bon Secours In Motion Physical Therapy Sports Performance. Fill your plate with seasonal salad fixings, fresh fruit and just-picked herbs from your own garden. You can often buy herbs in pots in the grocery store or home improvement store at about the same cost as packaged fresh herbs. And ladies know—the grill is your friend if you want a break from the kitchen.

When you fire up your grill, try lean meats and fish, Bailey says. The key for success with lean meats such as flank steaks is to marinate them first. A good marinade for flank steaks includes low sodium soy sauce (leave out if you’re watching your salt intake), crushed garlic cloves, chopped ginger root, a little vermouth and a little canola oil. Lean meats are cheaper too. Fish, especially thicker fish such as tuna, also are great for grilling, she says.

Fresh corn on the cob is tasty almost any way you cook it. Try it on the grill— pull the husk back, take off the tassels or silk, add a butter-olive oil spread and grill it, Bailey suggests. Other good veggies for grilling either alone or with meat are onions, yellow squash, zucchini and bell peppers of all colors. For extra flavor, take the stem from a rosemary branch, remove the rosemary leaves and save for another use, soak the branch for a couple of hours and then use it as a skewer—you’ll appreciate the rosemary flavor, Bailey says. For dessert, grill pineapple—even canned will work. You may not even miss the cookies.



Kidney Care

Prevent dialysis and transplants with a few simple steps.


When patients walk into the office of kidney specialist Dr. Joanne Siu, they’re usually scared. “When people hear they have a kidney problem, they immediately think ‘dialysis,’” says Siu of Peninsula Kidney Associates in Hampton. Other patients see her for the first time from a hospital bed. “I can’t tell you how many people I’ve seen in the hospital,” she says. “Their blood pressure is sky high, 200 over 100, and we’re already talking to them about dialysis. They’re shocked. They had no idea.” The bad news—kidney disease may cause few to no symptoms. The good news—just because you’ve been referred to a kidney specialist doesn’t mean you’ll be heading to a dialysis center the next day. The better news—you can take steps to prevent and slow kidney disease.

“We do have a high incidence of kidney disease in Hampton Roads,” Siu says. “Because we have so many patients progressing to end stage kidney disease, the dialysis units are having to increase in number.”
Healthy habits and preventive care make a difference. More than 70 percent of kidney failure is caused by diabetes (the leading cause) and high blood pressure (the number two cause), Siu says. Smoking accelerates kidney disease. So, if you needed any more reasons to eat healthy, lose weight and quit smoking—do it for your kidneys. Early detection of high blood pressure, diabetes and kidney disease is key to preventing kidney failure. African-Americans are at higher risk—researchers have linked a gene found in this population to kidney disease, Siu says. Other risk factors include a family history of diabetes, high blood pressure and kidney disease.
Left untreated, diabetes and high blood pressure accelerate kidney disease, Siu says. “But a lot of people have no idea they have diabetes and hypertension,” she says. “You can get a blood pressure check very easily. You don’t even have to go to a doctor—you can get it done at a pharmacy. For diabetes, all it would have taken would have been a simple urine or blood test and we could have detected it at an early stage and tried to manage it with diet and exercise.”

Knowing you have kidney disease is important as you partner with your physician to treat high blood pressure too. “Certain types of blood pressure medication are better for kidney disease in terms of slowing it down,” she says. Being overweight, of course, is a contributing factor to diabetes, high blood pressure and kidney disease. Hampton Roads has an obesity rate of 25 percent, Siu says, and growing. It’s more common to see patients in the hospital weighing 300 to 400 pounds,” she says. What this means is that even though kidney disease remains a disease that affects the elderly, it is starting to develop in young people too. “I see it more often in 20- to 40-year-olds now,” Siu says. “Once you start to damage the kidneys, kidney disease is going to progress. Even if you control it, it’s hard to reverse it. We try to slow it down so they won’t end up on dialysis.”
Dialysis is akin to having a part time job—except you don’t get paid. Most patients go to a dialysis center three times a week and spend about four hours on the machine each session, Siu says.
You’re on a lot of dietary restrictions—few fluids, low salt. And, “once you’re on dialysis, the only real option is getting a transplant,” she says.

In recent years, there has been a big push for pre-emptive kidney transplants, says transplant specialist Dr. Hoang-Hai Nguyen, also of Peninsula Kidney Associates. Studies have shown that transplanting a kidney before or instead of starting dialysis improves patients’ morbidity and mortality, he says. (That means you live longer.) Unfortunately, many patients have to wait four years for a kidney transplant, Nguyen says. The National Kidney Foundation, Peninsula Kidney Associates and others offer kidney disease screenings, often for free. Let this be your wakeup call—it can save your life.



Focus On This

Many health habits also help your eyes.

You’ve likely heard that you need to lower your cholesterol to reduce the risk of heart disease, lower your blood sugar to reduce your risk of diabetes, cut back on sun exposure to lower your risk of skin cancer and quit smoking to reduce your risk of lung cancer. If those health risks haven’t gotten your attention, focus on this—those healthy lifestyle changes also can help prevent eye problems. And any change in your vision should prompt you to call your eye doctor. First, look at cataracts. Symptoms might include having trouble driving in low light conditions such as a dark road with no streetlights, at dusk or in the rain, says Dr. Samuel N. Garrett of Virginia Beach Eye Center. You may have trouble reading the fine print—and a stronger prescription doesn’t help, Garrett says. The bottom line is cataracts—a yellowing and hardening of the eye’s lens—come with age, Garrett says. “Everyone gets them starting at age 40. It’s going to get worse over time if you live long enough.”

Your eye doctor will monitor your cataract as it grows. Eventually, you’ll likely have surgery to remove it once it significantly influences your daily living, Garrett says. But you can delay the inevitable. Diabetics get cataracts at a younger age than the rest of the population, so Garrett recommends controlling blood sugar. One study suggested a connection between a lot of sun exposure and cataracts, so put on a hat and those sunglasses. “It’s hard to prove it, but most of us really believe that heart healthy living— eating right, exercising, controlling your weight—will reduce your chances,” Garrett says. “Any insult to your body— high blood sugar, high cholesterol, being drunk all the time—builds up in your eye’s lens.”

Another eye problem is macular degeneration, which again affects older people. About three percent of the population hasit and that’s increasing as more people move into the senior citizen category, Garrett says. Macular degeneration is when the retina wears out—almost like arthritis, he says. One symptom is central vision loss. There are two kinds of macular degeneration— dry (which accounts for about 90 percent of cases) and wet, Garrett says. Although age is the biggest risk factor, another major risk factor is smoking. One more reason to kick the habit. Vitamins, especially A, C, E, zinc and fish oil, have shown in some studies to slow the progress of the dry form of macular degeneration in those who already have it, Garrett says. There’s also a monthly injection treatment, but it’s pricey—$1,500 a shot. “But the alternative is going blind,” he warns.

Holes, tears and detachments in or of the retina are another issue for concern. Symptoms include seeing more floaters, seeing flashing lights and/or shadows and loss of peripheral or central vision, Garrett says. An injury or trauma could be to blame or the issue could be the result of high near-sightedness or family history, he says. The sooner you see your eye doctor the better. That’s because a detached retina could start off a tear and then worsen to a complete detachment. “When a tear hasn’t progressed to detachment, it’s easierto treat,” he says.

Finally while any of these symptoms should prompt you to visit your eye doctor, you should get routine eye exams anyway because one condition that robs people of their vision often causes no noticeable symptoms. Glaucoma, elevated pressure in the eye, affects one percent of the population but has no or few symptoms until the end, Garrett says. “Most of the time (the higher pressure) is not felt by the patient,” Garrett says. “The damage happens so slowly. People lose their peripheral vision and they can’t even tell except in testing situations. The central vision is the last to go. We get people who are seeing fine until the end and then they’re losing their optic nerve.” Glaucoma affects more African- Americans so that population should be aware of the risk. Other risk factors include a family history and people who have had eye surgery. “Even without symptoms, you need to have periodic eye exams,” Garrett says.

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