Can your Antibiotic cause an Untimely Death?

So many people know about the broadband antibiotic Azithromycin, also known as the Z-Pak, and many times people will call their Healthcare Practitioner (HCP) and ask for it by name. And over 55.3 million prescriptions were written for the Z-Pak last year alone! Not only is that a bad idea because using such a powerful antibiotic and not necessarily treating the appropriate organism can lead to antibiotic resistance organisms, but a new study is showing that the use of Z-Paks can also lead to heart arrhythmias, stroke, and death.

Z-PakWhat can happen?

The New England Journal of Medicine recently published a study, showing that people who took the Z-Pak were more likely to die of a heart attack, stroke, sudden cardiac arrest, or an arrhythmia (abnormal beating of the heart) than those prescribed other antibiotics. The Z-Pak is used so much because there are less pills over a shorter period of time than other antibiotics, such as amoxicillin, and there are many people with penicillin allergies that cannot take amoxicillin, so there is an increased use, because patients may be more likely to actually take the medicine appropriately and for the prescribed amount of time. All Medicaid patients on the Z-Pak and other antibiotics from 1992 to 2006 were looked at, at it was found that those on the Z-Pak were 2.5% more likely to die than those on other antibiotics. And, certain patients had a 10% increase for risk of death. Unfortunately they are still looking into the exact mechanism that maybe causing certain patients to die, but they are still researching that further.

Am I at Risk?

Now just because this study came out, and you may be taking a Z-Pak to treat a bacterial infection, it does not mean that you are going to die! The subset of patients that had a higher risk of cardiac death had a history of cardiac disease and/or arrhythmias (irregular heartbeats) for various different reasons. So, while that particular reason is being studied, HCP’s need to ensure that they are utilizing the Z-Pak appropriately and when needed, and using more bacteria specific antibiotics, especially when patients have a cardiac history.  Also, it is important to only use antibiotics when you have a bacterial infection; many people go to their HCP in the throes of a viral infection and insist upon antibiotics, and clearly there are risks.

Trust your HCP that they will treat you with an antibiotic, if necessary, and realize that asking for a specific brand, may not be the most appropriate course of treatment, just because they have more advertisements! Asking for drugs by name, and pressuring your HCP for a specific treatment may not be the best thing for your health.  Seek treatment when necessary and have some faith that your HCP knows what is best!

Yours in Good Health


What does my blood pressure actually mean?

People are getting their blood pressure checked before every appointment they have with HCPs, but I feel like many times people are told what their pressure is, then they are reassured that “it’s good” or “we need to watch that”…and’s that’s it!  It seems to be a big question to many people of what their blood pressure should be and what the numbers actually mean? It’s a shame that more Healthcare Practitioners (HCP’s) don’t explain it to you, but increasing your own blood pressure (bp) IQ is a great place to start to improve your wellness!

What is the top number?

If you are told that your bp is 120/80, the top number (120) is also known as the systolic pressure. Basically, every time your heart beats, it is using pressure to force the blood from the heart our to your hands, feet, head, and all of those vital organs that help you to live. Blood that leaves the heart to get to all of these other areas, is full of oxygen, so that the oxygen can be used at those sites far from the heart and lungs, and the blood travels through arteries to get there. So, the force that is required by the heart to push that blood out through the arteries is your systolic blood pressure. A systolic blood pressure of 120 mmHg (millimeters of mercury) or below is considered good. A systolic pressure of 121-139  is considered pre-hypertension or “borderline” hypertension, and any reading greater than 140 is considered hypertension (AKA high blood pressure).

What is the bottom number?

If your blood pressure is 120/80, then 80 is your diastolic pressure (the bottom number.) Your diastolic pressure is the pressure in your arteries between your heart beats (so when the blood is not rushing out from the heart).  And, similar to high systolic pressures, high diastolic pressures can also be a sign of decline in health and we need to make some changes. A diastolic pressure less that or equal to 80 is good, 80-89 is pre-hypertension, and 90 or higher is considered diastolic hypertension.

What does this mean?

If you are in the “pre-hypertension” zone, you can sometimes make some healthy lifestyle choices that will help to decrease your pressures like eat a low salt diet, decrease your fat and cholesterol intake, start working out (or work out more), and drink more water. Also, cutting out red meats and eating more lean proteins can help to decrease the fat and cholesterol intake and make some pretty big changes in your blood pressure.  Sometimes it is also related to stress, so learning some de-stress techniques, doing yoga, meditation, acupuncture, can all help with decreasing stress and anxiety and do wonders for blood pressure. Work with your HCP to create a plan, but if these measures don’t work, and sometimes they don’t because of genetic high blood pressure, then you may need to start a medication to help regulate those pressures.

How often should I get checked?

If you are healthy, and your blood pressures are normally below the 120/80 mark, with no other health issues, you can go two years between getting checked ( I usually suggest annual screening, and even just checking your blood pressure at the pharmacy).  If you are pre-hypertensive, you should go every 6 months just to see if the interventions you are making are having an effect on your pressures.  And if you are hypertensive and starting medications, your HCP may have you getting your blood pressures checked regularly while you are starting your medications to make sure you are getting the correct dose and then you don’t need to check as often.  My personal suggestion, if you are on any sort of blood pressure regulation medication is to purchase a blood pressure cuff (electronic) from the pharmacy, and have it just to check your blood pressure every once in a while to make sure that you are on the right track! Plus if you ever get symptoms like light-headedness or headaches that won’t go away, you can check quickly to see if your blood pressure (either low or high) may be the culprit!

It is a good idea to know what your blood pressure is, and now you know what those numbers mean.  Talk to your HCP if you have any concerns, or are worried about treatment options, they will work with you to find the best treatment that works with your lifestyle.

Yours in Good Health



Your Blood Type Can Determine Your Risk of Heart Disease?

There has been some interesting research coming out lately looking at various blood types (Type A, B, AB, or O) as an indicator for risk of heart disease.  To me, this is really fascinating, because there are so many times that people come up to me and tell me a horrible story about someone who is totally fit, eats right, young, and then “drops dead of a heart attack” (a quote I hear a lot).  I always think that there has to be a family history, something undiagnosed, or a predisposing factor. So, this research is important because maybe it really is part of those “genetics” that cause some people to be at a higher risk for certain diseases without having any other risk factors!

What is your Heart Disease risk based on your Blood Type?

There are two very large, ongoing studies that Harvard University runs, looking at various healthy populations, and they collect data on these research participants in all aspect of their lives: diet, nutrition, health issues, pregnancy, sleep, etc. and they continue to collect this data on these people for the duration of their lives. Between these two ongoing studies, the researchers looked at just shy of 90,000 people, analyzing data from 24 to 26 years for each participant, and what the data showed was pretty amazing.  People who have blood Type AB, have a 23% higher risk of heart disease as a baseline, whereas Type B put a 16% higher risk, and Type A was a 6% increased risk, as opposed to people with Type O blood, who have minimal risks (basically none).  Strange, right?  Just having one blood type, in particular, can seem to put you at a higher risk for heart disease and heart attacks.

How can your Blood Type determine your risk?

This part is still being studied for a more exact reasoning, because the way that the human body works, especially with blood and the clotting cascade, it is very difficult to pin point one factor (or explanation) for why different blood types carry within their cells innate varied risks for heart disease.  But the researchers have a hypothesis (a suggested reason) for why this phenomenon may occur: people who have Type O blood tend to bleed more (take longer to clot), so they would be less at risk for their blood spontaneously clotting to cause a heart attack or stroke. Also, people who have Type A blood, have been found to have higher Low Density Lipoprotein (LDL) levels (which is the bad cholesterol) circulating in their blood, as they lack an enzyme (that Type O has) which makes removing cholesterols more efficient.  Cholesterol is bad because it builds up in arteries and causes plaques and hardening of the vessels, which leads to an increased risk of plaques breaking off and causing a heart attack, less blood flow to the heart, and also increases the risk of clots forming that can lead to a stroke or heart attack.  So, if you have more circulating cholesterol, you have a higher risk of heart disease which can cause heart attacks.  Now, again, it is not truly known why people with Type O tend to bleed more or why people with Type A have more cholesterol circulating, but it is being studied to find more exact reasonings.

Is there anything I can do to decrease my risk for heart disease?

You cannot change your genetics, which is a bummer, but you can live a healthy lifestyle to promote heart health:

– Stay at a healthy weight

– Exercise at least 30 minutes per day 5-6 days a week

– Avoid smoking and using other tobacco products

– Avoid a high fat diet and load up on fresh fruit and veggies

– Get regular check ups to monitor your blood pressure, heart rate, and cholesterol levels

Talk to your HCP about your risks, and have an open communication about what is the BEST way to maintain a healthy heart based on your life and lifestyle, and when/if you need to be on any blood pressure medication.  It is always good to be monitored for healthiness, especially if you have a family history or Type AB blood, as we now have learned.  And….if you don’t know your blood type, that test can be performed in about 30 seconds (I learned in 8th grade science class- we all took a drop of blood and figured out our blood types- which I am now learning from various people is really strange.)  So figure out your risk factors, talk to your HCP, and live a healthy lifestyle (as best you can!)

Yours in Good Health



Belly fat may be worse for your health than obesity?

I guess it is one more reason to get into shape: there has been recent research to support that those of us with belly fat but a “normal” weight are at a higher risk for cardiovascular death than those that are obese. Good gravy.  Another thing to be worried about, but I guess it goes back to the whole “fat” skinny thing.  You can be within your appropriate weight but if you don’t work out and tend to have a lot of belly fat, this might be the inspiration you need to improve your diet and tighten that tummy!

What’s the Scoop?

New research (within the past two months) from the Mayo Clinic highlights the fact that people with a “normal” Body Mass Index (BMI) with belly fat present are at the highest risk of cardiovascular death, even when taking into account various risk factors such as race, age, sex, diabetes, and hypertension (high blood pressure).  Yikes.  It has been known that people with centrally based fat (thick around the middle) are at a higher risk for complications from their increased fat, but this is a new finding that people of a “normal” BMI are in this increased risk category.  This study was performed on 12,785 people over the age of 18 for over 15 years, and they found that people within their “normal” BMI with extra belly fat were 2.8 times more likely to die of cardiovascular causes, and 2.1 more likely to die from all other risk factors.  That is pretty significant. You think that you are at your normal weight, you could use to lose a little in the middle, but you are actually at a much higher risk for cardiac death?!?!  Ugh.  One more thing to worry about.

What can I do to decrease that risk?

– Get 30 minutes of cardiovascular activity a day (running, walking, biking, swimming, whatever gets you moving!)

– Drinks lots of water and ditch the high sugar sodas and other beverages

– Eat lots of fiber (whole grains, fruits, and vegetables)

– Get your green leafy vegetables in your diet (power packed with vitamins and fiber to fill you up)

– Don’t smoke (or quit if you do!)

– Eat less saturated and trans fats (they fill you up but they sit in your arteries and slow your metabolism)

– Coenzyme Q10 supplementation may be beneficial (still being researched but is thought to help reduce circulating cholesterol to prevent plaques from building up)

– Keep your Cholesterol levels in check

– Get regular check ups with your HCP

Basically, the best thing that you can do is eat a clean diet full of whole grains, fruits, and vegetables, getting in your exercise, and talk to your HCP about your risk.  It is also a good idea to check your blood pressure, if you have a tendency towards high blood pressure- just buy one Over The Counter (OTC) from your local pharmacy to make sure that your blood pressure is in check even when you aren’t getting a physical! Talk to your HCP, see what your personal risks are, and try to minimize that belly fat!

Yours in Good Health


Lower Your Cholesterol Levels with Food!

Cholesterol is always one of those buzz words that people talk about and a health issue that they are worried about. It is something that we should all be screened for, and keep in our thoughts when we eat daily. As part of a healthy lifestyle, adding certain food to our diets can help to naturally remove the “bad” cholesterol from our bodies and increase the “good” cholesterol.

What kinds of Cholesterol are there?

There are two different kinds of cholesterol: Low Density Lipoproteins (LDLs) and High Density Lipoproteins.  I think that is where most people tend to zone out!  The LDLs are the “bad” cholesterol’s that tend to build up as plaques in your arteries and increase your risk of heart attacks, heart disease, and stroke.  The HDLs actually prevent heart attack and stroke, and they are thought to bring LDL cholesterol away from the heart and into the liver to be broken down and excreted by the liver.  Your LDLs should be kept below 100 (and some HCP’s will even tell you to get them below 70).  And HDL levels should be kept above 50 (the higher the better on this one!) Also, people over 20 ears old should get checked every 5 years, and once you hit the ripe old age of 35 (for men) and 45 (for women) you should be screened more frequently, and based on your past medical history, your HCP may screen your with your annual physical.

What can I eat to decrease my LDL and increase my HDL?

There are many foods that can help boost your “good” cholesterol and help to decrease the “bad”, of course this is along with a healthy lifestyle of exercising 20-30 minutes minimum a day and, drinking lot of water, and if this doesn’t help, you may have to use medications to drop your “bad” cholesterol levels.

Oats: two servings of oats per day have been shown to decrease LDL by up to a little over 5% in 6 weeks. It has a substance in the oats that absorb the LDLs and help you to excrete them so they don’t adhere to your artery walls.

Red Wine: Some of the grapes used in making Rioja wine were found to have high fiber levels, and a study conducted in Spain found that people with slightly elevated LDLs had around a 9% drop in LDLs and those who entered the study with high LDLs had around a 12% decrease.

Fish high in Omega-3 Fatty Acids: Salmon, Arctic Char, Mackerel, & Sardines are high in Omega 3’s can help to increase HDL’s by 4% when replacing other meals with proteins high in saturated fats.

Beans: Adding 1/2 beans (black, kidney, pinto) to soup can help to decrease LDLs up to 8% because they are so full in fiber, it can help to draw the LDLs out.

Olive Oil: It is full of Monounsaturated Fatty Acids (MUFA) that help to lower LDL levels and actually increase HDLs

Black Tea: one serving of black tea a day can decrease LDLs up to 10% in only 3 weeks!

Avocado: Whilst high in calories and fat, they are also full of the MUFAs, so they should be used in moderation, but a tasty treat to boost “good” cholesterol!

Chocolate: In a large study, participants that added a serving of cocoa powder to their diet daily for 12 weeks increased their HDLs by 24%.

Garlic: Helps top lower cholesterol by preventing LDLs from sticking to the artery walls, and it is suggested to eat 2 to 4 fresh cloves a day (but yikes, get ready for some kickin’ breath!)

Walnuts: When eating 1.5 oz of walnuts 6 days/ week for a month, study participants were found to have a decrease in LDLs by 9.3%, but just like avocados they are high in fat and calories, so watch how much you eat, and try to stick to the 1.5oz per day.

Adding these foods to a healthy lifestyle can help to keep your cholesterol in a good, healthy range, and if you tend to eat a higher fatty diet, try to supplement a higher fat food for one of these cholesterol lowering foods.  Talk to your HCP about your risks, your current cholesterol levels, and make sure that you have follow-up cholesterol levels checked after changing your lifestyle to show improvement.  Try to add these foods and live a heart healthy lifestyle!

Yours in Good Health



Atrial Fibrillation (AFib): Symptoms, Causes, & Treatments

Atrial fibrillation is a very common cardiac issue, although I am hearing about more and more people being diagnosed with it, and I am getting lots of questions from readers about this diagnosis.  Again, it is very common, and I think that people should be aware of the symptoms, the causes, and the treatment of this cardiac arrhythmia (and arrhythmia is just when the heart beats at an abnormal rate or rhythm.)

What is Atrial Fibrillation?

It is an abnormal heartbeat, that can be very rapid, and lead to poor blood flow to various parts of the body, as the heart isn’t able to completely fill with blood before contracting (each beat), so only some of the blood that should be going out through your arteries to the extremities is available.  The atria (the top two portions of the heart) are beating faster and not in sync with the ventricles (the lower portions of the heart.)  Normally the Sinus Node (a group of cells in your heart) act as a natural pacemaker for you heart; it sends out a signal that passed through the atria (the upper two chambers of your heart) and causes them to contract and pump blood into the ventricles (the lower to chambers), then the signal hits the AV (atrioventricular) Node, which causes the ventricles to contract and move blood out from the heart into the extremities. in Atrial Fibrillation, the Sinus Node sends chaotic signals, so the atria are quivering in attempting to respond to each electrical signal, and the  AV Node becomes overwhelmed with the electrical signals as well, so the ventricles also beat faster than normal (though not as fast as the atria).  The normal heart rate is 50-90 and in AFib your heart rate can be as fast as 100-175 beats per minute.

It is normally not life threatening, as people live with it chronically, or they flip in and out of it, but it can have some serious complications, and if you go into a rapid a fib, you should be seen immediately by medical services, especially if you are feeling unwell, light-headed, etc.  There are various different treatments, including medications and electrical treatments.  Many people live long lives with chronic atrial fibrillation, it is just important to know the symptoms, treatments, risks of treatments, and when you should seek immediate medical attention.

What are the Symptoms?

*If you have any of these symptoms, you should be seen by your HCP to get your heart checked out and make sure that is the source.  Also, as I said above, there is paroxysmal AFib which comes and goes with symptoms, and chronic, in which your heart is continuously in this abnormal rhythm.

-Palpitations (a fluttering in the chest, rapid/racing heart rate)




-Shortness of breath

*If you ever have chest pain along with any of these symptoms, or alone, you should seek immediate medical attention because you may be having a heart attack. Please go to the nearest emergency department or call 911.

What are the causes of AFib?

-Congenital heart defects (heart defects you are born with)

-Heart Attacks

-High Blood Pressure

-Heavy use of stimulants (caffeine, medications, tobacco)

-Heavy alcohol use

-Sick Sinus Syndrome (a defect of the sinus node where it speeds up on its own)

-Emphysema or other chronic lung diseases (like Chronic Obstructive Pulmonary Disease COPD)

-Abnormal heart valves

-Prior cardiac surgery

-Viral infections

-Sleep Apnea (where you lose your airway for short periods of time while sleeping)

-Stress from Pneumonia or other illnesses

What will put me at higher risk?

-A family history: If anyone in your family, especially a close relative has AFib, you are also at risk.

-Age: The older you are, the more increased your risk becomes. Especially if you have any chronic illnesses

-High Blood Pressure: If you have uncontrolled high blood pressure, you are at a higher risk for AFib.  If you have made the proper lifestyle changes to get more exercise, eat healthy, and take medications to treat the blood pressure, then your risk shouldn’t be increased.

-Heart disease: If you have a history of heart attacks, valvular disease, heart surgery, or other arrythmias.

-Drink Alcohol: Usually binge drinking (5 drinks in two hours) can put both men and women at a higher risk for atrial fibrillation. (take heed college students!)

What are the major Complications?

Well, one of the biggest risks is stroke. When the atria are quivering and not completely expelling all of the blood they fill with to the ventricles, the blood leftover is at risk to clot (little micro clots) and when they get ejected eventually into the blood stream, it can travel to the brain, impede blood flow, and cause a stroke (death of some of the brain cells due to a lack of blood flow.)  Also, when your heart is working so hard constantly, without treatment, it can lead to heart failure; your heart is unable to meet the demand of your body by being able to eject enough blood to get to where it needs to go.

How is AFib diagnosed?

It is early important to bring with you a list of symptoms of your HCP, when you most experience them, all of your past medical history, any and all medications you take, and be very honest with your HCP about your lifestyle (eating habits, exercise, etc.) Your HCP will take that into account when doing your physical assessment, listening to your heart sounds, and checking your blood pressure and heart rate.  You will also most likely have:

An EKG: an Electrocardiogram which is a 12 lead assessment of the electrical impulses of your heart. 12 little stickers are placed on the skin on your chest, and little plastic/metal leads are connected, you will be asked to stay still for about 30 seconds, then a print out of your hearts impulses comes out.  It shows what is going on and is not very invasive at all, and a snap shot of your heart.

A Holter Monitor: A monitor with about 5 leads is attached to your for 1 to 2 days, and is worn under your clothing, it constantly checks the rhythm of your heart and if you feel symptoms, you push a button, and all of that information is downloaded by your HCP so they can correlate symptoms and your heart rhythm.

An Event Recorder: Similar to a Holter monitor, but worn for a month, and it only records when you have an arrhythmia, and it sends signals to your HCP when you have those events, and it helpful at showing when arrhythmias happen at unexpected times (like during sleep.)

Echocardiogram: basically an ultrasound of your heart through your chest wall, there is some lubricant applied to your chest, and a hard plastic wand is moved over it to show how your heart is functioning and can give  a 3D view of the actual functioning of the heart. It can help to diagnose if you have any structural abnormalities.

Blood Tests: your HCP will check to see if you have a thyroid problem or any other electrolyte abnormalities that would cause your heart to beat irregularly.

Chest X-Ray: Just a quick and less invasive way to see your heart and lungs and diagnose a possible pneumonia that could cause your symptoms.

What are the treatments?

The treatments are aimed at controlling your heart rate and preventing blood clots. If you are caught quickly with the arrhythmia, you can be cardioverted (your heart rate can be attempted to be manipulated and changed) back to a normal rhythm using either electricity (you will be given sedation and get a moderate amount of electricity to shock the heart back into a normal rate)  or you can be given Intravenous medications to do the same thing  (which requires monitoring and a possible overnight in the hospital).  Before any form of cardioversion you will be given a blood thinner to prevent clots from forming and from being ejected into the blood to prevent a stroke. And you will also have to take the medications for 4-6 weeks after a successful cardioversion.  Most often Coumadin (warfarin) is used as a blood thinner, but you have to be careful, as there are MANY side effects with Coumadin (and the other blood thinners commonly used such as Dabigatrand and Rivaroxaban.)

If the cardioversion is NOT successful, you will be kept on a blood thinner and a medication to keep your heart rate 60-90 and prevent the rapid Atrial Fibrillation.  Some of the medications that may be used to rate control your heart are:

-Amiodarone (Cordarone)

-Dofetilide (Tikosyn)

-Metoprolol (Lopressor)

-Sotalol (Betapace)

-Dronedarone (Maltaq)

There are two surgical procedures that can be done that can treat AFib as well.  A radio ablation is when the HCP puts a catheter through your groin artery into your heart, and where there are areas of “hot spots” or cells that are acting like a pacemaker (like your Sinus Node), electricity is used to ill off those hot spots and cause scarring. Electrical impulses in the heart cannot go through scar tissue.  There is also a surgical Maze procedure where there are small cuts made in the heart tissue to also cause scaring and prevent the electrical impulses from causing the quivering of the atria; this needs to be done during open heart surgery so is usually down when someone is having open heart for another reason (such as valvular repair) and if they do not respond to other treatments.  These are both pretty invasive, but if you do not want to chronically be on medications or are not responsive to medications, they are great options.

How do I prevent AFib?

Some of the risks you have no control over, like family history or congenital defects, but overall, living a healthy lifestyle, eating low-fat and low sodium, and getting at least 20-30 minutes of exercise daily greatly helps you in preventing AFib.  Also, quit smoking, and don’t intake too many stimulants (maybe you don’t need that 4th cup of coffee and lay off the 5 hour energy?).  Try to limit your drink in g to 1-2 drinks per day, and just be aware of the symptoms.  If you are at all worried about your risks, or you have any of the symptoms, talk to your HCP and see if there is anything else you can do to prevent AFib.

Yours In Good Health