Heart attack symptoms, response differ in women vs. men

AHA_heartstatementA woman’s heart attack can have different underlying causes, symptoms and outcomes compared to men, according to a new scientific statement released last week by the American Heart Association.

The new statement from the American Heart Association is its first to address heart attacks in women, and the organization is concerned women are being undertreated.

It notes that there have been dramatic declines in cardiovascular deaths among women due to improved treatment and prevention of heart disease as well as increased public awareness.

However, heart disease remains the #1 killer of women in the U.S. Most people associate heart problems with chest pain that radiates to the jaw or arm. However, symptoms of a heart attack in women may be different and can include:

  • Extreme fatigue
  • Shortness of breath
  • Indigestion or nausea
  • Pain in the jaw or upper back

The American Heart Association noted that another problematic finding, perhaps because of these different symptoms, was that women wait longer to get treated – the median delay is about 54 hours in women and 16 hours in men.

If you experience these symptoms — especially if you have risk factors for coronary artery disease such as high blood pressure or diabetes — seek medical attention. Although signs and symptoms of heart disease may differ in women, the basics of prevention are the same, regardless of gender: Eat healthy, don’t smoke, exercise regularly and consult with your doctor about your cholesterol.

To learn more about symptoms, risk factors and prevention techniques that are specific to women, consider my upcoming lecture on women and heart disease on February 16. Find more information and register for the event here.

And don’t forget to wear red this Friday for National Wear Red Day, a national day of action dedicated to raising awareness about heart disease being the #1 killer of women.

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Shah, Shimoli_13a

 

Dr. Shimoli Shah is a cardiologist at the Knight Cardiovascular Institute. She sees patients at the Beaverton Cardiology Clinic and the Center for Women’s Health. Dr. Shah specializes in heart disease in women. 

What you need to know about Zika virus

This post originally appeared on the OHSU Doernbecher Healthy Families blog.

Medical and public interest has focused on Zika virus and its effects on the unborn babies of pregnant women. Zika virus is spread by mosquitoes; this virus has been detected in countries in Central America, South America, the Caribbean and Mexico.

Zika virus usually causes mild disease (fever, rash, pink eye, joint pains) and goes away without the person needing much medical attention.

However, there may be a relationship between pregnant women having Zika virus infection, and their babies having a birth defect known as microcephaly (a head size that is much smaller than expected), which may cause significant brain damage and may be life-threatening. The Centers for Disease Control and Prevention (CDC) has strongly advised that pregnant women do not travel or live in areas with Zika virus. If a woman has traveled or resided in a country with Zika virus during her current pregnancy, she is advised to discuss with her doctor how this may affect her baby.

Zika virus has been seen in the continental United States in travelers returning to the U.S. from regions with Zika virus. In addition, the mosquito that can spread the virus does exist here in the U.S. There is the possibility that Zika virus may be spread to non-travelers if they are bitten by mosquitoes who previously bit a Zika-infected person in the U.S.

To prevent Zika virus infection in all persons (including pregnant women), people should focus on preventing and avoiding mosquito bites – this involves wearing long-sleeved shirts and pants, using plenty of approved insect repellent and avoiding being outdoors, particularly at dusk and dawn.

For more information on Zika virus, including possible effects on unborn children, please view the dedicated CDC webpage, the CDC’s Questions & Answers: Zika virus infection (Zika) and pregnancy and the CDC’s Travel Health Notices.

Dawn Nolt, M.D., M.P.H.
Clinical Associate Professor
Division of Pediatric Infectious Diseases
OHSU Doernbecher Children’s Hospital

 

OHSU in the news: Our experts weigh in on the Zika virus
Traveling to Mexico? OHSU shares warning over birth-defect-linked Zika virus (January 25 via Portland Business Journal)
Birth defect-causing Zika virus likely headed to U.S. (January 25 via KOIN 6)
Travel advisory for pregnant women and Zika virus expands (January 23 via Bend Bulletin)

Eating well in the new year

food for health-loHave you resolved to eat better in 2016, but you aren’t quite sure where to start?

Last week, U.S. News & World Report released their annual review of 38 popular diets and chose the best based on ease, nutrition, safety, and effectiveness.

The top ten best diets on the list are all safe, smart, and healthy eating plans.

This report can be used as a guide for choosing a plan that will work best with your lifestyle and goals.

I love the DASH (#1 overall) and Mediterranean (#4 overall) diets for their focus on balanced nutrition from whole foods such as fruits, vegetables, whole grains, and proteins including seafood, beans, nuts, and low-fat dairy.

Though they aren’t designed specifically for weight loss, most people find that they do lose weight when they follow these plans as they reduce their intake of higher-calorie processed foods. Both plans are excellent for improving heart health and reducing the risk of disease.

A newcomer to the list, the MIND diet (#2 overall), combines the DASH and Mediterranean diets with an emphasis on foods that impact brain health. This primarily includes whole plant foods such as leafy greens, nuts, berries, beans, and whole grains, while also including fish, olive oil, and wine. Several less-healthy groups of foods are limited (but not necessarily eliminated) – red meats, butter and stick margarine, cheese, desserts/pastries, and fried or fast foods.

Keep in mind that the MIND diet is a newer eating plan, so not as many resources such as cookbooks exist compared to DASH and Mediterranean diets.

My Heart-Healthy Plate

My Heart-Healthy Plate

 

Even if you don’t follow a named “diet,” you can still take steps to eat better in 2016 using these principles:

  • Fill half your plate with non-starchy vegetables and fruits. Produce should make up half of what we eat throughout the day. (Check out OHSU’s My Heart-Healthy Plate for more tips and details.)
  • Cook at home more often, so you rely less on highly-processed convenience foods and dining out.
  • Increase your intake of meatless meals (using beans, lentils, or tofu as the protein source) and fish.
  • Swap refined grains for whole grains. Whole grains provide added nutrients and fiber and will keep you feeling satisfied longer.
  • Cut back on (or eliminate!) sweetened drinks; stay hydrated with herbal tea, seltzer, or plain water.

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Severson-Tracy_13_blog

Tracy Severson, RD, LD, is the dietitian for the Center for Preventive Cardiology at the Knight Cardiovascular Institute. She specializes in nutrition counseling for cardiovascular health and weight management.

 

OHSU’s Most Read Blog Posts of 2015

“OHSU has one purpose and that purpose is to improve the health and well being of Oregonians. And we live that each and every day across all of our missions and across all 96 thousand square miles of this state.”

– OHSU President Dr. Joe Robertson

From groundbreaking partnerships that advance global health to a seemingly simple act of heroism by an “off the clock” OHSU nursing student, this year was full of large and small stories that changed the lives of many.

Here are our most read blog posts of 2015:

intelhealth

1. Intel & OHSU Announce Collaborative Cancer Cloud at Intel Developer Forum

Each year, millions of people all over the world learn that they have a cancer diagnosis. Instead of going through painful chemotherapy that can kill healthy cells along with cancerous cells, what would happen if those patients were able to be treated as individuals based on their specific genome sequencing, and a precision treatment plan could be tailored specifically for their disease?

2. 10 things we love about OHSU nurses

In honor of National Nurses Week, we shared our love for OHSU nurses in this top ten list. We adore our talented team, which made it quite difficult to narrow to only ten. Our #1 reason? They put patients first.

3. OHSU Nursing student shows heroism off the clocknursingstudent

“Driving home from the Portland airport one night, OHSU nursing student Christina Carmichael saw something strange on Interstate-5 near Albany…Soon she identified it as a woman rocking back and forth.” How Carmichael’s heroic actions made the difference between life and death for a young woman in need.

4. Nicholas Kristof’s “Pathways to Becoming a Global Citizen”

New York Times columnist, Nicholas Kristof, was our esteemed speaker for the Fifth Annual Kathryn Robertson Memorial Lecture. Mr. Kristof’s talk, Pathways to Becoming a Global Citizen, inspired our OHSU community to take action at home and abroad.

5. Getting started: 4 simple steps for beginning runners

Running is a simple and cost-effective way to get fit and stay in shape. Getting started is often half the battle. To help you along, OHSU Sports Medicine physicians share simple guidelines for taking your running or walking to a new level.

But that’s not all! 2015 was a history-making year. You won’t want to miss these popular stories:

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JessJessica Columbo is OHSU’s Social Media Manager. Her team can be reached at socialmedia@ohsu.edu. You can also join the conversation on Facebook or follow OHSU on Twitter and Instagram.

How to: Make realistic resolutions

It’s that time of year again. Amidst the shopping lists, holiday parties, and all those cookies, you might be thinking that 2016 will finally be the year you stick to your New Year’s resolutions.

But, like so many of us, you also might find yourself trudging through February or March with distant memories of motivation.

Being realistic about resolutions can be harder than it seems, especially when the start date is still a few weeks (and a few celebrations) away.

Resolutions aren’t for everyone, but if they’re on your mind this month, here are a few dos and don’ts of setting realistic goals.

Do

  • Do focus on the relevant and attainable. Remember that resolutions are about reflecting on the previous year and identifying how change can positively impact your life. Be realistic about what changes mean the most to you and focus on the significant few.
  • Do stay positive. We all experience difficulties when it comes to doing certain tasks or activities. Instead of dwelling on those, shift your focus to improving your existing strengths. Doing so can improve your self-esteem and confidence in your ability to meet your goals. For example, if you’re already good at writing or knitting, help a friend sharpen his or her skills. Not only will teaching help you improve, but giving feels great.
  • Do make a plan and start small. You probably didn’t learn to ride a bike overnight. Enabling change is a little like using muscle memory. It takes time to change patterns of behavior or habits, so start small. Whether that’s 10 minutes of meditation or running a day, small steps lead to big change.
  • Do take it easy on yourself. Staying on track is important, but hitting a few bumps and missteps along the way is perfectly normal. Life is hectic and things happen. Don’t give up because you splurged on a dessert one day or skipped a workout.
  • Do share your goals–and celebrate your mini-victories. Whether you choose to share your goals with family or friends, a local club or organization, or even on social media, sharing challenges and successes and gaining support may help keep you headed in the right direction.

Don’t

  • Don’t expect perfection. Don’t let perfect get in the way of good. Remember that most resolutions are about improving, about being better than you were the day or month before.
  • Don’t be afraid to ask for or accept help. Some days are stressful. That’s why the people in your world are there to help. Don’t be afraid to ask for some extra motivation or have someone help keep you on track by regularly checking in on your progress.
  • Don’t lose sight of what’s important. Don’t let a focus on self-improvement become an unhealthy obsession. Remember the people and things in your life that bring you joy, regardless of change.

As the end of the year nears, remember that January 1 isn’t the start date of grand change. It’s an opportunity to look back and move forward to a healthier, better you. So join us in shifting our focus to the smaller things (let’s call them micro-resolutions) that create positive change one tiny step at a time.

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Davoudian, Teni_15Teni Davoudian, Ph.D., a clinical psychologist and the newest member of the Mental Health and Wellness team at the Center for Women’s Health.

On 10K, a sister’s love carries on

The 10th floor of OHSU’s Peter O. Kohler Pavilion is a meaningful place for Maddie Collet. Her sister, Allison, was a patient in the unit after she was diagnosed with brain cancer. She passed away when Maddie was 13.

Maddie, a Certified Nursing Assistant, now cares for patients on that same floor. Below, she shares her family’s story and the ways in which Allison continues to inspire and influence her own path.

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When my sister was 5 years old, she decided she wanted to be a doctor. She was accepted to the OHSU School of Medicine in 2007, and she would have been an absolutely incredible physician had she had the chance.

Allison found out she had a brain tumor when she was 19. She underwent surgery and a round of radiation, and the tumor turned out to be benign. During her first semester, Allison had a seizure at the gym. A trip to OHSU’s Emergency Department and an MRI scan showed that the tumor had come back, and it was malignant.

After a long and hard fight, my sister passed away in 2009 when I was 13. OHSU actually held a memorial service for her, and there’s a tree planted for her on campus.

I suppose you could say I grew up in hospitals because looking back on my childhood, those memories definitely stand out from the rest. Weirdly, I’m obsessed with the medical world and I can’t imagine myself in any other field – I would absolutely attribute that to Allison. I guess her obsession must have rubbed off on me!

This past summer I was on a backpacking trip when Nurse Manager Carol Holm called me about a position on 10K. We clicked right away and she ended up hiring me over the phone. The next thing I knew, I was flying back to Oregon and moving to Portland to start a new job at OHSU.

When my mom told me my sister had once been a patient on 10K, I seriously contemplated quitting. Allison was once in one of these beds. My parents once paced up and down these halls. This is a sacred space – lives are saved, lost and forever changed here. But throughout all of the ups and downs, there has been one constant: her. It’s been such a cathartic and therapeutic experience for me.

I’m so happy to be part of the 10K family and humbled by the fact that I get to share it with my sister. She’s here every day, helping me answer call lights and take vitals. She’s here watching the sunrise over Mt. Hood on early morning tram rides. Feeling her presence is something I’ve needed for a long, long time.

Our family’s relationship with OHSU is very special, and the opportunity to share Allie’s story is also very special for me. She always was and always will be my greatest role model.

 

onward

Give Back
If you would like to support OHSU’s work to end cancer or to make a gift in honor of a loved one, please visit www.OnwardOHSU.com.

Give Local: The Knight Cancer Institute’s Community Partnership Program

For many Oregon communities, taking on a challenge as big as cancer can seem daunting. It can be tough to find the resources needed to make effective changes from the ground up. That’s why the Knight Cancer Institute’s Community Partnership Program is taking “give local” to the next level.

The Community Partnership Program works directly with organizations to provide funding and other resources to grow community-academic collaborations addressing a community’s most urgent cancer-related needs. Organizations with projects funded by the program team up with OHSU faculty on a variety of cancer-targeting projects ranging from a needs assessment to growing an existing program.

Farmers Market

Funded projects demonstrating the power of community collaboration include a prescription Community Supported Agriculture program to increase consumption of fresh fruit and vegetables, a sun-safety education program for elementary school students, creating evidence-based, culturally appropriate cancer education for various audiences and the creation of a health-equity analysis supporting a regional retail licensing policy for tobacco products. The full list of funded projects can be found here.

Community Partnership Program co-directors Jackilen Shannon, Ph.D., R.D. and Kerri Winters-Stone, Ph.D., F.A.C.S.M. shared more about the evolution of the program and what it has achieved for Oregon communities.

Q: What was the need for this program?

JS: Community organizations frequently have the greatest knowledge about the needs within their communities relating to cancer prevention, screening, access to treatment and survivorship.  However, local organizations may lack the funding or other resources needed to develop ideas, test out new programs, or evaluate interventions that could translate to sustainable services in the community. That’s where the Community Partnership Program steps in.

Q: What makes this program different from other grant programs?  How is this program important to these communities?

KWS: The Community Partnership Program is unique in offering training and technical assistance that are based on best practices in public health, together with funding. The technical assistance provided by OHSU faculty members can mean anything from helping organizations through an Institutional Review Board (IRB) approval to sharing knowledge they’ve acquired from working with previous research. The goal is for communities to grow both sustainable, effective programs and relationships.

Q: What do you feel are the program’s biggest achievements currently?

JS: We’re very happy that we’ve funded 30 community projects affecting 31 out of 36 Oregon communities in mostly rural areas. To reach that many counties through our grantees is a great achievement we share together. To me, an equally meaningful achievement is that these grants will build off of community-academic collaborations.

Q: At the end of this program, what are the top things you hope to have accomplished?

KWS:  At the end of this program, I hope we will have been successful in helping communities establish cancer prevention, screening,  and survivorship programs locally throughout the state. Ultimately, we hope these programs will dramatically reduce the burden of cancer throughout the state.

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Winters-Stone,KerriDr. Kerri Winters-Stone is a researcher and co-leader of the OHSU Knight Cancer Institute Cancer Prevention and Control Program. Her research focus centers on the use of physical activity to prevent and manage chronic disease.

 

 

 

Jackilen-ShannonDr. Jackilen Shannon is a nutritional epidemiologist with a strong track record of investigation in the role of diet and nutrition in carcinogenesis. She joined Oregon Health and Science University in 2000.

 

OHSU celebrates 30th anniversary of first heart transplant in Oregon

OHSU has long been known for bringing cutting-edge care and medical firsts to Oregonians. Even as we chase after the medical breakthroughs of tomorrow we understand the importance of celebrating and learning from our past.

The first heart transplant in Oregon, performed by Dr. Albert Starr in 1985.

The first heart transplant in Oregon, performed by Dr. Albert Starr in 1985.

This December, our Heart Failure and Transplant Program at the OHSU Knight Cardiovascular Institute celebrates the 30th anniversary of the first heart transplant in Oregon, done at OHSU by renowned cardiovascular surgeon Dr. Albert Starr.

Since the program’s first in December 1985, OHSU has performed over 650 heart transplants and continues to this day to be the only heart transplant center in Oregon.

Our team has established a tradition of providing outstanding care to heart transplant patients with many living a remarkable 10-20 years after the procedure.

Don Shirilla

Don was among the first few in Oregon to receive a heart transplant from Dr. Starr.

Don Shirilla is a proud example of this tradition. Don was among the first few in Oregon to receive a heart transplant from Dr. Starr, more than 29 years ago.

“I had finished the Honolulu marathon just six months before I found out I needed a heart transplant. And I was able to run short races again after I recovered. I’m so grateful to Dr. Starr and the team at OHSU for a second chance at life and keeping me healthy to this day,” says Don.

Don’s transplant anniversaries bring him happy memories, as he reflects on how his transplant changed his outlook on life. It helped him build stronger relationships with family and friends.

“It taught us all to appreciate the good things we have.”


Take a look back at OHSU’s announcement of the first successful heart transplant in Oregon:

YouTube Preview Image

Five facts about frostbite

Winter is upon us, and it’s important to keep your family safe in dropping temperatures. Whether you’re hitting the slopes or just working outside around the house, be sure know these five facts about frostbite:

  1. Frostbite is caused by freezing injury usually to the nose, ears, cheeks, chin, fingers and toes, parts of the body frequently exposed to the cold and whose circulation is easily impaired due to the cold. Prevention includes keeping these body parts covered with insulation, not going out in extreme cold, and keeping the whole body warm with adequate insulation, food and hydration and avoiding smoking and alcohol.
  2. The early signs of frostbite are loss of feeling and color in these exposed Hands holding a mugareas. The skin becomes white or grayish-yellow in color and it feels firm or waxy. Do not ignore these early signs, otherwise frostbite can lead to blistering and permanent loss of tissue including amputation of fingers, toes, ears and nose. Be vigilant with your fellow adventurers outside to look for signs of frostbite on each other.
  3. At the first signs of frostbite immediately stop what you are doing and take measures to warm up affected area. This may be as simple as putting on extra clothing or warming up fingers by blowing on them or putting them in your armpits. If this does not help then get into a warm environment, change out of wet clothing and put on new dry clothing.
  4. Further measures include putting frostbitten extremities in warm water (heated to 100-105⁰F, have companion test warmth with their hands). Always try to warm up affected areas before attempting evacuation. Do not use fires, heating pads or stoves to directly warm up skin, this can lead to further injury.
  5. Do not walk on frostbitten feet unless absolutely necessary to evacuate to safety. Once affected areas are re-warmed do not let them get frozen again. This will lead to even more injury. If you are an outdoor adventurer, take a wilderness first aid course to help prevent and treat all kinds of outdoor emergencies.

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CCOM_02-17-09Dr. Craig Warden is a Professor of Emergency Medicine and Pediatrics at OHSU. He currently serves as the Medical Director of the Global Mission Readiness in Clackamas, the Oregon State Urban Search & Rescue Task Force 1, Clackamas County Emergency Medical Dispatch and Clackamas County Emergency Medical Services Advisory Council.

A big step for our tiniest patients: Oregon, Portland have nation’s lowest premature birth rates

In a new report from the March of Dimes, the national non-profit dedicated to improving the health of babies by preventing birth defects, infant mortality and premature birth, Oregon, Portland and Vancouver have the lowest rates of premature babies.

According to the March of Dimes, “preterm births are defined as births before 37 weeks of pregnancy and are a leading cause of infant mortality.”

In their 2015 Premature Birth Report Card, Oregon’s preterm birth rate of 7.7 percent is the lowest among the 50 states and the District of Columbia. We also received an A for exceeding the group’s 2020 national goal of 8.1 percent.

At OHSU, we’re dedicated to helping babies begin healthy lives. Dr. Aaron Caughey, chair of department of obstetrics and gynecology, has a special interest in preventing preterm births. As chairman of the Oregon Perinatal Collaborative, he leads a group of healthcare providers who work to improve pregnancy and birth outcomes.

He believes that this recognition was achieved in large part because people, programs and legislation in Oregon are actively coming together (more so than in other places) to serve the same mission: improving the lives of women and children in Oregon.

And while this is wonderful news for growing families across the state, there is still work to do to improve the national premature birth rate of 9.6 percent and to close the gaps in the March of Dimes’ disparity index, which looked at preterm birth rates across racial and ethnic groups within a geographic area. In those rankings, Oregon came in 13th.

To read more about Oregon’s report card or to review all the rankings, visit the March of Dimes website.

 

March of Dimes: 2015 Premature Birth Report Cards

March of Dimes: 2015 Premature Birth Report Cards

 

Why 96,000 Square Miles?

OHSU Health Fair at Pioneer Square.

President Robertson is fond of saying that OHSU has a 96,000 square mile campus, serving Oregonians “from Enterprise to Coos Bay, from Portland to Klamath Falls.”

This blog aims to highlight that breadth. 96,000 Square Miles (96K for short) will focus on the people of OHSU, the Oregonians we serve and the ripple effect of our work in Oregon and beyond.

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