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Health Essentials

Your kitchen holds the key to your heart

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• What we eat or do not eat can affect our cardiovascular health

Whoever coined the phrase, “the way to a man’s heart is through his stomach” may have been onto something bigger than he or she had intended. We can now authoritatively state that this pathway applies to women and children as well and it may just not be what you are thinking. The kitchen may not only get you a life-partner, it may also deter­mine your heart health.

This year we are discussing heart health from January so that together we can modify what we eat in the month that most people are very pro­active about resolutions with health at the fore. Just as charity begins at home, so does heart health and to be more precise; “Heart Health Begins in the Kitchen.”

Cardiovascular diseases affect as many women as men but the risk among women is seriously underesti­mated. Heart disease is actually the number one killer of women in the world, causing 1 in 3 female deaths. Cardiovascular diseases claims over 17.5million lives each year and is the WORLD’S BIGGEST KILLER. This killer boasts of being responsible for 31 per cent of all deaths globally. Con­trary to popular belief 4 out of 5 of these deaths occur in low and middle income countries and men and women were equally affected. Why? The high income countries often have the skill and technology to keep the victims alive.

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Children are vulnerable too. Their risk for these diseases can begin be­fore birth, during foetal development and may even increase exponentially during childhood with exposure to unhealthy diets, lack of exercise, smoking and alcohol consumption. Poor children, they have no control over their mother’s eating habits yet they start paying for this even before they can catch a glimpse of what this world looks like.

An undernourished mother and an over nourished one both place their unborn child at risk of cardiovascular disease.

The mother is at risk from this poor eating pattern. It is becoming increasingly clear that the food you prepare in your kitchen or fail to pre­pare may not only kill you, it may be the cause of the woes of your yet to be born child.

I hate to think that we put such a strain on children; not only do they have to cope with the emotional bur­den of living with a parent suffering from a cardiovascular disease; they may again lose a parent or even both from this evil.

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Then they will have to deal with cardiovascular disease of their own. We compete to feed our children with diets with useless calories (sugar lad­en) and diets high in bad fats.

In addition to “cooking” cardio­vascular diseases in our kitchens we have also created a society where it is fashionable to avoid physical activ­ity; computer games reign supreme and children sit for hours behind a desk supposedly studying. We finally complete the kill by filling our envi­ronment with secondhand tobacco smoke.

We all know the risk factors for heart disease and strokes but I will list them once again:

• Hypertension

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• Diabetes

• High cholesterol

• Smoking & excessive alcohol consumption

• Overweight or obesity

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• Inadequate intake of fruits and vegetables

• Inadequate physical activity (lack of exercise)

• Excessive Salt Intake (salt like sugar is something we learn to take. We are not born with appetite for salt. Let us teach the right things to our young ones)

• Genetics??

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There is certainly good news, 80 per cent of premature heart attacks and strokes are preventable. Healthy diet, regular exercises not using tobacco products (includes passive smoking) are the keys to prevention.

Let’s protect our children from heart disease; encourage the intro­duction of daily physical activity sessions in school, let’s discourage the sale or even the presence of coloured water laden with sugar and being paraded as nutritious drinks.

Encourage children to eat less salt and oil but rather more fruits and vegetables. Beware of the dan­ger “hiding” in many snacks. We will face resistance from the little ones but if we are serious about reducing the death toll especially in developing countries then we have no option but to adopt these measures.

Always strive to Make your KITCH­EN HEART FRIENDLY

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AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood choles­terol, BMI)

Dr. Kojo Cobba Essel

Health Essentials Ltd/ Mobissel

(dressel@healthessentialsgh.com)

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*Dr. Essel is a medical doctor, holds an MBA and is ISSA certified in exercise therapy, fitness nutrition and correc­tive exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’

Thought for the week – “Heart disease does NOT discriminate. It can hit anyone regardless of age, gender, race, social class or eco­nomic status BUT you have far more control over your heart health than you may realise.”

Reference:

1. World-heart-federation.org

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2. WHO website

3. Mayo Clinic – Essential Heart Guide 2012.

By Dr. Kojo Cobba Essel

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Health Essentials

Identifying the geriatric giants & taking appropriate steps

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An elderly woman suffering from headache
An elderly woman suffering from headache

This week I bumped into Deborah, one of my avid readers and I promised her I will be writing this weekend. So Deborah, this is for your reading pleasure and to pick some golden nuggets for the future.

The quest to find the best way to make one’s golden years, happy, exciting, healthy and a time most people look forward to continues unabated. One factor that keeps popping up is the need to grow friendships with people more than 20 years younger than yourself.

Do not take this for granted. It is a form of “social security” since these close friends who are much younger than you will step in to support you in more ways than you can ever imagine.

Some conditions may make life challenging for older adults but knowing these Geriatric Giants helps us to take the necessary steps to reduce our risk.

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“Geriatric Giants” refers to a group of chronic health conditions that are common in the elderly, typically 65-year-olds and older.

These conditions quite often co-occur and can impact on the independence, dignity and overall wellbeing and quality of life of an elderly person.

These Geriatric Giants include:

  1. Impaired Intellect/ Memory (e.g. Dementia)
    1. one of the major battles we need to deal with is challenges with memory
    1. Exercise, adopt the Mind Diet, build a great social network and enjoy time outdoors
    1. Keep reading and solving puzzles for as long as possible
  2. Instability – leading to much feared falls
    1. A good reason to indulge in Balance Training and Core Strengthening exercises from today
    1. Ensure your home is safe; avoid clutter such as cables crisscrossing floors, toys etc. These are all trip hazards and should be avoided
    1. Many healthy, happy and fun-loving older adults have died soon after a fall with its attendant complications.
    1. Do whatever it takes to avoid falling
  3. Immobility (opening the doors to pressure sores, joint stiffness)
    1. Even when you are unable to move about on your own it is important to get support to change positions as often as possible or get an appropriate mattress or bed that prevents prolonged pressure over any single point.
    1. Make sure you passively or actively move joints daily.
  4. Incontinence (urine, faeces or both)
    1. This is one of the reasons older adults prefer to stay at home and avoid going out to meet friends etc.
  5. Iatrogenic Disorders – adverse effect of medication
    1. Quite often most older adults are on several medications and some side effects such as drowsiness may seem to cause more unhappiness and may even lead to falls.
  6. Inappetite – this may result in poor nutrition
    1.  This may also be linked to loss of teeth thus making chewing very difficult or limited.
    1. The loss of smell and taste may also reduce the amount of food one may willingly eat.

The power to reduce the impact of the Geriatric Giants starts now and should be a lifetime commitment. It is never too early to start making the appropriate lifestyle modifications, nor is it too late to reduce the impact of the giants on one’s life.

Other conditions that significantly impact on the lives especially of the elderly are:

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  • Sleep Disorders
    • Good sleep has the power to give us energy, improve our thought pattern and even helps us to make good choices.
    • Good sleep sets the tone for a healthy life
  • Constipation
    • This is a challenge that confronts quite a number of older adults.
    • Movement, fibre and lots of water go a long way to reduce the stress that frequent constipation generates.
  • Fraility
    • Muscle loss is real and as we age, we lose a significant percentage of our muscle plus our bones also become brittle.
    • Make sure strength training is part of your exercise schedule
  • Polypharmacy
    • Another headache that needs to be confronted head-on
    • Everyone especially older adults need a good primary care physician or a general practitioner who can coordinate all medicines from the different Specialists who may be attending to an elderly person. This ensures that unnecessary medicines are dropped

The goal of care at all times is to optimise the quality of life. As family, professional caregivers and friends we should always show respect so that the dignity of the elderly is preserved at all times. For those of us who are not yet in the age group with such challenges, we need to start the conversation about the type of care we will prefer and take steps to stay healthy and independent for as long as possible. The goal should be a long Healthspan and not just a long Lifespan.

AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)

Dr. Kojo Cobba Essel

Health Essentials Ltd (HE&W Group)

(dressel@healthessentialsgh.com)

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*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’

 Thought for the week “There is no magic formula to being happy but making a conscious effort to be happy goes a long way.” – Dr. Kojo Cobba Essel

By Dr. Kojo Cobba Esse

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Why Ghana’s ‘no bed syndrome’ is a policy failure, not a clinical failure -Part 2

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Kwabena Mintah Akandoh -Minister of Health

The call to action

We must move beyond the cycle of temporary outrage. I propose a four-point blueprint for the Ministry of Health and the government:

1.       A Digital Bed-Tracking Command Centre: Legally mandate all public and major private hospitals to update a live, digital bed-registry every hour. The NAS must be able to see a vacancy before they move. This must be matched with the available resources and services so that the right patient will be sent to the right facility.

2.       Strategic Capacity Expansion: We must stop building “prestige projects” and start building high-volume stabilisation centres. We need a targeted investment to triple the ER bed count in Accra and Kumasi within 24 months. This should then be extended to other regional capitals.

3.       Specialised Emergency Hubs: Designate specific hospitals as “Centres of Excellence” for Cardiac and Stroke care (and for other health emergencies), ensuring they have 24/7 imaging and intervention capabilities as well as the requisite expertise to manage these conditions. Policy makers must incentivise public-private partnerships to ensure that a heart attack in Accra or Kumasi can be treated with the same urgency as one in New York.

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4.       Develop a nationwide trauma system: This is extremely important because trauma is a major cause of deaths in Ghana. In the US, each state has a statewide trauma system with three levels. Level 1 trauma centres are usually University Teaching hospitals that provide comprehensive trauma care and also play an important role in local trauma system development, regional disaster planning, increasing capacity and advancing trauma care through research. Level II trauma centres are expected to provide initial definitive trauma care for a wide range of injuries and injury severity.

Level III centres provide definitive care to patients with mild trauma. Having such systems is imperative to ensure proper treatment of trauma patients.

Even for those who survive trauma, disability is a major assault on economic potential and viability.  Importantly all this cannot happen with a cash and carry system. Emergencies should be managed under a different model to save life and limb first. Obviously, there is a need to ensure that healthcare facilities will be able to recover their investments in emergency care, and that balancing act needs careful consideration.

Frontline clinicians are often forced to bear the public’s anger for infrastructure deficits they did not create and cannot fix. This is a failure of governance, not a lack of clinical care. Responsibility lies with the policy makers who manage the nation’s resources.

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The “No Bed Syndrome” is a systemic disease. It cannot be cured with a directive from the Ministry of Health, parliament or a lecture on ethics. It requires a blueprint, a budget, and the political will to treat this like the menacing threat it is.

It is safe to say that non-emergent healthcare is excellent in Ghana for the most part if you can afford it. However, emergency care is suboptimal. We had a sitting president die from an emergency health issue and a former vice president also die from an emergency. If that is not enough warning, it is clear that anyone can be a victim of an emergency.

If we do not act, the next ambulance driving aimlessly through the streets of Accra could be carrying anyone, including the very people who have the power to fix this issue.

Prof. Jonathan Laryea is a Professor of Surgery at the University of Arkansas for Medical Sciences in Little Rock. Arkansas. He is board certified in General Surgery, Colorectal Surgery and Clinic Informatics.

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He is a graduate of the University of Ghana Medical School (Class of 1997)

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