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On a daily basis, we see patients who are seeking treatment for hardening of the arteries, typically in the legs or neck (PAD-peripheral arterial disease); weakening of the main artery in the abdomen (AAA-abdominal aortic aneurysm); and varicose veins. In each case, there are traditional ways of being treated (what we call “Open” Vascular Surgery) as well as innovative alternatives (what we call “Endovascular” Surgery).

How do we arrive at our recommendations and how do you decide what’s best for you?

It helps if your Vascular Surgeon performs both types of procedures rather than just one since s/he can draw on personal experience as well as the results of research, to tailor treatment to your specific needs.

You have to consider the trade-offs between short and long term risks and benefits.

• For AAA and varicose veins, endovascular techniques have virtually replaced traditional treatment given their low risk of complications and excellent outcomes, and both are well supported by the literature.

• In PAD – from the carotid arteries in the neck to various arteries in the legs – results of newer technologies are a “mixed bag.”

If you are referred to and seen by a Vascular Surgeon, be sure and discuss traditional and endovascular treatment options before you make your final decision.

(Ed. note - As it is heart month, we asked Dr. Rocco Ciocca, Chief of Vascular Surgery, to explain a little more about heart attacks and peripheral artery disease.)

In the last blog we defined a condition known as PAD, which is a constellation of problems related to narrowing of the arteries outside the heart.

PAD, If left untreated, can lead to having a stroke, worsening high blood pressure, difficulty walking, non-healing sores on the legs and feet and in extreme cases gangrene necessitating amputation of the involved body part.

I briefly mentioned how it can be diagnosed and would like to describe that in more detail here.

The great news is that doctors do not need order a bunch of painful or expensive tests to diagnosis PAD. The best and most cost-effective test is a thorough history and physical exam. During that, the health care provider will listen to your symptoms and ask questions about your medical history and your risk factors.

The major risk factors for PAD are:

• smoking
• diabetes
• hypertension (high blood pressure)
• high cholesterol levels

Sleep is just as important to child development as a healthy diet and exercise, although it is one of the most commonly overlooked aspects of a child’s life.

As adults, most of us can mutter through on little sleep for a day or so before we get unbearably grumpy, but with kids, their bodies are growing and connecting neurons in the brain all the time. Sleep is absolutely critical for healthy development.

While they sleep their brains are processing and sorting everything they learned that day, and that’s not just the stuff they learned at school; their bodies are honing their fine motor skills and processing the social interactions of the day.

To make sure your child is getting the proper amount of quality sleep, here are some tips:

 We laugh at the scene in Elf when Buddy douses his spaghetti with maple syrup, but this probably isn’t too much of an exaggeration of how much sugar Americans are consuming (the USDA estimates roughly 32 teaspoons of sugar daily, nearly 100 pounds annually). Like Buddy demonstrates, this is way too much. Rather than remind you (and myself) of the horrendous health effects that excess consumption of processed sugar can have, let’s instead dissect the refined sweet stuff stashed in your cupboard, and then examine the alternatives that have a bit more to offer our taste buds and overall health.

(Ed. note - As it is heart month, we asked Dr. Rocco Ciocca, Chief of Vascular Surgery, to explain a little more about heart attacks and peripheral artery disease.)

Most people are familiar with the phrase “heart attack” and know that it can be a life threatening condition.

The most common case of a “heart attack” or myocardial infarction is the sudden closure or clotting of a vessel or vessels that supply blood and thus oxygen and other nutrients to the heart. The heart is a muscle and without adequate blood flow the muscle dies. The most common case of a heart attack is “hardening of the arteries” or atherosclerotic disease of the arteries. The disease, which is most commonly related to various risk factors such as age, smoking, high blood pressure, high cholesterol and high suger levels in the blood (diabetes), causes abnormal blockages to develop in critical blood vessels in the body limiting flow. The blood vessels of the heart are not the only vessels affected.

In fact, hardening of the arteries is a systemic (total body) process that involves many other blood vessels of the body. When it involves the other peripheral arteries of the body it is know as PAD, peripheral artery disease. The diagnosis, prevention, and treatment of PAD are managed by vascular specialists such as vascular surgeons.

This February for Heart Health Month, let's focus on the positive.

Too often when discussing eating for heart health we focus on the things we should be decreasing (sodium, saturated fat, trans fat, added sugar) rather than focusing on the many positive things we could be adding to our diets.

So what can you add to your food intake for heart health?

We know from national surveys that the majority of Americans are not consuming recommended amounts of fruits, vegetables, whole grains, diary, seafood, and heart healthy oils. This translates to a lack of important nutrients, such as Vitamin D, potassium, calcium, and fiber.

Think of one healthful item from each category above that you could add into your diet over the month of February. Here is a list of one of my favorite foods from each category to give you some ideas.

Flip the calendar to February and just like Pavlov’s dogs, you may immediately salivate for dark chocolate, bright red roses and heart shaped everything. You may think that Valentine’s day is a romantic holiday fueled by Victoria’s Secret, florists and chocolatiers, but there is a reason for everyone to celebrate this Heart Healthy Month. For the 40 plus percent of people flying solo this season (the ones that rolled eyes at the heart encircling the 14th on the office calendar), there are reasons why you too should read on and learn of the health highlights of this ‘guilty pleasure’.

First - learning the language of chocolate and discovering the nutrients hidden in this gift from earth can empower you to look beyond the diet taboo and instead intentionally enjoy the benefits chocolate has to offer (perhaps innocently on more than one occasion per year).

Within the fruit pods of the Theobroma cacao tree lie cacao beans, the preliminary form of chocolate harboring the health benefits which transform the reputation of this guilty pleasure into an innocent delight. Cacao refers to the tropical tree (see image below) and bean, and is not to be confused with the term cocoa.

There are approximately 20-60 cacao beans per pod, which are removed from their pods, undergo fermentation and then are dried, roasted, and crushed. The resulting nibs are separated from their shells. You can purchase cacao nibs at natural foods stores (Whole Foods, PCC, Madison Market). These nibs are then ground to extract cocoa butter while producing a brown paste known as chocolate liquor during the extraction process.

When further extraction is performed, the cocoa mass that results can be ground to produce unsweetened cocoa powder. Unsweetened chocolate, the most commonly recognized form of chocolate by consumers, is made by mixing heated chocolate liquor with cocoa butter and sometimes lecithin. Bittersweet, semisweet, or simply sweet chocolate has sugar, vanilla and lecithin added.

Now that you are more fluent in the language of chocolate, you can advance to learn of the nutrients and other components in chocolate contributing to its health benefits.

Join us for a night out at Swedish!

What do a surgical robot and the Sammamish Symphony String Quartet have in common? You can see both at Swedish/Issaquah on Wednesday, Feb. 8 at 6 p.m.
 
Bring your valentine to this fun night out at Swedish — the Sammamish Symphony String Quartet will be holding a 90-minute performance starting at 6 p.m. Swedish is excited to host the quartet, so bring your family, friends and neighbors for this free community concert. It promises to be a fun, relaxed evening. While listening to the quartet’s beautiful music, you can also browse and shop our boutiques. The Shops at Swedish will remain open until 8 p.m. — find that special gift for your valentine, just in time for Valentine’s Day! Plus, complimentary chair massages will be offered in the Be Well shop — come take advantage of the mini massages.   
 
In addition, Swedish’s new robotic surgical system will be out on display; you can see the high-tech equipment used for knee surgeries up close! (Can't come, but interested in how the robots are used in knee surgeries? Check out these highlights from a live knee surgery.)
 
Café 1910 — Swedish/Issaquah’s café — will be open until 8 p.m. so stop by to meet our chefs and see what delicious food they have to offer. As an added treat during the event, Starbucks will offer a free tall drip of their featured Valentine’s Coffee — Verona.

It’s already February?! If you’re feeling stressed with 2012 passing so quickly, re-visiting this post on stress & the importance of breathing might help (originally posted on Parentelligence here). 

It’s no secret that we’re all just a little stressed these days. Between the economy and information overload on the internet, we have all sorts of things to worry about nowadays. Stress and anxiety can cause physical pain, emotional strain, and strain in your relationships. When you’re stressed, your body is secreting hormones that put you into that ‘fight or flight’ state. Long term, this state will wear on your body.

Our children pick up on our heightened state and become stressed and anxious, too.This is not a good state for children to thrive in. We learn best when we’re comfortable and relaxed, not if we’re nervous and anxious.

Parents need to learn how to regulate their own stress so that we may help our children learn the same coping techniques.

Tips to regulate stress in the immediate moment:

It's heart month, and with the Super Bowl this weekend (and suggestions from the media that sporting events may trigger heart attacks), I decided to whip up my low-fat, smokey, heart-healthy three-cheese fondue, as well as ask cardiologist Mark Reisman, MD, for some tips.

Low-fat, smokey, three-cheese fondue (serves 6)

Ingredients