For a long time cholesterol in totality was seen as a bad thing for your body although the truth was a little more complicated than that. Cholesterol primarily is divided into two types, one of which can be categorized as bad cholesterol and the other as good cholesterol. Let's have an in-depth look at both the categories.

Ldl or low density lipoprotein aka bad cholesterol: cholesterol is a wax like chemical which is found all over the body and it has important functions to perform. Cholesterol is carried all over the body by lipoproteins. The low density lipoproteins are denoted as bad cholesterol as they can accumulate on the walls of the blood vessels and cause blockages resulting in many ailments. Ldl levels of 190 and above are considered dangerous. 

Some of the risks associated with it are:
1. Heart disease
2. Stroke
3. Atherosclerosis
4. Peripheral artery disease among many others

Hdl or high density lipoprotein aka good cholesterol - this is a form of cholesterol which is usually desired in higher quantities as it removes ldl from the system by dislodging it from the arteries and then carrying it through the bloodstream into the liver. The liver then breaks it down and removes it from the body. Thus, higher number of hdl cholesterol is always desirable. Some of the ideal numbers for hdl cholesterol within the body are:

For women - ideal: 60 mg/dl, dangerous: 50 mg/dl or lower
For men - ideal: 60 mg/dl, dangerous: 50 mg/dl lower

The role of triglycerides
Good and bad cholesterol levels also depend on the levels of triglycerides within the body and not just ldl or hdl cholesterol. Triglycerides are another type of fat which are used to store energy within the body, but can also affect your health. It is most associated with atherosclerosis when the levels of triglycerides are high within the body. 

Some habits that contribute to high levels of it are
A. Lack of physical activity
B. Obesity or being overweight
C. Excesses in alcohol consumption
D. Smoking
E. Bad diet and others

Thus the good cholesterol vs bad cholesterol war also includes other factors, most of which can be easily changed by making subtle changes in lifestyle and incorporating healthier habits. This will increase the good cholesterol and the other relevant elements and reduce the bad.

Good Cholesterol Vs Bad Cholesterol

Psychogenic breathlessness or pseudo-dyspnea is a condition where the patient suffers from shortness of breath time to time. This disease is often confused with a similar breathing disorder called Chronic Dyspnea. While there are a lot of factors involved in chronic dyspnea, like allergens and pulmonary diseases, psychogenic breathlessness has more to do with the current state of mind.

One of the most challenging factors is the diagnosis and differentiation between both conditions. Sometimes, the psychogenic breathlessness is so concentrated that there is no way to differentiate between the two.

Procedure of Diagnosis of Psychogenic Breathlessness:

Here are the steps that doctors typically follow to diagnose Psychogenic Breathlessness

To differentiate between the two diseases (Chronic Dyspnea and Psychogenic Breathlessness), the doctor will ask the patient to try breathing harder. A patient with chronic dyspnea will find it even harder to take a breath when he or she tries to. However, a person with psychogenic dyspnea will show improved conditions when they try to breathe harder

A thorough examination of the chest will be done

Blood tests and lung function test (spirometry) will also be conducted to rule out pulmonary diseases

Causes of Chronic dyspnea:

Allergens causing allergic bronchitis (also known as asthma) is the main reason behind Chronic Dyspnea. Other common causes of the true or chronic dyspnea are heart diseases, COPD which occurs because of smoking. Then there are rare disorders like ILD (sarcoidosis), neuromuscular diseases, infections, anemia, obesity/deconditioning.



Causes of Psychogenic dyspnea or psychogenic breathlessness:

Acid reflux: Acid reflux can cause certain sensation on the inner lining of the esophagus (esophagitis). The esophagus has several nerve endings on the inner linings, when the acidic reflux touches these nerve endings, a temporary breathlessness occurs.

Anxiety: People with anxiety can also develop breathlessness. Though exercises help for a short period of time, a patient needs to see a psychiatrist for this condition.

Panic Attacks: These are also a cause for breathlessness. The temporary feeling of choking is common in people who experience panic attacks.

Treatment:

Medication: Medicine for acidity is prescribed to patients having Pseudo-Dyspnea, due to acid reflux.

Anxiety pills and Talking therapy: People suffering from anxiety are recommended to see a psychiatrist for better evaluation of their problem. Medications (anxiety pills) prescribed by the psychaitrist may help in controlling the breathing pattern in a person. Psychological therapies (Talking therapy) have been effective for people suffering from breathlessness due to anxiety.

Placebo: If the problem remains unsolved and unknown, sometimes doctor prescribes placebo medication, for example sweetened aerosol. Doctors believe that if the patient thinks he/she is taking a real medication, his/her condition can be controlled by eluding the mind.

It is important to remember that Psychogenic Breathlessness is as real as chronic breathlessness and patient doesn t pretend to have this condition. When the first symptoms of it start appearing, a specialist doctor (pulmonologist) should be consulted who after confirming the diagnosis of psychogenic breathlessness, may refer you to a psychiatrist or psychologist for further treatment.

Psychogenic Breathlessness - Causes, Symptoms and Treatment of It!

Over the last few decades, the word cholesterol has assumed a different connotation. It has come to be known as a silent killer that spells doom for health. However, what we need to realize is that a certain amount of cholesterol is essential for the proper functioning of the body. The liver produces about 85% of the cholesterol that is required by the body normally. The ever changing food habits have introduced a lot of processed foods that are loaded with saturated fats. Along with this, reduced physical activity has led to accumulation of cholesterol in the blood.

The types of cholesterol are based on the density and we have 2 types of density that is Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL). LDL is more dangerous than HDL, called as bad and good cholesterol respectively. In addition, the triglycerides and lipoprotein are also critical indicators of overall cholesterol levels. Depending on a person's age, height and weight, normal levels are derived for each of these four.

Because of their density of the cholesterol molecules, as they are circulating in the blood stream, they tend to get sluggish and settle down along the walls of the blood vessels, referred to as plaque. This plaque attracts more and more cholesterol from the blood and the layer gets gradually thicker. This reduces the thickness of the blood vessels and in severe cases even completely blocks blood flow to important organs like the brain and heart, leading to severe conditions like stroke and heart attack respectively.

However, it is not always that all cholesterol is bad. It is one of the essential things for the proper body functions with the main functions listed below.

1. Each cell in the body requires it to form the cell membrane, the protective layer around the cells
2. Synthesis of vitamin D is done with the help of cholesterol, which is very essential for skin health
3. It also helps in hormone formation. In addition to steroids, other hormones like testosterone, estrogen, cortisol require cholesterol as a main ingredient
4. Formation of neurotransmitters and overall nerve function requires cholesterol. This ensures optimal neurological functioning.

So, as noted above, there are, both good and bad aspects to cholesterol. It is not all that dangerous a thing that it is made out to be. The trick is to maintain a good level of cholesterol so that the body's requirements are met, and at the same time, the harmful effects are kept at bay. Some important parameters to manage, include the percentage of bad cholesterol in the blood and the ratio of triglycerides to HDL in the blood. These are considered fair indicators of heart health and if need be, lifestyle changes and/or medications can be undertaken to manage overall health and reduce risk of heart disease and stroke.

Cholesterol: Good and Bad of It

Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

5 natural ways to control your blood pressure

Blood pressure rises with each heartbeat and falls as your heart relaxes. The normal blood pressure should be less than 120/80 mm hg. An increase or decrease on either end can cause various problems.

Here are some of the natural ways to control your blood pressure.

1. Having a diet low in sodium

In the event of a high blood pressure, curtail the consumption of foods that are rich in sodium. However, research reveals that sometimes it is not just enough to cut down on sodium in your diet. A person suffering from high bp should consume foods rich in minerals like calcium, magnesium and potassium as well to keep his/her bp in check.

2. Drink plenty of water and curtail the consumption of alcohol

In case a person suffers from low blood pressure, it is advisable to drink plenty of water as low blood pressure is usually accompanied by bouts of dehydration, and consumption of water can help increase your blood pressure. Also, health drinks, which are rich in electrolytes, help your raise blood pressure. But one should avoid drinks that are high in sugar, and abating your alcohol consumption also helps to quite an extent.

3. Burn extra calories and exercise regularly

Blood pressure usually increases with weight. Being overweight can lead to sleep apnea, which is marked by disruptive breathing while you sleep, which in turn condition can lead to increased blood pressure. Studies have found that weight loss is one of the most effective ways to control high bp. Regular physical activity is also advised to maintain a stable blood pressure.

4. Avoid long, hot showers

The hot water in showers and spas can expand your blood vessels, which can often lead to a drop in blood pressure. A common sign of this would be dizziness and fainting while taking a bath. Therefore, for people suffering from this condition, using warm water rather than hot water is advisable.

5. Completely avoid stress

One of the contributing factors of high blood pressure is chronic stress. Stress tends to affect blood pressure in indirect ways. Many react to stress by overeating, consumption of alcohol and smoking, all of which can increase your blood pressure. Try to know what triggers your stress and take steps to avoid it.


If you would like to consult with me privately, please click on 'consult'.
Related Tip: Got High Blood Pressure? Eat These 5 Foods!



5 Tricks that Control Your Blood Pressure, Naturally

Somebody in the world suffers a stroke every two seconds. Stroke affects physical as well as mental health gravely. It can be a life- altering situation leading to new limitations overnight. Such limitations can be physical or mental, affecting mobility and cognition. According to psychologists, cognitive functions of the brain encompass speech, language, functional memory, spatial- motor systems, ability to switch between tasks, executive functions like task organization, attention, and being able to employ tools and symbols.

When the stroke strikes, it irreversibly damages a part of the brain. It happens due to hemorrhage or blocked supply of blood. However, the brain can be trained and taught compensatory strategies. These compensatory strategies consist of attention increasing activities that require neurological utilities. These activities and exercises are formed in a way to improve the memory. Both pictorial and hearing skills are engaged in these activities.

Memory, attention span, and executive activities are dependent on each other and any problem regarding these affects an individual s daily life. That is why to improve the complete mental capacity, exercises are required. These exercises help to improve memory and attention span. In cognitive rehabilitation, goals are set as per the requirements of the patient and treatment is then followed. This requires some plans and strategies to carry out daily activities. These plans may consist of planning and analysis of the task.

The recovery varies from individual to individual depending upon the restoration of the damaged neurological functions supporting specific cognitive area. However, there are very limited types of treatments for cognitive rehabilitation, mostly generic treatments which depends on doctor s experience.

Evidence is found by researchers which supports the cognitive rehabilitation after stroke, in which the areas discussed are smaller than the issues faced by the stroke survivors. The studies fail to talk about the long-term results and common treatments for daily tasks. It is now really important for us to have a serious innovation in the field of cognitive rehabilitation with the amount of stroke patients increasing day by day.

Before one going for rehabilitation, he/ she should ensure that why they need it and what are their needs that are to be fulfilled through rehabilitation. Experts recommend rehabilitation so that patients are able to lead as normal lifestyle as possible post stroke strikes them.

Who are more prone to stroke?

Old age people, alcoholics, people with high cholesterol levels, active smokers, Diabetic patients, people who consume drugs, people suffering from Hypertension, patients going through transient ischemic attack (TIA) are all very much prone to a stroke.

It is also very important to consult a doctor after stroke. He will advise you the best possible way to treat the problem. 

Take away

Stroke these days can happen to anyone which although largely depends upon the age factor, but one's lifestyle can also make him/her the target of stroke. There is cognitive rehabilitation which can help a person to recover post stroke through activities and exercises and change in lifestyle. It is important for an individual to consult a doctor if he/she finds any difficulty in carrying out daily activities with one side of the body.

Cognitive Rehabilitation Post Brain Stroke!

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