Monthly Archives: August 2014

Living with Diabetes: Eye Care By: Dr. Chard Bubb

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Individuals diagnosed with diabetes are at an increased risk for other serious health problems. High blood sugar (glucose) can cause eye problems and even blindness in patients with diabetes. Blurry vision might signal a more serious health problem in diabetic patients. According to the National Eye Institute (NEI), diabetes is the leading cause of blindness for American adults.

The NEI defines diabetic eye disease as a group of problems that might arise as a result of complications of diabetes. Diabetic eye diseases include cataracts, glaucoma and diabetic retinopathy. These conditions can cause severe vision loss or may even lead to blindness.
A cataract is a clouding or fogging of the normally clear lens of the eye, which results in an inability to focus on light and in impaired vision. Glaucoma occurs when the fluid inside the eye does not drain properly, which can lead to excess pressure in the eye. This pressure can damage the nerves and blood vessels in the eye and cause changes in vision. Although these conditions can also occur in people without diabetes, those diagnosed with the disease are 60 percent more likely to develop cataracts and 40 percent more likely to suffer from glaucoma.

The most serious eye-related disorder caused by diabetes is diabetic retinopathy, a condition that can lead to a permanent loss of sight. Diabetes affects the blood vessels in the eye. If these blood vessels leak or experience blockage, they can cause changes in the retina and in vision. Those that have been diagnosed with diabetes for a longer period of time are more likely to develop retinopathy. Many people who have diabetic retinopathy may only experience a mild form of the condition that never progresses to vision loss. According to the Centers for Disease Control and Prevention (CDC), it is still the leading cause of blindness among American adults aged 20 to 74 years. Those who suffer from retinopathy may not notice any symptoms of eye damage until it is too late for treatment to be effective, which is why it is extremely important for patients diagnosed with diabetes to undergo regular eye exams.

All patients diagnosed with diabetes, both type 1 and type 2, are at risk for diabetic eye diseases. However, these conditions can be prevented by taking steps to control blood sugar levels and blood pressure. HealthCare Partners also recommends patients with diabetes to see their eye doctor at least once a year for a comprehensive dilated eye exam.

Remember to inform providers of symptoms such as blurry vision, red eyes that do not go away, diminished peripheral vision and eye pain. Thankfully, serious eye diseases can be prevented and treated if patients stay involved in their care and maintain regular check-ups with their HealthCare Partners provider.

Providing Essential Health Information to Emergency Responders By Dr. Reza Berjis

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Health care professionals often emphasize the importance of patients providing up-to-date information about their medical conditions. It is vital for providers to know if patients have health conditions such as pharmaceutical allergies, diabetes or cardiac issues that could be impacted by specific medications and treatments. Sometimes people are unable to provide this information when it is needed the most, however. During an emergency situation such as a stroke or heart attack, patients might be unable to relay crucial details about their personal health issues to the providers who must administer treatment.

Fortunately, there are steps people can take to prepare for such situations. August is Medic Alert Awareness Month, aimed at raising awareness of tools people can utilize to convey their personal health information when they are unable to speak to emergency responders. Medical identification tags in particular can play a key role in helping providers save a patient’s life. Emergency responders encourage individuals with unique or significant medical conditions to wear these tags relaying that the person has a medical condition that might need immediate attention or that directly affects their treatment. These identification tags, which can be worn as bracelets, necklace or on clothing, can provide important information for providers in an emergency situation, especially if the patient is incapable of speaking or too young to communicate medical needs.

Medical identification tags are available for purchase at many drug stores and pharmacies, including Wal-Mart and CVS. MedicAlert, a nonprofit dedicated to helping save lives in emergency situations, also sells medical identification tags in the form of a variety of accessories. HealthCare Partners encourages people with important medical conditions to research medical identification tags and consult their providers about the possible benefits of wearing a tag.

Ensuring the Proper Amount of Sleep for Kids By Dr. Sandeep Reddy

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Obtaining enough sleep is essential for a child’s emotional, physical and academic well-being. Studies have shown that nearly one-fourth of American children are affected in one way or another by inadequate sleep. That’s nearly 15 million children. This can impact the child in many ways from mood, to school performance or social behavior.

As adults, it’s up to us to make sure children — despite their frequent objections — get enough sleep each day. In the same way we make sure they get to and from school and have three square meals each day.

The American Academy of Pediatrics (AAP) recommends children obtain as much sleep as possible, with the amount needed decreasing as they get older. Newborns, for example, require 15 to 18 hours of sleep a day, while those from 1 to 12 months should get 14 to 15 hours. Children between the ages of 1 and 3 should get 12 to 14 hours of sleep, while children 3 to 6 need 10 to 12 hours.

As children enter school, this often means that naps are no longer part of their daily routine. Children ages 7-12 should get at least 10 to 11 hours of quality sleep each night while teens, ages 12-18, need eight to nine hours.

An AAP study showed that sleep problems have a negative relationship with daytime behavior. Specifically, children with sleep problems had more internalizing and externalizing behavior problems and poorer adaptive skill development. The study also showed that children with moderate-to-severe sleep problems had greater behavior difficulties — but not necessarily poorer adaptive functioning ¬— than children with mild to moderate sleep problems.

There are many ways to ensure children get a peaceful and restful night’s sleep. Some of these include keeping a set bedtime for both weekdays and weekends, limiting TV, playing video games or on the computer the hour prior to bedtime. Reduce the number of caffeinated drinks during the day; encourage them to sleep in their own bed each night and helping them relax by reading to them or giving them a bath prior to bedtime.

HealthCare Partners recommends keeping a semblance of regular sleep patterns. This is especially important for younger children. This way, when school resumes, getting them back into a nightly routine will be that much easier.

Unusual Diagnosis Leads to Lasting Patient-Doctor Relationship By Dr. Stephen Portz

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Ask Nick Giorgione what he has learned about his heart condition during the past 13 years, and the 26-year-old can get very specific.The Henderson resident knows walking up stairs will leave him winded. He has experienced firsthand that sprinting on a treadmill will trigger a device in his chest to administer internal electric shocks.

Nick is also certain of something else: He has a comprehensive understanding of his hypertrophic cardiomyopathy, a wide-ranging cardiac disease, thanks to cardiologist Dr. David Navratil with HealthCare Partners Cardiology.

Navratil has served as Nick’s cardiologist for 13 consecutive years, demonstrating the personalized care that serves as the crux of HealthCare Partners’ Total Care Model. “On the list of people most crucial to my life, Dr. Navratil is at the top,” Nick says.

Cardiac Issues at a Young Age
At an evening football practice in 2001, Nick noticed he felt strange. The 13-year-old suddenly saw everything suddenly grow fuzzy. He woke up still on the field to paramedics leaning over him with defibrillator paddles. It was the first cardiac arrest of his life. “I just knew I was at football practice and I wasn’t supposed to be on the ground,” Nick says.

When he was transported to Desert Springs Hospital, Nick’s father, Steven Giorgione, sought the expert opinion of Navratil, an old family friend who is board-certified in internal medicine, cardiovascular diseases and cardiac electrophysiology. Navratil quickly diagnosed Nick with hypertrophic cardiomyopathy. The condition involves the heart muscle becoming abnormally thick, making it difficult for the organ to pump blood. Symptoms can range from mild to severe, with some patients at high risk for sudden death.

Within a week, the cardiologist surgically implanted an automatic implantable cardioverter defibrillator (AICD) into the teenager’s chest. The device monitors his heart rate and administers shocks to the heart in response to any issues that arise. “I have fewer than a dozen of these cases in my practice, and none of them are as aggressive as Nick’s condition,” Navratil says.

The Total Care Model
Navratil was the clear choice to remain Nick’s cardiologist following his diagnosis, initiating a doctor-patient relationship that has lasted more than a decade. “I trust him because he’s seen everything I’ve gone through,” Nick says.

This ongoing continuum of care is an important component of the Total Care Model practiced by HealthCare Partners Nevada, a medical network serving more than 300,000 patients a year. The organization offers 290 primary care providers and more than 1,700 specialists across Southern Nevada.

HealthCare Partners has experienced many successful patient stories like Nick’s through the Total Care Model, a unique approach to health care focusing on comprehensive, patient-focused care. Under this approach, primary care providers, specialists and professional staff work as a coordinated team to manage all aspects of patients’ care and overall health.

Battling for Control
Nick initially struggled to accept his diagnosis. His case of hypertrophic cardiomyopathy involves high risk of cardiac arrest during physical activity. This was crushing news for Nick to hear at 13 years old, when, at already more than 6-feet tall, competitive sports were his passion.
Navratil offered a broad-minded prognosis, allowing Nick to follow his passion for sports while carefully monitoring his symptoms.

Nick learned the hard way he could never be as active as he wished, experiencing two heart attacks within a month when he tried playing competitive basketball. With Navratil’s support, Nick resolved to finding other avenues for success.“Navratil gave me the confidence that this condition wasn’t going to kill me,” Nick says.

Nick always felt free to discuss any questions with his cardiologist. Navratil has continued to meet with him throughout the years to review tests and consult with Nick following any additional incidents. The cardiologist conducted two more surgeries for Nick’s AICD. When Nick needed a hand operation at 18 and the doctor on duty casually mentioned turning the AICD off, Navratil responded to Nick’s concerns by visiting the hospital and ensuring that the device would stay on during the procedure. “I always know he’s the one who can handle anything related to my condition,” Nick says.

Looking Forward
Nick has since found many accomplishments outside athletics. He recently graduated from law school at the William S. Boyd School of Law, and he is currently studying for the bar exam. He still sees Navratil at least twice a year, he adds. He hopes one day to apply his personal experiences to support youths facing similar cardiac conditions.

Navratil commends his patient’s persistence with managing the condition throughout the years.“Nick has done very well living with a disease that can be challenging for many people,” Navratil says. “He can still enjoy most things in life.” Nick plans to continue doing so, with Navratil’s ongoing assistance. “You couldn’t pay me to go to a different cardiologist,” he says.