Monthly Archives: July 2015

Key Tips on Heat and Sun Safety this Summer By: Dr. Victoria Guerra Farley

Fun in the Sun

Southern Nevada’s triple-digit temperatures have returned this summer, and with them a wide range of health risks. The intense temperatures and sunshine can pose many risks to people’s safety and overall wellness, but there is no reason people can’t still enjoy the outdoors. With the proper precautions recommended by HealthCare Partners Nevada, individuals and families can remain safe and healthy throughout their summertime activities.

Key tips on heat and sun safety include:

Remain hydrated:

When temperatures are high, it is very easy to become dehydrated when people don’t drink enough fluids to replace what is lost when they sweat. Dehydration can cause headaches, weakness, confusion and even unconsciousness, according to the Mayo Clinic. Stay hydrated by drinking plenty of water regularly, even when you are not thirsty.

Protect Against Sun Exposure:

Spending time outdoors without skin protection can be highly dangerous, as most skin cancers are a direct result of exposure to Ultraviolet (UV) rays from the sun, according to the American Cancer Society. To avoid this, HealthCare Partners Nevada recommends regularly applying products with sun protection factor (SPF) values of 30 or higher. Although higher SPF values do filter out more UV rays, no sunscreen protects the skin completely.  This is why it is also important to take additional steps to guard against the sun, including wearing a hat, UV-blocking sunglasses and clothing with SPF embedded, if possible.

Prevent Heat-Related Illnesses:

The body’s temperature can reach dangerous levels during extremely hot weather. Typically, your body cools itself by sweating. When you are exposed to too much heat, however, sweating is just not enough, and heat illnesses such as heat rash, heat exhaustion and even life-threatening heat stroke can occur. Monitor for common signs of heat-related illness, including red, dry skin, excessive sweating, nausea and a fast heartbeat. Stay safe by remaining in the shade whenever possible and hydrating often.

Limit Outdoor Activities:

Limit engaging in strenuous outdoor activities during hot days to avoid heat-related illnesses. Try to avoid going outside from 10 a.m. to 4 p.m., the time of day when it is hottest and UV rays are most intense, according to the American Cancer Society3. Schedule activities such as running, biking and lawn work early in the morning or later in the afternoon when temperatures are cooler.

Use Caution with Swimming:

Swimming and water sports are especially enjoyable in the summertime. Experiencing these activities with a partner makes them safer and even more fun. Always remember to supervise children whenever they are in the water. According to the Centers for Disease Control and Prevention, about one in five people who die from drowning are children 14 and younger[2]. Being alert around water is extremely important, but the most vital precaution is learning to swim.

There’s plenty of fun to be had this season. Just remember these simple tips from your providers at HealthCare Partners Nevada to ensure a safe and enjoyable summer.


Preparing for School Sports Participation and Preventing Injuries By: Dr. Eileen Shi


An approaching new school year is an opportunity for many families to consider sports participation in programs offered in the communities and schools. At HealthCare Partners, we believe getting your child involved in sports and activities is a great way to build physical and mental strength, to introduce healthy challenge and to encourage commemorative interactions with peers. However, activities can bring injuries that are common even in the most well-prepared participants. We hope to delineate some of the most common and overlooked risks here to help our families achieve an injury-free experience with sport participation.


Exercising on a regular basis have been shown to improve over-all health and mental acuity. Summertime offers a break from school routines to try out new sports and activities to discover what they enjoy to do outdoors. The American Academy of Pediatrics recommend limiting the amount of time children spends in front of TV’s and computer screens to prevent long periods of sedentary lifestyle and to encourage children to engage in fitness activities. Regular exercise for children fortifies a foundation for children to be active throughout their lives and build healthy habits that protects that from many chronic conditions such as childhood obesity and Type 2 Diabetes.


There are many potential injuries that can occur during sport participation. Each year, nearly 9 million pediatric patients are treated in emergency departments for unintentional injuries, including sports-related injuries. Children and adolescents are particularly vulnerable to injury because of their natural curiosity, inexperience, size and immature development. The most commonly encountered sports-related injury are sprains, strains, injuries from repetitive and overuse motion, dehydration and heat-related illnesses.


Families can take simple steps to prevent such issues. These include ensuring that children are dressed in sport-appropriate protective gear, such as a fitted helmet, mouth and wrist guards.  Stretching before and after intense physical activity also helps prevent overuse-related injuries. In addition, staying hydrated throughout physical activity especially when outdoors is pivotal to prevent the onset of heat-related illness such as dehydration and heat exhaustion.


Most medical and sport professionals recognize the importance of sports physical prior to starting a new competitive season.  This medical exam can be key to identifying underlying conditions that might affect a youth’s ability to compete and allows for monitoring the status of prior injuries.


HealthCare Partners Nevada clinics are happy to provide sports physicals, which we also encourage parents to schedule early this year.  Many schools require students to undergo a sports physical before they can try out for a team.  Scheduling these physicals early int he year can help ensure that your children can pursue their preferred sport without delay and restrictions.


If injuries do occur, parents should be careful with determining if medical treatment is necessary before returning to practice.  This is especially important with young children who cannot always communicate the severity and nature of their injuries.  If symptoms such as swelling, scrapes or bruising do not show improvement in 2-3 days, parents should take their children to see a pediatrician to assess the extent of the injury.  If a child loses consciousness, a visit to the emergency department is necessary.


HealthCare Partners Nevada offers multiple locations, and our physicians are happy to answer questions about children’s general health and safety.  For more information, please visit


What You Need to Know about Urinary Incontinence By: Dr. Kimball Huang

Live well photoAccording to the Urology Care Foundation, a quarter to one-third of men and women in the U.S. suffer from urinary incontinence, presenting serious challenges to a large segment of the population. Urinary incontinence is the loss of bladder control, and its symptoms range in severity. While age is a factor, obese individuals, men with prostate issues and women who have given birth are at a greater risk of developing urinary incontinence[1].

Signs of urinary incontinence include occasional leakage whenever you cough or sneeze, in addition to having sudden and powerful urges to urinate that are so strong that you can’t get to the bathroom in time[2]. It can also be an indicator of bladder cancer, and with July being National Bladder Cancer Awareness Month, this is an opportune time to discuss the condition.

There are three main types of urinary incontinence: urge, overflow and stress. Urge incontinence occurs when you have a strong need to urinate and cannot get to the bathroom before leakage occurs. Causes of urge incontinence include bladder infections and neurological issues such as stroke and dementia. Overflow incontinence happens when a bladder is so full that it leaks urine, while stress incontinence occurs when the sphincter muscles, which normally hold urine in the bladder, weaken and release urine[3].

Urinary incontinence can be the result of an underlying medical condition, such as kidney stones, a urinary tract infection, enlarged prostate or constipation[4]. Since many sufferers are embarrassed to talk about this problem, larger health issues can go undiagnosed. Therefore, it is important to discuss any instance of incontinence with your HealthCare Partners Nevada provider.

During your visit, your provider will perform a physical examination and ask questions about your daily habits, including what you typically eat and drink, and any medications or supplements you take. When visiting your doctor, he or she will also ask you which type of incontinence you are experiencing and how long you have experienced symptoms.

Urinary incontinence can be effectively managed or treated, so it is imperative to seek medical assistance as soon as you notice symptoms. There are many treatments and medications available to manage urinary incontinence, so please remember to talk to your HealthCare Partners Nevada provider to discuss your treatment plan. For more information about the services HealthCare Partners Nevada offers, please visit




[1] Urology Care Foundation, 2015, “What is Urinary Incontinence?”

[2] Mayo Clinic, Aug. 7, 2014, “Diseases and Conditions: Urinary Incontinence.”

[3] University of Rochester Medical Center, 2015, “Urinary Incontinence.”

[4] Mayo Clinic, Aug. 7, 2014, “Diseases and Conditions: Urinary Incontinence.”

The Truth About Cholesterol By Dr. Judith Ford, MD, Lead Physician of Clinical Quality at Healthcare Partners Nevada


Elevated total cholesterol can be an indicator of failing heart health, although it is far from a death sentence. It is attainable to achieve cholesterol health by living a healthy lifestyle and following the recommendations of knowledgeable medical professionals. HealthCare Partners Nevada, a medical network with locations across Southern Nevada, strives to make patients aware of their risk factors and develop customized treatment plans suited to their needs. High cholesterol is one of the major causes of coronary heart disease, heart attack and stroke, and early detection helps save lives.

 Good vs. Bad Cholesterol

There are two different types of cholesterol – low-density lipoprotein (LDL) and high-density lipoprotein (HDL) – and the body’s total blood cholesterol is measured by adding the LDL and HDL cholesterol levels, along with 20 percent of the body’s triglyceride level. Triglycerides are a type of fat that can enter the bloodstream through foods that are high in simple sugars, fat and carbohydrates. In addition, elevated triglyceride levels can contribute to the hardening of arterial walls and increase the risk of heart disease and stroke, according to the Cleveland Clinic.

LDL is often called “bad” cholesterol because it can build up in the arterial walls and form plaque, which can reduce blood flow and increase the risk of heart disease. HDL cholesterol is known as the “good cholesterol” because it is thought to help remove the LDL cholesterol that clogs the arterial walls. While higher HDL cholesterol levels indicate strong cardiovascular health, raising HDL cholesterol via medication has not been proven to be beneficial, according to a study published by the British Medical Journal.

Monitoring cholesterol levels is crucial, since low HDL and high LDL cholesterol are major risk factors for heart disease. Heart disease is a leading cause of death among men and women in the U.S. and, according to the Centers for Disease Control and Prevention, roughly 730,000 Americans suffer heart attacks each year. Of those, approximately 525,000 are first-time heart attacks. Heart disease claims more than 600,000 lives in the U.S. each year and is the No. 1 cause of death among most ethnicities.

Risk Factors and Symptoms

High blood cholesterol itself is not symptomatic, so many people are unaware of their condition. It is important to undergo cholesterol testing so medical professionals can begin their treatment plan. Dr. Rakesh Kalra, a HealthCare Partners Nevada physician, says something he always emphasizes to his patients is that body type is not an indicator of high cholesterol. A thin frame, regular exercise and living a healthy lifestyle does not ensure healthy cholesterol levels. On the other hand, being overweight is not necessarily an indicator of elevated cholesterol and triglyceride levels.

There are numerous ailments and lifestyle choices that can contribute to a person developing high cholesterol. According to the University of Maryland Medical Center, a diet high in saturated fat and trans fats, a lack of exercise, obesity, high blood pressure and diabetes are some of the top risk factors. Genetics are the most important risk factor, and poor cholesterol health can be passed down from a parent.

“Genetics play a key role with cholesterol,” says Dr. Irene Lambiris, a physician with HealthCare Partners Nevada. “Between the ages of 20 to 30, individuals should undergo one cholesterol check. If that cholesterol check is abnormal, it is advisable to proceed to annual checkups.”

Dr. Kalra says he has high cholesterol as a result of genetics. He works out and watches what he eats to help prevent the onset of heart disease. When it comes to relaying the importance of cholesterol, he says it can be difficult to get through to certain patients.

“People tell me, ‘I’m thin, I don’t have to worry about cholesterol,’” Dr. Kalra says. “They don’t understand the importance of getting cholesterol down to prevent heart attacks and stroke. The really thin people, and even young people, often don’t realize how important it is to get cholesterol under control.”

Medicating High Cholesterol

When it comes to treating high cholesterol, the goal is to reduce cholesterol levels to a point where the risk of developing heart disease or suffering a heart attack decreases. Dr. Lambiris says she starts to become concerned when a patient’s LDL cholesterol is above 160 milligrams per deciliter (mg/dl). Prior to starting medication, HealthCare Partners Nevada recommends a cholesterol-lowering diet, physical activity and weight management for six months. If that does not work, medication, along with diet and exercise, is the next step.

There are myriad cholesterol medications that help regulate cholesterol levels, including statins, bile acid sequestrants, nicotinic acid, fibric acids and cholesterol absorption inhibitors[8]. Statin drugs, including Lipitor and Crestor, are very common in cholesterol treatment and lower LDL and triglyceride levels while slightly raising HDL levels. Cholesterol absorption inhibitors and bile acid sequestrants lower LDL levels and can be taken alone or in conjunction with statin drugs. Nicotinic acid drugs lower LDL cholesterol and triglyceride levels, while fibric acids are typically implemented to treat high triglyceride and low HDL levels.

Statins are recommended for most patients because they are the only cholesterol-regulating medications that have been proven to decrease the risk of a heart attack. They reduce the amount of cholesterol deposited into the lumen of the artery, which is the hollow part of the artery in which blood passes through. Statins also lessen the inflammatory state of the artery, making the plaque more stable so that it does not break off and cause a heart attack. Dr. Lambiris compared the lumen to pipes in a house, saying “If they keep getting clogged, that’s a problem.”

The Red Meat Debate

According to Dr. Kalra, red meat can have an adverse impact on cholesterol, since it is generally high in cholesterol and saturated fat. Dr. Kalra says red meat is typically safe to eat occasionally, although it is important to select the right kind. If people are going to eat beef, he suggests purchasing lean beef with 10 percent fat or less. The American Heart Association recommends consuming no more than six ounces of cooked, trimmed lean meat a day, which includes shellfish, skinless poultry, and trimmed, lean red meats.

Processed, highly salted red meats such as bacon, sausage and salami are associated with a much higher risk of heart disease. They are loaded with calories and saturated fat and are often packed with sodium. According to a Harvard T.H. Chan School of Public Health study, eating 50 grams a day of processed red meats like sausage and bacon resulted in a 42 percent greater risk of heart disease and 19 percent higher risk of Type 2 diabetes.

“The sodium content in processed red meats is exorbitant, and eating too much salt can increase blood pressure as well,” Dr. Lambiris says. “I encourage my patients to avoid eating processed red meats.”


Eggs were long considered harmful to heart health because of their high cholesterol content. In recent years, that school of thought has changed, and many medical professionals sing the praises of eggs as a nutrition-packed staple of a well-balanced diet. In fact, most healthy individuals can eat at least seven eggs a week without increasing their risk of heart disease, according to the Mayo Clinic. In addition, studies have shown that egg consumption can also reduce the risk of stroke.

The negative perception of eggs has led to Americans eating fewer than ever. According to the U.S. Department of Agriculture, the average American in 1945 ate 421 eggs per year, a number that dropped to 250 by 2012.

“People can eat two eggs a day, and it will not impact cholesterol like we used to think,” Lambiris says. “I would rather have my patients eat an egg omelet in the morning than oatmeal.”

Oatmeal is high in carbohydrates, which raises the body’s triglyceride levels, Dr. Lambiris says. She notes that oatmeal is broken down into sugar and stored as fat, whereas protein and fat sources like eggs are broken down more easily and used as fuel much quicker than carbohydrates. While eggs are high in cholesterol, the impact of egg consumption on blood cholesterol is minimal when compared with trans fats and saturated fats. The risk of heart disease may be more closely related to the foods many people eat with eggs, such as the sodium in bacon, sausage, ham and the saturated fat or oils with trans fats used to fry eggs and hash browns.

Overall Diet

While having in-depth diet discussions with his patients, Dr. Kalra provides them with a handout outlining healthy foods low in saturated fat, fat free or 1-percent dairy products, lean meats, whole grains, fruits and vegetables. In addition, he suggests consuming 25 grams of fiber per day. According to the Mayo Clinic, fiber contributes to reducing “bad” cholesterol levels, controls blood sugar and helps maintain bowel health.

“I have seen miraculous health improvements in patients committed to diet and lifestyle changes,” Dr. Lambiris says. “Sometimes, lifestyle changes are not enough because of genetics, but we do want to get them on that path where they are living healthier lives.”

And a healthy lifestyle, combined with regular checkups and a commitment to medications, can help keep cholesterol levels in check. HealthCare Partners Nevada’s primary care providers and cardiologists are committed to promoting healthy cholesterol levels and are happy to answer any questions about cholesterol and heart health. Visit to learn more about the services offered by HealthCare Partners Nevada.