What fruits and vegetables are best for your heart?

What fruits and vegetables are best for your heart?
As seen in the Odessa American “Medical Matters”: What fruits and vegetables are best for your heart? by Dr. Fernando Boccalandro


A heart healthy diet is fundamental in preventing heart disease, even with the use of current prescribed cholesterol-lowering drugs. Thus, it is important to understand the value of a good diet in heart disease prevention.

Diets that are cholesterol-free, such as plant-based diets or low in cholesterol, processed and refined foods, can markedly reduce serum cholesterol levels and help to prevent heart diseases as part of a healthy lifestyle.

My patients frequently ask me what fruits and vegetables are best as part of a heart-healthy diet?

  • A handful a day of nuts such as almonds and walnuts. It’s filling and will help your heart.
  • Berries including strawberries, blueberries, raspberries and cranberries are very nutritious with phytonutrients and fiber.
  • Dark beans including black beans and kidney beans are high in fiber, vitamins and minerals.
  • Colorful vegetables such as carrots, sweet potatoes, red peppers and acorn squash have carotenoids, fibers and multiple vitamins which complement a heart-healthy diet.
  • Spinach is a great leafy vegetable packed with great nutrients and can be used instead of lettuce.
  • Steamed or boiled asparagus is low calorie and has beta-carotene and fiber.
  • Broccoli is also a great snack with multiple vitamins, folate, calcium and nutrients.
  • Tomatoes are excellent either fresh or sun-dried. Sun-dried is a convenient way to enjoy them.
  • In general, fruits are rich in beta-carotene, vitamins, potassium, magnesium and fiber. However, fruits could have a high sugar content requiring attention in diabetics.
  • A small amount daily of dark chocolate with at least 70% of cocoa can also be heart healthy.


It is always preferable to eat these food products unprocessed and in their natural form … just as they come out of your backyard garden… rather than canned or already processed. If you do not want to grow your own, take advantage of the local Farmers Markets this summer. Your heart will glad that you did!



May is Stroke Month. Let’s learn a bit more about what a stroke is and available treatments.

May is Stroke Month. Let’s learn a bit more about what a stroke is and available treatments.  

by Karry Morris MSN, RN-BC
Cardiovascular Nurse – Medical Center Hospital Cardiovascular Services


Most strokes are caused by blood clots. It happens much like a heart attack does. A blood clot travels to a small blood vessel and becomes lodged, causing a blockage that results in a loss of blood flow and a lack of oxygen to the vital organ. When a blockage occurs in the heart, it is called a heart attack. When the blockage happens in the brain, it is called a stroke.

If brain tissue loses circulation and oxygen, the parts of the brain dependent on the blood supply of the blocked vessel may die. The death of tissue in the brain, and the resulting stroke, can lead to a lifetime of challenges for the stroke survivor.

Depending on where the stroke occurs, the damage can result in the loss of the ability to walk, talk, eat, think, move or even breathe. Fortunately, there is a medication that can “melt” the clot that is causing the stroke. But you have to call 911 and get to the hospital FAST!

The medication is called “Alteplase” or “Activase” and is a potent medication that essentially “melts” the clot causing the blockage, restoring oxygen-rich blood to the brain. The medication can literally prevent the lifelong effects of stroke … but only if you receive it within the first four and a half hours of stroke symptoms.

Alteplase is in a category of drugs known as “thrombolytics”. Many people know about drugs that they call “blood thinners” (such as Aspirin) that prevent clots from forming in the first place. Alteplase is much more powerful and is able to actually dissolve the clot that has already formed. They are often called “clot-busters” by the medical community.

As parts of the brain begin to die during a stroke, the effected brain tissue becomes more and more fragile over time. About four hours after stroke onset, the dying and dead brain tissue is becoming so fragile, it becomes too late to give the medication. The soft brain tissue, coupled with a strong thrombolytic, put the brain at a greater risk for bleeding at this point. The medication is considered safe and effective, and some tout it as a miracle … but it can only be used in the first four and a half hours. If you don’t arrive to the hospital in time, it may be too late to receive the treatment.

This is why it is so important to be able to recognize stroke and call 911 right away. Waiting any amount of time can make the difference in whether you are able to receive the medication or not. Receiving the medication can result is the reversal of the stroke, avoiding paralysis and even death. If you arrive too late, medical professionals are unable to provide the medication, and can only hope for the best for the stroke survivor.

For many years, there was no cure for stroke. Alteplase, however, can reverse the effects of stroke, allowing you to live your life without the often devastating results of stroke … but only if you get medical attention immediately.

Never ignore the signs of stroke. Time is brain!


Medical Matters: Osteoporosis – Are You at Risk?

As seen in the Odessa American “Medical Matters”: 

Osteoporosis – Are You at Risk?
by Dr. James Ingram

Osteoporosis is a disease of the bones that many people will experience in their lifetime as it is the most common bone disease in humans. Osteoporosis is a silent disease until it is complicated by a broken bone.

Osteoporosis means porous bone (full of holes). When a person has osteoporosis, the pores become larger which makes the bones brittle and weak. Because the bones are then weak and brittle, they can fracture easily … even with simple activities like sneezing or bumping into furniture.

Osteoporosis is diagnosed by a medical evaluation that includes an examination of your height and a bone density test. This bone density test is the only way to diagnose osteoporosis prior to a broken bone. The most common bone breaks are of the spine, hip and wrist.

It is estimated more than 10 million Americans have osteoporosis. Osteoporosis is not just a disease that affects women. After the age of 50, more than 50 percent of women and 25 percent of men will break a bone due to osteoporosis.

All women who have experienced menopause and men over the age of 50 should be evaluated for osteoporosis risk factors to determine if they need to be tested.

There are many factors that put us at risk for developing osteoporosis. Some factors are modifiable while other factors are not.

Factors leading to Osteoporosis that cannot be altered include:

  • Age greater than 50
  • Caucasian and Asian women
  • Petite women
  • Family history of osteoporosis

Although you cannot control the factors from age and genetics, you can alter the following factors that lead to Osteoporosis:

  • Smoking – Smoking makes the bones less healthy and more prone to breaking or not healing after a break.
  • Low vitamin D levels – A healthy diet with calcium and vitamin D is essential for bone health. Add fruits and vegetables daily to improve your bones.
  • Lack of exercise – Regular exercise is important for strong bones. Activities like walking, swimming and biking can improve the health of your bones.

If you feel you are at risk for osteoporosis and have never had a bone density test, talk to your doctor today.


Benefits of Group Exercise

Benefits of Group Exercise
by Andrew Enriquez, Exercise Specialist – Mission Fitness

Think back to when you were a kid and how much you loved going outside to play and how much fun it was just being around friends. Secondly, think back to when we were teenagers and how much we craved to be around a group of friends while hanging out on weekends. Even as adults, we still desire to do things in a group because we enjoy socializing and being a part of something while having fun!

Many things are just made more fun when done in a group rather than by ourselves. Group exercise is a great way to feel young again while being able to socialize and be around others who desire the same thing as you!

Group exercise is typically known as a group of people performing exercises while being led by an instructor. There are many different group exercise formats. You may have tried step classes, core, yoga, spin, muscle pump, toning classes, dance choreographed classes or others. There are a variety of different classes that you can do that may be of interest to you and your friends. You’ll typically find group exercises at a local gym or club and your choice of classes may depend on your schedule, instructor expertise and the type of gym or club you attend.

Group exercise offers a variety of benefits you might miss out on if you choose to work out on your own. Some of the benefits include exposure to a social and fun environment, a safe and effectively designed workout, a consistent exercise schedule, an accountability factor for participating in exercise and a workout that requires no prior exercise knowledge or experience.

Here are a few reasons why you may benefit from group exercise:

  • One of the main reasons many people quit a certain workout program, or stop working out altogether, is because they get bored! With group exercise, you’ll always stay motivated and interested with different instructor styles, workout formats, different props and weights to use and a variety of different music to keep you pumped up. Not to mention that an hour can fly by because you’re having fun and socializing with other while getting a quality workout.
  • Another reason is that many don’t even know where to start once they purchase a gym membership. So attending a group exercise class will take all that stress away because the workouts have already been made for you from the instructor! All you must do is show up with an open mind, a positive attitude and enjoy.
  • Usually, each class is structured with a purpose. Depending on the type of class you take, you may be doing a class that focuses on cardiorespiratory fitness, muscular fitness, stretching, etc. Each class should also have a format that includes warming up, cooling down and stretching. Often, many of us forget to add these components into our own routine which can possibly cause us to get an injury of some sort. With group exercise, it’s all taken care of for you!

Group exercise can be so diverse as it even reaches communities outside of gyms or clubs. You can sometimes find people participating in boot camps or yoga at a park, cyclists along the side of the road and even Tough Mudders or Spartan Races.

Many people just want to be a part of something bigger than themselves. The social aspect of group exercise makes it so much easier for you to build new relationships with people while getting a great workout in at the same time!



MEDICAL MATTERS: Shoulder pain can be early sign of arthritis or other injury

MEDICAL MATTERS: Shoulder pain can be early sign of arthritis or other injury

As seen in the Odessa American “Medical Matters”: http://www.oaoa.com/people/health/medical_matters/article_6d6d2726-2cef-11e7-9a68-736e9c105440.html


MEDICAL MATTERS: Shoulder pain can be early sign of arthritis or other injury
by Dr. James Ingram

Dr. James Ingram is a Board Certified Orthopedic Surgeon and specializes in Sports Medicine.

“I saw my Doctor about my shoulder pain. He took an X-ray and told me ‘nothing is wrong’.”

A more appropriate response would have been, “there’s nothing broken”. Most sources of shoulder pain are not obvious on an X-ray. The shoulder is a remarkable joint with more movement than any other joint in our body. Thus, diagnosis of the specific cause of pain in the shoulder can be difficult.

The earliest signs of arthritis in the shoulder typically appear in the joint connecting the collar bone to the shoulder blade (acromio-clavicular or AC joint). In the absence of injury, this joint can show signs of arthritis on x-ray as early as age twenty-five. Pain associated with this joint is increased with lying on the side, using the arm at shoulder height or higher, pulling things toward you or away from your body. The pain does not make motion impossible but the use of the shoulder increases the pain.

Rotator cuff tears may be partial or complete. Risk factors for rotator cuff problems include male gender, high blood pressure and elevated cholesterol. Trauma is also a major cause, fall on shoulder or outstretched hand, shoulder dislocation, lifting or pulling heavy objects. Partial tears are more painful, full thickness tears result in loss of motion and weakness. Many partial tears do not require surgery. Full thickness tears will not heal without surgery. But with therapy, the patient may regain an acceptable motion and use, depending on the patient’s needs.

A cartilage ring surrounds the socket of the shoulder. This cartilage ring, the rotator cuff and the joint capsule provide a stable joint with an extensive range of motion. Tears of this cartilage ring cause pain and mechanical symptoms. They usually result from shoulder dislocation or an unexpected pulling injury to the arm. The bicipital tendon, one of two tendons to the bicep muscle is attached to this cartilage ring. Tears of the bicipital tendon are common. Usually the result of lifting heavy objects. Tears of this tendon usually do not require surgery. The patient will lose ten to fifteen percent of strength bending the elbow. A cosmetic deformity of the bicep contour will occur, but does not contribute to significant weakness.

The shoulder joint contains cartilage and is prone to developing arthritis. The onset is gradual. Primary complaint is pain. As the arthritis becomes more severe the patient will eventually lose motion. The pain is described as constant, increased with use and many times associated with painful catching and grinding.

Another frequent source of “shoulder pain” is actually referred from the neck. The patient’s neck may not hurt! The pain is typically in the back of the shoulder blade. The majority of time, the pain will go below the elbow sometimes causing numbness and tingling in the fingers. Pain that is solely due to a shoulder problem may go to the elbow but not below. Unfortunately, having an injured shoulder does not mean you don’t also have a neck problem, and vice versa.

The key to minimizing shoulder pain lies in maintaining muscle fitness not only the rotator cuff, but the muscles that stabilize your shoulder blade. The shoulder allows us an incredible ability to perform complex tasks. Shoulder pain consequently can be a source of severe dysfunction.



Life After Bariatric Surgery

Life After Bariatric Surgery
by Dr. Darren Glass

Life after bariatric surgery is not easy. Far from it, but well worth it.

The first few weeks after surgery, patients are adjusting to their new stomach anatomy and have to remain on a carefully controlled liquid diet. Their activity quickly advances back to normal. They may take a week or two off from work, but there is very minimal pain after a few days and there are no restrictions in activity for the motivated patient.

After a few weeks, we advance the diet to soft foods which includes things like tuna salad, egg salad, lunch meat, eggs, cheese and yogurt. Then over the next few months, we advance to normal foods – mostly meat, a little bit of cooked vegetables and very little else.

Exercise is encouraged. Patients are encouraged to eat their small meals slowly and regularly, even though they are not hungry, and to minimize snacking. Patients who do this faithfully will lose about 2/3 to 3/4 of their excess weight in the first year after surgery.

Along with this weight loss comes resolution of medical comorbidities such as diabetes, hypertension, acid reflux and obstructive sleep apnea.

Quality of life improves and patient satisfaction is excellent following surgical weight loss. Definitely well worth it!




Benefits of Bariatric Surgery

Benefits of Bariatric Surgery
by Dr. Darren Glass

Bariatric surgery has been around for a long time, well over 60 years. It has gone from experimental, dangerous, fringe medicine, to safe, routine, elective, standard of care. The concept of simple weight loss surgery is outdated is now seen as life-changing metabolic surgery. This means that these surgeries have positive, beneficial effects on medical comorbidities such as diabetes, hypertension, dyslipidemias, obstructive sleep apnea and a whole host of other medical conditions previously controlled and managed, but never cured.

Bariatric surgery patients get off their diabetes medicines quickly, sometimes the day of surgery. Their blood pressure medication requirements go down with weight loss. Their acid reflux is improved/cured, their cholesterols normalize and they get off their CPAP machines. Their arthritis improves, their hearts and lungs have to work less hard and their quality of life improves.

Bariatric surgery is not for everyone. But if your BMI is over 40 and/or you have the above comorbidities, your life could be changed forever!


So, you just got out of the hospital! Here are some ways to keep it that way.

So, you just got out of the hospital! Here are some ways to keep it that way.
by Rachel Weiland, PharmD, BC-ADM, MCHS Ambulatory Care Pharmacist

Eat healthy

Focusing on nutrient-dense, fresh foods can help you lose weight, have more energy, lower your blood pressure, improve your cholesterol, enhance your immune system and so much more. Some great foods to incorporate are:

fruits and vegetables

lean meats and fish such as baked or grilled chicken and salmon

egg whites


Try to avoid foods high in sugar, salt or saturated fats such as sweets, sodas, fried foods, chips, fast food and frozen meals.



Try to find a routine that combines strength training and cardio. High impact activities such as running or jump roping are great for strengthening bones and preventing fractures later in life. If you cannot do high impact exercises due to having bad joints, try swimming or biking to get your heart working and improve your endurance. Many people neglect strength training when trying to get in shape, but being physically stronger can help prevent falls, and having more muscle mass increases your metabolism, meaning you will burn more calories throughout the day. Many women are afraid that they will end up with a masculine build if they lift weights … when in reality, it would take years of very consistent, heavy weight training to do so.


I think we all know that getting enough sleep is beneficial for our health. Sleep improves our immune systems, gives us more energy and allows our bodies to recover. If you have trouble falling asleep, develop a sleep hygiene routine. No, sleep hygiene isn’t referring to being clean … it simply means to establish a sequence of bedtime activities to do before you go to bed. This might include things like changing into your pajamas, reading a chapter of a book and brushing your teeth. If you do the same routine every night, your brain will recognize that it’s time to go to bed, and you will be able to fall asleep more easily. Try your best to avoid staring at screens such as your phone, laptop or TV right before bed as this can signal to your brain to stay awake.

Fill any new medications right away

It is important that you don’t have any interruptions in taking your medications after you get out of the hospital. If you are prescribed any medications that you cannot afford, be sure to call your doctor immediately so that it can be changed to something else. You may also be able to find coupon cards or patient assistance programs to help get the cost down. Go online to the drug’s website to see if anything is available.

Know how to take your medications

Do you need to take your medication with food? On an empty stomach? In the morning? At bedtime? If you don’t know, ASK! Also, you will probably come across a time when you forget to take your medication, and remember several hours later. Ask your pharmacist what you should do in this situation, as the answer depends on the medication. Look closely at your discharge papers to see what medications were discontinued, so you don’t keep on taking medications that you don’t need, and can interact with your current medications.

Schedule follow up appointments

Sometimes you will already have doctors’ appointments scheduled for you. It is important to attend these appointments so you can continue to be monitored and catch anything before it gets to the point that you need to go back to the hospital. If no appointments are scheduled for you, be sure to schedule an appointment with your primary care doctor as soon as possible.


Heart Disease – Causes and Risks

Heart Disease – Causes and Risks
by Karry Morris MSN RN-BC
Cardiovascular Nurse, Medical Center Hospital

Heart disease is the #1 killer in the nation, causing approximately one in three deaths every year. It is a great time to evaluate your own risk and take steps to reduce your chances of developing heart disease. If you have conditions that can contribute to the development of heart disease, keeping those under control can greatly reduce your risk:

High blood pressure:

110/70 is considered perfect blood pressure. Keeping your blood pressure around this range can often be achieved with proper treatment. If you have high blood pressure, see your doctor regularly, take your medicine faithfully (even if you feel good) and keep an eye on your blood pressure. We suggest having a cuff at home and checking your blood pressure often, recording these results for your doctor.

Many people have high blood pressure and don’t even know it. Many know they have it and don’t treat it. This can be a deadly mistake.

If you do not know if you have high blood pressure, find out! They call hypertension the “Silent Killer” for a reason.


The fluctuations of blood sugar associated with diabetes cause changes within the arteries that increases risk for heart disease. Keeping your blood sugar under control and reducing fluctuations can help reduce risk.

Like blood pressure, if you are diabetic, it is recommended you check your blood sugar often, keep a record and work with your doctor to help keep your sugar levels under control.

Overweight and Obesity:

Not keeping your weight under control not only increases your overall risk of heart disease, but it also contributes to development of diabetes, high blood pressure, high cholesterol and other diseases.

Keeping weight under control by eating a healthy diet and exercising regularly is one of the best things you can do to improve your overall health and reduce heart attack risk.

 Reduce your risk by:

  • Seeing your doctor regularly and take any medicine your doctor prescribes
  • Eat right and exercise
  • Keep your conditions under control – diabetes, high blood pressure and high cholesterol. Knowing your numbers is great place to start. Make an appointment with your doctor to undergo testing and evaluate your personal risk for heart disease. Those with heart disease in their immediate family are especially at risk and should take proactive steps to reduce their own risk.

Lastly, be able to recognize an emergency and act!

Signs of heart attack include:

  • Pain, pressure, squeezing or fullness in the chest
  • Pain or discomfort in one or both arms, neck, jaw, back or stomach
  • Shortness of breath
  • Cold sweat, nausea, lightheadedness, loss of consciousness

If you think you or someone else is having a heart attack, always CALL 911!

Driving yourself to the emergency room is not only dangerous, but can be deadly.
It is also a good idea to learn CPR, especially if your loved ones are at risk.







MEDICAL MATTERS: Good Nutrition is Vital for Pregnancy

MEDICAL MATTERS: Good Nutrition is Vital for Pregnancy
As seen in the Odessa American “Medical Matters”: http://www.oaoa.com/people/health/article_a63f49c0-0c5c-11e7-ae5b-5f1dde4cc0cb.html

by Dr. Avelino Garcia

Good nutrition is vital for a healthy pregnancy. Between fatigue and pregnancy cravings, it can seem difficult to keep healthy eating habits. Planning healthy meals and staying physically active can help.

Eating five or six small meals daily, rather than three large meals, can help with nausea and can also help pregnant women get extra vitamins and minerals needed for growing babies. Each day, eat foods from the major food groups, keeping fats and sugars in moderation. Fresh fruits and vegetables, whole grains and lean proteins are encouraged. Be sure that red meats are fully cooked, not rare, as this can cause illness in a pregnant woman. Fish and seafood are good sources of protein, but stay away from seafood with high mercury content such as shark, swordfish, king mackerel or tilefish. Limit white (albacore) tuna to 6 ounces weekly.

Hydration is also a key part of proper nutrition. Pregnant women are encouraged to drink at least two liters of water daily. Symptoms of dehydration in pregnancy include thirst, headache and uterine cramping. Sugary and caffeinated drinks increase risk for dehydration, so they are to be avoided.

Staying physically active is one of the healthiest things an expectant mom can do for her unborn baby. Thirty minutes of low intensity exercise, like walking, is encouraged.

Unless an expectant mother has a high-risk pregnancy, exercise can help regulate blood sugar levels, keep blood pressure in the normal range, and minimize abnormal weight gain.

The United States Department of Agriculture has made meal planning easier by creating www.choosemyplate.gov. The website assists everyone, including pregnant women, figure out how to make healthy choices with each meal. According to the American College of Obstetricians and Gynecologists (ACOG) Frequently Asked Questions (FAQ) on Nutrition During Pregnancy, the MyPlate website gives “personalized nutrition and physical activity plans by using the ‘Super Tracker’ program. This program is based on five food groups and shows the exact amounts needed each day from each group during each trimester of pregnancy.”