Cholesterol Basics Part Deux

There are four basic types of cholesterol commonly listed on a fasting lipid profile.

1. Total cholesterol: this is the total amount of cholesterol in your blood.  This number alone is meaningless without a breakdown of the other cholesterol types.
2. HDL (high density lipoprotein): this is good cholesterol.  Think of it as a truant officer; HDL picks up extra cholesterol from the body's tissue and takes it to the liver for disposal.  Exercise increases HDL levels.
3. LDL (low density lipoprotein): this is bad cholesterol.  Deposits extra cholesterol in vessel walls, thereby contributing to hardening of the arteries and heart disease.
4. Triglycerides: the major form of circulating fat found in the body.  The function of triglycerides is to provide energy for cells.  These levels increase directly after a meal, which is why a lipid profile should only be drawn on a fasting patient.

Maintaining an appropriate weight, eating a healthy diet, exercising and not smoking are all factors that will help keep your cholesterol levels within healthy levels.  But what if you're already doing all of these things and your cholesterol levels are out-of-range?  Stay tuned for a discussion of other ways to treat your high cholesterol.

Cholesterol Basics

Cholesterol is a waxy, fatty substance that is found in your body and many foods.  Your body is capable of making all the cholesterol you need.  In fact, the body requires cholesterol to function properly. 

If you consume too much cholesterol, your body will collect and deposit cholesterol.  When cholesterol accumulates in your vessels, it creates "plaque".  These plaque deposits cause narrowing and hardening of the vessels.  This narrowing restricts blood flow, and in the case of restricted blood flow to the heart, chest pain.  If the vessel is completely blocked, a heart attack occurs.

Plaque Build Up in Artery from the NHLBI Diseases and Conditions Index

What are risk factors for high cholesterol? 

• The trump card is genetics.  If you have family members with high cholesterol, you may be genetically predisposed to high cholesterol as well. 
• Age, weight, diet and physical activity levels are also risk factors.
• Diabetes.  High blood sugar levels can cause damage to the inner lining of the body's vessels.  This damage creates an easy foothold for plaque to attach.

What can you do to lower your cholesterol levels?

• Talk with your healthcare provider about testing your fasting cholesterol levels.  You and your provider can discuss different treatment options, such as medication and lifestyle changes if your test results are not optimal.
• Maintain a healthy diet and weight.
• Increase your physical activity levels.
• Don't smoke.
• If you have diabetes, keep your blood sugar within optimal levels.

Stay tuned for more cholesterol basics!

Skeletal Muscle Rebuilding

I just have to brag on UT Austin today.  Another excellent research project from Dr. Roger Farrar, one of my kinesiology professors, on rebuilding skeletal muscle in patients with limbs injured in accidents such as shark bites and IEDs (improvised explosive devices).  This is something that has never been accomplished before.

Dr. Farrar's research was funded by a 3-year, $550,000 grant from the U. S. Army and will greatly benefit wounded soldiers.

Dr. Dixie Stanforth - Get Back in that Prom Dress!

An excellent article from the University of Texas, my alma mater, features Dr. Dixie Stanforth from the Department of Kinesiology and Health Education.  Dr. Stanforth reminds us that loss of muscle mass and lower fitness levels are not the inevitable result of aging.  She is working with Fox Sports and the Gatorade Training Council to promote fitness, especially for those who were althletes in high school.  The television program is called "Replay", and allows those former high school athletes a chance to relive sports experiences such as high school rivalry games.

It is a great reminder for those of us in our, ahem, thirties that fitness is the result of hard work.

These Feet Were Made for Walkin'...

"I've just worked a 12-hour shift, and boy are my dogs barking!"  When your feet hurt, you are miserable.  Foot health is important for everyone.  Here are some tips to maintain your tootsies:

1) Do not go barefoot.  Wear appropriate shoes for the situation.  I have seen many a toe injury (including crushing injuries and fractures) from wearing flip-flops while moving a couch that would have been avoided by wearing shoes.  When working around the house or in the yard, wear socks and closed-toe shoes.  Applying lotion before donning socks can also soften callouses and cuticles.

2) Cut and file your toenails straight across to avoid ingrown toenails.  Few things are more painful than foot surgery, even if it's a simple procedure.  If you feel as if you have the beginning of an ingrown toenail, you can try taking a small piece of a cotton ball and inserting it under the corner of the toenail to lift it up.  However, you must replace the cotton daily and closely monitor for signs and symptoms of infection, which include fever, presence of discharge, a foul odor, or red streaks running away from the site.  If any of these are present, do not use the cotton and get to a healthcare provider immediately.

3) If you workout, make sure you purchase proper workout shoes.  This helps stabilize the foot and ankle, as well as protect your feet.

4) If an area of skin on your foot is slightly reddened from a pressure point, such as a strappy sandal, but the skin is not broken, you can try moleskin to protect the area from further breakdown.  Moleskin is a flannel material with a sticky back that you purchase in sheets from the foot care section of a grocery or drug store.  This sheet may be cut to size and applied, and each application is thrown away after use.  For example, I bought a strappy heel to wear as a bridesmaid.  I wore the shoes around the house for about an hour, and noticed where the red marks were on my feet.  I applied moleskin to the previously reddened areas before the wedding and was able to stand and dance in the shoes all night.

5) If the skin is blistered, try not to pop the blister.  A blister is nature's bandaid and, if left intact, will usually heal well on its own.  If you feel that the blister will shear open by force, it is better to make a small hole at the base with a sterilized needle, drain and then bandage.  I find that eye patches work well to cushion blister repair under a large bandaid or paper tape.

6) Wash feet with soap when you bathe and dry thoroughly.  Using a blow dryer set on a cool, low setting will help you dry in-between your toes to avoid fungal infection such as athlete's foot.  Clean, dry feet are much less suceptible to infection.

7) If you have been diagnosed with diabetes, your foot health is of supreme importance.  See your podiatrist regularly, and don't forget to examine the soles of your feet nightly.  Diabetics can suffer "peripheral neuropathy"; this occurs when the elevated blood sugar negatively affects nerve endings, especially in the feet.  This can cause loss of sensation, which is why diabetics are advised to examine the soles of their feet.  They may find a cut or foreign body they can't even feel.

8) Get pedicures at a reputable salon.  This will help keep your toenails and feet infection-free.  There's nothing like pretty, painted toenails to make you feel good about yourself and lift your spirits!

To Maintain and Elevate the Standard of My Profession...

"I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care."

Composed in 1893 by Mrs. Lystra E. Gretter and named the Florence Nightingale Pledge to honor the founder of modern nursing, this pledge has launched many a nursing career.  The weight of these words, however, is not always apparent to the graduate nurse.  This May will mark my fifteenth year as a registered nurse.  I will never forget the first time I saw "RN" after my name, engraved on the back of a caduceus necklace.

I establish this blog with the goal of maintaining and elevating the standard of my profession.  I am a registered nurse: a teacher, a healer, a shoulder to cry on, someone to laugh with, a soul to hold the space next to you when you need me.  I am traditional and modern, strong and soft.

I dedicate this blog to Florence Nightingale, and all my fellow registered nurses.