The signs and symptoms of high B/P=Hypertension could be:

Usually, high blood pressure causes no signs or symptoms. That’s why healthcare providers call it a “silent killer.” You could have high blood pressure for years and not know it. In fact, the World Health Organization estimates that 46% of adults with hypertension don’t know they have it.

When your blood pressure is 180/120 mmHg or higher, you may experience symptoms like headaches, heart palpitations or nosebleeds. Blood pressure this high is a hypertensive crisis that requires immediate medical care.

Remember this, for many High blood pressure is known as the “silent killer” and its given that nickname for a reason.  For those patients with high B/P they don’t feel ANY SIGNS OR SYMPTOMS OF HIGH B/P to go to the doctor!  So they let their B/P get so high, never going to the MD or regularly checking their B/P on their own and puff they die awake or in their sleep due to the high B/P that caused the death!

You may not feel that anything is wrong, but high blood pressure could be quietly causing damage that can threaten your health. The best prevention is knowing your numbers and making changes that matter in order to prevent and manage high blood pressure.

Why not just buy a blood pressure monitor from the pharmacy which will help you keep an eye on your B/P or even keeping your B/P therapeutic and have no HTN!

A BIG factor in helping to reduce or decrease high blood pressure for those with hypertension is DIET alone will impact greatly.  Less SODIUM=Salt in the diet will have an impact in lowering your B/P!

Your provider will diagnose you with one of two types of high blood pressure:

• Primary hypertension. Causes of this more common type of high blood pressure (about 90% of all adult cases in the U.S.) include aging and lifestyle factors like not getting enough exercise.
• Secondary hypertension. Causes of this type of high blood pressure include different medical conditions or a medication you’re taking.

Most people with high b/p are asked to eat less sodium. Sodium attracts water and makes the body hold fluid. To pump the added fluid the heart works harder. Also sodium in the body causes the arteries to vasoconstrict increasing pressure in the vessels causing the pressure to rise.

Most people with high b/p are asked to eat less sodium at 2000mg or less a day and this is to prevent water retention and vasoconstriction in which both actions increase the blood pressure. Follow your doctor’s advice about your sodium intake.

Many prepared foods and spices are high in sodium. But, the most common source of sodium is table salt. Table salt is 40% sodium and 60% chloride. One teaspoon of table salt contains 2000mg of sodium.  Get rid of your table salt period will help you in trying to lower your B/P or keeping your B/P therapeutic (in the norm).

HINTS IN HOW TO LOWER YOUR SODIUM IN YOUR DIET:

What is Sodium (NA+)?  One it’s an important substance in our body. It helps your body balance the level of fluid inside and outside of the cells; this prevents the cells from becoming dehydrated. To keep up this balance, the body needs about 2000mg of sodium a day or less. Yet most of us eat 3000 to 6000mg of sodium each day.  On average Americans eat 3400mg of sodium a day and now it is recommended to eat 1500 mg a day.  A major start is no salt shaker on the table and don’t add salt to your foods unless you know the amount in them already with not going over 1500 mg of salt a day or what your cardiologist recommends who is the expert!

Other tips could  be:

-Season foods with fresh or dried herbs, vegetables, fruits or no-salt seasonings.

-Do not cook with salt or add salt to foods after they are on the table.

-Make your own breads, rolls, sauces, salad dressings, vegetable dishes and desserts when you can.

-Stay away from fast foods. They are almost all high in salt.

-Eat fresh, not frozen or canned, and do eat unsalted vegetables. These have less sodium than most processed foods. Read the labels and if they don’t have a label DON’T EAT IT. Read the labels and eat the portioned size it says to for 1 portion with keeping a diary of what you ate with adding the sodium and when it reached 2000mg no more food that day with salt in it unless the doctor prescribes less.

Know this frozen meals are often high in sodium. In fact, it’s estimated that around 70% of the sodium people consume in the United States comes from prepackaged, processed, and restaurant foods = high in sodium.

-Buy water packed tuna and salmon. Break it up into a bowl of cold water, and let stand for 3 minutes. Rinse, drain and squeeze out water.

-Don’t buy convenience foods such as prepared or skillet dinners, deli foods, cold cuts, hot dogs-one of the worst foods to eat to begin, frozen entrees or canned soups. These have lots of salt. Be picky on what you eat.

-Again, read all labels for salt, sodium or sodium products (such as sodium benzoate, MSG). Ingredients are listed in the order of amount used. A low sodium label means 140mg of less per serving. Try to buy products labeled low sodium/serving. Do not eat products that have more sodium than this per serving.

-AHA states, “If you drink, limit your alcohol consumption to no more than two drinks per day for men and no more than one drink per day for women. A drink is one 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits or 1 oz. of 100-proof spirits.

I’ve read that red wine is heart healthy — can I drink as much as I’d like?
Unfortunately, red wine as a miracle drink for heart heath is a myth. The linkage reported in many of these studies may be due to other lifestyle factors rather than alcohol. Like any other dietary or lifestyle choice, it’s a matter of moderation and disciplining yourself in almost anything especially junk food, processed foods, foods high in fat or fried should once in awhile in aiding yourself in controlling your blood pressure.  Don’t only do moderation when the B/P goes high instead make the moderate eating of bad foods a regular part of your life and high odds it will only aid in helping your B/P to stay normal or to get in a therapeutic range.  The other way is only a high potential to aid in getting hypertension or increasing your b/p.

If you need help–
If cutting back on alcohol is hard for you to do on your own, ask your healthcare provider about getting help.

The AHA says your lifestyle plays an important role in treating your high blood pressure. If you successfully control your blood pressure with a healthy lifestyle, you might avoid, delay or reduce the need for medication.

Foods to keep out of your diet or ever have on a regular basis and have maybe have once every 3 months or less

-Canned Vegetables, sauerkraut. Self rising flour and corn meal. Prepared mixes (waffle, pancake, muffin, cornbread, etc…)

-Dairy Products high in fat- like buttermilk (store-bought), canned milks unless diluted and used as regular milk).  I personally switched to skim milk and drink it every day and with other things taken in my life in moderation with trying to watch my weight still keeps my b/p under 120/80.   Egg substitute limit to ½ cup/day. Eggnog (store bought) and salted butter or margarine do not buy everyday but have eggnog around holiday time is what I do and that’s it.  I limit my butter intake where it is on bread and never add it to cooking or have extra on the table for like mashed potatoes.  Trust me processed foods have plenty in them and bakery goods without question.

-Soups: Boullon (all kinds), canned broth, dry soup mixes, canned soups are severely high in sodium especially the noodles you add water to.  Just have one of them and your already over 1000mg of salt.  Surprise, Dietary Guidelines for Americans recommends adults limit sodium intake to less than 2,300 mg per day—that’s equal to about 1 teaspoon of table salt! Salt is in the majority of foods so look on the back of the food and read the amount of fat,carbohydrates and salt is in a serving with seeing what the food’s size of a serving is.  It may make you fall in the chair.

-Meats and meat substitutes not to buy=Canned meats, canned fish, cured meats, all types of sausages, sandwich meats, peanut butter, salted nuts.  High in sodium again.

-Prepared mixes (pie, pudding, cake) or store bought pies, cakes, muffins.

-Cooking ingredients to use low sodium type or limit to 2 tbsp/day=ketchsup, chili sauce, barbecue   sauce, mustard, salad dressing.  Read the label!

-Drinks to stay away from Athletic Drinks (such as energy drinks-caffeine/Gatorade), canned tomato or vegetable juice (unless unsalted).  Caffeine is a commonly used neurostimulant that also produces cerebral vasoconstriction by antagonizing adenosine receptors. Chronic caffeine use results in an adaptation of the vascular adenosine receptor system presumably to compensate for the vasoconstrictive effects of caffeine=vasoconstriction of all blood vessels=this increases your b/p.

NIH=The National Library of Meidicine found this with caffeine (https://www.ncbi.nlm.nih.gov/books/NBK202224/):

The West Florida Vein Center states this about caffeine:

“Caffeine is a drug found in coffee, soda and tea, doesn’t just wake you up. It sets your whole body into a different motion, stimulating the nervous system and constricting blood vessels. Caffeine is safe when ingested in moderation, but excessive consumption can lead to vascular complications like high blood pressure, poor circulation and narrow blood vessels.  I have 2 cups a day on average.  Being a night RN I have one in the morning to have one at night.  When off of work just one or two in the am.

Upon consumption, caffeine gives you your morning jolt of energy. It achieves this by attaching to your adenosine receptors, which ordinarily dilate your brain’s blood vessels. Instead, your blood vessels constrict, also known as vasoconstriction. When vasoconstriction of the brain occurs, the pituitary gland sounds an alarm and reacts as if in an emergency state. It then releases adrenaline, which leads to increased heart rate.“

Know adrenaline is released in fight or flight and adrenaline causes peripheral vasoconstriction which further increases the B/P due to pressure build up in the vessels away from the core or center of the body.  That is what peripheral means.

The West Florida Vein Center further states:

“With vasoconstriction comes faster heart rate but slower blood flow. A study by “Human Brain Mapping” found heavy caffeine users experienced “reduced cerebral blood flow by an average of 27 percent.” What this means? Excessive caffeine intake leads to unnecessary stress on your venous system. Because your brain receives an inadequate amount of blood, your whole venous system operates under stress to compensate for the blood flow changes.

When stressed, veins are at greater risk of disease. Venous conditions like varicose veins and deep vein thrombosis can occur with vasoconstriction. Narrow blood vessels can prevent sufficient blood flow, causing clotting and inflammation.  To avoid stressing your venous system, limit coffee intake to 24 ounces per day.” OR we say less if you can!  Even better is decaffeinated coffee and no venous constriction will occur or if you need the caffeine have one glass or 12 ounces of caffeinated and the rest of the day decaffeinated coffee.

So yes, long term caffeine heavy users do get overall VASOCONSTRICTION that increases your blood pressure in the body, including in the brain.  While there’s no broad percentage of caffeine dependence in the US population, smaller studies have been conducted. According to a study conducted by the University of Florida, 28% fulfilled the criteria for caffeine dependence compared to 50% for alcohol and 80% for nicotine.  From this study 2 factors cause vasoconstriction Nicotine and Caffeine.  Remember one of the symptoms of high B/P is a headache! So change your diet if you need to in your life, based on this information and hope it is useful!

Remember Moderation to stopping completely out of your diet things that increase your blood pressure is the key to helping you reach normal blood pressure with other factors like obesity, and disease from Diabetes to Athero- sclerosis (which is partly or completely blocking an artery vessel) including arteriosclerosis which is brittle arteries and Renal Failure (acute or chronic).

(Updated 5/12/24)

Understand the numbers in your B/P!

“Hypertension Stage 1 is when blood pressure consistently ranges from 130 to 139 systolic or 80 to 89 mm Hg diastolic. At this stage of high blood pressure, health care professionals are likely to prescribe lifestyle changes and may consider adding blood pressure medication.

Hypertension Stage 2 is when blood pressure consistently is 140/90 mm Hg or higher. At this stage of high blood pressure, health care professionals are likely to prescribe a combination of blood pressure medications and lifestyle changes.

Hypertension Stage 3-This stage of high blood pressure requires medical attention. If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and then test your blood pressure again. If your readings are still unusually high, contact your health care professional immediately. You could be experiencing a hypertensive crisis!

Experiencing new symptoms with your B/P this high than call 911!

American Heart Association (https://www.heart.org/en/health-topics/high-blood-pressure-understanding-blood -pressure-readings)

Know the numbers of concern and know yours to keep your health well and avoiding problems from High B/P. We will review S/S with more tomorrow continuing the topic hypertension (HTN).

  Systolic BP is heart at work, Diastolic BP is heart at rest!

High Blood Pressure – what is it?

High Blood Pressure or Hypertension affects 80 million Americans and nearly half of the people in the UK between the ages of 65 and 74, and a large percentage of those between the ages of 35 and 65. One of the problems associated with high blood pressure is that you will probably not even know you have it until you happen to have your blood pressure taken during a routine physical examination.  In our B/P you have 2 numbers one on the top that is called your systolic b/p that will always be higher that the bottom number b/p.  What do they mean? The top number systolic B/P will be the number representing your heart pressure at work whereas the bottom number called diastolic B/P will always be lower that the top number representing the B/P at rest.  Normal B/P for some is 90/50 for those who are a work out nut, in good shape, and at their normal weight level or body mass index (BMI).  For others normal B/P can go has high as 120/80 or less.  High B/P is over 120/80.  In earlier years 122/80 was considered the norm now its not.  Where do you really see problems for a high B/P?  Well looking at a B/P chart this should give you some direction:

Remember in the nursing and medical field a systolic B/P of 180 these professional get concerned for stroke or a vessel somewhere about to burst (Ex. like a abdominal aneurysm which many don’t feel since its in their abdomen making room for the pouch vessel to grow making the vessel wall weaker to pop and than for many when realized its too late, take the actor John Ritter!)  With a stroke it can be caused by a hemorrhagic stroke-this meaning a vessel ruptures (most commonly high B/P) or ischemic stroke a build up of a blockage or blockages of a vessel in the brain).

Upon diagnosis, you may wonder why you never saw it coming. Most people don’t. Only those with severe high blood pressure experience any warning signs at all.

These signs can include headaches, impaired vision, and black-outs.

What is blood pressure ?

It is the measurement of the force that blood applies to the walls of the arteries as it flows through them carrying oxygen and nutrients to the body’s vital organs and systems. Naturally, our blood is under pressure as it rushes through our arteries. Even those with blood pressure in the normal range will experience an increase in their blood pressure during rigorous physical activity or during times of stress. It only becomes a problem when the blood continues to run high. This condition of blood pressure is known as hypertension or high blood pressure and in 95% of the cases, the cause of it is never known. However, we do know the factors that set a person up to develop hypertension.

Factors influencing High Blood Pressure:

They are as follows:

NON-MODAFIABLE RISK FACTORS ARE 4:

1. HEREDITY-HIGH B/P RUNNING IN THE FAMILY

2. AGE-THE OLDER, THE HIGHER PROBABILITY YOU WILL END UP WITH B/P DEPENDING ON YOUR HEALTH AND HOW GOOD YOU TAKE CARE OF YOURSELF.

3. GENDER or SEX-MALES VS FEMALES.  THE GENDER THAT BEATS THE OTHER EASILY IS MEN!

4. RACE-HIGHIER IN AFRO-AMERICAN AS OPPOSED TO WHITE.

MODAFIABLE RISK FACTORS=FACTORS YOU CAN CONTROL IN YOUR LIFESPAN:

1-Obesity=Those with a body mass index of 30 or greater.

2-Drinking more than 2 to 4 alcoholic drinks a day.

3-Smoking

4-High cholesterol

5-Diabetes

6-Ongoing Stress/Anxiety

7-Continuous use of excessive salt consumption

Possible causes of High Blood Pressure

Sometimes the cause of a person’s high blood pressure is determined, but this happens in only 5% of the cases. When a cause is found, the person is diagnosed with secondary high blood pressure [hypertension]. In most of these cases, the cause can be linked to an underlying illness such as kidney disease, adrenal gland disease, or narrowing of the aorta. Contraceptive pills, steroids, and some medications can also cause secondary high blood pressure [hypertension], though instances of this are not all that common since in most cases these can be stopped or with medications changed if a med is still needed to resolve high blood pressure.

Reviewing High Blood Pressure and the important numbers

We hear the numbers, but do we really know what they mean? Since your blood pressure numbers can help you to understand your overall health status, it is important that you keep track of it. By knowing where your numbers are right now, you can head off such serious high blood pressure complications as angina, heart attacks, stroke, kidney damage, and many others that might surprise you – like eye problems and gangrene.

Hear is a review of understanding what blood pressure means and tells our medical professionals from RN’s who see the pt the most and see the vital signs with doctors being told who generally provide your blood pressure to you in terms of two numbers – a top one and a bottom one. For example, if your blood pressure is 120/80, they may say that you have a blood pressure of 120 over 80. Here is a definition again for these numbers:

The top number– this is your systolic blood pressure. It measures the force of blood in the arteries as your heart beats. The top number means the pressure is reading your heart at work.  That is why this number is always highier.

The bottom number – this is your diastolic blood pressure. It is the pressure of your blood when the heart is relaxed in between the times when it is pumping. Means the pressure is reading your heart at rest.  That is why the number is always lowest.

Your blood pressure requires monitoring when you have a systolic blood pressure of 140 or over and/or a diastolic blood pressure of 90 or over. Those with diabetes must maintain a lower blood pressure that those who don’t have the condition. Diabetics should maintain a blood pressure of less than 130/80.  It would be ideal at 120/80 and there are some that do.

Monitors for measuring High Blood Pressure

It is wise to monitor your blood pressure at home in addition to having it taken at your doctor’s office. This will allow you to provide your doctor with readings that have been taken over time, providing a more in depth look at your personal health condition. This will help him or her to prescribe the right hypertensive medication and treatment for your specific condition.

Tips to help reduce your B/P:

The best you could do over 50 or if already diagnosed with high blood pressure than monitor it at home with automatic B/P machines or get a manual one with a stethoscope for taking your B/P measurement with your pulse for some that you take from the upper arm at home each day when you first get up. Especially have a B/P monitor is recommended in taking your B/P meds to eval how good the med is working but if on lopressor or metoprolol (commonly used antihypertensives) or any selective beta blocker which can lower your B/P and pulse. Since with metoprolol or lopressor if the b/p is 90/60 or the pulse is lower than 60 you should call the M.D. first since readings that low could bottom out your B/P and pulse with making them too low putting the pt at problems with dizziness, feeling weak to bottoming out so bad you just sleeps or better falls.  So call your doctor immediately before taking the med.  Always take the B/P from the upper arm above the elbow unless your M.D tells you otherwise.  You’ll also want to make sure that the blood pressure monitor you are considering has been proven in clinical trials. Trusted name brands include those made by Omron, LifeSource, Mark of Fitness, Micro Life, and A and D Instruments. There are other brands available – the important thing is to do your research.

Always check with you cardiologist preferred or your general practitioner before making any changes in your lifestyle in anyway for safety.

Updated 5/07/24

“Key facts

“Biomarker testing is the analysis of a person’s tissue, blood and other substances, known as biomarkers, that can provide information about a disease. While most current applications of biomarker testing are in oncology and autoimmune diseases, there is research underway to benefit other patients including those with neurological conditions like Parkinson’s.

While biomarker testing can provide people with critical information about their health, insurance coverage is failing to keep pace with innovation. We urge states to take legislative action to require health plans, including Medicaid, to cover biomarker testing so that more individuals have access to this important health care tool.

Legislative action on biomarker testing access coincided with the MJFF’s groundbreaking news, announced in April 2023, that researchers have discovered a new biomarker tool that can reveal a key pathology of the Parkinson’s: abnormal alpha-synuclein — known as the “Parkinson’s protein” — in brain and body cells.

Last year, twelve states passed legislation related to expanding insurance coverage for biomarker testing — Arizona, California, Georgia, Kentucky, Louisiana, Maryland, New Hampshire, Nevada, New Mexico, New York, Oklahoma and Texas. In 2024, MJFF is pursuing legislation in Colorado, Connecticut, Hawaii, Indiana, Iowa, Maine and Pennsylvania.”

Michael J. Fox Foundation for Parkinson’s Research

(https://www.michaeljfox.org/news/shaping-future-parkinsons-states-2024-policy-priorities)

What are the signs and symptoms (s/s) of this disease?

The early signs and symptoms of Parkinson’s disease that are often overlooked by both patients and doctors because the symptoms are subtle and the progression of the disease is typically slow. S/S of parkinson’s disease are:

Parkinson’s disease does not affect everyone the same way. In some people the disease progresses quickly, in others it does not. Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some patients, while for others tremor is only a minor complaint and different symptoms are more troublesome.

• The tremors associated with Parkinson’s disease has a characteristic appearance. Typically, the tremor takes the form of a rhythmic back-and-forth motion of the thumb and forefinger at three beats per second. This is sometimes called “pill rolling.” Tremor usually begins in a hand, although sometimes a foot or the jaw is affected first. It is most obvious when the hand is at rest or when a person is under stress. In three out of four patients, the tremor may affect only one part or side of the body, especially during the early stages of the disease. Later it may become more general. Tremor is rarely disabling and it usually disappears during sleep or improves with intentional movement.                                
• Rigidity, or a resistance to movement, affects most parkinsonian patients. A major principle of body movement is that all muscles have an opposing muscle. Movement is possible not just because one muscle becomes more active, but because the opposing muscle relaxes. In Parkinson’s disease, rigidity comes about when, in response to signals from the brain, the delicate balance of opposing muscles is disturbed. The muscles remain constantly tensed and contracted so that the person aches or feels stiff or weak. The rigidity becomes obvious when another person tries to move the patient’s arm, which will move only in ratchet-like or short, jerky movements known as “cogwheel” rigidity.
• Bradykinesia, or the slowing down and loss of spontaneous and automatic movement, is particularly frustrating because it is unpredictable. One moment the patient can move easily. The next moment he or she may need help. This may well be the most disabling and distressing symptom of the disease because the patient cannot rapidly perform routine movements. Activities once performed quickly and easily — such as washing or dressing — may take several hours.
• Postural instability, or impaired balance and coordination, causes patients to develop a forward or backward lean and to fall easily. When bumped from the front or when starting to walk, patients with a backward lean have a tendency to step backwards, which is known as retropulsion. Postural instability can cause patients to have a stooped posture in which the head is bowed and the shoulders are drooped.

As the disease progresses, walking may be affected. Patients may halt in mid-stride and “freeze” in place, possibly even toppling over. Or patients may walk with a series of quick, small steps as if hurrying forward to keep balance. This is known as festination.

A detailed overview of the Unified Parkinson’s Disease Rating Scale that is used by doctors to follow the course of disease progression and evaluate the extent of impairment and disability.

Abstract

The Movement Disorder Society Task Force for Rating Scales for Parkinson’s Disease prepared a critique of the Unified Parkinson’s Disease Rating Scale (UPDRS). Strengths of the UPDRS include its wide utilization, its application across the clinical spectrum of PD, its nearly comprehensive coverage of motor symptoms, and its clinimetric properties, including reliability and validity. Weaknesses include several ambiguities in the written text, inadequate instructions for raters, some metric flaws, and the absence of screening questions on several important non-motor aspects of PD. The Task Force recommends that the MDS sponsor the development of a new version of the UPDRS and encourage efforts to establish its clinimetric properties, especially addressing the need to define a Minimal Clinically Relevant Difference and a Minimal Clinically Relevant Incremental Difference, as well as testing its correlation with the current UPDRS. If developed, the new scale should be culturally unbiased and be tested in different racial, gender, and age-groups. Future goals should include the definition of UPDRS scores with confidence intervals that correlate with clinically pertinent designations, “minimal,” “mild,” “moderate,” and “severe” PD. Whereas the presence of non-motor components of PD can be identified with screening questions, a new version of the UPDRS should include an official appendix that includes other, more detailed, and optionally used scales to determine severity of these impairments.

How Parkinson’s disease is diagnosed based on factors such as signs/symptoms, patient history, physical examination, and a thorough neurological evaluation.

Furthermore, making the diagnosis is even more difficult since there are currently no blood or lab tests available to diagnose the disease. Some tests, such as a CT Scan (computed tomography) or MRI (magnetic resonance imaging), may be used to rule out other disorders that cause similar symptoms. Given these circumstances, a doctor may need to observe the patient over time to recognize signs of tremor and rigidity, and pair them with other characteristic symptoms. The doctor will also compile a comprehensive history of the patient’s symptoms, activity, medications, other medical problems, and exposures to toxic chemicals. This will likely be followed up with a rigorous physical exam with concentration on the functions of the brain and nervous system. Tests are conducted on the patient’s reflexes, coordination, muscle strength, and mental function. Making a precise diagnosis is essential for prescribing the correct treatment regimen. The treatment decisions made early in the illness can have profound implications on the long-term success of treatment.

 Questions to Ask Your Doctor About Parkinson’s Disease

Since you’ve recently been diagnosed with Parkinson’s disease, ask your doctor these questions at your next visit.

1. What stage is my illness in now?

2. How quickly do you think my disease will progress?

3. How will Parkinson’s disease affect my work?

4. What physical changes can I expect? Will I be able to keep up the activities, hobbies, and sports I do now?

5. What treatments do you suggest now? Will that change as the disease progresses?

6. What are the side effects of medication?…

Because the diagnosis is based on the doctor’s exam of the patient, it is very important that the doctor be experienced in evaluating and diagnosing patients with Parkinson’s disease. If Parkinson’s disease is suspected, you should see a specialist, preferably a movement disorders trained neurologist.

A comprehensive overview of the major non-motor complications that are often associated with Parkinson’s disease, including:

-Cognitive impairment –Dementia –Psychosis       -Fatique–Depression -Sleep disturbances -Constipation -Sexual dysfunction -Vision disturbances.

“VA uses the term “military sexual trauma” (MST) to refer to sexual assault or threatening sexual harassment experienced during military service. MST includes any sexual activity during military service in which you are involved against your will or when unable to say no. People of all genders, ages, sexual orientations, racial and ethnic backgrounds, and branches of service have experienced MST. Like other types of trauma, being PTSD.  MST can negatively affect a person’s mental and physical health, even many years later. Examples include:

• Being pressured or coerced into sexual activities, such as with threats of negative treatment if you refuse to cooperate or with promises of better treatment
• Sexual contact or activities without your consent, including when you were asleep or intoxicated
• Being overpowered or physically forced to have sex
• Being touched or grabbed in a sexual way that made you uncomfortable, including during “hazing” experiences
• Comments about your body or sexual activities that you found threatening
• Unwanted sexual advances that you found threatening”

U.S. Dept of Veteran’s Affair (https://www.mentalhealth.va.gov/msthome/index.asp)

Parkinson Disease (PD) is a chronic and progressive movement disorder, meaning that symptoms continue and worsen over time. Nearly one million people in the US are living with Parkinson’s disease. The cause is unknown, and although there is presently no cure, there are treatment options such as medication and surgery to manage its symptoms.

Parkinson’s involves the malfunction and death of vital nerve cells in the brain, called neurons. Parkinson’s primarily affects neurons in an area of the brain called the substantia nigra. Some of these dying neurons produce dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination. As PD progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally.

There are three types of Parkinson’s disease and they are grouped by age of onset: 

1-Adult-Onset Parkinson’s Disease – This is the most common type of Parkinson’s disease. The average age of onset is approximately 60 years old. The incidence of adult onset PD rises noticeably as people advance in age into their 70’s and 80’s.

2-Young-Onset Parkinson’s Disease – The age of onset is between 21-40 years old. Though the incidence of Young-Onset Parkinson’s Disease is very high in Japan (approximately 40% of cases diagnosed with Parkinson’s disease), it is still relatively uncommon in the U.S., with estimates ranging from 5-10% of cases diagnosed.

3-Juvenile Parkinson’s Disease – The age of onset is before the age of 21. The incidence of Juvenile Parkinson’s Disease is very rare.

Impact of the disease:

Parkinson’s disease can significantly impair quality of life not only for the patients but for their families as well, and especially for the primary caregivers. It is therefore important for caregivers and family members to educate themselves and become familiar with the course of Parkinson’s disease and the progression of symptoms so that they can be actively involved in communication with health care providers and in understanding all decisions regarding treatment of the patient.

According to the American Parkinson’s Disease Association, there are approximately an estimated 1 million Americans living with Parkinson’s disease and more than 10 million people worldwide.  That number is expected to rise as the general population in the U.S. ages. Onset of Parkinson’s disease before the age of 40 is rare. All races and ethnic groups are affected.

Knowledge is Critical when Dealing with a Life-Altering Condition such as Parkinson’s Disease and being able to make the changes to last longer and at your optimal level of functioning! First step is accept you have it!

If you or a loved one has been diagnosed with Parkinson’s disease, it’s critical to learn everything you possibly can about this condition so that you can make informed decisions about your treatment. That’s why we created the Medifocus Guidebook on Parkinson’s Disease, a comprehensive 170 page patient Guidebook that contains vital information about Parkinson’s disease that you won’t find anywhere in a single source.

The Medifocus Guidebook on Parkinson’s Disease starts out with a detailed overview of the condition and quickly imparts fundamentally important information about Parkinson’s disease, including:

Possible factors that could impact someone in being diagnosed with this disorder:

1-Genetic Factors

In some patients, genetic factors could be the primary cause; but in others, there could be something in the environment that led to the disease. Scientists have noted that aging is a key risk factor. There is a 2-4% risk for developing the disease for people over 60. That is compared to 1-2% risk in the general population.

2-Environmental Factors

Some scientists believe that PD can result from overexposure to environmental toxins, or injury. Research by epidemiologists has identified several factors that may be linked to PD. Some of these include living in rural areas, drinking well water, pesticides and manganese.

Some studies have indicated that long term exposure to some chemicals could cause a higher risk of PD. These include the insecticides permethrin and beta-hexachlorocyclohexane (beta-HCH), the herbicides paraquat and 2,4-dichlorophenoxyacetic acid and the fungicide maneb. In 2009, the US Veterans Affairs Department stated that PD could be caused by exposure to Agent Orange.

We should remember that simple exposure to a single toxin in the environment is probably not enough to cause PD. Most people who are exposed to such toxins do not develop PD but could be a risk.

The Parkinson’s Disease Foundation notes that even after decades of intense study, the causes of Parkinson’s disease are not really understood. However,they agree in saying that many experts believe that the disease is caused by several genetic and environmental factors, which can vary in each person.

“Not everyone has a work schedule that resembles the traditional nine-to-five day. In fact, more than 22 million Americans work evening, rotating, or on-call shifts. You face many challenges when working non-traditional hours. It can be hard to keep up with family and friends. You may feel disconnected from the people you care about the most. You may have trouble organizing your time and activities. You may be frustrated to realize that most things are planned around the schedule of the typical day worker. It may seem like no one has your needs in mind.  Your physical health may also suffer from shift work. It can be very hard to get the sleep you need to stay well rested. This can make you more likely to get sick. It also makes you at potential that the job is hard for you to stay alert on the job.  Being tired increases the chance that you could suffer a work-related injury. Even driving home from work is a risk when you are sleepy.  Studies show that sleepiness can have a negative effect on any of the following:

1. Attention 2. Concentration 3. Reaction time 4. Memory  5. Mood.

A main challenge of shift work is that it forces you to sleep against the clock. You have an internal body clock in your brain that produces circadian rhythms.  If you work at night, you must fight your body’s natural rhythms to try and stay awake. Then you have to try to sleep during the day when your body expects to be alert.

It is a good idea to take a nap just before reporting for a night shift. This makes you more alert on the job. A nap of about 90 minutes seems to be best. Naps during work hours may also help you stay awake and alert. You may also want to take a nap during the night shift “lunch hour.” This can make you more productive and more satisfied”

UCLS Health (https://www.uclahealth.org/medical-services/sleep-disorders/patient-resources/patient-education/coping-with-shift-work)

Sleep isn’t just a time to rest and give your body and brain a break. It’s a critical biological function that restores and replenishes important body systems. Now, yet another study on shift workers shows that their unusual hours may be cutting their lives short—and that’s especially true for those who have rotating night shifts, rather than permanent graveyard duty.

You wake up, feel hungry, and fall asleep each day around repeating 24-hour “circadian” cycles controlled by your body’s internal clocks. These clocks are synchronized by a central pacemaker in the brain. Cycles of light and dark are important for the function of the brain’s master clock. Other cycles, such as the behavioral activities of eating and fasting or sleeping and waking, are important for peripheral clocks in the liver, gut, and other tissues.

When you stay awake all night or otherwise go against natural light cycles, your health may suffer. Long-term disruption of circadian rhythms has been linked to obesity, diabetes, and other health problems related to the body’s metabolism.

In a study published in the American Journal of Preventive Medicine, scientists led by Dr. Eva Schernhammer, an epidemiologist at Brigham and Women’s Hospital, studied 74,862 nurses enrolled in the Nurses’ Health Study since 1976. The nurses were an ideal group for studying the effects of rotating night shifts on the body, since RNs tend to have changing night shift obligations over an average month rather than set schedules.

After 22 years, researchers found that the women who worked on rotating night shifts for more than five years were up to 11% more likely to have died early compared to those who never worked these shifts. In fact, those working for more than 15 years on rotating night shifts had a 38% higher risk of dying from heart disease than nurses who only worked during the day. Surprisingly, rotating night shifts were also linked to a 25% higher risk of dying from lung cancer and 33% greater risk of colon cancer death. The increased risk of lung cancer could be attributed to a higher rate of smoking among night shift workers, says Schernhammer.

The population of nurses with the longest rotating night shifts also shared risk factors that endangered their health: they were heavier on average than their day-working counterparts, more likely to smoke and have high blood pressure, and more likely to have diabetes and elevated cholesterol. But the connection between more rotating night shift hours and higher death rates remained strong after the scientists adjusted for them.

You wake up, feel hungry, and fall asleep each day around repeating 24-hour “circadian” cycles controlled by your body’s internal clocks. These clocks are synchronized by a central pacemaker in the brain. Cycles of light and dark are important for the function of the brain’s master clock. Other cycles, such as the behavioral activities of eating and fasting or sleeping and waking, are important for peripheral clocks in the liver, gut, and other tissues.

When you stay awake all night or otherwise go against natural light cycles, your health may suffer. Long-term disruption of circadian rhythms has been linked to obesity, diabetes, and other health problems related to the body’s metabolism.

Previous studies have shown that some metabolites—the products of metabolism—in blood can have daily rhythms. An international research team led by Drs. Hans P. A. Van Dongen and Shobhan Gaddameedhi at Washington State University investigated whether disruptions in these rhythms are influenced by the central pacemaker in the brain or reflect behavioral activities, such as working the night shift. The study was funded in part by NIH’s National Institute of Environmental Health Sciences (NIEHS). Results were published online in the Proceedings of the National Academy of Sciences on July 10, 2018.

Ten men and four women, aged 22 to 34 years, stayed at a research lab for one week. Half had a night-shift sleep pattern for three days and half had a day-shift pattern. The night-shift pattern causes the central pacemaker and behavioral rhythms to be at odds. After three days, the volunteers were kept awake for one day in a constant routine with a constant level of temperature and light. They received identical snacks every hour and provided blood samples every three hours.

The research team found only small differences in the day-shift and night-shift patterns for melatonin and cortisol, which mark the activity of the brain’s master clock. This finding suggests that the master clock is resistant to influence from the night-shift pattern.

The team analyzed the levels of 132 metabolites during the 24-hour constant routine. About half (65) of the metabolites had a significant daily rhythm. Of these, 27 had a significant 24-hour rhythm for both sleep patterns. Only three of these metabolites (taurine, serotonin, and sarcosine) kept the same peak time, similar to the master clock markers melatonin and cortisol. The other 24 showed a 12-hour shift in rhythm for the night-shift pattern.

The researchers noted that the particular metabolites and pathways affected by the night-shift sleep pattern relate to the liver, pancreas, and digestive tract. These findings suggest that night-shift sleep patterns can disrupt certain metabolite rhythms and the peripheral clocks of the digestive system without affecting the brain’s master clock.

“No one knew that biological clocks in people’s digestive organs are so profoundly and quickly changed by shift work schedules, even though the brain’s master clock barely adapts to such schedules,” Van Dongen says. “As a result, some biological signals in shift workers’ bodies are saying it’s day while other signals are saying it’s night, which causes disruption of metabolism.”

Further research is needed to better understand the role of these metabolic pathways in obesity, diabetes, and other medical conditions for which shift workers are at increased risk.

Nearly 15 million Americans work a permanent night shift or regularly rotate in and out of night shifts, according to the Bureau of Labor Statistics. That means a significant sector of the nation’s work force is exposed to the hazards of working nights, which include restlessness, sleepiness on the job, fatigue, decreased attention and disruption of the body’s metabolic process.

Those effects extend beyond the workers themselves, as many of us share the road with night-driving truckers, count on the precision of emergency-room workers and rely on the protection of police and national security personnel at all hours.

Now, psychologists are gaining a better understanding of how exactly night and shift work affect cognitive performance and which interventions and policies could keep shift workers and the public safer.

“The basic take-home is that fatigue decreases safety,” says Bryan Vila, PhD, a sleep expert and criminal justice researcher at Washington State University–Spokane. Learning healthy sleeping practices is “just as important as occupational training,” he says.

Poor scheduling, combined with unhealthy attitudes about the need for sleep, can cause major problems for night workers. That’s because working at night runs counter to the body’s natural circadian rhythm, says Charmane Eastman, PhD, a physiological psychologist at Rush University in Chicago. The circadian clock is essentially a timer that lets various glands know when to release hormones and also controls mood, alertness, body temperature and other aspects of the body’s daily cycle.

Possible solutions

Of course, many workers can’t give up the night shift entirely. So the question is, how can night shift workers adapt to their schedules?

Charmane Eastman, PhD. Founding Director, Biological Rhythms Research Lab.  Her education is PhD, University of Chicago / BS, State University of New York at Albany.  Her Research Areas are:  Shift work, jet lag, human circadian rhythms (especially effects of bright light and melatonin), social jet lag, circadian misalignment

There are two ways, says Rush University’s Eastman. One is through symptomatic relief by using such stimulants as coffee and caffeine pills to stay awake during the night, then taking sedatives to sleep in the morning. The other way is to shift the body’s circadian clock so that it better tolerates working at night and sleeping during the day.

Eastman and her team are exploring the latter approach. “The circadian clock is very stubborn and hard to push around,” she says.

Previous research has established that you can delay the circadian clock by about one or two hours per day. To determine that, researchers measure the body’s circadian rhythm by monitoring “dim-light melatonin onset,” or the time at which the pineal gland begins to secrete melatonin, which is triggered by the circadian clock. Normally, it kicks in a couple hours before people are ready to sleep. “It’s an output that’s a way of seeing what the circadian clock is doing,” Eastman says. “It’s a very good marker of the phase of the time of the clock.”

By exposing experimental subjects to intermittent bright light during their night shifts and having them wear sunglasses on their way home and sleeping in very dark bedrooms, Eastman and her team have found that within about a week, they can shift someone’s circadian rhythm to align perfectly with working a night shift and sleeping during the day.

Through WebMD.com it points out March 2010 the following:   In terms of lifestyle, working odd hours leads to some obvious problems. People who do shift work tend to have sleep disturbances and sleep loss. They might feel isolated, since their jobs cut them off from their friends and families. They might find it harder to exercise regularly, and may be prone to eat junk food out of a handy vending machine, says Scheer.

Including in this note, I myself, being a RN 35 years basically, who has worked all shifts (mostly 12 hr shifts than driving home and for the past 4.5 years a 2 hr drive to and back to the hospital) disagree with this statement in that preventing junk food and of course exercise in your week you need discipline in obtaining right foods, exercise and habits.  It is a challenge with no question but can be obtained if the right mind is set to it.

As WebMD points out, “The long-term effects of shift work are harder to measure. But researchers have found compelling connections between shift workers and an increased risk of serious health conditions and diseases.”.  It really depends on what where you prior to going into night shift, is it 12 hr shifts or 8 hr shifts or part time or perdiem.  It messes up the circadium cycle but you can bounce back depending on often you work night shift. ”

Remember, I point out night shift is not 3 to 11 pm but 11pm and on till am in long hours.  Since many don’t fall asleep till after 10pm and on.  Another major ingredient I would like to point out is, what is your medically history? Is this a worker with no medical history/in shape/ and great health habits? What is your age? Is this worker someone who is with diabetes?, cardiac disease?, overweight? etc…  We need to look at the whole picture always!

Scheer backs my statement up with the following: “”There is strong evidence that shift work is related to a number of serious health conditions, like cardiovascular disease, diabetes, and obesity,” says Frank Scheer PhD,. “These differences we’re seeing can’t just be explained by lifestyle or socioeconomic status.”

Scheer in Web MD states “It’s important to keep the risks in perspective. Even if performing shift work is a risk factor for some diseases, it’s only one of many — just like not getting enough sleep or eating too many sweets. If you’re in good health to begin with, the overall risks to any given person performing shift work remain low.  Scheer states he cautions that the implications of the study, which was published in the Proceedings of the National Academy of Sciences in 2009, are limited. A small laboratory experiment can’t fully reflect what’s happening to actual shift workers. It’s also possible that some of these health effects might improve as people get used to shift work. On the other hand, it’s also possible that these effects would just worsen over time. For now, we don’t know.

Keep in mind the things listed in books, internet and etc… are all based on experiments with including theory/principle based on knowing how the anatomy and physiology of the body works under stress or not stressed and how the body is taken care of by that individual is a major role in the turn out of night shift working.