“Every two seconds someone in the U.S. needs blood.  Approximately 36,000 units of red blood cells are needed every day in the U.S.  Nearly 7,000 units of platelets and 10,000 units of plasma are needed daily in the U.S.  Nearly 21 million blood components are transfused each year in the U.S.  The average red blood cell transfusion is approximately 3 pints.”

American Red Cross

“According to the National Center for PTSD , about 7 or 8 out of every 100 people will experience PTSD at some point in their lives.”

National Institute of Mental Health

Many risk factors revolve around the nature of the traumatic event itself.

Traumatic events are more likely to cause PTSD when they involve a severe threat to your life or personal safety: the more extreme and prolonged the threat, the greater the risk of developing PTSD in response. Intentional, human-inflicted harm—such as rape, assault, and torture— also tends to be more traumatic than “acts of God” or more impersonal accidents and disasters. The extent to which the traumatic event was unexpected, uncontrollable, and inescapable also plays a role.

Women’s changing role in our military

A growing number of women are serving in the US military. In 2008, 11 of every 100 Veterans (or 11%) from the Afghanistan and Iraq military operations were women. These numbers are expected to keep rising. In fact, women are the fastest growing group of Veterans.

What stressors do women face in the military?

Here are some stressful things that women might have gone through while deployed:

-Combat Missions.                                                                                                                                                                               –Military Sexual Trauma (MST). A number of women (and men) who have served in the military experience MST. MST includes any sexual activity where you are involved against your will, such as insulting sexual comments, unwanted sexual advances, or even sexual assault.

-Feeling Alone. In tough military missions, feeling that you are part of a group is important.

-Worrying About Family. It can be very hard for women with young children or elderly parents to be deployed for long periods of time. Service members are often given little notice. They may have to be away from home for a year or longer. Some women feel like they are “putting their lives on hold.”

Because of these stressors, many women who return from deployment have trouble moving back into civilian life. While in time most will adjust, a small number will go on to have more serious problems like PTSD.

How many women Veterans have PTSD?

Among women Veterans of the conflicts in Iraq and Afghanistan, almost 20 of every 100 (or 20%) have been diagnosed with PTSD. We also know the rates of PTSD in women Vietnam Veterans. An important study found that about 27 of every 100 female Vietnam Veterans (or 27%) suffered from PTSD sometime during their postwar lives. To compare, in men who served in Vietnam, about 31 of every 100 (or 31%) developed PTSD in their lifetime.

What helps? Research shows that high levels of social support after the war were important for those women Veterans.

What can you do to find help?

If you are having a hard time dealing with your wartime memories, there are a number of things that you can do to help yourself. There are also ways you can seek help from others.

• Do things to feel strong and safe in other parts of your life, like exercising, eating well, and volunteering.
• Talk to a friend who has been through the war or other hard times. A good friend who understands and cares is often the best medicine.
• Join a support group. It can help to be a part of a group. Some groups focus on war memories. Others focus on the here and now. Still others focus on learning ways to relax.
• Talk to a professional. It may be helpful to talk to someone who is trained and experienced in dealing with aging and PTSD. There are proven, effective treatments for PTSD. Your doctor can refer you to a therapist. You can also find information on PTSD treatment within VA at: VA PTSD Treatment Programs.
• Tell your family and friends about LOSS and PTSD. It can be very helpful to talk to others as you try to place your long-ago wartime experiences into perspective. It may also be helpful for others to know what may be the source of your anger, nerves, sleep, or memory problems. Then they can provide more support.

Don’t be afraid to ask for help. Most of all, try not to feel bad or embarrassed to ask for help. Asking for help when you need it is a sign of wisdom and strength.

Don’t let PTSD get in the way of your life, hurt your relationships, or cause problems at work or school.

PTSD treatment can help.

Learn what treatment is like to help you make choices about what’s best for you.

If you suspect that you or a loved one has post-traumatic stress disorder (PTSD), it’s important to seek help right away. The sooner PTSD is confronted, the easier it is to overcome. If you’re reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past.

TYPES OF TREATMENT:

• Trauma-focused cognitive-behavioral therapy. Cognitive-behavioral therapy for PTSD and trauma involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replacing them with more balanced picture.
• Family therapy. Since PTSD affects both you and those close to you, family therapy can be especially productive. Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems caused by PTSD symptoms.
• Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. Antidepressants such as Prozac and Zoloft are the medications most commonly used for PTSD. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.
• EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. Eye movements and other bilateral forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress.

When looking for a therapist for post-traumatic stress disorder (PTSD), seek out mental health professionals who specialize in the treatment of trauma and PTSD. You can start by asking your doctor if he or she can provide a referral to therapists with experience treating trauma. You may also want to ask other trauma survivors for recommendations, or call a local mental health clinic, psychiatric hospital, or counseling center.

“PTSD can happen to anyone. It is not a sign of weakness. A number of factors can increase the chance that someone will have PTSD, many of which are not under that person’s control.”

U.S. Department of Veterans Affairs

“Most people who have Crohn’s also have symptoms of ulcerative colitis but rectal bleeding, or blood in the stools, is much more common in people who have UC than those with Crohn’s.  Because Crohn’s disease affects more of the body, it can cause some problems that doctors don’t usually see in people who have ulcerative colitis.”

WEB MD

“Calm the flame in your gut naturally.”

James Bogash DC (also Author of the book Chron’s Disease and Ulcerative Colitis)

“Treatments for coronary heart disease include heart-healthy lifestyle changes, medicines, medical procedures and surgery, and cardiac rehabilitation.”

National Heart, Lung and Blood Institute

Surgical procedure in which one or more blocked coronary arteries are bypassed by a blood vessel graft to restore normal blood flow to the heart. These graft usually come from the patient’s own arteries and veins located in the chest (thoracic), leg (saphenous) or arm (radial). The graft goes around the blocked artery (or arteries) to create new pathways for blood to flow to the heart.

1.) Lifestyle changes

Making a commitment to the following healthy lifestyle changes can go a long way toward promoting healthier arteries:

• Quit smoking.
• Eat healthy foods.
• Exercise regularly.
• Lose excess weight.
• Reduce stress.

2.) Drugs

Various drugs can be used to treat coronary artery disease, including:

• Cholesterol-modifying medications. By decreasing the amount of cholesterol in the blood, especially low-density lipoprotein (LDL, or the “bad”) cholesterol, these drugs decrease the primary material that deposits on the coronary arteries. Your doctor can choose from a range of medications, including statins, niacin, fibrates and bile acid sequestrants.

• Your doctor may recommend taking a daily aspirin or other blood thinner. This can reduce the tendency of your blood to clot, which may help prevent obstruction of your coronary arteries.

If you’ve had a heart attack, aspirin can help prevent future attacks. There are some cases where aspirin isn’t appropriate, such as if you have a bleeding disorder or you’re already taking another blood thinner, so ask your doctor before starting to take aspirin.

• Beta blockers. These drugs slow your heart rate and decrease your blood pressure, which decreases your heart’s demand for oxygen. If you’ve had a heart attack, beta blockers reduce the risk of future attacks.
• Nitroglycerin. Nitroglycerin tablets, sprays and patches can control chest pain by temporarily dilating your coronary arteries and reducing your heart’s demand for blood.
• Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). These similar drugs decrease blood pressure and may help prevent progression of coronary artery disease.

3.) Procedures to restore and improve blood flow

Coronary artery stent

Sometimes more aggressive treatment is needed. Here are some options:

• Angioplasty and stent placement (percutaneous coronary revascularization). Your doctor inserts a long, thin tube (catheter) into the narrowed part of your artery. A wire with a deflated balloon is passed through the catheter to the narrowed area. The balloon is then inflated, compressing the deposits against your artery walls.

A stent is often left in the artery to help keep the artery open. Some stents slowly release medication to help keep the artery open.

• Coronary artery bypass surgery. A surgeon creates a graft to bypass blocked coronary arteries using a vessel from another part of your body. This allows blood to flow around the blocked or narrowed coronary artery as described at the top of this article. Because this requires open-heart surgery, it’s most often reserved for cases of multiple narrowed coronary arteries.

Alternative medicine

Omega-3 fatty acids are a type of unsaturated fatty acid that’s thought to reduce inflammation throughout the body, a contributing factor to coronary artery disease. However, recent studies have not shown them to be beneficial. More research is needed.

• Fish and fish oil. Fish and fish oil are the most effective sources of omega-3 fatty acids. Fatty fish — such as salmon, herring and light canned tuna — contain the most omega-3 fatty acids and, therefore, the most benefit. Fish oil supplements may offer benefit, but the evidence is strongest for eating fish.
• Flax and flaxseed oil. Flax and flaxseed oil also contain beneficial omega-3 fatty acids, though studies have not found these sources to be as effective as fish. The shell on raw flaxseeds also contains soluble fiber, which can help lower blood cholesterol.
• Other dietary sources of omega-3 fatty acids. Other dietary sources of omega-3 fatty acids include canola oil, soybeans and soybean oil. These foods contain smaller amounts of omega-3 fatty acids than do fish and fish oil, and evidence for their benefit to heart health isn’t as strong.

Part II Causes of CAD:

Coronary artery disease is thought to begin with damage or injury to the inner layer of a coronary artery, sometimes as early as childhood. The damage may be caused by various factors, including the following which are problems we can prevent or better control through better diet, some form of exercise balanced with rest.  Including keeping our stress controlled in a productive way (like work out program to doing hobbies).

Causes that are modifiable (that we can change or help control):

• Smoking-Stop it
• High blood pressure-Lose weight, decrease junk food and sodium in your diet, exercise.  If on B/P meds be compliant in taking them.
• High cholesterol-Eat better food, lose weight, or if on anti-cholesterol meds be compliant in taking them.
• Diabetes or insulin resistance-Lose weight, eat foods=no sugar, and be compliant with your diabetic meds.
• Sedentary lifestyle-Get in an exercise program; stay active.

Causes that are nonmodifiable (that you can’t change):

-Race:  Race refers to common characteristics passed down through the genes. Non-Hispanic whites (63%) have roots in Europe, the Middle East, or North Africa. Blacks (13%) have origins in any of the black racial groups of Africa or Afro-Caribbean countries. Asians (5%) may have ancestors anywhere from India to Japan. This geographic diversity within racial groups means that there are actually greater genetic differences within than between certain groups.

Know this: Rates of high blood pressure, diabetes, and heart disease vary among people of different backgrounds.

Adults living in the United States are more likely to die from heart disease than any other cause, regardless of their racial or ethnic heritage. But certain minority groups face a greater risk than others. These differences appear to stem from an increased prevalence of high blood pressure, diabetes, and obesity seen in some populations compared with white Americans.

Still, teasing out the reasons isn’t easy. Genetic differences do exist. But diversity within different racial and ethnic groups means that genetic traits common to some groups can’t be generalized to an entire race.

Many intertwined factors likely contribute to the higher heart disease rates seen among some groups. Their lower average incomes affect where they live, which in turn affects their access to healthy food, safe places to exercise, and quality health care. In other words, “your ZIP code is more important than your genetic code,” says Dr. Eldrin Lewis, a cardiologist at Harvard-affiliated Brigham and Women’s Hospital.

But even after adjustment for factors related to socioeconomic differences, disparities in rates of heart disease and its risk factors persist, Dr. Lewis says. In the United States, nearly half of all black adults have some form of cardiovascular disease, compared with about one-third of all white adults. A genetic difference that predisposes blacks to high blood pressure might play a role.

For further details on race groups and their risk at coronary heart disease see https://www.health.harvard.edu/heart-health/race-and-ethnicity

–Heredity:  A family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. Your risk is highest if your father or a brother was diagnosed with heart disease before age 55 or if your mother or a sister developed it before age 65.

-Age:Just like a car the older you get the highier the risk of problems with the vehicle and the same with the body. 

-Gender: Men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause.

Learn more tomorrow on treatment of CAD in Part III!