a hello and welcome to HealthLine this Tuesday evening.

I'm Jennifer Blomquist.

I have the privilege of hosting the show tonight.

If you're a new viewer to HealthLine I just want to make sure you're aware that this is a live show and we're here in the studio right now and what's great about it is you get free advice on this show.

Nothing in the world anywhere is free anymore but you do get free advice here.

So that's why we have that phone number up at the bottom of the screen.

We will keep it up for you throughout the show which ends a little before eight o'clock.

So if you have a question that you'd like to ask the health professionals who've been kind enough to join us tonight to answer your questions call sooner rather than later.

So the number is (969) 27 two zero if you're outside of Fort Wayne still a free call.

Just put an 866- in front of there and you have two options and you call in you can ask a question live during the show.

They won't just throw you on the air.

They'll talk to you and give you a little advice before you would ask your question live and that's great.

But we have a lot of folks who call in and they would prefer that I ask the guests the question and you can do that you can relay your question to the call screener and they will relate it to us out here in the studio and we'll get your question answered.

>> So again, the phone sometimes tend to get backed up later in the show so I would call sooner rather than later.

>> Let me go ahead and introduce you to the two women who have been kind enough to join us tonight.

Now sitting next to me is Jill Zom and she is a registered nurse and next to her is Katie Breeda and she is a nurse practitioner.

So two people in the nursing field and we're talking about women's heart health and of course February is all about heart health and I think hopefully most people will take you know, take advantage of just just some tips on things you might not think about, especially if you're younger and maybe you're not experiencing any issues or things to think about to avoid issues down the road, things you could do to prepare now.

So again, if you want to ask Jill or Katie a question any time during the show, please feel free to call us.

In the meantime, we're going to start talking about heart health but we welcome your interruption at any time.

So I thought it was funny you guys sent me some, you know, topics and things to to cover and the first thing I saw the word bikini and it said it was like a bikini analogy and I thought I wonder why that is.

So do you want to talk about the the bikini approach to women's health ?

>> Sure.

So a lot of times with women's health physicians can kind of focus more on the gynecological exam which would be, you know, the pelvic exam, the exam, things like that and then also the childbearing part of life and they get so focused on that and the horses are covered by evictee.

>> Right.

And the woman can be so focused on that part in those childbearing years especially they kind of forget a little bit that they have other things that need to be addressed, especially our cardiovascular health .

And so that's why we term it.

The kidney health is that sometimes health professionals and the patient themselves and kind of get caught up in those things and you hear things frequently women might share in a conversation about doing their well woman exam or those kind of things and you don't often hear them talking about checking their cholesterol level and their blood pressure and that's important too.

Yeah, and it's you know and we hear so much about and not to you know, to belittle this at all is very important.

But we hear so much about a lot of the common cancers for women, you know, especially cancer.

That's you there's been such a big campaign about that over the years and even other other areas where women might need to think about hysterectomy as down the road or treatment of different cancers and parts of the body.

But I agree people don't talk about these other things and I know one of the one of the factors you said or one of the issues you brought up was you should know what you weigh and your your other vitals that are OK if you want to talk about that, you know, just be a BMI.

Is it important to know your body mass index?

>> Absolutely.

I think numbers are an important thing.

Preventative care is as a wonderful thing to look into.

There's no better time than now to start looking at your health and your numbers.

So when we say look at your numbers making sure your blood pressure is well controlled, you know we can try our weights under control looking at cholesterol.

So specifically things like LDL which is a bad or lousy fraction of cholesterol.

So we want to make sure that that number is lower to prevent buildup of blockages in arteries causing heart disease.

>> I saw a public service announcement years ago they've stopped running and I wish they would run it again.

But it was a woman who she was kind of holding on to her chest so she was obviously experiencing a heart what appeared to be a heart attack.

>> She was younger and she called nine one one and they said we'll be there ASAP, you know, and then she's on the ground and she's looking around her house and the kids of toys all over and she can hear the kids yelling in the background and there are dishes all over and she said, well, can you give me ten minutes?

>> And it was like we put so much emphasis on taking care of our families and our homes and jobs and stuff and then we forget to a lot of we forget to take care of themselves and that's that's my passion really is making sure women remember self care because we forget that we were so many hats you were mother, wife, chauffeur, chef.

>> Yeah, counselor, teacher.

You know, we were these hats that we take on and off all the time but we forget to put our own on sometimes and do our own preventative.

Katie mentioned that knowing our numbers and we may be more concerned about making your husband's numbers or our elderly parents numbers that we forget about and our children that we forget about ours and so that's that's important that that women not only think about that for themselves then I always like to remind people that, you know, we want a healthy community, we want a healthy Fort Wayne and we need to remember that women make the majority of health care decisions and so they make them for their children, their husband, their elderly parents and if they're not well educated on what's a good cholesterol, how to access care, how to eat right move right and things like that, then we won't have a healthy community.

So we need to have women that are well educated in our health and you know yeah, women do.

>> I saw a sign that said, you know, women are the glue that hold together another sign that said mom's the glue that holds it all together and it's true.

You know, we do we do a lot and I think some women just feel guilty thinking oh, you know, if I do this doctor appointment I'm going to be tied up all morning.

>> I'm not going to, you know, get these other things done because it is a time investment as well as it can be financial .

>> Katie, if you want to address that, just telling people why it's worth it.

Exactly.

I mean I think women present sometimes a little bit differently than men as far as heart attack symptoms and so they might be a little hesitant to present or seek care if they are having discomfort.

So kind of knowing what signs and symptoms to look out for .

So things like chest discomfort or heaviness if you feel like your overall is like a band around there ears just squeezing OK, that is kind of something to be mindful of pain in the jaw so just women tend to have more what we say like micro vascular disease so their symptoms can be a little bit different and just encourage you know rather people come in and we say things are fine rather than the opposite.

So it is it can be a financial burden in time but I think it is important not to ignore symptoms and to seek help when you when you have those issues.

>> And I just want to remind everybody we haven't had anybody calling yet but the phone lines are open.

There's a number at the bottom of the screen.

It's (969) 27 to zero.

It's still a toll free call if you're outside Fort Wayne if you put in 866- in front of that number again we have Jill sitting next to me.

She is a registered nurse and next to her is Katie Breeda who is a nurse practitioner and we're talking about women's heart health .

So please feel free to call in any time.

They've got lots of great advice I could pass on to you or maybe at least point somebody in the right direction if they have concerns.

That was one thing I want to ask you about with the with women's signs because yeah, I've heard women who've survived heart attacks and say I had no idea I was having a heart check.

They just knew something was wrong because because you know, you watch in the movies or you know, reenactments on TV and it's always somebody grabbing their chest.

But I've heard one woman said that her arm felt numb.

I know pain in the chest so I don't know and I think people are thinking well, I don't want to over be overly concerned.

>> But what what are some other things that might be unusual?

>> Yeah, so fatigue, shortness of breath like a sudden onset.

Exactly sudden onset, you know, and people tend to know their bodies pretty well and so if you kind just have this gut feeling that something isn't right, I always pay attention to that.

But you have your chest discomfort pressure if it radiates to the jaw or again like you said, not everybody's that textbook crushing chest pain left arm radiation everyone's a little bit different.

But if you just feel that this isn't right, I don't feel like I normally do.

Something's not right.

>> I definitely go get go get get get it checked out.

I guess you're like yeah we're not doing that as we're going to leave for others.

>> Yes I I when one patient I had over the years she was actually a home health aide and was taking care of a patient and was having all of those shortness of breath fatigue and just kept going and going and I hear that story a lot more from I feel like a lot more for women than men where they just keep pushing through because they have so many people feel responsible for sure.

So yeah.

So it's important for us to take ourselves too.

>> Yeah I was going to say it's kind of like when you're on the airplane and they tell you you know you have a child next to you, you've got to take care of yourself first make sure you have the oxygen masks on before helping your child.

You're of no use, you know.

So yeah, if you I I guess we had a doctor years ago that said if you love your family then you've got to love yourself first which sounds selfish but it's really not.

So what we did have somebody who wanted to ask you guys a question.

So Diane, I think you are on the line.

No, I guess she wants me to ask the question for her.

So she has been on a cholesterol lowering medication for six months and I guess she's wondering what the long term effects of that could be and we can't say the brand of it but it is a very common cholesterol lowering drugs.

>> So so sometimes we we talk about patients and the side effect of cholesterol medicine sometimes is living longer and that's a good thing.

And so it is very beneficial to be on cholesterol medicine if your cholesterol is high it can reduce any, you know, potential for a buildup of blockages in the arteries.

Some side effects that we can see that's mostly associated would be like muscle aches or fatigue and so that is just something that keep in mind but it's always something to talk to your health care provider about if you are experiencing those symptoms.

>> Is it the kind of medication where once you start because I understand there's some cardio vascular drugs that really once you start taking them it's almost like you're going to have to take this rest of your life or are there, you know, cholesterol lowering or high blood pressure medications if you if your numbers get better or things change, can you maybe stop taking that?

Sometimes you can keep it that way.

You know, it really is individual.

But yes, you know, when you make lifestyle modifications there are times where you may be able to stop some medications but that's really is very individual.

It's between you and your physician obviously.

However, we you know, sometimes when we make some lifestyle changes we can make some tweaks in that.

Yeah.

And that could be a really big incentive for patients who don't like being on a lot of drugs and they find themselves in that place and you know, making some long term lifestyle modifications they may be able to reduce their medication so that they're on possibly so I always like to remind patients that it's baby steps you didn't wake up one morning with a lousy cholesterol and you had a perfect one the night before it.

>> It's it slowly built and so it's a slow build to get back to health with lifestyle changes.

So it's not something where, you know, that would be a good discussion with you and your physician of maybe I don't like on all of these medications.

What ones could potentially I reduce by making some changes in how I move and eat and things like that?

>> It's always good to have goals, you know?

Yeah, because I I know during cold and flu season I was at the pharmacy a lot.

My kids were sick a lot this year and I would just people you know, you're not supposed to listen and I wasn't listening to what they were getting but you know, they would rattle off like five and six different medications that they were getting and I thought gosh, you know, that would be kind of sad and expensive to be on that.

>> So maybe setting goals to get rid of one of them at least, you know, like you said baby steps so one thing I want to talk to you about was cardiac issues in pregnancy which people don't think about because if you're in your pregnancy childbearing years those will be women on the younger and the age scale.

But I've heard that I've heard stories of women having some heart issues during pregnancy and even after.

>> So I don't know.

Katie, did you want to address that?

So oftentimes during pregnancy just with the volume of extra fluid that we have, we a lot of patients can experience palpitations or a fast heart rate.

>> They can have shortness of breath.

They can have swelling in the legs.

Those can be all common things that happen.

However, sometimes they can affect the patient's day to day living and so having a discussion with the patient's physician to see if those symptoms need to be evaluated further, whether we need to discuss that monitor to monitor heart rates, do an ultrasound of the heart to look at the pumping function if there's any medications that potentially could be used but then also making sure that we're doing our best to screen for and against do a great job of screening for gestational diabetes, high blood pressure.

>> So doing what we can to, you know, kind of mitigate or reduce the risk of those of the you know, diabetes and high blood pressure because we are finding that women who do have gestational diabetes and hypertension they can have cardiac symptoms even as early as ten years after delivery.

So it is something to be mindful of and I think also knowing what your risk factors are, you know, if you have a family history of heart disease ,making sure we're having a healthy weight, you know, making sure we're not diabetic, blood pressure is under control and then also not smoking is another risk factor for heart disease.

>> Do you I mean would it be kind of common for maybe somebody who is in really good health and then they're in their pregnancy experience some pretty severe cardiac issues would that happen or is it usually something that would be preexisting and that is exacerbated?

Not always.

I mean everyone's different certainly.

But oftentimes if patients do have those symptoms during pregnancy, we do see that it usually can resolve as far as like you know, shortness of breath and in the fast heart rates it tends to resolve after delivery.

But being mindful of if patients do have anything like the diabetes or high blood pressure, sometimes that may not go away after after delivery.

>> You know, I was going to ask with subsequent pregnancies I mean maybe you could maybe it was just an issue during the pregnancy but would a woman expect to have that and other pregnancies down the road?

>> Is that pretty common?

It's possible that they you know, pregnancy is different.

So but one thing I will say about the pregnancy is there's kind of a little line in the world of cardio OB which is where we talk about upset Opsware obstetrician obstetrics and cardio kind of combined there are intersect that pregnancy is your first great stress test of the heart.

>> You know the stress test you hear people usually a little bit older going through a stress test where you get on the treadmill and things like that.

>> But there's kind of a little line in that world of cardio be that pregnancy is our first real stress test on the heart for a female.

Yeah, well it's a lot you know, when you think about it, people just kind of minimize it but it's a lot of huge changes and then I can carry an extra well ideally twenty five to thirty pounds.

I didn't stick to that.

I admit I gained a little more than that but but yeah it's you know and it happens in a relatively short amount of time you know just nine months all those huge changes.

>> So I just wanna remind everybody they just showed me the card a couple of minutes ago that we're down to just ten minutes so now we're probably down to more like eight .

We could still get a bunch of questions answered.

So please feel free to do that.

We got to have a good question earlier from Diane about cholesterol lowering medication so it doesn't have to be specifically even if you're mad you can call in and ask a heart question if you want but time is slipping away so there's a number of nine six nine to seven to zero again if outside of Fort Wayne 866- we'll make it a toll free call for you before we move on to some other things.

One other question I had about the pregnancy was I was surprised some of the statistics about women who deliver babies early that if you have a premature birth birth that you are more at risk of heart issues.

>> Why would that be?

So it just you know, again the stress on the body and then going through an early delivery and you know, why was that delivery early?

Were they having issues with hypertension or diabetes and just making sure we're monitoring you know, Mom the baby during that time?

>> Sure.

Another thing people don't like to talk about this so much but diet plays such a big role and I know you were suggesting to go with vegan diets or Mediterranean.

I don't know if you guys want to talk about that and then we do have a question but we can get James we'll get to you in just a minute here.

>> So certainly yeah, we do recommend the Mediterranean.

That's a very popular and it's mostly you know it you're staying away from the red meat.

You're stay away from processed foods.

Stay away from the sugars, things like that.

>> You're mostly looking at a lot of fish and your greens.

You think about, you know, somebody over the Mediterranean what they would eat, you know they would do a lot of fresh greens, more fish than red meat ,you know, things like that rather than we're so Americanized here with the fried food and a lot of red meat potatoes that's kind of our staple and then plant based is is a really a well researched eating plan and that's where you're just really trying to focus more on plants and not anything that came from an animal.

Yeah.

And just because you say I'm going to try to plant base for my heart which is great it doesn't mean you can never have that glass of milk or that pad of butter or you know, on a special occasion you want to have that at steak or something that is you'll do better in transitioning if you don't do that all all and cut your success.

>> Exactly.

Exactly.

But if you just try to say I'm going to try to do more plants, you know, that's a good way to start.

>> Yeah, I think yeah I've heard that that fails if people just cut themselves up it's like you know, stopping smoking cold turkey.

>> Oh it's yeah.

So you know start with like a meatless Monday.

Yeah.

So that all right.

>> Well we got one coming up so what else are going to go that might start it.

So we had another person James called and wanted me to ask the question for him.

He wanted to say how active should you be after 40 if you have a family history of cardiac problems?

>> So so we recommend at least 30 minutes of aerobic exercise about five times a week sometimes it's not always feasible for everybody.

So even just a little bit even if you start off with five minutes of walking or anything that you enjoy yoga, anything that's going to get that heart pumping.

So walking is a great thing swimming if you have access to a pool and then again and I just repetition is key knowing what your risk factors are so James mentioned family history of heart disease.

So I think that's key.

That's just something that we can't change our genetics and so knowing that there is a family history but then also what can we do as a person to modify your other risk factors so exercise you can think of prescribing exercise as another prescription, making sure that you're eating a healthy diet and then also not smoking and then knowing your numbers and you know, a lot of people think oh they've got to belong to a gym or something expensive.

But I remember years ago there was a woman that I just knew through school another mom and she just said we just do crazy dance at our house.

She's like the kids and I go on the basement half hour she's like and it's good family time.

The kids love it and then she's like it's free and and she's like I feel like I'm getting them interested in exercising.

She's like maybe someday when they're on their own they'll want to join the gym or something.

But I mean it helped I mean she felt like it really kept everybody in her family fit, you know, and and had a good time together.

So we only have a couple of minutes left.

So I don't know if you want to talk about just that.

We've touched a little bit on the hereditary aspect of it so would a woman necessarily could she have heart issues that she could get from either parent or would it be more common which she experienced more from the maternal side like for mom or grandma had would she be more likely or does it not matter paternal or maternal doesn't really it doesn't matter.

>> It doesn't matter.

I didn't really know didn't know things kind of genes for the most part.

Yeah, for cardiovascular.

Yeah.

But I always like to remind people too that just because you have a genetic history you have that history there you're both your parents have heart disease.

Does it mean you're sentenced to that?

I always say lifestyle modification.

You know you don't have to say well I've got genes for it so I'm just going to give up and eat cookies and drink boiled eggs.

>> I'm going to have heart disease anyways.

You can definitely use that as a tool as a motivator to move more and eat right and sleep right and manage your stress because you know you have that risk.

>> I'm glad you said that, Jill, because I I know I've heard you know, we have so much cancer on both sides of my family but I look at those people and I think I don't live like they did.

You know, my grandma I mean I don't know how much salt she put in.

>> All I'll say is she never put a salt shaker on the table because she used like the whole container of salt when she was cooking butter they didn't think anything about using like bacon grease is an ingredient in things.

And so I'm glad you brought that up because yeah.

You're not necessarily condemned to that same fate because a lot of us do live differenty than our grandparents or even our parents do, you know so and social and emotional well-being I know is part of heart health .

I don't know if you guys want to maybe be people with some thoughts about that because that does play a role.

>> It does for sure.

You know, I mentioned earlier we were too many hats as women so making sure that you're taking time for yourself.

I always like to kind of tell my patients that for just a moment.

I hope for a longer than a moment but I would like you to be able to have a moment your day where you can say I have nowhere to be no one needs me and I have nothing to do.

>> We need that.

We need to have those Barack breaks in our day and schedule that in allow yourself to have that time where you can just breathe and not be worrying and not be anxious because we don't where there's more and more studies about how stress does impact our cardiovascular health .

>> So we have to be very careful about that and make sure that we carve out that time for ourselves.

>> It's important for whatever makes you happy.

>> For some people it might be a book.

For others it might be gardening something that makes you happy every day to reduce that stress load.

>> Sure.

And delegate women we're not good about that.

We're not good about that.

But I've trained my husband and he still has some training left to do.

But after twenty three years and have you probably two on your end being more the cardiology aspect of it that you can probably tell when somebody is kind of worn out it was stressed out absolutely.

>> I mean we can even see patients come in and they can have heart attacks simply related to stress and that's usually that has to be a pretty significant stressor on someone's life .

But again, doing what you can to understand everybody I stress we're not going to get rid of that but working through it and asking for help if you need help you know, talking with a therapist or meditation yoga again what Jill said finding something that you enjoy or confiding in with someone else you know, get a buddy and go for a walk or just something you don't have to do this alone.

>> Yeah.

And so reaching out and asking for help which I think is really hard for women to do sometimes it is where the worst at doing that I will occur so well.

Katie Brita, thank you so much.

Such a pleasure to have you both.

I hope you'll come back really soon.

I know I learned a lot.

I hope all of you did too.

And many thanks to those of you who called in with great questions tonight.

Take care.

Have a good Tuesday evening and we'll see you next week for another HealthLine