If we are honest about our current state, while we have made great strides in new discoveries and treatments for a great number of conditions, our system has never been more fragile.
The general public is increasingly distrustful of healthcare providers and the “system.” Part of this is directly related to the very poor handling of communication of the COVID pandemic. Other parts affecting this view include the many months-long wait for an appointment that many experience across the USA, the moral injury of not only providers like doctors and mid levels (NP’s and PA’s), but also that of nurses that has led to a shorter temperament and sometimes a less than ideal caring environment. We had a shortage of providers before the Affordable Care Act (ACA) was passed, and after its passing there was an even larger deficit. Then not long afterward, we were met with a worldwide pandemic like we have never seen and lost many providers to both illness and resignation over frustrations of seeing patients die.
Those providers who have stayed the course, or joined in the effort of delivery of care are trying to steady the helm, but there is an ongoing stress related to long lines to be seen, lack of time to talk with patients or provide quality patient education, and patients who aren’t sure whom they can trust in many situations. It is a very scary feeling to be extremely ill and afraid if your provider is taking your symptoms seriously or if it feels they don’t have time for you. I hear this over and over again and have personally experienced this myself, and witnessed it with my own family members across many facilities and providers, and I have over 35 years of experience in healthcare.
While we are tending to patients to heal the sick, we are now tasked with simultaneously healing the system, and this task cannot be taken lightly. It will take some time to rebuild trust, and to equalize the number of providers that are needed for the populations across the country.
Hopefully, with more patient education, we can assist by helping people to help themselves through a better understanding of their various ailments and measures they can take themselves at home before running to the doctor for everything. This will then hopefully free up some of those coveted appointments for those who are in more immediate need and help to lessen some of the extreme stress placed on our healthcare system as a whole.
This health blog is designed with an idea of empowering people with trusted information about healthcare issues so that they may be able to not only better understand the healthcare system and challenges, but also how we can live healthier lives and try to avoid and/or reverse chronic illnesses where possible. Many believe that patients lack any self control or governance in how they live and eat, and this leads to an immediate move to prescribe something for every single issue, but I believe in the power of people to evolve, and learn, and to place more effort on living in a more healthful manner. It will not be easy as many company’s place addictive substances in their products because they want you to buy more, but strengthening willpower to become more independent and focusing on wellness will help in some way for every person, so do what you can to help yourself. This self help to wellness is the ultimate exercise of self love.
Brian holds a Master degree in Health Administration (MHA), a Bachelor of Science in Health Sciences (BSHS), and a Certificate in Clinical Bioethics which bestows the ability to serve on ethics boards, help make healthcare decisions, and provide continuing medical education.
He is a national author and speaker and health consultant in all aspects of healthcare delivery, with special interests in risk adjustment, population health, public health, clinical bioethics, patient safety, and patient education.
*All posts and materials posted here are for education and demonstration purposes and are not intended to be medical advice. It is important to remember that every person is unique with unique diagnoses, and may be taking different prescriptions and supplements. I encourage each person to discuss your conditions with a trusted healthcare provider and be engaged to learn along your individual path to wellness.
While our world has grown in technological and scientific accomplishments, many have become consumed with newly evolved living habits that may not offer the healthiest of choices. It sometimes seems that with our fast paced living, thoughts of wellness have been sidelined while we are constantly fed promises of pills and other pharmaceutical treatments that are often unnecessary if we adjusted our way of living.
Every living thing needs clean air, clean water, and clean food for consumption, yet we have many failing water systems, pollution filling our air, and foods that are not only fast, but also pumped full of chemicals and hormones that can be harmful to life itself. Shockingly, some of the very institutions that were formed to protect the public, allow for certain levels of chemicals and additives that are known to be harmful. The problem here is that no one can accurately estimate the volume of these substances that are consumed by each individual over time. Over time, these unnatural additives can contribute to, and/or cause disease or illnesses and sometimes hasten medical problems and even shorten the lifespan of people.
It is estimated that 80% of known chronic conditions can be avoided with diet and lifestyle modifications, thereby reducing the need for medical intervention. There are of course some conditions like genetic disorders and life accidents that cannot be avoided. Yet, there are a great number of opportunities to improve many chronic conditions through healthy living choices and diet modifications.
We are constantly advertised to for this drug or that one (always with the quick rundown of potential side effects, often including death) but every medication comes with strings attached. Many without medical knowledge have a false impression that medicine can cure almost anything. It cannot. There are many limitations to what can be fixed or remedied. In an ideal world, everyone should be able to focus on healthier living to avoid the need of medical intervention wherever possible. Finances and family schedules can interfere with this goal, but if we collectively concentrate on changing our living environment standards, to include our standards for clean healthy foods, then over time, we can change how we live and improve our quality of life with less disease and illness.
There are also many dietary choices, herbal remedies, and other supplements that can help the body to correct off balanced items and change the course of some chronic conditions, but its always important to discuss these things with your trusted healthcare provider. There are sometimes side effects, and some of these interventions can affect or interact with other medications.
It is absolutely unfair and incorrect that healthier options always cost more and the detrimental junk foods are cheaper. While the economy and personal finances certainly affect the choices that people make, if enough people become more educated and concerned for the utmost of health possibilities, then pressure from the marketplace can influence not only the products being offered in becoming more health conscious, but also help stabilize the prices of those items.
One of the goals of this blog is to educate on healthcare matters and providing new ideas to promote lifestyle changes is one of those goals. Within each chronic condition, we will attempt to provide tools and educational information specific to that condition, diagnosis or illness, that can assist you on your wellness journey.
You can use the search bar on this blog to look up various conditions and we will be updating information regularly on current topics as well as adding new ones for your consideration. All information is carefully crafted with the intent to provide accurate and ethical principles in a manner that can be easily understood, while also reliable as truthful because trust is a number one priority in healthcare. As always, we truly wish you well.
Brian holds a Master degree in Health Administration (MHA), a Bachelor of Science in Health Sciences (BSHS), and a Certificate in Clinical Bioethics which bestows the ability to serve on ethics boards, help make healthcare decisions, and provide continuing medical education.
He is a national author and speaker and health consultant in all aspects of healthcare delivery, with special interests in risk adjustment, population health, public health, clinical bioethics, patient safety, and patient education.
*All posts and materials posted here are for education and demonstration purposes and are not intended to be medical advice. It is important to remember that every person is unique with unique diagnoses, and may be taking different prescriptions and supplements. I encourage each person to discuss your conditions with a trusted healthcare provider and be engaged to learn along your individual path to wellness.
The heart is a uniquely special and important organ. Medical issues that can occur with the heart can involve many areas to include blockages of the vessels, issues with the fitness of the muscular tissues of the heart, infections of the heart, valve issues, and various rhythm issues which are commonly known as cardiac conduction disorders. These rhythm issues are presented below.
Cardiac Conduction Disorders
Common cardiac conduction disorders include supraventricular tachycardia, AV blocks, sick sinus syndrome, atrial/ventricular fibrillation, and atrial/ventricular flutter.
It is helpful to have a basic understanding of how the heart’s electrical system works before discussing the various conduction disorders that can occur. The heart is a muscle, which also has its own electrical system. Many may be more familiar with cardiac problems that can occur due to arterial clogging or blockages, such as coronary artery disease (CAD), or there may be a disease complication affecting the muscle of the heart causing it to become weak, such as in cardiomyopathy. When the electrical impulses have problems or difficulties, a cardiac conduction disorder may occur. There are many different types of cardiac conduction disorders and some patients can experience these intermittently, while others may persist for a chronic period of time or may be life-long. Some patients have more than one conduction disorder simultaneously. Possible treatments for conduction disorders include surgery, ongoing medication and observation, or an electrical assistive device implant.
The Sino Atrial (SA) node, located in the upper right quadrant of the heart, is the pacemaker of the heart. The SA node sends an electric signal that prompts the heart to contract/pump. When this signal is blocked, interrupted, sent too frequently or infrequently, or the ventricular response is out of sync, conduction disorders may occur. Conduction disorders can develop over time, can be caused by medications, consuming other supplements, foods, or drinks, or can be congenital.
Think of the heart as a square with upper and lower portions. Example:
Chambers of Heart Example
Right Atrium
Left Atrium
Right Ventricle
Left Ventricle
Simplistic view of heat chamber positioning
Measure of Heart Rate Example
Source: Google Images, Web 2024
In the diagram above of a normal heartbeat, the “P” is the SA node’s (Right Atrium) electrical impulse for the heart to pump or beat, the QRS is the ventricular (Right & Left Ventricles) response (heartbeat), and the “T” is a re-polarization of electrical energy for the process to repeat itself. These points are measured when reviewing various heart conduction disorders and help identify where the conduction disorders may be occurring.
Various intervals between complexes are measured to analyze heart rhythms.
Figure: Heartbeat Dissected
Source: Google Images, Web 2024
In a NSR (Normal Sinus Rhythm), all complexes are normal, evenly spaced, with a rate of 60-100 beats per minute.
Example of Normal Sinus Rhythm
Source: Google Images, Web 2024
Bradycardia is a slower than normal heart rate. Tachycardia is a faster than normal heart rate. Both are a normal part of daily heart function and response.
Example of a Sinus (normal) Bradycardia
Source: Google Images, Web 2024
Example of a Sinus (normal) Tachycardia
Source: Google Images, Web 2024
An extremely slow or persistently-below-normal heart rate often is due to a malfunctioning SA node. The condition is called sick sinus syndrome. The typical intervention for a sick sinus syndrome is the placement of a pacemaker to make the heart rate normal again. Various pacemaker models may be used.
Everyone’s heart rhythms vary, based on physical and emotional status, nutrition, and temperature. Each person’s pulse, or heart rate, can change from minute to minute. Likewise, heart rate will speed up (tachycardia) or slow down (bradycardia) as a response to physical and emotional factors. Cardiac conduction disorders can occur when these heart rates go too far beyond normal parameters (whether too fast or too slow). Many people will have skipped beats and bouts of fast and slow heart rates as a part of everyday life experiences. Only when these conduction disorders persist, create symptoms that would cause a concern for compounded problems, or are not addressed do they become a problem.
When a faster than normal heart rate originates at or above the atrioventricular node (AV), the condition is supraventricular tachycardia (SVT). Atrial fibrillation is a type of supra ventricular arrhythmia. In A-Fib (atrial fibrillation), there are irregular impulses reaching the AV node and only some are being transmitted. Another type of SVT is documented as paroxysmal supraventricular tachycardia (PSVT). The word paroxysmal means that there is a sudden burst or display of the tachycardia in portions or waves where there is a great intensity, which calms and then bursts forth in display again. A supraventricular tachycardia is a rapid atrial rhythm, while a ventricular tachycardia is a rapid ventricular rhythm.
Example of a Supraventricular Tachycardia (SVT)
Source: Google Images, Web 2024
Atrial Fibrillation/Flutter
Atrial Fibrillation
Source: HAA
Example of Atrial Fibrillation
Source: Google Images, Web 2024
In the above examples, a clear difference between a normal heart rhythm and atrial fibrillation is clearly demonstrated. The placement of the P, QRS, and T waves are obviously out of rhythm. This is from the intense “shaking” or “churning” of the ventricles from the atrial hyperactivity or rapid firing of impulses. Atrial fibrillation is a very common diagnosis that is usually managed through blood thinning medications (such as Coumadin or warfarin) to prevent clots from forming from the churning activity. Sometimes atrial fibrillation can be a short event or converted and other times it is a life-long diagnosis. In some cases, a pacemaker may be implanted for the treatment of A-Fib, and if the patient has more than one conduction disorder, for example a history of sick sinus syndrome (or SA node malfunction) as well as A-Fib, and there is a pacemaker in place, the patient likely still has A-Fib and this can be revealed by the current use of Coumadin or warfarin, other blood thinner, or A-Fib medication. Pacemakers are most often implanted for SA node malfunction or sick sinus syndrome and not for A-Fib.
Ventricular fibrillation is a condition in which there is uncoordinated contraction of the cardiac muscle of the ventricles in the heart, making them “quiver” rather than contract properly. It is life threatening and requires immediate attention for life-saving purposes. Ventricular flutter is an arrhythmia, more specifically a tachycardia that affects the ventricles with a rate of over 200 beats per minute. It has been considered as a transition between ventricular tachycardia and fibrillation. It is a critically unstable arrhythmia that can result in sudden cardiac death. Both of these conduction disorders require cardioversion (shock treatment) as well as medication support. Patients who have had known problems with short runs of these arrhythmia’s may be placed on an Automatic Internal Cardiac Defibrillator (AICD) which is a special pacemaker than can monitor for problem rhythms and shock the patient when necessary.
Ventricular Fibrillation/Flutter
Source: HAA
Example of Ventricular Fibrillation
Source: Google Images, Web 2024
Example of Ventricular Flutter
Source: Google Images, Web 2024
Atrioventricular (AV) Block
When the SA node sends its electrical impulse downward through the heart, the electrical impulse runs along a normal pathway. These bundles (or electrical lines) can become blocked for various reasons, causing a “bundle branch block.” When this occurs, something is blocking the normal flow of the signal, which results in a form of AV block. There is a disruption of the electrical message between the atrium (top of the heart) and the ventricles (bottom of the heart).
Documentation of AV blocks is important because there are many different types of blocks. The blocks are classified by measurements of the PR interval in the heartbeats (mentioned earlier) and are often named for physicians who discovered them.
Electrical System of Heart
Source: Google Images, Web 2024
First Degree AV Block: PR interval is greater than 0.20 sec.
Second Degree AV Block:
Type I (also known as: Mobitz I, or Wenkebach): Progressive prolongation of PR interval with dropped beats (the PR interval gets longer and longer, and finally one beat drops).
Type II (also known as: Mobitz II, or Hay): PR interval remains unchanged prior to the P wave, which suddenly fails to conduct to the ventricles.
Third Degree AV Block (Complete): No association between P waves and QRS complexes.
Bundle Branch Block: General defects in the electrical conduction system of the heart between the atrial and ventricle portions of the heart. Bundle branch blocks are fairly common and often do not cause any issues.
Heart conduction disorders can be serious. some patients might discount dizziness or fatigue to the causes of their symptoms, and older patients may experience age prejudice related to potential dementia or simple aging when a cardiac condition may be underlying. It is important to discuss all symptoms in detail with your healthcare provider so that the appropriate tests can be performed.
Diagnostic testing can include blood work, cardiac monitoring, exercise stress testing, and echocardiograms. Such testing is chosen based on the symptoms being presented in an effort to discover what issues might be present and which treatments might be best for each patient.
Brian holds a Master degree in Health Administration (MHA), a Bachelor of Science in Health Sciences (BSHS), and a Certificate in Clinical Bioethics which bestows the ability to serve on ethics boards, help make healthcare decisions, and provide continuing medical education.
He is a national author and speaker and health consultant in all aspects of healthcare delivery, with special interests in risk adjustment, population health, public health, clinical bioethics, patient safety, and patient education.
*All posts and materials posted here are for education and demonstration purposes and are not intended to be medical advice. It is important to remember that every person is unique with unique diagnoses, and may be taking different prescriptions and supplements. I encourage each person to discuss your conditions with a trusted healthcare provider and be engaged to learn along your individual path to wellness.
