2018 Reading Challenge: Books 1-5

My goal this year was to read 35 books. Every 5-10 books I try to post mini-reviews. My more detailed reviews are usually on my Goodreads profile (which is also shown in the footer of my blog). If you are interested, you can also join the Ask Your Internist group on Goodreads.

Hidden Figures (audiobook): 4*

This was not the best audiobook. I feel that it would have been much easier to follow the text. Even despite the struggle to keep up with the characters, it was very interesting!

Sanctuary of Outcasts: 3.5*

I gave this 3.5 stars at the beginning of the year, but I will have to say it is probably a 4 star rating. This book has stayed with me and I have thought back to several of these characters many times. This has unexpectedly stayed with me.

My Side of the Mountain (audiobook with Coy): 4*

I loved this book as a kid. I think that every kid dreams of growing up in the wild and living off the land. However, I am grateful for my pillow-top mattress and grocery store. Sleeping in a tree doesn’t sound that fun to me today.

Extremely Loud and Incredibly Close (e-book): 4.5*

The way this is written pretty much necessitates that you read the actual text. Not an e-book. Not audiobook. The actual book. I think this would have improved my reading experience. I liked the book way better than the movie. The movie does not follow the plot of the book closely at all.

Great Expectations (Kindle book with audiobook whisper-sync): 2.5*

I really wish I could have those hours back. Sometimes I think that we call them classics just to feel like we didn’t waste our time.

2018 Reading Challenge: Books 41-49

One of my hobbies is reading. I was the 2 time champion of the summer reading program at the Glen Allen public library when I was a kid. So there were only 3 of us in the program, but still… I LOVE books.

I took a hiatus from reading for fun during college, medical school, and residency. There was no time for reading for fun. I spent plenty of time reading pathophysiology, pharmacology, and other thrilling texts such as Harrison’s Internal Medicine. I am pretty sure the only book I read that was not a textbook was an assigned reading of Sherlock Holmes for our Intro to Clinical Medicine course by Dr. Jimmy Stewart.

Since I finished residency, I have resumed my hobby with gusto. I am on Goodreads (see link at bottom) in order to keep up with my Read and Want to Read lists. My goal this year was to read 35 books. Thanks to Audible, I have surpassed this goal easily. I am up to 51. I usually post my reviews in batches. I will go back and catch you up each week until you are up to speed!

Books 40-49:

Anxious for Nothing by Max Lucado: 3.5*

This is your typical Lucado book. Easy read or listen, quotable lines, but a little redundant. Great for someone who struggles a little with anxiety, but for those of you who grapple with it daily- don’t expect this to bring any major breakthroughs for you.

Why I Hate Green Beans: 3.5*

Great book for those who struggle with physical appearance insecurities and/or single Christian folks who are tired of people asking them when they’re going to get married. The author is hilarious. She also loves the bachelor so maybe I should give it 4*.

A Tale of Two Cities: -2*

I hated it in high school and I hate it now. It is still the worst of times.

The Outlander: 5*

I just love historical fiction. I’m not going to elaborate because you’ve probably already seen the TV show which is probably nothing like this wonderful book.

In Shock: 5*****

I LOVED this book. A critical care doctor who has personally experienced all types of shock except neurogenic and lived. Now SHE can teach you about empathizing with your patients. She has changed the way I practice. Note: this is not just a book for health care professionals… this is just an amazing story.

An American Marriage: 4*

My initial reaction to this book was “meh” but after thinking about it for a few days, I think it’s 4 for sure. It’s complicated and I’m not sure what to think about it, but I think that’s the point.

The Selection, The Elite, and the One: 5*

I am a sucker for young adult dystopian fiction and I love the bachelor. This is like hunger games meets the bachelor, minus Chris Harrison.

Silent Killers: High Blood Pressure

woman-3187087_1920What is blood pressure?

  • Blood pressure is the measure of the pressure exerted on the walls of your arteries by your blood.
  • The top number, or systolic pressure, is the pressure within the artery when the heart is contracted.
  • The bottom number, or diastolic pressure, is the pressure within the artery when the heart is relaxed.

Why is it important?

  • The pressure within our arteries keeps blood flowing throughout our body to take oxygen rich blood to our brain, muscles, organs, and skin to keep us functioning.

At what point is a blood pressure too high?

  • Blood pressure goals have recently been lowered. The goal blood pressure is now less than 120/80 for most individuals.
  • Elevated blood pressure is 120-129/80.
  • Stage 1 hypertension is 130-139/80-89.
  • Stage 2 hypertension is >140/90.
  •  For patients 60 and older, the goal is not as low. We aim for a goal of 140/80.
  • Patients with other chronic medical issues, such as diabetes, heart disease, or chronic kidney disease may be treated more aggressively since they are at higher risk of cardiovascular events and organ damage.

How do I know I have high blood pressure?

  • Your physician will screen you for hypertension at your wellness exam or yearly physical. Many offices do yearly health fairs for their patients.
  • You can also go to a local store and buy your own monitor and monitor it at home.

What are the symptoms of high blood pressure?

  • Some will develop headaches and fatigue. Some patients explain to me that they “just feel off” or have a “funny feeling in their head”.
  • Some people have no symptoms at all.
  • Worrisome symptoms are chest pain, shortness of breath, blurry vision. You should seek immediate medical attention if you should ever experience these symptoms.

When should I get treatment?

  • In order to be diagnosed with hypertension, a physician needs two separate readings above goal and two separate visits.
  • Many physicians like to have their patient monitor blood pressures at home so that they may differentiate between true hypertension and “white coat syndrome”.

What is white coat syndrome?

  • The body’s response to stress will automatically increase your blood pressure. Some people find coming to a doctor’s visit very stressful, and in turn, their blood pressure will be elevated.
  • Some individuals will have this response even if they do not feel as if they are anxious about being at the doctor.
  • You cannot be diagnosed with white coat syndrome without having appropriate home blood pressure monitoring to prove that your pressures are normal away from the clinical setting.

Are there remedies besides medications?

  • Yes! Some patients with mild elevations in blood pressure can bring their pressures down to goal with diet adjustment, exercise, stress reduction, and weight loss.

What causes someone to have high blood pressure?

  • Lifestyle plays a role in developing hypertension.
    • Persistent stress
    • High salt diet
    • Sedentary lifestyle
    • Excessive alcohol use
  • Hypertension can be caused by genetics. Some of these patients will need some form of treatment for their blood pressure no matter how hard they work on lifestyle changes.
    • African-Americans have a greater risk of developing hypertension. It tends to be more severe, occurs earlier, and causes greater damage than in non-black patients.
  • Some medications can cause high blood pressure and should be used with caution in those with hypertension.
    • Oral contraceptives (birth control pills)
    • NSAIDs (nonsteroidal anti-inflammatory drugs), especially taken chronically
    • Certain antidepressants
    • Steroids
    • Certain decongestants
    • Certain weight loss medications
    • Stimulant ADHD medications
    • Illicit drugs, especially methamphetamine and cocaine
  • Certain medical conditions can also cause hypertension. Physicians often look for these secondary causes before diagnosing a patient with essential (primary) hypertension.
    • Obstrucive sleep apnea
    • Fibromuscular dysplasia
    • Primary kidney disease
    • Thyroid disorders
    • Other hormonal disorders (aldosterone, parathyroid hormone)
    • Polycythemia

What will happen to me if I don’t get my hypertension treated?

  • High blood pressure is a silent killer, as the title suggests. Untreated, it can cause many health issues including:
    •  increased risk of heart attack and heart failure
    •  kidney disease and eventually kidney failure
    •  worsening vision or blindness
    •  stroke
  • Hypertension is the most important modifiable risk factor for premature cardiovascular disease. It is now even more common than cigarette smoking!
  • Risk of having a complication increases as the blood pressure increases.