MedStar Health Blog

Every 37 seconds, someone in the United States dies from heart disease.

The good news is there are things you can do today to reduce your chances of developing heart disease, and you don’t have to do it alone. With the onset of the COVID-19 pandemic, many may be delaying medical care that can help with this important prevention. But telemedicine is changing that.

Your primary care provider, or PCP, knows your health and medical history better than anyone else. You’ve built a trusting relationship that helps you talk openly and honestly about your health changes, which is why they’re great partners in helping you maintain a healthy heart. Through the MedStar Health Video Visits, you can connect with your PCP in the comfort and safety of your home. These scheduled visits allow you to talk with your provider over secure video from your computer, tablet, or smartphone.

A PCP can help you prevent heart disease by:

1. Identifying your risk for heart disease.

Your primary care provider’s main goal is to help you stay healthy. One of the ways they do this is by looking at your risk factors for various diseases, including heart disease.

A risk factor is something that increases your chances of developing a disease. By looking at your medical history and talking to you about your current lifestyle, your PCP can better understand your risk.

The following risk factors increase your chances of developing heart disease:

• High blood pressure
• Tobacco use
• History of diabetes
• Obesity
• Being of certain ethnicities, including African American or Hispanic
• Aging

Your doctor can evaluate your risk factors to determine if you have a low, moderate, or high risk of developing heart disease. Knowing you have a moderate or high risk can help you and your PCP determine if you need to make lifestyle changes to lower your risk and improve your chances of preventing heart disease. If you have a low risk, chances are you are already living a healthy lifestyle and maintaining a good heart.

2. Setting realistic goals for preventing heart disease.

If your primary care provider identifies you as someone who is at risk for heart disease, you can count on them to help you set achievable goals that will reduce your chances of developing it. Since your primary care provider knows you, they’ll make sure your goals are realistic.

A primary care provider can also offer resources and suggestions to make healthy habits easier. They’ll help to keep you accountable by checking in regularly on your progress towards those goals. And, they may help you enlist your family to support your lifestyle changes.

3. Supporting your lifestyle changes.

Once your PCP helps you set goals, it’s time to take steps toward achieving your goals. Many times lifestyle changes can help you reach your goals. That’s because healthy habits have the biggest impact on your blood work and can greatly reduce your risk of heart disease.

Lifestyle changes may include:

• Regularly checking and managing your blood pressure
• Increasing your activity level to at least 30 minutes a day, most days of the week
• Making healthier food choices, such as:
  • Eating more vegetables and fish
  • Limiting fatty meats (e.g. Choose chicken breast instead of chicken thigh)
  • Avoiding sugary foods
• Quitting smoking

One of the most important things your PCP can do is help you figure out WHY you want to reach your goals because that will help you stay motivated to follow through with your lifestyle changes. Do you want to be around to walk your daughter down the aisle? Or, do you want to make sure you can run and play with your grandchildren ten years from now? Understanding your personal reasons for lowering your risk of heart disease will help you stay focused and persistent in your lifestyle changes.

4. Coordinating seamless care with a cardiologist.

When lifestyle changes or other interventions aren’t successful in lowering your risk of heart disease, your PCP can refer you to a cardiologist or a cardiac surgeon if needed. Cardiologists and cardiac surgeons are experts in preventing and treating heart disease. Having a connection to a reputable heart specialist through your PCP can ensure you receive coordinated and seamless care.

Your primary care provider probably has one or two cardiologists that they maintain a close relationship with. Many times, both the PCP and the cardiologist are within the same health system, which offers many benefits including:

• Less duplicative care. Since your PCP is already communicating with the cardiologist, you won’t need to complete any repeat tests, screenings, or blood work.
• More personalized, focused care. Your PCP will share your medical history and preferences with your cardiologist. That helps them to be prepared before you even arrive for your appointment.
• Quicker treatment process. Because you have a direct link to the cardiologist through your PCP, you may not have to wait as long for an appointment. And since your cardiologist will already know what is and isn’t working, they can get started quickly on new treatment options.

How to catch heart disease early.

Regular screenings or tests can help you prevent heart disease or catch it early. For example, you should have your blood pressure checked at least once a year. Monitoring your cholesterol is also important at various frequencies for the following age groups:

• Ages 20-39 should get their cholesterol checked every four to six years
• Ages 40 and older should receive more frequent checks

If you already have a primary care provider, hopefully you are taking steps to minimize your risk of heart disease. If not, it’s important to know the first signs. Be sure to talk to a doctor if you notice any of the following heart disease symptoms:

• High blood pressure
• Diabetes symptoms, such as:
  • Increased thirst
  • Frequent urination
  • Unexplained weight loss

Once heart disease has started, you may have other symptoms, including pain in the chest, arms, or jaw.

In my experience as an internal medicine doctor, I’ve noticed that women may not experience some of the same traditional symptoms as men when it comes to heart health. For example, women are likely to experience more subtle symptoms when having a heart attack, which makes them easier to ignore.

To learn more, take the women’s heart disease risk assessment from MedStar Heart & Vascular Institute.

You know your body best, so if something doesn’t seem right, make it a priority to talk to a doctor.

Interested in learning more about how a PCP can help you prevent heart disease? Watch Dr. Newkirk explain the role your PCP can play in helping you maintain a healthy heart.

How to choose a helpful primary care provider.

If you don’t already have a primary care provider, it’s important to find one who can help you minimize your risk of developing heart disease. Here are a few qualities to look for.

Choose someone who comes recommended by friends or family. If you have loved ones with similar values, they may appreciate qualities in their PCP that will also resonate with you.

Ask about their specialties or areas of interest. Every person has unique health needs, and those needs change as people age. You want to find a PCP that keeps your needs in mind.

Find a PCP at a convenient and accessible location. You want it to be easy to see your PCP when and where you need them so that you’re more likely to show up for scheduled appointments.

Pay attention to the atmosphere of the office. Once you visit your new PCP, think about how the office made you feel. Were they welcoming? Were they responsive when you needed them to answer a phone call or call back? Do they have availability and easy ways for you to make an appointment?

Don’t wait to talk with a primary care provider.

During these challenging times of COVID-19, you may be inclined to delay visits to the doctor as you take steps to limit any exposure to the virus. But even during a pandemic, your ongoing health needs remain of great importance.

That’s why MedStar Health is offering virtual care through MedStar Health Video Visits. These scheduled video visits are designed to provide a secure way to keep up with medical appointments from the safety of your home, including ones with your PCP. You can schedule a MedStar Health Video Visit by calling your provider’s office.

Keeping your hands clean is the best way to protect you and your family from COVID-19. Here’s a quick look at best practices you can implement right away.

Hand Soap or Sanitizer?

Either one! Both are equally effective for coronavirus protection if you follow the proper steps for use.

For handwashing:

• Run hands under water (any temperature) and use enough soap to work up a good lather to cover your hands
• Vigorously scrub every surface of your hands and fingers for 20 seconds minimum (you probably already know that’s the Happy Birthday song, sung twice!)
• Pay careful attention to often-missed spots, like the back of your hands, your fingertips, and your fingernails
• Rinse well, but don’t turn off the faucet yet! (Remember: Your hands weren’t clean when you first turned it on)
• Dry your hands well with a clean towel, THEN use the towel to turn off the faucet…and to open the door, if applicable

Extra Tip: I personally recommend placing paper towels by your sinks if more than a couple of people share them. Otherwise, replace your cloth hand towels daily.

For hand sanitizing:                                                                                                       

• Choose a hand sanitizer that’s at least 60% alcohol
• Dispense enough into your hands to cover all parts of your hands and fingers
• Scrub every surface as you would for hand washing (see above)
• Continue to rub the sanitizer into your skin until it dries completely

Extra Tip: Check the expiration date on your hand sanitizer. If it’s expired, the alcohol content may be reduced, so it may no longer contain the minimum 60% alcohol concentration needed to effectively kill germs.

Six Feet, Really? Even If I’m Not Sick?

Yes! We all know that a cough or sneeze can send respiratory droplets into the air. But people also spray these tiny droplets just by talking. Because COVID-19 is widespread in the region, people may be contagious before any obvious symptoms appear. So play it safe and keep your distance.

The six-foot separation is recommended by the Centers for Disease Control and Prevention based on scientific studies of how far respiratory droplets typically travel by air before dropping.

Housecleaning Every Week? Every Day?

You don’t have to do a full housecleaning every day, but make sure to wipe off high-touch surfaces with a disinfecting agent frequently—especially surfaces other people touch. COVID-19 can linger on certain surfaces for up to two or three days once it lands there.

Don’t forget these frequently touched surfaces in and near your home:

• Table and counter tops (wipe clean before disinfecting)
• Backs of chairs
• Faucets and flush handles
• Doorknobs, kitchen handles, drawer pulls
• Banisters/railings
• Remotes and touchpads
• Light switches
• Pet leashes and cages
• Car handles, knobs, steering wheels
• For electronics—phones, tablets, laptops—look up the manufacturer’s recommendations to clean safely

Many brands of ready-to-use, household “disinfectant” or “germicidal” cleaners or wipes will provide effective cleansing. To ensure a product is proven effective for novel coronavirus disinfection, review the Environmental Protection Agency’s list of Disinfectants for Use Against SARS-CoV-2. Products on this list always carry an assigned “EPA registration number” on their package.

Extra Tip: You can make your own highly effective disinfectant solution with bleach and water. The CDC recommends mixing 1/3 cup bleach per gallon of water or 4 teaspoons bleach per quart of water.

Are Stronger Cleaning Solutions Better?

Not necessarily. It’s important to remember that the water component of any hand sanitizer or disinfecting cleaner is important as well! Water is an essential ingredient in these solutions; higher concentrations are less potent because proteins are not denatured easily in the absence of water.

So avoid using straight alcohol on your hands or undiluted bleach on household surfaces. It’s not as effective for coronavirus protection and can also be harmful.

What Can I Learn From What MedStar Washington Hospital Center Is Doing?

Maintaining a clean and safe environment is a priority for our patients, visitors, and associates. In addition to routine environmental cleaning, we are keenly aware of high-touch surfaces, such as railings, door handles, tabletops, and bathroom fixtures. We clean these areas frequently each day. This is the same approach you should take in your home.

A few years ago, we also started using a technique known as no-touch disinfection. This technique uses ultraviolet light technology as an added measure to decontaminate surfaces in patient rooms, procedural areas, and public restrooms. Of course, you can’t do that kind of thing at home. But staying on top of a regular cleaning routine—and doing a thorough job of it—can go a long way to protect against virus transmission.

You may be surprised to learn that oral cancer is one of the deadliest and most disfiguring forms of cancer.

About 53,000 Americans are affected by it each year, including men and women, smokers and non-smokers, young adults and older ones. April is Oral Cancer Awareness Month, a great reminder to review the basics about who’s at risk for this disease and what you can do to monitor for it, so you’re able to spot the signs in the early stages when this cancer is easiest to treat.

FACT 1:  The phrase “oral cancer” can often refer to two very different kinds of cancer.

Oral cavity cancer occurs in the front part of the mouth—most commonly the tongue, floor of the mouth, inside of cheeks, and lips. The primary culprit is tobacco use (smoking or chewing varieties), followed by frequent alcohol consumption, and repeated trauma within the mouth from problems like poor-fitting dentures, loose teeth, or even chronic tongue biting. This type of cancer can be very aggressive and difficult to treat successfully.

Oropharyngeal cancer affects the back of the mouth, including the tonsils, back of the tongue, larynx, and upper throat. While tobacco, alcohol, and mouth trauma can play a role in oropharyngeal cancer, we now recognize that human papillomavirus, or HPV, is the most common underlying cause of this condition. HPV is in the same family of sexually transmitted viruses—often better known to patients as a cause of cervical cancer—for which we now have a widely recommended vaccine for adolescents and young adults. This type of cancer often responds better to available treatments.

FACT 2:  While one type of this cancer is trending downward, the other is on the rise—especially in younger adults.

Decreases in tobacco use in the U.S. have no doubt fueled a decrease in the number of oral cavity cancers. We typically see these among people in their 60s and 70s.

On the other hand, however, we’re seeing a rise in oropharyngeal, or back-of-the-mouth cancers, especially in adults in their 50s and 60s and sometimes much younger. This increase is directly related to certain types of sexually transmitted HPV infections, which can be passed during oral contact. Because these cancers may not appear for decades after exposure to HPV, it’s hard to tell how the HPV vaccine—which debuted in 2006—will affect these numbers in the years ahead, but we’ll likely see fewer cases as more people get vaccinated.

For now, the Centers for Disease Control and Prevention (CDC) recommends routine HPV vaccination for everyone up to age 26, ideally starting before sexual activity. The vaccine is also recommended for other individuals in some cases, so ask your healthcare provider about it.

FACT 3: Oral cancer is often extremely serious.

According to the Oral Cancer Foundation, just over half of people diagnosed with this cancer will live longer than five years, making it the sixth leading cause of cancer death in the U.S. That troubling statistic stems mainly from the fact that these cancers are often not diagnosed early, and the signs can be easy to miss. These can also be fast-growing cancers, especially when related to tobacco and/or alcohol use. (HPV-related back-of-the-mouth cancers have a better prognosis, with 80% to 90% of patients still alive after five years.)

Required surgeries and other treatments can also be challenging and traumatic for a later-stage cancer. They can lead to disfigurements, such as removal of part of the tongue or other tissues, as well as problems with swallowing and speaking. It can be very difficult to return to a normal life after this type of cancer, so prevention and early detection are critical.

FACT 4: You should check regularly for early signs.

This is true for every adult but is even more important if you use tobacco or drink alcohol regularly. Take a look inside your mouth and feel around your neck every so often to be sure nothing has changed.

Here are the signs to act on if they persist longer than two weeks:

• A flat white or red patch anywhere in your mouth (note that, in its early stages, these cancers rarely cause discomfort)
• A lip or mouth sore
• A growth or lump inside your mouth or in your neck
• Discomfort with swallowing
• Hoarseness

Regular twice-yearly dental visits are also an excellent way to monitor this cancer, as dentists are uniquely qualified to spot early signs of it. This kind of examination is typically part of a routine check-up and doesn’t cost extra. Primary care physicians also tend to do oral exams as part of their routine wellness exams.

FACT 5: Early action and a good care team can make a life-saving difference.

If you detect any potential signs of this cancer, don’t wait. Make an appointment with either your dentist, primary care physician, or an otolaryngologist. Your dentist or a medical specialist you’d be referred to would typically do a simple biopsy in their office and refer you for additional testing as needed. The biopsy requires a small sample of cells from the questionable area, and it’s quick and inexpensive. You’ll have results within a few days and, if anything is detected, an imaging test—such as a CT scan or PET scan—can provide more details.

Because this diagnosis can affect many aspects of your life, it’s essential to choose a treatment center that offers a team approach. At MedStar Washington Hospital Center, our otolaryngologists are supported by a coordinated care team that includes medical oncologists, radiation oncologists, speech and physical therapists, oral surgeons, and counselors who can assist with the emotional impact this type of cancer can bring. This approach allows us to consider our patients holistically, recommend the best treatment options, and ensure they’re well cared for every step of the way.

As more people recognize the early signs and take steps to prevent them—such as avoiding tobacco, minimizing alcohol, and getting the HPV vaccine for themselves and their children as recommended—there's hope that the statistics for oral cancer may improve significantly in the years ahead.