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Sunday, January 16, 2011

Sodium

Sodium.  Salt.  It's the bane of my existence as a cardiologist.

In medical school, we learn that 85% of diagnosis is history.  This is very true, especially when it comes to uncontrolled hypertension or congestive heart failure.

Why does sodium matter?  Sodium consumption leads to retention of fluid.  This can raise the blood pressure, and in someone with a weak or stiff heart, can lead to congestive heart failure.

When I encounter a patient with an extremely elevated blood pressure or new onset heart failure, the first thing I ask about is diet.

Me:  Do you watch your salt intake?
Patient:  Yes, I never add salt to my food.

And there is the first fallacy:  Just because you are not salting your food does not mean you are consuming a low-sodium diet.  There is often plenty of sodium in the food you are eating.

Me:  What did you eat yesterday?

The answers to this question are always interesting.  Here are some of the recent high-sodium items consumed by patients of mine:
Soup "but it was homemade soup, not from a can"
Pad Thai "with just a quarter of a cup of fish sauce"
Hot dogs
In 'N Out Burger
Pizza
Various foods on a cruise ship
Las Vegas buffet

If you are eating at a restaurant, you can assume you're getting a ton of sodium.  Any soups, or entrees labled au jus, in broth, marinated, in soy sauce, these will all be highest in sodium.  Or, if it comes from a box or a can at the grocery store, be cautious and read the label.  And finally, any homemade broth from an animal is loaded with sodium -- the drippings of the animal are very concentrated in sodium.

Read here for more on diet and hypertension and heart failure.
Image from legacy.co.mohave.az.us

Friday, January 07, 2011

Resolutions

My resolution is to do more yoga and to stretch.

Me and my nieces doing yoga on the Wii Fit
In the past, I've been of the mindset that you train hard to get better.  Which to some extent is true.  But, it's important to take care of your body too.  Yoga helps to strengthen and stretch.  Massage is good too.  I think that a combination of massage and yoga has helped improve and nearly resolve a hip flexor strain that I had been dealing with over the past few months.