JOANN R. GURENLIAN
I know this is not an amazing revelation, but women are different from men. On February 5, we can demonstrate that by wearing red in support of the American Heart Association's (AHA) Go Red for Women campaign. For more than 10 years, the AHA has worked to educate women that heart disease is not just a disease that men get. In fact, every minute, a woman dies of a heart attack, stroke, or other form of cardiovascular disease (CVD) in the United States. Most of these cases are preventable through a heart-healthy lifestyle.
So, what does that have to do with us? Well, since our focus is all about prevention, let's use this month to promote heart health, as well as awareness of the signs of CVD and risk factors for CVD, among our female patients. Many of our female patients tend to think of the rest of their family members first, putting themselves last. Do they know that symptoms of a heart attack are different for women than men? Do you? We tend to think of a heart attack as presenting with crushing chest pain. Well, it often does, especially in men. However, signs of a heart attack in women may be shortness of breath, nausea or vomiting, back or jaw pain, dizziness, lightheadedness or fainting, pain in the lower chest or upper abdomen, and extreme fatigue. How easy it is for women to excuse away those symptoms as indigestion, being overworked, or being out-of-shape. We are masters at ignoring ourselves and important signs of health issues, and that may well be why women die from heart attacks.
When our female patients present with jaw pain or other interesting health symptoms this month, let's explore further and find out how long they have had these problems. Ask if there are any other symptoms similar to what I described above.
Take the next steps and review risk factors for CVD, including high blood pressure, high cholesterol, weight, body mass index, and high blood glucose. You can actually assess three of the four measures in your office by taking vital signs (blood pressure and weight) and using a glucometer. Other risk factors include smoking, genetics, physical activity, diet, and stress.
For patients who want to learn more, there is a Go Red Heart Checkup that they can take online in under five minutes (www.goredforwomen.org/know-your-risk/find-out-your-risk/heart-checkup). This test is a perfect opportunity for you to reinforce key health messages and tie them to your oral health education program. In fact, I recommend you use the Checkup tool yourself to see how you are doing. The life you save this month may be your own!
As part of your education program, remind your adult patients that the AHA recommends regular testing occur as follows:
• Blood pressure- every regular health-care visit, starting at age 20
• Cholesterol- every five years, starting at age 20, or more often if total cholesterol is above 200 and other cardiovascular risk factors are present
• Weight and body mass index- every health-care visit, starting at age 20
• Waist circumference- as needed, starting at age 20
• Blood glucose- every three years, starting at age 45
Notice that this testing starts at a young age (20), so we should not assume that heart health actions can be postponed until middle age or later.
As you read this column, you are probably thinking that you don't have time for these discussions and assessments. You are really busy and have a lot of scaling to do, and your patients probably aren't interested in a lecture about heart health when they come for their "cleanings."
I am reminded of a patient who came into my office with a flushed face, who told me that she did not want her blood pressure taken and that I should just get on with the appointment. She was not in a good mood, she did not feel well, and she just wanted to get on with her day. Her stomach was upset, her midback was hurting, and she wasn't sure if she felt like sitting through a dental hygiene appointment.
Somehow, I convinced her to let me take her blood pressure and pulse. Her blood pressure was 224 / 110 mm Hg right arm, and her pulse was 100 bpm right arm. I assured her that we did not need to proceed with dental hygiene treatment because I suspected she was having a cardiac problem. It took a few minutes for the dentist and me to convince her to let us call 911, but in the end, she consented. It turned out that our patient had three blocked arteries! Sometimes it is OK to be different and practice a new approach. On Friday, February 5, 2016, or maybe throughout the entire month, Go Red! RDH
JOANN R. GURENLIAN, RDH, PhD, is president of Gurenlian & Associates, and provides consulting services and continuing education programs to health-care providers. She is a professor and dental hygiene graduate program director at Idaho State University, and president of the International Federation of Dental Hygienists.