12
Thursday, MAY 30, 2019 •
The San Diego Voice & Viewpoint www.sdvoice.info
HEALTHY LIVING Your Heart Health: Part 3 in a 3 Part Series
Decreasing Your Risk By Dr. Jerome Robinson, M.D.
To treat or prevent congestive heart failure, aerobic exercise of at least 150 minutes per week is recommended, however any exercise beats a sedentary lifestyle with no exercise at all. Exercise Rehabilitation programs are now covered by Medicare and most health insurance companies. Exercise in heart failure patients has been shown to improve both quality of life and symptoms of heart failure as well as decrease hospital readmissions. Medical therapy starts with decongesting the body of excess fluid. Diuretics is an initial therapy, but most surely thereafter must be followed by beta blockers, ACE inhibitors or Angiotensin receptor blockers and aldosterone antagonists. This forms
the basis of so-called ‘guideline directed medical therapy(GDMP)’. Newer medications described as neurohormonal modulation and heart rate controlling therapy (i.e., patients with heart rates greater than 70) have been added to Medical therapy since the initial 2013 guidelines were published. These medicines have added a great deal of benefit in my African American patients with heart failure. Other factors have also been added in the most recently revised update that deserve attention. Sleep-disordered breathing is now a class 2A recommendation in heart failure patients to work up obstructive sleep apnea. Its treatment recommendation is only a 2B recommendation, pending results of large randomized clinical trials. Iron deficiency is another risk factor
present in nearly 60% of heart failure patients and needs to be further evaluated. Treatment with oral iron therapy does not seem to change results. However, the intravenous form of iron shows tremendous promise. The risks benefits, however, of intravenous iron, with its adverse consequences, needs to be factored into the equation. IV iron therapy is not currently a guideline-recommended therapy at this time. Putting all of this information together, you can decrease your risk of an adverse outcome, increase your quality of life and possibly increase longevity at a lesser cost to the Healthcare System. Heart failure remains one of the most common and costly chronic diseases that we managed and more importantly is the most debilitating for both the patient and family. You must be your own advocate by knowing your numbers and being screened and treated for other modifiable risk factors. By establishing that great relationship between you and your treating physician in an atmosphere of shared decision-making and shared knowledge of the medical issues you have and the goals of therapy, you can do well.
Prostate screening is a must By Ricki Fairley, The Cincinnati Herald My friend Alan ended his four-year battle with prostate cancer, and I started my war to engage Black men and make them know the importance of prostate cancer screening. Though Alan and I have been friends for 30 years, when he got cancer, we formed an even more special bond. As a Stage 3A Survivor of Triple Negative Breast Cancer, I know my purpose is to talk about breast health. I am now adding prostate screenings to my stump speech. At age 55, Alan had a prostate cancer screening test, the PSA. It was normal. Two years later, it had inched up to the top of the normal range. Although, he was getting annual physicals, his Caucasian, very well-regarded internist in their very affluent suburban town told him that PSA testing was not reliable (this is not true!), and he didn’t recommend them. Life went on, a very good life, full of love, laughter, dancing, a blossoming family. Alan led an exceptionally physically fit lifestyle. He had been a disciplined runner since he was in his 30’s and engaged in other types of fitness activities such as lifting weights and tennis. Following his 70th birthday celebration, he had a visit from his brother-in-law who was being treated for prostate cancer. When brought to Alan’s attention, he realized that he was having some symptoms (changes in urination). Alan’s wife, Yvonne, then insisted he bypass his internist, and they went to a local urologist who told him his PSA was 149.9, shockingly high. Because of the high number, he sought
the best care possible and ended up with the Chief of Urology for a major NY hospital. His PSA just 3 weeks later registered at 180. Stage 3B prostate cancer was the diagnosis, which began a path of treatment. He started with Lupron, 10 weeks of radiation, 5 days a week, driving from his home in Ridgewood to Manhattan and then to his office in Morristown, NJ, to work all day as a Chief Investment Officer, a grueling daily regime. His PSA went down for a short time and then began to increase. Despite intense chemotherapy, immunotherapy, including participation in 2 clinical trials, the aggressive cancer spread throughout his body. Despite the pain and anguish of debilitating cancer, Alan lived his life to the fullest, welcoming a new grandbaby 9 weeks before he passed and signing his favorite song, “My Way” from his hospice bed.
recommend a watch-and-wait approach over surgery or radiation therapy. When diagnosed early, prostate cancer is treatable! And note that the disparity in health care happens at all socioeconomic levels. Alan had good health insurance and doctors with good reputations. Was Alan’s struggle with prostate necessary? Could this have been prevented had he been screened more frequently? Would there have been a different outcome if he had been going to an African American physician?
We know Alan would have taken different actions if he had been made aware of the high incidence of prostate cancer among Black men and the benefits of PSA screening.
According to the American Cancer Society, Prostate cancer is the second leading cause of cancer death in American men, behind lung cancer. African-American men are twice as likely to develop prostate cancer and twice as likely to die from it.
African American men do and should have different screening recommendations where screening begins at age 40, rather than age 55 for a white man without a family history of the disease. Heed this warning. Don’t let distrust of the healthcare system or a Caucasian doctor that doesn’t make prostate cancer screening s priority stand in your way. Get screened regularly and live your life to the fullest!
Research indicates that prostate cancer is not an equal opportunity disease. Black men in the U.S. have substantially higher prostate cancer incidence and mortality rates than the general population. They are also more likely to be diagnosed with an aggressive form of the disease—which is typically treated with surgery and radiation therapy. Yet, black men are less likely than white patients to seek treatment, and when they do, their doctors are more likely to
BUSINESS
Iota Phi Lambda Celebrates 90 Years with Call to ‘Buy Black’ By Lauren Poteat NNPA Newswire Washington Correspondent
According to a recent study done by Guidant Financial, Black-owned businesses have seen a dramatic increase since 2015, particularly among Black women. However, in the same survey, it was also reported that while the number of Black-owned businesses are at an all-time high, Blackowned business sustainment and substantial economic growth remain stagnant. Working to better close economic gaps and help nurture Black communities to achieve greater financial excellence, Iota Phi Lambda Sorority, the first Black Greek-lettered business sorority, established in 1929, sets off their 90th anniversary, with a call to action for people of color to “rule in the art of business.” “There’s an issue with sustaining Black-owned businesses,” Outgoing 22nd National Iota Phi Lambda President Stephanie Dilworth said. “On June 1, our organization will celebrate 90 years of nationwide service, so it is extra
important that we continue to help support our communities and work to build economic opportunities, specifically geared toward other Black people.”
Emphasizing community empowerment, Dilworth also noted how important it was for Black people to support Black-owned businesses.
“Our organization is comprised of women committed to the growth of our communities that really need our support and we are working very hard to make sure that we equip our people to have wealth that they can pass on to the next generations,” Dilworth continued.
“The creation of Black-owned businesses is at an all-time high, but keeping them going is difficult, especially with limited access to capital,” Dilworth said.
The same business survey also went on to list some of the main reasons for loss of Black business growth, including a tight labor market, challenges with recruiting and retaining employees and lack of capital and cash flow. In a previous ProjectDiane report, which provides information about Black women and startup funding, only 0.2 percent of all venture capital funding was allocated toward startups founded by Black women in 2016, while just 34 Black women business owners received more than a million dollars of funding in the years previous.
“People will complain about smaller, Blackowned businesses having slightly higher prices than their competitors and then spend their money with those same competitors instead, not realizing that most of these mainstream companies, have more access to capital and revenue… If we want to get smaller Blackowned businesses generating that same kind of revenue, then we have to ‘Buy Black.’ We have to spend with them and help support them in their growth,” Dilworth continued. Committed to all aspects of business, Iota Phi Lambda also strongly encourages youth entrepreneurship, pushing communities to lay the groundwork for youth business-minded endeavors early.
“For Iota Phi Lambda, it is important that we teach and build them young,” Dilworth said. “We take pride in our youth and truly do believe they are our future.” “Most of our business workshops and programming are geared toward our millennials, from our Youth: Future Iota Leaders mentoring program, to our Lola M. Parker Foundation and scholarships, to our recent partnership with Microsoft for our previous IGNITE Youth Leadership and Innovation convention, we are committed to the youth.” Iota Phi Lambda sorority supports other non-business-focused programs, including their Iota Mothers Assistance Program— See ACTION page 15