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Heart Health – Kennedy cardiologist Josh Crasner, DO, interview
Courier-Post, 1/30/2017

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Published by Jefferson Health New Jersey, 2017-02-08 14:10:17

Courier-Post HeartHealth

Heart Health – Kennedy cardiologist Josh Crasner, DO, interview
Courier-Post, 1/30/2017

Monday, January 30, 2017 | Section D
BODYS+PIRITcourierpostonline.com

7ways CANDY GRANDE FOR THE COURIER-POST
to help
protect Pat Bottino, 64, of Newfield, knew his mother and father both
an
at-risk had heart disease, but never really worried about how it may
heart
affect him – especially when he was younger. But now he is

living with heart disease, he has hardening of the arteries,

and tries to face his challenges with a positive attitude and a

healthier lifestyle. ♥ “The more I learned about my

condition and the more I spoke with my doctor, I was not as

fearful and concerned,” says Bottino, co-owner of Shop-Rite

stores. “I have to limit myself and I exercise more, but I feel

great and wouldn't have it any other way.” ♥ Bottino says his

exercise routine is more regimented, and he eats healthier

meals, but his lifestyle changes make him feel better and

healthier in general. See HEART, Page 2D

Does compression HEALTH CORNER
clothing really work?
Get health answers at
ANGIE FERGUSON Deborah event

USA TODAY NETWORK - FLORIDA

In recent years, compression gear KIM MULFORD @CP_KIMMULFORD
has become increasingly popular with
professional athletes and regular gym GETTY IMAGES/ISTOCKPHOTO Get the beat on heart health in Feb- GETTY IMAGES/ISTOCKPHOTO
goers alike. ruary.
Exercise causes muscular fatigue and en’s Heart Center. “We want to raise
Compression clothing, however, is muscular fatigue results in damage to On Saturday, Feb. 4 from 10 a.m. to 2 awareness about the need to fight heart
nothing new and has been around for muscle cells. p.m., Deborah Heart and Lung Center disease in women.”
decades. Its roots are based in the clin- will host the 7th Annual Women’s See DEBORAH, Page 2D
ical setting where tissue compression Health EXPO at Lenape High
was used to treat a variety of disorders School at Church and Hartford
including lymphedema, deep vein roads, Medford.
thrombosis (DTV) and chronic venous
problems. While there are definite bene- Deborah physicians will join
fits for compression in the medical field, other health professionals to pro-
it is unclear whether this newer genera- vide health screenings to the more
tion of slick active gear really gives us than 1,000 women expected to attend.
See GEAR, Page 2D
“Each year we work in conjunction
with the American Heart Association’s
Wear Red Day,” said Dr. Renee Bull-
ock-Palmer, M.D.,director of the Wom-

2D COURIER-POST, Monday, January 30, 2017 BODY + SPIRIT courierpostonline.com

Heart that these recommendations are not for with the doctor. “Be alert when it comes 5. Relieve stress: Rainear says stress
only short-term use but are lifelong,” he to your overall medical health,” says plays an important part in cardiovascu-
Continued from Page 1D says. “Patients should check their blood Crasner. “It is a lot more costly, stressful lar disease, and can worsen its progres-
pressure, know their cholesterol levels and devastating when you don't take sion. “Mental stress, in certain cases, can
“The most exercise I get is when I'm and follow-up with their physicians reg- care of your health in a proactive man- actually cause weakening of the heart,”
with my three grandchildren,” laughs ularly.” ner.” he says. “Techniques to reduce mental
Bottino, who has a 10-year-old grand- 3. Make nutritious meals and snacks: stress include meditation, a quiet walk in
daughter and twin 8-year-old grandchil- Joshua Crasner, a cardiologist at Ken- “Incorporating more fish, fruits and veg- the park, deep breathing practice, listen-
dren, one boy and one girl. “And my wife, nedy Hospital for 22 years, says some of etables into the diet along with avoiding ing to music, playing an instrument and
Fran, is always making me healthy din- his patients with heart disease worry trans and saturated fats should be di- pet therapy. If needed, patients should
ners. She is a good influence for me.” about premature death, and missing etary goals,” says Rainear. “Use of more seek the help of a mental health profes-
their family's birthdays, celebrations mono unsaturated and polyunsaturated sional to help maintain a positive atti-
Bottino, who has been married for 44 and holidays. fats found in salmon, avocado, nuts, flax tude.”
years and has three children, says his seed and olive oil are beneficial. I recom- 6. Remain positive: Another challenge
wife does her own exercises and encour- “The most important thing people mend eating whole grains instead of re- for those with heart disease is depres-
ages him to park a distance from stores with heart disease can do is learn from fined grains. I also recommend avoiding sion, says Rainear. “Patients with myo-
and walk a bit more instead of getting the their experience and condition and try to alcohol, as it may interfere with medica- cardial infarction may also suffer from
front spots. be careful,” says Crasner. “Taking con- tions and cause heart rhythm abnormal- major depression after the heart at-
trol of your life is powerful. I spend a lot ities.” tack,” he says. “This problem is indepen-
Stress also is something Bottino has of time with my patients, counseling dently associated with higher risk of
learned how to handle better. them and giving them materials they Rainear says patients may want to death.”
need to learn this. We encourage people seek advice from a dietician for further
“My job, like everyone else's, is ex- to take control and then they gain confi- information. If patients with heart disease do feel
tremely stressful, but I try to leave my dence.” depressed, Rainear says they should dis-
work at work,” he says. “When I do get Crasner agrees that a proper diet has cuss it immediately with the physician.
stressed I talk about it with my wife or Another challenge those with heart an important role in cardiovascular 7. Follow medication regime: Crasner
adult children. I don't keep it in. You can disease face is being realistic with their health, but also says if it's a holiday, fam- says every patient is different, so medi-
take medication for the problems, but health, says Crasner. ily celebration or party don't feel guilty cations will vary, but every patient
have to find a way to relieve stress.” about indulging in a delectable treat. should follow their medication instruc-
With regard to exercise, diet, and oth- “We all need to enjoy our lives and what tions.
Bottino's cardiologist, Kris Rainear, er lifestyle changes, Crasner says don't we eat,” says Crasner. “Just make it an
has been practicing in Vineland for 20 set unattainable goals. exception and not the rule. As long as you “Most incidents require a blood thin-
years and with Penn Cardiology in are not making it a meal, once in a while ner, a cholesterol-lowering medication
Vineland for 4 years. He believes life- “The heart and body are the finest ma- is OK.” and a beta blocker,” says Crasner. “As it
style changes are key to reducing risks chine ever made,” says Crasner. “It's like 4. Start exercising: “We always recom- pertains to vitamins and supplements, I
associated with heat disease. a car, if you put in the proper fuel, baby it, mend aerobic exercise on a regular ba- say if they have a healthy diet and it's a
and don't make it go over its limits, it sis,” says Crasner. “Exercises like bik- broad-reaching diet they don't need any-
“Heart disease has a broad-spectrum should function properly for a long ing, swimming, rowing, fast-paced walk- thing else. Some studies say fish oil may
from mild blockages in the coronary ar- time.” ing, yoga, stretching and sports like bas- have benefits, but it's not really clear
teries or thickening of the walls of the ketball and tennis are good. The whether it does help.”
heart to heart valve dysfunction and Here are seven things to keep in mind important thing is being consistent with
heart failure,” he says. “When patients if you have a heart condition. exercising and doing it for 30 minutes a Rainear says it is wise to keep medica-
are diagnosed with heart disease, it is 1. Reduce risks – Put those cigarettes day, five days a week.” tions organized. “A pillbox can be helpful
very important to change their lifestyle down and make other changes to reduce in organizing medications and assuring
to become healthier and therefore re- risk, says Rainer. “Risk factor modifica- Crasner says to start slow with exer- compliance,” he says. “I instruct my pa-
duce progression or reverse the heart tions such as controlling diabetes, hyper- cising, and do not engage in power lifting tients to keep an updated list of their
disease.” tension and hyperlipidemia along with or heavy weights, which can put a strain medications in their wallets or smart
smoking cessation have been proven to on the heart. However, light weights like phone.”
Rainear says trying to achieve an op- prevent progression of coronary disease dumbbells are OK to try.
timal weight and getting regular exer- and recurrence of myocardial infarc-
cise also decrease cardiovascular risk. tion/heart attack,” he says.
2. Be proactive: Monitor your health,
“Cardiac patients have to understand and discuss any concerns or changes

Couple has to draw the line Shoulder problem
when it comes to mom indicator of heart
disease; what is
CAROLYN HAX This part you need to discuss in ad- might be to cut the tie. ‘non-HDL’ level?
TELL ME ABOUT IT vance with your wife, but an important If this were your parent, you would
element of drawing a line on the abuse is DR.
Adapted from a recent enforcement. As partners and co-par- be able to take the interim step of vis- MEHMET
online discussion. ents, please empower each other to say iting solo to keep your wife and kids out OZ and
to her, when she doesn’t back down on of her reach, since protecting them DR. MIKE
Dear Carolyn: My her abuse, “This visit/conversation is would be paramount. ROZIEN
mother-in-law has zero re- over.” And to follow through on it by THE YOU
spect for boundaries. On a showing her the door/changing the sub- But as the spouse, the road is tough- DOCTORS
recent visit, she told us we ject/leaving her home. er. You can make the suggestions to
were raising our newborn your wife that I did; you can stand up Q: I re-
child incorrectly, criti- Let her wail till she’s blue about her for your family at every opportunity, cently injured my rotator cuff while
cized our marriage, told my wife that her awful childhood. This is all you give her: though your wife gets the last word on swimming. I’m 61 and in good health,
personality was awful, and brought up “I’m sorry about your awful childhood. the pack-up-and-leave/kick-her-out de- but when I went to my doctor, he said he
things that she was mad about that my No one deserves to be treated as you cision (sell it well, it’s important); you wants me to get an EKG as well as an
wife had done as a child. were. That’s why we’re drawing the line can urge your wife to cut the tie either MRI for my shoulder. Since when is my
When we challenge her statements, with you now. Unkindness is not wel- temporarily or permanently, depend- shoulder connected to my heart? Is this
she turns into a guilt martyr and says we come.” No negotiating. ing on the damage her mother is doing. a case of overtesting?
don’t want a relationship with her, and
she brings up her own awful childhood. As necessary, encourage your wife to You can also start refusing to be pre- — Jeannie N., Nashville, Tennessee
At what point is it appropriate to agree keep her distance from Mom for a period sent for these visits, but that’s problem- A: Sorry about your shoulder, Jean-
with her and cut ties? of time (depending on how often you all atic given that your wife is likely Vic- nie, but your doctor probably wasn’t
— No Boundaries typically see her — think in terms of tim Zero of her mom’s hostility. To opt overtesting. For people over 60, shoul-
When she says any of these things — skipping a couple of regular visits) to let out is to stand up for yourself, which is der injuries sometimes can indicate
that you’re raising your kid wrong, that her know you are serious. indeed necessary sometimes, but your that something else, such as heart dis-
your marriage stinks, that your wife is wife might need you to stand up for her ease, is going on. A recent study in the
awful, anything along these lines, be If/when she humbles herself to ap- more than you need to protect yourself. Journal of Occupational and Environ-
completely clear: “I will not tolerate proach you, or if you’re both game to try mental Medicine revealed a strong cor-
your saying things like that about me/us/ again, then set up another visit. Repeat Email Carolyn at tellme@wash- relation between rotator cuff tendino-
my wife.” It’s not just a lack of bound- steps as needed until your mother-in-law post.com, follow her on Facebook at pathy (various forms of tendonitis) and
aries, it’s emotional abuse, and it’s so im- gets the message that hostility will gain www.facebook.com/carolyn.hax or localized joint pain and cardiovascular
portant for witnesses to step in. her nothing but an empty room. chat with her online at noon Eastern disease (CVD). Liver and gallbladder
time each Friday at www.washington- disease also can cause referred shoul-
Of course, she might never get the post.com. der pain!
message, in which case the only option Now, since you’re a swimmer, your
chances of having CVD are reduced.
Deborah Deborah’s staff will provide screen- ga; t’ai chi by Next Step Strategies; rei- There’s a better chance that your shoul-
ings for blood pressure, glucose, body ki by Angelique; mini make-overs by der injury is due to repetitive use. All of
Continued from Page 1D fat analysis, pulmonary function testing, RetroChic Beauty and Jamberry Nails; the soft tissue surrounding the shoul-
balance, cholesterol/lipid panels, sleep shakes from b.good; women’s self-de- der loses some of its flexibility with
She will be joined by Dr. Denise Zin- apnea, asthma information, peripheral fense by Clay Jiujitsu; painting with age. An MRI usually will ID the prob-
grone, associate director of the Women’s arterial disease assessment, bariatrics, PaintTyme, Inc.; entertainment and lem.
Heart Center; Dr. Jenine Vecchio, direc- and wound and lung cancer information. music therapy by the NJ School of Mu- The shoulder is the most versatile
tor, Diabetes Center at Deborah; Dr. Additional screenings include MyoVi- sic; custom-tailored work-out plans and mobile joint in your body. It moves
Navdeep Brar, attending, pulmonary; sion Scans by Performance Health Chi- from Soulscapes Fitness; blow-outs, ex- backward, forward, up, down and
and Dr. Niya Jones, associate, cardiolo- ropractor; hearing screenings by NuEar; tensions, and hair care from True Col- around in circles because of the rotator
gy. colon cancer information by NJCEED; ors Hair Salon; Zumba by Anytime Fit- cuff, which connects all the muscles to
and sun damage assessments and HIV ness; and heart-healthy cooking demos the bones of the shoulder. It’s made up
“Bringing together the expertise of screenings by the Burlington County from Shop Rite. of four tendons that form a covering
pulmonology, cardiology, endocrinology, Health Department. over the head of the upper arm bone
and diabetes, we can really offer our vis- Music will be provided by MORE (humerus) and top of the shoulder. If
itors a full picture of what it takes for a The EXPO features pampering mas- FM, and there will be door prizes and you’re a seasoned swimmer and this is
woman to stay ‘heart healthy,’” she add- sages and bodywork from partners Riz- giveaways. your first run-in with rotator cuff prob-
ed. “We are really looking forward to the zieri Aveda School and Massage Envy lems, you’re fortunate.
one-on-one time with our visitors.” Spa; Yoga Therapy by Evelyn and Yoga Event parking and admission is free. Physical therapy is in your future
in the Pines; Pilates and barre demon- Lenape High School is located at 235 whether your injury requires surgery
strations by Powerhouse Fitness and Yo- Hartford Road. Call (800) 555-1990 Ext. or not.
4 or visit www.demanddeborah.org Q: My doctor told me that I should
lower my non-HDL cholesterol level.
Gear levels. cluded show no improvement from a I’ve heard about LDL, the bad choles-
It’s fair to agree that exercise causes performance perspective. While that is terol, but what exactly is non-HDL, and
Continued from Page 1D valuable information, it is also notewor- what is a healthy level?
muscular fatigue and muscular fatigue thy to mention that the same studies — Judith L., West Lafayette, Indiana
any edge when it comes to training per- results in damage to muscle cells. The also showed very few, if any, negative A: Don’t let the phrase “non-HDL”
formance and recovery. most commonly known cause of muscu- effects on physical abilities or perfor- confuse you. (“H” is for “healthy.”) The
lar fatigue is the build up of lactic acid. mance outcomes. lousy LDL cholesterol you hear so
If you’re not familiar with active com- much about isn’t the only artery-clog-
pression gear yet, it is a type of athletic Lactic acid is a byproduct of exercise However, all researchers could ging, heart-damaging lipid. Your goals
clothing that provides gentle compres- and increases in concentration as exer- agree on one benefit. All athletes ex- are still the same: to protect your heart,
sion of the arms and legs. The manufac- cise intensity increases. Lactic acid pressed a decreased perception of brain and sex life by lowering your
turers of these clothing products claim needs to be removed by the liver and muscular soreness. All test subjects lousy cholesterol levels, no matter
that this compression assists in the re- muscles. The process of transporting believed they were feeling better and what you call them. Your first step is to
moval of unwanted byproducts pro- lactic acid to the liver through the blood more recovered independent of their make lifestyle adjustments, such as
duced during exercise – primarily lactic stream relies on compression from sur- blood chemistry results. Therefore, if losing weight if you need to, getting in
acid, and may decrease muscle damage rounding muscles to facilitate this pro- athletes gained a psychological or 10,000 steps or the equivalent daily and
during exercise. gression – enter compression clothing. physiological gain, it didn’t matter, be- ditching the inflammation-producing
cause they perceived that they felt bet- Five Food Felons (all trans and most sat
How does the clothing relate to train- For a true and accurate determina- ter and they performed better. fats, added sugars and syrups, and any
ing? Physiologically speaking, intense tion of the efficacy of compression gar- grain that isn’t 100 percent whole).
exercise and competition leads to phys- ments, athletes would need to be blood Angie Ferguson is an exercise physi- Your second is to take a modern statin
iological adaptations that in the long run tested before and after exercise and with ologist from Fort Myers, Florida. She is (atorvastatin or rosuvastatin) if life-
result in improved performance but in and without compression clothing to de- a USA Triathlon Advanced Level 2 style changes don’t do the trick.
the short term leads to fatigue, soreness, termine lactate levels in the blood, re- coach, Ironman Certified coach, Slowt- But what does “non-HDL” mean?
cellular damage and sometimes dimin- moval rates and recovery. The amount of witch Certified coach, USA Cycling Well, very simply, it means all the blood
ished performance. The faster you are compression would also need to be uni- coach and has a Specialty in Sports Nu- lipids (fats) you have that are NOT at-
able to recover from the short-term sore- form as there are no regulations on the trition certification. For more training tached to HDL, the good-for-you-be-
ness and fatigue, the sooner and more amount of compression and manufac- tips, read her blog at www.triathlon- cause-it-transports-cholesterol-out-of-
frequently you are able to train at higher tures adapt compression based on style, trainingisfun.com or contact her at your-body lipoprotein.
fabric and cost. To date, studies are very www.gearedup.biz. Email questions to youdocsdaily@
limited. sharecare.com.

In fact, studies that have been con-


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