Knowledge of health and diseases is not just for physicians, but it is the obligation of each of us to know about our body, how it functions, how it becomes ill because it is our body and we will suffer when it is not functioning normally, and how it will affect our performance and future.
We are trustees of their bodies and if we do not discharge our trust efficiently, we will be questioned about it. Our faith has a very deep effect upon our mental and physical health. Diseases result from the disassociation of the harmony between body and spirit, and our faith demands that this han-nony be maintained.
Health is defined as a state of complete physical, mental and social well-being and the ability to maintain a good quality of life. On the other hand, the disease state is one in which the body cannot function normally as a whole, or any organ of it, for a given period of time, and cannot enjoy the quality of life it is used to. If uncorrected, it will lead to severe disability and death. Dimensions of wellness include physical fitness, nutritional awareness, stress awareness and management, environmental issues, and self-responsibility in all these areas.
According to statistics from the Centers for Disease Control, about one million people die each year from cardiovascular disease, i.e., heart attack and its complications. Other conditions at the top of the list include cancer of the lung, breast and colon, about auto accidents 50,000 annually, 200,000 from AIDS, 40,000 homicides, various infections, diabetes and liver diseases. Smoking related deaths are about 350,000 every year. In a survey published in USA Today, the top national concerns were the spread of AIDS, 43%, crime, 33%, drug abuse, 32%, and homelessness, 25%. Let us discuss some of these health concerns individually.
CORONARY ARTERY DISEASE
The statistics for coronary artery disease in the US are grave. About one million people die every year, about two every minute. Some 680 daily hospitalizations take place for heart attacks. There are some 5.4 million people with diagnosed coronary artery disease. The direct health cost is about $8 billion per year and the total economic cost is around $60 billion. Coronary artery disease starts with angina, or chest pain, around the heart, which is due to blockage of the coronary arteries because of excessive damage to the lining or deposition of cholesterol. This causes thickening of the inside of the arterial wall, blocking the lungs and circulation, which results in reduced blood flow and decreased oxygen supply to the heart. Angina occurs when the oxygen supply is insufficient to meet the heart's demands.
Risk factors for coronary artery disease include smoking, which increases the heart rate, makes the heart work harder, and increases blood pressure. Smoking also damages blood vessels and platelets and causes spasm in the coronary arteries. The second risk factor is excessive weight gain which places a strain on the heart and high cholesterol which causes cholesterol deposits to form inside the coronary arteries. Stress is also a contributing factor because during stress the heart beats faster and blood pressure increases. High blood pressure is a major risk factor for the heart, putting a strain on patients with angina. Lack of exercise may also contribute to development of coronary artery disease.
The warning signs of angina include chest pain on the left side, sometimes with radiation to the arm and neck, usually with exertion but sometimes at rest, sometimes during emotional stress or exposure to cold, or after ingestion of a large meal. Usually, the chest pain is alleviated by rest and by taking nitroglycerin. The confirmation of coronary artery disease is made by performing an electrocardiogram, exercise testing and obtaining an xray of the coronary arteries taken during cardiac catheterization. Heart attack occurs when the blood supply to a certain portion of the heart is completely cut off and the heart tissue is about to die.
The treatment for angina is with use of medications to improve circulation of the heart or to reduce the performance workload of the heart by cleaning the inside of the arteries, called angioplasty, or replacing the a blocked artery with coronary bypass surgery. Any of these procedures alone would not be sufficient to change the outcome unless attempts are made to control all of the risk factors for the heart, including smoking, obesity, high blood pressure, cholesterol, triglycerides, a sedentary lifestyle and diabetes, if present.
HIGH BLOOD PRESSURE
Blood is pumped through the heart to different organs. However, the pressure of it has to be maintained in a satisfactory range. High blood pressure due to narrowing of the vessels or due to increase in heart rate may damage circulation and distant organs. A blood pressure of over 140/90 is considered high and about 130/80 would be considered normal.
Some 30 million Americans suffer from high blood pressure or hypertension. For the majority of them, the cause is not known, but about 10 percent have a curable cause related to hormonal imbalance. Sometimes the cause is related to problems of circulation in the kidneys. Excessive salt intake, obesity and other drugs like oral contraceptives can aggravate high blood pressure. If not controlled, hypertension can cause stroke, heart failure, heart attack, kidney and eye damage
The majority of patients with high blood pressure have no symptoms or very mild symptoms. Therefore, an annual blood pressure check is advised. Some patients complain of headache, dizziness, palpitations fatigue. In more severe cases, the symptoms are related to complications of hypertension of the heart, brain or kidneys. In the heart it causes
can cause renal failure, can lead to osteoporosis, affect the outcome of pregnancy and development of children. One must control his diabetes as it is difficult to heal because of poor circulation.
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Warning symptoms of diabetes include excessive thirst and urination, weight loss, bluffed vision, fatigue, excessive appetite, increased sleep, and difficulty in healing. The tests needed to confin-n the diagnosis are fasting and post meal blood sugars, a glucose tolerance test, and a glycosylated hemoglobin, in addition to a good physical examination. The treatment in both types means a strict diabetic diet, physical activity, weight management, and depending on age, either insulin or oral hypoglycemic agents. With strict diabetic control the lifestyle and prognosis for a diabetic patient may be as good as for a nondiabetic patient, and the complications can be delayed if not prevented. However, strict diabetic control is difficult to achieve for most patients.
Anyone who has a family history of diabetes or is 20 pounds above his ideal body weight or has any of the aforementioned symptoms, must seek his physician's screening for diabetes.
Cholesterol is a blood fat which is needed to make certain hormones and is part of our diet. However, excessive cholesterol damages the lining of the arteries and causes other problems The non-nal range for total cholesterol varies with age, but on the average, it should be less than 180. There are other types of cholesterol. One is HDL, which is the good type of cholesterol, and if it is high, the risk for heart disease is less. Then there are the triglycerides, which are another type of blood fat, which is more related to carbohydrate intake. If that is high, there is also a risk factor for heart disease but not as much as for cholesterol.
Cholesterol formation could be an inherited trait or due to dietary intake of high-cholesterol foods or high saturated fat intake. If the cholesterol is 260 or more, the risk for heart attack is increased 400%. Therefore, one must have cholesterol screening very frequently. Our diet nowadays is high in calories and contains an average of 435 mg. of cholesterol and 36 percent fat. The better diet would be that which contains fewer than 300 mg. of cholesterol and less than 30 percent fat, which should be of unsaturated or vegetable fat. One must avoid eggs, not to take more than 2-3 eggs per week and many items which are made from eggs or butter such as cakes and pastries should also be avoided. Again, physical activity also reduces cholesterol and increases HDL. The milk taken should be either skim or lowfat type.
Smoking is becoming very common in underdeveloped countries while Western countries are becoming smoke-free societies. However, we should know that smoking is an addiction. As compared to nonsmokers, smokers have twenty times more risk of developing lung cancer, fifteen times more risk of heart attacks, and ten times more for esophageal cancer. Emphysema and bronchitis, peptic ulcer disease and poor circulation in the legs are also related to smoking. During pregnancy if a woman smokes, she can cause abortion, fetal death and prematurity.
In the US about 350,000 deaths annually can be attributed to complications of smoking. Smoking costs the nation about $13 billion in health care annually and $25 billion in lost productivity. Thirty years ago, cancer of the lung was the tenth leading cause of cancer in women, but now it is the second. Although smoking is so bad, about $1 billion a year is spent on promotion of cigarettes in this country and exporters of tobacco are given federal grants to produce more cigarettes and export them to other countries.
Smoking not only causes lung cancer, but also cancer of the mouth and esophagus. Chewing tobacco can especially cause cancer inside the mueosal lining of the mouth. Pipe smoking also has significant risk factors for mouth cancer as well as having a nicotinic effect on the heart. Emphysema is a bad lung disease and many patients are dependent on oxygen 24 hours a day to survive. Many such patients cannot have any emergency surgery because the lungs would not be able to withstand anesthesia and they could have a delay in recovery during surgery if surgery were performed. Giving up smoking improves the performance of the lungs. It is never too late.
Cancer is another area of health concern for us. We must do our best to have a healthful lifestyle if we cannot avoid the pollution in the food and air. We can give up smoking to avoid lung cancer. We can eat a high-fiber diet to avoid colon cancer. Cervical cancer in women is related to having multiple sex partners and having sex at an early age. Again, this may have something to do with the lifestyle. Similarly, breast cancer may be related to not breast-feeding or having a childless marriage.
About 50,000 Americans die on the highway due to auto accidents with 500,000 surviving every year with injuries. Most of the time auto accidents are related to driving too fast or too slow, changing lanes quickly, making left turns at intersections, driving under the influence of alcohol or drugs like Valium, and not wearing seat belts. All these things are preventable conditions and we should do our best to save our lives and health, and those of our friends and families. As the Quran says, "Anyone who saves one life is as if he has saved the life of whole mankind" (5:35).
Stress is a gift of modem society and American life. Everyone is under stress. Any change in our lives, whether good or bad, adds to stress. Our vacations cause stress as does changing jobs or schools. Everything is stressful and affects our health. It can cause peptic ulcers, irritable bowel syndrome, impotence, heart attacks, high blood pressure, reduced resistance to infection and personality disorders, not to speak of lack of sleep. Stress is even now being linked to cancer.
In addition to these stressors that everyone has, we have some additional stress factors including attacks on our religion by the media calling us terrorists and fundamentalists, cultural incompatibility with local populations, and the generation gap between immigrant parents vs. our American-bom children, and even practicing Islam like fasting or doing prayers while working full time. Coping with stress is a separate issue and there are guidelines from the Quran and Sunnah.
Prevention of chronic diseases includes recognition of warning symptoms of diseases and seeking medical attention. In one study, when asked what people do about their symptoms, sixteen percent said they did not do anything, sixty-three percent said that they used home remedies, only eighteen percent said they went to their physicians, and one percent went to the emergency room.
We are usually not good about taking care of our health by not going to a physician early. When we go to the emergency room, sometimes it is too late. We should also insist on getting annual health checkups which should include an electrocardiogram, a blood pressure check, cholesterol, triglyceride and blood sugar checks, a chemistry profile with a CBC, urinalysis and general physical examination. These are the preventive aspects of health which, if combined with routine childhood vaccinations, good nutrition and exercise, will help maintain this body in a healthy state for the time that it has been destined to live.
For some, fear of disease may be a reason for righteousness, as mentioned by a sermon at St. Andrews Church in London in July, 1722. "The fear of disease is a happy restraint to a man's indulgence and vain desires. If men were more healthy, there is a great chance they would be less righteous." To the contrary, a Muslim's quest for physical health is in conforniity with his quest for salvation. God says in the Quran, "O you who believe, fear God, and let a person see what He sends forth for the hereafter, and observe your duty to God! Lo! God is informed of what you do and be not like those who forgot God and God calls them to.forget themselves" (59:18-19).