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The Doctor Is In: Women and Heart Disease

From raising children to maintaining busy work schedules and keeping up with household chores, women’s lives are more hectic than ever. Women often put everyone else in their family first, but it’s important that they take time for their own health.

Dr. “Dee” Prastein, heart surgeon at Lexington Cardiovascular Surgery, a Lexington Medical Center physician practice, talks about women and heart disease, encouraging all of us to “Just Say Know.”

Prastein_Labcoat_Standing_ORWhat differences have you noticed between men and women with heart disease?
Women tend to delay things, living with heart disease longer and presenting later. We see women who go about their routine chores while having chest pain or chest discomfort, ignoring or dismissing it. Sometimes they live with symptoms until they become so tired that they physically can’t do anything. It’s only then that they see a doctor.

What do women tell you about why they didn’t see a doctor sooner?
They seem to be focused on everyone except them. They put their families first. We see wives encouraging their husbands to see a doctor, but women often live with symptoms until they can no longer hide them.

How can heart surgery be different for men and women?
Women do really well with heart surgery because they seem to tolerate pain better than men. Also, older patients often tolerate pain better than younger ones.

How does smoking affect our hearts?
Nicotine causes hardening of the blood vessels, making them more stiff and narrow. That hardening of the arteries makes blockages more apparent sooner. You could say nicotine is the opposite of nitroglycerin, which allows blood vessels to become bigger.

What about diabetes?
With diabetes, high levels of sugar in your bloodstream allow the buildup of plaque in every blood vessel in your body, including the arteries in your heart.

What message do you have for women about heart disease?
I want women to know that it’s not normal to have no energy or to have chest discomfort such as pain or burning. If you do, see your doctor. Women who smoke, have a family history of heart disease or have diabetes should be especially careful. Don’t ignore symptoms. We can treat them and prevent a major heart attack.

The DASH Diet: Good for Your Blood Pressure

By Laura Stepp RD,LD, CDE at LMC

High blood pressure (hypertension) and pre-hypertension are two conditions that can be controlled with diet. According to the Centers for Disease Control, it is estimated that about half of all Americans have at least one risk factor for heart disease. High blood pressure (140/90) or Pre-hypertension (120/80-139/89) is one of those risk factors.

shutterstock_200040200Making a few changes to your food choices can help to naturally lower your blood pressure. High blood pressure can go unnoticed therefore it is important to have your blood pressure checked annually.

The DASH diet: Dietary Approaches to Stop Hypertension is a well-researched and documented pattern of eating that has been shown to help lower blood pressure. The DASH diet is a plant-based diet high in potassium and fiber and lower in saturated fat and sodium. In addition to helping to lower blood pressure, the DASH diet has been shown to help people naturally lower cholesterol and for many obtain a healthy weight. The DASH diet is closely related to another very well researched diet: the Mediterranean diet. Both of these dietary lifestyles are based on increasing ones intake of whole foods such as whole grains, fruits, vegetables and nuts/seeds. Adopting the DASH diet lifestyle helps to increase the intake of vitamins and minerals (such as Calcium, Potassium and Magnesium) needed by the body to help maintain normal blood pressure, cholesterol levels, and weight.

A DASH diet based on 2000 calories per day (what the food labels are based on) consists of:
Whole Grains and whole grain products: Wheat, Barley, Rye, Oats, Quinoa, Corn
6-8 oz (1 oz = 1 slice of bread, 1 cup of cereal hot or cold, ½ c cooked grain)

Vegetables
4-5 (1/2 cup cook or 1 cup Raw = serving)

berries2Fruit
4-5 (small/medium, ½ cup cooked, 2/3 cup mixed raw = serving)

Low Fat Dairy
2-3 (8 oz milk, ½ cup plain yogurt, 1 oz cheese = serving)

Nuts, Seeds, Legumes (dried beans, black eyed peas, split peas, lentils)
4-5/week (1 oz nuts/seeds = ¼ cup; ½ cup cooked legumes)

Lean Meats: Fish/Poultry (skinless)
2 (for Women 3-4 oz = serving; Men 4-6oz = serving)

Fats & Sweets
Limited: keep small and in moderation, use liquid oils such as Canola or olive oil, use butter spreads with expeller pressed oils vs stick margarine. If used, limit butter and other high saturated fat foods. Desserts on special occasions vs. daily.

A fresh and simple recipe we tested (which received good reviews for both taste and simplicity):

chickpea-wraps.jpg_1_272×1_005_pixelsChickpea Wraps with Grapes and Walnuts

    1 can (15 oz.) chickpeas (garbanzo beans), drained and rinsed
    2 cups seedless red grapes, halved
    1/2 cup finely chopped red onion
    1/2 cup coarsely chopped roasted walnuts
    1 Tbsp. finely chopped fresh basil
    1 Tbsp. finely chopped fresh rosemary
    1 Tbsp. finely chopped fresh thyme
    1/2 cup plain, low-fat Greek yogurt
    2 Tbsp. fresh lime juice
    1 tsp. Dijon mustard
    Freshly ground black pepper
    8 (8-inch) whole-wheat tortillas

    In large mixing bowl, gently mash chickpeas with potato masher just to break skins. Add all remaining ingredients except tortillas and gently combine.

    On bottom half of tortilla, spoon 1/2 cup mixture in broad line. Fold left and right sides toward center until almost touching. Fold bottom edge toward center. Roll wrap firmly upwards. Place toothpick 2 inches from each end. Slice wrap diagonally and place cut side up on plate or platter. Repeat. Serve immediately or cover and refrigerate until ready to serve.

    Makes 8 servings
    Per serving (2 halves): 367 calories, 10 g total fat (1 g saturated fat), 58 g carbohydrate,
    15 g protein, 10 g dietary fiber, 425 mg sodium (lower with low sodium beans & no added salt)

Welcome Heart Surgeon Deyanira “Dee” Prastein, MD

Lexington Medical Center is pleased to announce that Dr. Deyanira “Dee” Prastein has joined the hospital’s network of care as a heart surgeon. She joins Dr. Jeffrey Travis at Lexington Cardiovascular Surgery, a Lexington Medical Center physician practice, to provide comprehensive cardiovascular care that meets the needs of our community. She is the first female heart surgeon in the Midlands.

Prastein_Labcoat_Standing_ORDr. Prastein has world-class training in cardiothoracic surgery, studying inside some of the most prestigious heart programs in the world. Her intensive work includes experience with the most state-of-the-art procedures available today.

Prior to joining Lexington Medical Center, Dr. Prastein was the lead cardiothoracic surgeon at Duke Regional Hospital in Durham, N.C. A graduate of the Medical College of Virginia, Dr. Prastein completed a general surgery residency at the University of Maryland and cardiothoracic surgery training at the Wake Forest University School of Medicine.

During her residency, she participated in extensive research on heart failure. She then worked at Papworth Hospital in England, a facility famous for being one of the first in Europe to perform heart transplants.

Dr. Prastein compares open heart surgery to an orchestra playing music.

“All of the players in the operating room have different roles and everything has to come together,” she said. “It’s paced so that things happen at the right time and tempo. Everyone knows the steps and what time to do certain things, and the timing matters.”

Dr. "Dee" Prastein and Dr. Jeffrey Travis of Lexington Cardiovascular Surgery inside Lexington Medical Center's open heart surgery suite.

Dr. “Dee” Prastein and Dr. Jeffrey Travis of Lexington Cardiovascular Surgery inside Lexington Medical Center’s open heart surgery suite.

Dr. Prastein decided that she wanted to be a heart surgeon while in medical school.

“I thought that cardiothoracic surgery was the most amazing thing you could do as a surgeon and doctor,” she said. “Our brain makes us human and the person you are, but none of that matters if you don’t have a working heart.”

Lexington Medical Center’s heart program is affiliated with Duke Medicine. Dr. Prastein learned about the hospital while working there. And she was impressed.

“Lexington Medical Center is very passionate about and dedicated to making its heart program succeed.”

She also liked that Lexington Medical Center has made efforts to make sure they have the best cardiologists and surgeons available, and supporting staff to provide top-notch care.

“I love what Lexington Medical Center has created. My goal is to make the hospital’s heart program grow and thrive. There’s a lot of goodwill and passion for treating patients with heart disease, and I want to make sure I’m part of that success.”

She understands that heart surgery is a scary proposition for patients and their families. So, she works to put them at ease.

“Right before surgery, I talk to my patients, hold their hand, look into their eyes and tell them, ‘I’m going to take good care of you.’”

She knows that heart surgery will improve their quality of life and help them to live longer.

Working as a doctor has been a dream of Dr. Prastein since childhood. She was born in Nicaragua and lived there until she was 10, when war led her family to move.

“When we lived in Nicaragua and the war started, I wanted to help people,” she said. “In my eyes, there were only two people you could run to for help – priests and doctors.

Obviously, I couldn’t be a priest, so I wanted to be a doctor.”

Dr. Prastein settled in Fairfax, Virginia, outside of Washington, D.C., with her parents and brothers. Her mother and father, a civil engineer, sent her to college at George Mason University, where she graduated with a degree in chemistry.

There, she met her husband, Jonathan. They’ve been married for nearly 20 years and have a son named Jascha, who will be two years old in March. In her spare time, Dr. Prastein enjoys spending time with Jonathan and Jascha, and running. She has completed five marathons.

“I am proof that you can do anything with hard work. I am truly living the American dream.”