“Damn it!” Nikki snapped as she slammed her purse down on the table. “Why did I do that? Why did I go of on her like that?!”
Still silently scolding herself sternly, Nikki went back to her research. “Right now, this is the best thing I can do-for everybody.”
“Stroke Risk Factors: “Risk factors you can do something about include: high blood pressure(hypertension), high blood cholesterol, smoking, diabetes, being overweight, physical inactivity, excessive alcohol consumption and stress.”
“What is High Blood pressure–Also known as hypertension, high blood pressure happens when the force of blood pushing against artery walls as blood gets pumped out of the heart, is extremely high. High blood pressure is the number one risk factor for stroke and a major risk factor for heat disease, so it’s extremely important that it’s properly controlled. Over time, high blood pressure can narrow and eventually block arteries. It also strains the heart and eventually makes it weaker. Extremely high blood pressure can also make blood vessels in the brain burst.
Hypertension affects one out of every five Canadians. It’s the number one risk factor stroke and a major risk factor for heart disease, so it’s extremely important that it’s properly controlled. But, forty-two percent of Canadians with high blood pressure don’t even know they have it. You can’t see it, or feel it. But the good news is it can be controlled.
How it causes heart disease and stroke–Over time high blood pressure can damage blood vessel walls resulting in scaring which promotes the build-up of fatty plaque, which can narrow and eventually block arteries. It also puts a strain on the heart and eventually weakens it. Extremely high blood pressure can cause blood vessels in the brain to rupture–causing a stroke.”
As her fists clenched tight on top of the binder, Nikki rasped, “Damn it, Victor! Why didn’t you just stay put? Why couldn’t you do that, for once? Now, who knows how much damage your stubborn pride has done!”
Trying to ignore the rage building within her, Nikki shook her head and continued on. “Reduce your pressure. Reduce your Risk–With proper diagnosis and treatment of high blood pressure, people can cut their risk of stroke by up to forty percent and heart attack by up to twenty-five percent.
Tips to get your blood pressure in check include: Because high blood pressure has no symptoms, individuals should have their blood pressure checked at least once every two years by a healthcare professional. If patients have been told they have high-normal blood pressure, Canadian guidelines recommend they have their blood pressure checked at least once a year. Lead a healthy lifestyle. Eat a balanced diet, be physically active and smoke free, and reduce salt and alcohol intake to help lower blood pressure. Achieve and maintain a healthy weight. Even a modest weight reduction–as little as ten percent– can dramatically lower an individual’s chances of having a heart attack or stroke. Set aside some time daily to relax. Stress can make blood pressure rise–in short term, at least. If a patient’s blood pressure is high, he or she should talk to his or her doctor regarding drinking alcohol. Discuss blood pressure monitoring with your doctor.”
“This explains a lot! Between the stress at work, his diet and exercise, this was bound to happen! Damn it, Victor, how could you be so careless!”
Nikki felt the familiar rage bubbling up inside her once again but bludgeoned it and read on. “Cholesterol, heart disease and stroke–High blood cholesterol is a major risk factor for heart disease and stroke. By lowering your cholesterol, you can dramatically reduce your risk of heart disease and stroke.
High cholesterol may lead to a buildup of plaque in the artery walls and narrow arteries –called atherosclerosis– which can make it more difficult for blood to flow through the heart and body, putting patients at higher risk of circulatory problems, heart disease and stroke.”
“Victor had to have known this, he had to at least known some of this! Why didn’t he listen? If he had-” Nikki stopped herself short and reminded herself sternly, “That isn’t going to do anybody any good!”
Taking a deep breath and trying to relax, Nikki continued. “Ten ways to get your cholesterol in check– Test your cholesterol. Ask your doctor to check it if: You’re male and over forty, you are female and over fifty or post-menopausal. Check it if You have heart disease, stroke, diabetes or high blood pressure, of your waist measures more than one-hundred-two centimetres or forty inches for men or eighty-eight centimetres or forty inches for women, or if you have a family history of heart disease or stroke. Avoid trans fats which are often found in foods made with shortening or partially hydrogenated vegetable oil, hard margarines, fast foods and lots of pre-made foods. These raise bad cholesterol and lower good cholesterol. Cut down your fat intake to twenty to thirty-five percent of your daily calories.”
Slumping back onto the couch, her head resting on the top edge, Nikki whispered bitterly, angrily, “All those nights we had ice cream for a midnight snack sure didn’t help matters! Why did I eat that stuff, why? If I hadn’t, maybe this wouldn’t be happening!” But, as much as she tried to ignore it, a little voice inside her whispered, “Because you didn’t know. You didn’t know anything because, as usual, Victor didn’t tell you anything! As usual, you husband kept it from you because he didn’t think it was important, or he was trying to protect you! Either way, it wasn’t your fault!”
Shaking her head, she bludgeoned the voice and read on. “Choose healthy fats such as polyunsaturated and monounsaturated, found mainly in vegetable oils, nuts and fish. Limit your intake of saturated fat; found mostly in red meat and high-fat dairy products. Eat more whole grains, cereals, vegetables and fruit. Snack wisely. Choose low-salt pretzels, plain popcorn or fruit, rather than higher-fat or ‘junk food’ types of snacks. Use lower-fat cooking methods like baking, broiling or steaming and try to keep away from fried food. Be smoke-free. Smoking increases LDL ‘bad cholesterol.’ Get physically Active. Being physically active most days of the week can improve “good” cholesterol levels.”
“I can just see his face if I gave him plain popcorn or low-salt pretzels, let alone anything low fat!” Nikki thought to herself aloud with a hint of a smile.
Meanwhile, on the quiet roads of the outskirts of town, Vicki was barrelling towards the hospital. ‘Damn it, Dad! What happened? What in God’s name could’ve happened? What’s going on and why won’t Mom tell me anything? Why didn’t she come home and why didn’t she call before now? Why didn’t you just come home? Why?’ Vicki thought to herself furious as she held the steering wheel in a death grip.
Nick stayed close behind her, careful not to lose sight of her as he tried to keep his speed reasonable. “Vicki, what’s wrong with you? You’re driving like a maniac! What’s going on with you? Are you trying to get yourself killed?” He mumbled as he kept a close eye on her as she swerved right and left, taking corners and turns entirely too quickly.
Back at Memorial, Nikki sat exactly where she had been for the past few hours, intensely absorbed in her research. “Heart disease (Arterial Fibrillation)–Heart disease is a major risk factor for stroke. Individuals with heart disease are twice as likely to have a stroke as those without it. Arterial fibrillation is a kind of heart problem called arrhythmia. This is when the heart’s electrical system which controls the heartbeat doesn’t function correctly–making the heart beat at fast, irregular intervals. This can cause blood clots to form, which may lead to stroke. Arterial fibrillation affects about two-hundred-thousand to two-hundred-fifty-thousand Canadians and approximately six percent of individuals sixty-five and over have arterial fibrillation. It’s estimated that as much as fifteen percent of all strokes are caused by arterial fibrillation. Arterial fribrilation may be caused by high blood pressure, a family history of arterial fibrillation, heart disease, a congenital abnormality, can happen after heart surgery, or can be caused by another disease like a thyroid condition.
Warning Signs: Symptoms–Treating arterial fibrillation aids in stroke prevention. That’s why it’s critical to recognize the symptoms so you can get treatment if you need it. Although some individuals don’t have any symptoms, others feel an irregularity right away. If you experience these symptoms, see your doctor to find out the cause and whether or not treatment is needed: racing, uncomfortable heartbeat, ‘flopping’ feeling in your chest, dizziness, sweating and chest pain or pressure, difficulty catching your breath, feeling weak.”
“He must’ve been terrified when he realised what was going on,” Nikki thought to herself aloud as she thought about Victor having had a heart attack before she finally found him and tried to suppress a shudder.
Stoically, she continued. “Risk Factors Continued: Being overweight–If you’ve been struggling with your weight, you aren’t alone. Almost sixty percent of Canadian adults are either overweight or obese; which is a growing concern since it’s a significant risk factor for heart disease and stroke. By achieving and maintaining a healthy weight you can significantly reduce your risk of heart disease and stroke and control other conditions like high blood pressure, high blood cholesterol and diabetes. However, with our busy lives, it’s not always easy to find the time to eat right and be active. To help you get started, here’s an easy plan.
Assess yourself–Waist circumference- Measuring your waist is the fastest and easiest way to see if your shape is putting your health at risk. Individuals who carry extra weight around the middle(apple shape) versus around the hips (pear shaped) are at higher risk of health problems including high blood pressure, high blood cholesterol, diabetes and heart disease. Generally, men with a waist circumference of thirty-five inches or eighty eight centimetres or more are at higher risk and women with a waist circumference of thirty-five inches or eighty-eight centimetres or more are at greater risk.”
“I need to get checked out just to make sure I’m okay.” Nikki told herself, making a mental note to talk to her doctor.
Trying her best to clear her head, she went on. “BMI–Another way of finding out if your weight falls within a healthy range is to consult something called the Body Mass index (BMI). This is a ratio of height and weight, which allows for a range of weights to be associated with good health versus only one ideal weight. Find out whether weight is putting you at risk for obesity related diseases such as high blood pressure, high cholesterol, diabetes and heart disease and stroke.
Eat right–When it comes to diet, variety is crucial. Try a variety of nutritious foods, ones that can help prevent disease and taste great.”
Fighting exhaustion, she continued. “Get active– There are many important reasons for making physical activity part of daily life. It’s a great way to keep a healthy diet going, to reduce high blood pressure, lower blood cholesterol levels, manage stress and decrease your risk of heart disease and stroke. Tips to maintain a healthy weight–Eat a healthy diet and be physically active. Lose weight slowly. Achieving a healthy weight is a long-term commitment. Avoid fad diets. Eat a diet that’s lower in saturated and trans fats and includes fresh vegetables and fruit, complex carbohydrates and foods higher in fibre. Use less fats in cooking. Bake, broil. steam, boil, microwave or barbeque food. Manage portion size. Divide the plate into for sections, fill three quarters with grains and vegetables and fill the last quarter with meat or meat alternatives. If overeating is you means of coping with stress, identify where your stress is coming from and learn new ways to cope.”
“Excessive alcohol consumption–Although alcohol–particularly red wine–is good for your heart, drinking too much of any kind of alcohol can increase blood pressure and contribute to the development of heart disease and stroke. While there is some evidence that individuals who drink moderately have a somewhat lower risk of heart disease and stroke than those who don’t drink or drink excessively, if you really want to have an impact on your heart health you’re better off eating a healthy diet, being physically active most days of the week and becoming smoke-free. If you drink alcohol, limit yourself to one or two standard drinks per day, to weekly maximum of nine for women and fourteen for men. One drink is equal to: three-hundred-forty-one milliletres or twelve ounces (one bottle) of regular strength beer; one-hundred-forty-two milliletres or five ounces of wine; forty-three milliletres or one-and-one-half ounces of spirits.
Moderate your alcohol intake– Discuss the risks of drinking alcohol with your doctor. If you have high blood pressure, limit your alcohol use and/or talk to your doctor regarding alcohol. If you don’t drink, don’t start. If you do drink, wait a minimum of an hour between drinks and alternate alcoholic drinks with water or juice. Avoid excessive drinking or getting drunk. Guidelines don’t apply if you have liver disease, mental illness; are taking certain medications, have a personal or family history of drinking problems or cancer, are pregnant, attempting to get pregnant or breastfeeding, or are told not to drink for legal, medical or other reasons. If you have concerns regarding how drinking may affect your health, consult your doctor.”
“Drinking as much tequila and brandy or whiskey as he has been the last few days and weeks can’t have helped!” Nikki muttered to herself frustrated before refocusing on her research.
“Physical inactivity–Individuals who aren’t physically active have twice the risk for heart disease and stroke. Active living is critical to maintaining good heart health throughout your life. Whether it’s gardening, walking or running, being active means something different to everybody-but everything counts.
Make it part of your life–There are many important reasons to make physical activity part of your life. It’s a great way to maintain a healthy weight, reduce high blood pressure, lower cholesterol levels, manage stress and cut your risk of heart disease and stroke. It can also help prevent or control diabetes. It’s not even necessary to have an intense workout to get the healthy benefits. As little as thirty minutes most days of the week is all it takes to start–and everything counts, even gardening, housework or dancing with your kids.”
Nikki smiled as she thought of her twins. “Maybe you can help me keep Daddy healthy? What do you think?” She asked with a small smile. After a moment or two, she felt a swift, strong kick and smiled once again. “We’ve got a deal then.”
Feeling somewhat better knowing there were some things she could do to help Victor get back to normal, she finished. “Then, slowly work your way up to sixty minutes.”
On the third floor, Casey sat in her office, still fuming over the argument she’d had with her sister. “Why doesn’t she get it? I’m only trying to help her! She’s driving herself crazy with all that stuff. Why does she insist on doing everything on her own? She’s got to realize she’s not some superwoman! She needs to take help when it’s offered!”
Reconsidering, she continued thoughtfully, “She is under a lot of stress and she definitely brings new meaning to the phrase stress does strange things to people, but she can’t go around biting everybody’s head off, including mine! She needs to realize she can’t do everything on her own all the time! She can’t do that if she wants to have a smooth pregnancy, which I’m getting the feeling she’s not!”
Heaving a tired sigh, Casey decided, “I’ll finish up signing off on these charts and go back downstairs to talk to her. If she’s calm enough to have a mature, calm, adult conversation, I’ll talk to her, I might even stay with her–otherwise I’m out of here!”
In the waiting room, Nikki was taking a break from reading to consider the situation with her sister and how to solve it. “I was out of line if she comes back, I’ll talk to her and try to explain things. It’s definitely not a good idea to go find her now. She was really upset when she left. I really can’t blame her. There’s no excuse for how I treated her, the things I said.
I’m just so worried about what’s going on with Victor, and not hearing anything from anybody isn’t helping! What does everybody think; that I’m just going to sit here quietly and wait?”
Feeling herself getting upset and remembering the possible effects it could be having on her pregnancy, Nikki took a deep breath to calm herself down before diving back into her research. “Tips to get active–Pick activities you enjoy, begin slowly and find a buddy to keep you motivated. Keep in mind that doing any physical activity is better than doing none at all. If you feel short of breath, dizzy or experience discomfort in your chest, shoulders or arms stop what you’re doing.
Walk it off–Walking’s probably the simplest heart-healthy activity. All you need is a good pair of shoes. You can walk around the block, or in the park, or just incorporate more walking into your daily routine by getting off the buss or subway one stop early and walking the rest of the way, or by walking or biking to the store.”
“I bet if I play my cards right, I can get him to come for a walk with me after supper, when he’s better.” Nikki thought to herself out loud with a small, slightly proud smile.
“Dig into gardening– When you think of all the digging, raking fertilizing, planting, pruning and watering it offers a great chance to get outdoors an be active all spring and summer long.”
“Victor gardening; not in this lifetime! I’d have better luck getting him to do the grocery shopping for a week!” Nikki said to herself with a chuckle as she tried to picture him working in any garden.
“Play with the kids or kick the ball around, throw a frisbee, skip rope or play tag–A family walk or bike ride is another way to stay fit, spend time together and teach your children to enjoy being physically active. Lead by example because children learn more from what you do than what you say. Make it part of your life. Take the stairs instead of the elevator. Wash and wax your car yourself instead of taking it to a carwash. Trade in your power lawnmower for a push mower, or walk to the corner store instead of driving.”
“He has been more involved in this pregnancy than he was with Victoria or Nicholas, so maybe I can get him to exercise a little more if I get the twins involved.
Feeling the twins’ swift, strong, but short kicks, Nikki again smiled softly and murmured, “Good, I’m glad I’ve got you two on board. I need all the help I can get with Daddy. He’s way too stubborn.”
Back in Kansas, Hope sat at her kitchen table carefully considering the conversation she’d had with Victoria hours earlier. “What could be going on with Victor? What could be wrong? He can’t be gone. He can’t be dead; not now, not when he hasn’t even gotten a chance to get to know his son!”
After only hesitating for a moment, Hope picked up the phone and called Victoria.
In Genoa City, as she drove like a madwoman, Victoria paid no attention to anything else except reaching her father. ‘I have to get there in time!’ she thought to herself almost frantically as she gripped the steering wheel so hard, so tight that her knuckles turned white.
Her cell phone ringing tore her from her thoughts as she pulled off the side of the road to answer it. “Hi Hope.”
“Victoria, what’s going on with your father? What happened?”
“I don’t know, all my mom would tell me when she finally called was that Dad’s in the hospital and for me and Nick to get there as soon as possible.” Though she didn’t feel like discussing this , or anything else, with anybody, she did her best to stay calm out of respect for her father’s ex-wife and the friendship they still shared.
“What can I do? Is there anything I can do?” Hope asked, heartbroken.
“No, there’s nothing anybody can do at this point. I’ll call you as soon as I hear anything else.” Vicki told her honestly.
“Okay, I’ll say a few prayers.” Hope told her, trying to keep the heartbreak from her voice.
“Thanks. We’re going to need them, especially Dad!”
Completely unaware of the chaos her children and Hope had been thrown into, Nikki went on with her research. “Stress–Even though stress can sometimes be a good thing, too much of it can actually hurt your health and increase your risk of heart disease and stroke. Too much stress may contribute to high blood cholesterol levels, high blood pressure and can heighten the risk of blood clots, these all increase the risk of heart disease and stroke. So, whether you’re dealing with good (i.e. weddings) or bad (i.e. death) stress, everybody can benefit from learning effective stress-busting techniques. It can make your heart rate increase, making the heart pump harder, it can make blood sugar levels increase, along with making fats in the bloodstream increase. Ongoing or frequent stress puts more demand on the heart and enhance plaque development. ”
“Only if they want to learn them,”Nikki murmured, thinking how difficult it would be to teach Victor anything he didn’t want to know.
“Types of stressors– Lots of life events like moving, leaving school, changing jobs and experiencing losses may cause stress. ‘Daily hassels,’ like being stuck in traffic, deadlines or conflicts can also be stress-provoking.”
“Yeah, especially when you’re dealing with Victor Newman!” Nikki agreed.
Shaking her head and refocusing, she continued. “It’s important to identify your stressors so you can learn to deal with them effectively.”
With a smirk, Nikki thought to herself, ‘These people obviously haven’t met Victor, or anybody like him! Trying to teach him’s like trying to teach a toddler–you have to get him to pay attention to you first!’
Still wearing somewhat of a smile, Nikki continued. “Symptoms of excess stress–If you’re suffering from high stress levels, you may feel tense or anxious, have headaches, stomach complaints or even symptoms that mimic old illnesses. Long-term exposure to stress can also lead to mental health problems like depression and anxiety.
Heart disease, stroke and stress–The relationship between stress and heart disease and stroke isn’t entirely clear, however some individuals with high levels of stress or prolonged stress may have higher blood cholesterol, increased blood pressure or may be more prone to developing atherosclerosis or narrowing of the arteries). If your life is full of stress, it can be difficult to lead a healthy lifestyle. Instead of being physically active to relieve stress, some individuals might respond by overeating, eating unhealthy foods, consuming too much alcohol or smoking–reactions that can increase can heighten the risk of developing heart disease and stroke.”
Thinking of how Victor usually handles stress, Nikki said to herself, “Or, they yell and scream at everybody around them, whether or not they deserve it!”
After stretching a bit, she went on. “Responding to stress with anger can also be harmful, since it sets off a series of physiological changes including increased heart rate and elevated blood pressure levels that can increase your chance of having a heart attack. And, individuals who are prone to anger are also more likely to turn to unhealthy behaviours such as smoking, excessive alcohol consumption and overeating.”
“Guilty, guilty and guilty! Victor needs to learn to handle stress better! If he had, he wouldn’t be in this mess, none of us would!”Nikki bit out from between clenched teeth as she pounded the binder of research once with her fist.
“Stress-busting tips–Identify the source of your stress. Figure out what’s really bothering you–it’s the first step in managing your stress. Be physically active. It can be a great stress-buster and a boost to your heart health too! Make sure to talk to your doctor before beginning any activity program. Share your feelings. Talking to your friends, family or coworkers can help you feel better.”
‘Victor; talk about his feelings–not in this lifetime!’ Nikki thought to herself shaking her head before continuing. “Take time for yourself. In trying to meet everyone else’s needs, don’t short-change yourself. Make time for yourself. Make time to laugh. It’s the body’s natural stress-release mechanism. Eat well. Don’t skip lunch, and leave the office if you can. Don’t skip vacations. Getting away from it all is important to your mental and physical health.”
“Whoever came up with this has definitely never had anybody like Victor for a patient. Aside from taking time for himself and not smoking or drinking too much, aside from the last few days and the last couple of weeks, I don’t think he’s ever done any of this stuff! Although, usually he’s usually pretty good about his diet.”
“On the other hand,” she thought with a slow, somewhat devious smile, “I have another excuse to pester him about going on vacation.”
Reminding herself why she was doing this and how it did no good to focus on Victor’s many shortcomings and faults, Nikki continued. “Risk Factors you can’t control–Age– The older you get, the better your chances of having a stroke. Even though strokes can happen at any age, the majority of them happen to individuals over sixty-five.
Gender– Men have a higher risk of having a stroke than women. This is especially true for men over age fifty-five and for women the risk increases after menopause. Until menopause, women have a lower risk than men. But, ultimately, more women die of stroke than men. A family history of heart disease or stroke– Your risk of heart disease increases if close family members i.e. parents, siblings or children developed heart disease before age fifty-five, or in the case of female relatives before menopause. It also increases if you’ve had a previous stroke or a TIA, your risk of stroke is increased. Ethnicity–First Nations people and those of African or Asian descent are more likely to have high blood pressure and diabetes and therefore, are at increased risk of heart disease compared to the general population.”