STAY HEALTHY. STAY OUT OF THE ER.


We love interacting with the people of the Laredo community, but we’d much rather do it outside the ER than inside it. Keep up with the latest knowledge from our professionals to help keep yourself in the peak of health.




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13/Dec/2018

 

Studies have proven a link between nutrition and school performance -better nutrition yields better learners.  When students engage in unhealthy behaviors, such as poor dietary habits, substance abuse, and lack of physical activity, their school performance suffers.

With the frenzied pace that usually accompanies a new academic year, however, it’s easy to choose speed and convenience over nutrition.  Students often try to squeeze eating in between activities such as classes, extra-curricular activities, sports practices, homework, and after-school jobs – making it easier to opt for fast food and vending machines. However, with a little bit of planning, we can shape better habits that will improve nutrition and learning. Here are five tips you should keep in mind:

1.) An extra five or ten minutes of sleep may sound good, but arranging for enough time every morning to sit down to a nutritious breakfast can really pay off.  So, skip the donuts and sugary cereals and choose high-fiber whole grains and protein. One of the best choices is old fashioned oatmeal, which can be made quickly and topped with fruit and almonds. Whole wheat toast and an egg can be a healthy choice, too. Keeping hardboiled eggs in the fridge and ready to go makes them a fast, on-the-go power breakfast. If you’re concerned about the fat content of eggs, just skip the yolks – they are easily removed from hard-boiled eggs and also can be separated from the whites before cooking other egg preparations.

2.) Fish rich in omega-3 fatty acids have long been heralded by nutritionists as a superior brain food, and though fish consumption is on the rise, Americans still eat far too little. And that’s a shame because eating these kinds of fish can actually reduce our risk for dementia and mental decline and can enhance our memory.  While salmon and trout are some of the best choices, tuna can also make a great choice for a healthy school lunch. Simply grab some whole wheat crackers and a package of water-packed tuna for a great start to a brain-healthy lunch – or mix some in with ready-to-eat salad greens.

3.) A small number of nuts or seeds, like walnuts, almonds, or pumpkin seeds, along with dark chocolate, can actually make a healthy snack – and it tastes great, too! They have powerful antioxidant qualities, which help with cognition. Plus, the small amount of caffeine in chocolate can give you a little boost of concentration when you need it. Just don’t overdo it: keep these snacks to one ounce per day.

4.) Trade white for wheat everywhere you can. It’s just as easy to make lunches from a sandwich on whole wheat bread instead of white bread, and many breakfast cereals boast whole grains, too (but be sure to read labels and look for choices high in fiber). Make a big batch of whole-wheat pasta salad with veggies, herbs, and olive oil to have on hand in pre-portioned containers for healthy, convenient lunches.

5.)Berries are another great way to add a sweet flavor without feeling guilty. Blueberries and other berries can help with memory due to their antioxidants. Berries also are high in fiber. They’re easy to toss into a reusable container for a healthy morning snack between classes.

 

We know that these changes may seem big, but they can be really easy to incorporate into your daily habits if you just give it a try. And if you still feel that you’re not getting enough nutrition from your diet, ask your doctor about a vitamin and mineral supplement.

 

 

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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13/Dec/2018

Each August, as we transition from summer to a new academic year, a shift in our daily routines is just one of the significant changes we undertake. One of these changes is that of our sleep schedules. During the summer months, sleep cycles for many people become distofdfdrted, causing us to go to bed later, wake up earlier, and get less rest than what can ideally sustain our bodies in the coming seasons. By getting less than the recommended amount of sleep, we are wreaking havoc on our internal clocks at a pivoted point in the year!

Getting a sufficient amount of sleep as we adjust to a new routine is really important – and not just to prevent us from dozing off in class or other activities. Not getting enough sleep may also lead to a number of serious health conditions, such as obesity, diabetes, depression, substance abuse, and even heart problems such as irregular heartbeat, high blood pressure, and stroke. Inadequate sleep is also a factor in what the Centers for Disease Control estimates as 6,000 fatalities are caused by drowsiness each year.

In addition to helping us avoid all these pitfalls, getting adequate sleep actually helps us become better learners – improving attention, alertness, and even our problem-solving skills. Plus, getting the proper amount of sleep can lower our stress levels, improve mood, and enhance physical coordination.

All this means that taking a few simple steps to get our sleep schedules back on track for the start of the school year is totally worth it, especially since most students in middle school and high school don’t get enough sleep on school nights. While adults can thrive on 7-8 hours of sleep, according to the American Academy of Sleep Medicine, elementary and middle school students need 9-12 hours per night, and teens need 8-10 hours each night. Here are a few pointers that can help:

– Start gradually. About a week or two before a major change in schedule is expected, begin to adjust bedtimes and wake times by about 15-30 minutes a day toward your optimum weekday schedule.

– Be diligent. While it might feel good to hit the snooze button a few times each morning, sticking with your plan to adjust your sleep cycle will be worth it in the end.

– Do it together. Have the entire household participate, not only to keep each other accountable, but also to let everyone reap the benefits of better sleep.

– Observe. As you begin to adjust your sleep schedule, take note of how you feel throughout the days and whether it gets easier each day to wake up.

– Use technology. Fitness gadgets and apps can help track your sleep duration and quality.

One more extra step you can take is to join the campaign for sleep. School districts across the country are beginning to see the value in later start times for school, especially at the high school level. The American Academy of Sleep Medicine actually recommends that middle and high schools start no earlier than 8:30 a.m., arguing that the later start time helps kids get the sleep they need to perform well in school and stay healthy. So, if your school district gets an early start each day and you feel your kids could benefit from a later start time, share your concerns with the district.

 

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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13/Dec/2018

Vacation may be one of the most exciting aspects of summer breaks. We enjoy extended time off of work or school, traveling to new or favorite familiar places, eating good food and enjoying time with friends. We certainly look forward to it and we know you do too! But catching the travel bug can also lead to catching foreign illnesses if we aren’t prepared for the health concerns we might face at our destination.

In order to know-before-you-go, let’s take a look at some of the steps you can take to ensure you and your family stays healthy before, during and after your trip.

Pre-trip

– Investigate health concerns at your destination – Many destinations in the US and abroad pose unknown health risks. Zika, measles outbreaks and damage caused by hurricanes are some of the most common issues that travelers will face this summer. Research the potential risks for your destination by checking the CDC’s destination list.

– Create a travel health kit – Prescription and over the counter medicines are easy to remember to throw in your toiletries bag, but a great way to prepare for small, unexpected issues is to put together a travel health kit. The kit should include not only your medicines, but also first aid supplies, sunscreen, bug spray, and your health insurance card.

– Expect the unexpected – Have copies of your passport, credit cards, health insurance cards and contact information to leave for a trusted family member or friend in case they get lost during your travels. If you’re traveling to another country, find out if your insurance plan covers medical costs abroad.

 

During Your Stay

– Be conscious of what you’re eating and drinking – There’s nothing worse than having a full day of activities planned canceled because you came down with food poisoning. Pay close attention to the freshness of seafood and meats. If you’re venturing to Latin America, be sure to drink bottled water instead of water from a tap.

– Protect yourself from extreme temperatures – Hot or cold, the elements can do damage to your body. Always wear sunscreen of at least SPF 15 or higher in the sun, and wear protective gear that covers your head, hands, and feet in colder climates.

– Always wear your seatbelt – Did you know that motor vehicle crashes are the number one killer of healthy US citizens in foreign countries? Some general guidelines for choosing transportation in a foreign country are to only ride in marked taxis, be alert when crossing the street (especially in countries where drivers are on the left), and avoid over-crowded or top heavy modes of transportation.

 

Post-Trip

– Pay attention to how you feel – Travel-related illnesses may not present themselves until after you are home. Even if you felt fine when you got back, if you start feeling sick over the next few days, it may be time to see a doctor. Post trip symptoms that warrant a doctor’s visit can be fever, persistent diarrhea, or skin issues such as rashes, boils, or bug bites.

– Boost your vitamin C intake – Give your immune system some help in recovery by eating fruits and vegetables rich in vitamin C. Broccoli, cauliflower, tomatoes and strawberries are all excellent sources of vitamin C. Health supplements like Airborne and Emergen-C have also shown to improve immune system function.

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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13/Dec/2018

Being healthy does not only mean taking care of yourself physically, it also means taking care of yourself mentally. Do you ever get the feeling that you’re stressed out ALL of the time? You work 8+ hours a day, the kids need taking care of, the ins and outs of everyday life are dragging you down faster than you realize and trying to be healthy can take a back seat to managing the hassles.

 

It’s time to start thinking of the big picture of your health including mental health! When life starts to slow down over the summer and school break is in full swing, it’s the perfect time to start taking care of YOU. Here are 7 simple things you can do to give yourself the boost you deserve:

 

– Switching up your workouts – With the days getting brighter earlier, add walking or biking first thing in the morning to your daily routine! Either with a friend or by yourself, the combination of a fresh experience with physical activity is sure to give your mood a boost.

– Cleaning the house – Focus 5 to 10 minutes of your day cleaning or reorganizing the part of the house that you spend the most time in. Even just small amount of cleaning can help you feel like your life is less cluttered, helping lower the opportunity for anxiety and depression to creep in.

– Freshen up your summer wardrobe – New sunglasses? New beach bag or bathing suit? Go for it! Treating yourself with summer themed items will help you get in the carefree attitude. They don’t call it retail therapy for nothing!

– Plan a vacation – Summer is all about rest and relaxation, and the best way to do that is to get out of town (or just out of the house). Whether you’re taking a trip abroad or having a night at a hotel downtown, vacations can help you hit the reset button. See a new show, try some new food, get out and discover new places! New experiences equal new knowledge, and expanding your mind is an important aspect of maintaining mental health.

– Get some sun – Hey sunshine, it’s time to open up those blinds! When you wake up in the morning, walk over and pull the curtains open. It sounds like a no-brainer, but studies have shown that more sunlight can boost your happiness and energy levels!

– Do some summer reading – Whatever your preferred genre is – biographies, murder mystery, sci-fi or romance – indulging in a good read can be a much-needed daily escape! On the beach, on a park bench, in the backyard or just on the sofa, pick a few interesting titles and lose yourself.

– Make time for naps or meditation – Nothing restores your state of mind quite like a power nap. Take 20 minutes every day to lay down, or just be still and breathe. Sleep or focus on positive things in your life or the goals you’re trying to accomplish that day/week. A little daily time of being centered can manifest health benefits over longer periods of time!

 

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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13/Dec/2018

We all know that the month of July is a time for fun in the sun! Many of us are flocking to vacations, pool parties, camping trips and sporting events that will occupy a large part of our time during the warmer months. These activities can be exciting, but they can often take a dangerous turn if we are not thinking about our exposure to the elements – Heat Exhaustion can strike without notice or warning, and quickly turn to the more deadly Heatstroke without treatment.

The CDC tells us that heat-related illness kills up to 600 people every year in the US alone, but we can easily avoided it if we can recognize the risk. Obvious risk factors like time of day and activity level do play a major role in the onset of heat-related illnesses, but there are other contributors that may not be as easily noticeable. Some important factors to recognize are:

1.)Using prescription medication – The elderly are especially susceptible to heat-related illness due in large part to the use of medications that are used to treat heart conditions, blood pressure or urinary problems. If you are out and about on a hot day with your grandparents or other older friends, be sure that they are properly hydrated, shaded and have frequent breaks from activity.

2.)Alcohol use – It’s safe to say that people who are on vacation or at a backyard party are usually not thinking about the risk of sun exposure as their first concern, especially once someone has had a few drinks, protection from the sun may be an afterthought. For those times this summer when the only thing on your mind is having a good time, be sure that sunscreen, shade, and hydration come first!

3.)Being overweight or obese – anyone carrying more weight can be prone to overheating quickly. As the body is expending more energy to move, it also cannot process the heat it’s taking on through thicker bodily layers. This combination can be a fast track to heat-induced issues for people who are overweight.

We know that recognizing risk factors is half the battle when it comes to fighting heat-related illness, but the other half is being able to identify heat exhaustion and heatstroke in time to avoid permanent physical consequences.

 

Heat Exhaustion

 

Heat Exhaustion can be thought of as the precursor to Heatstroke, and though it is less serious, treatment should be rendered immediately if you see someone displaying symptoms.  Identifiable symptoms of heat exhaustion are:

  • Muscle cramping
  • Nausea or vomiting
  • Excessive sweating
  • Cold, clammy skin
  • Dizziness or fainting
  • Headache

 

The best treatment for Heat Exhaustion is to help that person to cool themselves and lower their body temperature. A person suffering from mild Heat Exhaustion can recover if they take the steps rest and thoroughly rehydrate – move into the shade, remove excess clothing, drink water or a sports drink, and run cold water over the skin if it’s available. If the symptoms do not improve within an hour, it’s time to call a doctor.

 

Heatstroke

 

After the stages of Heat Exhaustion progress, we are now dealing with the most dangerous heat-related illness: Heatstroke, and it can be deadly. Heatstroke can cause damage to nearly every major bodily system if not treated immediately. Recognizable symptoms of Heatstroke include:

  • Hot, dry skin (this person is no longer sweating)
  • Racing heartbeat
  • Confusion
  • Slurred speech
  • Loss of consciousness
  • Seizures

 

It is vitally important that anyone who is suffering from Heatstroke seek emergency medical attention immediately because as we mentioned before, permanent damage to the body and its functions can occur very quickly.

 

The bottom line for fun in the sun: if you’re going to be out in it, be prepared! Pack sunscreen, shady hats, and plenty of fluids. The risk of Heat-related illnesses can definitely be scary, but with awareness and knowledge, you can enjoy your summer fun knowing that you’re ready to handle the heat!

 

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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13/Dec/2018

Studies have found that people have the potential to be their happiest in their 50s. If you are in your 50s with many of life’s challenges well behind you, you may agree. Perhaps you have a little more free time – more time to focus on what fulfills you. More time to find new interests. More freedom and flexibility.

 

However, your 50s can also be a time of some physical decline for those not staying vigilant about their health. A slower pace of life can also induce boredom and even depression. Physical aches and other medical conditions can begin to show up, seemingly out of nowhere, leaving you with a feeling of hopeless.

 

On the other hand, there is good news! In your 50s, you are still young enough to stay fit – or even to get fit if you aren’t already. And you are also young enough to learn new habits, adopt new ways of thinking, and adapt to new lifestyle changes that will leave you happier than ever – like these:

 

  • Eating smarter – Including more healthy fats, like those found in salmon, almonds, and avocados, has been shown to improve heart health. Eating more fruits and vegetables, fortified cereals, and other sources of whole grains, are great choices for bodies with slower metabolisms. Be sure to drink your milk, too – or find calcium in other foods like low-fat cheeses.
  • Exercise – It’s never too late to start the latest exercise craze – or to return to a sport you loved in your youth. Regular exercise can help reduce your risk of memory problems later in life, keep your joints strong and flexible, and lower your risk of heart problems and cancer. Whether you enjoy a brisk walk, a jog in the park, yoga, or even weight lifting, exercise is great at any age – and using technology to track your progress is a great way to stay on track and accountable to yourself. Smartphone apps and wearable gadgets abound and can help you improve your health one step at a time.
  • Continue to learn – This phase of life is the perfect time to learn something new – like a musical instrument, a foreign language, a craft or technical skill, or even a new vocation that can turn you into a budding entrepreneur. Science shows us that learning actually keeps our brains healthy, in addition to making us happier people.
  • Socialize – In our 50s, many of us are starting to find ourselves with empty nests. That makes it a great time to build our social circles. Host a book or dinner club. Organize a block party. Make new friends. Even a new friend with four legs can be a great addition to your life – and pet owners have been found to have lower cholesterol and risk of heart disease. Go figure, and go adopt today!
  • Take care – Even if you aren’t the type to dutifully visit your physician’s office once every year, make it a habit in your 50s. Staying on top of your health with regular well checks in your 50s can help you identify early signs of manageable, treatable conditions – before they become debilitating.  In other words, visiting the doctor now while you are still healthy can help keep you that way for decades more to come.

 

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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13/Dec/2018

When we contemplate eating healthfully, we usually think about the types of foods to avoid – things like saturated fats, refined carbohydrates, sodium, added sugars, etc. As part of Nationals Men’s Health Month, we are excited to celebrate all the amazing foods and beverages that are both delicious and healthy – and are especially good for your heart.

Heart disease is the leading cause of death for men in the US, and one way to help lower your risk is by eating well daily. Making changes in your diet to consume more heart-healthy foods and fewer unhealthy foods can be easier when you enjoy these tasty options:

Salmon and other fish rich in omega-3 fats – Try to eat at least eight ounces of salmon and other fish like tuna and trout each week.  These types of fish contain high amounts of omega-3s, which have an anti-clotting benefit to keep your blood flowing and can lower your triglycerides.

Other examples of heart-healthy foods include:

1.) Walnuts – like salmon, walnuts, along with other nuts like almonds and cashews, are high in omega-3 fats and can improve your cholesterol levels. Eat five ounces each week for a heart-heathy snack or use as a salad topping

2.) Berries – Raspberries, blueberries, cranberries, and strawberries are all high in antioxidants, fiber, and vitamin C, which can help lower your risk of stroke.

3.) Oatmeal – Start your day with a hearty bowl of oatmeal, which is loaded with soluble fiber that can help reduce heart disease and improve cholesterol.

4.) Fruits and vegetables – You can’t go wrong with a diet high in fruits and vegetables, but choosing spinach, tomatoes, asparagus, avocados, and broccoli will deliver nutrients that are great for your heart health.  Fruits like oranges and cantaloupes are also high in fiber and nutrient rich.

5.) Coffee and green tea – Even that cup of joe you look forward to every morning can help decrease your risk of developing heart failure and stroke, when consumed in moderation. Green tea has been shown to help reduce high blood pressure, too.

6.) Red wine – When consumed in moderation, red wine, with its antioxidants, is a better choice for your heart than other alcoholic beverages and can improve good (HDL) cholesterol levels.

7.) Dark chocolate – Perhaps we’ve saved the best for last – and it’s the perfect dessert to end a heart-healthy meal. Dark chocolate, in moderation, has been shown to protect against atherosclerosis – a build-up of plaque inside the arteries.

We think these heart-healthy foods are winners for their taste and for their health value – and with all of these heart-healthy choices, it will be easy to observe National Men’s Health Month with great eating. For more ideas on how to incorporate heart-healthy choices into your diet, check out the American Heart Association’s “Healthy for Good” recipes at https://recipes.heart.org/.

Here’s to your health – and to great, heart-healthy food!

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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13/Dec/2018

Exercise can improve your mood and attitude. What you might not know is that the reverse is also true: a positive attitude can improve your workouts. It’s pretty easy to see, then, that a positive attitude/powerful workout can be a great back and forth cycle that can really get you healthy, fit, and strong.

 

But how do you accomplish this in the first place? How can you overcome a lack of confidence that may be hindering your performance in the gym? It turns out that turning your mindset around isn’t as hard as you might think, as long as you take it one step at a time:

 

  • Set attainable goals – You are more likely to feel like a winner when you set realistic workout goals for yourself each day, based on how you feel that day. If you’re steadily building up repetitions and staying healthy – great! Keep going! But if you find yourself injured, don’t be discouraged. Adjust your goals based on what you can accomplish – and do as much as you can to stay on track.
  • See yourself winning – Whatever your ultimate goal is – competing in a triathlon, bench pressing a certain weight – picture yourself doing exactly that. Doing so can help you get in a mindset that will get you ready to work toward your goals.
  • Encourage yourself – No matter how you are feeling – whether inadequate, confused, or discouraged – you can always remind yourself that you can achieve your goals. When faced with real obstacles, like injuries, it’s important to stay positive but also be as compassionate with yourself as you would be with a workout buddy. Adjust your routine as needed but remind yourself of your successes to stay on track. Even just giving yourself a pep talk, like you would with a workout partner, can help elevate your mood, improve your attitude, and lead to better performance.
  • Disconnect – The headlines in the news from around the world can get us feeling down, so make sure you head into every workout with a clear head. Disconnect from news media or other sources of discouraging news and focus on just you. Listen to music and warm up. Or listen to complete silence as you meditate. Free yourself from the worries of the world, even if only for a short time, so that you can focus on a proper mindset for a killer workout.
  • Find support – Building a support network – even if it’s just one person cheering you on – can also help you stay motivated and ready to succeed. Supportive people can also help keep you accountable, positive, and moving toward your goals.
  • Give yourself a break – Give yourself permission to take a breather from your workouts when you really need it. Sometimes our bodies just need some recuperation time, and that’s OK. Use that time to continue to chart your path toward achieving your goals.
  • Then keep going – When you’re ready to work out again, give it all you’ve got – and remember the successes that have gotten you to where you are. Keep your goals in your sights and believe – really believe – you’ll reach them. And you will.

 

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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13/Dec/2018

If someone were to tell you that the simple act sitting down could put your health at risk, would you believe them? Sitting may seem like the most innocent of tasks, but studies have shown that extended periods of uninterrupted sitting may raise your risk of serious illnesses like heart disease or diabetes. Sitting is an unavoidable professional hazard for most of us, but there are steps you can take to increase your daily levels of mobility.

 

Ways to Sit Less and Move More

  • Nudge yourself – set an alarm on your phone or smart watch to remind yourself to get up at least once every 90 minutes.
  • Go mobile – need to take an important phone call? Walk and talk! But be aware of your surroundings, distracted walking and talking can put you and others at risk.
  • Get personal – instead of emailing or calling your coworkers, walk over to their space for a face-to-face discussion.
  • Step it up – keep track of your daily steps with your smart phone or watch, or a fitness tracker.
  • Go the distance – take the stairs instead of an escalator or elevator.
  • Try a standing desk – if your office allows for work at a counter or for a motorized standing desk, opt for the standing option.

 

 

 

If you need another reason to consider standing, making time to stand can also help you burn calories. By taking just one hour a day to stand, you could potentially burn over 300 additional calories per day.

 

Consider these tips the next time you feel chained to your desk. Now get up and get moving!

 

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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13/Dec/2018

Many families have felt the impact a stroke can have on a loved one, bud did you know that the Hispanic community might be more at risk than others? Stroke is currently the 4th leading cause of death for Hispanics, and compared to non-Hispanic whites, our community is having strokes at much younger ages due to risk factors such as high blood pressure, diabetes and obesity.

 

But what is a stroke and how can you recognize when it’s happening to yourself or someone else? A stroke occurs when blood flow to an area of the brain is restricted or cut off, resulting in brain cells dying due to lack of oxygen. This can affect facial movement, as one side of the face may begin to droop, as well as causing slurred or impaired speech. Strokes are a medical emergency, so if you witness someone exhibiting these signs, call 911 immediately.

 

While this information may seem alarming, over 80% of strokes can be prevented with healthy lifestyle adjustments.

 

 

How You Can Prevent Stroke

Here are some steps you can take to significantly reduce your risk of stroke:

Aspirin: Aspirin can help reduce your risk of stroke, but do not take Aspirin if you think you may be having a stroke, as this may make some types of stroke worse.

Blood Pressure and Cholesterol: Monitoring your blood pressure and cholesterol can help you recognize your risk factors sooner.

Eat healthy and stay active: Choose healthy foods with less salt, as sodium can raise your blood pressure. Try getting at least 30 minutes of light physical activity in per day.

Go to the doctor: If you feel you are at risk, find a doctor you feel comfortable with discussing your health and risk factors with, including your age, lifestyle habits and if anyone in your family has had a stroke.

Get other health conditions under control: If you have a condition like diabetes already, be sure that you are managing it daily.

 

While scientists aren’t sure exactly why Hispanics are at a greater risk for high blood pressure, obesity and diabetes, these risk factors are all preventable or manageable. With a conscious effort, you can help yourself avoid preventable stroke.

 

 

For more health tips, follow us on Facebook! Laredo Emergency Room is open 24 hours a day, 7 days a week, 365 days a year.


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