Deborah Howell (Host): Hello, everybody, I’m Deborah Howell. You are listening to Weekly Dose of Wellness brought to you by MemorialCare Health System. Today’s guest is Dr. Ewa Farrelly, a family doctor at MemorialCare Medical Groups, new primary care office in Long Beach. Dr. Farrelly went to medical school at USC and completed her training at the Long Beach Memorial Family Medicine residency program, where she was chief resident in 2011 and 2012. Her philosophy of medicine is to provide patients with the education and tools to take control of their own health. Amen. Welcome, Dr. Farrelly.

Dr. Ewa Farrelly (Guest): Thank you.

Deborah: We hear a lot of talk these days about knowing your numbers. So what does is mean to know your numbers?

Dr. Farrelly: Well, knowing our numbers doesn’t just mean memorizing results of our last blood test.

Dr. Farrelly: There’s usually a whole lot of tests that come back and you don’t really need to know them all. What we mean when we say “know your numbers” is knowing which ones are important, what these numbers mean in regards to our health, and knowing what values we should strive for, you know, what the normal values are.

Deborah: Yes. And also getting a baseline, so that if something is elevated, you know what your normal baseline is.

Dr. Farrelly: Yes, because everybody is different. Deborah: Right. So, let’s talk about specific numbers. What are we talking about here?

Dr. Farrelly: Well, again, we are all different, so our medical history will dictate what lab tests we need to order, but all humans, we all share the same enemy. And that enemy is heart disease.

Deborah: Yes.

Dr. Farrelly: So, to help us prevent heart disease, we do check a lot of numbers, and those are the ones that are important for you to know. Those numbers are your cholesterol, your blood pressure, your weight and for those of you with diabetes, hemoglobin A1c.

Deborah: And when we say the first one, we need to know the good and the bad cholesterol numbers.

Dr. Farrelly: I was – yes, I was going to go into those details...

Deborah: Yes, we have time.

Dr. Farrelly: Let me describe. So cholesterol is really confusing. There is probably about six numbers that show up when you get a cholesterol panel. But the most important ones for you to remember are the LDL, which is known as the bad cholesterol, and the HDL, which is known as the good cholesterol. And sometimes it’s good to look at the triglycerides as well.

Deborah: Okay.

Dr. Farrelly: Back in the past, we used to just look at the total cholesterol, and it’s easy to remember; we were always told: “Hey, we want it to be less than a 100.”

Deborah: Right.

Dr. Farrelly: Or two hundred. But that’s not always what we, doctors, use to help treat you. We actually look mostly at the LDL (the bad cholesterol) and the HDL (the good cholesterol).

Deborah: Are people actually hospitalized for high cholesterol just as a symptom of itself?

Dr. Farrelly: No, not that I’ve ever heard of.

Deborah: Okay, I was always curious about that. But it is what it does to the body.

Dr. Farrelly: That’s correct.

Deborah: Okay.

Dr. Farrelly: So that bad cholesterol can cause problems with your heart, your kidneys, your brain in the future; and so we want it treated early to prevent those problems from happening.

Deborah: Absolutely. That was very, very well put. Thank you so much, doctor. What do these numbers tell us and our doctors about our health?

Dr. Farrelly: So, let’s start with the LDL, the bad cholesterol. It’s what the doctors used the term whether you need medicine or not. So, our goal is to strive for an LDL of less than 100, but generally we won’t treat you until it’s above 160. So, we like to just keep a close eye on it if it does get above a hundred and then work with you to drop those numbers. On the other hand, the HDL, the good cholesterol, is really what we use in research as a marker of heart disease risk. So, if that HDL is above 60, you’re doing a great job, you’re really less likely to get heart disease. We count that as a negative risk factor, meaning a good thing. But anything below 40 is an increased risk of heart disease and so we work with you to drop that.

Deborah: Now, when you say you work with the patient, do you immediately just put them on medicine or do you try to get then to do dietary changes and maybe some exercise regiments before you go to the medication level?

Dr. Farrelly: I am definitely a “postpone the medicine as long as you can” type of doctor. And I do work with my patients really closely to get them to work with their bodies to make their body better. Exercise, change in diet, increased water intake. Things like that can really change your numbers without needing to be dependent on the medication.

Deborah: Okay. This is a little bit off topic, but I wanted to ask so many people so many times, and this might be the chance. You said: “Increase your water intake”. Some people think that when you drink so much water, it saps the vitamins from your system. Can you speak to that?

Dr. Farrelly: I have never actually heard that before. I don’t believe that at all. I think that what’s – how do I explain this? When we eat the appropriate amount of vegetables and meat, the proteins that we need. Those will be absorbed into our body. Water goes kind of a separate route and it does get absorbed into our body and then it goes out our kidneys. And we can have as much of it as we need. Of course, we worry about the sodium. So we don’t want to have too much or too little.

Deborah: What is it about the sodium that is so harmful?

Dr. Farrelly: Well, it can increase our blood pressure significantly because it keeps the fluid in our blood vessels. So we have more pressure. And so, keeping our sodium at a reasonable amount is a good thing to drop our blood pressure. But having too little is also bad.

Deborah: So, retaining water is not just bad for the thighs because your jeans don’t fit; it’s actually a medical problem.

Dr. Farrelly: That’s correct.

Deborah: Okay. How often should we have our blood work done to monitor our numbers?

Dr. Farrelly: That’s a really good question. And it completely depends on who you ask. You’ll have some doctors that check every six months and some doctors that check every five years.

Deborah: Wow.

Dr. Farrelly: But it’s important to realize that almost all the medical guidelines recommend a cholesterol tests every five years for healthy adults – not every year. But your blood pressure should be checked at every visit and so should your weight.

Deborah: Okay. And when do the alarm bells start going off in terms of weight gain? They say over 40 you’re going to gain five pounds every five years or something like that. But at what point do you start raising your eyebrows as a physician?

Dr. Farrelly: Well, I keep a close look at that BMI number you may have heard of a lot: the Body Mass Index. Because it takes into account your height as well as your weight. And so, if your BMI is getting higher and higher every time I see you, then we’re going to start having that discussion about what’s going on in your life, why is this happening?

Deborah: Right.

Dr. Farrelly: I expect some weight gain, especially in women; it’s a natural part of getting older.

Deborah: Right.

Dr. Farrelly: But I do keep a close eye on how fast it happens.

Deborah: Okay, that’s reasonable.

Dr. Farrelly: You know, no more than one pound every few months. Deborah: You shouldn’t be gaining much more than that.

Deborah: Okay. Now, in addition to knowing our numbers, doctor, and keeping them in check; what other things can we do to contribute to overall wellness?

Dr. Farrelly: Oh, there’s so much. You know, I cannot emphasize over and over how important it is to exercise.

Deborah: Yes. Are we talking aerobic exercise or just anaerobic?

Dr. Farrelly: Both. So, aerobic exercise is important, because you’re stimulating your heart and lungs. You’re letting them be active and keeping them healthy. You’re stimulating your body to convert that fat into energy. And you’re releasing endorphins into your body that improves your mood, makes you feel good, makes you realize that you are a great person.

Deborah: Runner’s [high].

Dr. Farrelly: Whereas the anaerobic or weightlifting exercises are really important because you’re stimulating your muscles to use up all that sugar that’s floating in your blood.

Deborah: Right.

Dr. Farrelly: And you’re also strengthening your bones so you don’t get osteoporosis or bone loss.

Deborah: Women, women, women – weightlifting, yes.

Dr. Farrelly: Yes.

Deborah: Not huge bar bells. You don’t have to do that, unless you want to.

Dr. Farrelly: Little three and five-pound weights are the best.

Deborah: More reps, less weight, right?

Dr. Farrelly: Exactly.

Deborah: And how often should we be weight training every single week?

Dr. Farrelly: I recommend two to three times a week. And not for a long time. I never tell people to go out and workout for an hour, because that’s a big part of your day.

Deborah: Yes.

Dr. Farrelly: I recommend 30 minutes of exercise every day. And two of those days to be with weights.

Deborah: Okay. That’s reasonable. Exercising can just be walking, you know.

Dr. Farrelly: That’s true. It can definitely be walking, as long as you do it briskly and you feel a little bit tired after you finish.

Deborah: Right. I can’t believe this; our time is up already. We could go on for weeks.

Dr. Farrelly: Wow.

Deborah: I know.

Dr. Farrelly: Definitely.

Deborah: Thank you so much for being such a great guest. We’ve been speaking with Dr. Ewa Farrelly about the importance of knowing your numbers in order to maintain your overall wellness. I learned a lot, I had a great time and hope you did too. Thank you, doctor, for your time today.

Dr. Farrelly: Thank you so much.

Deborah: I’m Deborah Howell and I hope you can join us next time as we explore another Weekly Dose of Wellness, brought to you by MemorialCare Health System. Take care, know your numbers and have a wonderful week.