Hypertension, diabetes most common diagnoses at Cherokee Nation health

BY D. SEAN ROWLEY
Senior Reporter
02/13/2019 08:29 AM
Main Cherokee Phoenix
Dr. James Baker, medical director for the Three Rivers Health Clinic in Muskogee, speaks with a patient. He said parents can teach children to make healthy dietary choices to avoid hypertension and diabetes, the most common diagnoses at Cherokee Nation health facilities. D. SEAN ROWLEY/CHEROKEE PHOENIX
TAHLEQUAH – Although it may not have been a clinical study, but the Cherokee Nation’s health clinics recently tracked the frequency of diagnoses among their patients, and at seven of 10 facilities, hypertension and type 2 diabetes were the most common.

Primary hypertension, or high blood pressure, was the most common diagnosis at nine clinics.

“A lot of blood pressure and a lot of sugar is genetic,” said Dr. James Baker, medical director for the CN Three Rivers Health Clinic in Muskogee. “You’re stuck with that, and of course Native American populations seem to be – this diet they have adopted, the modern day American diet – is not conducive to the Indigenous people. That makes it really frustrating. The fry bread and lard given through the commissaries was not what consisted diets of the Native Americans. The buffalo ran free, different grains and berries were available – that was Native America. Today’s diet is not conducive to good health, but good health is still achievable.”

Within the CN jurisdiction, the effects of technology are impacting health. Baker said cell phones, the internet and extended screen time are allowing calories to accumulate around people’s middles. He said the “5210” program encourages five fruits and vegetables, less than two hours of screen time, an hour of exercise and zero sodas per day.

Efforts to prevent high blood pressure and weight gain are aimed at fewer diagnoses at the clinics, but there will always be a need for treatments because of hereditary factors.

“The bottom line to all of the trials that have been done, is that it doesn’t matter what type of blood pressure medicine you’re on, the most important thing is getting control,” Baker said. “The Joint National Committee on the Treatment of Hypertension has changed the criteria, and the new number is 140 over 90. You’re blood pressure should not be over 140/90 if you are an adult less than 60 years age. If you are over 60 years of age, you can now be at 150 over 90.”

Baker said the first steps to treating hypertension involve lifestyle changes – diet and exercise, smoking cessation and reducing sodium intake.

“They now say to keep sodium down to 2400 milligrams a day,” he said. “Watch your cholesterol. Watch your sugar numbers if you are diabetic, moderate alcohol if you are a drinker. If you’re not, don’t do it at all.”

A sedentary lifestyle exacerbates health dangers, and Baker said regular exercise can mitigate hypertension, adding that something is better than nothing.

“Eat better, move more and be tobacco free,” he said. “Those things go a long way to help out. Find ways to make it happen for you. If you can’t go run a marathon, OK, but move. If you just can’t stop smoking, decrease the amount that you smoke. If you love your steaks and burgers and grilling, try to cut back on portion sizes. Anything you can do to have a degree of moderation.”

Baker said “all or nothing” also need not apply to medication. Some patients may be hindered by the expense of prescriptions or health conditions.

“If you can’t take all your medications, then take those that you can,” he said. “They will help. Those who can get closer to all those goals are in better shape, but those way out of kilter on blood pressure need to get some degree of control.”

Only the Gadugi employee health clinic in Tahlequah did not list hypertension as its most common diagnosis. Across 339 patient visits to this clinic, there were 73 diagnoses of acute maxillary sinusitis, which is a common cold symptom, and another 73 cases of “unspecified” acute maxillary sinusitis. There were 62 cases of allergic rhinitis due to pollen, and hypertension was fourth most common with 61 diagnoses.

At the Cooweescoowee Health Center in Ochelata, hyperlipidemia, or an overabundance of fats, triglycerides and cholesterol in the blood, was the second most common diagnosis.

At the Muskogee clinic, the second most common “diagnosis” was the child wellness examination.

“Our pediatricians are very aggressive about wanting to ensure that our children our fully taken care of,” Baker said. “Preventative screenings, anything they can pick up early on. They focus on the child’s wellness. There is a strong effort to determine if children are above the body mass index for their age groups. Are they showing appropriate growth? Are there changes that can be made so they don’t go on to develop hypertension or diabetes?”

Baker said child welfare exams are essential to identifying health issues, and they educate children and parents.

“It can help parents get on the right wavelength,” he said. “It’s important for your children to make the correct choices, and parents can go a long way to teach those choices.”

Baker said taste is a learned behavior. Kids might have a proclivity for sweets, but parents can explain how mom and dad grew up strong by eating healthy and encourage a good diet through action.

“A bowl of apples on the table is not enough,” Baker said. “The tender loving care of the parent slicing the apples and taking them around to the children, or glasses of water, will make the child more apt to do that.”
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