Simple Strategies in Preventing & Treating Viral Infections

Simple Strategies in Preventing & Treating Viral Infections

by | Mar 3, 2026 | Healthy Living

Thankfully the cold and flu season will soon be behind us. In northern Idaho it seems like so many people are getting sick with multiple complications. New strategies and old remedies really do work, but few people know about them or use them effectively.

Reducing the Viral Load
The virus invader attacks the body first through the nose and throat. Once inside the moist warm environment it multiplies exponentially. The first warning is a light irritating runny nose or scratchy throat.  

While the first symptoms may be small, it’s imperative to act immediately to reduce the exponential viral replication! It takes some time for natural immunity to recognize the invader and initiate the response to destroy it.

Once immunity is activated white blood cells move into the nose and throat to attack the invaders. The area becomes red, swollen, edematous and painful. Mucus production increases to flush the virus out of the system. This process is an amazing creation from God to heal the body and the common symptoms of a cold.

Early Treatment with Xlear
Recent studies have shown some antiviral and antibacterial properties of the nasal spray Xlear.  The main ingredient is a natural product: Xylitol. Emerging research shows promise by altering the salt concentration within the nose thus becoming more resistant to viruses and bacteria. The manufacturer states:

Using Xlear xylitol saline spray at the first sign of symptoms or after high‑risk exposures may help keep nasal passages moist, support mucus clearance, and potentially lower the number of germs in your nose, but it should be considered supportive care rather than actual medicine.

It’s recommended to be used twice a day, is inexpensive and available on Amazon.

Listerine Gargle
When encountering those first symptoms it’s important to destroy the virus that entered the throat. Listerine mouthwash is an antiseptic for the throat. Gargling with Listerine or a similar product 4 times a day helps to reduce viral replication.

Nasal Lavage
Few people perform nasal lavage, but this treatment is a major key for preventing sinus infections and highly recommended by ear nose and throat (ENT) physicians. The inflammation in the nose produces a great deal of watery mucus. The swelling and secretions often block the sinus passages and ultimately the mucus may become infected.

Nasal lavage is a method for rinsing the nose and sinuses with a saline solution which helps to flush the mucus out. It should be done at least twice a day. Individuals who suffer from frequent sinus infections should speak to a healthcare provider before using nasal lavage regarding the frequency of treatment.

The best approach is to insert warm water into the bottle, add the saline packet and shake it. Tilt the head facedown over the sink. Open the mouth and squirt the solution into one nostril and then the other until the solution is gone.

Discomfort and stuffiness are reduced when the mucus is flushed out. The bottle and solution may be purchased from most pharmacies.

Inhalers
As the virus irritates the back of the throat and airway some people may experience an annoying hacking cough with certain more virulent viruses. Individuals who have issues with coughing should speak with their healthcare provider about the benefits of having an inhaler on hand for more serious viral infections.

Most people use an inhaler incorrectly and don’t get the benefit from the prescribed medication. It’s vital to use an aerochamber or spacer for best results. Without it most of the medication ends up in the mouth and not in the lungs where needed.

Insert the inhaler into one end of the chamber and shake the device. Push the inhaler button and take a deep breath through the other opening. Hold it for 5 to 10 seconds, then take 5 small slow breaths in and out. Keep the mouth closed while the medication is moving deeper into the lungs and don’t talk for 5 minutes. Repeat the process for the second puff.

This technique allows the medication to move deeper into the lungs opening and relaxing the airways thereby reducing the cough.

Cool Mist Vaporizer
Using a cool mist vaporizer at night allows moisture to enter dry and irritated nasal passages, irritated throat and lungs.

Cepacol Extra Strength Sore Throat and Cough Lozenges with Benzocaine
An irritated throat can cause trauma to the voice box. Benzocaine causes a numbing sensation within the throat and helps soothe the irritated areas. Voice rest is a must!

Warm Tea with Honey
This treatment seems simple but is also very effective to soothe an irritated throat.

The Importance of Vitamin D
Vitamin D is needed for every immune cell to wage war against a virus, bacteria or cancer cell. Remember once used it needs replaced. Further complicating the situation, it takes 3 weeks from the intake of the D3 supplement to be converted into the Vitamin D hormone the immune system can use.

Another problem is that physicians disagree on what is considered an appropriate level. Complicating the issue is most lab values are often outdated. When research changes it may take years for those new values to be reflected in the lab result on a blood test report.

Few people in northern climates get enough Vitamin D from the sun. It’s imperative to get a Vitamin D level lab test. It helps the healthcare provider determine the best dose for the individual. Vitamin D3 and K2-M7 along with calcium promote bone strength and strengthen immunity.

Day Quil/Night Quil for High Blood Pressure
It’s best to let a virus run its course. A low-grade fever (<100.4 F) is a sign that the immune system is fired up doing its job. However, the symptoms can get annoying. Day Quil/NightQuil for High Blood Pressure helps reduce some of the discomfort. Seniors should consider beginning with half the dose. Its best to check with a healthcare provider before using this over-the-counter medication.

Healthy Lifestyles
A healthy diet rich in fresh fruits and vegetables, lean meats and dairy enhance immunity. Getting adequate sleep each night, physical activity and fresh air are vital.

Interestingly, Florence Nightingale (Godmother of Nursing) came from a wealthy family. During the Crimean War (1850’s) she found wounded soldiers dying from putrid hospital conditions. She opened the windows, changed the linens and dressings and literally brought sunshine and better food into their lives. The Lord used Florence and her nurses to heal the wounded. Simple things still help and apply to viral infections (colds), the flu and a host of abominable conditions of which people suffer.

When To See a Healthcare Provider
Dr. Jennifer Robinson described 6 situations when individuals should follow up with a healthcare provider.

  1. You have trouble breathing or have chest pain (seek immediate help).
  2. An adult with a temperature that lingers over 100.4 degrees F.
  3. You can’t keep anything down.
  4. Severe sore throat pain.
  5. Lingering cough.
  6. Lingering headache and congestion.

On A Personal Note
My goal is to post this blog on the first day of the month but I’m running behind. I was feeling overconfident that my last cold was 2 years ago. My prevention strategies were working! However, while caring for my young grandchildren with ear and sinus infections I contracted their bug.

While I took my own advice, it did linger longer than I expected. There were a few uncomfortable days, but it worked, and my prayers were answered. The Lord healed me without any complications.

If you have suggestions or tips of what has worked for you, please share them in the comments. Pray about better solutions to deal with your next viral infection and prepare for it now. Get the supplies you may need as described in this blog. Talk with your healthcare provider about strategies specific to your needs. May God bless you and heal you too.

O Lord my God, I cried to you for help, and you have healed me (Psalm 30:2).

I’m a Christian nurse who helps people navigate the murky waters of healthcare.

References

“Nasal Spray: The Best Nasal Spray for a Stuffy Nose,” Sinus Care Xlear, 2026. https://xlear.com/collections/nasal-spray#information

  1. Weasler, “What Happens When You Take Vitamin D and K2 Together?” Verywell (November 11, 2025). https://www.verywellhealth.com/vitamin-d-and-k2-11772376

  1. Johnson, “The Role of Vitamin D in the Fight Against Cancer,” A Nurse’s Voice Blog (November 1, 2024).

https://anursesvoice.substack.com/p/the-role-of-vitamin-d-in-the-fight

“Crimean War, Eurasian History [1853-1856],” Britannica (March 1, 2026). Eurasianhttps://www.britannica.com/event/Crimean-War

  1. Robinson, “When Should I See a Doctor for a Cold or Flu?” WebMD (November 5, 2024). https://www.webmd.com/cold-and-flu/when-see-doctor

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

Visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.

Ozempic & Health Insurance Crisis

Ozempic & Health Insurance Crisis

by | Jan 4, 2026 | Healthy Living

Recently, a healthcare insurance agent described an alarming situation in northern Idaho. He said that approximately 7,000 people could be dropped from their health insurance coverage due to the alarming increase in the cost of drugs. One of the culprits may be the new miracle weight loss drugs.

Nearly 73% of Americans are either overweight (31%) or obese (42%). Ozempic a new GLP-1 hormone medication was originally approved to treat diabetes but was also found to have an amazing effect on weight loss.

Expensive Weight Loss Drugs
Recall that most plans have a deductible. Once it’s reached the insurance company pays for the remaining costs through year end. Ozempic and other GLP-1 drugs have exploded in use in the past 2 years. The cost to the consumer varies depending on insurance coverage. It’s not uncommon to pay $1,000 a month.

As an example of the problem, if Ozempic costs you $1,000 per month and you have a $5,000 deductible (as many people do) it won’t take long to reach the deductible. The insurance company pays for the remaining doses.

The problem is that many companies are going bankrupt paying for these newer drugs and are stopping coverage for all GLP-1 drugs. Consumers will be forced to pay out of pocket costs anywhere between $1,300 to $2,000 a month.

How It Works
Ozempic is one of many GLP-1 hormone injection medications. They work by stimulating the pancreas to release more insulin which lowers blood sugar. They also slow food from leaving the stomach so one feels fuller longer. Weight loss ensues immediately.

The main side effects from rapid weight loss may be muscle loss and loss of fat deposits more noticeable around the face. There is a concern for increased risk for thyroid type cancers as well. Further, aspiration pneumonia may occur if food isn’t completely eliminated from the stomach before anesthesia.

Obama Care Extensions Issue
The other thing impacting Americans is the loss of insurance subsidy support. Lower income people qualify for Medicaid, seniors have Medicare and most employed workers have employee healthcare. The issue arose for those working without access to healthcare insurance. Hence the Affordable Care Act was born also known as Obama Care.

The cost was supposed to be determined by a sliding scale based on income. During the COVID pandemic the sliding scale payment system was altered but set to return once the pandemic was over in 2025. Those who have a higher income pay more while those with a lower income pay less.

However, in the interim healthcare costs have skyrocketed! Someone must pay those costs: either the consumer, the insurance company or this debt-ridden government (taxpayers). But no one is looking at how to control the outrageous costs!

 

On A Personal Note
Last week I called my local congressman. I shared a solution to this crisis that I’ve seen work. In 2000 our heart institute in Chicago bought a new technology that could detect subclinical atherosclerosis or plaque buildup years before someone had a heart attack.

The Coronary Artery Calcium Score noninvasive test takes images of the arteries that surround the heart looking for calcium deposits which are a part of inflammation. I’ll write more about this test next month. The original cost was $400 and not covered by insurance. Other hospitals began purchasing this technology. People could determine which hospital had the best price and go there. The cost plummeted! In February Heart Month of 2009 you could get this test for $50.

Further, I sat next to a health insurance executive on a plane and asked him why we can’t buy health insurance like car insurance? Most of us don’t have car insurance for oil and tire changes. We pay those ourselves. I told him I’d buy a catastrophic hospital plan and pay for the smaller visits, etc. myself. I’d shop around for the best deal and get my test done at that facility. Costs would plummet!

Unfortunately, greed and corruption have infected so many of our political decisions on both sides of the aisle. Simpler solutions are unacceptable. We’re naïve to know what’s going on and even more resistant to get involved and change things. It’s a mess!

Finally, remember there are risks with any medication. Do your homework and ask a lot of questions. Pray for wisdom for our leaders on both sides of the aisle to come up with solutions that are fair and reasonable for all citizens. We also pray that 2026 will bless our nation with peace around the world and laws that are fair and just for all people. Happy New Year to you and yours…Jennie

I am a firm believer in the people. If given the truth, they can be depended upon to meet any national crisis. The great point is to bring them the real facts (Abraham Lincoln).

References

“New CDC Data Show Adult Obesity Prevalence Remains High,” CDC Newsroom, (September 12, 2024). https://www.cdc.gov/media/releases/2024/p0912-adult-obesity.html

  1. Puckey, “How Much Does Ozempic Cost With or Without Insurance?” Drugs.com (November 18, 2025). https://www.drugs.com/medical-answers/what-ozempic-cost-insurance-without-insurance-3578680/

I’m a Christian nurse who helps people navigate the murky waters of healthcare

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

You may visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.

Prescriptions – How the System Works

Prescriptions – How the System Works

by | Jul 11, 2025 | Healthy Living

Recently, President Trump made news with an Executive Order designed to decrease the cost of prescriptions for Americans. He told a story that articulates the problem best:

A friend of mine who’s a businessman, very, very, very top guy, most of you would have heard of him. Highly neurotic, brilliant businessman, seriously overweight … and he takes the … fat shot drug. He called me up and he said, ‘President… I’m in London and I just paid for this fat drug I take…I just paid $88 and in New York I pay $1,300.’

Unfortunately, this problem is all too common for most Americans who take medications that have not been released in a generic form. President Trump’s first paragraph of the Executive Order describes the problem:

 The United States has less than five percent of the world’s population and yet funds around three quarters of global pharmaceutical profits. This egregious imbalance is orchestrated through a purposeful scheme in which drug manufacturers deeply discount their products to access foreign markets and subsidize that decrease through enormously high prices in the United States.

For as long as I remember the argument for the disparity of the cost of what Americans pay for non-generic medications compared to the rest of the world is that we need to fund research and development. There is no doubt that American drug companies’ revolutionary drugs have developed incredible solutions to many health problems. However, the question remains why must Americans shoulder most of the costs?

The Current System
It takes years to develop a new drug and then test it for efficacy and safety. Drug studies are very expensive involving thousands of people. The FDA then evaluates the results to determine if the new drug should be approved for use. The system only works if the FDA evaluators are independent of the pharmaceutical companies. For years there has been a revolving door of evaluators serving in the FDA then accepting positions at pharmaceutical companies. Questions have arisen regarding the objectivity of these affiliated members.

Generic Drugs
After 20 years or so the new drug’s recipe becomes available to other manufactures and generic drugs are born. They are significantly cheaper than the trade name or newer patent protected drug. Most healthcare providers utilize generic drugs whenever they can to reduce costs for their patients. Currently many are made in other countries. There is a move to bring that manufacturing back to the United States.

Pharmacy Benefit Managers: The Middlemen
Compounding the problem are the large pharmacy benefit managers or also known as middlemen who go-between the drug company and the pharmacy. The Federal Trade Commission issued an interim report in 2024: The report details how prescription drug middlemen profit at the expense of patients by inflating drug costs and squeezing main street pharmacies. It’s a complicated system that President Trump is looking into with the recent Executive Order.  

What You Can Do if Your Medications Cost to Much

 Insurance
If you’re on Medicare during the annual enrollment period, you can change your drug plan to one that is more affordable. Rates tend to increase annually so it’s a good idea to examine your plan and change it to a cheaper one that covers your costs better. A Medicare/Secondary advisor can evaluate your plan.

Coupons
Good RX, and others provide coupons that you present to your pharmacist to get a better price on an expensive medication. They usually require a cash payment to use the coupon. As an example, go to goodrx.com and enter your medication. A list of local pharmacies will be displayed and their cost for that drug. Just because you have most of your medications at one pharmacy doesn’t mean you have to remain with that pharmacy when using a cash payment and a coupon. You may pick up the expensive one at one place and use your insurance for the others at a different place.

Hardship Cases
For some people the cheaper generics just simply don’t work and a newer more expensive trade name still under patent is needed but you can’t afford it. You can contact the drug manufacture directly to inquire if you qualify for a major reduction in cost based on your financial situation.

On A Personal Note:
My husband had a slight detached retina a few years ago. It required several repairs, and very expensive eye drops to heal it. With a little bit of homework, we worked with the doctor, pharmacy and insurance company to find solutions and drops that worked but were more affordable.

I’m on an estrogen derivative that is very expensive. I used Good RX for a few years but the price was still very expensive. Surprisingly, I found it much cheaper on the Amazon Pharmacy. It’s easy to use. Amazon provides a form for the healthcare provider to email the prescription. The medication is sent out in the mail.

Finally, Americans have been expected to carry the heavy burden of all the nations around the world on many issues. It’s time that they step up and share these costs as well. The bottom line for this is to pray for our representatives to come up with commonsense Judea Christian governance to solve the problems of today. May they do so…

Let the wise hear and increase in learning, and the one who understands obtain guidance (Proverbs 1:5).

References:

Kinsey Crowley, “Trump Mentions ‘Fat Shot Drug’ in Executive Order Announcement. Will Ozempic Get Cheaper?” USA Today (May 13, 2025). https://www.usatoday.com/story/news/2025/05/13/trump-fat-shot-drug-ozempic-prices-wegovy/83595110007/ .

“Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” The White House, (May 12, 2025). https://www.whitehouse.gov/presidential-actions/2025/05/delivering-most-favored-nation-prescription-drug-pricing-to-american-patients/

Sydney Lupkin, “A Look at How the Revolving Door Spins from FDA to Industry,” NPR Shots Health News (September 28, 2016). https://www.npr.org/sections/health-shots/2016/09/28/495694559/a-look-at-how-the-revolving-door-spins-from-fda-to-industry

Ananya Mandal MD, “Drug Patents & Generic Pharmaceutical Drugs, News medical Life Sciences (September 24, 2016). https://www.news-medical.net/health/Drug-Patents-and-Generics.aspx

“FTC Releases Interim Staff Report on Prescription Drug Middlemen,” Federal Trade Commission (July 9, 2024). https://www.ftc.gov/news-events/news/press-releases/2024/07/ftc-releases-interim-staff-report-prescription-drug-middlemen

GoodRX.com. https://www.goodrx.com    

“How It Works” Amazon Pharmacy. https://pharmacy.amazon.com/?nodl=0&ref_=nav_cs_pharmacy

I’m a Christian nurse who helps people navigate the murky waters of healthcare.

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

You may visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.

Cholesterol, Saturated Fats & Statins

Cholesterol, Saturated Fats & Statins

by | Apr 11, 2025 | Healthy Living

Recently there has been a great deal of controversy over saturated fat intake, elevated LDL cholesterol and the statin drugs to treat high levels. Does a fatty diet or high LDL cholesterol increase one’s risk for a heart attack and stroke? Should an individual take a statin to lower cholesterol? What are the risks and benefits?

How Does Atherosclerosis (Plaque) Develop?
When born the arteries throughout the body are smooth like the inside of the cheek. Years of risk factors begin to take a toll and damage the interior lining. High blood pressure roughens up the lining much like sandpaper. Elevated glucose or sugar scratches the lining as it travels by.

Inflammation occurs when the body recognizes the damage and sends an army of white blood cells to heal it. The area becomes red and swollen much like any other wound. LDL cholesterol traveling through the blood becomes trapped within the damaged area, worsening the problem.

It’s well known that if you lower the amount of LDL traveling in the blood, less will become trapped within the damaged area. Healing occurs as a fibrous cap covers the area preventing a rupture that could cause a heart attack.

Understanding Cholesterol
Total cholesterol is made up of HDL or healthy cholesterol, LDL lousy cholesterol and VLDL very lousy cholesterol. It’s called lousy because it can get trapped in damaged arterial walls. The HDL helps the body eliminate the LDL. The VLDL cholesterol changes and is a harder predictor and generally not discussed by healthcare providers. Cholesterol is needed in hormone production.

Early studies looked at the total cholesterol number to predict outcomes and treatments. However, since the total number is made up of healthy and unhealthy cholesterol it was discarded. Today the focus is on the level of LDL cholesterol for treatment goals.

Multiple studies have shown that lowering LDL cholesterol reduces one’s risk for a heart attack and stroke when abnormal risk factors or insulin resistance is present. Even those opposed to statin treatment agree on this truth. However, criticism has continued regarding potential bias of the research when most funding may have come from the drug companies manufacturing the drug.

Insulin Resistance or Metabolic Syndrome
When an individual ingests food, it’s converted to glucose. The pancreas secretes insulin to use the glucose for energy. Sedentary, obese people will not be able to burn off the excess glucose which will be converted to stored fat. Over time the pancreas literally wears out, excess glucose remains in the blood scratching artery linings, and one may become a diabetic. Early warning signs are Insulin Resistance or the Metabolic Syndrome.

If an individual has 3 of the 5 signs, they are considered insulin resistant:

  1. Obesity or waist measurement over 35 inches for a woman and 40 inches for a man.
  2. Elevated fasting glucose >100
  3. High blood pressure >130/85
  4. Fasting triglycerides >150
  5. Low HDL <50 for a woman and <40 for a man

Saturated Fats
Since the 1980’s food manufactures have increased portion sizes. Today one restaurant entre is enough food to feed 3 people. Restaurateurs have shared that it costs about the same to make the larger portions but can be sold at a much higher profit.

Americans have lost the ability to judge an appropriate portion size. Almost everything has been super-sized along with American waistlines and a host of diseases. The trend continues to escalate with 81% of adults either 30% overweight, 42% obese or 9% severely obese.

Of children (2 to 19 years old) 41% are either 16% overweight, 19% obese or 6% severely obese.

Keto diets high in protein and saturated fats decrease appetite for weight loss but it is unknown what the impact will be on long term health. However, a new study by Dr. Matthew Budoff raised some interesting questions.

Budoff’s team examined 80 healthy adults matched by age, gender, race, normal blood pressure and nonsmoker. The average age was 55 and were followed for 4.7 years. Coronary artery calcium scores tests (previously discussed in February 2025 blog) and CT angiography were done to ascertain atherosclerosis buildup.

Comparisons were made between one group with an average LDL of 272 mg/dL on a Keto diet (high in saturated fats) while the other Miami Heart group’s average LDL was 123 mg/dL. Astonishingly, no significant difference was found between the 2 groups regarding the amount of plaque buildup.

Budoff’s team postulated that those eating an extremely high amount of saturated fats perhaps had larger more buoyant LDL cholesterol that simply were too big to get stuck even with such high LDL levels. The other group may have had smaller denser LDL that even with lower levels may have become lodged more easily. The size of the LDL particles was not measured. They cautioned that more research is needed since this was a small sample size.

Statins
Statins were introduced in the 1990’s. They work by blocking an enzyme the liver needs to make LDL cholesterol. The risks and benefits of any treatment should be ascertained. Rhabdomyolysis is a rare complication that causes severe pain, liver damage, kidney failure and death. More common side effects may include annoying muscle pain (5% of adults), digestive problems, elevated glucose, mental fuzziness, etc. Statins may interact with some common medications. However, most people tolerate them very well.

How are Cholesterol, Saturated Fats and Statins Connected?
Dr. Paul Saladino is a prominent outspoken critic of statin therapy to lower LDL cholesterol. He advocates for a diet very high in saturated fats, minimal fruits and vegetables and several hours of daily physical activity. Most would find this lifestyle difficult to maintain.

He argues that 86% to 90% of Americans have some form of insulin resistance which is the primary cause of heart disease or plaque build-up. LDL cholesterol may get stuck in the damaged areas, but it’s not the villain. He argues that if one does not have insulin resistance high levels of LDL cholesterol are not a health risk. However, he does indicate when statins are helpful:

If you’re insulin resistant and we lower your LDL cholesterol, your risk for heart disease is unequivocally lower. However, we didn’t treat the real cause which is insulin resistance or a metabolic disorder.  

On A Personal Note:
Interestingly I met Dr. Budoff when he visited our heart institute in Chicago. He’s a pioneer and leader in the calcium score technology to detect hidden plaque that cause heart attacks and I have great respect for him. I found his study and Dr. Saladino’s comments fascinating.

The question remains, if you have an LDL cholesterol over 100 mg/dL what should you do? Should you take statins that your doctor is recommending? I highly recommend a non-contrast coronary artery calcium score test to be your tie breaker. It’s a simple test. If you don’t have any buildup, then you have time to work on your healthier lifestyle and keep an eye on it. However, if you have buildup, you probably need a statin to prevent circulating LDL cholesterol from getting lodged into those damaged areas.

Recently, a young 45-year-old man I know died from a sudden heart attack. He ignored his abnormal glucose levels, obesity and high cholesterol. If he had obtained a coronary artery calcium score test the dangerous plaque buildup would have been identified and treated.

Don’t ignore your numbers either and remember the more you do with your healthier lifestyle…the less medication you’ll need to correct problems.

God bless you as you move toward a heart healthy life.

Whether you eat or drink or whatever you do…

do it all for the glory of God (1 Corinthians 10:31).

References:

  1. Wang et al. “Compounding Benefits of Cholesterol Lowering Therapy for the Reduction of Major Cardiovascular Events: Systematic Review & Meta-analysis,” Circulation Cardiovascular Quality Outcomes (June 6, 2022). https://pubmed.ncbi.nlm.nih.gov/35430872/

“Metabolic Syndrome,” Cleveland Clinic (September 9, 2023). https://my.clevelandclinic.org/health/diseases/10783-metabolic-syndrome

“Overweight & Obesity Statistics,” National Institute of Diabetes, Digestive & Kidney Disease (September 2021). https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity

Budoff et al., “Carbohydrate Restriction-Induced Elevations in LDL Cholesterol & Atherosclerosis,” Journal of the American College of Cardiology, (August 28, 2024). https://pmc.ncbi.nlm.nih.gov/articles/PMC11450898/

  1. Johnson, “Heart Attack: Test to Determine Hidden Plaque Buildup,” A Nurse’s Voice (February 1, 2025.) https://anursesvoice.substack.com/publish/posts/detail/156138911?referrer=%2Fpublish%2Fposts

“Statins Side Effects: Weigh the Benefits & Risks,” Mayo Clinic (March 11,2025). https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013

“Paul Saladino MD: The FDA Approved Poison You Eat Every Day” (SRS #179), The Shawn Ryan Show (March 5, 2025), https://www.youtube.com/results?search_query=paul+saladino+md+podcast .

I’m a Christian nurse who helps people navigate the murky waters of healthcare.

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

You may visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.

Heart Attack Risk: Test to Determine Hidden Plaque Buildup

Heart Attack Risk: Test to Determine Hidden Plaque Buildup

by | Feb 5, 2025 | Healthy Living

February is Heart Month, a time to consider one’s risk for a heart attack. The Non-contrast Coronary Artery Calcium (CAC) Score Screening test accurately detects subclinical (silent) buildup months or years before the heart attack may occur. However, few healthcare providers prescribe it for high-risk patients. Most people are completely unaware of this life saving technology.

Are You at Risk?
The major risk factors for a heart attack are:

  1. Men over 45, women over 55
  2. History of a heart attack in a mother before the age of 55 and a father before 45
  3. Smoking
  4. High blood pressure
  5. High blood glucose
  6. Elevated LDL cholesterol
  7. Excess weight
  8. Unhealthy diet
  9. Inactivity
  10. Stress
  11. Excess alcohol
  12. Inadequate sleep
    It’s often been said that genetics loads the gun, but lifestyle pulls the trigger. However, living a heart healthy lifestyle is a challenge for most of us. If your blood pressure, glucose or LDL cholesterol remains too high it’s time to consider medications to protect your heart, brain and kidneys from damage.

    The calcium score test is the tie breaker. If the number is 0 or low, it will buy you some time. However, if it is higher, it’s time to get more aggressive to prevent further buildup.

How Do Blockages Develop?
Blockages develop from a variety of factors. High blood pressure causes a sandpaper effect to occur on the inside lining of the arteries. Higher blood glucose scratches the lining as it moves through the blood. The body recognizes the danger and launches an assault to repair the damage. Those areas become red and swollen and white blood cells move in to heal it. LDL cholesterol traveling through the blood becomes lodged in the damaged areas.

With any inflammation that has gone on long enough (TB, cancer or coronary artery disease) calcium deposits are left behind to wall off the area. Plaque buildup is just another name for this inflammatory process. The calcium deposits are measured on this test and provide a window into how much damage may be occurring.

 

Non-contrast Coronary Artery Calcium (CAC) Score Screening Test
This test became available 30 years ago. During one breath hold, approximately 40 images are taken of the 4 main coronary arteries that surround the heart. The radiation dose in a non-contrast CAC screening scan is about equal to a mammogram. The accuracy of the CAC score test is a strong predictor of future events.

What Do the Results Mean?

0 CAC Score                          Encourage a healthy lifestyle, consider a statin if LDL cholesterol >190 mg/dL, repeat in 3 to 5 years depending on risk factors.

1 to 99 CAC Score                 Healthy lifestyle, treat LDL cholesterol to <100 mg/dL and treat high blood pressure and other risk factors.

100 to 299 CAC Score           All above + treat LDL cholesterol to <70 mg/dL and consider low dose aspirin (some people are at risk for bleeding- always check with your doctor before taking).

300 to 999 CAC Score           All above + treat LDL to < 55 mg/dL and use low dose aspirin in people who can tolerate it.

Over 1,000 CAC Score         All above + consider other tests and treatment options.

It indicates the level of plaque buildup (none, small, moderate or large amount). It doesn’t mean there is a blockage but the higher the number the greater the buildup and the bigger the problem.

However, remember the best stress test may only detect a blockage > 70%. Heart attacks may occur in much smaller blockages. If someone has a normal stress test and several risk factors, it’s a good idea to get a CAC score to rule out potential buildup unseen by the stress test.

Who Should Get a Calcium Score Test?

—Men 55 to 80 years old, women 60 to 80 years old.

—People 40 to 55 years old with multiple risk factors.

—People with abnormal cholesterol levels concerned about taking a statin.

Who Should Not Get a Calcium Score Test
If you’ve already had a heart attack or stroke you have plaque buildup and should be treated aggressively. The score will not add any value.

Where Can I Get the Test?
Most radiology centers provide this screening. It may be covered by insurance or Medicare if you have a strong secondary plan. The cost out-of-pocket is around $200. Some states require a healthcare provider’s order while others do not. The test is ordered as Non-contrast Coronary Artery Calcium Score Screening or simply Cardiac Calcium Score. The screening non-contrast test has a much lower dose of radiation exposure than the contrast test.

On A Personal Note:
I counseled nearly 1,000 people in Chicago after they had this test. We measured their blood pressure, cholesterol and glucose, asked them about their lifestyle habits and provided information on their findings. We found many people who were living normal lives completely unaware of the silent danger building up in their arteries.

In the early 2000’s minimal research existed on what happens when you give people that information. I enrolled nearly 200 high risk people and measured how the results changed their lives.

Whether they were CEO’s of major Fortune 500 companies, farmers or housewives they had similar questions. I found that the higher the CAC score motivation to take prescribed medications and make healthier choices was enhanced. 

Frankly, I’m frustrated that physicians in my area are not ordering this test for at risk people. It’s quick, easy and painless and provides incredible information. The guidelines recommend it in high-risk individuals.  

If you’re at risk…speak with your healthcare provider today. Provide a hard copy of this article. If you’re in a state that doesn’t require an order…call and get more information. I’d love to hear your experiences in the comments below and answer any questions.

Finally, my book Wake Up Call 911: It’s Time to Reduce your Risk for a Heart Attack and Stroke is available through my website for $10 (jenniejohnsonrn.com), email (ask@jenniejohnsonrn.com), Amazon or Ebay. It includes the information that I gave my patients: the simple steps to change your life.

The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown(science fiction writer, H. P. Lovecraft).

Reference:

Lifestyle Changes to Prevent a Heart Attack, American heart Association (January 2, 2025). https://www.heart.org/en/health-topics/heart-attack/life-after-a-heart-attack/lifestyle-changes-for-heart-attack-prevention

  1. J. Maron et al. “Coronary Artery Calcium Staging to Guide Preventive Interventions: A Proposal & Call to Action,” JACC Advances (November 11, 2024). https://www.jacc.org/doi/10.1016/j.jacadv.2024.101287

Cardiac Stress Testing: What It Can & Cancot Tell You, Harvard Health Publsihing, Harvard Medical School (April 15, 2020). https://www.health.harvard.edu/newsletter_article/cardiac-exercise-stress-testing-what-it-can-and-cannot-tell-you

  1. E. Johnson et al. “Does Knowledge of Coronary Artery Calcium Affect Cardiovascular Risk Perception, Likelihood of Taking Action, and Health-Promoting Behavior Change?” Journal of Cardiovascular Nursing (2015). https://pubmed.ncbi.nlm.nih.gov/24434820/

    I’m a Christian nurse who helps people navigate through the murky waters of healthcare.

Beloved, I pray that all will go well with you and that you may be in good health,

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

You may visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.

Lessons Shared from Knee Replacement Surgery: What You Should Know

Lessons Shared from Knee Replacement Surgery: What You Should Know

by | Jan 15, 2025 | Healthy Living

Recently, my husband and I had total knee replacement surgeries… his left and my right. Even though I have a PhD in nursing I was stunned how much I didn’t know about it and wanted to share our lessons with you. Aging causes arthritis to develop, destroying the joint cartilage that separates bones. Pain follows and one wonders if surgical repair is needed? What’s involved? How long before I’m back to normal? What are the complications? What can I do to have a positive outcome?

When Is Surgery Needed?
At first the damage is barely noticeable. It’s annoying but overtime the pain worsens. It’s a good time to see an orthopedic physician to learn strategies to protect the knee to delay surgery. Various injections ease the pain for a very short time, but it returns when the drug wears off. Physical Therapy helps to strengthen the muscles around the damaged joint to reduce pain and discomfort. Braces are also recommended to support and strengthen the injured knee. Ultimately a knee replacement operation may be required. When the pain begins to interfere with sleeping or normal daily activities, it’s a good time seek options.

10 Point Questionnaire
Our surgeon Dr. Joseph Bowen developed the Measuring Impact of Diagnosis 1 to 10 scale to help determine if we were ready for surgery. The lower number 1 meant – Nothing will keep you from the activity while 10 meant –  The pain is so bad that you avoid the activity. I loved to go for walks while listening to music but eventually that ended (10). I hated entering big box stores for fear of pain from long walks finding an item (8). The 1 to 10 scale provided clarity. If I answered a 1, 2 or low number the surgery would probably be more traumatic than helpful. Other strategies would be more useful. However, if I answered 8, 9 or 10 the surgery would improve my quality of life.

Physical Therapy (PT)
The most challenging and least understood aspect when facing a knee replacement operation is what one will face in the post operative period. Immediately after surgery healing begins and scar tissue forms which can freeze or limit range of motion (ROM) in the joint. Strategies are employed to start moving the impacted leg. While some activity begins immediately after surgery, you can expect to start outpatient PT at the center within a few days after surgery.

The battle continues to prevent scar tissue adhesions from forming. Each day the activity increases as healing occurs. The goal of the PT session is to bend and straighten the surgical leg and lasts 2 months, generally twice a week and is invaluable! I was shocked to learn that some orthopedic surgeons don’t even order it. However, if you want to get back to an active life… you must get the range of motion back and that takes work. Life will return to a more normal routine after 2 months but allow 3 months before you’re able to help someone else. 

The Best Surgeon
The first most important step is to find the best orthopedic surgeon in your area. We had 2 opinions which were covered by insurance. Ask other healthcare providers who they would have do the surgery. The second appointment was invaluable. We found an amazing surgeon. Literally everywhere we went nurses and other staff told us, He is the only one who’d do my surgery. Do they treat you kindly and answer all your questions? How many do they do in a year? You want someone who focuses primarily on the knee for the best outcomes. 

Importance of Protein for Healing
Another orthopedic surgeon told me to begin drinking a protein shake daily 1 month before surgery to promote healing. My appetite was poor after surgery. The daily supplementation provided the extra nutrition needed. It’s also important to increase fluid intake as well. However, if you have any kidney, heart or diabetes disease be sure to get clearance from your healthcare provider before you push fluids and protein.

Pain Control
The post operative pain was well controlled. Between the numbing agents used prior to surgery and the narcotics given during the operation, pain was greatly reduced for 24 hours. Tylenol and Tramadol were ordered around the clock every 6 hours initially. Oxycodone which is a strong narcotic is used for breakthrough pain. Despite taking Tylenol and Tramadol, if the pain consumes you and it’s all your thinking about…it’s time for an Oxycodone. I weaned myself down to ½ which took the edge off when the others weren’t working.

However, during PT at certain points in the bending and straightening… pain returns. It’s a helpful idea to premedicate before PT to get the most motion and progression out of it.

Tramadol and Oxycodone are addictive. Opinions vary on how long it may be needed following knee replacement surgery. Our surgeon wanted us using the pain meds, so we’d do the PT to keep the knee bending and straightening. It’s a good conversation to have with your surgeon.

Reduce Swelling
Swelling limits motion and increases pain. It’s important to focus on reducing it as much as possible. Our physical therapists highly recommended above the knee compression stockings. My husband is 6’4” tall and it was difficult to find them long enough. A wonderful company in North Carolina sent them out which fit him perfectly.

Everyone recommended ice after any kind of PT activity for 20 minutes applied above and under the knee. Our PT team recommended 2 Comfort Gel packs (from Amazon). In addition, several orthopedic surgeons recommended the continuous Breg Polar Care Circulating Cold Water Flow system. It doesn’t damage the skin like direct contact from ice but keeps cool water circulating to reduce swelling and pain. You can insert frozen water bottles in the Breg Cube instead of ice.

Complications
Baby aspirin is ordered to reduce blood clot formation along with hourly movement and flexing of the feet. Frequent walking is very important. Walkers are used for the first weeks to prevent falling.

Bleeding may occur but is less common due to improvements in surgical techniques.

Infection is a major concern. You will monitor your temperature and report any elevations to your surgical team. Constipation also occurs. We were given daily doses of Senokot to promote the emptying of the colon slowed down by narcotics. Two glasses of prune juice a day was ordered along with Milk of Magnesia if needed for constipation. 

Medications
Keep track of all your medications, especially the pain meds. Write the times beginning with 7am through the next 24 hours in rows on the left side of a page. Create columns across the top of the page for each medication. There will be many new ones and it’s far too easy to get confused. It’s important to be accurate. Add a 1 or 2 in the time slot for how many pills you are to take with each scheduled dose. Record when all pain meds are taken as well. You may have to print a new page each day as the pain med times may change.

If you have high blood pressure, diabetes or kidney disease work with your healthcare provider to maintain balance in your numbers. This is a major surgery with a great deal of temporary medications that can make these problems worse. Monitor those numbers and report any concerns to your doctor. 

Metal Allergies
If you are someone who developed a rash from cheap jewelry or any metal, you need to have a conversation with your surgeon. After 25 years of wearing a white gold wedding band the protective coating rubbed off and I developed a nasty itchy allergy under the ring. I was concerned about what metal would be in the orthotic implant and did a lot of homework on this issue.

Unfortunately, the information is uncertain. There hasn’t been much research on this concern. Over time orthotics may fail. One wonders, was it related to an undiagnosed allergy to the metal in the device? Some orthopedic surgeons don’t think this is a real issue. However, one surgeon told me that he uses a hypoallergenic orthotic in all his patients. Another minimized my concerns. Our surgeon listened and placed a hypoallergenic implant in me.

Metal testing is an emerging area of research. I believe one day it will be standard practice especially in people with a history of a metal allergy. An orthopedic nurse in Oklahoma told me they offer metal testing to all their knee replacement patients before surgery. You can search Orthopedic Analysis for more information on the test they use. My test showed that I was highly reactive to nickel.

Interestingly, I also developed a rash underneath the dressing the surgeons used to cover the knee. Apparently, I’m also allergic to the adhesive used to secure the dressing. Let your surgeon know if you have any tape allergies as well.

On A Personal Note
My husband developed a severe knee injury while playing basketball in college 50 years ago. Over the years he saw many orthopedic doctors and physical therapists who helped him buy time. He reinjured it last summer and finally needed it repaired. I injured my knee 8 years ago playing my first and last game of Pickleball. My severely bowed leg altered my gait causing hip pain too. We never expected to have surgery just 5 weeks apart to say the least.

Remember that this is a major operation unlike any other one you may have had because it’s a joint and bone operation. Realistically, you should have help for at least 2 weeks after surgery.

You will be working very hard to get your range of motion back and relearn how to walk with a normal gait. Most of the work is simple stretching exercises but the final bending and straitening is painful but mandatory. By week four I was doing 1 hour of PT at home or the center twice a day followed by 20 minutes of ice packs on top and below my knee. Listening to music really helped.

Interestingly, we learned that when the weather changes…knee discomfort increases, and the Lord created bodies that heal unbelievably rapidly. Each day we saw improvements.

Life is returning to normal and we’re looking forward to more active lives. If you have questions or comments, please share your thoughts and experiences. You can also email me, and I’d be happy to talk one on one as well.

May this new year  bring a more peaceful world.

For I will restore health to you, and your wounds I will heal, declares the Lord (Jeremiah 30:17).

References:

“Knee Replacement,” Mayo Clinic, (November 15, 2024). https://www.mayoclinic.org/tests-procedures/knee-replacement/about/pac-20385276.

Dr. Joseph Bowen, Kootenai Clinic Orthopedics, (2024). https://www.kh.org/.

  1. Nguyen Pharm D. & D. Synder MD, “Tramadol and Oxycodone: What are the Differences?” Very Well Health, (July 24, 2023). https://www.verywellhealth.com/tramadol-vs-oxycodone-7508613.

Rescue Legs Medical Compression Stockings. https://www.rescuelegs.com//.

I’m a Christian nurse who helps people navigate through the murky waters of healthcare.

Beloved, I pray that all will go well with you and that you may be in good health,

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

You may visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.