Two Things You Can Do To Improve Stroke Survival Chances
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Dr. Andrew’s Stroke Survival Guide
This is Dr. Nadine Andrew. She’s a Senior Research Fellow in the Department of Medicine at Monash University. She’s the Research Data Lead for the National Center of Healthy Aging. She is lead investigator on the NHMRC-funded PRECISE project… The most comprehensive stroke data linkage study to date! In short, she knows her stuff.
We’ve talked before about how sample size is important when it comes to scientific studies. It’s frustrating; sometimes we see what looks like a great study until we notice it has a sample size of 17 or something.
Dr. Andrew didn’t mess around in this regard, and the 12,386 participants in her Australian study of stroke patients provided a huge amount of data!
With a 95% confidence interval because of the huge dataset, she found that there was one factor that reduced mortality by 26%.
And the difference was…
Whether or not patients had a chronic disease management plan set up with their GP (General Practitioner, or “family doctor”, in US terms), after their initial stroke treatment.
45% of patients had this; the other 55% did not, so again the sample size was big for both groups.
Why this is important:
After a stroke, often a patient is discharged as early as it seems safe to do so, and there’s a common view that “it just takes time” and “now we wait”. After all, no medical technology we currently have can outright repair that damage—the body must repair itself! Medications—while critical*—can only support that and help avoid recurrence.
*How critical? VERY critical. Critical critical. Dr. Andrew found, some years previously, that greater levels of medication adherence (ie, taking the correct dose on time and not missing any) significantly improved survival outcomes. No surprise, right? But what may surprise is that this held true even for patients with near-perfect adherence. In other words: miss a dose at your peril. It’s that important.
But, as Dr. Andrew’s critical research shows, that’s no reason to simply prescribe ongoing meds and otherwise cut a patient loose… or, if you or a loved one are the patient, to allow yourself/them to be left without a doctor’s ongoing active support in the form of a chronic disease management plan.
What does a chronic disease management plan look like?
First, what it’s not:
- “Yes yes, I’m here if you need me, just make an appointment if something changes”
- “Let’s pencil in a check-up in three months”
- Etc
What it actually looks like:
It looks like a plan. A personal care plan, built around that person’s individual needs, risks, liabilities… and potential complications.
Because who amongst us, especially at the age where strokes are more likely, has an uncomplicated medical record? There will always be comorbidities and confounding factors, so a one-size-fits-all plan will not do.
Dr. Andrew’s work took place in Australia, so she had the Australian healthcare system in mind… We know many of our subscribers are from North America and other places. But read this, and you’ll see how this could go just as much for the US or Canada:
❝The evidence shows the importance of Medicare financially supporting primary care physicians to provide structured chronic disease management after a stroke.
We also provide a strong case for the ongoing provision of these plans within a universal healthcare system. Strategies to improve uptake at the GP level could include greater financial incentives and mandates, education for patients and healthcare professionals.❞
See her groundbreaking study for yourself here!
The Bottom Line:
If you or a loved one has a stroke, be prepared to make sure you get a chronic health management plan in place. Note that if it’s you who has the stroke, you might forget this or be unable to advocate for yourself. So, we recommend to discuss this with a partner or close friend sooner rather than later!
“But I’m quite young and healthy and a stroke is very unlikely for me”
Good for you! And the median age of Dr. Andrew’s gargantuan study was 70 years. But:
- do you have older relatives? Be aware for them, too.
- strokes can happen earlier in life too! You don’t want to be an interesting statistic.
Some stroke-related quick facts:
Stroke is the No. 5 cause of death and a leading cause of disability in the U.S.
Stroke can happen to anyone—any age, any time—and everyone needs to know the warning signs.
On average, 1.9 million brain cells die every minute that a stroke goes untreated.
Stroke is an EMERGENCY. Call 911 immediately.
Early treatment leads to higher survival rates and lower disability rates. Calling 911 lets first responders start treatment on someone experiencing stroke symptoms before arriving at the hospital.
Source: https://www.stroke.org/en/about-stroke
What are the warning signs for stroke?
Use the letters F.A.S.T. to spot a stroke and act quickly:
- F = Face Drooping—does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
- A = Arm Weakness—is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
- S = Speech Difficulty—is speech slurred?
- T = Time to call 911
Source: https://www.stroke.org/en/about-stroke/stroke-symptoms
Last but not least, while we’re sharing resources:
Download the PDF Checklist: 8 Ways To Help Prevent a Second Stroke
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Invigorating Sabzi Khordan
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Have you ever looked at the nutritional values and phytochemical properties of herbs, and thought “well that’s all well and good, but we only use a tiny amount”? Sabzi khordan is a herb-centric traditional Levantine sharing platter served most commonly as an appetizer, and it is indeed appetizing! Never again will “start your meal with a green salad to ensure a gentle blood sugar curve” seem like a chore:
You will need
- Large bunch of parsley
- Small bunch of tarragon leaves
- Small bunch of basil leaves
- Small bunch of mint
- Small bunch of sorrel leaves
- 7 oz block of feta cheese (if vegan, a plant-based substitution is fine in culinary terms, but won’t have the same gut-healthy benefits, as plant-based cheeses are not fermented)
- 9 oz labneh-stuffed vine leaves in olive oil (if vegan, same deal as the above, except it’s harder to find plant-based substitutes for labneh (strained yogurt cheese), so you might want to use our Plant-Based Healthy Cream Cheese recipe instead and make your own)
- 2 tbsp za’atar (you can make your own by blending dried hyssop, dried sumac berries, sesame seeds, dried thyme, and salt—but if you haven’t had za’atar before, we recommend first buying some like the one that we linked, so that next time you know what you’re aiming for)
- 3 tbsp extra virgin olive oil
- 10 radishes
- 6 scallions
- 9 oz walnuts, soaked in water overnight and drained
- 1 cucumber, cut into batons
- Warm flatbreads (you can use our Healthy Homemade Flatbreads recipe)
Method
(we suggest you read everything at least once before doing anything)
1) Arrange the feta, labneh, za’atar, and olive oil in separate little serving dishes.
2) Arrange everything else around them on a platter.
3) Serve! You may be thinking: did we really need a recipe to tell us “put the things on a plate”? The answer here is that this one today was shared mostly as a matter of inspiration, because when was the last time you thought to serve herbs as the star of the dish? Plus, it’s an excuse to try za’atar, not something so commonly seen outside of the Levant.
An alternative presentation
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Herbs for Evidence-Based Health & Healing
- Making Friends With Your Gut (You Can Thank Us Later)
- 10 Ways To Balance Blood Sugars
Take care!
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Workout Advice For Busy People
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Hampton at Hybrid Calisthenics always has very sound advice in his uplifting videos, and this one’s no exception:
Key tips for optimizing workouts without burning out
“We all have the same 24 hours” is a folly when in fact, some of us have more responsibilities and/or other impediments to getting things done (e.g. disabilities).
A quick word on disabilities first: sometimes people are quick to point out Paralympian athletes, and “if they can do it, so can you!” and forget that these people are in the top percentile of the top percentile of the top percentile of human performance. If you wouldn’t disparagingly say “if Simone Biles/Hussein Bolt/Michael Phelps can do it, so can you”, then don’t for Paralympians either 😉
Now, as for Hampton’s advice, he recommends:
Enjoy short, intense workouts:
- You can get effective results in under 30 minutes (or even just a few minutes per day) with compound exercises (e.g., squats, pull-ups).
- Focus on full-body movements also saves time!
- Push closer to failure when possible to maximize efficiency. It’s the last rep where most of the strength gains are made! Same deal with cardiovascular fitness, too. Nevertheless, do take safety into account in both cases, of course.
Time your rest periods:
- Resting for 2–3 minutes between sets ensures optimal recovery.
- Avoid getting distracted during rest by setting a timer to stay focused.
- 10almonds tip: use this time to practice a mindfulness meditation. That will greatly reduce the chance of you becoming distracted.
Remember holistic fitness:
- Fitness isn’t just about exercise; diet, sleep, and stress management are equally important for your fitness as much as for the rest of your health.
- Better sleep and reduced stress will help you exercise more consistently and avoid junk food.
Address burnout:
- If feeling too exhausted to apply these tips, focus on getting better rest and reducing stress first.
- Taking a short break to reset can help in the long run.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- How To Do High Intensity Interval Training (Without Wrecking Your Body)
- How To Rest More Efficiently (Yes, Really)
Take care!
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Starfruit vs Soursop – Which is Healthier?
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Our Verdict
When comparing starfruit to soursop, we picked the soursop.
Why?
First, by starfruit, we also mean carambola, which is a different name for the same fruit, and by soursop we also mean graviola/guyabano/guanábana, which are different namers for the same fruit. Now, as for their health qualities:
In terms of macros, the soursop has more carbs and fiber, the ratio of which also give it the lower glycemic index. So, a win for soursop here.
When it comes to vitamins, starfruit has more of vitamins A, B5, C, and E, while soursop has more of vitamins B1, B2, B3, B6, B7, B9, and K. Another win for soursop.
In the category of minerals, starfruit has slightly more copper, manganese, and zinc, while soursop has much more calcium, iron, magnesium, phosphorus, and potassium. One more win for soursop!
Adding up the sections makes for a clear and overwhelming win for soursop, but let’s address to quick safety considerations while we’re here:
- Soursop extract has been claimed to be an effective cancer treatment. It isn’t. There is no evidence for this at all; just one unscrupulous company that spread the claims.
- Soursop contains annonacin, a neurotoxin. That sounds scary, but much like with apple seeds and cyanide, the quantities you’d have to consume to suffer ill effects are absurd. Remember how capsaicin (as found in hot peppers) is also a neurotoxin, too and has many health benefits. Humans have a long and happy tradition of enjoying things that are toxic at high doses, but in small doses are neutral or even beneficial. Pretty much all things we can consume (including oxygen, and water) are toxic at sufficient doses.
In short, both of these fruits are fine and good, neither will treat cancer, but both will help to keep you in good health. As for nutritional density, the soursop wins in every category.
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer ← soursop has no special cancer treatment properties, but actual evidence shows these fruits are beneficial (being good as a preventative, and also definitely a worthy adjunct to—but not a replacement for—mainstream anticancer therapies if you have cancer).
Take care!
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Chorus or Cacophony? Cicada Song Hits Some Ears Harder Than Others
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ST. LOUIS — Shhhooo. Wee-uuu. Chick, chick, chick. That’s the sound of three different cicada species. For some people, those sounds are the song of the summer. Others wish the insects would turn it down. The cacophony can be especially irritating for people on the autism spectrum who have hearing sensitivity.
Warren Rickly, 14, lives in suburban south St. Louis County, Missouri. Warren, who has autism, was at the bus stop recently waiting for his younger brother when the sound of cicadas became too much to bear.
“He said it sounds like there’s always a train running next to him,” his mother, Jamie Reed, said.
Warren told her the noise hurt.
Starting this spring, trillions of the red-eyed insects crawled their way out of the ground across the Midwest and Southeast. It’s part of a rare simultaneous emergence of two broods — one that appears every 13 years, the other every 17.
The noisy insects can be stressful. People with autism can have a sensitivity to texture, brightness, and sound.
“I think the difference for individuals with autism is the level of intensity or how upsetting some of these sensory differences are,” said Rachel Follmer, a developmental and behavioral pediatrician at Lurie Children’s Hospital in Chicago.
“It can get to the extreme where it can cause physical discomfort,” she said.
When a large group of cicadas starts to sing, the chorus can be as loud as a motorcycle. Researchers at the University of Missouri-St. Louis this year crowdsourced cicada noise levels as high as 86 decibels, about as loud as a food blender.
That can be stressful, not melodic, Follmer said.
To help children cope, she suggests giving them a primer before they encounter a noisy situation. For cicadas, that could mean explaining what they are, that they don’t bite or sting, and that they’ll be here for just a short time.
“When something is uncomfortable, not having power in that situation can be very scary for a lot of individuals, whether you’re on the spectrum or not,” Follmer said.
Jamie Reed’s family has been using this and other strategies to help her son. Warren wears noise-canceling headphones, listens to music, and has been teaching himself about cicadas.
“For him, researching it and looking into it I think grounds him a little bit,” Reed said.
Fatima Husain is a professor and neuroscientist at the University of Illinois Urbana-Champaign and studies how the brain processes sound. She said people with tinnitus may also struggle with cicada song.
Tinnitus, a ringing or other noise in the ears, is a person’s perception of sound without an external source.
“Some people say it sounds like buzzing, like wind blowing through trees, and ironically, quite a few people say it sounds like cicadas,” Husain said.
For most people with tinnitus the cicada’s song is harmless background noise, according to Husain, but for others the ringing can prevent easy conversation or sleep. Those with tinnitus are also more likely to have anxiety or depression. A loud persistent sound, like singing cicadas, can make someone’s tinnitus worse, Husain said.
It’s not always bad, though. The cicada’s song can also be a relief.
For some, tinnitus gets worse in a quiet environment. Husain said she’s seen reports this year of patients saying the cicadas’ song has been like soothing white noise.
“The sound is loud enough that in some ways it’s drowning their internal tinnitus,” Husain said.
As loud as the cicadas can be, they won’t necessarily damage anyone’s hearing, according to the Centers for Disease Control and Prevention. Hearing loss builds up over time from repeated exposure to loud sounds. Cicadas aren’t loud enough for long enough to do lasting damage, Husain said.
Everyday sources of noise come with a higher risk. Husain said constant exposure to loud highways, an airport, industrial sites, or household appliances like blenders and hair dryers can be a concern. And they can take a toll on someone’s emotional well-being.
“If you are being exposed to very loud sounds for a part of your school day or your working day, it may make you more stressed out; it may make you more angry about things,” she said.
Unlike the highway or an airport, cicadas won’t be around long. Most of the current brood will be gone in the next few weeks. Just in time for another noisy summer event: the Fourth of July.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Nudge – by Richard Thaler & Cass Sunstein
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How often in life do we make a suboptimal decision that ends up plaguing us for a long time afterwards? Sometimes, a single good or bad decision can even directly change the rest of our life.
So, it really is important that we try to optimize the decisions we do make.
Professors Richard Thaler and Cass Sunstein look at all kinds of decision-making in this book. Their goal, as per the subtitle, is “improving decisions about health, wealth, and happiness”.
For the most part, the book concentrates on “nudges”. Small factors that influence our decisions one way or another.
Most importantly: that some of them are very good reasons to be nudged; others, very bad ones. And they often look similar.
Where this book excels is in highlighting the many ways we make decisions without even thinking about it… or we think about it, but only down a prescribed, foreseen track, to an externally expected conclusion (for example, an insurance company offering three packages, but two of them exist only to direct you to the “correct” choice).
A weakness of the book is that in some aspects it’s a little inconsistent. The authors describe their economic philosophy as “libertarian paternalism”, and as libertarians they’re against mandates, except when as paternalists they’re for them. But, if we take away their labels, this boils down to “some mandates can be good and some can be bad”, which would not be so inconsistent after all.
Bottom line: if you’d like to better understand your own decision-making processes through the eyes of policy-setting economists (especially Sunstein, who worked for the White House Office of Information & Regulatory Affairs) whose job it is to make sure you make the “right” decisions, then this is a very enlightening book.
Click here to check out Nudge and improve your decision-making clarity!
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What are ‘Ozempic babies’? Can the drug really increase your chance of pregnancy?
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
We’ve heard a lot about the impacts of Ozempic recently, from rapid weight loss and lowered blood pressure, to persistent vomiting and “Ozempic face”.
Now we’re seeing a rise in stories about “Ozempic babies”, where women who use drugs like Ozempic (semaglutide) report unexpected pregnancies.
But does semaglutide (also sold as Wegovy) improve fertility? And if so, how? Here’s what we know so far.
Remind me, what is Ozempic?
Ozempic and related drugs (glucagon-like peptide-1 receptor agonists or GLP-1-RAs) were developed to help control blood glucose levels in people with type 2 diabetes.
But the reason for Ozempic’s huge popularity worldwide is that it promotes weight loss by slowing stomach emptying and reducing appetite.
Ozempic is prescribed in Australia as a diabetes treatment. It’s not currently approved to treat obesity but some doctors prescribe it “off label” to help people lose weight. Wegovy (a higher dose of semaglutide) is approved for use in Australia to treat obesity but it’s not yet available.
How does obesity affect fertility?
Obesity affects the fine-tuned hormonal balance that regulates the menstrual cycle.
Women with a body mass index (BMI) above 27 are three times more likely than women in the normal weight range to be unable to conceive because they are less likely to ovulate.
The metabolic conditions of type 2 diabetes and polycystic ovary syndrome (PCOS) are both linked to obesity and fertility difficulties.
Women with type 2 diabetes are more likely than other women to have obesity and to experience fertility difficulties and miscarriage.
Similarly, women with PCOS are more likely to have obesity and trouble conceiving than other women because of hormonal imbalances that cause irregular menstrual cycles.
In men, obesity, diabetes and metabolic syndrome (a cluster of conditions that increase the risk of heart disease and stroke) have negative effects on fertility.
Low testosterone levels caused by obesity or type 2 diabetes can affect the quality of sperm.
So how might Ozempic affect fertility?
Weight loss is recommended for people with obesity to reduce the risk of health problems. As weight loss can improve menstrual irregularities, it may also increase the chance of pregnancy in women with obesity.
This is why weight loss and metabolic improvement are the most likely reasons why women who use Ozempic report unexpected pregnancies.
But unexpected pregnancies have also been reported by women who use Ozempic and the contraceptive pill. This has led some experts to suggest that some GLP-1-RAs might affect the absorption of the pill and make it less effective. However, it’s uncertain whether there is a connection between Ozempic and contraceptive failure.
Some women have reported getting pregnant while taking the contraceptive pill and Ozempic. Cottonbro Studio/Pexels In men with type 2 diabetes, obesity and low testosterone, drugs like Ozempic have shown promising results for weight loss and increasing testosterone levels.
Avoid Ozempic if you’re trying to conceive
It’s unclear if semaglutide can be harmful in pregnancy. But data from animal studies suggest it should not be used in pregnancy due to potential risks of fetal abnormalities.
That’s why the Therapeutic Goods Administration recommends women of childbearing potential use contraception when taking semaglutide.
Similarly, PCOS guidelines state health professionals should ensure women with PCOS who use Ozempic have effective contraception.
Guidelines recommended stopping semaglutide at least two months before planning pregnancy.
For women who use Ozempic to manage diabetes, it’s important to seek advice on other options to control blood glucose levels when trying for pregnancy.
What if you get pregnant while taking Ozempic?
For those who conceive while using Ozempic, deciding what to do can be difficult. This decision may be even more complicated considering the unknown potential effects of the drug on the fetus.
While there is little scientific data available, the findings of an observational study of pregnant women with type 2 diabetes who were on diabetes medication, including GLP-1-RAs, are reassuring. This study did not indicate a large increased risk of major congenital malformations in the babies born.
Women considering or currently using semaglutide before, during, or after pregnancy should consult with a health provider about how to best manage their condition.
When pregnancies are planned, women can take steps to improve their baby’s health, such as taking folic acid before conception to reduce the risk of neural tube defects, and stopping smoking and consuming alcohol.
While unexpected pregnancies and “Ozempic babies” may be welcomed, their mothers have not had the opportunity to take these steps and give them the best start in life.
Read the other articles in The Conversation’s Ozempic series here.
Karin Hammarberg, Senior Research Fellow, Global and Women’s Health, School of Public Health & Preventive Medicine, Monash University and Robert Norman, Emeritus Professor of Reproductive and Periconceptual Medicine, The Robinson Research Institute, University of Adelaide
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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