Heart Attack: His & Hers (Be Prepared!)
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Heart attack symptoms vary by sex. This is governed by hormones, so if you are for example a postmenopausal woman and not on HRT, your symptoms might be nearer that of men.
The following symptom list is intended as a rough “most likely” guide. You may not get all of the symptoms you “should”. You could get symptoms from the “wrong” category. So don’t sweat the minutiae, but do be aware of…
Symptoms for everyone:
- Jaw, neck, and/or back pain
- Nausea and/or vomiting
- Shortness of breath
- Feeling of impending doom ← heart attack survivors assure us that you’ll know this one if you experience it
Additional symptoms (mostly) just for men:
- Pressure and/or pain in the upper chest
- Discomfort and/or tingling in the arms
- Sudden cold sweat
Additional symptoms (mostly) just for women:
- Pressure and/or pain in the lower chest and/or abdomen
- Feeling of fullness and/or indigestion
- Fatigue, dizziness, possibly fainting
In the event of experiencing symptoms…
Call 911 or your local equivalent.This is not the time to wait to see if it goes away by itself. If unsure, call. Better safe than sorry/dead.
If you are not alone, or if it is someone with you who is having the suspected heart attack, it may be quicker to go to the Emergency Room by car, than wait for an ambulance.
Even if you choose to do that, you should still call 911 anyway, as the responder will be able to instruct you in real-time, not something we can do in a newsletter.
Note that if available, this means three people in the car is ideal:
Driver, patient, and third person on the phone giving information and following instructions.
Emergency situations rarely go entirely by-the-book, but with a little foreknowledge and at least one person with a calm head, preventable deaths can be avoided.
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What To Do If Having A Stroke Alone?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝Thank you for the video about what to do if you have a heart attack alone, what about what to do if you have a stroke alone?❞
(for anyone who missed that video, here it is)
That’s a good question, especially as stroke risk is rising in the industrialized world in general, and the US in particular.
However, let’s start with the caveat that if you are having a stroke, there’s a good chance you will forget what we are about to say, what with the immediate effects it has on the brain. That said…
The general advice when it comes to looking after someone else who is experiencing a stroke, is, “don’t”.
In other words, call emergency services, and don’t do anything else, e.g:
- don’t give them anything to eat or drink
- don’t give them any medications
- don’t let them go to sleep
- don’t let them talk you out of calling emergency services
- don’t let them drive themselves to hospital
- don’t drive them to hospital yourself either*
*This is for two reasons:
- an ambulance crew has skills and resources that you don’t, and can begin treatment en-route, and also,
- not all hospitals have appropriate resources to treat stroke, so the ambulance crew will know to drive to one that does, instead of driving to a random hospital and hoping for the best
So, flipping this for if it’s you having the stroke, and you’re cognizant enough to remember this:
- do call an ambulance; stay on the line and don’t do anything else unless instructed by the emergency services.
In order to do that, of course it’s important to recognize the symptoms; you probably know these but just in case, the mnemonic is “FAST”:
- Face: is there weakness on one side of their face?
- Arms: if they raise both arms, does one drift downwards?
- Speech: if they speak, is their speech slurred or otherwise unusual?
- Time: to call emergency services
It’s great to not get caught out by surprise, so you might also want to check out:
6 Signs Of Stroke (One Month In Advance)
Take care!
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Evidence doesn’t support spinal cord stimulators for chronic back pain – and they could cause harm
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In an episode of ABC’s Four Corners this week, the use of spinal cord stimulators for chronic back pain was brought into question.
Spinal cord stimulators are devices implanted surgically which deliver electric impulses directly to the spinal cord. They’ve been used to treat people with chronic pain since the 1960s.
Their design has changed significantly over time. Early models required an external generator and invasive surgery to implant them. Current devices are fully implantable, rechargeable and can deliver a variety of electrical signals.
However, despite their long history, rigorous experimental research to test the effectiveness of spinal cord stimulators has only been conducted this century. The findings don’t support their use for treating chronic pain. In fact, data points to a significant risk of harm.
What does the evidence say?
One of the first studies used to support the effectiveness of spinal cord stimulators was published in 2005. This study looked at patients who didn’t get relief from initial spinal surgery and compared implantation of a spinal cord stimulator to a repeat of the spinal surgery.
Although it found spinal cord stimulation was the more effective intervention for chronic back pain, the fact this study compared the device to something that had already failed once is an obvious limitation.
Later studies provided more useful evidence. They compared spinal cord stimulation to non-surgical treatments or placebo devices (for example, deactivated spinal cord stimulators).
A 2023 Cochrane review of the published comparative studies found nearly all studies were restricted to short-term outcomes (weeks). And while some studies appeared to show better pain relief with active spinal cord stimulation, the benefits were small, and the evidence was uncertain.
Only one high-quality study compared spinal cord stimulation to placebo up to six months, and it showed no benefit. The review concluded the data doesn’t support the use of spinal cord stimulation for people with back pain.
What about the harms?
The experimental studies often had small numbers of participants, making any estimate of the harms of spinal cord stimulation difficult. So we need to look to other sources.
A review of adverse events reported to Australia’s Therapeutic Goods Administration found the harms can be serious. Of the 520 events reported between 2012 and 2019, 79% were considered “severe” and 13% were “life threatening”.
We don’t know exactly how many spinal cord stimulators were implanted during this period, however this surgery is done reasonably widely in Australia, particularly in the private and workers compensation sectors. In 2023, health insurance data showed more than 1,300 spinal cord stimulator procedures were carried out around the country.
In the review, around half the reported harms were due to a malfunction of the device itself (for example, fracture of the electrical lead, or the lead moved to the wrong spot in the body). The other half involved declines in people’s health such as unexplained increased pain, infection, and tears in the lining around the spinal cord.
More than 80% of the harms required at least one surgery to correct the problem. The same study reported four out of every ten spinal cord stimulators implanted were being removed.
Chronic back pain can be debilitating. CGN089/Shutterstock High costs
The cost here is considerable, with the devices alone costing tens of thousands of dollars. Adding associated hospital and medical costs, the total cost for a single procedure averages more than $A50,000. With many patients undergoing multiple repeat procedures, it’s not unusual for costs to be measured in hundreds of thousands of dollars.
Rebates from Medicare, private health funds and other insurance schemes may go towards this total, along with out-of-pocket contributions.
Insurers are uncertain of the effectiveness of spinal cord stimulators, but because their implantation is listed on the Medicare Benefits Schedule and the devices are approved for reimbursement by the government, insurers are forced to fund their use.
Industry influence
If the evidence suggests no sustained benefit over placebo, the harms are significant and the cost is high, why are spinal cord stimulators being used so commonly in Australia? In New Zealand, for example, the devices are rarely used.
Doctors who implant spinal cord stimulators in Australia are well remunerated and funding arrangements are different in New Zealand. But the main reason behind the lack of use in New Zealand is because pain specialists there are not convinced of their effectiveness.
In Australia and elsewhere, the use of spinal cord stimulators is heavily promoted by the pain specialists who implant them, and the device manufacturers, often in unison. The tactics used by the spinal cord stimulator device industry to protect profits have been compared to tactics used by the tobacco industry.
A 2023 paper describes these tactics which include flooding the scientific literature with industry-funded research, undermining unfavourable independent research, and attacking the credibility of those who raise concerns about the devices.
It’s not all bad news
Many who suffer from chronic pain may feel disillusioned after watching the Four Corners report. But it’s not all bad news. Australia happens to be home to some of the world’s top back pain researchers who are working on safe, effective therapies.
New approaches such as sensorimotor retraining, which includes reassurance and encouragement to increase patients’ activity levels, cognitive functional therapy, which targets unhelpful pain-related thinking and behaviour, and old approaches such as exercise, have recently shown benefits in robust clinical research.
If we were to remove funding for expensive, harmful and ineffective treatments, more funding could be directed towards effective ones.
Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney; Adrian C Traeger, Research Fellow, Institute for Musculoskeletal Health, University of Sydney, and Caitlin Jones, Postdoctoral Research Associate in Musculoskeletal Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Rest For The Restless (Legs)
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Any tips for dealing with restless legs syndrome?❞
As a neurological disorder (Willis-Ekbom Disease, as it is also called
by almost nobody outside of academia), there’s a lot that’s not known about its pathology, but we do know that looking after one’s nerves can help a lot.This means:
- Avoid alcohol, as this is bad for everything, including nerves
- See also: How To Reduce Or Quit Alcohol
- Don’t smoke, as this is bad for everything, including nerves
- Do exercise those restless legs! It may sound funny, but in seriousness, movement promotes nerve health
- See also: Walking… Better.
- Take care of your blood sugars, because diabetic neuropathy can also cause this
- See also: 10 Ways To Balance Blood Sugars
- Massage your legs, and enjoy a hot bath/shower
You can also take into account the measures recommended for dealing with peripheral neuropathy, e.g:
Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
There are also medication options for RLS; most of them are dopamine agonists, so if you want to try something yourself before going the pharmaceutical route, then things that improve your dopamine levels will probably be a worth checking out. In the category of supplements, you might enjoy:
NALT: The Dopamine Precursor And More
Take care! And… Want something answered here? Send us your questions!
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- Avoid alcohol, as this is bad for everything, including nerves
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Are Squats the Ultimate Game-Changer?
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Dr. Jess Grochowsky, PT, DPT, MTC, CLT, CMPTP, says the answer is yes, and here’s why:
The most complete exercise
Squats are a powerful full-body exercise that targets legs, core, and (when weights are used) upper body. All in all, they enhance strength, mobility, metabolism, and joint health, making them essential for longevity and maintaining quality of movement throughout life.
In particular, they allow a much greater range of movement through more dimensions than most exercises do, meaning that (unlike a lot of more linear exercises) they build functional strength that sees us well in everyday life—mobility, joint control, and muscle stability.
Proper Squat Technique:
- The squat involves lowering the center of mass (which is slightly behind your navel and slightly down; exact position depends on your body composition and proportions) toward the floor.
- Use the “head to hips” principle to maintain a straight spine: as the head moves forward, the hips go back.
- Different foot positions (sumo, narrow, etc) target various muscles.
4 key variables to adjust squats:
- Base of support: the surface you stand on (firm vs unstable like a Bosu ball) affects stability and muscle engagement.
- Foot position: wide stances increase stability and target inner thighs and glutes; narrow stances focus more on quads.
- Weights: can use free weights, kettlebells, or bars. Adding weights increases intensity and can incorporate upper body exercises (e.g. bicep curls, overhead presses, etc).
- Squat depth: ranges from partial to deep squats, depending on functional goals.
Types of squats and variations given in the video:
- Firm surface squats: provide stability and allow even weight distribution.
- Unstable surface squats: engage smaller stabilizing muscles.
- Yoga ball squats: shift the center of mass backward, increasing quad and glute activation.
- Weighted squats: add resistance to increase muscle load and core stability (e.g. one-sided weights for oblique engagement).
- Dynamic weighted squats: incorporate quick movements, like kettlebell swings, for power and coordination.
- Single-leg squats: enhance balance and increase workload on one side of the body.
For more on all of these plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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Figs vs Plums – Which is Healthier?
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Our Verdict
When comparing figs to plums, we picked the figs.
Why?
In terms of macros, figs have more protein, carbs, and fiber; the glycemic index is about equal so we’ll call this category either a tie, or a nominal win for figs (as the “more food per food” option).
In the category of vitamins, figs have more of vitamins B1, B2, B3, B5, B6, B7, B9, and choline, while plums have more of vitamins A, C, E, and K. We may subjectively prefer one set of vitamins or the other (depending on the rest of our diet, for example), but by the numbers, this is a 7:4 victory for figs.
When it comes to minerals, figs have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while plums are not higher in any minerals. An easy win for figs here.
Of course, enjoy either or both, but if you’re going to pick one for nutritional density, we say it’s figs, as illustrated scientifically below:
Want to learn more?
You might like to read:
Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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The Other Alzheimer’s Risk Factor
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The usually-listed 7 known risk factors of dementia (in general, not just Alzheimer’s) do not include today’s item. For a recap, those were:
The 7 Known Risk Factors For Dementia
The bonus risk factor
This idea is not completely novel; it’s been known for a while that traumatic brain injury (TBI) can increase the risk of dementia, but it has generally been chalked up to “if you damage an organ, then that organ does not function so well afterwards”.
However, in the case of Alzheimer’s, it seems there’s something deeper at play. Specifically, a study that found…
❝…traumatic brain injury alters the small vessels in the brain, resulting in an accumulation of amyloid beta—a hallmark of Alzheimer’s disease.
The findings suggest that vascular dysfunction could be an early driver in neurodegenerative disorders rather than being caused by neuronal damage.❞
This association held true even in quite young patients!
The study from Sweden looked at brain tissue from TBI patients (who had had to have brain tissue removed for medical reasons due to bleeding and swelling), and found that the (traumatic) changes to the vascular smooth muscle cells were associated with increased aggregation of amyloid-β.
In terms of establishing cause and effect: since it could be safely concluded the amyloid-β had not caused the TBI (which all had external explanations such as “car crash” or such), it can be deduced that almost* certainly the TBI caused the amyloid-β aggregation.
*because little to nothing in science is every truly certain. As in life in general, really; the difference is that scientists admit it!
You may be wondering: what was the control? It would be a very generous group of citizens indeed who would volunteer bits of their brains that hadn’t needed removing. However, the answer is that the control brain bits came from a biobank, and were from uninjured patients with no history of TBI or neurodegenerative disorders, and who had died from systemic, unrelated causes. Having been dead for a matter of hours, and the fixation time for the brain bits from the living people taking long enough that everybody’s brain bits had been out of their respective living bodies for a similar length of time, this was deemed an acceptable, if imperfect, control.
You can read the study in its entirety here; it is fascinating:
The practical take-away
The practical take-away, of course, is: look after your brain
Not just in the sense of eat fiber, get healthy fats, move more, get good sleep, stay intellectually stimulated, etc*, but also in the sense of “keep your brain physically safe”.
Now, you may think that you already try not to get into car crashes, and perhaps you do not compete in contact sports, but do be aware that one of the leading causes of TBI in older people is, ignominiously, falling down.
And if you think “that only happens to older/other people”, then be aware: there’s a first time for everything and you are not immune. With that in mind, do check out:
Fall Special! ← the seasonal title notwithstanding, this is about not falling down in the first place, and being less injurable if you do fall down
*This was a modest and vague list for brevity’s sake, so for much more detail, enjoy:
How To Reduce Your Alzheimer’s Risk ← this is rather more comprehensive
Want to know more?
Here you can read about the largest study of its kind into lifestyle factors and Alzheimer’s disease:
Alzheimer’s Causative Factors To Avoid ← the methods and conclusions of Dr. David Snowdon’s famous “Nun Study”
Take care!
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