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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  • Tinnitus: Quieting The Unwanted Orchestra In Your Ears

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    Tinnitus—When a “minor” symptom becomes disruptive

    Tinnitus (typically: ringing in the ears) is often thought of less as a condition in and of itself, and more a symptom related to other hearing-related conditions. Paradoxically, it can be associated with hearing loss as well as with hyperacusis (hearing supersensitivity, which sounds like a superpower, but can be quite a problem too).

    More than just ringing

    Tinnitus can manifest not just as ringing, but also as whistling, hissing, pulsing, buzzing, hooting, and more.

    For those who don’t suffer from this, it can seem very trivial; for those who do… Sometimes it can seem trivial too!

    But sometimes it’s hard to carry on a conversation when at random moments it suddenly sounds like someone is playing a slide-whistle directly into your earhole, or like maybe a fly got stuck in there.

    It’s distracting, to say the least.

    What causes it?

    First let’s note, tinnitus can be acute or chronic. So, some of these things may just cause tinnitus for a while, whereas some may give you tinnitus for life. In some cases, it depends on how long the thing in question persisted for.

    A lot of things can cause it, but common causes include:

    • Noise exposure (e.g. concerts, some kinds of industrial work, war)
    • High blood pressure
    • Head/neck injuries
    • Ear infection
    • Autoimmune diseases (e.g. Type 1 Diabetes, Lupus, Multiple Sclerosis)

    So what can be done about it?

    Different remedies will work (or not) for different people, depending on the cause and type of tinnitus.

    Be warned also: some things that will work for one person’s tinnitus will make another person’s worse, so you might need to try a degree of experimentation and some of it might not be fun!

    That in mind, here are some things you might want to try if you haven’t already:

    • Earplugs or noise-canceling headphones—while tinnitus is an internal sound, not external, it often has to do with some part(s) of your ears being unduly sensitive, so giving them less stimulus may ease the tinnitus that occurs in reaction to external noise.
    • White noise—if you also have hyperacusis, a lower frequency range will probably not hurt the way a higher range might. If you don’t also have hyperacusis, you have more options here and this is a popular remedy. Either way, white noise outperforms “relaxing” soundscapes.
    • Hearing aids—counterintuitively, for some people whose tinnitus has developed in response to hearing loss, hearing aids can help bring things “back to normal” and eliminate tinnitus in the process.
    • Customized sound machines—if you have the resources to get fancy, science currently finds this to be best of all. They work like white noise, but are tailored to your specific tinnitus.

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  • Insomnia Decoded – by Dr. Audrey Porter

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    We’ve written about sleep books before, so what makes this one different? Its major selling point is: most of the focus isn’t on the things that everyone already knows.

    Yes, there’s a section on sleep hygiene and yes it’ll tell you to cut the caffeine and alcohol, but most of the advice here is beyond that.

    Rather, it looks at finding out (if you don’t already know for sure) what is keeping you from healthy sleep, be it environmental, directly physical, or psychological, and breaking out of the stress-sleep cycle that often emerges from such.

    The style is light and conversational, but includes plenty of science too; Dr. Porter knows her stuff.

    Bottom line: if you feel like you know what you should be doing, but somehow life keeps conspiring to stop you from doing it, then this is the book that could help you break out that cycle.

    Click here to check out Insomnia Decoded, and get regular healthy sleep!

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  • Altered Traits – by Dr. Daniel Goleman & Dr. Richard Davidson

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    We know that meditation helps people to relax, but what more than that?This book explores the available science.

    We say “explore the available science”, but it’d be remiss of us not to note that the authors have also expanded the available science, conducting research in their own lab.

    From stress tests and EEGs to attention tests and fMRIs, this book looks at the hard science of what different kinds of meditation do to the brain. Not just in terms of brain state, either, but gradual cumulative anatomical changes, too. Powerful stuff!

    The style is very pop-science in presentation, easily comprehensible to all. Be aware though that this is an “if this, then that” book of science, not a how-to manual. If you want to learn to meditate, this isn’t the book for that.

    Bottom line: if you’d like to understand more about how different kinds of meditation affect the brain differently, this is the book for you.

    Click here to check out Altered Traits, and alter yours!

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  • Delay Ageing – by Dr. Colin Rose

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    Note: the title is spelled that way because it is British English. We generally write in US English here at 10almonds, but we’ll first quote directly from Dr. Rose as written:

    ❝I have written Delay Ageing because there is some very important recent University research on ageing and age related illness that deserves to be made accessible to a general audience.❞

    What is this research? Well, there’s quite a lot over its 300-odd pages (exact number depends on the edition and whether we count end matter), and most of it is tweaks and refinements on things with which you’ll probably be at least brushingly familiar if you’re a regular 10almonds reader.

    Dr. Rose addresses the nine hallmarks of aging, of which there are ten, ranging from such things as “telomeres get shorter” and “DNA accumulates damage”, to “stem cells become exhausted” and “cells fail to communicate properly”, and asks the question “what if we were to target all these things simultaneously?”.

    Rather than going for drugs on drugs on drugs (half of them to deal with undesired side effects of the previous ones), Dr. Cole leaves no stone unturned to find lifestyle interventions that will improve each of these, even if just a little. Because, all those “little” improvements add up and even compound, and on the flipside, mean that factors of aging aren’t adding up and compounding so much or so quickly anymore.

    The rather broad umbrella of “lifestyle interventions” obviously includes food under its auspices, and with it, nutraceuticals. So to give one example, if you’re taking a fisetin supplement (a natural senolytic agent), you’ll find science vindicating that here. And much more.

    The style is… Less pop-science and more “textbook written for laypersons”, and you may be thinking “isn’t that the same?” and the difference is that the textbook has a lot less polish and finesse, but often more precise information.

    Bottom line: if you’d like to combat aging on 10 different fronts with easily implementable lifestyle interventions, and know exactly what is doing what and how, then this is the book for you.

    Click here to check out Delay Ageing, and delay aging!

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  • Menopause, & When Not To Let Your Guard Down

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    This is Dr. Jessica Shepherd, a physician Fellow of the American College of Obstetricians & Gynecologists, CEO at Sanctum Medical & Wellness, and CMO at Hers.

    She’s most well-known for her expertise in the field of the menopause. So, what does she want us to know?

    Untreated menopause is more serious than most people think

    Beyond the famous hot flashes, there’s also the increased osteoporosis risk, which is more well-known at least amongst the health-conscious, but oft-neglected is the increased cardiovascular disease risk:

    What Menopause Does To The Heart

    …and, which a lot of Dr. Shepherd’s work focuses on, it also increases dementia risk; she cites that 60–80% of dementia cases are women, and it’s also established that it progresses more quickly in women than men too, and this is associated with lower estrogen levels (not a problem for men, because testosterone does it for them) which had previously been a protective factor, but in untreated menopause, was no longer there to help:

    Alzheimer’s Sex Differences May Not Be What They Appear

    Treated menopause is safer than many people think

    The Women’s Health Initiative (WHI) study, conducted in the 90s and published in 2002, linked HRT to breast cancer, causing fear, but it turned out that this was quite bad science in several ways and the reporting was even worse (even the flawed data did not really support the conclusion, much less the headlines); it was since broadly refuted (and in fact, it can be a protective factor, depending on the HRT regimen), but fearmongering headlines made it to mainstream news, whereas “oopsies, never mind, we take that back” didn’t.

    The short version of the current state of the science is: breast cancer risk varies depending on age, HRT type, and dosage; some kinds of HRT can increase the risk marginally in those older than 60, but absolute risk is low compared to placebo, and taking estrogen alone can reduce risk at any age in the event of not having a uterus (almost always because of having had a hysterectomy; as a quirk, it is possible to be born without, though).

    It’s worth noting that even in the cases where HRT marginally increased the risk of breast cancer, it significantly decreased the risk of cancers in total, as well fractures and all-cause-mortality compared to the placebo group.

    In other words, it might be worth having a 0.12% risk of breast cancer, to avoid the >30% risk of osteoporosis, which can ultimately be just as fatal (without even looking at the other things the HRT is protective against).

    However! In the case of those who already have (or have had) breast cancer, increasing estrogen levels can indeed make that worse/return, and it becomes more complicated in cases where you haven’t had it, but there is a family history of it, or you otherwise know you have the gene for it.

    You can read more about HRT and breast cancer risk (increases and decreases) here:

    HRT: A Tale Of Two Approaches

    …and about the same with regard to HMT, here:

    The Hormone Therapy That Reduces Breast Cancer Risk & More

    Lifestyle matters, and continues to matter

    Menopause often receives the following attention from people:

    1. Perimenopause: “Is this menopause?”
    2. Menopause: “Ok, choices to make about HRT or not, plus I should watch out for osteoporosis”
    3. Postmenopause: “Yay, that’s behind me now, back to the new normal”

    The reality, Dr. Shepherd advises, is that “postmenopause” is a misnomer because if it’s not being treated, then the changes are continuing to occur in your body.

    This is a simple factor of physiology; your body is always rebuilding itself, will never stop until you die, and in untreated menopause+postmenopause, it’s now doing it without much estrogen.

    So, you can’t let your guard down!

    Thus, she recommends: focus on maintaining muscle mass, bone health, and cardiovascular health. If you focus on those things, the rest (including your brain, which is highly dependent on cardiovascular health) will mostly take care of itself.

    Because falls and fractures, particularly hip fractures, drastically reduce quality and length of life in older adults, it is vital to avoid those, and try to be sufficiently robust so that if you do go A over T, you won’t injure yourself too badly, because your bones are strong. As a bonus, the same things (especially that muscle mass we talked about) will help you avoid falling in the first place, by improving stability.

    See also: Resistance Is Useful! (Especially As We Get Older)

    And about falls specifically: Fall Special: Be Robust, Mobile, & Balanced!

    Want to know more from Dr. Shepherd?

    You might like this book of hers that we reviewed not long back:

    Generation M – by Dr. Jessica Shepherd

    Take care!

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  • PFAS Exposure & Cancer: The Numbers Are High

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    PFAS & Cancer Risk: The Numbers Are High

    Dr Maaike Van Gerwen studies the effects of exposure to PFAS on cancer development.
    Image Credits Mount Sinai

    This is Dr. Maaike van Gerwen. Is that an MD or a PhD, you wonder? It’s both.

    She’s also Director of Research in the Department of Otolaryngology at Mount Sinai Hospital in New York, Scientific Director of the Program of Personalized Management of Thyroid Disease, and Member of the Institute for Translational Epidemiology and the Transdisciplinary Center on Early Environmental Exposures.

    What does she want us to know?

    She’d love for us to know about her latest research published literally today, about the risks associated with PFAS, such as the kind widely found in non-stick cookware:

    Per- and polyfluoroalkyl substances (PFAS) exposure and thyroid cancer risk

    Dr. van Gerwen and her team tested this several ways, and the very short and simple version of the findings is that per doubling of exposure, there was a 56% increased rate of thyroid cancer diagnosis.

    (The rate of exposure was not just guessed based on self-reports; it was measured directly from PFAS levels in the blood of participants)

    • PFAS exposure can come from many sources, not just non-stick cookware, but that’s a “biggie” since it transfers directly into food that we consume.
    • Same goes for widely-available microwaveable plastic food containers.
    • Relatively less dangerous exposures include waterproofed clothing.

    To keep it simple and look at the non-stick pans and microwavable plastic containers, doubling exposure might mean using such things every day vs every second day.

    Practical take-away: PFAS may be impossible to avoid completely, but even just cutting down on the use of such products is already reducing your cancer risk.

    Isn’t it too late, by this point in life? Aren’t they “forever chemicals”?

    They’re not truly “forever”, but they do have long half-lives, yes.

    See: Can we take the “forever” out of forever chemicals?

    The half-lives of PFOS and PFOA in water are 41 years and 92 years, respectively.

    In the body, however, because our body is constantly trying to repair itself and eliminate toxins, it’s more like 3–7 years.

    That might seem like a long time, and perhaps it is, but the time will pass anyway, so might as well get started now, rather than in 3–7 years time!

    Read more: National Academies Report Calls for Testing People With High Exposure to “Forever Chemicals”

    What should we use instead?

    In place of non-stick cookware, cast iron is fantastic. It’s not everyone’s preference, though, so you might also like to know that ceramic cookware is a fine option that’s functionally non-stick but without needing a non-stick coating. Check for PFAS-free status; they should advertise this.

    In place of plastic microwaveable containers, Pyrex (or equivalent) glass dishes (you can get them with lids) are a top-tier option. Ceramic containers (without metallic bits!) are also safely microwaveable.

    See also:

    Here’s a List of Products with PFAS (& How to Avoid Them)

    Take care!

    Don’t Forget…

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