How To Survive A Heart Attack When You’re Alone

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Dr. Alan Mandel emphasizes the importance of staying calm and following these steps to improve survival chances:

Simple is best

Here’s how you will survive a heart attack alone: briefly.

So, you will need to get help as quickly as possible. 90% of people who make it to a hospital alive, go on to survive their heart attack, so that’s your top priority.

Call emergency services as soon as you suspect you are having a heart attack. Stay on the line, and stay calm.

While having a heart attack is not an experience that’s very conducive to relaxation, heightened emotions will exacerbate things, so focus on breathing calmly. One of the commonly reported symptoms of heart attack that doesn’t often make it to official lists is “a strong sense of impending doom”, and that is actually helpful as it helps separate it from “is this indigestion?” or such, but once you have acknowledged “yes, this is probably a heart attack”, you need to put those feelings aside for later.

If you have aspirin available, Dr. Mandel says that the time to take it is once you have called an ambulance. However, if aspirin is not readily available, do not exert yourself trying to find some; indeed, don’t move more than necessary.

Do not drive yourself to hospital; it will increase the risk of fainting, and you may crash.

While you are waiting, your main job is to remain calm; he recommends deep breathing, and lying with knees elevated or feet on a chair; this latter is to minimize the strain on your heart.

For more on all this, plus the key symptoms and risk factors, enjoy:

Click Here If The Embedded Video Doesn’t Load Automatically!

Want to learn more?

You might also like to read:

Heart Attack: His & Hers (Be Prepared!)

Take care!

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  • ‘Tis To Season To Be SAD-Savvy

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    Seasonal Affective Disorder & SAD Lamps

    For those of us in the Northern Hemisphere, it’s that time of the year; especially after the clocks recently went back and the nights themselves are getting longer. So, what to do in the season of 3pm darkness?

    First: the problem

    The problem is twofold:

    1. Our circadian rhythm gets confused
    2. We don’t make enough serotonin

    The latter is because serotonin production is largely regulated by sunlight.

    People tend to focus on item 2, but item 1 is important too—both as problem, and as means of remedy.

    Circadian rhythm is about more than just light

    We did a main feature on this a little while back, talking about:

    • What light/dark does for us, and how it’s important, but not completely necessary
    • How our body knows what time it is even in perpetual darkness
    • The many peaks and troughs of many physiological functions over the course of a day/night
    • What that means for us in terms of such things as diet and exercise
    • Practical take-aways from the above

    Read: The Circadian Rhythm: Far More Than Most People Know

    With that in mind, the same methodology can be applied as part of treating Seasonal Affective Disorder.

    Serotonin is also about more than just light

    Our brain is a) an unbelievably powerful organ, and the greatest of any animal on the planet b) a wobbly wet mass that gets easily confused.

    In the case of serotonin, we can have problems:

    • knowing when to synthesize it or not
    • synthesizing it
    • using it
    • knowing when to scrub it or not
    • scrubbing it
    • etc

    Selective Serotonin Re-uptake Inhibitors (SSRIs) are a class of antidepressants that, as the name suggests, inhibit the re-uptake (scrubbing) of serotonin. So, they won’t add more serotonin to your brain, but they’ll cause your brain to get more mileage out of the serotonin that’s there, using it for longer.

    So, whether or not they help will depend on you and your brain:

    Read: Antidepressants: Personalization Is Key!

    How useful are artificial sunlight lamps?

    Artificial sunlight lamps (also called SAD lamps), or blue light lamps, are used in an effort to “replace” daylight.

    Does it work? According to the science, generally yes, though everyone would like more and better studies:

    Interestingly, it does still work in cases of visual impairment and blindness:

    How much artificial sunlight is needed?

    According to Wirz-Justice and Terman (2022), the best parameters are:

    • 10,000 lux
    • full spectrum (white light)
    • 30–60 minutes exposure
    • in the morning

    Source: Light Therapy: Why, What, for Whom, How, and When (And a Postscript about Darkness)

    That one’s a fascinating read, by the way, if you have time.

    Can you recommend one?

    For your convenience, here’s an example product on Amazon that meets the above specifications, and is also very similar to the one this writer has

    Enjoy!

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  • Three Critical Kitchen Prescriptions

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    Three Critical Kitchen Prescriptions

    This is Dr. Saliha Mahmood-Ahmed. She’s a medical doctor—specifically, a gastroenterologist. She’s also a chef, and winner of the BBC’s MasterChef competition. So, from her gastroenterology day-job and her culinary calling, she has some expert insights to share on eating well!

    ❝Food and medicine are inextricably linked to one another, and it is an honour to be a doctor who specialises in digestive health and can both cook, and teach others to cook❞

    ~ Dr. Saliha Mahmood-Ahmed, after winning MasterChef and being asked if she’d quit medicine to be a full-time chef

    Dr. Mahmood-Ahmed’s 3 “Kitchen Prescriptions”

    They are:

    1. Cook, cook, cook
    2. Feed your gut bugs
    3. Do not diet

    Let’s take a look at each of those…

    Cook, cook, cook

    We’re the only species on Earth that cooks food. An easy knee-jerk response might be to think maybe we shouldn’t, then, but… We’ve been doing it for at least 30,000 years, which is about 1,500 generations, while a mere 100 generations is generally sufficient for small evolutionary changes. So, we’ve evolved this way now.

    More importantly in this context: we, ourselves, should cook our own food, at least per household.

    Not ready meals; we haven’t evolved for those (yet! Give it another few hundred generations maybe)

    Feed your gut bugs

    The friendly ones. Enjoy prebiotics, probiotics, and plenty of fiber—and then be mindful of what else you do or don’t eat. Feeding the friendly bacteria while starving the unfriendly ones may seem like a tricky task, but it actually can be quite easily understood and implemented. We did a main feature about this a few weeks ago:

    Making Friends With Your Gut (You Can Thank Us Later)

    Do not diet

    Dr. Mahmood-Ahmed is a strong critic of calorie-counting as a weight-loss strategy:

    Rather than focusing on the number of calories consumed, try focusing on introducing enough variety of food into your daily diet, and on fostering good microbial diversity within your gut.

    It’s a conceptual shift from restrictive weight loss, to prescriptive adding of things to one’s diet, with fostering diversity of microbiota as a top priority.

    This, too, she recommends be undertaken gently, though—making small, piecemeal, but sustainable improvements. Nobody can reasonably incorporate, say, 30 new fruits and vegetables into one’s diet in a week; it’s unrealistic, and more importantly, it’s unsustainable.

    Instead, consider just adding one new fruit or vegetable per shopping trip!

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  • Why are tall people more likely to get cancer? What we know, don’t know and suspect

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    People who are taller are at greater risk of developing cancer. The World Cancer Research Fund reports there is strong evidence taller people have a higher chance of of developing cancer of the:

    • pancreas
    • large bowel
    • uterus (endometrium)
    • ovary
    • prostate
    • kidney
    • skin (melanoma) and
    • breast (pre- and post-menopausal).

    But why? Here’s what we know, don’t know and suspect.

    Pexels/Andrea Piacquadio
    A tall woman and her partner are silhoutted against the sunset.
    Height does increase your cancer risk – but only by a very small amount. Christian Vinces/Shutterstock

    A well established pattern

    The UK Million Women Study found that for 15 of the 17 cancers they investigated, the taller you are the more likely you are to have them.

    It found that overall, each ten-centimetre increase in height increased the risk of developing a cancer by about 16%. A similar increase has been found in men.

    Let’s put that in perspective. If about 45 in every 10,000 women of average height (about 165 centimetres) develop cancer each year, then about 52 in each 10,000 women who are 175 centimetres tall would get cancer. That’s only an extra seven cancers.

    So, it’s actually a pretty small increase in risk.

    Another study found 22 of 23 cancers occurred more commonly in taller than in shorter people.

    Why?

    The relationship between height and cancer risk occurs across ethnicities and income levels, as well as in studies that have looked at genes that predict height.

    These results suggest there is a biological reason for the link between cancer and height.

    While it is not completely clear why, there are a couple of strong theories.

    The first is linked to the fact a taller person will have more cells. For example, a tall person probably has a longer large bowel with more cells and thus more entries in the large bowel cancer lottery than a shorter person.

    Scientists think cancer develops through an accumulation of damage to genes that can occur in a cell when it divides to create new cells.

    The more times a cell divides, the more likely it is that genetic damage will occur and be passed onto the new cells.

    The more damage that accumulates, the more likely it is that a cancer will develop.

    A person with more cells in their body will have more cell divisions and thus potentially more chance that a cancer will develop in one of them.

    Some research supports the idea having more cells is the reason tall people develop cancer more and may explain to some extent why men are more likely to get cancer than women (because they are, on average, taller than women).

    However, it’s not clear height is related to the size of all organs (for example, do taller women have bigger breasts or bigger ovaries?).

    One study tried to assess this. It found that while organ mass explained the height-cancer relationship in eight of 15 cancers assessed, there were seven others where organ mass did not explain the relationship with height.

    It is worth noting this study was quite limited by the amount of data they had on organ mass.

    A tall older man leans against a wall while his bicycle is parked nearby.
    Is it because tall people have more cells? Halfpoint/Shutterstock

    Another theory is that there is a common factor that makes people taller as well as increasing their cancer risk.

    One possibility is a hormone called insulin-like growth factor 1 (IGF-1). This hormone helps children grow and then continues to have an important role in driving cell growth and cell division in adults.

    This is an important function. Our bodies need to produce new cells when old ones are damaged or get old. Think of all the skin cells that come off when you use a good body scrub. Those cells need to be replaced so our skin doesn’t wear out.

    However, we can get too much of a good thing. Some studies have found people who have higher IGF-1 levels than average have a higher risk of developing breast or prostate cancer.

    But again, this has not been a consistent finding for all cancer types.

    It is likely that both explanations (more cells and more IGF-1) play a role.

    But more research is needed to really understand why taller people get cancer and whether this information could be used to prevent or even treat cancers.

    I’m tall. What should I do?

    If you are more LeBron James than Lionel Messi when it comes to height, what can you do?

    Firstly, remember height only increases cancer risk by a very small amount.

    Secondly, there are many things all of us can do to reduce our cancer risk, and those things have a much, much greater effect on cancer risk than height.

    We can take a look at our lifestyle. Try to:

    • eat a healthy diet
    • exercise regularly
    • maintain a healthy weight
    • be careful in the sun
    • limit alcohol consumption.

    And, most importantly, don’t smoke!

    If we all did these things we could vastly reduce the amount of cancer.

    You can also take part in cancer screening programs that help pick up cancers of the breast, cervix and bowel early so they can be treated successfully.

    Finally, take heart! Research also tells us that being taller might just reduce your chance of having a heart attack or stroke.

    Susan Jordan, Associate Professor of Epidemiology, The University of Queensland and Karen Tuesley, Postdoctoral Research Fellow, School of Public Health, The University of Queensland

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Are You Taking PIMs?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Getting Off The Overmedication Train

    The older we get, the more likely we are to be on more medications. It’s easy to assume that this is because, much like the ailments they treat, we accumulate them over time. And superficially at least, that’s what happens.

    And yet, almost half of people over 65 in Canada are taking “potentially inappropriate medications”, or PIMs—in other words, medications that are not needed and perhaps harmful. This categorization includes medications where the iatrogenic harms (side effects, risks) outweigh the benefits, and/or there’s a safer more effective medication available to do the job.

    See: The cost of potentially inappropriate medications for older adults in Canada: A comparative cross-sectional study

    You may be wondering: what does this mean for the US?

    Well, we don’t have the figures for the US because we’re working from Canadian research today, but given the differences between the two country’s healthcare systems (mostly socialized in Canada and mostly private in the US), it seems a fair hypothesis that if it’s almost half in Canada, it’s probably more than half in the US. Socialized healthcare systems are generally quite thrifty and seek to spend less on healthcare, while private healthcare systems are generally keen to upsell to new products/services.

    The three top categories of PIMs according to the above study:

    1. Gabapentinoids (anticonvulsants also used to treat neuropathic pain)
    2. Proton pump inhibitors (PPIs)
    3. Antipsychotics (especially, to people without psychosis)

    …but those are just the top of the list; there are many many more.

    The list continues: opioids, anticholinergics, sulfonlyurea, NSAIDs, benzodiazepines and related rugs, and cholinesterase inhibitors. That’s where the Canadian study cuts off (although it also includes “others” just before NSAIDs), but still, you guessed it, there are more (we’re willing to bet statins weigh heavily in the “others” section, for a start).

    There are two likely main causes of overmedication:

    The side effect train

    This is where a patient has a condition and is prescribed drug A, which has some undesired side effects, so the patient is prescribed drug B to treat those. However, that drug also has some unwanted side effects of its own, so the patient is prescribed drug C to treat those. And so on.

    For a real-life rundown of how this can play out, check out the case study in:

    The Hidden Complexities of Statins and Cardiovascular Disease (CVD)

    The convenience factor

    No, not convenient for you. Convenient for others. Convenient for the doctor if it gets you out of their office (socialized healthcare) or because it was easy to sell (private healthcare). Convenient for the staff in a hospital or other care facility.

    This latter is what happens when, for example, a patient is being too much trouble, so the staff give them promazine “to help them settle down”, notwithstanding that promazine is, besides being a sedative, also an antipsychotic whose common side effects include amenorrhea, arrhythmias, constipation, drowsiness and dizziness, dry mouth, impotence, tiredness, galactorrhoea, gynecomastia, hyperglycemia, insomnia, hypotension, seizures, tremor, vomiting and weight gain.

    This kind of thing (and worse) happens more often towards the end of a patient’s life; indeed, sometimes precipitating that end, whether you want it or not:

    Mortality, Palliative Care, & Euthanasia

    How to avoid it

    Good practice is to be “open-mindedly skeptical” about any medication. By this we mean, don’t reject it out of hand, but do ask questions about it.

    Ask your prescriber not only what it’s for and what it’ll do, but also what the side effects and risks are, and an important question that many people don’t think to ask, and for which doctors thus don’t often have a well-prepared smooth-selling reply, “what will happen if I don’t take this?”

    And look up unbiased neutral information about it, from reliable sources (Drugs.com and The BNF are good reference guides for this—and if it’s important to you, check both, in case of any disagreement, as they function under completely different regulatory bodies, the former being American and the latter being British. So if they both agree, it’s surely accurate, according to best current science).

    Also: when you are on a medication, keep a journal of your symptoms, as well as a log of your vitals (heart rate, blood pressure, weight, sleep etc) so you know what the medication seems to be helping or harming, and be sure to have a regular meds review with your doctor to check everything’s still right for you. And don’t be afraid to seek a second opinion if you still have doubts.

    Want to know more?

    For a more in-depth exploration than we have room for here, check out this book that we reviewed not long back:

    To Medicate or Not? That is the Question! – by Dr. Asha Bohannon

    Take care!

    Don’t Forget…

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  • PS, We Love You

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    PS, we love you. With good reason!

    There are nearly 20,000 studies on PS listed on PubMed alone, and its established benefits include:

    We’ll explore some of these studies and give an overview of how PS does what it does. Just like the (otherwise unrelated) l-theanine we talked about a couple of weeks ago, it does do a lot of things.

    PS = Cow Brain?!

    Let’s first address a concern. You may have heard something along the lines of “hey, isn’t PS made from cow brain, and isn’t that Very Bad™ for humans, mad cow disease and all?”. The short answer is:

    Firstly: ingesting cow brain tissue is indeed generally considered Very Bad™ for humans, on account of the potential for transmission of Bovine Spongiform Encephalopathy (BSE) resulting in its human equivalent, Creutzfeldt–Jakob Disease (CJD), whose unpleasantries are beyond the scope of this newsletter.

    Secondly (and more pleasantly): whilst PS can be derived from bovine brain tissue, most PS supplements these days derive from soy—or sometimes sunflower lecithin. Check labels if unsure.

    Using PS to Improve Other Treatments

    In the human body, the question of tolerance brings us a paradox (not the tolerance paradox, important as that may also be): we must build and maintain a strong immune system capable of quickly adapting to new things, and then when we need medicines (or even supplements), we need our body to not build tolerance of them, for them to continue having an effect.

    So, we’re going to look at a very hot-off-the-press study (Feb 2023), that found PS to “mediate oral tolerance”, which means that it helps things (medications, supplements etc.) that we take orally and want to keep working, keep working.

    In the scientists’ own words (we love scientists’ own words because they haven’t been distorted by the popular press)…

    ❝This immunotherapy has been shown to prevent/reduce immune response against life-saving protein-based therapies, food allergens, autoantigens, and the antigenic viral capsid peptide commonly used in gene therapy, suggesting a broad spectrum of potential clinical applications. Given the good safety profile of PS together with the ease of administration, oral tolerance achieved with PS-based nanoparticles has a very promising therapeutic impact.❞

    Nguyen et al, Feb 2023

    In other words, to parse those two very long sentences into two shorter bullet points:

    • It allows a lot of important treatments to continue working—treatments that the body would otherwise counteract
    • It is very safe—and won’t harm the normal function of your immune system at large

    This is also very consistent with one of the benefits we mentioned up top—PS helps avoid rejection of implants, something that can be a huge difference to health-related quality of life (HRQoL), never mind sometimes life itself!

    What is PS Anyways, and How Does It Work?

    Phosphatidylserine is a phospholipid, a kind of lipid, found in cell membranes. More importantly:

    It’s a signalling agent, mainly for apoptosis, which in lay terms means: it tells cells when it’s time to die.

    Cellular death sounds like a bad thing, but prompt and efficient cellular apoptosis (death) and resultant prompt and efficient autophagy (recycling) reduce the risk of your body making mistakes when creating new cells from old cells.

    Think about photocopying:

    • Situation A: You have a document, and you want to copy it. If you copy it before it gets messed up, your copy will look almost, if not exactly, like the original. It’ll be super easy to read.
    • Situation B: You have a document, and you want to copy it, but you delay doing so for so long that the original is all scuffed and creased and has a coffee stain on it. These unwanted changes will get copied onto the new document, and any copy made of that copy will keep the problems too. It gets worse and worse each time.

    So, using this over-simplifier analogy, the speed of ‘copying’ is a major factor in cellular aging. The sooner cells are copied, before something gets damaged, the better the copy will be.

    So you really, really want to have enough PS (our bodies make it too, by the way) to signal promptly to a cell when its time is up.

    You do not want cells soldiering on until they’re the biological equivalent of that crumpled up, coffee-stained sheet of paper.

    Little wonder, then, that PS’ most commonly-sought benefit when it comes to supplementation is to help avoid age-related neurodegeneration (most notably, memory loss)!

    Keeping the cells young means keeping the brain young!

    PS’s role as a signalling agent doesn’t end there—it also has a lot to say to a wide variety of the body’s immunological cells, helping them know what needs to happen to what. Some things should be immediately eaten and recycled; other things need more extreme measures applied to them first, and yet other things need to be ignored, and so forth.

    You can read more about that in Elsevier’s publication if you’re curious 🙂

    Wow, what a ride today’s newsletter has been! We started at paracetamoxyfrusebendroneomycin, and got down to the nitty gritty with a bunch of hopefully digestible science!

    We love feedback, so please let us know if we’re striking the balance right, and/or if you’d like to see more or less of something—there’s a feedback widget at the bottom of this email!

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  • Staying Healthy and Active After 60

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Questions and Answers at 10almonds

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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

    Q: How to be your best self after 60: Self motivation / Avoiding or limiting salt, sugar & alcohol: Alternatives / Ways to sneak in more movements/exercise

    …and, from a different subscriber…

    Q: Inflammation & over 60 weight loss. Thanks!

    Here are some of our greatest hits on those topics:

    Also, while we’ve recommended a couple of books on stopping (or reducing) drinking, we’ve not done a main feature on that, so we definitely will one of these days!

    Don’t Forget…

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    Learn to Age Gracefully

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