On Monday night, I watched as Damar Hamlin had cardiopulmonary resuscitation (CPR) on the football field. Medical personnel quickly shocked his heart back into a normal rhythm. Meanwhile, distraught players openly cried, and the National Football League (NFL) suspended the game.

In an early morning statement the following day, the Buffalo Bills organization reported that Hamlin’s “heartbeat was restored on the field” and that the football player was under sedation at the University of Cincinnati Medical Center.

Just over three days later, Hamlin awakens and shows his brain function is intact:

Doctors: Hamlin shows’ substantial improvement buffalo Bills safety Damar Hamlin is beginning to awaken.

Bills safety Damar Hamlin is beginning to awaken.

www.espn.com.

While the American football player is recovering, Dr. Timothy Pritts reminds us that Hamlin is critically ill. Thankfully, his neurological function appears to be intact. The 24-year-old is moving his hands and feet and communicates by writing (while unable to speak — he is still on a mechanical ventilator).

Hamlin’s first written communication upon awakening from his deep sedation-induced multiday sleep? He offered a note with this question: “Did we win?”

I love Dr. Pritts’ response: “The answer is yes, Damar, you won. You won the game of life.”

Cardiac arrest remains a public health crisis.

Sudden cardiac arrest is not uncommon and remains a public health crisis. The American Heart Association Heart and Stroke Statistics — 2022 Update shows the following:

There are more than 356,000 out-of-hospital cardiac arrests (OHCA) annually in the U.S., nearly 90 percent of them fatal. That translates to nearly 1,000 individuals daily.

The survival to hospital discharge after emergency medical services (EMS)-treated cardiac arrest languishes at an unimpressive 10 percent.

Sports-related sudden cardiac arrest

Sports-related sudden cardiac arrest (SCA) represents the following percentages of SCA by age in Portland, Oregon (USA):

Two other important observations:

• The sudden cardiac death incidence during youth sport participation is approximately 1.83 deaths per 10 million athlete years.
• Pre-participation screening of 5,169 middle and high school students (with an average age of 13) from 2010 showed high-risk cardiovascular conditions in approximately 1.5 percent.
• Recent research indicates the incidence of out-of-hospital cardiac arrest in children in the USA is 23,514.

Covid-19 pandemic and cardiac events

You may wonder how the COVID-19 pandemic has affected the incidence of out-of-hospital cardiac events. In New York City, the incidence of OHCA attended by emergency medical services tripled in 2020 compared with a year earlier.

In addition, the pandemic brought increased delays in starting CPR for out-of-hospital cardiac arrests. Despite no chance in the frequency of bystander CPR, there was a drop in the frequency of shockable rhythms, bystander AED (Automated External Defibrillator for shocking the heart back to a normal rhythm) use, and out-of-hospital cardiac arrest in public locations.

Timely, quality CPR is key to survival

Within seconds of the nationally televised event, medical personnel from Cincinnati’s Paycor Stadium initiated high-quality cardiopulmonary resuscitation (CPR) on Damar Hamlin. Soon, an ambulance came onto the field to rush Damar Hamlin.

The quick medical response likely saved Hamlin’s life. A doctor appeared by Hamlin’s side within one minute of his collapsing and immediately determined that the player had no pulse. CPR immediately began.

Cardiac arrest, CPR, awareness, and treatment

About one in six (18 percent) individuals in the United States report recent CPR training. Nearly two in three reports having had CPR training at some point.

CPR training rates appear lower in older people, those with less formal education, lower income groups, and Hispanic/Latino individuals. That’s according to a survey of over 9,000 people in the USA in 2015.

Here are the leaders in laypeople-initiated CPR for out-of-hospital cardiac arrests (OHCA):

Non-medical professionals used the “shocking device” (AED) in six percent of events, delivering a shock in 1.3 percent.

Laypeople used AEDs in nine percent of out-of-hospital cardiac arrests. States with higher use rates include Nebraska (16 percent), Alaska (10 percent), Minnesota (9 percent), Oregon (13.5 percent), Washington (11 percent), Pennsylvania (10 percent), North Carolina (9.5 percent), and Utah (9.5 percent).

Cardiac arrest — My take

First, learn CPR. It is important for all of us, especially those with sport-playing children. A kid can get hit in the chest by a baseball or basketball. A cardiac arrest can occur if the strike is in the wrong chest location at precisely the wrong time in the heart’s electrical cycle.

Second, please advocate for AEDs everywhere that is reasonable. All malls, schools, and other well-traveled public spaces should have them.

Third, never be afraid to use the AED. The machine tells you exactly what to do and will not ask you to deliver a shock unless needed.

I took a CPR refresher course last week. You should consider taking one, too.

The post Football Player Hamlin’s On-field Collapse Reminds Me to Know CPR appeared first on Medika Life.

His wife, Dr. Celine Gounder, says, “it’s just one of these things that had been brewing for years, and for whatever reason, it happened at this point.” She explained the findings on “CBS Mornings” in her first interview since her husband’s passing.

Grant Wahl’s wife reveals the cause of death in the first interview since he died at World Cup in Qatar.

www.cbsnews.com

Following an autopsy performed by the New York City Medical Examiner’s Office, we learned that he died from “the rupture of a slowly growing, undetected ascending aortic aneurysm with hemopericardium.”

Dr. Gounder explains that “the chest pressure he experienced shortly before his death may have represented initial symptoms. No amount of CPR or shocks would have saved him.”

Grant Wahl’s remarkable life

Born in Mission, Kansas (USA ) in 1973, Wahl graduated from Princeton University. During his first year, he covered Princeton’s men’s soccer team, then coached by Bob Bradley, who would go on to manage professional soccer teams.

Bradley opened the door for Wahl to study abroad in Argentina. Wahl spent time with the Boca Juniors before returning to the United States for the 1994 FIFA World Cup. Wahl volunteered that his experiences with the veteran coach catalyzed his love of soccer.

Wahl began his journalism career with the Miami Herald as an intern in 1996. He joined Sports Illustrated in November 1996, covering college basketball and soccer. Here are some of his reporting career highlights:

• 12 NCAA basketball tournaments
• Eight FIF Men’s World Cups
• Four FIFA Women’s World Cups
• Five Olympic games

Wahl first gained critical acclaim for his Sports Illustrated cover story “Where’s Daddy?” a look at the growing number of illegitimate children born to professional athletes.

MIT Sloan Sports Analytics Conference Speaker | Grant Wahl

Senior Writer, Sports Illustrated Grant Wahl is one of the world’s leading soccer journalists. Comfortable writing long…

www.sloansportsconference.com

Notable among his stories was a 2002 one with high school student and future basketball superstar LeBron James. Here is James speaking about Wahl:

“He was always pretty cool to be around. He spent a lot of time in my hometown of Akron. Whenever his name comes up, I’ll always think back to me as a teenager having Grant in our building down at St. V’s. It’s a tragic loss. It’s unfortunate to lose someone as great as he was. I wish his family the best. May he rest in paradise.

In October 2009, while covering the 2010 FIFA World Cup qualification, Wahl was robbed of his phone and wallet at gunpoint in broad daylight in Tegucigalpa, Honduras; earlier in the day, he had interviewed interim Honduran president Roberto Micheletti, who later apologized to Wahl over the incident.

Meet the President, Get Robbed: Just Another Day in Honduras | Grant Wahl’s Blog | FanNation.com

TEGUCIGALPA, Honduras — For a few minutes on Friday night, Honduran interim president Roberto Micheletti sounded happy…

web.archive.org

Wahl and aneurysm

An aortic aneurysm is a balloon-like bulge in the aorta, the body’s largest artery — “sort of the trunk of all the blood vessels,” explains Wahl’s wife, Dr. Gounder. She is an infectious disease specialist and CBS News medical contributor. An aortic aneurysm can “dissect” or — as in Wahl’s case — rupture.

Aortic aneurysms can dissect or rupture:

• The force of blood pumping can split the artery wall’s layers, allowing blood to leak between them. This process is called a dissection.
• The aneurysm can burst completely, causing bleeding inside the body. This phenomenon is a rupture.
• Dissections and ruptures are the cause of most deaths from aortic aneurysms.

According to the United States Centers for Disease Control, aortic aneurysms or dissections caused about 10,000 deaths in 2019. Approximately three in five were among men. A history of smoking accounts for about 75 percent of all abdominal aortic aneurysms.

Thoracic aortic aneurysm

Grant Wahl had a thoracic (in the chest) aortic aneurysm burst. Men and women are equally likely to get thoracic aortic aneurysms. The condition becomes more common with increasing age.

Thoracic aneurysms are typically caused by high blood pressure or sudden trauma. Some inherited conditions, including Marfan syndrome and Ehlers-Danlos syndrome, are associated with a higher incidence of the condition.

The CDC offers these symptoms of thoracic aortic aneurysm:

• Sharp, sudden pain in the chest or upper back
• Shortness of breath
• Difficulty breathing or swallowing

Abdominal aortic aneurysm

An abdominal aortic aneurysm occurs below the chest. Abdominal aortic aneurysms (AAA) are more common than thoracic aortic aneurysms. AAAs are more common in men and those 65 and older. White individuals are more likely to have them (compared with Black people).

Abdominal aortic aneurysms are usually the product of atherosclerosis (hardened arteries), but infection or injury can also cause them. Unfortunately, AAAs often don’t have associated symptoms. When symptoms do occur, they can include groin, buttocks, or leg pain. Some have throbbing or deep pain in the side or back.

Other aneurysm types

Aneurysms can occur in other body sites. For example, a ruptured brain aneurysm can cause a stroke. Aneurysms may be discovered in the neck, groin, or behind the knees. Such aneurysms are less likely to dissect or rupture but can be associated with clots. The clots sometimes break away ad block blood flow through an artery.

Aortic aneurysm risk factors

The leading risk factor for an aortic aneurysm is smoking. Other risk factors include high blood pressure (hypertension), high cholesterol, and hardened arteries (atherosclerosis). Here are some potential risk-reducing maneuvers you may wish to consider:

• If possible, keep your blood pressure below 130/80 mm Hg.
• Don’t smoke.
• Have a healthy diet.
• Get regular physical activity.
• If you have an aneurysm discovered by screening (or chance), please see a specialist who can monitor your condition. Monitoring may include periodic imaging (for some, a procedure to lower the rupture risk).

Inherited connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome, can also increase your aortic aneurysm risk. A family history of aortic aneurysm is also linked to a higher risk.

Finally, the US Preventive Services Task Force recommends an ultrasound screening for abdominal aortic aneurysms in men between the ages of 65 and 75 who have smoked.

I will end with the words of his wife, Dr. Céline Gounder:

“I want people to remember [Grant] as this kind, generous person who was really dedicated to social justice.”

Thank you for joining me for this brief look at the life of Grant Wahl and aneurysm risk reduction.

The post Soccer Journalist Dies of an Aneurysm – Five Ways to Reduce Risk appeared first on Medika Life.

Not too long ago, our family joined the rare disease community. For years, our child exhibited a multitude of disconnected symptoms that all seemed to have different explanations, if they had explanations at all. The growing list included dizziness, rapid heart rate, stomach aches, rib pain, joint pain, unexpected dislocations, migraines and others.

Spider-Web-like Health Ecosystem

The symptoms accumulated, along with a cascade of specialist appointments, diagnostic tests and treatments. So did the hours of speaking – and negotiating – with our health insurance carrier. Along the way, we encountered all sorts of personalities in our spider-web-like health ecosystem, most compassionate and wanting to help our child, others bewildered or frustrated, and still others deaf to our worries and requests. The boldest and best among the health professionals we worked with were those willing to confess their uncertainty. In medicine, the response “I don’t know” is now an act of courage.

Fifty years ago, when modern medicine came of age, there were far fewer treatments for common, non-communicable diseases such as high blood pressure, cardiovascular diseases or mental illness. While medicine has become more advanced and specialized, it has also become increasingly fragmented. The important family physician – who should have sufficient time and compensation to coordinate care – is often out-of-the-loop as patients rush to a myriad of medical specialists – each hyper-focused on their piece of the biological puzzle.

Fee-for-service care disadvantages primary care medicine and a patient’s coordinated care.  This financial model may work for simple – in and out – cases, but when it comes to chronic illnesses, it does not. Add to that the complexity of electronic medical record systems with limited interoperability. Now, specialists face “telephone-game” obstacles to accessing colleagues’ clinical notes and diagnostic data for a shared patient.

Now, shift from common non-communicable diseases to needle-in-the-haystack conditions.  It’s baffling for patients, parents and providers.  Over time, doctors may even become frustrated with these patients. People with multiple, disparate symptoms with no “one pill to heal them all” are sometimes labeled problem patients owned by no one. In these circumstances, young female patients often experience gender bias and provider judgments that the puzzling symptoms must be “in their heads.”

Communication is Part of the Care

When you hear hoofbeats behind you, think horses, not zebras. As 14^th-Century theologian and philosopher William of Occam would suggest, the more common explanation is the correct diagnosis. But medical students – and the doctors they become – need to be careful not to develop a foolish consistency.  This is not the Middle Ages of Medicine.  It is the 21^st Century of miracle medicine where patients must have a voice.

While it is easier to treat confusing and contradictory symptoms than to ask why a patient is experiencing them, savvy doctors rely more on their patients’ collaboration to help them solve medical mysteries. Information, communication, and advocacy can build a bridge linking doctors and patients.

Traumatized by the Medical System

But, most often in healthcare, the gatekeepers – providers and payers – feel they know best. This overconfidence can quickly unravel in the face of the challenges of rare whack-a-mole diseases. Physicians trying to help feel helpless and grasp at straws when their initial diagnoses and treatments do not solve their patient’s problems. Over time, many patients are traumatized by a medical system that seeks to help, but is seen as fallible.  As different solutions are sought, the system pays more and more for that same patient over time. The patient’s underlying illness remains unaddressed. No one wins.

This two-decade journey to arrive at my child’s diagnosis (Ehlers Danlos Syndrome) has taught me several lessons.

• TEAM:  Any successes result from the passion of individuals —parents, physicians, payers or policymakers — who are determined to work together to find solutions and willing to listen.

• TECH:  Good health information begins to force our fragmented health system to converge around the patient. When data is accessible, artificial intelligence finds needle-in-a-haystack solutions, uniting the myriad of like cases so that health professionals can learn, engage, and arrive at answers sooner.  Physicians who also engage patients promptly through the EHR system are more than answering the questions of anxious patients; they demonstrate partnership in the care.

• TRUST: I have seen how critical advocacy is. As a health communicator, I have been fortunate to serve on the boards of organizations such as the American Academy of Pain Medicine Foundation, American Heart Association, Leukemia & Lymphoma Society, The Marfan Foundation and Let’s Win for Pancreatic Cancer, which unite healers and patients, and participate in the Centers for Medicare and Medicaid Part D Working Group: all great forums for accurate information that improve public health through informed decisions.

These lessons all point to passionate, informed collaboration as the key to restoring clarity and sanity to the fragmented health system and driving quality care for patients, whether they have common ailments or rare conditions. I integrate these lessons into my work to benefit clients and, most importantly, change the lives of the patients they serve.

Our family’s lives were changed by one cardiologist who dared to utter a simple sentence: “You need a team.” Her idea to put one together should not have been so revelatory, nor so atypical, but it was. She understood collaboration fundamentally and saw patients and their caregivers as her partners in healing.

Collaboration – Overused Word; Underused Strategy

For those whose work touches patient care and public health, I encourage you to collaborate, talk, and merge your experiences with others. Remember, this work directly touches people’s lives. This work makes a difference. Give thought to how you can bond with others to change the course of care. Collaboration is an often-overused word but is too often underplayed as a behavior.

I call on my readers and colleagues to look to the innovators of ideas, products and relationships and recognize that through collaboration with each other, we have an opportunity to recast the health ecosystem. Recognize that our work is a life-saving effort about being part of people’s transformational moments. And be courageous enough to know when you don’t know.  From there, we can begin the journey toward healing, together.

The post Looking for Zebras: Medical Mysteries and Transformational Patient Moments appeared first on Medika Life.

A stroke happens when something interrupts the blood supply to a part of the brain or a blood vessel in the brain bursts. Either event leads to brain cell damage or death.

Our brain needs oxygen, delivered by arteries carrying oxygen-rich blood. Compromise this oxygen delivery, and brain cells begin to die within minutes. Unfortunately, may suffer long-lasting damage, disability, or death.

Let’s briefly explore some lifestyle habits and health conditions that can raise your risk for stroke. We’ll end with fice ways you might drop your chances of having a stroke.

Stroke risk factors

The American College of Cardiology explains that several risk factors can increase the probability you will have a stroke:

• Older age. While a stroke can occur at any age, the risk doubles every decade between 55 and 85 years.
• High blood pressure is the leading risk factor for a stroke.
• Race: Blacks and Hispanics are more likely to experience a stroke.
• Smoking can cause blood clots and raise blood pressure.
• Mini-strokes, or TIAs (transient ischemic attacks).

• Physical inactivity
• Being obese.
• Diabetes.
• High cholesterol.

You may have noticed that many of the risk factors for stroke also apply to heart disease. High blood pressure (hypertension), a sedentary lifestyle, excessive weight, and elevated cholesterol can negatively affect your heart or blood vessels.

Also, some heart problems can increase your stroke risk. These heart conditions include atrial fibrillation (an irregular heartbeat), disorders of the heart valves, and enlargement of a heart chamber. With any of these problems, clots can break loose and interrupt the blood supply to the brain.

Stroke: My risk reduction action plan

My father died of a stroke related to atrial fibrillation. I am more committed to practicing stroke risk-reducing maneuvers. Here is my action plan:

1. Move

I know that getting adequate physical activity is one of the single best ways that I can reduce my risk of a heart or brain event. I never use the excuse that I don’t have time; I can always walk ten minutes thrice daily (or get up every 45 minutes to walk a minimum of 75 steps).

2. Know your numbers

I keep an eye on my blood pressure and cholesterol. No excuses.

3. Manage stress

Managing stress is not something I historically thought about much. Now I know not to let my mind get the better of me. Chronic stress increases stress hormones and chemicals that promote inflammation in my body and brain.

The answer for me? I do deep breathing and mindfulness-based meditation to counteract stress. Exercise helps, as do activities (such as practicing the piano) that allow me to unplug.

4. Watch your weight

Maintaining a healthy weight is worth the effort. Even dropping a few pounds can improve my heart health. The American College of Cardiology reminds us that “many studies have shown that people who store excess fat around their midsection are at much greater risk for several health problems. These illnesses include heart disease, stroke, sudden cardiac death, certain cancers, and dementia.

5. Diet

A heart-healthy diet is a way to lower your risk of a stroke. Here’s a guide:Heart-Healthy Diets | CardioSmart – American College of CardiologyWhat it is: Although there isn’t a single Mediterranean diet, this eating plan commonly emphasizes: Fresh fruits and…www.cardiosmart.org

If a stroke happens, it is important to get the individual to the hospital as soon as possible. Here are some of the symptoms to look for:

https://drive.google.com/viewerng/viewer?url=https%3A//www.cdc.gov/stroke/docs/Know_the_Facts_About_Stroke.pdf&embedded=true

The post Five Ways to Drop Your Stroke Risk appeared first on Medika Life.

In the United States, the ten leading causes of death are:

1. Heart disease
2. Cancer
3. Accidents
4. Chronic lung diseases
5. Stroke
6. Alzheimer disease
7. Diabetes
8. Kidney disease
9. Flu and pneumonia
10. Suicide

Cardiovascular disease — Scope of the problem

These ten top causes of mortality represent 73 percent of all deaths occurring in the United States. Cardiovascular disease is the number one cause of death among high-income countries and is projected to be the leading cause of death worldwide by 2030.

We have made significant progress in identifying risk factors associated with cardiovascular disease. The INTERHEART study looked at 27,000 cases and controls from 52 countries, with researchers concluding this:

Over 90 percent of the risk for heart attack (myocardial infarction) may be explained by nine potentially changeable risk factors.

The myocardial infarction (MI) risk factors include apolipoprotein B/apolipoprotein A ratio, smoking, diabetes, hypertension, abdominal obesity, psychosocial factors, fruit/vegetable consumption, physical activity, and alcohol consumption.

Modify these individual risk factors, and you may significantly reduce your risk of having a cardiovascular event. Today, I want to add one more item to our risk reduction list. Today we look at how having good interpersonal relationships can drop your risk of heart disease and stroke.

Cardiovascular disease and social relationships

Individuals who have satisfying social connections with others tend to recover more quickly from significant health scares such as heart attacks. Create a social web, and you are more likely to live longer.

Here’s some proof:

Swedish researchers followed 13,600 adults for three years. The investigators discovered that having few or no close friends increases the chance of having a first-time heart attack by 1.5 times.

How might friends help us to dodge heart attacks? First, social support can help lower our stress levels. Unhealthy stress levels can facilitate inflammation in our arteries, triggering atherosclerosis (clogged arteries), heart attack, and stroke.

Physical touch can have an impact, too. A 2018 study found that receiving a hug relieved negative emotions such as stress. Positive and welcome physical touch can have health benefits.

Moreover, when you experience stress, friends can channel us towards a more healthy reaction. Having friends helps us to drop our pulse and blood pressure.

Still, not all friendships are healthy. A joint study from Brigham Young University and the University of Utah (USA) revealed that ambivalent and unpredictable friendships could make you ill. These suboptimal relationships can raise our blood pressure.

Finally, we are more likely to engage in healthy behaviors if we have a network of family and friends. A rich social fabric makes it more likely that we will exercise regularly, quit smoking, and eat fruits and vegetables.

The post One Trick to Lowering Heart Risk: Friends Have Benefits appeared first on Medika Life.

I recently wrote about the positive association between strength training and longevity.Weight-lifting and LongevityRUN, SWIM, JOG, OR WALK. So many cry out for all of us to get more physical activity. But are we being remiss in not…medium.com

But today, I want to focus on how you can use resistance exercise to facilitate better sleep.

Strength training: Types

Resistance training can build muscle mass, increasing your overall metabolic rate. Hang on to that thought, as we’ll return to how the resulting muscle fatigue and recovery can promote better sleep.

Let’s look at some of the benefits of resistance training, whether with bands, weightlifting, or the use of your body weight. Here are some forms of strength training:

• Muscular endurance. This approach uses sustained exercise to increase muscular endurance. Think high repetitions using light weights or your body weight.
• Muscular hypertrophy. Muscle building takes advantage of moderate-to-heavy weights to promote muscle growth.
• Circuit training. You cycle through various exercises for this full-body conditioning approach with minimal or no rest between them.
• Explosive power. Use power and speed to maximize your power output. Trained athletes often use explosive power exercises to improve explosive movements in their sport.
• Maximum muscular strength. Here, you use a low number of repetitions (typically two to six) and heavier weights to increase your overall strength. Stay away from this unless you are experienced and have mastered your form and technique.

Strength training: Benefits

There are numerous health benefits associated with strength training. Let’s look at three of them.

1. Strength training makes you stronger

With strength increases, you should be able to perform your activities of daily living better, whether carrying a heavy bag of groceries or walking to the neighborhood market.

While we all can benefit from resistance exercises, the approach may be essential for older adults.

2. Strength training and fall risk reduction

Do strength training, and you will likely lower your chances of suffering from a traumatic fall. One review, including over 23 000 adults over age 60, discovered a one-third reduction in falls among those who did an exercise program incorporating balance, resistance, and functional training.

Practice weight training, use resistance bands, do tai chi, or practice bodyweight exercise and reap the benefits.

3. Strength training and blood sugar levels

Did you know that strength training can lower the risk of developing diabetes? Furthermore, it can often help those with diabetes to better manage it.

How does strength training work its magic? Resistance training removes glucose (a sugar) from your blood, sending it to our muscle cells. Our blood sugar levels can improve with the resultant increase in muscle mass.

Here’s some proof: A study of over 35 000 women revealed a nearly one-third (30 percent) reduction in the chances of developing type 2 diabetes for those engaging in strength training (compared with those who did not do strength training).

4. Strength training and calorie burn

Did you know that strength training can help you burn calories more efficiently? Here is how strength training works its magic: It increases our metabolic rate.

5. Strength training and heart health

Do strength training regularly, and you may reduce your “bad” LDL cholesterol, drop your blood pressure, and improve your blood circulation.

I have presented five benefits of strength training, but there are many more. You can improve your self-esteem, increase flexibility, make your bones more robust, etc.

Strength training: Promoting better sleep

We have better quality sleep with strength training-induced muscle fatigue and our body’s recovery process. What’s the secret sauce?

Listen to Dr. Alicia Pate, speaking to Healthline: “A 2017 review finds that regular resistance exercise improves all aspects of sleep, with the greatest benefit being sleep quality.”

Resistance training helps the body produce a chemical called adenosine, which promotes sleep. Adenosine is blocked by caffeine, incidentally.

Dr. Pate observes that “these resistance benefits on sleep are less when combined with aerobic training or aerobic training alone.”

A recent study looked at nearly 400 overweight or obese adults. These inactive subjects also had high blood pressure.

Over one-third (35 percent) of the subjects had poor quality sleep at the study start. Looking at the relationship between exercise and sleep, the researchers report that among the four out of ten not getting at least seven hours of sleep at the study’s start:

• Sleep increased by 40 minutes for the resistance exercise group
• Sleep increased by 23 minutes in the aerobic exercise group
• Sleep increased by 17 minutes in the combined exercise group
• Sleep increased by 15 minutes in the control group

In addition, the approaches that incorporated resistance training (resistance training, with or without aerobic exercise) appeared associated with better sleep efficiency. The aerobic and no exercise groups had no improvement in sleep efficiency.

The time to get to sleep, or sleep latency, improved by three minutes in the resistance-only exercise group. The other groups experienced no improvement.

Strength training: My take

The research findings will compel me to focus more on resistance training, even as I continue my walking regimen. With age, sleep is becoming a bit more challenging.

I am pleased to learn that resistance exercise may help me. I’ll keep you posted on the results of my little personal experiment. I know that the resistance workout needs to be challenging.

The post Strength Training and Sleep appeared first on Medika Life.

Today we explore a study suggesting that as blood pressure rises above 90 mm, we risk damaging our heart’s blood vessels (coronary arteries). Today we look at that recent discovery before turning to more practical issues about blood pressure measurement:

• How often should you check your blood pressure?
• What time of day is best?
• Should you immediately repeat the measurement?
• What substances should you avoid for 30 minutes before checking you?

First of all, thank you for joining me today and caring about your health.

Blood pressure basics

I recently bought a blood pressure measuring tool. Do you know what the medical term is for the device? Kudos if you know this remarkably long name: Sphygmomanometer.

When I measure my blood pressure, the machine gives me two numbers, systolic and diastolic blood pressure. The former refers to systole, when my heart pumps blood into the main blood vessels, the aorta.

Diastolic points to diastole, the resting time when blood refills the heart. My heartbeats and the blood pressure rises to the systolic level. In-between beats, it drops to the diastolic level.

I have long thought that I had ideal blood pressure, with a systolic blood pressure of 110 to 118. The American Heart Association agrees with my assessment, offering these observations about blood pressure:

• Normal: Systolic less than 120 and diastolic less than 80
• Elevated: Systolic 120 to 129 and diastolic less than 80
• High blood pressure, stage 1: Systolic 130 to 139 or diastolic 80 to 89
• High blood pressure, stage 2: Systolic 140 or higher or diastolic over 90
• High blood pressure crisis (contact a doctor immediately): Systolic 180 or higher or diastolic over 120

A medical professional must confirm a high blood pressure diagnosis. If you have shallow blood pressure, you should connect with a medical professional.

Blood pressure: A new normal?

Am I right in thinking I am perfect for my blood pressure? Now comes a study that calls our historical definitions of blood pressure into question.

The study title gets right to the point: “Intensive Blood Pressure Control Lowers Cardiovascular Risk.”

Let’s get a bit more granular: When systolic blood pressure rose above 90 mm, the risk of coronary artery damage rose with it. The study suggests that we have made significant improvements in modifying heart disease risk factors (such as tobacco cessation), but we have more work to do. Cardiovascular disease remains the leading cause of death in the USA.

For every 10 mm increase in systolic blood pressure, the risk of calcium deposits and cardiovascular events rose accordingly. Compared with people with systolic pressures of 90 to 99 mm, those with pressures of 120 to 129 mm were 4.58 times more likely to have experienced a cardiovascular event.

We in the USA (and elsewhere) have work to do. As we put on more and more pounds, we increase our risk of two risk factors for heart disease — type 2 diabetes and high blood pressure.

Yes, we have pills for treatment, but they can come with side effects. You probably know what I am going to say: Use lifestyle, including my five pillars of health:

• Move (walking is my go-to)
• Get adequate sleep
• Eat well (and watch your cholesterol and blood sugar levels)
• Mindfulness
• Community engagement

It goes without saying to avoid tobacco and to dodge excess alcohol. Now back to blood pressure. As positive encouragement, I offer this: Individuals in traditional non-industrial societies typically maintain systolic blood pressure in the low 90s throughout life.

Measuring your blood pressure

The Mayo Clinic offers guidance on performing accurate blood pressure monitoring at home:

• Check your blood pressure device’s accuracy. Check it against your healthcare provider’s office model before you start using a monitor. Your provider can also make sure you are using it correctly.
• Measure your blood pressure twice daily. Check in the morning before eating or taking medications, and check again in the evening. Aim for the same times each day.
• Don’t measure blood pressure immediately after you awaken. If you exercise in the morning, check before exercising.
• Avoid caffeine, alcohol, and tobacco use in the 30 minutes before measuring, and go to the toilet first (a full bladder may increase your blood pressure).
• Sit quietly during monitoring and always use the same arm. Get your arm to the level of your heart when measuring. Put the cuff on bare skin, not over clothing.
• Repeat the measurement one to three minutes after the first measurement. Write down the results.

Be kind to your heart, brain, and kidneys. Watch your blood pressure. Most of us, myself included, can do better. Thoughts?

The post Rethinking Blood Pressure appeared first on Medika Life.

Pre-Covid, I took a trip to Lugano (Switzerland) to attend a medical meeting. Great meeting, breathtaking scenery, and fabulous food. I won’t bore you with the story of how I missed a flight on Air Italia as I perched at the Air Italy gate in Milano.

The flights were long and suboptimal for my blood circulation. I always wear compression socks or stockings for longer flights to promote blood vessel (vascular) health.

Travel — Why compression socks?

You probably have seen compression stockings that gently squeeze around the legs at various lengths. Let’s explore how they work and why you should consider flying with them for long trips.

We begin with this important observation: Our blood flow through our veins and back to the heart is augmented by the pump of our calf muscles. Unfortunately, when we travel by air, we typically are not moving around a lot. As a result, our blood can become more stagnant, setting us up to develop dangerous blood clots.

The contractions of your calf muscles help blood get back to the heart.

Compression stockings come in a variety of lengths. These socks gently squeeze our legs more than the usual type of socks. By doing so, you promote better circulation of the blood.

Foot surgeon Georgeanne Botek, DPM of the Cleveland Clinic (USA), reminds us that nearly 90 percent of leg disorders originate in the veins. Compression stockings increase the pressure in the tissues below the skin. Again, Dr. Botek:

“By gently squeezing the legs, compression socks increase the tissue pressure beneath the skin.” She adds that this “reduces excess fluid leakage from the capillaries, increasing the absorption of this tissue fluid by the capillaries and lymphatic vessels.”

Besides reducing swelling, compression socks can drop the ability of superficial veins to expand to fill with blood. This squeezing process can prevent blood from flowing backward and resulting in congestion.

So what’s the big deal with blood pooling in your legs? This process can result in skin changes, vein wall and valve damage, inflammation of the pools (thrombophlebitis), varicose veins, and blood clots.

While blood clots are not expected for most healthy folks, compression socks can keep your blood flowing nicely, reducing clot risk and symptoms like discomfort or swelling.

Compression socks — How to use them

Before you wear them for flying (especially for longer flights such as four or five hours or more), practice wearing them a few times beforehand, I put them on while I am waiting at the gate to board.

Action plan

Besides wearing compression socks, other ways you may reduce your blood clot risk include:

• Wearing loose-fitting clothing.
• Maximize your legroom by putting your belongings in the overhead compartments.
• Hydrate with lots of water before and during your flight.
• Minimize salty foods.
• When possible, move — walk the length of the airplane every hour or so if you are on a long flight.

Downsides

Compression socks may not be for you if you have skin that easily bruises or is compromised. For the vast majority of us, the socks are safe. If you don’t know if the socks are appropriate for you, please check with a valued health care professional.

Conclusions

Compression socks may make your long flight or car travel more comfortable. Your doctor may recommend compression stockings if you have a history of blood clots or insufficiency of your veins. You may be a candidate for a prescription pair rather than over-the-counter ones.

Finally, if you have symptoms of a blood clot (deep venous thrombosis or DVT), the condition can be life-threatening. Symptoms may include swelling in one or both legs. Some have persistent leg cramps, while others notice sudden redness or other skin discoloration to the leg. Clots sometimes cause veins that are red or swollen.

If you have concerning symptoms, please see a medical professional immediately.

Thank you for joining me today. Do you wear compression socks? If so, for long flights or car rides? With the pandemic (hopefully) winding down, do you have travel plans?

The post Travel? Don’t Forget This. appeared first on Medika Life.

Moreover, a 2021 study found that four out of ten adults between the ages of 50 and 64 without a heart-disease diagnosis still had early signs of atherosclerosis (colloquially known as hardening of the arteries) that put them at a greater risk of experiencing a heart attack.

More specifically, atherosclerosis is a disease in which plaque builds up inside your arteries. Plaque is composed of cholesterol, fat, calcium, and other substances. Over time, plaque hardens and narrows your arteries, limiting oxygen-containing blood to your tissues and organs.

Atherosclerosis can be associated with severe problems, including heart attack, stroke, or death. With this high risk of heart disease or stroke in mind, I want to give you three ways you can improve your cardiovascular health.

We don’t fully understand why atherosclerosis occurs, but one theory is that the inner wall of an artery is damaged. High blood pressure, high cholesterol, smoking cigarettes, and diabetes can cause injury. Other contributants can be lack of exercise and a diet high in saturated fat.

Here is what atherosclerosis looks like in a significant blood vessel:

Fortunately, there are some lifestyle maneuvers you can pursue to support your heart health. Let’s look at the top three ways to improve your heart health:

#1. Move

Even if you are not a big fan of vigorous exercise, it does not take much to improve your cardiovascular health. Start with a walk:Does Walking Extend Life?ARE YOU ONLY TO GET in a 15-minute walk as your physical activity of the day? My patients often ask whether walking…medium.com

Strength training and aerobic-style physical activity are also excellent approaches. Find a physical activity you enjoy and be consistent in doing it. Regular walking is a central pillar of my physical activity routine.

#2. Relax

The mind-calming practice of meditation may play a role in reducing your risk of heart disease, according to a scientific statement published in 2017 in the Journal of the American Heart Association.

Experts reviewed dozens of studies published over the past two decades and discovered that meditation might improve a host of factors linked with heart disease — making it worth including in an overall program for ongoing heart care.

Take a seat

There are many different styles and approaches to meditation, but here is a straightforward routine:

1. Sit quietly and close your eyes. Breathe slowly.
2. Relax all of your muscles, beginning with your feet, legs, and thighs.
3. Shrug your shoulders and roll your neck to the left and then right.
4. On each exhalation, say “peace” out loud or to yourself.
5. Please don’t get discouraged when your thoughts wander (and they will). Go back to repeating the pattern.
6. Continue for five to 10 minutes.

#3. Eat well

Diet plays a significant role in heart health and can impact our risk of heart disease. Here are some heart-healthy foods, according to Healthline.com:15 Incredibly Heart-Healthy FoodsHeart disease accounts for nearly one-third of all deaths worldwide (). Diet plays a major role in heart health and can…www.healthline.com

My take

I take things in small chunks, preferring to focus on simple, achievable goals that I can take on each day. I hope that these three tips help you to advance your cardiovascular health.

Thank you for joining me today.

The post 3 Ways to Improve Your Heart appeared first on Medika Life.

Just transplanting an animal’s organ into a human will not work. The person’s immune mechanisms will immediately reject the transplanted organ. So, what is to be done? The key is to genetically engineer the animal to produce organs that are less likely to be rejected. In the last 20 years, there’s been substantial progress on the research front to produce genetically modified pigs. Why pigs? Pig organs are about the same size as human organs but also share many physiologic similarities.

Recent technologies, including CRISPR, have allowed more possibilities to genetically engineer the pig’s genome. A few specific genes have been identified that are critical. Some were modified and some inactivated, called “knocked out.” It’s not just a matter of changing the pig’s genetics, but it’s also having a very specific anti-rejection drug combination. This includes the standard drugs used to prevent rejection of human organs and a specially designed monoclonal antibody against a part of the immune system called CD 40. This monoclonal antibody has been found to be essential and critical to the successful transplantation of a heart in the nonhuman primate model with animals maintained without rejection for upwards of 900 days.

In September 2021, a xenograft kidney from a genetically engineered pig was placed in a brain-dead patient still on life support. It was observed for 58 hours at the New York University Langone Hospital Center with the family’s permission to study for evidence of function and rejection. As a result, the surgical and research team, led by Dr. Robert Montgomery, himself a donor heart transplant recipient, were able to obtain critical information about the pig organ after transplantation. “Whole-body donation after death for the purpose of breakthrough studies represents a new pathway that allows an individual’s altruism to be realized after brain death declaration in circumstances in which their organs or tissues are not suitable for transplant.”

On Friday, January 7, Bartley Griffith, MD, Muhammad Mohiuddin, MD, and an extensive team of multi-specialties successfully implanted a genetically modified pig heart obtained from the Revivicor company. Revivicor created the genetically modified pig and hence the heart to the investigators’ specifications. This included modifying ten genes with three knocked out that lead to antibody development and one knocked out that controls the pig organs’ growth. The patient will also receive various anti-rejection drugs plus the monoclonal antibody aimed at CD40.

The patient, a 57-year-old man, was on life support and not eligible for a human donor organ. His projected lifespan was in days to weeks. He understood the risks of the procedure and that it was a first-time human experiment. But as he said before surgery, “It was either die or do this transplant. I want to live. I know it’s a shot in the dark, but it’s my last choice… I look forward to getting out of bed after I recover.”

The Food and Drug Administration (FDA,) having reviewed the research data, authorized the procedure “for compassionate use” on New Year’s Eve. As of Tuesday, January 12, the patient was doing well with no evidence of rejection. Only time will tell if he will make a full recovery and have his pig heart perform for many years.

Dr. Griffith is a cardiovascular surgeon with years of experience in transplanting human hearts and lungs. He has been working on xenotransplantation for over a decade. Dr. Mohiuddin joined with Dr. Griffith at the University of Maryland School of Medicine and Medical Center about five years ago to further pursue his research from the National Institutes of Health. He and colleagues developed the initial techniques to prevent rejection by gene modifications and anti-rejection drugs.

Together Griffith and Mohiuddin established the Xenotransplantation Center with Griffith as clinical director and Mohiuddin as scientific director. But, of course, there is a large team, not just the two of them. The Center investigators received a $15.7 million sponsored research grant to evaluate Revivicor genetically-modified pig hearts in further baboon studies. Last week’s surgery was the current culmination of those studies with a first in human heart xenotransplantation.

A new dawn has likely arrived for organ transplantation. But, of course, this was only the first patient. It remains to be seen how effective it will be in this man or how effective it will be in others treated with other genetically engineered pig organs like kidneys, pancreas, or lungs. But without question, it’s an exciting time with transplant-waiting individuals having a new potential on the horizon for returning to a reasonably normal life.

Stephen C Schimpff, MD, MACP, is a quasi-retired internist, professor of medicine, former CEO of the University of Maryland Medical Center, and author of Longevity Decoded — The 7 Keys to Healthy Aging and his co-authored book with Dr. Harry Oken BOOM — Boost Our Own Metabolism

The post A Pig Heart Was Transplanted Into a Human a Few Days Ago Is This The Future of Organ Transplantation? appeared first on Medika Life.