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Thinking of Your Heart At Valentine’s


'Heart of Hearts' photo (c) 2008, terren in Virginia - license: http://creativecommons.org/licenses/by/2.0/Valentine’s Day brings hearts and chocolates, romantic thoughts and perhaps the bittersweet memory of young love lost. Heartache is a pain like no other, utterly indescribable to one untouched by romantic catastrophe. The heart has been the center of the human intellect and our very soul for 99 percent of human history. No less than Aristotle taught reason and love emanated from the heart. Makes sense, that’s where you feel the pain of heartbreak.

The familiar red heart symbol dates back at least 3,000 years and is believed to originate from the shape of mating swans necks, or more colorfully, women’s buttocks. The color red is assumed to come from the color of blood.

We know a lot more about curing heartache from clogged arteries than, unfortunately, unrequited love.

The physical side of the heart is simply a pump, weighing just over half a pound and making blood go round and round. It is built like the energizer bunny and is good for 2, 3, occasionally even 3.5 billion beats. The heart, perhaps unfortunately, doesn’t get its oxygen from the blood in the heart, but rather from coronary arteries outside the heart. Blood and oxygen to the heart muscle go from the outside in, not, as commonly believed, the inside out. A somewhat precarious arrangement, as these coronary arteries tend to clog.

Making the heart last a long time is all about the quality of the heart you are born with, and maintenance, like so many other things in life.  Hard to change build-quality without picking your parents. (If we get to pick our parents I want to be taller, smarter and better looking while I’m at it – why just improve the inside?).  Maintenance however, is at least as important as what you get to start with.

Avoiding a “broken heart” is a worthwhile exercise, as heart disease is the leading cause of death in America. Speaking of exercise … yes, exercise is one of the most important things you can do to keep your heart in good working condition. Exercise is actually a “three-fer.” Exercise lowers your blood pressure, helps you lose weight and raises your good cholesterol. If blood pressure and cholesterol are still out of sorts despite exercise, they can be lowered with medication.

It is probably occurring to you that how you live has a lot to do with your risk of heart disease. Blood pressure, cholesterol, body weight and diabetes are all worsened by the typical high fat/high calorie American diet. Until recently, a lot of heavy meals were finished off with coffee and a cigarette or two. Smoking is rapidly dying out. Fortunately coffee isn’t bad for you.

But, despite so much negativity, life still needs to be a little fun – especially on Valentine’s Day. Alcohol and dark chocolate are good for your heart. A glass of wine with a healthy dinner should help you not miss the double cheeseburger quite as much; and a piece of chocolate for dessert should satisfy the sweet tooth of your sweetheart.

So flowers, red wine and chocolate are romantic and heart-healthy Valentine’s Day gifts, and remember, a little romance also counts as exercise.

Take Care and Happy Valentine’s Day.

Dr B.

Make The Day After The Super Bowl a Better One: Hangovers At A Glance

With the Super Bowl coming this weekend – and the parties and unfortunate hangovers that go with it – it is worth restating that there is no cure for a hangover other than not drinking.

Much has been written and remains in pop culture regarding remedies for the dreaded hangover. A surprising amount of scientific literature fails to explain the hangover syndrome other than it may be a mild version of severe alcohol withdrawal. Headache, nausea, vomiting, rapid heartbeat, thirst, difficulty with concentration, dizziness and general muscle soreness are all common symptoms.

The most extensive review of medical literature in recent past by the British Medical Journal failed to show any convincing evidence of any therapy or dietary supplements that can consistently help the symptoms or help understand precisely why it happens. This year several commercially available products have surfaced that reportedly help cure or treat hangovers. These are entirely unproven claims. Do not waste your money on them.

Understanding a few simple facts that are clear, should be kept in mind any time alcohol is consumed.

There are many moving pieces to this puzzle. Limiting your alcohol consumption and drinking responsibly, if not abstaining entirely, is your best choice.

The less alcohol ingested the less likely you are to experience problems. Making an effort to drink plenty of water may be helpful. We know problems arise when people get dehydrated, which is a common characteristic of hangovers as well as many other medical conditions.

Alcohol is both a toxin to the liver and a diuretic. The liver usually tolerates small amounts of alcohol, but even small amounts are dehydrating. You actually lose more fluids drinking alcohol than you consume.

The type of alcohol consumed may increase risk of hangover. Clear distilled spirits such as vodka appear less likely than dark fermented alcohol (wine, beer, or bourbon) to cause a hangover. According to reliable research, congeners that add to the darker color are toxins created in fermentation and play a greater role in the bad side effects. Again, it is worth emphasizing too much alcohol consumed of any type leads to problems.

A safe amount is hard to identify due to many variations in individual metabolism, body weight and composition, medications, general health, gender and age.

Besides drinking responsibly, consuming plenty of water before and during the times of alcohol ingestion may be helpful in minimizing the ill effects. Some experts recommend a glass of water for every alcoholic beverage. They also suggest consuming only one alcoholic beverage per hour as a rule of thumb.

Use of non-steroidal anti-inflammatory such as ibuprofen or naproxen after drinking seems like it makes sense. However, research has failed to demonstrate any consistent response. Acetaminophen when drinking should be avoided due to its own liver toxicity, which can be magnified in the presence of alcohol.

Drink responsibly. Do not drink and drive. Even small amounts of alcohol impair judgment before you are aware of its effects. Be mindful and pro-active about alcohol consumption. It is the only way to avoid a hangover or worse.

Dr. Bruce Kaler

 

 

Staying Safe: Avoiding Snow Removal Injuries

With snow finally hitting many parts of the country, it’s a good time to consider ways to avoid common injuries associated with snow removal.

The most common injuries associated with snow removal include sprains and strains, particularly in the back and shoulders. When using snow blowers, cuts and even severe damage to fingers and hands can occur if used improperly.

Although a very laborious chore at the most inconvenient time, snow removal can be good exercise. But do not underestimate the difficulty of this strenuous and sometimes dangerous activity.

You should probably check with your doctor about your ability to pursue such strenuous physical activity if you are over 40 years old. Many people lead such sedentary lives that sporadic physical activity such as snow removal can be dangerous to your health.

Clearing snow puts a lot of stress on the heart and multiple joints. Unless you are already healthy and in good physical condition you should leave this work to someone else. Almost 20,000 emergency room visits are related to shoveling snow, snow blowers, and manual ice removal in winter.

Working in cold wet slippery conditions where it may be hard to use good body mechanics can only lead to problems. Be sure you are equipped properly. This starts with your clothing. Dressing in layers to achieve adequate insulation and ventilation in the cold is important. Appropriate hat and gloves can protect against cold and rough work. Warm insulating socks and shoes that have slip-resistant soles are also important.

Warming up your muscles with some light activity before you start is important to all exercise activities. Snow removal takes a slow steady pace, so don’t be in a hurry. Take frequent breaks, it is very strenuous work. Staying well hydrated is easily overlooked in cold weather. You will probably work up a sweat even though it may be frigid outside.

Use a snow shovel in good condition that is comfortable for your size and height. Go slowly, picking up small amounts of snow each time. Be attentive to good lifting technique. Avoid bending at the waist and let your legs do more of the work. While staying more upright, abs and back engaged, bend the knees in a slight squat, feet about shoulder width apart to lift safely and efficiently. Stay close to the snow you are lifting while avoiding complete arm extension.

When possible you may be able to push the snow off to the side with your shovel without actually lifting. In deep snow, remove small amounts with your shovel starting at the top of the pile, not at the bottom. Maintain an awareness of your surroundings and the ground on which you are working. Be cautious about hidden objects buried in the snow or working on uneven surfaces.

Snowblowers need close attention and familiarity with your machine. Some things to remember:

- Do not modify or tamper with any of the machine’s safety features.

- Add fuel and do other maintenance only when the machine is completely off.

- Do not leave a running machine unattended.

- When a machine jams or clogs, never stick hands in the snowblower. Stop the engine and wait at least 5 to 10 seconds for the blades to stop moving.

- Beware of recoil when the machine is stopping.

- Use a long solid object to remove ice or debris from the machine. Remember the engine remains quite hot even though you are working in the cold.

- If you are using an electric snowblower know where the cord is at all times. Keep children away from the machine and the work area.

With some common sense steps you can avoid back injury or worse while clearing a path for your winter needs and enjoyment. Stay warm and stay safe.

Dr. Bruce Kaler

The Bad Side of Drug Research

There are a lot of people running around with chemistry degrees and there is a lot of drug research being done. Inventing the next hot pharmaceutical drug has always been the dream of many researchers, and the quickest way to substantial praise, if not fame. (In terms of fame, can you name the inventor of Inderal, Tagamet or Viagra? I can’t either). Yet these are all breakthrough drugs that changed millions of lives.

Recently the hallowed halls and white lab coats of pharmaceutical research are finding competition from clandestine labs. Yes, these underworld types are doing drug research.
The process of inventing drugs of abuse is, strangely enough, not unlike traditional pharmaceutical research.

For a few very bright, and/or very lucky researchers, truly ground-breaking work is being done. For the rest, a tiny variation on a successful parent molecule is sought. Some of these end up better than the parent drug and some are worse. Many have similar effects to the parent drug with one important difference – they are not covered by the original drug’s patent.

On the clandestine side, variations on illegal drugs are sought.

A minor difference in a molecule temporarily makes the law obsolete. Ecstasy is a variation on the methamphetamine molecule. It took several years for laws to catch up with the street. The change also temporarily evades drug screen detection since an exact molecular match is required. There are also tremendous tax advantages to having an illegal enterprise (not paying taxes, at least for a while).

Anyone watching the news has seen several recent examples of this clandestine research.

K2 is a variation on the THC molecule; “bath salts” are another variation on the methamphetamine molecule. Both resided briefly in the unrestricted and almost undetectable area of gray market drugs.
The law has caught up with both of these compounds, and the technology to detect them followed quickly. They smoldered along out of sight to most of society for a few years, and then became illegal right when most of us heard of them for the first time.

This is going to be the drug problem of the 21st century.

There are already many new illegal drugs circulating in areas where polite society doesn’t look. As long as they are not widely distributed, they will continue unnoticed. The cycle is contracting by recent experience. Ecstasy was widely available for five years before becoming illegal; K2 and Spice – two or three years. Bath Salts were restricted only months after hitting the underground big time.

This represents a fundamental ground shift in illegal drug use. Before this, well-known drugs were abused and there were few surprises. Cocaine, marijuana and heroin have been with us for centuries. We understand well every bad thing they can do to you.

So, as we shop carefully for organic greens at the grocery store to stay healthy, a few of our kids are unwittingly entering the cutting edge of illicit drug research.

Give your kids a hug and remind them people are paid to have new drugs tested on their bodies, and it is done in carefully monitored medial settings.

Happy New Year (and take care).

Dr. B