Heart Attack vs. Heart Failure: Which do YOU have??

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The vast majority of people do not really understand the difference between a HEART ATTACK and the entity known as HEART FAILURE. The confusion is entirely understandable. It’s a bit complicated. So, what exactly is the difference?

A heart attack happens when the blood supply to the heart muscle itself is compromised. That blood supply comes from the ‘coronary’ arteries and if one or more gets blocked sufficiently, the heart muscle doesn’t get oxygen and portions of the muscle can die off if blood supply is not restored in time (like within a few minutes). Thus, the term ‘having a coronary’ is the same as having a heart attack.

Coronary disease (credit: Mayo Foundation)

When a muscle doesn’t get enough blood, there is pain. Everyone knows about the pain of a heart attack: severe chest pain, sometimes with radiation into the arms (left arm more than right) or neck.  ANGINA is the name for the same heart muscle pain that happens before the muscle dies. This can go on for months before an actual heart attack. When the muscle dies from lack of blood, it is called an INFARCTION, or more specifically, a MYOCARDIAL INFARCTION. When that happens, all you can do is try to heal and rehabilitate.

The causes of coronary heart disease are well known: smoking, diabetes, elevated cholesterol and triglyceride levels, other genetic factors and many less common causes.

HEART FAILURE is more about the strength of the heart, not the blood supply. Heart failure happens when the heart muscle becomes weak and cannot pump blood with enough force to keep everything humming along. Instead of pain, heart failure causes symptoms of weakness and fatigue, swelling of the legs, and swelling in the lungs which leads to difficulty breathing with exertion or when lying down flat. The symptoms can worsen over months to years until other vital organs are not getting enough blood. This leads ultimately to organ failure and death.

 

Heart Failure (Credit: American Heart Association)

What causes HEART FAILURE? The most common cause is when enough of the heart muscle has died from one or more infarctions during heart attacks that there isn’t enough strong heart muscle to pump adequately. About 70% of heart failure in developed countries comes from prior myocardial infarctions.

Other causes include high blood pressure, toxins such as alcohol or cocaine, viral infections that affect the heart muscle itself, and certain hormonal diseases. This is different from bacterial infections that affect heart valves in a condition called endocarditis.

An important difference between heart attacks and heart failure is that heart attacks can be reversed if treated soon enough. If you are having symptoms of a heart attack, i.e. crushing chest pain with radiation down one or both arms, the sooner you arrive at an Emergency Department and receive anti-clotting drugs, the better your chances of not killing off any heart muscle that could lead to heart failure.

Heart failure, on the other hand, once it is established, seems to be relentless, worsening gradually to the point where the only treatment is a heart transplant.

https://www.jameschanningshaw.com

JFK assassination coverup continues: 53 years and counting

America continues to be lied to about JFK's assassination. The evidence is solid for triangulated gunfire in Dealy Plaza, November 22nd, 1963, with the definitive round coming from the grassy knoll, a head shot fired by James Files. Listen to Wim Dankbaar's 2003 interview with James Files (through jfkmurdersolved.com and Youtube) After much academic hand wringing over how the multiple shots actually occurred, this interview is as credible as they come. It sews up how the hit was carried out. But that is merely the technical part. The story of who organized the assassination and the successful cover up is more complicated and clearly implicates government insiders who wanted Kennedy neutralized. The concept of Oswald as a lone whacko gunman has been completely disproved but remains party line in all major network media sources.

If you are interested in learning more, the nine part series on youtube, THE MEN WHO KILLED KENNEDY is a good starting point. 

https://www.jameschanningshaw.com

jfkmurdersolved.com

CLINTON'S LOSS, TRUMP'S WIN

The United States elected a populist last night. Democrats squandered their chance to nominate a populist to go head-to-head against Trump. The battle between the free market-winner-take-all approach of Trump and the democratic socialist approach of Bernie Sanders would have been the more just fight at this time in America.  At least then, the true sentiment of the American people, for better or for worse, could have been more honestly gauged. Instead, a milque-toast establishment insider with a bad reputation was rammed into position by DNC leadership. Rigged, indeed. It showed an arrogant sense of entitlement, one to deliver the first woman president. And it backfired. Big time. The one good outcome of this colossal failure of the DNC could be to question the value of backroom politics that caused the mismatch. It appears that Americans are no longer willing to accept nominees chosen by political insiders and the media.

That said, whether Trump’s leadership will see successes for the entire country, not just Wall Street and the wealthy, remains to be seen.

November 9, 2016

https://www.jameschanningshaw.com

Spaghetti squash recipe

Let's face it: squash is one of earth's less exciting flavors. You have to do something with it to bring out the flavors. I have found that caramelizing enhances best. Works with all squash varieties, but try this:

Spaghetti squash is a lovely variety that, when cooked, falls apart into strings about the size of spaghetti. The secret is slicing into pieces that will maximize contact surface with the baking pan This allows the surfaces to brown and caramelize into a beautiful, tasty dish that needs nothing but salt and pepper.

1. split squash and clean center
2. cut into slices about one or two inches thick
3. brush both sides with olive oil
4. salt lightly and (optional) sprinkle with celery seed
5. bake at 400F for about one hour, turning once so both sides get browned slightly
6. let cool enough to cut rind away. It usually falls off easily. Discard rinds.
7. stir in bowl as needed to create the spaghetti effect.
8. reheat as needed, season to taste and serve! 

great accompaniment to braised beef or lamb 

Also: see terrific link to a comprehensive review of this wonderful squash:
https://www.quickeasycook.com/spaghetti-squash/ 

MSNBC?--not so much any more

 

I used to crave MSNBC, Chris Matthews, Rachel Maddow. Smart people, those two. And more or less politically compatible with my liberal thinking, except when it came to them actually promoting the results of the Warren Commission which LBJ commissioned to avoid a real investigation that might have suggested triangulated gunfire including a shot from the front right that took off the back of JFK’s head. How anyone can still buy into Lee Harvey Oswald as JFK's killer amazes me. But that’s getting off point.

Just recently, I decided I can no longer watch Chris or Rachel or anyone else on MSNBC. And it’s not just the incessant Cialis ads and other obnoxious direct-to-consumer advertising by Big Pharma. Chris and Rachel and the gang are so biased in their reporting, so pro-Clinton, and so utterly dismissive of Bernie Sanders and his ideas that it is clear that they or their bosses must be trying to manipulate the election. Did they do this in the Obama/Hillary primaries of ’08? Don’t remember. Must not have had the channel back then.

Sander’s proposals are not  out-of-line with liberal Democratic views. It must be that Sanders-the-man is out-of-line with those who are beholden to Hillary Clinton in some way, or perhaps it is the owners and broadcasters at MSNBC. This generally applies to all the major networks, it’s just more painful at MSNBC. Even PBS, usually so thorough in their coverage of both and all sides of an argument, has been dismissive of Bernie’s message, assuming that Hillary is definitely the nominee, discouraging the all-important battles of ideas.

Come to think of it, maybe it IS Big Pharma. If MSNBC is dependent upon those drug company ads for their profit margin, it would make sense to be against Bernie Sanders because of his strong opposition to the deplorable ways of Big Pharma.

 Whether it is biased individual anchors, the influence of Big Pharma, or indebted management, I’m almost finished with MSNBC. I’ve also given up on the rest of corporate network TV, and I suspect I’m not alone in this thinking. Unbiased, respectful reporting will have to be found elsewhere.

https://www.jameschanningshaw.com

How do you visualize time?

Do you have a personal approach to the visualization of time? I have yet to come across someone's personal mental images of time. I'm talking about small-scale time, not Stephen Hawking cosmological time.

For more than 60 years, my fixed image has been a flat linear strip that displays the upcoming week. It goes backward and forward to infinity as needed but the upcoming week is always present, with next Monday looming first:

2-D visualization of time, one week at a time

 My perspective is always as depicted: from the left, looking down on the route. I navigate much of my life from this generic mental map.


Have YOU possessed a personal visualization of time in your head throughout your life? If so, please share a description and/or graphic in 'comments'.

Best regards, 

James

https://www.jameschanningshaw.com

Breakfast most Important?

Someone said breakfast was the most important meal and it stuck to humanity like scripture. Is it true, or just another myth, like eight glasses of water and cutting toenails straight?

What is so important about breakfast? Well...for any reason other than pleasure or starvation prevention, not much, it turns out. Re-hydration after a twelve hour fast makes sense, and some hunger when you wake up is to be expected.

Many careers have been made from studying breakfast. PubMed lists 1264 papers with ‘Breakfast’ in the title; Cochrane Library lists 2838 published trials with ‘Breakfast’ in title, abstract, or key words. These are mostly in lower-impact journals and none showed definitive results. 
Hard to fathom the time and effort when the findings were so marginal. Most researchers tested every possible measurement; one used ‘dual-energy X-ray absorptiometry-derived fat mass indexes’ to ultimately show no breakfast benefit! Most are too small to have any relevance whatsoever. Sad, really, though the curiosity is admirable.

Most studies investigated breakfast and obesity. Others looked at diabetes. A few addressed cognition and mood. Most tested types of food eaten and a few looked at whether skipping breakfast had deleterious effects. In sum: nada.

Some valuable nuggets can be gleaned, however:

1. Eggs and pork sausages turned out to ‘possibly’ reduce hunger and subsequent calorie intake. Both claimed the benefit came from the protein when eggs are 50% fat and sausages are 30% fat, neither of which was factored in.

2. One tidbit of data from two studies: eating 400 mg of cholesterol (2-3 eggs) daily for up to six weeks does not increase your blood lipids or weight. This is good news.

3. A 2013 review by Public Health England looked at Breakfast and Cognition. From 37 publications, some positive effects on cognitive performance were mentioned but all were variable, small, dependent on type of assessment, and in the conclusion, ‘not possible to comment on the implications.’ Not helpful, really. If they had only looked at adding a cup of coffee…!

4. A study of oatmeal was funded and written by PepsiCo which owns Quaker Oats. Would it surprise you to learn that the researchers found some benefits from oatmeal? Insignificant, however.

So, the real question remains: Does breakfast matter?

What is clear is that breakfast is not a magic bullet for overall health, weight control, general well-being or anything else. It’s fine to skip breakfast if you are not hungry. It’s fine to eat eggs and/or sausages (in moderation), oatmeal, cereal or croissants. The precise nutrient mix is not crucial. Eat what you like.

If you feel better after having breakfast, there is your answer. If you are obese, moderation is key. Enjoy your day.

 Links:
http://james-channing-shaw.blogspot.ca/2009/10/ways-to-combat-obesity.html

http://james-channing-shaw.blogspot.ca/2009/05/myth-of-cutting-toenails-straight.html
 
https://www.jameschanningshaw.com 

The myth of 8 glasses a day

April 02, 2007|James Channing Shaw | Special to The LATimes

Can Doctors and Patients be Partners in Healthcare?

 This post was originally published in OJCPCD (On-line Journal of Community and Patient-Centered Dermatology) link: ojcpcd.com 

                       

Trust in doctors. It used to be absolute. If our sick patients improved, we were celebrated. When we failed, families praised us for trying. This arrangement ws not right, but no doctor went to any great lengths to change the perception.

About three decades ago, the pendulum swung. Now doctoring is frequently viewed as market share, self-promotion, unnecessary procedures and testing. It would seem that professionalism has become obsolete.

  

Patients, too, have changed with the times. Many patients would like to have every test imaginable, expect their health problems to be cured  painlessly, no disruption to social calendars, easy parking, and why can’t this cancer be cured if man landed on the moon back in 1969?

Greedy doctors and entitled patients. Can anything be done to reduce the smoldering hostility? Yes, but not without considerable effort on both sides.

We doctors don't usually become more humble during our training. Quite the opposite, we can become more arrogant as we rise in stature and gain self-confidence. Those without an innate sense of professionalism and the altruistic dedication that goes with it will have to be taught how to deal with patients conscientiously, free of arrogance, greed, and conflicts of interest. More importantly, these skills will need to be evaluated throughout a doctor’s career. Fortunately, medical schools and credentialing boards have started to recognize this and are developing methods for teaching and evaluating such competencies.

In the patient arena, the sad truth remains that there are no guarantees. Human cell biology is considerably more complex than rocket science. A single DNA mutation during embryonic development causes a debilitating, life-long disease. A three-year-old child develops brain cancer or leukemia. These unfortunate individuals and their doctors have little control over the causes or outcomes. We should be thankful for what discoveries have been made over the years, and should expect that our own doctor’s training and continued medical education reflect that learning.

As for the high expectations of patients, I suspect they will continue. New drugs and diagnostics get marketed aggressively. Hopeful patients clamor to get the latest scan or drug they saw advertised on U.S. television. Most patients don’t understand the risk of harm that comes from unnecessary testing and treatment.

If patients were to routinely receive balanced pros and cons of treatments and tests, they might develop more reasonable expectations. Corporate entities and pharmaceutical companies certainly will not be providing that balance. We doctors must do it. Some progress is being made, however: Choosing Wisely®, Choosing Wisely Canada® and the Conference on Preventing Overdiagnosis are addressing the harm that can come from too much medicine.

A true patient-doctor partnership? For doctors, that would mean caring for the whole patient, examining best evidence before making recommendations for testing and treatment, and placing patient care above financial gain. For patients, it would mean recognizing that uncertainty always exists and that more medicine is not always better medicine. Finally, we all need to understand that medical decisions must ultimately include not only the wishes of individual patients and their doctors, but consideration of societal and public health priorities as well.

https://www.jameschanningshaw.com