September 10th, 2011 by John Mandrola, M.D. in Research
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How could it have happened?
He was strong; do you remember how he could get uphill? He was fit; can you ever recall seeing him out of shape? His blood pressure was perfect, low even. He bragged about his exemplary cholesterol levels.
He was lean and mean.
Wait a minute…what was that about being mean?
When an endurance athlete in middle age is felled by a sudden heart attack, these questions always arise. It’s mysterious, as the idea holds that exercise and fitness should inoculate one from heart disease. But it does not.
There is more to the story of heart attacks than just the big five: genetics, smoking, high blood pressure, diabetes and cholesterol. Read more »
*This blog post was originally published at Dr John M*
June 17th, 2011 by AnneHansonMD in Opinion
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The voice at the other end of the line was angry and accusatory: “You didn’t even talk to me! You never knew my son! You didn’t talk to any of us!”
I explained to her that since she had never even met the defendant, there was no way she could have any information that would be relevant to the accused’s state of mind at the time of the crime. The victim and the defendant were total strangers and there was no apparent reason for the killing, which made the crime even more tragic. Her son was dead in a random incident, in a crime that was unquestionably motivated only by the defendant’s untreated psychiatric symptoms.
The defendant’s family was equally shocked and horrified. They were all hardworking solid citizens, with no history of criminal contacts, substance abuse or mental illness. When their daughter started getting sick Read more »
*This blog post was originally published at Shrink Rap*
January 28th, 2011 by DrCharles in Health Tips, Research
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“This job is killing me” is not a statement of jest. It is a desperate plea of outright sincerity.
Stress, anxiety, depression — all have been associated with an increased risk of cardiovascular disease and mortality. But can interventions to help people cope with stress positively affect longevity and decrease risk of dying? The results of a new study in the Archives of Internal Medicine would imply the answer is an encouraging “yes.”
Constructively dealing with stress is easier said than done, but it would seem logical that if we can reduce our psychological and social stressors we might live longer and delay the inevitable wear and tear on our vessels. This study proved that one such intervention, cognitive behavioral therapy (CBT) for patients who suffered a first heart attack, lowered the risk of fatal and nonfatal recurrent cardiovascular disease events by 41 percent over eight years. Nonfatal heart attacks were almost cut in half. Excitement may be dampened by the fact that all-cause mortality did not statistically differ between the intervention and control groups, but did trend towards an improvement in the eight years of follow up.
Definitely less suffering. Maybe less deaths.
The authors state that psychosocial stressors have been shown to account for an astounding 30 percent of the attributable risk of having a heart attack. Chronic stressors include low socioeconomic status, low social support, marital problems, and work distress. Emotional factors also correlated with cardiovascular disease include major depression, hostility, anger, and anxiety. Read more »
*This blog post was originally published at The Examining Room of Dr. Charles*
November 9th, 2010 by Edwin Leap, M.D. in Better Health Network, Opinion, True Stories
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When we physicians don’t get our way, or don’t get the response we desire, we can be intimidating. I have seen this play out many different ways. I have been treated rudely by other physicians. I was once threatened by a very prominent one, who told me (in response to the fact that I dared question his tone): “Be careful son, you’re digging yourself a deep hole.” I don’t know what kind of hole, or where it would have taken me, but he was certain I was digging it. Oddly enough, I rather like digging holes. (Very zen.)
Physicians yell at one another, or curse. Physicians stomp around and slam down charts. I don’t like it at all. I think it suggests immaturity. I always tell students and residents that in the ER, especially, the physician is “Captain of the Ship,” and the Captain must never lose his or her cool.
But physicians, sadly, do the same to non-physicians. Nurses, in particular, earn their ire as they scream, curse, stomp and engage in all sorts of negative behaviors. It also happens to paramedics, unit secretaries, dietary workers, therapists, administrators and all manner of persons. Read more »
*This blog post was originally published at edwinleap.com*
May 16th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Health Tips, Humor, Opinion, True Stories
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Dr. Whoo and I seem to be in the same place at the same time — we both struggle with our weight because we’re using food for something other than sustenance. We use it to manage stress. Overeating is, after all, a wonderful sedative. It soothes the savage beast and all that. And it really works. I’ve probably saved my marriage and my job and kept from killing my kids and my husband by sedating myself with food. Read more »
*This blog post was originally published at The Blog that Ate Manhattan*