Learn To Examine Health Information Critically
These days, it’s easy to find health information, but hard to know what to trust. When you come across a new piece of medical information, ask critical questions before changing your behavior. Where is the information coming from? Is it based on anecdotal evidence, or were careful experiments conducted? Is it from a trustworthy university or research center, or from a fringe organization with a specific agenda? Is it being played up on the news just to get ratings? How does it compare with the information that is already out there? Has the idea been thoroughly tested, or is it just a promising hint from a single preliminary study? What does your doctor think of it? It’s important to adapt to new insights, but it’s just as important not to blindly follow every trendy suggestion that comes along. Remember, the stronger the original theory was,the more powerful the new evidence must be to overturn it.
Critical thinking is especially needed when you look for information on the Internet. When you type words into a search engine, the results that come up are not necessarily based on research.
Sometimes a company that wants to sell you its product may have created the page, and the product may not be based on scientific research or may not even be safe for you!
You should always question where information on the Internet comes from. Web sites from the government generally give good information, as do the sites listed in the “Resources” section of this book on page 79. You can also always ask a librarian if you have questions about whether a Web site is a good one to trust or not. [See Appendix 2 on page 75 for more information about how to examine health advertisements critically.]
What Symptoms Should Tip You Off a Heart Attack ?
The classic symptoms of a heart attack include intense, sometimes squeezing, chest pressure or pain, often radiating to the jaw or left arm, and frequently accompanied by profuse sweating, or a nearly overwhelming sense of fear or impending doom.
Unfortunately, many patients with heart attacks do not have this classic presentation. Their discomfort may be relatively mild, and may be localized to the back, abdomen, shoulders, or either or both arms. Nausea and vomiting, or merely a feeling of heartburn, may be the only symptom. These less classic symptoms may not make patients think of a heart problem, and may keep them from seeking medical help. Indeed, up to 30% of heart attacks are diagnosed by taking a routine ECG long after the fact.
This is why people with one or more risk factors for coronary artery disease need to pay close attention to any unusual symptoms involving the upper half of the body. This warning would apply, for instance, for any middle-aged or older person who is obese, sedentary, a smoker, a diabetic, overweight, has high cholesterol, or has a family history of heart disease. (Ideally, of course, such people will have been evaluated by a competent physician who will have screened them for the presence of coronary artery disease, coached them on risk factor modification, and heightened their awareness of potential cardiac problems.)
What are the Consequences of a Heart Attack?
When a portion of heart muscle dies, several bad things can happen. If the amount of damage is large enough, the patient can develop immediate heart failure and shock. (When doctors refer to “shock,” they are talking about extremely low blood pressure, caused by the heart’s inability to pump sufficient blood to the body’s tissues.) When heart failure occurs immediately after a heart attack, there is an extremely high risk of early death.
If the amount of heart damage is only mild or moderate, heart failure does not occur – at least, not right away. However, in the effort to heal itself, the heart goes through a period of “remodeling,” in which the heart enlarges and changes shape. This remodeling eventually leads to a decrease in cardiac pumping efficiency, and can lead to a more gradual onset of heart failure months or years after the heart attack. To a large degree, the outcome of a heart attack depends on the amount of heart muscle that dies. This, in turn, is related to which coronary artery is blocked (click here for a description of the coronary arteries), and to where in the artery the blockage occurs. (A blockage near the origin of an artery will affect more heart muscle than a blockage farther down the artery.)
During the first few hours of an acute heart attack, a transient form of electrical instability occurs that makes the heart prone to develop ventricular tachycardia and ventricular fibrillation - frequently lethal heart arrhythmias. Furthermore, during the healing process, the scar tissue that replaces the dead heart muscle can cause a permanent electrical instability. Thus, sudden death is common both during acute heart attacks and among survivors of heart attacks, and accounts for approximately 50% of all deaths due to coronary artery disease.
Embarrassing Sex Questions
1. Why aren’t my breasts a perfectly matched set?
Unless they’ve been surgically altered, most women’s breasts are not perfectly matched. That’s because breasts are made of mammary gland tissue and fat, and there are naturally different amounts in each, explains Dr. Glenn Updike, assistant professor of obstetrics and gynecology at Magee Women’s Hospital in Pittsburgh.
All women have some difference in their breasts; for some, the difference is more pronounced. Usually, this is only a cosmetic, and sometimes comfort, issue. (If it’s embarrassing or impacting your sex life, surgical remedies are available.) However, while different-sized breasts are common, if one breast suddenly becomes much larger than the other it could indicate an infection or tumor, so have your gynecologist evaluate it immediately.
2. Is it normal to pass gas during orgasm?
When you climax, the muscles around your genitals – including the sphincter muscle – relax, and when they do, it’s not unusual for a little gas to escape, says Dr. Millicent Comrie, MPH, founder and medical director of the Long Island College Center for Women’s Health in Brooklyn. But even before orgasm, because the penis rubs against the anus through the vaginal wall, the in-and-out motion may trigger gas, Comrie says. If it’s a frequent problem and really embarrassing to you, she suggests taking an over-the-counter anti-gas medication that contains simethicone before having sex.
3. If I had a dream about having sex with another woman, does that mean I’m gay or bisexual?
Not necessarily, says Michele Sugg, a certified sex therapist in Branford, Connecticut, and member of the American Association of Sexuality Educators, Counselors, and Therapists. It could mean you’re attracted to women (or a particular woman), but it could also mean you’re missing the closeness that friendships with women brings. “Sometimes women symbolize nurturance, love and closeness,” Sugg explains. “If you’re in a relationship with a guy and you’re not getting enough closeness, a dream like this might symbolize that you need more of that.”
It’s important to remember that an erotic dream doesn’t define your sexual identity. “Even if it means you feel sexually attracted to another woman, you don’t need to pigeonhole yourself,” Sugg says. “A lot of studies find that women’s sexuality is more fluid. Maybe at times you’ll be attracted to women and at times you won’t be. There’s a scale rather than being gay, straight or bi.”
Sleep Eating
Sleep eating is a sleep-related disorder, although some specialists consider it to be a combination of a sleep and an eating disorder. It is a relatively rare and little known condition that is gaining recognition in sleep medicine. Other names for sleep eating are sleep-related eating (disorder), nocturnal sleep-related eating disorder (NS-RED), and sleep-eating syndrome.
Sleep eating is characterized by sleepwalking and excessive nocturnal overeating (compulsive hyperphagia). Sleep eaters are comparable to sleepwalkers in many ways: they are at risk for self-injury during an episode, they may (or may not) experience excessive daytime sleepiness, and they are usually emotionally distressed, tired, angry, or anxious. Sleep eaters are also at risk for the same health complications as compulsive overeaters, with the added dangers of sleepwalking. Common concerns include excessive weight gain, daytime sleepiness, choking while eating, sleep disruption, and injury from cooking or preparing food such as from knives, utensils, or hot cooking surfaces. There is also the potential for starting a fire.
As with sleepwalkers, sleep eaters are unaware and unconscious of their behavior. If there is any memory of the episode, it is usually sketchy. A sleep eater will roam the house, particularly the kitchen, and may eat large quantities of food (as well as non-food items). In the morning, sleep eaters have no recollection of the episode. However, in many cases there are clues to their behavior. One woman woke up with a stomachache and chocolate smeared on her face and hands. Candy wrappers littered the kitchen floor. The next morning her husband informed her that she had been eating during the night. She was shocked and distressed because she had no recollection of the event.
As in the case described above, food consumed by sleep eaters tends to be either high sugar or high fat. Odd combinations of foods, such as potato chips dipped in peanut butter or butter smeared on hotdogs, as well as non-food items, have been reported. Oddly, one person was discovered cutting a bar of soap into slices and then eating it as if it were a slice of cheese!
Sleep eating is classified as a parasomnia. It is a rare version of sleepwalking, which is an arousal disorder. In 1968, Roger Broughton published a paper in Science (159: 1070-1078) that outlined the major features of arousal disorders. They are:
* Abnormal behavior that occurs during an arousal from slow wave sleep;
* The absence of awareness during the episode;
* Automatic and repetitive motor activity;
* Slow reaction time and reduced sensitivity to environment;
* Difficulty in waking despite vigorous attempts;
* No memory of the episode in the morning (retrograde amnesia); and
* No or little dream recall associated with the event.
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