HOW A STROKE CAN CHANGE YOUR PERSONALITY

Sep 14, 2018 | Healthy Tips

By Heidi Moawad, MD 

A stroke can produce major life-altering changes, such as vision and diminished physical strength and coordination. In addition to the obvious physical handicaps of a stroke, a stroke can also produce significant personality changes. If you are a stroke survivor, your post-stroke behavioural changes can hit you and your loved ones by surprise if you suddenly do not act like “yourself” anymore.

Once you learn how to identify the most common personality changes after a stroke, you can begin to gain a sense of reassurance, knowing that there is an explanation for why you or your loved one might be acting a little different. Recognizing personality changes can be a huge step in modifying unwanted behavior as you purposefully work towards getting back some of the personality traits that make you feel more like “you.”

Depression

After a stroke, it is very common to experience a sense of unhappiness and sadness. In fact, as many as 60 percent of stroke survivors report prolonged depression, which is depression that is more severe and long lasting than routine sadness.

Post-stroke depression results from a combination of biological and situational factors. First of all, the obvious effects of a stroke, such as weakness, vision loss, and coordination problems may cause a sense of sadness if you feel disempowered by your handicap. Additionally, after a stroke, you might worry about your health or experience anxiety about your own mortality. The resulting feelings of helplessness or hopelessness can contribute to post-stroke depression.

And the stroke-induced damage to the brain can produce changes in the way the brain functions, resulting in altered biological activity that leads to depression.

Despite all of these elements that contribute to the development of post-stroke depression, post-stroke depression is usually treatable with a combination approach that includes medication and counseling.

Many people, however, are reluctant to seek treatment for depression. Some stroke survivors hesitate to take on the label of depression out of concern that it can be a self-fulfilling prophecy. Others do not trust the medical system to deal with emotional issues, and others view depression as a sign of weakness.

However, if you or your loved one has lingering feelings of sadness or hopelessness, you can get effective help for this problem. The recognition that your depression is not your fault and is not a sign of weakness is an empowering step towards getting the right medical treatment.

Loneliness 

After a stroke, isolation can occur if you are no longer able to do the same things you used to do. If you have to leave your job after a stroke, or if you are no longer a part of your regular social life, this can lead to a sense of loneliness.

Some stroke survivors have severe disabilities that make it difficult to drive, leave the house or even get out of bed. Extreme disability may necessitate moving into a new living environment, in part to obtain more assistance with daily living, and in part to reduce isolation and loneliness. Each stroke survivor can overcome the post-stroke sense of loneliness in his or her own unique way.

Loss of Cognitive Skills

The loss of cognitive skills after a stroke can happen after a stroke in almost any region of the brain, but most often in the frontal lobe, the parietal lobe or the temporal lobes.

Changes in cognitive skills include trouble with problem-solving, reading difficulties, and trouble with simple mathematical calculations. Some stroke survivors become forgetful, forgetting names, or losing things or forgetting to take care of important tasks. Cognitive deficits can also cause confusion or may make it difficult to understand concepts that a stroke survivor would have previously been able to understand.

The loss of cognitive skills can be very distressing for stroke survivors, and many stroke survivors may be in denial, making excuses for frequent mistakes, or even lying about errors to avoid embarrassment.

Building up cognitive skills is a challenge, but just as physical disability can improve with physical therapy, cognitive disabilities can improve with dedicated cognitive therapy.

Emotional Instability

Many stroke survivors find themselves becoming very emotional or inappropriately crying or laughing. Some stroke survivors experience a condition called pseudobulbar affect, which is characterized by mood changes and uncontrollable emotional expressions.

Lack of Motivation

A stroke can lead to a lack of motivation, which is called apathy. Apathy occurs after most types of brain injury. There are several reasons for post-stroke apathy.

The decline in cognitive abilities (problem solving and thinking skills) after a stroke can make many tasks seem too challenging and unsolvable. Additionally, the development of post-stroke depression, having less responsibility to deal with after the stroke, and sometimes the feeling that “nobody will notice” what you do, can all lead to apathy.

Lastly, apathy may also occur due to changes in the structure and function of the brain secondary to the stroke itself.

Aggression 

Some stroke survivors become unexpectedly hostile and angry, behaving in ways that are mean or physically aggressive. Aggression, like the other behavioural and personality-related stroke changes, is often a result of both the emotional feelings about the stroke and the stroke-induced brain injury.

Aggression is particularly noticeable in stroke survivors who have a stroke pattern that produces vascular dementia. Vascular dementia occurs when many small strokes happen over time, leading to a buildup of injuries throughout the brain, and resulting in a distinctive type of dementia. Vascular dementia is characterized by a decline in memory and thinking skills, confusion, trouble finding things, trouble with directions, and changes in behavior.

Denial of a Stroke: Anosognosia 

Anosognosia describes a stroke survivor’s inability to recognize that he or she has had a stroke. Anosognosia is manifest by an interesting overconfidence and unawareness that there is anything wrong after a stroke. In fact, a person who has anosognosia may express surprise and bewilderment at the fact that there is any medical care being administered at all.

Stroke survivors who have anosognosia present a challenging problem for loved ones and caregivers, who try to offer assistance and care, often with no cooperation. Sometimes stroke survivors who have anosognosia treat those who are trying to help them with dismissal or rejection.

Lack of Empathy

The lack of empathy after a stroke is caused by brain damage that affects regions of the right side of the brain. A lack of empathy is a behavioural change that is usually upsetting for friends and loved ones, but is typically unnoticed by the stroke survivor.

It is not easy to predict whether a lack of empathy will improve after a stroke, as some stroke survivors can show improvement, while others do not.

Loss of Sense of Humour 

A sense of humour requires insight and the quick thinking. Humour is often based on the recognition that dissimilar ideas do not belong together and that they are funny and amusing when placed together.

Many types of stroke can diminish a stroke survivor’s sense of humour. A stroke survivor who was previously funny might not be able to construct jokes and a stroke survivor who would have been able to recognize and laugh at jokes might not be able to do so anymore.

A loss of sense of humour can be difficult to recover from because this stroke effect is caused by a loss of cognitive skills. However, understanding that the lack of humour is the result of a stroke, and not a personal rejection, can help in preventing hurt feelings and misunderstandings when a stroke survivor does not respond to light-hearted joking as expected.

Loss of Social Inhibitions

Some stroke survivors may behave in ways that are considered socially inappropriate after a stroke of the right or the left frontal lobe. Behaviours such as taking food from a stranger’s plate, insulting people out loud or even undressing or urinating in public, may pose challenges for the caretakers and family members who are primarily responsible for the safety and care of a stroke survivor.

Generally, a stroke survivor who displays socially unacceptable behavior does not have the insight to understand that the actions are not acceptable, and is unlikely to apologize or try to correct the behavior.

The language or insults of a stroke survivor who has suffered from a frontal lobe stroke are not necessarily consistent with a person’s ‘normal’ pre-stroke personality or beliefs. And it is very important to be aware that mean statements are not reflective of what a stroke survivor ‘really feels, deep down inside,’ but are more likely to be phrases that he or she heard in a completely unrelated setting, such as in a book or on a television show.

The loss of social inhibition can be somewhat better controlled when the stroke survivor is comfortable, in a familiar environment, and under as little stress as possible.

Jealousy 

A rare type of stroke causes a syndrome called Othello Syndrome, which is characterized by irrational and illogical jealousy, particularly in the context of romantic relationships. This syndrome can affect stroke survivors as a result of brain injury affecting areas of the right cerebral cortex.

A Word from Verywell

A stroke can cause major personality changes that can make you feel as if you have lost yourself or that you’ve lost the loved one you used to know so well. Personality changes after a stroke can be emotionally draining for everyone involved.

However, if a stroke survivor and loved ones understand that the source of the behavior comes from stroke-induced brain damage, it can reassure everyone in knowing that the unpleasant behavior is not premeditated or intended to be personally insulting. High functioning stroke survivors who learn about the typical post-stroke behavioural changes can gain enough insight to be able to make some changes, which can result in more satisfying interpersonal relationships.

HOW A STROKE CAN CHANGE YOUR PERSONALITY

URINARY TRACT INFECTION: WHAT YOU SHOULD AND SHOULD NOT EAT

Sep 12, 2018 | Healthy Tips

By Pamela Fernandes, MD

50% of women experience a urinary tract infection (UTI) in their lifetime. It costs over 1 billion USD and results in 1 million hospitalizations. It’s common among women compared to men. UTI’s are an infection of the urinary tract involving the kidneys, ureters, bladder, and urethra. Left untreated the infection can escalate and damage the kidney and ureters, permanently leading to scarring and renal failure.

The most common cause is due to bacteria from the gastrointestinal system. The anus is usually quite close to the urethra in women. Bacteria like E. coli travel from the digestive system. These bacteria can also be introduced during sex like Chlamydia and Mycoplasma.

Symptoms of UTI

Some of the common symptoms of a urinary tract infection are painful urination, burning sensation on urinating, an intense urge to urinate, pressure or fullness on the bladder, discharge, nausea, vomiting, cloudy or strange smelling urine, fever and back pain. If severe then you may also see blood in the urine.

Risk Factors

There are certain risk factors that increase the chances of getting a urinary tract infection. These include unprotected sex, intake of antibiotics, not urinating frequently, choosing baths over showers, lack of water in the diet, bacterial entry from the anus and pregnancy. Old age and gender do play a role since immunity is lower in the elderly and the urethra is shorter in women.

Foods You Should Eat When You Have a Urinary Tract Infection: Certain foods are known to help relieve symptoms of UTI.

Water

Water keeps your system hydrated and helps your body flush out toxins. Most people don’t drink enough water. Infections are caused by a buildup of bacteria and with decreased water consumption. The bacteria can be flushed out of the system with hydration.  Studies have shown that increased water intake can help in the prophylaxis and treatment of UTI’s.

Cranberry juice

Everyone’s heard of cranberry juice as a cure for UTI’s. And the science proves it. Two randomized controlled studies prove that cranberry juice does reduce the number of symptomatic UTI’s over a twelve-month period. Unsweetened cranberry juice is best as sugar tends to worsen the infection. You can dilute 1 ounce of juice with 7 ounces of water. Cranberries have proanthocyanidins. This is a compound that prevents E.coli from multiplying within the urethra.

Pineapple

Pineapple contains bromelain. It’s a protease mixture or enzyme mixture that has been proven to have anti-inflammatory properties. It also increases wound healing and immunomodulatory effects. It’s also being studied as an anticancer agent.

Probiotics

Among pregnant and breastfeeding women, probiotics are often recommended. Probiotics contain healthy bacteria which help your immune system and staves off infection. Probiotics like fermented yogurt and live cultures can give you a dose of “good” bacteria.

Vitamin C

If you want to prevent a UTI infection you can take Vitamin C. It makes the urine acidic. This prevents bacteria from multiplying. With the bacteria controlled, the chances of a UTI are less.

Lemon juice

Lemon juice also contains ascorbic acid. It makes the urine acidic and controls the bacteria. You can drink lemon juice or can be used prophylactically in those who have frequent UTI’s.

Baking soda

Urine alkalinization has been studied in female patients with lower UTI’s. In fact, in chronic patients, this alkalinization is done with sodium bicarbonate. You can use ½ tsp of baking soda in warm water and drink this in the morning. This wouldn’t be suitable for people with hypertension as it contains sodium which increases blood pressure.

Apple Cider Vinegar

Dilute two tbsps. of apple cider vinegar in a cup of water. You can add honey to this mixture. Drink this in the morning till your infection clears. Apple cider vinegar hasantimicrobial activity against E. coli, Staphylococcus aureus, and Candida albicans.

Garlic

Garlic has been studied for its effects against dyslipidemia and its antithrombotic effects. It has numerous benefits that now clinicians are considering garlic tablets as part of therapy. However, in uncomplicated urinary tract infections, it also plays a role due to its antifungal and antimicrobial properties. There is very limited scientific evidence about the usage of garlic for non-E. coli UTI.

Blueberries

A few blueberries in your diet either whole or juiced would be great till your infection clears.

Like cranberries, they also contain proanthocyanidins which help stave off E Coli.

Foods to avoid

When you have a UTI there are some foods that can worsen your condition.

Sugar

Sugars can contribute to the growth of yeast which can aggravate your UTI. Any refined flour, white bread, pasta and sweet stuff can be responsible for increasing your sugar levels. Increase sugar levels also affect the immunity and hence can encourage the growth of bacteria and slows down the resolution of your infection.

Caffeine

Caffeine is a stimulant and a diuretic. It is known to be a bladder irritant as it produces early urgency and increases the frequency of urination. If you have symptoms if UTI you should avoid, coffee, tea, and alcohol.

Spicy food

Lay off the spice and other foods that can irritate the bladder. You don’t want a very active bladder when you have a UTI.

Red meat

Red meat also tends to add more acid to your gut and lowers pH levels in the body. Try and avoid red meat if you have an active urinary tract infection. Eat a high fibre diet instead.

Diagnosis and Treatment

After asking about your symptoms, and making a tentative diagnosis your doctor may want to physically examine you and order a routine urine test and a bacterial culture of your urine. This is to confirm if you have an infection. And also to determine the causative bacteria or microorganism responsible for the infection.

Usually, doctors will instruct you to submit a clean catch sample of urine. This is done by washing the area and then collecting a sample midstream. The sample is collected in a sterile container to prevent cross contamination.

Treatments are usually targeted towards the offending bacteria. And these are usually antibiotics. Bacteria that are sensitive to the antibiotics will be killed. However, with every urinary tract infection and subsequent treatment, the bacteria may develop resistance and so it’s essential that you prevent recurrent urinary tract infections.

URINARY TRACT INFECTION: WHAT YOU SHOULD AND SHOULD NOT EAT

5 FOODS THAT CAN CAUSE CANCER

Sep 8, 2018 | Healthy Tips

By Yasmine Ali, MD

The International Agency for Research on Cancer (IARC), a part of the World Health Organization (WHO), came out definitively with a report on cancer-causing processed meats, stating that such meats definitely can cause colorectal cancer. They have also stated that red meat in general “probably” causes cancers such as colon, pancreatic, and prostate cancer.

Given that obesity is a risk factor for a number of different cancers, it is helpful to do all you can to decrease your risk.

Below are five foods to avoid, based on the report.

1. Hot Dogs

According to the IARC press release, “Processed meat refers to meat that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavour or improve preservation.”

Hot dogs are listed as one example of processed meat that can cause cancer. Specifically, the IARC classified processed meat as “carcinogenic [cancer-causing] to humans, based on sufficient evidence in humans that consumption of processed meat causes colorectal cancer.”

According to the IARC, a little over the equivalent of one hot dog per day is enough to increase the risk of colorectal cancer by 18%.

2. Beef Jerky

Beef jerky also falls into processed meat group and was listed as a specific example in the IARC press release as a processed meat that can cause cancer.

The IARC press release regarding the recent findings stated that IARC experts “considered more than 800 studies that investigated associations of more than a dozen types of cancer with the consumption of red meat or processed meat in many countries and populations with diverse diets.”

The IARC Working Group found that “the most influential evidence came from large prospective cohort studies conducted over the past 20 years.”

3. Sausage

Sausage is another kind of processed meat that was given as an example in the IARC press release as being cancer-causing.

The IARC has stated that “each 50-gram portion of processed meat eaten daily increases the risk of colorectal cancer by 18%.”

The IARC further noted that “the consumption of meat varies greatly between countries, with from a few percent up to 100% of people eating red meat, depending on the country, and somewhat lower proportions eating processed meat.”

4. Ham

Ham is a processed meat that is not only carcinogenic due to its processed nature but has also been linked to high blood pressure and other cardiovascular diseases because of its very high sodium content.

Other processed deli meats, such as pastrami, salami, pepperoni, and the like, present the same cancer-causing risk.

5. Corned Beef

Corned beef was also one of the examples listed by the IARC as a processed meat linked to colorectal cancer.

The IARC further noted that “most processed meats contain pork or beef, but processed meats may also contain other red meats, poultry … or meat by-products such as blood.”

Other examples of processed meat listed in the IARC press release included canned meat and meat-based preparations and sauces.

Article Sources :

Nagle CM, Wilson LF, Hughes MC, et al. Cancers in Australia in 2010 Attributable to the Consumption of Red and Processed Meat. Aust N Z J Public Health. 2015; 39:429-33.

Amiano P, Chamosa S, Etxezarreta N, et al. Unprocessed Red Meat and Processed Meat Consumption and Risk of Stroke in the Spanish Cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC). Eur J Clin Nutr 2015 Sep 30. [Epub ahead of print]

5 FOODS THAT CAN CAUSE CANCER

ENLARGED HEART

Sep 7, 2018 | Healthy Tips

Overview

An enlarged heart (cardiomegaly) isn’t a disease, but rather a sign of another condition.

The term “cardiomegaly” refers to an enlarged heart seen on any imaging test, including a chest X-ray. Other tests are then needed to diagnose the condition causing your enlarged heart.

You may develop an enlarged heart temporarily because of a stress on your body, such as pregnancy, or because of a medical condition, such as the weakening of the heart muscle, coronary artery disease, heart valve problems or abnormal heart rhythms.

Certain conditions may cause the heart muscle to thicken or one of the chambers of the heart to dilate, making the heart larger. Depending on the condition, an enlarged heart may be temporary or permanent.

An enlarged heart may be treatable by correcting the cause. Treatment for an enlarged heart can include medications, medical procedures or surgery.

Symptoms

In some people, an enlarged heart causes no signs or symptoms. Others may have these signs and symptoms:

• Shortness of breath
• Abnormal heart rhythm (arrhythmia)
• Swelling (oedema)

When to see a doctor

An enlarged heart is easier to treat when it’s detected early, so talk to your doctor if you have concerns about your heart.

If you have new signs or symptoms that might be related to your heart, make an appointment to see your doctor.

Seek emergency medical care if you have any of these signs and symptoms, which may mean you’re having a heart attack:

• Chest pain
• Discomfort in other areas of the upper body, including one or both arms, the back, neck, jaw, or stomach
• Severe shortness of breath
• Fainting

Causes

An enlarged heart can be caused by conditions that cause your heart to pump harder than usual or that damage your heart muscle. Sometimes the heart enlarges and becomes weak for unknown reasons (idiopathic).

A heart condition you’re born with (congenital), damage from a heart attack or an abnormal heartbeat (arrhythmia) can cause your heart to enlarge. Other conditions associated with an enlarged heart include:

• High blood pressure.Your heart may have to pump harder to deliver blood to the rest of your body, enlarging and thickening the muscle.

High blood pressure can cause the left ventricle to enlarge, causing the heart muscle eventually to weaken. High blood pressure may also enlarge the upper chambers of your heart (atria).

• Heart valve disease. Four valves in your heart keep blood flowing in the right direction. If the valves are damaged by conditions such as rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may enlarge.
• Disease of the heart muscle (cardiomyopathy).As this thickening and stiffening of heart muscle progress, your heart may enlarge to try to pump more blood to your body.
• High blood pressure in the artery connecting your heart and lungs (pulmonary hypertension).Your heart may need to pump harder to move blood between your lungs and your heart. As a result, the right side of your heart may enlarge.
• Fluid around your heart (pericardial effusion).Accumulation of fluid in the sac (pericardium) that contains your heart may cause your heart to appear enlarged on a chest X-ray.
• Low red blood cell count (anaemia).Anaemia is a condition in which there aren’t enough healthy red blood cells to carry adequate oxygen to your tissues. Untreated, chronic anaemia can lead to a rapid or irregular heartbeat. Your heart must pump more blood to make up for the lack of oxygen in the blood.
• Thyroid disorders. Both an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism) can lead to heart problems, including an enlarged heart.
• Excessive iron in the body (hemochromatosis).Hemochromatosis is a disorder in which your body doesn’t properly metabolize iron, causing it to build up in various organs, including your heart. This can cause an enlarged left ventricle due to the weakening of the heart muscle.
• Rare diseases that can affect your heart, such as amyloidosis.Amyloidosis is a condition in which abnormal proteins circulate in the blood and may be deposited in the heart, interfering with your heart’s function and causing it to enlarge.

Risk factors

You may have a greater risk of developing an enlarged heart if you have any of the following risk factors:

• High blood pressure.Having a blood pressure measurement higher than 140/90 millimeters of mercury puts you at an increased risk of developing an enlarged heart.
• A family history of enlarged hearts or cardiomyopathy.If an immediate family member, such as a parent or sibling, has had an enlarged heart, you may be more susceptible to developing the condition.
• Blocked arteries in your heart (coronary artery disease).With this condition, fatty plaques in your heart arteries obstruct blood flow through your heart vessels, which can lead to a heart attack. When a section of heart muscle dies, your heart has to pump harder to get adequate blood to the rest of your body, causing it to enlarge.
• Congenital heart disease. If you’re born with a condition that affects the structure of your heart, you may be at risk of developing an enlarged heart.
• Heart valve disease. The heart has four valves — aortic, mitral, pulmonary and tricuspid — that open and close to direct blood flow through your heart. Conditions that damage the valves may cause the heart to enlarge.
• Heart attack. Having a heart attack increases your risk of developing an enlarged heart.

Complications

The risk of complications from an enlarged heart depends on the part of the heart that is enlarged and the cause.

Complications of an enlarged heart can include:

• Heart failure.One of the most serious types of enlarged heart, an enlarged left ventricle increases the risk of heart failure. In heart failure, your heart muscle weakens, and the ventricles stretch (dilate) to the point that the heart can’t pump blood efficiently throughout your body.
• Blood clots.Having an enlarged heart may make you more susceptible to forming blood clots in the lining of your heart. If clots enter your bloodstream, they can block blood flow to vital organs, even causing a heart attack or stroke. Clots that develop on the right side of your heart may travel to your lungs, a dangerous condition called a pulmonary embolism.
• Heart murmur.For people who have an enlarged heart, two of the heart’s four valves — the mitral and tricuspid valves — may not close properly because they become dilated, leading to a backflow of blood. This flow creates sounds called heart murmurs. Although not necessarily harmful, heart murmurs should be monitored by your doctor.
• Cardiac arrest and sudden death.Some forms of an enlarged heart can lead to disruptions in your heart’s beating rhythm. Heart rhythms too slow to move blood or too fast to allow the heart to beat properly can result in fainting or, in some cases, cardiac arrest or sudden death.

Prevention

Tell your doctor if you have a family history of conditions that can cause an enlarged heart, such as cardiomyopathy. If cardiomyopathy or other heart conditions are diagnosed early, treatments may prevent the disease from worsening.

Controlling risk factors for coronary artery disease — tobacco use, high blood pressure, high cholesterol and diabetes — helps to reduce your risk of an enlarged heart and heart failure by reducing your risk of a heart attack.

You can help reduce your chance of developing heart failure by eating a healthy diet and not abusing alcohol or using illicit drugs. Controlling high blood pressure with diet, exercise and possibly medications also prevents many people who have an enlarged heart from developing heart failure.

Diagnosis

If you have symptoms of a heart problem, your doctor will perform a physical exam and order tests to determine if your heart is enlarged and to find the cause of your condition. These tests may include:

• Chest X-ray.X-ray images help your doctor see the condition of your lungs and heart. If your heart is enlarged on an X-ray, other tests will usually be needed to find the cause.
• This test records the electrical activity of your heart through electrodes attached to your skin. Impulses are recorded as waves and displayed on a monitor or printed on paper. This test helps your doctor diagnose heart rhythm problems and damage to your heart from a heart attack.
• This test for diagnosing and monitoring an enlarged heart uses sound waves to produce a video image of your heart. With this test, the four chambers of the heart can be evaluated.

Your doctor can use the results to see how efficiently your heart is pumping, determine which chambers of your heart are enlarged, look for evidence of previous heart attacks and determine if you have congenital heart disease.

• Stress test.A stress test, also called an exercise stress test, provides information about how well your heart works during physical activity.

An exercise stress test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure and breathing are monitored.

• Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI).In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine called a gantry. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest.

In a cardiac MRI, you lie on a table inside a long tube-like machine that uses a magnetic field and radio waves to produce signals that create images of your heart.

• Blood tests. Your doctor may order blood tests to check the levels of certain substances in your blood that may point to a heart problem. Blood tests can also help your doctor rule out other conditions that may cause your symptoms.
• Cardiac catheterization and biopsy. In this procedure, a thin tube (catheter) is inserted in your groin and threaded through your blood vessels to your heart, where a small sample (biopsy) of your heart, if indicated, can be extracted for laboratory analysis.

The pressure within the chambers of your heart can be measured to see how forcefully blood pumps through your heart. Pictures of the arteries of the heart can be taken during the procedure (coronary angiogram) to ensure that you don’t have a blockage.

Treatment

Treatments for an enlarged heart focus on correcting the cause.

Medications

If cardiomyopathy or another type of heart condition is to blame for your enlarged heart, your doctor may recommend medications. These may include:

• Diuretics to lower the amount of sodium and water in your body, which can help lower the pressure in your arteries and heart
• Angiotensin-converting enzyme (ACE) inhibitors to lower your blood pressure and improve your heart’s pumping capability
• Angiotensin receptor blockers (ARBs)to provide the benefits of ACE inhibitors for those who can’t take ACE inhibitors
• Beta-blockers to lower blood pressure and improve heart function
• Anticoagulants to reduce the risk of blood clots that could cause a heart attack or stroke
• Anti-arrhythmic to keep your heart beating with a normal rhythm

Medical procedures and surgeries

If medications aren’t enough to treat your enlarged heart, medical procedures or surgery may be necessary.

• Medical devices to regulate your heartbeat.For a certain type of enlarged heart (dilated cardiomyopathy), a pacemaker that coordinates the contractions between the left and right ventricle may be necessary. In people who may be at risk of serious arrhythmias, drug therapy or an implantable cardioverter-defibrillator (ICD) may be an option.

ICDs are small devices — about the size of a pager — implanted in your chest to continuously monitor your heart rhythm and deliver electrical shocks when needed to control abnormal, rapid heartbeats. The devices can also work as pacemakers.

If the main cause of your enlarged heart is atrial fibrillation, then you may need procedures to return your heart to a regular rhythm or to keep your heart from beating too quickly.

• Heart valve surgery. If your enlarged heart is caused by a problem with one of your heart valves or it has caused heart valve problems, you may have surgery to repair or replace the affected valve.
• Coronary bypass surgery. If your enlarged heart is related to coronary artery disease, your doctor may recommend coronary artery bypass surgery.
• Left ventricular assist device (LVAD).If you have heart failure, you may need this implantable mechanical pump to help your weakened heart pump. You may have an LVAD implanted while you wait for a heart transplant or, if you’re not a heart transplant candidate, as a long-term treatment for heart failure.
• Heart transplant. If medications can’t control your symptoms, a heart transplant may be a final option. Because of the shortage of donor’s hearts, even people who are critically ill may have a long wait before having a heart transplant.

Lifestyle and home remedies

There are ways to improve your condition, even though you can’t cure it. Your doctor may recommend the following lifestyle changes:

• Quit smoking.
• Lose excess weight.
• Limit salt in your diet.
• Control diabetes.
• Monitor your blood pressure.
• Get modest exercise, after discussing with your doctor the most appropriate program of physical activity.
• Avoid or eliminate alcohol and caffeine.
• Try to sleep eight hours nightly.

Preparing for your appointment

If you think you may have an enlarged heart or are worried about your heart disease risk because of your family history, make an appointment with your doctor. If you have heart disease, your doctor may refer you to a heart specialist (cardiologist).

Here’s some information to help you prepare for your appointment.

What you can do

• Be aware of any pre-appointment restrictions. When you make the appointment, ask if there’s anything you need to do in advance, such as restrict your diet or fast before tests.
• Write down your symptoms, including ones that may seem unrelated to coronary artery disease.
• Write down key personal information, including a family history of heart disease, stroke, high blood pressure or diabetes, and major stresses or recent life changes.
• Make a list of all medications, vitamins or supplements you’re taking.
• Take a family member or friend along, if possible. Someone who accompanies you may remember something you missed or forgot.
• Write down questions to ask your doctor.

Preparing a list of questions will help you make the most of your time with your doctor. For heart disease, some basic questions to ask your doctor include:

• What is likely causing my symptoms or condition?
• What are other possible causes for my symptoms or condition?
• What tests do I need?
• What’s the best treatment?
• What foods should I eat or avoid?
• What’s an appropriate level of physical activity?
• Are there restrictions I should follow?
• How often should I be screened for heart disease? For example, how often do I need a cholesterol test?
• I have other health conditions. How can I best manage them together?
• Should I see a specialist?
• Should my children be screened for this condition?
• Is there a generic alternative to the medicine you’re prescribing?
• Are there brochures or other printed materials I can take? What websites do you recommend?

Don’t hesitate to ask other questions.

What to expect from your doctor?

Your doctor is likely to ask you questions, including:

• When did your symptoms begin?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• What is your typical diet?
• Do you drink alcohol? How much?
• Do you smoke?
• Are you physically active? How often do you exercise?
• Have you been diagnosed with other conditions?
• Do you have a family history of heart disease?

Enlarged heart

12 WAYS TOO MUCH SUGAR HARMS YOUR BODY

Sep 6, 2018 | Healthy Tips

How Much Is Too Much?

The American Heart Association recommends no more than 6 teaspoons (25 grams) of added sugar a day for women and 9 teaspoons (36 grams) for men. But the average American gets way more: 22 teaspoons a day (88 grams). It’s easy to overdo. Just one 12-ounce can of regular soda has 10 teaspoons of sugar — and no nutritional benefit.

Harm: Weight Gain

Sugar-sweetened beverages are a big source of added sugars for Americans. If you drink a can of soda every day and don’t trim calories elsewhere, in three years you’d be 15 pounds heavier. Putting on too much weight can lead to problems like diabetes and some cancers.

Harm: Heart Disease

One in 10 Americans gets 1/4 or more of their daily calories from added sugar. If you eat that much, one study found that you’re more than twice as likely to die from heart disease than someone who gets less than half as much. It’s not clear why. It could be that the extra sugar raises your blood pressure or releases more fats into the bloodstream. Both can lead to heart attack, stroke, and other heart diseases.

Harm: Diabetes

Sugary drinks, in particular, can boost your odds for type 2 diabetes. That can happen because when sugar stays in your blood, your body may react by making less of the hormone insulin, which converts the food you eat into energy. Or the insulin doesn’t work as well. If you’re overweight, dropping even 10-15 pounds can help you manage your blood sugar.

Harm: High Blood Pressure

Usually, salt gets the blame for this condition, also called hypertension. But some researchers say another white crystal — sugar — may be a more worrisome culprit.  One way they believe sugar raises blood pressure is by making your insulin levels spike too high. That can make your blood vessels less flexible and cause your kidneys to hold onto water and sodium.

Harm: High Cholesterol

Sugary diets are bad for your heart, regardless of how much you weigh. They can:

Raise your so-called “bad” (LDL) cholesterol and lower the “good” (HDL) kind.

Hike blood fats called triglycerides and hinder the work of an enzyme that breaks them down.

Harm: Liver Disease

Most packaged foods, snacks, and drinks are sweetened with fructose, a simple sugar from fruits or veggies like corn. Your liver turns it into fat. If you regularly pump fructose into your body, tiny drops of fat build up in your liver. This is called non-alcoholic fatty liver disease. Early diet changes can reverse it. But over time, swelling and scarring can damage your liver.

Harm: Cavities

You know sugar rots your teeth. How? It feeds the bacteria in your mouth, which leave behind acid that wears away your tooth enamel. Sugary drinks, dried fruits, candy, and chocolate are common offenders. Sour candies are among the worst. They’re almost as acidic as battery acid! If you eat tart treats, rinse your mouth with water afterward or drink some milk to neutralize the acid.

Harm: Poor Sleep

Too much sugar during the day can mess with your blood glucose levels and cause energy spikes and crashes. You may struggle to stay awake at work or doze off in class at school. In the evenings, a bowl of ice cream or cookies can pump you with sugar that can wake you up at night. It also can cut short the time you’re in deep sleep. So you may not wake up feeling refreshed.

Possible Harm: ADHD

It’s a common perception that sugar worsens the symptoms of attention deficit hyperactivity disorder. But the link is unproven. More studies knock down the theory that sugar causes or worsens ADHD than support it. We don’t know exactly what leads to ADHD, but your genes probably play a large role.

Harm: Mood Problems

Feeling down? Your sweet tooth may be part of the problem. Several studies have linked sugar and mental health problems. One of the latest showed that men who ate more than 66 grams of sugar a day — almost double what’s recommended — were 23% more likely to be diagnosed with anxiety or depression than men who ate 40 grams or less. Too much sugar could fuel depression through swelling, or inflammation, in your brain, which is more common in people with depression.

Harm: Gout

You may know that you can get this painful arthritis from eating too much red meat, organ meats, and lobster. The same goes for fructose. When your body breaks it down, it releases a chemical called purines. That can make uric acid build up in your blood, which in turn forms hard crystals in your big toe, knees, and other joints.

Harm: Kidney Stones

You get these when chemicals in your pee turn into solid crystals. Your body flushes out some kidney stones without much pain. Others can get stuck in your kidney or another part of your plumbing and block urine flow. Too much fructose — from table sugar, high-fructose corn syrup, or processed foods — raises your chances for kidney stones.

Harm: Aging

Sugary drinks may add years to your biological age. DNA called telomeres cap the end of your chromosomes to protect them from damage. Longer is better. Shortened telomeres may go hand in hand with age-related diseases like diabetes. One study found that people who drink 20 ounces of soda a day have shorter telomeres. Researchers figure that’s like adding more than 4 years to the age of your cells.

12 WAYS TOO MUCH SUGAR HARMS YOUR BODY