Is Your Student Safe?

The beginning of another school year means the beginning of school sports including football, soccer, cross country and swimming. All too often, school sports result in injuries to athletes and, in some cases, incidents of sudden cardiac arrest (SCA). Although SCA in athletes makes the headlines, it’s important to know that SCA can happen to anyone including a seemingly healthy child.

Sudden cardiac arrest in a young person usually stems from a structural defect in the heart or a problem with the heart’s electrical circuitry. The most frequent cause, accounting for about 40% of all cases, is hypertrophic cardiomyopathy or HCM.

HCM is a genetic heart condition that affects 1: 500 individuals, including men, women and children of all ages. HCM is characterized by a thickening of the heart muscle and can lead to sudden cardiac arrest.

Approximately 50% of individuals with HCM experience no symptoms, and don’t even know they have the condition, until tragically, sudden cardiac arrest occurs.  In 9:10 cases the outcome is fatal, resulting in unimaginable grief for families and fellow students.  Yet better outcomes can be achieved with early electrical stimulation of the heart – delivered by a small, fully automated, easy to use box.

Given that educational institutions house more than 20% of the American population every day, you’d think they would be fully prepared for this eventually. But sadly, they are not.

At the time of writing, only 19: 50 states in the U.S. require that at least some of their schools have automated external defibrillators [AED’s].  In some states, AEDs are required in public, but not private schools. In other states, AEDs are required in high schools, but not elementary schools. Some states require AEDs only in schools offering athletics. Only two states – Hawaii and Oregon – require AEDs in colleges.

To find out whether your state requires AEDs in schools, click here to view an interactive map.

Although schools and colleges are ideal and obvious locations for AED deployment, concerns regarding legal liability and litigation have been perceived as a barrier to purchasing and deploying AEDs.  Fortunately this is slowly changing.  Recognition of the need to protect youth from sudden cardiac arrest is gaining momentum in many states:

In Pennsylvania, Sen. Andrew Dinniman has sponsored Senate Bill 606, Aidan’s Law, named for Aidan Silva, a seven-year-old Chester County resident who succumbed to SCA in September 2010.  Aidan had no symptoms of a heart condition prior to his death. Aidan’s Law will help ensure that every public school in Pennsylvania has an AED that is up to date and ready to use.

Rep. Connie Pillich, of Cincinnati, has introduced a bill focused on SCA in student athletes. House Bill 180 requires the Ohio Department of Health and the Ohio Department of Education to jointly develop guidelines and materials to educate students, parents and coaches about SCA. The measure bans a student from participating in a school-sponsored athletic activity until the student submits a signed form acknowledging receipt of the guidelines and materials created by the health and education departments. Individuals would not be allowed to coach a school-sponsored athletic activity unless the individual has completed, within the previous year, a sudden cardiac arrest training course approved by the health department.

John Ellsessar, whose son Michael died during an Oxford High School football game in 2010 from cardiac arrest, believes automated external defibrillators should be as readily available at school settings as fire extinguishers.

Ellsessar, is pushing for legislation to require all schools to have defibrillators, said he and his wife were horrified when they learned that at most schools that have the medical devices, but they are locked away in nurses’ offices, instead of being ready for emergencies.

And in Rhode Island, high school seniors will be required to be trained in CPR and the use of a defibrillator before they can graduate. Under the legislation signed into law by Gov. Lincoln Chafee, students will receive training that includes a hands-on course in cardiopulmonary resuscitation and an overview of the use of an AED.

The National Parent Teacher Association has also adopted a resolution calling for public schools to develop emergency response plans that include summoning help, performing CPR and using automated external defibrillators to save lives. The PTA also called for ongoing CPR-AED training in schools and legislation that would fund placement of AEDs in every school, while providing immunity for people who use the lifesaving devices in good faith.

To learn more about sudden cardiac arrest and how you can help please visit http://www.sca-aware.org

Shining a New Light on Cardiac Arrhythmias

With a few flicks of a light switch Stanford University’s Oscar Abilez is one step closer to changing the lives of millions.

Currently, four million Americans suffer from some degree of cardiac arrhythmia. In some, the heart beats too slowly, in others, too quickly or at irregular intervals, resulting in shortness of breath, fainting and even death.

While pacemakers and implanted defibrillators can be used to correct arrhythmias, these small mechanical devices come with risks. Patients must undergo invasive surgical procedures to permanently implant the devices, which can cause cardiac tissue damage. There are other challenges too, such as lifestyle limitations and the occasional battery malfunction.

“It’s like using a cannon to kill an ant,” says Leon Esterowitz, director of the National Science Foundation’s Directorate for Engineering’s Biophotonics program.

Doctors and patients alike have been searching for a better solution.

And now they may have one.  Abilez, a cardiovascular physician with a doctorate in bioengineering, and his team have demonstrated that they can control the rhythm of the heart using light alone. In laboratory experiments the Stanford scientists are able to make heart cells expand and contract simply by switching light on and off.

This novel biological pacemaker was one of 40 new projects funded by the National Science Foundation’s INSPIRE initiative.

The project, Optogenetic Control of the Human Heart-Turning Light into Force, involves two seemingly disconnected and developing technologies: optogenetics and stem cells.

At first glance optogenetics seems more like a magic trick than science, using just flashes of light to control a targeted group of cells.

Only a few organisms, such as algae, have naturally light sensitive cells. In 2002, however, scientists in Germany were able to isolate the genes for the proteins – called opsins – responsible for cells’ light sensitivity and modify the genetic code of other cells so that they too would produce opsins.

Once produced, the opsins act like small hatches on the surface of a cell. When light shines on them, the hatches either open or close depending on the type of opsin they are. If the hatches open, electrical signals are able to flow through the cell and be translated into some action, such as regulating a heart.  In 2005, Karl Deisseroth MD, PhD and colleagues, also at Stanford, were able to genetically introduce opsins into neurons and control these cells with light; this work and subsequent work has led to the field of optogenetics.

Abilez’s grand vision is to take stem cells from a person suffering from cardiac arrhythmia and convert the cells into light sensitive cells that are responsible for pacemaker functions in the heart. These genetically modified cardiomyocytes would then be grafted onto a person’s heart and enable doctors to control the heart’s rhythm using light.

“The applications can be of very high reward,” says Natalia Trayanova, director of John Hopkins University’s Computational Cardiology Lab. “Current high-energy defibrillation is painful, traumatic and has been associated with a higher rate of mortality. Wouldn’t it be nice to be able to shine a light on someone’s chest and defibrillate them painlessly?”

Abilez has already successfully grown light sensitive cardiomyocytes. His next step is to test whether the lab-grown cells are accepted when coupled with a larger body of non-stem cell derived heart cells. If they are, then Abilez will be on his way to creating a less-invasive, longer-lasting treatment for arrhythmias.

Moreover, Abilez will have paved the way for optogenetic success in other fields. If he can successfully couple light-sensitive cells with normal cells, then his method of creating light-sensitive stem cells could be used by other researchers to grow any type of light-sensitive cell they wanted, from brain to pancreatic cells.

Optogenetics has huge implications for medicine. Researchers have already shown that they can stop a seizure, cure anxiety and even implant fake memories into the minds of mice.

There still are risks involved in cardiac optogenetics. Such risks, exist not with the treatment itself but with the feasibility of its development and there are still major hurdles to overcome before any applications can be realized.

Abilez acknowledges such risk, saying that there is a chance the team will discover that their light-sensitive stem cells cannot control the heart as well as they hope. A large part of the research’s difficulty is that the team is in uncharted waters – they have no prior research on which to base their efforts.

“We have to invent things along the way. We don’t have any precedent,” Abilez says.

So although we won’t be seeing these biological pacemakers anytime soon we think we speak for all cardiac arrhythmia patients when we say “Let there be light!”

When’s Your Time to Die?

What are your chances of dying in the next 10 years?

Obviously there are some activities that may increase your risk  such as driving drunk and active military duty in a war zone, but how about getting winded after walking several blocks or having trouble pushing a chair across the room

Turns out the latter might be just as dangerous as the former.

Researchers at the University of San Francisco VA Medical Center have recently come up with a “mortality index” to predict when a person may die.  Marisa Cruz and her colleagues have developed a list of 12 questions that can help predict chances of dying within 10 years for patients aged 50 and older.  The researchers created the index by analyzing data on almost 20,000 Americans over 50 who took part in a national health survey in 1998. They tracked the participants for 10 years. Nearly 6,000 participants died during that time.

While the test scores may satisfy people’s morbid curiosity, the researchers say their index wasn’t meant as guidance about how to alter your lifestyle.  Instead, it is mostly for use by doctors, to help them discuss the pros and cons of costly health screenings or medical procedures in patients who are unlikely to live 10 more years.

That said, we know that many of our readers are “simply dying” to take the test themselves – right now.

So without further ado…here’s how it works.

The 12 items on the mortality index are assigned points.  The fewer your total points the better odds of living.

• Men automatically get 2 points. In addition, men and women ages 60 to 64 get 1 point; ages 70 to 74 get 3 points; and 85 or over get 7 points.

• Two points each for: a current or previous cancer diagnosis, excluding minor skin cancers; lung disease limiting activity or requiring oxygen; congestive cardiac failure; smoking within the past 2 weeks; difficulty bathing; difficulty managing money because of health or memory problem; difficulty walking several blocks.

• One point each for: diabetes or high blood sugar; difficulty pushing large objects, such as a heavy chair; being thin or normal weight.

The highest, or worst, score is  26, which equates to  a 95% chance of dying within 10 years. To get that, you’d have to be a man at least 85 years old with all the above conditions.
For a score of zero, which correlates to a 3% chance of dying within 10 years, you’d have to be a woman of “normal weight” younger than 60 without any of those infirmities.

While it’s hardly surprising that a sick, older person would have a much higher chance of dying than someone younger why would being overweight be less risky than being of normal weight or slim?  One possible reason is that thinness in older age could be a sign of illness.

Dr. Stephan Fihn, a health quality measurement specialist with Veterans Affairs health services in Seattle, said the index seems valid and “methodologically sound.”
However, he adds that it is probably most accurate for the oldest patients, who don’t need a scientific crystal ball to figure out their days are numbered.

For fans of SRxA’s Word on Health, I’m pleased to report that my 10-year mortality index is zero. Let the blogging continue!

An Aspirin A Day…Takes Your Sight Away?

SRxA’s Word on Health has frequently reported on the health benefits of aspirin.  So we were more than a little shocked to read a new study in JAMA Internal Medicine which suggested that people who regularly use aspirin may be at increased risk of age-related macular degeneration [AMD].  This eye condition is common  among people age 50 and older and is a leading cause of vision loss in older adults.  AMD gradually destroys the macula, the part of the eye that provides the sharp, central vision needed for seeing objects clearly. 

In some people, AMD advances so slowly that vision loss does not occur for a long time. In others, the disorder progresses faster and may lead to a loss of vision in one or both eyes. The vision loss makes it difficult to recognize faces, drive a car, read, or do close work, such as sewing.

But don’t go tossing out your Bayer’s just yet!

In this study, researchers at the University of Sydney looked at a large group of  people who took  daily low-dose aspirin as a preventive measure for cardiovascular disease.

Of nearly 2,400 elderly people studied over a 15-year period, 10% were regular aspirin users. Of that group, 25% developed  macular degeneration over that time frame, compared to 9% who developed it but were non-aspirin users.

While these results were statistically significant, more research needs to be done before  recommending that patients stop taking doctor recommended aspirin.   Despite their results, even the researchers admit that there’s just not enough evidence to support stopping aspirin therapy unless a person already has strong risk factors for age-related macular degeneration.

Ophthalmologist Justis Ehlers, MD, agrees, “Aspirin has clearly been shown to have good secondary prevention for different cardiovascular diseases. We need to sort this out over time to see what it means.”

Fend off a 2nd Heart Attack with Fruit and Fiber

Each year, at least 20 million people worldwide survive a heart attack or stroke. Most of them, will then be prescribed a veritable cocktail of drugs including lipid-lowering agents, beta blockers, aspirin, anti-platelet medications, and angiotensin modulators.

In the misguided belief that this polypharmacy will guard against future catastrophic cardiovascular events, many patients think they don’t need to follow a healthy diet.

However a new, 5-year study of almost 32,000 patients in 40 countries showed those who ate a heart-healthy diet rich in fruits, vegetables and fish had an average:

• 35% reduction in risk for cardiovascular death
• 14% reduction in risk for new heart attacks
• 28% reduction in risk for congestive heart failure
• 19% reduction in risk for stroke

Researchers from McMaster University were able to demonstrate, for the first time, that while drug treatments, substantially lower the risk of another heart attack, a high quality diet also significantly lowers the risk.

Mahshid Dehghan, the study’s lead author and nutritionist at McMaster University’s Population Health Research Institute (PHRI) and his team assessed the association between diet quality and the risk of cardiovascular disease using information collected from men and women who participated in two major McMaster-led global studies: ONTARGET, and TRANSCEND.

Participants with cardiovascular disease were asked how often they consumed milk, vegetables, fruits, grains, fish, nuts, meat and poultry over the past 12 months. They were also asked about lifestyle choices such as alcohol consumption, smoking and exercise. A healthy diet was indicated by a high intake of fruits, vegetables, whole grains and nuts as well as a high intake of fish compared to meat, poultry and eggs.

The results showed that a heart-healthy diet offered a “consistent benefit” over and above the benefits of taking medications to reduce the risk of heart attack and stroke.

Globally, healthy eating was associated with a lower risk of cardiovascular disease by more than 20% in all regions of the world and across all income groups.

“Physicians should advise their high-risk patients to improve their diet and eat more vegetables, fruits, grains and fish,” Dehghan said. “This could substantially reduce cardiovascular recurrence beyond drug therapy alone and save lives globally.”

Think Before You Eat!

Tempted to have a burger and fries this lunchtime?  It wouldn’t hurt once in a while, right?  Not so fast.  Maybe it is time to think outside the bun after all.

According to new research from the Montreal Heart Institute,  it’s not just a lifetime of bad eating habits that leads to heart disease –  every single junk food meal has a damaging effect on your arteries.

That’s right! Each and every meal, composed mainly of saturated fat, is detrimental to the health of the arteries.  On the other hand, no damage occurs after consuming a Mediterranean-style meal rich in “good fats” such as mono-and polyunsaturated fatty acids. Better still, the Mediterranean meal may even have a positive effect on your arteries.

These findings were presented at the recent Canadian Cardiovascular Congress, by Dr. Anil Nigam, Director of Research at the Cardiovascular Prevention and Rehabilitation Centre (ÉPIC) and associate professor at the university’s Faculty of Medicine.  He undertook a study to compare the effects of junk food and typical Mediterranean meal on the vascular endothelium – the inner lining of the blood vessels.  Endothelial function is known to be closely linked to the long-term risk of developing coronary artery disease.

28 non-smoking men participated in the study. Their endothelial function was assessed at baseline.  They were then given the Mediterranean-type meal, which was composed of salmon, almonds, and vegetables cooked in olive oil.  51% of total calories came from fat – mostly monounsaturated fatty acids and polyunsaturated fats.

A week later they were given the junk food-type meal, consisting of a sandwich made of a sausage, an egg, a slice of cheese, and three hash browns. This time, 58% of the total calories came from saturated fatty acids containing no Omega-3’s.

Two hours and four hours after each meal, participants underwent further ultrasounds to assess how the food had impacted their endothelial function.  They found that after eating the junk food meal, the arteries of the study participants dilated 24% less than they did when in the fasting state. In contrast, the arteries were found to dilate normally and maintain good blood flow after the Mediterranean-type meal.

Additionally, subjects with higher blood triglyceride levels seemed to benefit more from the healthy meals than those with low triglyceride levels.

“A Mediterranean-type diet may be particularly beneficial for individuals with high triglyceride levels, such as patients with metabolic syndrome, precisely because it could help keep arteries healthy,” predicts Dr. Nigam.  “These results will positively alter how we eat on a daily basis. Poor endothelial function is one of the most significant precursors of atherosclerosis. It is now something to think about at every meal.”

Oh la la!  Are you ready to ditch the junk food in favor of a little “je ne sais quoi.”

There’s a Shot for That

On May 14, 1796 Edward Jenner injected fluid from the cowpox blisters on the hands of dairymaid Sarah Nelmes, into James Phipps, an 8-year-old boy.  Jenner hoped the fluid from the cowpox lesion would somehow inoculate the boy against the smallpox scourge which at the time was killing over 400,000 Europeans a year. His hunch proved correct.

Today vaccines save 3 million lives per year worldwide. By training the human immune system to recognize and ward off dangerous pathogens, vaccines can protect against disease for decades, or even for a lifetime. Preventive vaccines work by introducing harmless microbial chemical markers, known as antigens, which resemble the markers on living microbes. The antigens train the immune system to recognize and destroy those microbes should they ever appear in the body. By injecting cowpox antigens into Phipps bloodstream, Jenner primed his immune system to attack the similar smallpox virus.

Now, medical scientists are taking Jenner’s ideas in a whole new direction. By exploiting a growing understanding of the immune system they are developing therapeutic vaccines targeting established diseases rather than trying to prevent them.

Last spring, the FDA approved Provenge, a personalized immunotherapy that activates a patient’s own immune cells to target and attack advanced prostate cancer. To make the Provenge prostate cancer vaccine, biochemists at Seattle’s Dendreon Corporation extract a sample of a patient’s own immune cells and bathe them in a chemical soup of prostate cancer antigens that are chemically linked to a cytokine that screams, “Attack this!”.  The activated immune cells are then injected back into the patient’s body to spread the call to arms.

While Provenge was the first of the new generation of therapeutic vaccines, it’s certainly not the last. BCC Research has identified 113 therapeutic vaccines in development, many of which are already in human trials. They even go so far as to estimate that the market for therapeutic vaccines will have an annual growth rate of 115% and reach an estimated $2.9 billion in 2014.

Other cancer vaccines are among the front runners. With a near-endless supply of patients willing to undergo novel treatments, cancer researchers have been among the most aggressive in experimenting with therapeutic vaccination. The Cancer Vaccine Collaborative is working on treatments that target multiple cancer antigens, which should trigger a more aggressive immune response and increase the odds of defeating tumors. All of which is good news for the 1.5 million Americans diagnosed with cancer each year.

While cancers cause a proliferation of diseased cells, some autoimmune diseases, cause the cells of the immune system to turn against healthy tissues. In diabetes, for example, the immune system attacks insulin-making pancreatic beta cells.

In multiple sclerosis, it’s the myelin sheaths that are designed to protect the nerves that come under attack.

Autoimmune vaccines hold the promise of shutting down these attacks. One promising approach boosts T-regulatory cells, a subgroup of the white blood cells. At the University of Calgary’s Diabetes Research Centre in Alberta, immunologist Pere Santamaria has attached a cocktail of antigens from pancreatic beta cells to synthetic iron oxide nanoparticles. This stimulates the development of T-regulatory cells into killer T cells that destroy the immune cells which cause the serial killer like autoimmune attack.

Santamaria’s team recently tested his vaccine in diabetes-prone mice. It restored normal blood sugar and insulin levels in animals that already had diabetes and prevented or slowed its onset in young mice that had not yet developed the disease. The team is now readying the vaccine for human trials and is designing related vaccines to treat other autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, and inflammatory bowel disease.

If effective, such therapeutic vaccines could help the three million Americans with type 1 diabetes and the 400,000 people diagnosed with multiple sclerosis. Vaccines against dust mites and asthma are also in the works.

Some of the new therapeutic vaccines are actually designed to attack the body, albeit in a selective way. A new experimental heart-disease vaccine takes aim at unwanted biochemicals within the body, specifically low-density lipoprotein (LDL), better known as bad cholesterol. When large quantities of LDL cholesterol circulate through the bloodstream, it can be deposited on artery walls, leading to a buildup of plaque and triggering inflammation. Anti-cholesterol vaccines encourage the immune system to attack LDL and remove plaques. Scientists have also discovered that the vaccine lowers blood pressure and protects against the rupture of aneurysms, at least in mice.

Clinical trials in humans are expected to start later this year and if successful could help to prevent the 800,000+ deaths per year from cardiovascular disease.

Even more people could be helped by an anti-obesity vaccine. Nearly 75 million adults are classified as obese in the United States. Researchers are working on a vaccine that targets ghrelin – a gastrointestinal hormone that appears to stimulate appetite.

Others, are looking at vaccines to prevent addiction to cocaine, methamphetamines, opiates and nicotine.

It is too soon to know how and when these vaccines will come to market or how effective they will be, but it’s clear that therapeutic vaccines are coming and will be used against a host of the most prevailing public health issues of the 21^st century.

Be Still My Beating Heart! – Monty Python and the Holy Grail

Look up the term myocardial infarction (MI) in any medical dictionary and the definition will be something along the lines of –  the changes to the myocardium (heart muscle) that occur due to the sudden deprivation of circulating blood. The main change being necrosis, or death of myocardial tissue. Death of myocardial tissue.  As in dead, as in non-viable, as in beyond repair. Kind of reminds me of the infamous Monty Python Dead Parrot sketch… “Passed on! No more! Ceased to be! Expired and gone to meet ‘is maker!”….but I digress.

Fast forward from the British humor of December 1969 to an astonishing paper presented in Britain in April 2012  at the Frontiers in CardioVascular Biology meeting. In a keynote lecture, Dr Deepak Srivastava outlined results that have been described as a “game changer” with the potential to revolutionize the treatment of MI.   Srivastava used viral vectors to deliver genes directly into the hearts of adult mice that had experienced an MI. In his original “proof of principle” study, Srivastava was able to show that all that was needed for the direct  reprogramming of fibroblasts (a major component of scar tissue) into myocytes (the heart muscle cells responsible for  beating)  was the delivery of three genes.  The work , which took place in a Petri dish, was considered groundbreaking since it showed for the first time that unrelated adult cells could be reprogrammed from one cell type to another without having to go all the way back to a stem cell state. “Our ultimate hope is that, during the acute period following MI, patients will be able to receive direct injections of factors that transform the existing fibroblast cells in the “scar” into new myocytes. The resulting increase in muscle mass should help MI survivors to live more normal lives,” explained Srivastava.

Healthy heart tissue is composed of a mixture of several kinds of cells, including cardiomyocytes, which provide beating muscle and cardiac fibroblasts that provide architectural support to the myocytes. “When heart muscle cells become injured and die following an MI, patients have the major problem that these cells have little or no capacity for regeneration,” says Srivastava.  Part of the process of remodelling that occurs following the injury is that fibroblast cells migrate to the site and create the scar. At first, the process can be considered beneficial since without fibroblasts adding structural support damaged hearts would rupture. But later, difficulties arise when the fibrotic scar doesn’t contract like the muscle it has replaced. “Reduced global contractility means the heart has to work much harder, and the extra stress can ultimately lead to heart failure and even death,” said Srivastava.

One of the Holy Grails of cardiovascular research has been to replace these lost myocytes and return functionality to the heart.  Some of the first approaches to be investigated were the introduction of stem or progenitor cells to the sites of injury.  But many hurdles have been encountered including getting cells to integrate with neighboring cells in the heart, and there have been concerns that residual “rogue” cells could persist with the potential to keep dividing and give rise to tumors.

Srivastava, a pediatric cardiologist, explained how he got ahead of the game by “leveraging” knowledge from his work in embryo hearts. Over the past 15 years the focus of Srivastava’s lab has been to identify genetic factors responsible for the formation of embryonic hearts. From this work, his team identified 14 key genes that they felt were the major “on/off” switches for cardiac genetic programming. In this original study they were able to whittle things down to the three factors that were indispensible. The team then injected fibroblasts that had the three genes inserted directly into the scar tissue of mice.  They were able to show the fibroblasts differentiated into cardiomyocyte-like cells. In the latest study  they were able to take the process one step further by injecting a viral vector encoding the  3 genes directly into the scar tissue of mice who had just experienced an MI. “With these studies we’ve obtained even better results showing that the fibroblasts become more like cardiomyocytes and functionally couple with their neighbors. They could beat in synchrony and improve the function of the heart,” said Srivastava.

The next step will be to test the direct injection approach in a larger animal, such as a pig, whose heart is similar in size to a human.  But a big question remains “will the same combination of genes work in human hearts?” SRxA’s Word on Health will be watching and waiting. In the meantime…it’s back to Monty Python!

Heart Health Hits Home

As I child, I didn’t understand the concept of death, as an adolescent I thought  I was invincible, as a young adult, death was something that happened to grandparents, parents and their friends. But now I’ve come to the point in my life, maybe it’s the final step in growing up, when I suddenly realize it could happen to me.

Why the sudden comprehension of mortality?

Last week, two of my closest friends almost died.  One was sitting in my kitchen, drinking wine and catching up on the latest neighborhood gossip, when he remarked he didn’t feel well. A few questions and a blood pressure reading later, we were testing the limits of my car’s performance on route to the local Emergency Department. A few hours and a few tests later, he was in a Medevac helicopter and on his way to emergency cardiac surgery. Thankfully, he’s home now, doing well and embellishing the story of his MASSIVE heart attack, brush with death, and quadruple bypass surgery with each passing day. (Actually it was just a stent, placed under local anesthetic – but let that be our secret, I wouldn’t want to ruin his 15 minutes of fame!)

The other , a fabulous, funny, vibrant woman, suffered a thrombotic stroke and also ended up being hospitalized and having surgery.

Prior to these events, both friends had been generally healthy. They both exercised, they both watched their weight and neither saw these life-changing events coming. Their brush with mortality was the wake-up call they needed, and further lifestyle changes are being implemented as we speak.

It was also the wake-up call I needed. Yesterday I rejoined the gym and resolved to exercise more, eat and drink less and visit my doctor more often.  Nearly losing my friends was the inspiration I needed.

Cardiovascular disease is the leading cause of death in the United States; one in every three deaths is from heart disease and stroke, equal to 2,200 deaths per day.

“Heart disease takes the lives of far too many people in this country, depriving their families and communities of someone they love and care for—a father, a mother, a wife, a friend, a neighbor, a spouse. With more than 2 million heart attacks and strokes a year, and 800,000 deaths, just about all of us have been touched by someone who has had heart disease, heart attack, or a stroke.”  says Department of Health and Human Services Secretary, Kathleen Sebelius.

Recently, the American Heart Association/American Stroke Association  joined forces with Million Hearts™ to build healthier lives free of cardiovascular disease and stroke. As part of this they have developed a heart attack risk calculator and a life check calculator to help you understand your cardiovascular health and move you closer to your life goals.

For those, still looking for a motive, I highly recommend viewing a “Living Proof” video, created by physicians, nurses and patients at MetroSouth Medical Center.

In it, heart disease survivors and those who have lost loved ones to heart conditions used cardboard signs to deliver an urgent call to action. Their main messages?  Get screened for heart disease and early intervention and prevention pays off.

February is National Heart Month and I for one am taking notice.  Are you?

Fit to be President?

President Barack Obama knows a thing or two about fitness. Photographers have snapped him playing golf in Hawaii on Christmas Eve, doing impromptu pull-ups before giving a speech in Montana, and even playing a game of pick-up basketball on Election Day. His love of these sports, coupled with his well-documented gym habits and disciplined diet, has led the media to herald Obama as the new face of presidential health.

But, as SRxA’s Word on Health has learned, not all American presidents have been such model specimens of health. Some of them, far from it.  In fact, disease, injury, and destructive habits have run rampant in the 43 commanders-in-chief.

To mark this President’s Day we decided take a look at some the least healthy presidents in American history.

James Monroe, the Fifth President (1817-1825) was shot with a bullet during the Battle of Trenton.  To save his life, a doctor stuck his index finger into the wound to stop Monroe from bleeding out. In 1785, Monroe contracted malaria while visiting a swampy area of the Mississippi River. Sporadic feverish flare-ups plagued him for years afterwards.

In August 1825, Monroe suffered a severe seizure. Though the cause was never pinpointed, it’s speculated that it was triggered by either mushroom poisoning, a stroke, or cerebral malaria.

In 1830, Monroe developed a chronic lung illness that crippled him for several months, leaving him with labored breathing, fever, night sweats, and a nagging cough that sometimes had him spitting up blood. Though never officially diagnosed his symptoms are strongly suggestive of tuberculosis.

Theodore Roosevelt, the 26th President (1901-1909) was a frail and sickly child. In the hope of alleviating his asthma and other ailments Roosevelt was encouraged to do lots of physical activity. Boxing became one of his favorite hobbies. However, after being elected to the White House, he suffered a blow to his left eye resulting in a detached retina which left him blind on that side. Later he also lost the hearing in his left ear as a result of surgery necessitated by a middle ear infection

Roosevelt then contracted malaria and suffered an infected leg wound during an expedition into the Amazon rainforest. These injuries resulted in chest pains, high fever, and delirium. Though he didn’t die, he returned to America in a decrepit physical state, and was often unable to leave his bed for years afterwards.

Ronald Reagan, the 40th President (1981-1989) had many well documented health problems. Just like Roosevelt, these included hearing and sight issues. Reagan was so nearsighted that he was disqualified from serving during World War II. Later, when he got glasses, he was surprised to see that trees had leaves – something he’d never known before.

Reagan used a hearing aid in his right ear early in his presidency but later started wearing one in his left ear. It’s been speculated that his hearing was damaged during his early years as a Hollywood actor, when he was exposed to repeated loud gunshot during the filming of his Western movies.

Other health problems included multiple urinary tract infections, prostate stones, colon tumors and skin cancers.  Finally, though he was famous for having a near-photographic memory during his prime, Reagan’s memory deteriorated when he hit his 70s, and he would sometimes forget the names of key staffers and visiting dignitaries. He was diagnosed with Alzheimer’s Disease in 1994.

Woodrow Wilson, the 28th President (1913-1921) suffered from hypertension, headaches, double-vision and multiple strokes throughout adulthood. His third stroke, in 1906, left him blind in his left eye. Finally, in 1919, the president suffered a massive stroke that paralyzed his left side and forced him into a wheelchair. Wilson decided to keep his condition a secret from the public, so isolated himself in the White House, where for the last 3 years of his term his wife Edith made all presidential decisions for him.

, the 34th President (1953-1961) was a four-pack-a-day smoker. He also suffered from Crohn’s disease and gallstones, both of which required surgery. In 1955 Eisenhower suffered a heart attack so severe that his cardiologist advised the president not to run for a second term. Eisenhower ignored his advice, ran, and was reelected. His second term was marred by even more heart trouble: during a five-month span in 1968, he suffered four heart attacks and 14 cardiac arrests. These weakened him to the point where he could only be out of bed for 45 minutes a day, and he died the next year.

John F. Kennedy, 35th President (1961-1963) is remembered as a glamorous, tragic playboy, assassinated too young. What’s less well know is the litany of health problems he suffered throughout his life.

Kennedy’s childhood was riddled with health issues. At 2 years old, he contracted measles, whooping cough, chickenpox and then scarlet fever, which almost killed him. Later in his childhood, he frequently had upper respiratory infections and bronchitis, as well as allergies, frequent colds, asthma.

During his teens, Kennedy underwent an emergency appendectomy, had his tonsils removed, suffered a severe case of pneumonia, and two episodes of jaundice.

While studying at Harvard, Kennedy contracted urethritis, an inflammation of the urethra that results in painful urination. As he failed to seek immediate treatment, this became a chronic problem for many years.

After years of suffering back pains, Kennedy was diagnosed at age 30 with Addison’s disease, a rare endocrine disorder that generally results in fatigue, muscle weakness, nausea, and bronzing of the skin. Kennedy was so ill that he was given the last rites and physicians speculated that he would die within the year. However, steroid therapy and experimental medicinal implants of hormones, animal organ cells, vitamins, enzymes, pain killers and amphetamines and kept him alive. Then in 1966, he was diagnosed with hypothyroidism. The presence of two endocrine diseases raises the possibility that Kennedy had autoimmune polyendocrine syndrome type 2 (APS 2).

We wish all our readers a Happy and Healthy President’s Day.