YOU HAVE SIX MINUTES ... When Cardiac Arrest Strikes ... Know The Signs ... Know What To Do

(4-15-15)

There are two kinds of heart attack. One caused by a blood clot is called myocardial infarction. You recognize the symptoms -- chest pain that can last for hours (women may have symptoms of indigestion and anxiety, etc.). But cardiac arrest is different. It strikes suddenly with no warning and there is precious little time to get help to save the victim's life -- SIX MINUTES! The help needed is specific: cardiopulmonary resuscitation (CPR) and an electric shock to the heart.

Basically, cardiac arrest is caused by ventricular tachycardia, an abnormally rapid rhythm in the ventricle (lower) chambers of the heart, which can cause the heart to go into ventricular fibrillation, or very fast and chaotic. The ventricles can't move blood through the heart because there is no time in between the beats for blood to enter the chambers, so blood circulation stops and the victim collapses.

The cause, or trigger, of ventricular tachycardia can be any of a number of precipitants, even a previous myocardial infarction. Sometimes structural problems exist and even electrical disorders are present. Other contributory factors can be mineral imbalances in the blood (potassium, magnesium, etc.); stress; dehydration; inherited diseases; or even a sudden blow to the chest such as has happened when a ball player is hit by a hard ball in the chest.

Cardiac arrest doesn't give the victim time to react, it is too sudden; however others around him/her should be aware of what's happening. Signs that the person is in cardiac arrest: • suddenly faints or collapses; • stops breathing; • has no pulse; • may have twitching muscles. A person who has only fainted is still breathing and has a pulse. Remember, the heart is not pumping blood during cardiac arrest and everything stops.

The very first thing you should do if you see someone who may have had a heart attack is CALL 911. Don't wait for even a minute. Then, start CPR. The idea is to keep blood flowing to the brain and compressing the chest as in CPR does that. Ask someone if there is an automated external defibrillator available (AED). This is a portable machine that shocks the heart back into rhythm and anyone can use it. It has instructions on how to place the pads. It has a computer that will determine if the person is, indeed, in cardiac arrest and whether his heart should be shocked. Then it tells the operator when to administer the shock. It is safe. Waiting is not.

SIX MINUTES. Know what to do. If the emergency vehicle does not arrive in time, the victim will die, or at best survive with permanent brain damage. Take a course in CPR which is available through the American Heart Association and your local emergency department. See about obtaining an AED device for your clubhouse. Many folks even have one for their homes. Check out how long it takes your local emergency department to respond to a medical emergency. Arrange with your local emergency service department to come and speak to your association. Be ready.

For more information about AEDs contact the American Red Cross at 561-833-7711, or visit their website at http://www.redcross.org/services/hss/courses/aed.html for the National Red Cross for more information about the use of AEDs. Courses are available in their use. Also, contact the American Heart Organization in West Palm Beach at (561) 615-3888.

PELOSI'S NOTORIOUS QUOTE:

"You’ve heard about the controversies within the bill, the process about the bill, one or the other. But I don’t know if you have heard that it is legislation for the future, not just about health care for America, but about a healthier America, where preventive care is not something that you have to pay a deductible for or out of pocket. Prevention, prevention, prevention—it’s about diet, not diabetes. It’s going to be very, very exciting. But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy."

— Nancy Pelosi, as Speaker of the House, March 9, 2010, referring to Obamacare, otherwise known as the Affordable Care Act.

Socialized Medicine at its "Best"

— A personal experience in a foreign country

October 30, 2013

Seven years ago this month, I made a long-awaited trip to visit my "former" in-laws in Greece. I had not seen them since 1981. They had spent many years off and on with me and my then husband, their son, at our home in Maryland. They watched our children grow from birth to teen and preteen ages. I learned the language from my mother-in-law. She was diabetic, so I was her link to health care in this country, as she and my father-in-law spoke no English. She and I spent most of every day together, shopping, cooking, taking care of kids, etc. Father-in-law was the robust, soft-hearted, barrel chested "Walrus" of a man who was content to finger his worry beads when he wasn’t out tending to our vegetable garden or helping to move our 7 tons of Delaware River rocks we had ordered to be placed around our new swimming pool. For most of some 15 years, they were an integral part of our household.

Then, in 1981, they returned to Greece (they would normally spend a year or more with us, then a year there). It was then that our marriage also was on the downturn. It ended and I moved to be closer to my mother who had recently come to Florida. I had not only lost my marriage, but these two wonderful people who were my in-laws.

I began to fear that I would not see them before they died -- he had turned 90 and she was 6 years younger. I began to express my concern to my ex and my sons. My oldest son, Dimitri, and his wife and three children had just returned from Greece that summer. My youngest son had visited many times with his father and his father’s wife, but my daughter-in-law had not made the trip yet. And, there was a new baby.

So, finally, Tony, Jennifer, Alyssa (the baby) and I planned our trip. This was a good arrangement since I speak the language much better than Tony. I was finally going to see my dear in-laws again.

From rear:  Alexandra and Dimitri Tzoumas (my in-laws in Greece), my son Tony with granddaughter Alyssa, and Jennifer, daughter-in-law on the balcony of my in-laws' apartment in Athens, Greece. This is the last photo taken of them before my father-in-law's death and before my mother-in-law's death 3 months later.   Photo by Betty Thomas (Tzoumas) October, 2006

The reunion was fantastic, with hugs, tears, smiles, pictures, and more. We arrived Friday afternoon. Then, on Sunday evening, my father-in-law took suddenly ill, unable to breathe (I could hear fluid), and his heart was racing. He only wanted to go to bed, insisting it would pass. But, later that night, I summoned the housekeeper from her home and we called the "ambulance."

What a shock. The "ambulance" was only a "transporter", with two men who could do nothing but transport our patient to the hospital (not the one of his choice, but the one that the transporter goes to). You have to take a taxi to go to the other one. These men did not have anything to cover him with, did not perform any paramedical tests such as taking blood pressure or listening to the heart!

After much persuasion, my still-unable-to-breathe father-in-law was positioned on the bare, orange plastic transporter. We were to provide a blanket or something to cover him with. He was in a sitting position due to the small space of the elevator compartment.

My son and the maid accompanied them to the Emergency Room. It was difficult to get any information from the doctors who would only say he wasn’t getting enough oxygen and they suspected pneumonia. They were all night at the ER waiting for a room for Papou (grandfather).

Now in the room, the nieces and nephews congregated at the hospital. There was much to do. One asked the women at the desk if there was a doctor there? "Well, this is a hospital, what do you think?" "Might one be sent up to see my uncle?" she asked. "I can’t do that, you need to get a nurse to send a doctor to him," was the terse retort. "And where might I find a nurse," she queried. "Try downstairs in the cardiac unit." Finally a nurse was found. Then more upstairs, downstairs, pleading.

Meanwhile, Papou was still laboring to breathe, fitted with only an oxygen mask and a drip of some fluid (I suspect saline solution) to keep him hydrated. He would ask us to open the window because he couldn’t breathe. An x-ray had been taken, probably down in the ER, and an EKG. They saw fluid in the lungs. Then, in the afternoon, another EKG was taken and the team of four studied the two tapes for some 15 minutes. When the family asked what the doctors found, the answer was, "He is not good. He is old. He has pneumonia." We were told to hire nurses to stay with him in the evening and night. Also, we were instructed to bring in adult diapers for him. These were not provided (nothing was). I’m sure there’s more. I don’t know if he was fed.

Quite frankly, I believe he had congestive heart failure. His attack was sudden, with fluid suddenly filling up the lungs. Yes, he was 94, but he might have been saved with some simple procedures. We’ll never know. They never even tried.

The next day, he was moved down to cardiac care where he was (finally, but too late) intubated. The next morning (Wed.) at 1:10am, I received a call from the hospital that he had died. Finally, my ex arrived from the U.S. Wed. evening the hospital called to ask us to have the body taken to the refrigerator by the "funeralists" because he would begin to smell. It never occurred to us that he would not have been moved to the coroner (if they have one).

Now, understand that Greece has socialized health care. Is this what the future of Obamacare holds for us? Think about it.

Doctors Know Exercise Key to Good Health

Photo and story by Jimmy Shirley

Dr. Benedicto San Pedro, M.D. (pictured left) has had a family medical practice in Lake Worth for thirty-three years. About three years ago, the now sixty-four year old doctor began to notice he was feeling sluggish, unhealthy. Age happens to us all. So after some amount of research, he decided to join a fitness gym in Boynton Beach. Enlisting the aid of a trainer, he learned about physical fitness and how it is helped along by a good mental attitude.

Since then, combining proper nutrition and a smart work-out regimen, his body fat index dropped from 28% down to 15% and his "feel-good index" more than doubled. Judge for yourselves how fit the good doctor looks. 

  Married for thirty-six years with two grown sons, his wife also works out. He is the doctor of Betty Thomas, publisher of the Condo News, as well as her mother’s.

Buttonwood West Yoga Class

Photo by Murph Stone

(6-29-11) Ann Edmundson's Yoga Class in the Buttonwood West Clubhouse ... Ann's composure is so serene, so in line with the perfect spiritual insight required of Yoga. This disciplining and training of the mind can lead us to the perfect tranquility constantly eluding us. Pictured l-r are: Lorraine Betz; Helen Dickey; Eileen and Richard Baisley; Rita Carr. 

Not pictured is Jo McDonald. 

Plié Squat: (Strengthens  thighs and buttocks) This move can be done without any resistance, or with rubber tubing, or even holding light weights. Stand with feet wide apart, toes pointed outward, back straight, abdominal muscles contracted. Bend knees and lower your torso, keeping back straight, as far as you can without changing   the  position of the pelvis. Now, as you elevate back to  the starting position, squeeze your buttocks and leg 

muscles, which will make those muscles perform the move. You will feel it in your front and back thighs (quadriceps and hamstrings), inner and outer thighs and buttocks. If you are using the tube, you will stand with the arch of your foot (wear shoes) over the tube and a tube end in each hand crossed over from the opposite foot. Do 8 to 12 reps, 1 to 3 sets.

arms at sides with palms down.  Now, lift your pelvis (hips) up until you form a "bridge" in a straight line from your knees to your shoulders. You should be using only your heels to do the lift, not your whole foot. Lower yourself down to the starting position slowly and do repetitions. You should feel a tightening throughout your hamstrings, buttocks and torso muscles. If you are physically fit, try doing this move with one foot on the floor and the other a few inches off the floor, then switch feet. If you have problems with your back, advanced osteoporosis, or other health issues that might be aggravated by this move, don’t do it. If you feel pain while doing this move, stop. This move will help to improve balance and stability.

Health and Fitness Issues

By Betty Thomas

Pulmonary Embolism

(November 26, 2014)

A pulmonary embolism means there is a blood clot in an artery in the lung. The blood clot usually forms in the legs, buy can form in other parts of the body — deep vein thrombosis (DVT). These two conditions are called a venus thromboembolism (VTE). Pulmonary embolism can be life-threatening and requires prompt treatment..

The primary causes of DVT include surgery, especially hip surgery, cancer and immobility. Long airplane and auto trips are common risks for developing DVT. Symptoms depend on how many clots are in your lungs (there are almost always more than one) as well as your general health and whether there is any heart or lung disease present.

Symptoms of pulmonary embolism are as follows: Sudden shortness of breath that worsens with exertion and does not lessen with rest; Chest pain which worsens with exertion and when you take a deep breath; Cough which may contain blood; Leg pain and/or swelling in the calf; Cyanosis (clammy, discolored skin); Excessive sweating; Irregular or rapid heart beat; Dzziness or light headedness.

Risk factors include a family history of blood clots in the veins or lungs; heart disease and high blood pressure; ovarian, pancreatic or lung cancer, and cancers with metastasis, or breast cancer treatment drugs such as tamoxifen or raloxifene. Prolonged immobility such as bed rest, long trips, sitting in one position -- slows blood flow which can cause blood clots in the legs.

So, when might a dental appointment present a risk factor? Read Manny Luftglass’ Gone Fishin’ column for the answer.

Other risk factors include smoking, being overweight, supplemental estrogen and pregnancy.

If you suspect a pulmonary embolism, go to the hospital immediately. Take a list of all your symptoms to give to the doctors.

Tests include blood tests, chest x-ray, ultrasound, CT scan, V/Q lung scan to study air flow, pulmonary angiogram and an MRI.

Medications include blood thinners, clot dissolvers, and, if necessary, surgical removal of large clots and sometimes a vein filter.

Prevention: While traveling by air or car, get up and move around the plane, or get out and walk around the car, flex your leg muscles, extend your legs, fidget, contract your buttocks muscles, push down with your feet and rise up on your toes, do not cross your legs for long periods. Drink lots of fluids -- water, not alcohol. Wear support stockings.

A Beautiful Mind

(June 1, 2011)

Have you ever pondered what a beautiful thing your mind is? Just think about it. In one glance, your brain makes thousands of calculations about everything around it -- area, shapes, colors, density, material makeup, depth perception, proximity, purpose, smell, texture, as well as your own body and its relationship to its environment. Computers, even the fastest ones, haven't begun to compete with the human brain in all its complexities. But, your brain is subject to damage from a multitude of sources, including what you put into your body, how you use or don't use it, disease, age and so on. It behooves you to do whatever is in your power to protect your brain, thus your mind, in every way you can. Life-style is probably the most important aspect in protecting your brain's health.

Use it or lose it. Keep your brain active. TV is not a good source for mind games -- it can deactivate the brain's transmitters. Rather, engage in hobbies, read books and newspapers, play cards, play an instrument, etc.

Network with friends. Socializing is one of the most healthful aspects of a good life-style one can engage in. It provides a mental stimulation as you make plans for social events, share ideas, support each other in times of grief, rejoice together in times of joy, and in effect, connect with each other. It is also good for emotional health which is, after all, in the brain.

Reduce stress and anxiety in your life. I hate the feeling of anxiety more than anything I can imagine. Stress elevates the levels of cortisol in the brain. That's where the "fight-or-flight" response comes in. Another name for that is angst -- anger and stress. Besides being bad for the brain, angst is also bad for the heart. It stimulates the body to move fat to the abdomen where, as "deep fat", it causes an elevation in the bad cholesterol in the blood (LDL). Stress reducing activities include some of the above such as reading, playing an instrument, deep breathing and exercising. Prayer is a powerful tool.

Aerobic exercise is a must. Walking briskly increases the flow of blood in the body and the brain. The brain needs oxygen and nutrition to do its job, just like the muscles. Walk a mile a day or do other aerobic activities such as swimming, tennis and golf (if you walk the course), are recommended.

Get enough sleep. Too many of us are "night owls." People in their 60s, 70s, 80s, etc. have trouble sleeping. Watch what you eat and drink before bedtime.

If you are over 60, you may need to take vitamin B12 supplements containing at least 2.4 mcg of B12. About 20% of people over 60 and 40% of people over 80 can't absorb the vitamin very well. Vitamin B12 is important for the nerves to function properly.

If you have chronic pain, get help. Vital signs are listed thusly: 1) Heart rate; 2) Blood pressure; 3) Temperature; 4) Respiration; and now, 5) Pain is rapidly being referred to as the fifth vital sign. Tell your doctor if you have pain. Life-style changes can reduce pain such as weight reduction, exercise, relaxation, meditation, and so forth.

Volunteerism is being recognized as an important factor in mental health, and can be beneficial to people suffering from chronic pain. It helps take the mind off the pain like a good movie does.

A mind is a terrible thing to waste. Keep yours beautiful for as long as you can. It is, after all, your essence, your being.

Stroke symptoms different for women; Smoking alters body's proteins/enzymes

(May 4, 2011)

Men are from Mars and Women are from Venus. Well, now that that's been established and we understand the basis of our communication problems, here's news that may make that language barrier more of a problem. Stroke symptoms are reported differently by women than by men. Most studies have been done using male participants. Most doctors are men. Most text books have been written by men (or is it all text books?). A study conducted at the University of Michigan Medical School in Ann Arbor found marked differences in the way women reported their symptoms of stroke. The researchers aren't even sure whether the women experienced differences because of biological reasons or because they explain their symptoms differently than men. Stroke symptoms reported by most patients include dizziness, slurred or broken speech, facial paralysis, and sensory problems. But, in the study, women reported other symptoms such as fluctuations in consciousness and disorientation as well as limb pain in about 60% of the cases. Women also had more bleeding strokes than men, who are more likely to suffer stroke due to a blockage. These differences are probably due to differences in the cause of the strokes in the first place. Women's general cardiovascular disease has different signs as well. But the difference in describing symptoms to the emergency responders and doctors is delaying treatment for some women. Doctors often don't diagnose women's symptoms as being those of stroke, delaying the use of clot busters for women who are not suffering bleeding strokes, but rather blockage strokes.

Still smoking? Consider this ... We know that it's the nicotine in the cigarette smoke that causes the addiction to the habit. We thought it was the tar in the tobacco that caused all the harm. Well, researchers have discovered that a product of the breakdown of nicotine -- nornicotine -- may cause big problems. See, this nornicotine hooks up with glucose, generating "advanced glycation end-products (AGEs)", and binds to proteins causing them to change their function. Is this bad? Could be. Proteins are enzymes that stimulate chemical reactions in our bodies. They all have different shapes. Their shape (structure) gives the enzymes the ability to perform their jobs. They specialize. Alter the shape and you render the enzyme either useless or harmful. For example, nornicotine changes the structure of prednisone, (a steroid that is very similar to glucose). There is a possibility that nornicotine may hinder the effectiveness of other drugs. Researchers described nornicotine in this way ... they said that it "sears proteins much the way foods brown, leading to potentially harmful changes that could cause disease." AGEs are linked to vessel disease, diabetes and other ailments. More AGEs have been found in smokers than non smokers. Kim Janda, of Scripps Research Institute in California, and leader of the study, said, "You can (also) get this (AGEs) from the (nicotine) patch or gum." A Scripps tobacco expert, George Koob, says that more studies are needed to determine if "the effects of AGEs from nicotine are 'good, bad or indifferent'."

Nicotine has been shown to slow the healing of bone fractures predisposing nicotine-users (smokers, chewers [gum or tobacco] or patchers) to increased risk of hip fracture. It alters the effectiveness of estrogen and counters the effectiveness of antioxidants such as Vitamins C and E. Cigarette smoking is implicated in a myriad of health problems including severe disc degeneration, weakened spinal ligaments; slowed production of bone cells; rotator cuff problems; reduced delivery of oxygen to the tissues resulting in slow healing following surgery and fractures; and more. Lower back pain and sciatica are more common in both men and women smokers -- especially those who have smoker's cough. Smokers have more disabling leg cramps. There are hundreds of thousands of toxins in cigarette smoke and some toxins directly effect cells that are trying to heal. Hardening of the arteries caused by smoking may not reverse after smoking is stopped, but many other smoke-related issues will -- including speeding up the healing process.

There's another issue here. "Smoking is a major risk factor for bladder cancer," says Dr. Arie Belldegrun, chief of UCLA's Jonsson Cancer Center's urologic oncology division. It is predicted that some 70,530 cases of bladder cancer will be diagnosed in the U.S. this year and nearly 14,680 will die from it. Smokers and former smokers are at risk.

Focal Dystonia ... 

Involuntary Nerve Impulses

(April 6, 2011)

Focal dystonia or involuntary contractions (spasms) of a single muscle area, can affect any muscle area, but most common are the neck, eyelids, jaw, vocal cords and lower arm. These spasms in the lower arm may be characterized as writer's cramp or even the "Yips" familiar to some golfers who experience the twitch while putting. The spasm is often more pronounced when there is emotional or physical stress. The cause is not known but focal dystonia seems to occur in folks who are engaged in a profession or hobby which requires a sustained, abnormal posture. Then some occur during certain activities such as writing or using a putter on the golf course. Tests to rule out Parkinson's disease as well as seizure disorders are necessary before diagnosis of focal dystonia can be made. Treatment may be in the form of oral or injected medications or surgery. Botox and Myoblock injected into the offending muscle to block the nerve causing the spasm have proven to be the most effective.

Fighting Sarcopenia

(August 11, 2010)

Ever heard of Sarcopenia? No? Well, you probably have it. It usually starts in 'middle age' around 45. It's when your body seems to get the 'dropsy' and your fat ratio out does your muscle ratio — or muscle mass decline. That can lead to frailty in old age (excuse the term, but we need to 'cut to the chase'). We lose our muscle mass at the rate of about one percent a year after age 45, so let's see, how much is that? With that loss goes strength and your quality of life declines, too. No one is exempt, even top athletes, but the more muscle mass you have to start with, the longer it takes for frailty to set in. The problem in the first place is with loss of nerve cells and the chemicals that connect them with the brain. Additionally, a weakened immune system, possible increases other substances that break down muscle, as well as lowered levels of hormones due to age, mean that muscles are not stimulated to grow. Disuse accelerates the loss of muscle and so the cycle ensues.

The remedy, and there is one, requires effort on our part — strength training. The muscles are still there ... it just takes some effort to wake them up. The key to exercise for older people is finding the right intensity. In previous programs, very light weights were being used and the muscles weren't getting bigger. In a Tufts University study of nursing home patients, high-intensity workouts were done. The participants were men from 60 to 72. They did leg lifts using heavier weights. In a mere 3 month, the men increased their leg strength by more than double. Other weight-lifting studies in nursing homes have also shown similar results. For example, nursing home residents in their 90s went from needing a cane to walking without one after only 2 months in the program.

When you lift weights in a high-intensity program, the cells of the muscles actually tear. Then, as the muscle cells repair themselves, they effectively have divided and the result is more muscle cells and, of course, bigger muscles. So, what constitutes 'high-intensity'? Well, it depends on your 'maximum capacity'. That is, the maximum weight you can lift only one time. In a gym, the personal trainer will have you lift a very heavy weight and watch your muscle. As you lift the weight amount that is your maximum, your muscle will quiver as it strains against the weight. Then you will use a weight half that heavy to do your exercise for that particular muscle. An older person may start out with only 2 or 3 pounds, but must build that weight up to a more 'respectable' number, for example 10 or even 20 pounds. You are working arms, legs, thighs, shoulders, back, abdominals, etc. But, first start with the legs and arms.

Don't exercise the same muscle group two days in a row. Remember, the muscle cells need to repair themselves so they will be ready for the next session. They are more than willing, even anxious to get on with a program.

What about other exercise forms? What about walking and swimming? Well, studies have shown that these forms of exercise did not prevent or reverse sarcopenia. Only weight training accomplished that. There's just no way around it, folks. Pumping iron is your ticket to younger muscles.

You don't notice much in the first month or so. I remember when I first joined the gym, they told me that for the first month internal things were going on the cellular level and with hormones in the muscles. Then, after that I would start noticing changes. I found that, even turning the pages of the newspaper and the steering wheel felt different! Geez. What a hoot, I thought.

Building muscles also has other benefits. For one, your metabolism steps up because a muscle has faster molecules than fat, so it 'burns' hotter, spending more calories in the process. Also, muscles tug on the bones, and in doing so, cause the bones to absorb more calcium, protecting or reinforcing against osteoporosis. Balance is improved. You feel like you can do more, so you do more, and the more you do, the stronger your muscles are, and on, and on.

Nutrition is another factor in staving off sarcopenia. Older people tend to eat less protein. In fact, they have been found to consume less than half the recommended amount of protein. Muscles need protein. If you don't eat enough protein, your body will take it out of your muscles. In the same way, if you don't replace your calcium in sufficient quantities daily, your body will take calcium from your bones. All cells use calcium to function. All these are called building materials.

One Tufts study found that folks over age 55 should eat almost 1/2 gram of protein for each pound of their weight, so a person weighing in at 150 pounds should eat about 68 grams of protein a day. Your best source for protein, of course, is meat, poultry or fish. A 3 ounce piece has 21 grams of protein. Other sources of protein are tofu, peanut butter (2 tablespoons have 9 grams), milk, yogurt, cheese, eggs, and so forth.

Vitamin D also seems to play a role in maintaining muscle strength. We also know that the vitamin is important in the absorption of calcium. It is the lack of vitamin D that affects the muscles, not supplementing it. You need to get what you need from foods and some sunshine. (We don't have a problem here in Florida in the sunshine department, it's the folks who live in the far northern parts such as Chicago, Seattle and Boston.)

Well, now back to the weights. Outside of joining a health club, there are several forms of equipment that are available for the home. Besides the obvious (benches, bars, weight plates), there are stretch tubes, elastic bands, strap-on leg weights, cable machines for the home, and so forth. Research your options. Get back into the 'swing' of things.

Bulletin — This just in:

Deep Fat Changes Testosterone to Estrogen in Men, Leads to Estrogen Overload

Belly fat, also known as deep fat , to the fat that collects UNDER you abdominal muscles all around your organs. You can’t "pinch" it. It makes your waist big and your belly bulges. It happens in both men and women, although men’s bellies are more evident than women’s because women wear loose clothing to hide it. Men just tend to move their belts down under the belly and let it all hang out. Women are interested in appearance and men interested in what they put into the belly. They don’t call it a "beer belly" for nothing. Also, men often say their waist is still the same size because they drop their belt below the belly. Your waist is located just above the belly button, midway between the highest point of the pelvis at the side and the lowest rib margin, not around your pelvic area below that belly.

The fat in there is called visceral fat, as opposed to the fat just under the skin that you can pinch called subcutaneous fat.

So, what’s all the fuss about? Well, that visceral fat is responsible for the onset of metabolic syndrome which can lead to a much greater risk of heart disease and diabetes, stokes, cancer, high blood pressure, among other things.

Well, I am sure you have heard all that before. But, you still have that belly. Some men (we’re talking about men today) even boast about their big bellies.

But, there is something else you fellas ought to be thinking about. Male menopause. Huh? What’s belly fat got to do with that? Well, here’s the thing. That belly fat exacerbates the reduced production of testosterone that is associated with aging. The more belly fat you are sporting, the more it converts testosterone into estrogen. Fat cells contain the aromatase enzyme which is responsible for that conversion. (Yeah, you read right.) And, fellas, the fact is that estrogen dominance can lead to erectile dysfunction (ED). It is also the main cause of prostate enlargement and prostate cancer.

So, it can be said that male menopause, or andropause, if you prefer, is actually estrogen overload. And, fellas, pay attention, this is a real serious health hazard. You can count on that. Also, fat in the belly puts pressure on the kidneys which leads to high blood pressure. Besides, when was the last time you were able to comfortably cut you own toenails or tie your shoe laces?

Guys, there is just no good thing to say about that belly fat. It’s got to go.

But, what can you do about it. Well, it’s obvious that you must get rid of that belly -- NOW. First, go to the doctor and have your hormone levels checked. Also, start a serious life-style change which must include proper nutrition and plenty of exercise. Work on your cardiovascular exercise at least 3 times a week. Cut calories. Eat healthier foods. Eliminate unhealthy fats and stick to healthy oils such as extra virgin olive oil. Use that instead of butter or margarine. Eat more vegetables, fruits and beans. Cut out desserts. Reduce drastically your sugar intake. Let your sugars come from healthy foods. Reduce your sodium intake. Eat a healthy breakfast every day. That will jump start your metabolism. During the day, plan out what you are going to eat carefully. Forget about fast food and grand slam breakfasts. If you like pizza, choose thin crust, and toppings like chicken instead of pepperoni, and low fat cheese. You may have to make it yourself. Actually, I remember one fella used to bring low fat cheese to his favorite Italian restaurant and they would use that for his pizza. Now, that’s taking care of your customer. Ask your favorite pizza place if they will do that for you.

Now, for your goals. Your waist (location of your waist is mentioned above) should not be over 40 inches if you’re a man or 35 inches for a woman.

Calculate your Body Mass Index (BMI): Divide your body weight by the square of your height (your height in inches multiplied by itself), then multiply that by 703. The result is your BMI. In general, a result between 18.5 and 25 is optimal, while a number significantly higher or lower is cause for concern.

Now, figure your waist-to-hip ratio. (Hip circumference is measured at the widest measure over the buttocks and below the highest point of the hip.) 1. Measure your waist (waist is defined above) and write down that measurement in inches. 2. Now measure your hip at the widest point of your hips and buttocks. Write down that measurement in inches. Divide the waist measurement by the hip measurement. This is your waist-to-hip ratio. If your ratio is below .80 for a woman and .95 for a man, your at low risk. If your ratio is .81 to .85 for a woman or .96 to 1.0 for a man, you are at moderate risk. Over .85 for a woman or .96 for a man, you are at high risk for disease.

Let these numbers be a tool for you to understand the state of your health and do something about it.

About Aspirin for Heart Attack; Exercise & Osteoporosis; Big Gut; and Water Exercise.

(October 6, 2010)

• You've seen the PSAs on television advising people having a heart attack to take aspirin immediately. That's strong advice and should be taken seriously. In fact, researchers at the University of Texas Southwestern Medical School studied just how long it took aspirin to get into the bloodstream where it could do its life saving deed. They found that swallowing an aspirin whole took 12 minutes to get into the blood stream; drinking a liquid aspirin-containing substance took 7 minutes; and chewing a regular aspirin tablet delivered the benefits in just 5 minutes. The benefits are, of course, inhibiting blood clotting, which is why you would take aspirin during a heart attack. Remember those little tins that had a few aspirin tablets meant for carrying in one's purse or pocket? Time to get one if you are at risk for a heart attack.

• Exercise is necessary for bone health -- we know that. But, if you have advanced osteoporosis or low bone density, be wary of those exercises that require bending the spine, such as abdominal crunches, sit-ups, toe touches and the like. Spinal vertebrae that are weakened from osteoporosis or bone loss can break or crush easily. It is important that folks with osteoporosis or other low bone density causing diseases or conditions choose exercises carefully to avoid injury. Ask your doctor or therapist for exercise advice, and follow it.

• Got a gut? You might blame cortisol. That gut is probably due to visceral fat. That's the kind that packs itself in with your organs, under the muscles. You find it in the abdomen and it causes the belly to look bloated. Cortisol is a stress hormone that circulates in your body. When we experience danger or anger -- especially stress related anger, or angst -- that hormone gets to work to release fat into the blood stream for fuel that will be needed for the reaction to the danger or threat -- the flight or fight instinct. But, we modern models of humanity aren't doing much of either in our lifestyles. So, the body stores that fat as visceral fat where we can get to it fast -- in the abdomen around the organs. Problem? You bet! High cholesterol levels, high blood pressure and heart disease can be blamed at least in part to that bulging belly. To "get to that fat", we need to burn it off in the form of exercise. Regular, daily exercise is essential. It is also thought that sleep deprivation causes stress that increases cortisol output which leads to visceral fat. Consult your health or fitness professional for proper exercise programs and ask your doctor to explore the possibility of a sleep disorder.

• Now that the snow birds are coming back, I suspect that those water aerobics classes at the clubhouse pools will get back into full swing. If you've never tried water exercise, give it a whirl, folks. There's a benefit you'll never experience on land. The water, while it keeps you buoyant, gives every part of your body some resistance. The amount of resistance depends on you and on how fast you push against the water. You get both aerobic exercise for cardiovascular benefits and resistance for those muscles. It's great for anyone -- and particularly good for arthritis sufferers and folks with osteoporosis (be careful getting into and out of the pool, though.) In past years we did some articles and photos of the various water-aerobics classes in our readership, and it was evident that those who were in the program longer showed the benefits -- a youthful, vigorous appearance. If your community has such an activity, join them; if not, why not start a group yourself?