# Some good advice..



## Crusader74 (Mar 27, 2008)

Heart Attacks And Drinking Warm Water 

This is a very good article. Not only about the warm water after your meal, but about Heart Attacks . The Chinese and Japanese drink hot tea with their meals, not cold water, maybe it is time we adopt their drinking habit while eating. 



> For those who like to drink cold water, this article is applicable to you. It is nice to have a cup of cold drink after a meal. However, the cold water will solidify the oily stuff that you have just consumed. It will slow down the digestion. Once this 'sludge' reacts with the acid, it will break down and be absorbed by the intestine faster than the solid food. It will line the intestine. Very soon, this will turn into fats and lead to cancer. It is best to drink hot soup or warm water after a meal.
> 
> C ommon Symptoms Of Heart Attack...
> A serious note about heart attacks - You should know that not every heart attack symptom is going to be the left arm hurting . Be aware of intense pain in the jaw line .
> ...


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## Ex3 (Mar 27, 2008)

That's good info, thanks Irish. :)


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## Gypsy (Mar 27, 2008)

My dad experienced severe nausea before a few of his heart attacks.  Thanks for the info Irish.


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## EMSDoc (Apr 3, 2008)

Irish --

It is really important to let people know that heart attacks often have vague symptoms, especially in females and the elderly.

The classic "Levine's sign" where the guy clutches his chest and falls over is not really how most heart attacks present.

Nausea, fatigue, shortness of breath, sweating profusely, sudden weakness or malaise, grey ashen skin, sudden abdominal, arm, or jaw pain can all be subtle signs of a heart attack.

As for the cold water thing... it should not make a difference in digestion whether you drink cold or warm liquids with your meal.  If you were consuming enough cold beverages or foods to lower your body temperature enough to affect your enzymatic speed of digestion you would have other issues to worry about!

Thanks for passing the message along about the atypical signs of heart attack.  Many people don't think it could be their heart and wait way too long to seek medical attention.

EMSDoc :cool:


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## tova (Apr 4, 2008)

Good article!


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## Sigi (Apr 4, 2008)

EMSDoc said:


> As for the cold water thing... it should not make a difference in digestion whether you drink cold or warm liquids with your meal.  If you were consuming enough cold beverages or foods to lower your body temperature enough to affect your enzymatic speed of digestion you would have other issues to worry about!


Shit man I poor a bunch of ice into a glass and fill it with water for every dinner.  I don't know if I could stop doing that.


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## QC (Apr 5, 2008)

Heard that a short sharp series of coughs is a good way of administering CPR to yourself if you have a heart attack and are alone. Medics, any thoughts?


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## EMSDoc (Apr 6, 2008)

Queens Cadet...

Cough CPR is a medical myth, but unbelievably there is some truth behind the concept... as illustrated by this true story:

I'm in the cardiac care unit during my residency when a code blue is called a few rooms down the hall.  As I get near the room I hear the nurse in her best drill-sergeant voice ordering the patient to... "COUGH! COUGH! COUGH!"  I'm thinking WTF as I enter the room and look at the monitor.  The patient is in V-Tach, but apparantly still has a pulse as he is awake and alert, and is dutifully following the nurse's commands.  Just then... I wouldn't have believed it if I didn't see it with my own eyes... but the V-Tach broke spontaneously!  The patient was sitting there, completely unaware of what had just happened, and was no worse for wear.  I must have looked totally dumbfounded, as the nurse smiled, and with a twinkle in her eye said, "See that's how us 'old-timers' do it!"

So what is the physiology behind this?  Coughing stimulates the vagus nerve (see my post in the heat illness thread), which controls the parasympathetic nervous system.  Stimulation of the parasympathetic nervous system is designed to slow the intrinsic rate of the SA node of the heart, and therefore slow down the heart rate.  While this is a common non-pharmacological method of breaking a supraventricular tachycardia, it is not employed as much for ventricular tachycardias.  VTs tend to not respond as well to this modality of treatment (as they usually induce rapid unconsciousness).  But, it can work, as I witnessed with amazement that day in the CCU.

Now back to your original question... can you do cough CPR on yourself?  No.  You'd have to be on a monitor and see yourself go into an arrhythmia and then immediately act before you rapidly became unconscious.  Not going to happen.  But like any myth, there is a grain of truth to the legend.

EMSDoc :cool:


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## pardus (Apr 6, 2008)

EMSDoc said:


> As for the cold water thing... it should not make a difference in digestion whether you drink cold or warm liquids with your meal.  If you were consuming enough cold beverages or foods to lower your body temperature enough to affect your enzymatic speed of digestion you would have other issues to worry about!



Doc, it's not about body temp being lowered it's about pouring cold liquid onto the food/fat you just consumed, cold onto hot cools the hot, solidifying the fats to a certain degree hence the statement in the article.
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The Japanese and Chinese (to mention two peoples) have traditionally had far healthier diets than we in the west ever have.

Western medicine is still _somewhat_ ignorant enough to _mainly_ concentrate on symptoms and not root causes and preventative medicine.

Which is fine in itself but not when combined with the condescending attitude and flat out telling people that alternative ideas are BS to be ignored.
A Dr that tells you that is one you should seriously reconsider seeing again, think about it, is that _really_ in your best interests?

It isn't _wrong_ per se or medically unethical to tell you that but is it right?


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## QC (Apr 7, 2008)

OK EMSdoc, thanks...


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## EMSDoc (Apr 7, 2008)

Digestion of fats occurs primarily in the small intestine, and involves bile salts and pancreatic enzymes.  Before the food/drinks are released into the small intestine, they are mixed in the stomach with digestive enzymes and hydrochloric acid to form chyme.  This mixing lasts for about 20 minutes and would equalize any temperature differences that existed when the foods or drinks were swallowed before the food moved into the small intestine.  Therefore, the temperature of the ingested food or drink does not have any effect on the speed or effectiveness of enzymatic breakdown of fats in the small intestine.

As for a wholistic approach to medicine... I am a firm believer in the biopsychosocial approach to treating patients... meaning you take into account not only the disease, but also socio-economic and cultural factors, as well as considering all possible treatment modalities.  Hence, I feel accupuncture/pressure, massage, bio-feedback, herbal medicines, and other therapies can and should play a role in the organized treatment plan for a patient if these are appropriate modalities to help with his or her recovery.  The medical school I attended, and most of the progressive medical schools nationwide, are now teaching this biopsychosocial approach to medical care.

Preventative medicine is the key, and it is sad that the medical system is now just getting the idea that releasing money to spend on preventative medicine projects is good health economics.  It is much less costly, in pain and suffering for the patient and in health care dollars, if we are able to prevent a disease or injury, rather than attempting to fix/cure it when it occurs.

Doc :cool:


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## pardus (Apr 7, 2008)

Awesome!

Thanks Doc.


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## Lyle (Apr 8, 2008)

Snopes says its false:
http://www.snopes.com/medical/myths/coldwater.asp


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## pardus (Apr 8, 2008)

Choose said:


> Snopes says its false:
> http://www.snopes.com/medical/myths/coldwater.asp



Doc, I bet you were worried there for a while weren't you, don't worry, snopes said you are right :uhh:


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## Alvitr (Apr 8, 2008)

Good read!
Confess I never heard about the hot/cold fluids with meal thing before. Appreciate the clarification. What I have heard however is that it can be beneficial not to drink at all with your meals, instead only between your meals, as this would help keep your blood glucose level more even?? 

Adding some more pros for acupuncture as well. Ive had it and it sure did what no painkillers except Ketogan could do, and more morphine wasnt an option anymore :)


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## pardus (Apr 8, 2008)

Taoism teaches to only drink fermented drinks with a meal, something about enzymes and easy digestibility of the liquid and food due to them.


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## QC (Apr 8, 2008)

Oh great one, this would include, no doubt, frothy brow liquids? 

Sunk More Puss! ;)


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## pardus (Apr 8, 2008)

WANKER!!!


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## The91Bravo (Apr 9, 2008)

good article....

Kind of like going into MOPP 4 after a nerve agent attack... something to keep you busy while you are dying....


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## Polar Bear (Apr 9, 2008)

For heaven sakes a cold beer with a good steak is going to kill me. Guess I am going to die


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## LibraryLady (Apr 9, 2008)

Polar Bear said:


> ... Guess I am going to die



Yup

LL


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## Alvitr (Apr 9, 2008)

A bottle of Porter is known to make up for a whole meal though... Warm or cold.


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## pardus (Apr 9, 2008)

Polar Bear said:


> For heaven sakes a cold beer with a good steak is going to kill me. Guess I am going to die



I can think of a whole lot worse ways to go, bring it on.


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## medicchick (Apr 9, 2008)

Unless there's a link to an article, I tend to ignore it, as there is no source.

Most common S&S I saw with MI pts was the greyish color and the feeling of an elephant on their chest.


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## EMSDoc (Apr 9, 2008)

Pardus...

Good to know I'm not going against the internet mythbusters ;) ... lol

Doc Rogers...

Yup very sure it was V-Tach.  I have actually seen a number of patients with V-Tach and a pulse in my career... but only that one coughed himself out of it!

By the way... there is good evidence from a recent retrospective study at an academic medical center that Amiodarone does not have much effect for V-Tach with a pulse and lidocaine should be the drug of choice to break the dysrhythmia.  V-Tach without a pulse is still dealer's choice (but I personally am still a fan of "old school" lidocaine).

Alvitr...

Depends on what you drink with your meal... high carb drinks such as soda are certainly going to lead to larger swings in insulin levels then drinking plain water.

Weight control/insulin levels/glycemic index etc. means different things to different people as there is no "ideal" diet.  It is complex interaction between genetics, social context, a person's rate of metabolism, access to food, etc. that determines the best (or most realistic) diet for a specific person... and there are MANY different views on this subject depending on the expert speaking.  The importance is to incorporate what you eat into your lifestyle... eat a balanced diet, exercise, avoid articifical additives and chemicals when you can, and work with a doctor or nutritionist if help is needed figuring out what the best plan is for you.


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## WillBrink (Apr 10, 2008)

Polar Bear said:


> For heaven sakes a cold beer with a good steak is going to kill me. Guess I am going to die



You wont get out of this life alive anyway. Last time I checked, life was 100% fatal in 100% of the people 100% of the time. My father is 84. They found he had high cholesterol and told him a list of foods he can't eat. He's depressed about that. Now health and nutrition is my business, and it's what I research and write about, and I told him "dad, you're 84 and have not had a heart attack yet, nor does heart disease run in the family, so eat what ever the fu&^ you want."


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## EMSDoc (Apr 12, 2008)

ACLS lists amio as a class B recommendation (likely to help) and lidocaine as "class interderminate."

What is frustrating about this is we have all seen lidocaine work for years -- and you can't study it now because no IRB (institutional research board -- a bunch of suits that determine if your research study is safe) is going to ethically allow you to withold lidocaine from someone.  So it received this awkward label, and people started using amio as it was the sexy new drug that had a great PR department.

Don't get me wrong, amio is GREAT for rhythms that are not clearly vetricular, rhythms resistant to other anti-arrythmics (those who bought procainimide stock are SOL), or abberant superventricular rhythms like WPW with a fast ventricular response.  But it's right drug for the right rhythm, and in my opinion purely ventricular rhythms should be treated with lidocaine.

EMSDoc :cool:


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