Stroke and heart attack can be prevented and not only with healthy eating and physical activity. You can get help to get the situation under control.

A method to be used in our homes, through a tool that links diseases to air filtration: here’s what we should all have at home from now on.

How to prevent stroke and heart attack-(

Diseases such as stroke and heart attack can be connected to many causes, one of these, perhaps the least known, is COPD. This is chronic instructive pulmonary disease, a respiratory disease that affects the lungs and bronchi causing breathing difficulties. It can often accompany serious illnesses such as arrhythmias, strokes and heart attacks.

How to prevent stroke and heart attack at home

For the treatment of the air in homes, some tools and appliances are sometimes essential to have at home. We may not be aware of that there are airborne diseases, related to stroke and heart attack, which can cause serious consequences. Some diseases that cause respiratory problems are generated by plant pollens, animal allergens, but also house dust. Some tools such as the air purifier are therefore essential to make the environment as pure as possible. Today almost everyone has one, it seems like a craze like the air fryer, but it’s actually much more.

Air purifiers against stroke and heart attack

According to one study this, disease that makes cardiovascular health worrying, can be prevented through the use of air purifiers. How? By improving the air circulation, these appliances also improve health conditions.

Through the active filtering of air purifiers, pollutants and allergic substances present in the house are reduced. In this way the nose and bronchi are less in contact with inflammation of the airways. Some recent studies, carried out immediately after Covid and laundry, have shown that appliances are also essential for reducing viruses in the air, therefore they considerably prevent contact.

heart attack-stroke air purifier
Air purifiers against stroke and heart attack (

In short, in addition to the classic method of airing the house by keeping the windows open, it is almost essential to have an air purifier. This especially if we are in a closed environment without windows or if we live in a particularly busy area. In order to have as clean an environment as possible and to contract at least possible respiratory diseases, these small household appliances can significantly change the quality of our life.

Let’s not forget that the air we breathe is our primary source of livelihood, that allows us to live and for this we must treat it with the same care with which we choose healthy foods to eat or with which we dedicate our time to physical activity.

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Tanya Bunce, RN (Photo provided)


Following treatment for cardiovascular disease, the road to recovery starts with a cardiac rehabilitation program like the one offered at the Cayuga Center for Healthy Living. Patients with qualifying cardiac diagnoses receive medically monitored exercise and risk management education through the Cayuga Medical Center program. This program is certified by the American Association of Cardiovascular and Pulmonary Rehabilitation.

Numerous studies show that patients who participate in a cardiac rehabilitation program feel better, live a heart-healthier lifestyle, regain strength and reduce their cardiovascular disease risks.

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For people living with a heart condition, long COVID has added yet another
concern to their list of worries.

Research suggests that you are at increased risk of blood clots, heart
attack, heart failure, inflammation of the heart, and abnormal heartbeat
following a COVID-19 infection. One in three adults that has had COVID-19
experiences long COVID symptoms that can last weeks to months after the initial

Long COVID can affect anyone who contracts the virus, but recovery can be
especially complicated for those with a condition. Led by Dr. Shahzad
Ahmed, the

Cardiac Care program at Lower Bucks Hospital

provides specialized care for patients in the Philadelphia area who have
been diagnosed with heart conditions and are experiencing long COVID. 

Common heart symptoms following a COVID-19 infection:

  1. Fatigue, feeling tired
  2. Pounding heartbeat or palpitations
  3. Trouble breathing-shortness of breath
  4. Pain in chest- chest tightness
  5. Fast heartbeat
  6. Lightheadedness or dizziness
  7. Difficulty in sleeping
  8. Blood clots

What can you for your heart care if you have long COVID?

  1. You should continue heart healthy habits like exercise
  2. Stay on your heart medications unless advised by your doctor
  3. Watch out for any new symptoms that could be attributed to COVID

How can you prevent long COVID?

Stay up to date on your vaccinations and get appropriate boosters as new
strains of COVID-19 are emerging. It will prevent you from infection. Use
proper barrier precautions and follow your local health care advisories.

If you have heart symptoms, please don’t delay your care because of fear of
contracting COVID. All healthcare settings are required to have safety
measures in place to protect you from COVID-19. Call 911 in an emergency. 

Dr. Ahmed is currently accepting new patients at BMC Cardiology Practice, located at 501
Bath Road in Bristol. For more information or to schedule an appointment,
please call 215-785-5100.

About Shahzad Ahmed, MD, FACC, FSCAI, RPVI, Interventional Cardiologist, Director of Cardiology

Limited - Dr. Shahzad Ahmed MD, FACC, FSCAI, RPVI

Dr. Shahzad Ahmed

Dr. Ahmed is Board Certified in Interventional Cardiology, Cardiovascular
Medicine, Echocardiography, Nuclear Cardiology, Vascular Ultrasound, and
Internal Medicine. He was appointed Assistant Professor of Medicine at
Drexel University College of Medicine. Under his leadership, Lower Bucks Hospital has started many
new programs, including same-day discharge after percutaneous coronary
intervention, venous and pulmonary thrombectomy, carotid stenting and
implementing the radial first approach (cardiac cath through arteries of

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What is Cardiothoracic Surgery?

Cardiothoracic surgery is a specialty involving surgical procedures to correct problems affecting the circulatory system: heart, arteries, blood vessels, lungs, esophagus and other organs in the chest.

Our team is proud to deliver compassionate, patient-centered care throughout Iowa.


Our cardiothoracic surgeons treat the following conditions:

  • Arrhythmia
  • Congestive heart failure
  • Coronary artery disease
  • Heart attack
  • Heart valve disease
  • Thoracic aortic aneurysm

Cardiothoracic surgery procedures

We offer a full range of cardiothoracic treatments, including:

Coronary artery bypass (Open heart surgery)

Coronary artery bypass grafting (CABG) is the most common type of heart surgery to improve blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD). CHD is a disease in which a waxy substance called plaque builds up inside the coronary arteries, reducing oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina.

During CABG, a healthy artery or vein from the body is connected to the blocked coronary artery to go around the blocked portion. This creates a new path for oxygen-rich blood to flow to the heart muscle. Surgeons can bypass multiple blocked coronary arteries during one surgery.

Beating heart or off-pump coronary artery bypass surgery

Off-pump bypass or beating heart surgery can be performed on some patients with CHD. Traditional coronary heart bypass surgery is performed with the assistance of a heart-lung machine, which allows the heart’s beating to be stopped, so the surgeon can operate on a surface which is blood-free and still.

Using off-pump coronary artery bypass surgery, rather than stopping the heart, technological advances and new kinds of operating equipment now allow the surgeon to stabilize portions of the heart during surgery. With a particular area of the heart stabilized, the surgeon can bypass the blocked artery in a highly controlled operative environment. Meanwhile, the rest of the heart keeps pumping and circulating blood to the body.

Heart valve repair or replacement

For the heart to work well, blood must flow in only one direction. The heart's valves make this possible. Healthy valves open and close in a precise, controlling blood flow through the heart, using a set of flaps called leaflets. The leaflets open to allow blood to pass from one heart chamber into another or into the arteries. Then the leaflets close tightly to stop blood from flowing backward.

Surgery can repair or replace leaflets that don't open as wide or close as tightly as they should. This can cause blood to leak back into the heart chambers, rather than only moving forward into the arteries as it should.

Repair surgery mends the valve to work better, and replacement surgery removes the diseased valve with a new valve, either mechanical (TAVR) or biologic.

Using advance techniques and technology, the surgeon can repair the tissue of the damaged valve by means of minimally invasive heart surgery through small incisions in the right side of the chest, as an alternative to open-heart surgery. Not everyone is a candidate for minimally invasive heart valve repair, but for those who are, this surgery may result in less pain and a quicker recovery.

Heart pacemaker

A pacemaker is a small device that's placed under the skin of your chest or abdomen to treat an arrhythmia (abnormal heartbeat). Wires connect the pacemaker to your heart chambers. The device uses low-energy electrical pulses to control your heart rhythm. Most pacemakers have a sensor that starts the device only if your heart rhythm is abnormal.

Vascular procedures

Vascular intervention is often necessary to treat diseases of the arteries that have blockages. There are a variety of treatment options including medical treatment, minimally invasive procedures with stents or balloons to open arteries, and surgical bypass surgery if necessary. Individuals suffering from pain in the hip, thigh or calf when walking that improves with rest, or have non-healing wounds on their feet may be experiencing the symptoms of restricted blood flow.

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Black people are facing the consequences of delayed action against soot pollution — including premature death and serious health problems.
(Credit: Pixabay / Pexels)

by Harry Johnson ll

Visually breathtaking moments are a joy, from Simone Biles doing her signature double-flip with a half-twist to Steph Curry nailing one of his lethal 3-point shots. They don’t happen as often as we would like.

But most people experience breathtaking moments from inhaling soot-filled polluted air. Such moments bring no joy — just pain — from seeing a relative having a heart attack to being a child, like I was, suffering from asthma, or hearing others living with asthma yelling, “I can’t breathe.” We need cleaner air to breathe, to live and to thrive. We can get it by reducing pollution. One solution is strong standards on soot pollution. 

As young voices in the environmental justice and climate movement, NextGen America is urging the Biden administration to use all their authority to reduce the dangers of air pollution that diminishes the opportunities my generation might have to build health and wealth. An immediate effort to rectify the risks starts with more substantial soot pollution standards to protect the breath and health of our present and future generations. 

Earlier this month, the EPA took steps to tighten soot standards. Unfortunately, they were not enough. We need much stronger standards to protect our health, prevent premature deaths and advance environmental justice. Every day the administration delays taking strong actions only means more air and climate pollution in our communities and our lungs. 

On average, healthy adults breathe 12 to 20 breaths per minute or over 20,000 breaths daily. Soot is a danger to breathing. It’s a pollutant that can be inhaled, flowing from your lungs directly to your bloodstream, and poses heightened risks for children, seniors, and people with chronic illnesses.

Soot pollution can come from power plant smokestacks, exhaust fumes from cars, buses and trucks, and industrial sources that burn fossil fuels. Therefore, exposure to soot is linked to many health risks and chronic conditions, including asthma, heart disease, COPD, Parkinson’s disease, dementia, low birth weight, greater risk of pre-term birth, and higher infant mortality rates. 

If you live and work in areas where the air is clean and pristine, the chances of polluted air exposure from soot may be minimal. But if you are a Black or Hispanic person, if you live in a low-wealth community or other communities traditionally overburdened by pollution, every breath you take probably has an impact on your health and well-being due to soot particles.

Communities of color, especially Black communities, are disproportionately exposed to soot, an unfortunate consequence of decades of racially biased policy-making that continues unabated in many communities today. As a result, Blacks are overrepresented among those who either die prematurely or suffer health problems due to soot pollution. 

The lag in creating much stronger soot standards prolongs pollution’s risky health impact on our country and communities. The Biden administration can save nearly 20,000 lives each year with stronger limits on soot pollution. By tightening soot protections, other dangerous pollution from these sources will also be reduced. For Black communities, which are often overburdened with exposure to toxic pollutants, stronger soot standards would also help narrow racial disparities in health outcomes. 

Few people may be capable of taking our breath away like Simone Biles or Steph Curry can. But the Biden administration has both an opportunity and a responsibility to deliver a breathtaking policy moment by making stronger soot standards a reality. 

Every delay in setting better standards for providing cleaner air, protecting our health, and advancing environmental justice is a deadly blow to our generation’s health. It leaves young people in America facing the deadly consequences for generations. We don’t want the climate and pollution crisis robbing our generation or the next of health and wealth opportunities. 

We have the power of our voices to remind the President and EPA to make it a top priority to set federal pollution protections with the urgency science demands and our health and well-being commands to thrive into the future. We also have the power to continue electing climate and environmental justice champions. Our health and our climate can’t wait. We need action now.

Harry Johnson ll is vice president of strategic partnerships at NextGen America, a national public and political affairs executive, serial entrepreneur, fundraiser, and community builder. A North Carolina native, Johnson formerly held a number of senior political roles with multiple gubernatorial campaigns and campaigns for U.S. Congress and U.S. Senate. He also led federal government affairs for Dream Corps, Green For All.

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2. Pollution

From the whiff of a cigarette to tailpipe exhaust, a mask can protect you from the harmful effects of ambient air pollution.

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When you inhale polluted air, the soot (or particulate matter) can seep into the bloodstream by way of the lungs and cause serious health problems, according to the World Health Organization. And older adults are among those who are more susceptible to these complications.

“The big killer is actually ischemic heart disease,” or heart problems caused by narrowed heart arteries, says Richard Peltier, associate professor of environmental health sciences at the University of Massachusetts Amherst.

Research funded by the Environmental Protection Agency found that long-term exposure to air pollution accelerates the buildup of calcium in the coronary arteries, which can restrict blood flow to the heart and increase the likelihood of a heart attack. It’s estimated that between 7 million and 9 million premature deaths annually are linked to air pollution. “And most of that is cardiovascular disease [and] heart attacks,” Peltier says.

A mask can help to block some air pollution particles that you might otherwise inhale, which is why people who work with dust, debris and other pollutants often wear them.

Some masks are better than others at keeping pollution particles out, Peltier notes — he recommends an N95.

3. Flu, RSV and other respiratory ailments

COVID-19 isn’t the only respiratory illness that’s making people sick right now.

During winter especially, “many viruses circulate and cause respiratory diseases,” says Elie A. Saade, M.D., system director of medical quality and infection control at University Hospitals in Cleveland.

For example, there have been more than 25 million illnesses, 280,000 hospitalizations and 17,000 deaths from flu so far this season, according to Jan. 27 data from the Centers for Disease Control and Prevention. And throughout the fall, patients sick with RSV, or respiratory syncytial virus, were flooding hospitals throughout the country.

While the viruses that cause these illnesses — flu, RSV and COVID — are different, they all spread in similar ways: by small and large droplets that travel through the air. But high-quality masks, such as an N95 or similar, can help to block these germs that make us sick.

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In today’s lifestyle we have lost the understanding of the pivotal role breathing has on our body. Breathing provides oxygen to produce energy and maintain normal metabolism.

Exhaling carbon dioxide helps in maintaining pH levels in the blood. Deep breathing activates the relaxation response and reduces blood pressure and heart beat. This helps in reduction of stress. Proper breathing has shown to boost the immune system by increasing oxygenation, and improving mental health.

Our body controls breathing through a complex interplay between the respiratory centre in the brain and the muscles. The respiratory centre is located in the medulla oblongata and pons regions of the brainstem. It receives input from sensory receptors in the body and regulates the rate and depth of breathing. The respiratory centre receives signals from chemoreceptors in the blood and the brain, which monitor the levels of oxygen, carbon dioxide, and pH in the body. If the levels of these substances change, the respiratory centre adjusts the rate of breathing accordingly. The respiratory centre sends signals to the motor neurons that control the diaphragm and intercostal muscles, which regulate the volume of air in the lungs and the rate of breathing. The process of breathing is regulated by a feedback loop, where the rate and depth of breathing are adjusted based on the body’s need for oxygen and the levels of carbon dioxide and pH in the body.

There are various breathing patterns, each with a unique impact on the body. Some of the most common types include: Diaphragmatic breathing which involves breathing deeply into the diaphragm, expanding the abdomen, and filling the lungs with air. Another is controlled breathing which refers to techniques used to regulate the rate and depth of breathing, such as slow, deep breathing or breath-holding. Whereas mouth breathing refers to breathing through the mouth rather than the nose, and can impact the body’s ability to filter and humidify inhaled air. Shallow breathing involves taking shallow breaths that do not fully expand the lungs, and can be a sign of stress or anxiety. Rapid breathing is when the rate of breathing increases, can be a symptom of a variety of medical conditions, including panic attacks, asthma, and heart problems. It’s interesting to know Clavicular breathing is a type of shallow breathing that involves only the upper chest, and can occur as a result of stress or tension. The most famous Yogic breathing is type of breathing which involves various techniques used in yoga and meditation, including pranayama, which involves controlled breathing to promote physical and mental well-being.

Different activities and situations may require different breathing patterns. Diaphragmatic breathing involves using the diaphragm, a muscle at the bottom of the ribcage, to control the flow of air into the lungs. To practice diaphragmatic breathing, lie down on your back, place one hand on your chest and the other on your belly, and breathe deeply, focusing on moving your belly up and down as you inhale and exhale. Whereas slowing down the rate of breathing and taking deep breaths can help reduce stress and promote relaxation. To practice slow and deep breathing, inhale slowly through your nose and exhale slowly through your mouth, focusing on the sensation of your breath. On the other hand, breathing through the nose can help filter, warm, and moisten the air before it enters the lungs, which can improve lung function and reduce the risk of respiratory infections. Pursed-lip breathing involves exhaling through pursed lips, like you’re blowing out a candle. It can help improve lung function and reduce shortness of breath in individuals with lung conditions such as chronic obstructive pulmonary disease (COPD).

In general, the correct way to breathe is the one in which you feel comfortable and allows you to take deep breaths without strain. If you have a medical condition that affects your breathing, it is important to consult a doctor for specific guidance.

Advantages of proper breathing are many like Improved oxygenation, reduced stress and anxiety, increased energy levels, better posture, improved focus and concentration, reduced symptoms of depression, anxiety disorders, improved digestion, enhanced athletic performance, better sleep quality, boosted immune system, etc.

As we all know, yoga and deep breathing helps calm the nervous system. The breath aspect of yoga is called ‘pranayama’. Pranayama is a Sanskrit word which means "regulation of breath." It is a type of yogic breathing that involves controlled breathing exercises to promote physical and mental well-being.

In pranayama, the focus is on controlling the breath through specific techniques, such as slow and deep breathing, breath-holding, and alternate nostril breathing. These techniques are believed to help regulate the flow of prana, or life force energy, in the body, promoting physical, mental, and emotional balance.

Pranayama is often used in conjunction with yoga postures (asanas) and meditation, as a means of calming the mind and reducing stress. It is believed to have several benefits, including improved respiratory function, increased oxygenation of the body, reduced stress and anxiety, and improved overall well-being. Pranayama should only be practiced under the guidance of a trained instructor, as improper technique can lead to health issues.

We can also improve our breathing patterns by regularly exercising, maintaining moderate weight, avoiding cigarettes and tobacco consumption, avoiding eating large meals, staying hydrated, etc.



Views expressed above are the author's own.


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Image Source: BruceBlaus – CC BY-SA 4.0

I need to vent, because we need better ventilation.

The World Health Organization now recommends masking “for anyone in a crowded, enclosed, or poorly ventilated space.”  But few of us know the quality of ventilation in our spaces.

Those who can afford it might use a portable CO2 monitor as a proxy for this, since the more people are exhaling in a poorly ventilated space, the higher the CO2 level rises, and the more of the air you breathe has already been in someone else’s lungs. For the same reason, some nations have instituted requirements for public CO2 monitoring. In Belgium, for instance, anything over 900 requires remediation.

Last week, I took a CO2 monitor to a dentist’s office.  When I arrived at 7am, the reading was in the 700s.  Two hours later,  the level had risen to over 1000.  That’s a lot of unventilated exhalation from me and other patients in the open-plan space.  No telling how high it climbed later in the day.

The uber-rich know that COVID-19 is not a cold ([*]) and that we need better ventilation to avoid catching it. You can tell they know this because they are providing good ventilation for their own spaces.  The hashtag #DavosSafe emerged after the discovery of the situation of at the 2023 meeting of the World Economic Forum, laid out in their three-page “Guidance on Health Measures.”   Participants were required to have a negative PCR test, without which their badges would be deactivated and their entry denied, and rapid tests were provided and encouraged.  In addition, they had high-quality ventilation systems, HEPA filters, and perhaps upper-room Ultraviolet germicidal irradiation (UVGI). The prevalence of sweaters in photos of the event also suggests a lot of open windows.  In addition, the Forum provided high-quality masks and required masking of those working there (as “servants“), though not for those badged participants in the meetings. Given the other precautions, universal masking would be less crucial, though it appears that many attendees did wear masks, which of course also helps keep any infectious exhalations out of the shared air.

The need for cleaner air is not news.  We’ve known for years that SARS-Cov-2 is airborne, and reporters have for years been pointing to the handy historical analogy of cholera in nineteenth-century London, where John Snow fathered the field of epidemiology by figuring out that the danger came from human waste in the drinking water. (@NeoliberalSnow on twitter is his satiric incarnation, “Ineffectively addressing preventable disease through deregulation and individualism.”). It wasn’t vaccines or treatment that reduced the disease’s toll: it was better sewer management through public works.  Still, I need to vent, and you need to vent.

Ventilation is about moving air: bringing fresh air into an enclosed area to replace stagnant or noxious air, or removing pollutants from the air (OED I.3), introducing new ideas or therapeutically expressing negative feelings (OED I.5.b), debating or bringing public awareness to a subject (OED II.7.a).   We need to push into the air our anger about what Beatrice Adler-Bolton and Arnie Vierkant have characterized as the state’s “extractive abandonment” of the population.  We need to bring greater public awareness to the issue, and debate how to make happen the solutions we know are materially possible.  And we need to physically clear the air.

So yeah, I have some negative feelings about the fact that US life expectancy has continued to decline precipitouslyand we still do not have universal health care.  I have some righteous indignation about the fact that although the President has stopped thinking about the pandemic he says is over, those around him continue to protect him from contagion with measures not extended to the plebs.  I have some ire about the injustice that while we can’t breathe (because of cops, climate, or covid), the rich are breathing easy.

In the US, the private school attended by the offspring of CDC Director Rochelle Walensky and White House Coronavirus Response Coordinator Ashish Jha has also had ventilation upgrades.   There are likely many other such cases of improved air quality for me (“me” of the governing and Professional Managerial Class) and not for thee (me, workers and lumpenfolk), but of course they are not widely advertised, not generally ventilated.

The rest of us have plenty of toxic things in our indoor air.  All that cooking with gas has generously given us NO2, benzene, and fine particulate matter, the last of which is also amply supplied by diesel fuel and the wildfires kindled by climate change.  Homes, schools, offices, and other spaces also offer mold, lead, radon, pesticides, PCBs, and other nastiness. Most of them can kill you, though SARS-Cov-2 might kill you faster than most of the others.

Last year, the White House held a “summit” on improving indoor air quality and launched a “challenge”  asking organizations to voluntarily improve indoor air quality, and calling attention to funds that school districts might (or might not) use to upgrade ventilation and filtration of air.

The summit ended up recommending that spaces achieve 4-6 changes of air per hour (ACH).  That is likely to be an improvement for many places, but inadequate to protect us from the ambient danger of unchecked SARS-Cov-2.  For places occupied by people with airborne infections –which, given the widespread dropping of mitigation measures in the race to pretend the pandemic is over, can now mean pretty much anywhere–the CDC recommends 6-12 ACH, and some studies suggest 12 ACH is minimal.

Clearly, big stockholders and CEOs want to keep the economy going.  They’ve funded campaigns to minimize the dangers of the disease and move the public back to pre-pandemic spending.   And it’s paid off for them in another enormous wealth transfer upward. They presumably also want to avoid panic and organized mass labor actions. But there’s money to be made in the new markets created by privatization.  And of course they don’t care about the social murder of the poor, or we in the US wouldn’t have the lethal  health care system we already live (and die) with. The plan to end the emergency declaration and move the public response to the private market has generated some public ire about the projected cost of vaccines, but the market for indoor air quality firms is looking great!

To be sure, the quality of the “solutions” we might be sold for cleaner air will likely continue to be left to the market, as well.  Early in the pandemic, organizations that tried to do the right thing by cleaning the air sometimes ended up being sold products that were ineffective and possibly dangerous, as suggested by the current lawsuit against GPS(Global Plasma Solutions).  That company, in turn, has sued whistleblower scientist Marwa Zaatari.   The EPA cautions against devices that produce ozone.

Even effective and safe technologies can raise legal problems.  One dining house at Harvard installed UVGIdevices, but, because their presence in one space implied the need for them elsewhere, they presumably opened the university to charges of negligence in not installing them campuswide, and so they were removed.

Meanwhile, we can  organize to oppose the end of the pandemic declaration and demand mandatory improvements in indoor air quality.  We can build safe and reliable Corsi-Rosenthal boxes (or just box fans with HEPA filters) and share them.  We can wear masks to protect ourselves and each other. We can take action to make sure our schoolsand workplaces have cleaner air.  And we can vent!


[*] For anyone who has not heard the news, COVID-19 is a vascular disease that compromises the immune system; it increases the risk of heart,  brain, kidney, and other damage; repeat infections increase those risks; vaccination offers only partial protection; deaths are undercounted; and long covid affects 20-50% of those infected. Harms have, of course, especially affected those already vulnerable: racialized  communities, health-care and other front-line workers, poor people, those with disabilities, and so on. And the more it spreads, the more it mutates,  and the longer the pandemic lasts.


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In recent weeks, a surge of three viruses has swept over the United States: COVID-19, respiratory syncytial virus (RSV) and influenza.

Unfortunately, as virus numbers mounted, it got harder to find medications to relieve symptoms. Many people rushed to the drugstore looking for acetaminophen, better known as Tylenol, which is known for its fever and pain-reducing powers. Children's Tylenol is in particularly short supply, causing anxiety and stress for parents everywhere—and it doesn't help that Tylenol alternatives, like children's Motrin (ibuprofen), and in short supply too. 

Why Is There a Tylenol Shortage?

The current Tylenol shortage (and this is far from the only medicine shortage), isn’t actually a manufacturing issue, says Dr. Wendy Hasson, MD, a pediatrician and spokesperson for the American Academy of Pediatrics (AAP). “But it’s an enormous increase in demand,” she says. “There was probably an element of people trying to stock up, not unlike the infamous toilet paper incidents of early 2020.”

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High blood pressure—hypertension—refers to blood pushing against the walls of the arteries with chronically elevated force. Blood pressure that rises above normal levels and remains high can lead to serious health problems including heart attack, heart failure, stroke, and kidney failure.

Blood pressure is measured in millimeters of mercury (mmHg). The top number, known as the systolic pressure, represents the pressure within the arteries when the heart contracts while pumping blood. The bottom number, diastolic pressure, represents the pressure in the arteries when the heart relaxes between beats and fills with blood.

Normal blood pressure is defined as less than 120 over less than 80. A person whose blood pressure runs between 120–129 over less than 80 is said to have elevated blood pressure, a classification that is used to further encourage taking preventive diet and lifestyle measures. Stage 1 hypertension is diagnosed for those with systolic numbers between 130 and 139 OR diastolic numbers between 80 and 89. Systolic numbers that are 140 or over OR diastolic at 90 or over is considered Stage 2 hypertension, which is a serious risk factor for stroke and other cardiovascular events.

Blood pressure changes repeatedly throughout the day; it is lowest during sleep and increases upon waking. It also goes up when a person is excited, nervous, or physically active.

Hypertension is the most common risk factor for cardiovascular disease in the United States, affecting one in three adults, according to the National Heart, Lung, and Blood Institute (NHLBI). Untreated hypertension can lead to arterial damage, which in turn can result in impaired blood flow to vital organs, potentially leading to heart attack, kidney failure, stroke, eye damage, or aneurysm. Fortunately, once identified, high blood pressure often can be controlled to some degree with changes in diet and lifestyle.

What Are the Symptoms of High Blood Pressure?

Hypertension is often called a “silent killer” because even when severe, it often has no obvious symptoms. Some patients report headaches, dizzy spells, or nosebleeds, but these symptoms usually don’t occur unless there has been a rapid, acute change in blood pressure, or until blood pressure has reached dangerous levels.

What Are the Causes of High Blood Pressure?

The risk of developing high blood pressure increases with age as arterial walls lose their elasticity. There can be many contributing factors, yet doctors often cannot identify an exact cause for high blood pressure, in which case the person is said to have “essential hypertension.” Potential contributing factors include but are not limited to:

  • By chronically activating the sympathetic nervous system, stress can cause the arteries to maintain a more rigid tone.
  • Excessive salt consumption: The sodium in salt can cause excess water retention, which expands blood volume and ultimately increases blood pressure.
  • A diet low in calcium, magnesium, and potassium. These micronutrients help regulate the muscular structures of arterial walls and imbalances can influence arterial tone.
  • Insulin resistance: This condition can increase blood pressure by various mechanisms including increased systemic inflammation and sodium retention as a result of kidney damage.
  • Excessive alcohol intake, defined as drinking in excess of two drinks daily for men under age 65, or in excess of one drink daily for women or men over age 65.
  • Being overweight. The heart has to work harder to maintain circulation through excess adipose tissue.
  • Some prescription drugs, including steroids, birth control pills, decongestants, NSAIDS, and diet pills can raise blood pressure. Some over-the-counter medicines, such as those containing licorice root, ephedra, guaraná, kola nut, yerba maté, ginseng, and yohimbe may also raise blood pressure.

Some health problems including chronic kidney disease, thyroid disease, and sleep apnea may also cause blood pressure to rise.

According to the NHLBI, high blood pressure is more common, occurs at an earlier age, and is likely to be more severe among African Americans than in Caucasians or Hispanic Americans. Even young children can develop high blood pressure, but these cases often go undiagnosed. A U.S. Centers for Disease Control and Prevention study estimates that one in 25 youths ages 12 to 19 has hypertension, and one in 10 has elevated blood pressure. The principal cause is the ongoing epidemic of childhood obesity. It’s estimated that up to 30 percent of overweight and obese children have high blood pressure and that the problem is likely to worsen as the epidemic continues.

In some cases, blood pressure temporarily increases when it’s taken in the doctor’s office. This is due to a patient’s anxiety and is probably a conditioned response to seeing a doctor (“white-coat hypertension”) and, perhaps, to what physicians have told patients about the dangers of hypertension during previous visits. The best way to determine whether the elevated readings obtained in the doctor’s office are solely the result of white-coat hypertension is to check your blood pressure at home with a well-calibrated blood pressure monitor (they are widely available). If you decide to do this, check your blood pressure at least twice a day, at random times, and keep a log of your results to share with your doctor.

How Is High Blood Pressure Diagnosed?

Most people are familiar with blood pressure testing, which is performed using an inflatable arm cuff and a pressure-measuring gauge. As mentioned earlier, if your blood pressure is in the range of 120–129 mg Hg over less than 80 mmHg, a diagnosis of “elevated blood pressure” is considered. Blood pressure readings that range from 130–139 mmHg systolic OR 80–89 mmHg diastolic signal stage 1 hypertension. More severe hypertension—stage 2—is defined as a reading of 140 mmHg or higher or a diastolic reading of 90 mmHg or higher. Unless your blood pressure is extremely high, or you are having symptoms related to high blood pressure, your physician will probably ask you to return in a few days or weeks for a repeated set of blood pressure measurements before instituting therapy. A diagnosis of high blood pressure should not be based on a single high reading.

Several medical organizations, including the American Heart Association, recommend that anyone who has high blood pressure invest in a home monitor to perform regular blood pressure checks on their own and monitor response to treatment. This was proposed because only one-third of the 72 million Americans who have high blood pressure have it under adequate control. Frequent monitoring at home also provides doctors with documentation of your blood pressure outside the office and the effectiveness of prescribed medication, as well as the impact of lifestyle measures such as weight loss, exercise, and limiting salt intake.

What Is the Conventional Treatment?

Conventional treatment usually begins with recommendations to lose weight, get regular exercise, and quit smoking. Even a 10 percent weight loss can sometimes bring high blood pressure under control. Limiting intake of caffeine (in coffee, tea, sodas, and energy drinks) and alcohol can also help.

Medication usually is prescribed if blood pressure readings consistently exceed 140/90 (or 130/80 for diabetics or those with kidney disease), despite lifestyle changes. But even when drugs are prescribed, physicians usually recommend adhering to a low-salt diet that includes lots of vegetables and fruit, exercise, and stress reduction techniques, all of which can help keep the required dosage of medication to a minimum.

There are several different types of drugs used to treat high blood pressure. Here’s a rundown and brief description of how each type works:

  • Diuretics: Help the kidneys to flush excess water and salt from the body.
  • Beta blockers: Help the heart beat more slowly and less forcefully, and also relax arterial walls, together resulting in less pressure within blood vessels.
  • ACE inhibitors: ACE stands for angiotensin-converting-enzyme. This class of drugs inhibits the production of the hormone angiotensin II, which normally causes blood vessels to narrow, thereby increasing the pressure inside.
  • Angiotensin II receptor blockers: Protect blood vessels from the hormone angiotensin II so that the blood vessels can relax and widen.
  • Calcium channel blockers: Prevent calcium from entering the muscle cells of the heart and blood vessels, allowing both to relax.
  • Alpha blockers: Reduce nerve impulses that tighten blood vessels allowing blood to flow more freely.
  • Alpha-beta blockers: Reduce nerve impulses and slow heartbeat.
  • Nervous system inhibitors: Increase nerve impulses from the brain to relax and widen blood vessels.
  • Vasodilators: Relax muscles in blood vessel walls.

Conventional physicians are also likely to recommend the DASH diet (Dietary Approaches to Stop Hypertension), developed at the NHLBI (pdf) based on a large-scale study that identified the foods that affect blood pressure. It emphasizes generous amounts of fruits and vegetables and low-fat or fat-free dairy products that provide adequate calcium. The diet is also relatively low in fat and sodium. DASH researchers have shown that diets rich in potassium, calcium, and magnesium, and low in sodium (2,400 mg or less), play an important role in blood pressure control.

In addition to checking your blood pressure, a physician may recommend a urinalysis, an electrocardiogram (ECG) to evaluate the electrical activity of your heart, and perhaps other tests for signs of heart disease.

What Therapies Does Dr. Weil Recommend for Those With High Blood Pressure?

To lower blood pressure naturally, Dr. Andrew Weil recommends the lifestyle measures and nutritional supplements described below. If those changes don’t help, he recommends you seek guidance from your physician about prescribing one or more of the conventional medications described above. Here are Dr. Weil’s tips on how to lower your blood pressure.

  • Limit caffeine intake.
  • Limit alcohol intake.
  • Avoid processed foods. These are the biggest sources of sodium in today’s diets.
  • Maintain optimal weight. Even losing a small amount of weight can lower blood pressure.
  • Meditation, yoga, breathing exercises, and biofeedback can help lower blood pressure. Practice the 4-7-8 breathing technique.
  • Don’t smoke.
  • As little as 30 minutes of moderate exercise a day, such as walking, can help lower blood pressure.
  • Check your medicines. Discuss your current medications and their risks of increasing blood pressure with your doctor.

Nutrition and Supplements for High Blood Pressure

Dr. Weil recommends the DASH diet and the nutritional measures listed below:

  • Eat eight to 10 servings of vegetables and fruit per day.
  • Limit animal protein to six ounces per day.
  • Limit salt intake. If you are salt sensitive or have a family history of hypertension, reducing salt to about 1 teaspoon a day may help control your blood pressure.
  • Use garlic. It has a modest effect on blood pressure, potentially helping to relax blood vessels.
  • Consume four to five servings of nuts, seeds, and dry beans per week. This is equivalent to 2 tablespoons of nuts or seeds, or 1/2 cup of cooked dried beans.
  • Eat plenty of fish. Include at least three servings of fish a week, emphasizing cold-water fish such as wild Alaskan salmon and sardines, which are rich in omega-3 fatty acids.
  • Take fish oil supplements if you cannot get enough omega-3-rich foods.
  • Take calcium and magnesium. Inadequate intake of both of these minerals has been associated with high blood pressure. Women should get between 1,000 and 1,200 mg of calcium a day from all sources, while men need no more than 500–600 mg daily from all sources and probably do not need to supplement.
  • Take vitamin C. This antioxidant vitamin has been shown to lower blood pressure in people with mild to moderate hypertension.

Republished from


Epoch Health articles are for informational purposes and are not a substitute for individualized medical advice. Please consult a trusted professional for personal medical advice, diagnoses, and treatment. Have a question? Email us at [email protected]

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You Don’t Need To Ditch Your Gas Stove: Asthma Experts
Photo: Getty

A recent study linked gas stoves with asthma in children, but asthma experts say: it’s not that simple.

It has long been known that gas stoves emit chemicals including nitrogen oxide and formaldehyde that can irritate airways. But a recent study raised alarm bells by linking their use with the onset of childhood asthma. This has left many families wondering: do we need to ditch our gas stove?

Published in the International Journal of Environmental Research and Public Health, the study attributes 12.7 percent of childhood asthma in the U.S. to gas stove use. It goes on to say the amount of childhood asthma that could be prevented by avoiding gas stoves varies by state, but ranges from 13.5 to 21 percent. 

After the study’s release, Richard Trumka Jr., a commissioner with the U.S. Consumer Product Safety Commission, made headlines by saying the agency could even consider banning gas stoves. (The CPSC later backtracked, saying it was looking to reduce gas stove emissions, but not to ban.)

So where does this leave families with a history of asthma and allergies? According to Kansas City allergist Dr. Jay Portnoy, people don’t need to kick their gas stoves to the curb just yet. 

Gas Stove & Asthma Study: What It Means

The study looks at the population in general, he explains, and doesn’t measure the actual physiological effects of gas stoves on children. It also doesn’t prove that gas stove use causes asthma symptoms, says Portnoy, a professor of pediatrics at the University of Missouri-Kansas City School of Medicine.

Rather, the study shows that in states where gas stoves are more common, asthma rates are higher. Portnoy cautions, however, there could be many other factors at play.

The allergist says that in homes with gas stoves, especially those without proper ventilation, nitrogen oxide levels can be higher. However, it’s just one of dozens of substances that can be problematic. 

“It’s one of many things in an environment that might contribute to asthma symptoms, so people should be aware of it. But I don’t recommend that you tear out your gas stove,” he says. “Really, it’s just something for scientists is to point to and say, ‘Maybe we should do more studies to find out how much this matters.’” 

In the meantime, Portnoy says people should ensure gas appliances are regularly inspected and properly maintained. They should also turn on the range hood whenever a gas stove is in use.

“Those types of interventions can make a house with a gas stove a safe place to live,” says Portnoy. He adds that fireplaces, tobacco smoke and air fresheners are far more harmful to indoor air quality.

Gas Stoves’ Risks: Venting Matters

Dr. Khalil Savary agrees the study can be used to help reduce risks at the public health level. But he says it wasn’t intended to provide individual advice.

“I don’t think they were trying to attack individuals for putting a gas stove in their home. That’s not the goal,” says the pediatric pulmonologist and assistant professor of pediatrics at Rutgers New Jersey Medical School. “The goal was to say this is not a benign risk and we should, as a society, try and make changes to make things a little less risky.” He says this is especially the case with ventilation in urban settings. 

Savary emphasizes that proper ventilation is key. If people have ducted range hoods that vent to the outside, they should always run them while cooking. Those with recirculating range hoods, which don’t vent to the outside, should open windows during cooking to allow fresh air in. 

If people are renovating they might want to swap out their gas stove for an induction or electric range, he adds. But like Portnoy, he believes cooking with natural gas is not cause for alarm.

“I just put my gas stove in and I’m not ready to take it out,” says Savary with a laugh. “But if you want to cook your meals at home, and you want to do it in the best way possible, and try to reduce your impact on climate change, then go ahead and do your part.”

Related Reading: 
15 Easy Jobs for Better Breathing with Asthma and Allergies
Allergic Living’s Go-To Goods for Renovating with Environmental Allergies
TV Reno Expert’s Advice: How to Keep Water, Mold and Pests Out of Your Home

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Birmingham, England, Jan 30, 2023, ZEXPRWIRE, If you are a person who is afflicted with anxiety then you are most likely feeling a lot of stress as a result and experiencing physical symptoms and it can be very difficult to deal with alone, you may find yourself isolated, misunderstood and panicky.

Generalised anxiety disorder

Generalised anxiety disorder (GAD) is a common mental health condition. It occurs in approximately 4.8% of the population at some point in their lives. The symptoms include restlessness, muscle tension, irritability, fatigue, and poor concentration.

GAD has been defined as persistent excessive worry that is out of proportion to the effect of the events that trigger it. Patients report worrying about their own safety, their own health, finances, or other people.

Research into generalised anxiety disorder is increasing. Researchers have found that it is more prevalent among women than men. In addition, it is more likely to occur in adolescents than in adults.

Panic disorder

In the case of panic disorder, the symptoms include heart pounding, rapid breathing, chills, dizziness, stomach pains, and shortness of breath. You may also feel tingling or numbness in various parts of your body.

The symptoms are usually harmless but can cause a person to experience a great deal of stress. If you think you might have panic disorder, you should contact your doctor to get a diagnosis. There are a number of treatments available, including medicine, talk therapy, and cognitive behavioural therapy. Medications such as anti-anxiety medication may help, alongside therapy.

People with panic disorder report experiencing a multitude of sensations and occurrences. They have intense physical experiences, catastrophic thoughts, and social worries. These symptoms are accompanied by a number of negative self-evaluations. This can become a vicious cycle.

The best way to treat anxiety and panic is to provide timely psychological treatment. The right treatment can have a positive impact on the individual’s quality of life and on associated areas. Talking therapies are the most common form of treatment. It is important to keep track of your symptoms and find ways to avoid situations that trigger them until you’re able to resolve the issue.

Psychoeducation can provide individuals with the knowledge and skills to better cope with panic and anxiety.

Anxiety sensitivity

Anxiety sensitivity is an important risk factor for developing anxiety disorders. It consists of a tendency to perceive anxiety related bodily sensations as potentially harmful. This response may be amplified when the sensation is interpreted as a warning that something is dangerous.


Antidepressants are used to treat a variety of anxiety disorders. They work by increasing the activity of neurotransmitters in the brain. Often, they take around 6 weeks to start working.

The most commonly prescribed antidepressants are citalopram, amitriptyline, and trazodone. These medications are used to treat a wide range of anxiety-related problems, such as insomnia, panic disorders, and generalized anxiety.

If you are considering taking an antidepressant, it is important to talk with your doctor. You should report any recreational or prescription drugs that you are taking, as well as any changes in your mood. Your provider may recommend different types of medication or prescribe a different dosage.

You should report any changes in your mood or thoughts of harming yourself to your doctor and or therapist, so they are able to help and support you.

Many of these medicines can have unpleasant side effects, though. A sudden stop or change in dosage can result in withdrawal symptoms, such as dizziness and headaches. It is recommended that you gradually decrease your dose over time and discuss decreasing your dose with your G.P.

Family therapy

Family therapy for anxiety helps the whole family develop tools for coping with increased levels of distress. The benefits of this type of therapy have been shown to be long lasting.

The process is designed to improve both parental and child confidence. Children and parents learn about cognitive restructuring, psychoeducation, and exposure. They also learn to engage in developmentally appropriate activities.

How to Cope with Anxiety

When it comes to coping with anxiety, there are a few things you can do. Among these are self-regulation, exercising, and interacting with positive people. There are also medications and psychotherapy to consider.

Self-regulation of breathing

When it comes to coping with anxiety, self-regulation of breathing can be an excellent strategy. Whether you’re feeling anxious about a job interview or just about something that’s bothering you: deep and slow breathing can help. In addition to alleviating feelings of stress, it can also stimulate the vagus nerve, which is an important component of your nervous system.


Many people suffer from anxiety and exercise is an effective way to cope. Exercise can help reduce stress, boost confidence, and increase your energy level.

There are many different types of exercise. Some are better for anxiety than others. The key is to find something you enjoy doing and stick to it. You should also talk to your doctor before starting an exercise routine.

Anxiety is the result of a chemical imbalance. By depleting cortisol, exercise can improve your mood. In addition, endorphins released by exercise have an positive affect.

While most types of exercise may help relieve anxiety, some are more effective than others. Yoga is a good example. During yoga, you focus on breathing correctly.


One of the best ways to deal with anxiety is by establishing routines. This can be accomplished in many ways. Some examples include a regular sleep schedule, meditating, or even a morning ritual such as taking a stroll. These practices are great for both the mind and the body. They also help you get the most out of your day.

A good routine can take several weeks to form. You can try out different routines to see what works for you. When you do have a routine in place, make sure to reward yourself with some form of visual incentive. The best way to do this is to create a reward that is aligned with your goals.

Interacting with positive people

If you’re a socially anxious person, you’ve probably spent at least some time wondering what the best way is to interact with others in a social setting. There are many suggestions to help you achieve your goals. One of the best is a little structure. For example, one social anxiety patient can commit to introducing himself to a person in the first five minutes of a meeting. This might seem a little old fashioned, but it’s the easiest way to meet new people. For someone else, focussing on breathing and the here and now, can help alleviate their anxiety.

Another trick of the trade is to identify your key triggers. This can be done through therapy and research online.

Identifying personal triggers

Identifying personal triggers to cope with anxiety is a key component in dealing with any mental health problem. This is because triggers can lead to uncomfortable physical symptoms as well as a significant emotional reaction.

Anxiety triggers can be anything that makes you feel anxious or uncomfortable. They may include physical signs such as shaking, sweating, heart palpitations, and trembling. In addition, they may also trigger uncomfortable feelings such as irritability, frustration, and anger.

The best way to identify triggers is to keep a mood journal. Doing this will allow you to identify patterns and coping strategies. It will also help you to predict relapses and will also help you to build resilience against potential triggers.

Treatment combines psychotherapy and medications

The combination of medication and psychotherapy can be a successful treatment for anxiety.

Studies show that combining therapy and medication is more effective than either alone. In particular, it works better than antidepressant medication alone for treating major depression, obsessive-compulsive disorder (OCD), panic disorder, and social anxiety disorder.

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Another day, another outrageous sleeping hack. If you’re like me and can’t instantly fall asleep at night you’re probably always on the lookout for sleeping hacks. However, I don’t know how I feel about taping my mouth before I fall asleep, even if it does health benefits. But, according to a neuropsychologist taping your mouth shut at night might be better for your health.

Apparently up to half of all adults breathe through their mouths. Most people do this because their noses are blocked or restricted, but mouth breathing was not nature’s intention and can actually have a negative impact on your health.

Why mouth breathing could be impacting your health

“It’s very simple: noses are made for breathing, and mouths are made for eating, with air inhaled through the nose warmer, humidified, and filtered making it better for your overall health,” Dr. Elisabeth Honinx says.

“When you inhale through your nose, the mucous membranes and hairs in the nose are able to trap particles and help to prevent allergic reactions. Nose breathing also produces nitric oxide which relaxes the walls of blood vessels, helping to increase blood flow in the lungs and increase the amount of oxygen passing through your body.”

In contrast, mouth breathers have to compensate for their inefficient breathing with a higher-than-average respiratory rate and volume to help get enough oxygen to their cells and organs which can lead to a myriad of other health problems:

  • Dry mouth - Mouth breathing can cause the mouth to become dry by reducing saliva production which can lead to bad breath, tooth misalignment and even tooth decay.

  • Respiratory problems - Mouth breathing can cause the throat to become dry and inflamed, leading to respiratory problems such as sinusitis and bronchitis. Some studies have also shown that chronic mouth breathing can lead to sleep apnea which has been linked to an increased risk of cardiovascular issues, diabetes and even premature death.

  • Poor sleep - Mouth breathing can disrupt sleep through snoring or discomfort, leading to poor sleep quality and daytime fatigue for you and any partners.

Why taping your mouth can help

Mouth taping is a technique that involves covering your mouth with tape or an adhesive patch while sleeping to help encourage nasal breathing. It’s natural to find nose breathing difficult to practise at the start, but once you get started it will be much easier to stick to the habit, and mouth-taping can help,” Honinx says.

She continues: It might take some time to get used to, so it’s best to be safe and test it for a short period since it might cause discomfort or slight panic when you start.”

Start by taking short naps using mouth tape to help yourself get used to the sensation – you could even set your alarm slightly earlier and have a doze while taped up.

Then, once you feel comfortable you can progress to wearing tape overnight. Practising how to breathe through your nose during the day can also help, with Dr. Honinx recommending daily breathing exercises to help you make it a habit.

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With holiday travels during the Lunar New Year celebration in China having reached 90 percent of their pre-pandemic levels and tourist locations packed with vacationing revelers, the corporate press is claiming that COVID is finally over.

Such distortions only promote a completely anti-public-health sentiment that places supposed personal liberties above the well-being of community, threatening the physical survival of those now “free” to move about and mix socially. This will have significant repercussions for populations of every country and entrench the oft-stated policy that the “cure can’t be worse than the disease.” The international default policy openly values the economy, i.e. profits, over the lives of people, in this and any future pandemic.

China’s Ministry of Culture and Tourism has reported there have been more than 300 million trips thus far during the holidays. The chief China economist at Nomura Holdings inc., Ting Lu, told Bloomberg News“Pent-up demand is being released as many people rush to scenic spots, watch firework shows and crowd into restaurants and hotels. He added that government-released data “suggest the ‘exit wave’ is quickly coming to an end.”

Patients receive intravenous drips in an emergency ward in Beijing, Thursday, Jan. 19, 2023. China on Thursday accused "some Western media" of bias, smears and political manipulation in their coverage of China's abrupt ending of its strict "zero-COVID" policy, as it issued a vigorous defense of actions taken to prepare for the change of strategy. [AP Photo/Andy Wong]

The former editor-in-chief of the Global Times, Hu Xijin, wrote on social media, “The epidemic seemed to disappear from the vast majority of people suddenly. The Chinese Lunar New Year is very lively. The consumption has resumed rapidly.”

According to the World Health Organization (WHO) official figures for the week ending December 19, 2022, the world saw a single-week pandemic high of 45 million COVID cases, nearly twice that of the BA.1 Omicron wave that ran roughshod across the globe a year ago. This is the result of the demise of the Zero-COVID policy that had kept deaths to an enviably low figure in China of just over 5,000 in a country of 1.4 billion people. 

Since the surge in December throughout China, global COVID deaths jumped fourfold to over 40,000 for the week ending January 2, 2023, with “more than half of them from China,” as noted by WHO Director-General Tedros Adhanom Ghebreyesus. Official figures from Chinese health authorities have reported the following numbers of COVID-related deaths: 

·       December 8 to January 12:  59,938 deaths

·       January 13 to January 19: 12,658 deaths

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Respiratory distress, also called acute respiratory distress syndrome (ARDS), is respiratory failure caused by rapid onset of widespread inflammation in the lungs

It can occur in patients who are critically ill or significantly injured.

Symptoms can include shortness of breath, rapid breathing, and bluish skin coloration.

Respiratory distress can be a serious, even fatal, condition.

Anyone who experiences these symptoms should seek emergency medical care immediately.

Diagnosing the cause of respiratory distress is not easy and requires clinical knowledge, a careful physical examination, and attention to detail.


What is Respiratory Distress?

Respiratory distress, also called acute respiratory distress syndrome (ARDS), is respiratory failure caused by rapid onset of widespread inflammation in the lungs.

Patients with ARDS have severe shortness of breath and often are unable to breath without the support of a ventilator.

Symptoms can include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin coloration (cyanosis). Respiratory distress is a critical, often fatal condition, especially among the elderly and severely ill. If not properly treated, some extreme cases of respiratory distress can lead to a decreased quality of life.


Respiratory distress can be primary or secondary:

  • Primary respiratory distress means the problem is in the lungs.
  • Secondary respiratory distress means the problem is somewhere else in the body and the lungs are compensating.

Possible primary respiratory distress problems include:

  • Anaphylaxis
  • Asthma
  • COPD
  • Pleural effusion
  • Pneumonia
  • Pneumothorax
  • Pulmonary edema

Possible secondary respiratory distress problems can include:

  • Diabetic ketoacidosis
  • Head trauma
  • Metabolic acidosis
  • Stroke
  • Sepsis
  • Toxicological overdose

Causes of Respiratory Distress and Treatment

Respiratory distress has a range of causes that can affect treatment, so EMTs must start by carefully considering the source of the condition.

For respiratory distress, the focus is usually on the lungs and auscultation (listening for sounds from the lungs, heart, and other organs).

An EMS provider’s assessment may include a physical exam, incident history, and vital signs before deciding the next step in treatment and transport of their patient.

The following are some of the most common types of respiratory distress and a brief overview of the appropriate treatment for each one.


Airway Obstruction

There are many ways that a foreign object can lodge in an airway causing an obstruction.

For example, a stroke can damage swallowing reflexes, making the person more prone to choking.

Consumption of alcohol and some drugs can also suppress the gag reflex, which could also lead to choking.

Treatment: If the airway obstruction is mild and the patient is coughing forcefully, EMS providers may not interfere with the patient’s efforts to clear the obstruction.

If the patient has signs of severe airway obstruction, as indicated by a silent cough, cyanosis, or the inability to speak or breathe, you should intervene.

If in some cases a patient becomes unresponsive, you can perform a finger sweep to clear the airway obstruction, but only if you can see solid material blocking their airway.


Asthma is a chronic, inflammatory disease of the airways.

Asthma attacks can be induced by many different causes including allergens, infections, exercise, and smoke.

Patients with asthma are very sensitive to things such as dust, pollen, drugs, air pollutants, and physical stimuli.

During an asthma attack, the muscles around the bronchioles tighten, the lining of the inside the bronchioles swells, and the inside of the bronchioles fills with thick mucus.

This severely restricts expiration of air from the lungs. Patients will often describe a history of asthma and have a prescription for a metered-dose inhaler.

TreatmentBasic Life Support treatment considerations include:

  • Calming the patient
  • Airway management
  • Oxygen therapy
  • Assisting with a prescribed inhaler


Chronic obstructive pulmonary disease (COPD) is a group of diseases that includes asthma, emphysema, and chronic bronchitis.

COPD causes a slow process of dilation and disruption of the airways and alveoli, and it includes several related irreversible conditions that limit the ability to exhale.

Symptoms of COPD include shortness of breath, fever, and increased sputum production.

The patient’s medical history can include conditions such as upper-respiratory infection, chronic bronchitis, emphysema, smoking, or working with hazardous substances such as chemicals, smoke, dust, or other substances.

Treatment. Common medications for COPD include:

  • Prednisone
  • Proventil
  • Ventolin
  • Atrovent
  • Azmacort

EMS treatment for a COPD patient with respiratory distress should include high flow oxygen.

Congestive Heart Failure

Congestive heart failure (CHF) results from too much fluid in the lungs, making it difficult to get air in.

This is in contrast to COPD patients, who typically experience difficulty getting the air out.

CHF occurs when the ventricles are weakened by a heart attack, underlying coronary artery disease, hypertension, or valve disease.

This impairs the heart’s ability to contract and empty during systole and blood backs up in the lungs and tissues of the body.

CHF is usually chronic with acute exacerbations.

During an acute episode, the patient will typically present sitting up, short of breath, diaphoretic, and pale, or cyanotic in color.

Breathing sounds can include rales or wheezes.

The medical history can include increased salt ingestion, respiratory infection, non-compliance with medications, angina, or symptoms of acute coronary syndrome.

Treatment. Common medications include:

  • ACE inhibitors
  • Furosemide (Lasix)
  • HCTZ (hydrochlorthiazide)
  • Beta-blockers
  • Angiotensin II receptor blockers
  • Digoxin (Lanoxin)

When treating patients who are suffering from congestive heart failure, seat the patient upright and administer high flow oxygen.

You may also consider positive pressure ventilation with a bag-valve-mask (BVM) if the patient is experiencing severe respiratory difficulty.

Inhalation Injuries

Inhalation injuries are caused by inhaling chemicals, smoke, or other substances.

Common symptoms include shortness of breath, coughing, hoarseness, chest pain due to bronchial irritation, and nausea.

Individuals with decreased respiratory reserve, including a history of COPD or CHF, are likely to experience an exacerbation of the disease.

Treatment: If a patient is in respiratory distress, treat immediately with high flow oxygen.

Assist breathing with a bag-valve-mask (BVM) if the respiratory effort is insufficient as indicated by a slow rate and poor air exchange.


Symptoms of pneumonia include fever, chills, cough (often with yellowish sputum), shortness of breath, general discomfort, fatigue, loss of appetite and headache.

There can be chest pain associated with breathing (usually sharp and stabbing in nature) and worsened by coughing or deep inspirations.

Other signs that sometimes present are rales, clammy skin, upper abdominal pain, and blood-tinged sputum.

Treatment: Emergency care for pneumonia depends on the severity of the patient’s breathing difficulty but may include oxygen therapy.


A pneumothorax is the presence of air between the two layers of the pleura—which are the membranes lining the thorax and enveloping the lungs.

It is caused when an internal or external wound allows air to enter the space between these pleural tissues, which can cause the lungs to collapse.

A pneumothorax can occur spontaneously (e.g., a rupture caused by disease or localized weakness of the lung lining) or as a result of trauma (e.g., gunshot or stab wound).

People who have a prior history of pneumothorax or COPD may be more at higher risk of experience this medical condition.

In some rare instances, even forceful coughing can cause a pneumothorax.

A pneumothorax can cause sharp chest pain and shortness of breath.

The patient’s breathing will sound diminished and you may be able to feel air coming from under the patient’s skin.

Treatment:  EMS treatment of a pneumothorax includes high-flow oxygen. Be judicious with your use of positive-pressure ventilation. It can turn a spontaneous pneumothorax into a life-threatening tension pneumothorax.

Tension Pneumothorax

A tension pneumothorax is a progressively worsening pneumothorax that begins to impinge on the function of the lungs and the circulatory system.

It is caused when a lung injury acts like a one-way valve that allows free air to move into the pleural space but prevents the free exit of that air.

Pressure builds inside the pleural space and compresses the lungs and other organs.

Early signs of a tension pneumothorax include:

  • Increased dyspnea
  • Cyanosis
  • Signs of shock
  • Distended neck veins
  • Shift in PMI (Point of maximum intensity, where the heart is the loudest through auscultation)
  • Tracheal displacement
  • Tracheal deviation

Treatment: If the patient is hypotensive or showing signs of hypoperfusion, then EMS providers should initiate temporizing treatment for tension pneumothorax.

Open chest wounds should have a sealable dressing placed over them with a one-way air valve to prevent air build up.

This one-way valve can be created by applying an occlusive dressing and taping on three sides.

The EMS provider should perform needle decompression on the chest wall to release encased air.

Pulmonary Embolism

A pulmonary embolism (PE) can occur when a particle (such as a blood clot, fat embolus, amniotic fluid embolus, or air bubble) gets loose in the blood stream and travels to the lungs.

If the particle lodges in a major branch of the pulmonary artery, this can interrupt blood circulation to the lungs.

If blood cannot reach the alveoli, then it cannot be oxygenated.

This condition can be caused by immobility of the lower extremities, prolonged bed rest, or recent surgery.

Signs of PE are a sudden onset of shortness of breath, rapid breathing, chest pain worsened by breathing, and coughing up blood.

Treatment: Pulmonary embolism is a life-threatening condition and should be treated with high flow oxygen and rapid transport. Move the patient gently to avoid dislodging additional emboli (particles).

When to Call Emergency Number for Respiratory Distress

Breathing is something most of us do instinctively, day and night. We don’t even think about it.

So, if you experience shortness of breath or difficulty breathing it can be quite alarming.

If you experience shortness of breath that interferes with your daily routine or body functions, you should call Emergency Number or have someone drive you to the nearest Emergency Room immediately.

You should call Emergency Number immediately if you experience shortness of breath together with any of the following  symptoms:

  • Chest pain
  • Dizziness
  • Pain that spreads to your arms, neck, jaw or back
  • Sweating
  • Trouble breathing
  • How to Treat Respiratory Distress

If you experience shortness of breath, or shortness of breath together with any of the symptoms listed above, you need to call Emergency Number or get to an ER immediately.

Treatment of respiratory distress requires a doctor.

The first goal in treating respiratory distress will be to improve the oxygen levels in your blood.

Without sufficient oxygen, your organs can fail. Increasing your blood oxygen levels can be achieved through supplemental oxygen or a mechanical ventilator that pushes air into your lungs.

Careful management of any intravenous fluids will also be critical.


People with respiratory distress are usually given medication to:

  • Prevent and treat infections
  • Relieve pain and discomfort
  • Prevent blood clots in the legs and lungs
  • Minimize gastric reflux
  • Sedate

USA: How Do EMTs & Paramedics Treat Respiratory Distress

For all clinical emergencies, the first step is rapid and systematic assessment of the patient.

For this assessment, in the USA most EMS providers will use the ABCDE approach.

The ABCDE (Airway, Breathing, Circulation, Disability, Exposure) approach is applicable in all clinical emergencies for immediate assessment and treatment.

It can be used in the street with or without any equipment.

It can also be used in a more advanced form where emergency medical services are available, including emergency rooms, hospitals or intensive care units.

Treatment Guidelines & Resources for Medical First Responders

Treatment guidelines for respiratory distress can be found on page 163 of the National Model EMS Clinical Guidelines by the National Association of State EMT Officials (NASEMSO).

These guidelines are maintained by NASEMSO to facilitate the creation of state and local EMS system clinical guidelines, protocols, and operating procedures.

These guidelines are either evidence-based or consensus-based and have been formatted for use by EMS professionals.


The guidelines include a rapid assessment of the patient for symptoms of respiratory distress, which may include:

  • Shortness of breath
  • Abnormal respiratory rate or effort
  • Use of accessory muscles
  • Quality of air exchange, including depth and equality of breath sounds
  • Wheezing, rhonchi, rales, or stridor
  • Cough
  • Abnormal color (cyanosis or pallor)
  • Abnormal mental status
  • Evidence of hypoxemia
  • Signs of a difficult airway

Pre-hospital treatments and interventions might include:

  • Non-invasive ventilation techniques
  • Oropharyngeal airways (OPA) and nasopharyngeal airways (NPA)
  • Supraglottic airways (SGA) ort extraglottic devices (EGD)
  • Endotracheal intubation
  • Post-intubation management
  • Gastric decompression
  • Cricothyroidotomy
  • Transport to closest hospital for airway stabilization

EMS providers should reference the CDC Field Triage Guidelines for decisions regarding transport destination for injured patients.

Read Also

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Basic Airway Assessment: An Overview

Three Everyday Practices To Keep Your Ventilator Patients Safe

Benefits And Risks Of Prehospital Drug Assisted Airway Management (DAAM)

Respiratory Distress Syndrome (ARDS): Therapy, Mechanical Ventilation, Monitoring

Chest Pain, Emergency Patient Management

Ambulance: What Is An Emergency Aspirator And When Should It Be Used?

Notions Of First Aid: The 3 Symptoms Of A Pulmonary Embolism

Quick And Dirty Guide To Chest Trauma

Neonatal Respiratory Distress: Factors To Take Into Account

Resuscitation Manoeuvres: Cardiac Massage On Children

Emergency-Urgency Interventions: Management Of Labor Complications

What Is Transient Tachypnoea Of The Newborn, Or Neonatal Wet Lung Syndrome?

Tachypnoea: Meaning And Pathologies Associated With Increased Frequency Of Respiratory Acts

Postpartum Depression: How To Recognise The First Symptoms And Overcome It

Postpartum Psychosis: Knowing It To Know How To Deal With It

Clinical Review: Acute Respiratory Distress Syndrome

Seizures In The Neonate: An Emergency That Needs To Be Addressed

Stress And Distress During Pregnancy: How To Protect Both Mother And Child

Respiratory Distress: What Are The Signs Of Respiratory Distress In Newborns?

Emergency Paediatrics / Neonatal Respiratory Distress Syndrome (NRDS): Causes, Risk Factors, Pathophysiology

Respiratory Distress Syndrome (ARDS): Therapy, Mechanical Ventilation, Monitoring

Childbirth And Emergency: Postpartum Complications

Signs Of Respiratory Distress In Children: Basics For Parents, Nannies And Teachers

Three Everyday Practices To Keep Your Ventilator Patients Safe

Ambulance: What Is An Emergency Aspirator And When Should It Be Used?

The Purpose Of Suctioning Patients During Sedation

Supplemental Oxygen: Cylinders And Ventilation Supports In The USA

Behavioural And Psychiatric Disorders: How To Intervene In First Aid And Emergencies

Fainting, How To Manage The Emergency Related To Loss Of Consciousness

Altered Level Of Consciousness Emergencies (ALOC): What To Do?


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Some things just happen in life which we have no control over. We didn’t ask for it, we didn’t deserve it, we didn’t anticipate it. In those very moments, having a close support network, be it friends or family, is crucial. Easier to navigate a boat on a rough sea when you have someone helping you out.

But when those people turn their back on you, ridiculing you for your feelings rather than helping you deal with them, one has to make the very tough decision of leaving such people behind. One proud mother decided to share her daughter’s story on the r/PettyRevenge subreddit, and hundreds of people came to offer their support.

Although this may seem like a very vague way to start the article, it’ll make a lot of sense once we get into the story. Make sure you stick around to read the similar experiences from fellow netizens, and leave your own thoughts and stories in the comments below. If you want more, here’s another article. Now let’s dive in!

Having a parent diagnosed with cancer can rain down on one like a ton of bricks, leading to panic attacks and a need for someone to be there for you

Image source: Zhivko Minkov (not the actual photo)

However, when petty drama comes before being an understanding friend, things can get very messy, as they did in this story of petty revenge

Image source: imagesourcecurated (not the actual photo)

Image source: seventyfourimages (not the actual photo)

Image source: burghroot

As stated by MayoClinic, a panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening for everyone involved, as one might think they’re losing control, having a heart attack or even dying.

Panic attacks may come on suddenly and without warning at first, but over time, they’re usually triggered by certain situations. Some researchers believe that it’s caused by the body’s natural fight-or-flight response to danger, although there may not be an obvious danger present. Highly traumatic events in life can lead to these developing, as it happened to the daughter in the story.

To be the devil’s advocate, it can be really difficult when someone is experiencing anxiety or panic attacks, especially when one is unfamiliar with the symptoms. However, one should never put more pressure on a person struggling, as the roommate did.

Instead, if you actually care about the person having a panic attack, try to stay calm. The Help Guide instructs to gently encourage them to breathe slowly and deeply, asking them to watch while you gently raise your arm up and down, and to encourage them to sit somewhere quietly where they can focus on their breath until they feel better. You should never encourage someone to breathe into a paper bag during a panic attack, as it may not be safe.

If you’re ever struck with an anxiety or panic attack, has some advice. Focus on your breathing and concentrate on slowing down your breath, inhaling and exhaling on the count of 5. Some people say that stomping on the spot helps them reset their breathing pattern and get back in control. Lastly, focus on your senses. Mint-flavored sweets and gum, or the soft touch of a plushie can help with grounding.

If you find that they’re becoming a common occurrence, rather than a one-off, make sure you speak with your doctor or therapist, so that you can get on the right path to healing. Life is never easy, especially when you’re fighting the good fight alone. Having a parent diagnosed with cancer is hard-hitting, and the best you can do is take care of yourself and be there as much as you can.

We wish the family all the best and hope the mom wins the fight with cancer. Hoping the daughter has a smooth healing journey as well! Let us know your thoughts on this story in the comments below and I shall see you in the next one!

Dozens of people came to support the mom and daughter, praising the latter for how she handled the situation, and sharing their own stories

There were those that empathized with the roommate, however. Leave us your thoughts on this story in the comments!

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A yawn is an involuntary reflex when we open our mouths and breathe in deeply. It is an automatic body response to being tired or stressed. However, yawning excessively is a cause for cause as it can be a sign of an underlying health condition.

Man Yawning
Man Yawning

Although researchers are not sure why yawning occurs, however, it is commonly triggered by boredom, fatigue, and tiredness. One popular theory also indicates that when we are tired, our brain starts to slow down which causes our temperature to drop, and yawning helps regulate our body temperature.

According to the findings of a study published in the journal ‘Physiology and Behaviour,’ it was noted that the frequency of yawning decreases during winter. Another theory indicates that yawning is our body’s way to waking itself up as it forces blood to rush to our face which increases the brain’s alertness.

Common causes of yawning

Yawning may occur as a result of the following-

Causes of excessive yawning

  • Anxiety- Anxiety affects our heart rate, breathing, and energy levels. Anxiety is a cause of fatigue, breathlessness, and stress. Therefore, it is a common trigger for yawning, especially when the person starts feeling anxious.

  • Sleep deprivation- Excessive yawning is a sign of sleep deprivation which can be caused by insomnia, sleep apnea, or narcolepsy. Insomnia is a sleep condition where a person is unable to sleep at night. Narcolepsy is a chronic sleep disorder that makes people sleepy during the day. People with narcolepsy can go to sleep suddenly. Lastly, sleep apnea is a serious sleep disorder in which a person snores loudly and breathes irregularly.

  • Thermoregulatory disorders- Thermoregulation is our ability to regulate our body’s temperature within certain boundaries, even when the surrounding temperature is different. Thermoregulatory disorders disrupt this ability and can lead to abnormal temperature fluctuations. Therefore, it can cause excessive yawning as our body is unable to regulate its temperature properly.

  • Heart problems- In some rare cases excessive yawning may indicate a heart attack or even bleeding around the heart. Heart conditions can trigger excessive yawning because excessive yawning is related to the vagus never which runs from the bottom of the brain down to the heart and stomach. See a doctor immediately if along with excessive yawning, you are experiencing frequent pain in the chest, nausea, lightheadedness, and shortness of breath.

  • Stroke- Stroke victims generally experience excessive yawning. It is believed that yawning helps stroke victims regulate and reduce the brain and body’s core temperature.

  • Multiple sclerosis- Multiple sclerosis is a disease in which the immune system eats away the protective covering of nerves resulting in nerve damage that disrupts the communication between the brain and body. Multiple sclerosis can cause a lot of fatigue and disrupt the temperature of the body, therefore, a person suffering from multiple sclerosis may experience excessive yawning.


Treatment for excessive yawning depends upon the cause of yawning.

  • Excessive yawning due to a sleep problem- A person can treat excessive yawning caused by sleep problems by improving their sleep cycle and seeking assistance from a doctor in case of sleep apnea, insomnia, or narcolepsy.

  • Excessive yawning caused as a side effect of medication- If you are experiencing excessive yawning because of a side effect of a medication, then ask your doctor to either change the medication or prescribe a lower dose.

  • Excessive yawning caused by stress- Stress-related excessive yawning can be fixed by burning energy during the day. Exercise regularly in the morning and stop exercising right before bedtime.

Even though yawning is a common reflex in all human beings, you should see your doctor if you have been yawning excessively because it might be caused by an underlying medical condition such as epilepsy, liver failure, stroke, or cardiac problems.

Disclaimer - This content including suggestions provide general information only. It is in no way a substitute for a qualified medical opinion hence always consult an expert or doctor for more information.

First published on: 28 Jan 2023, 15:36 IST

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Whether you're driving the children to after-school clubs, trying to become a partner at a major law firm or both, it's hard to find people who don't consider themselves super-busy. Even retirees complain of having too much to do. But the dark side to our increasingly frenetic pace of life is the amount of stress we are putting ourselves under.

A work crisis hits, the wi-fi goes down, the plane gets delayed and we are left feeling mad – and producing more of the stress hormone cortisol than our body needs.

To be healthy, you've got to calm down.

Today, in the second part of my series giving you tips on how to live a longer and healthier life, I will explain why stress is so bad for us.

Candle meditation is great way for beginners to de-stress

Candle meditation is great way for beginners to de-stress

You might have wondered why it is that when you finally take a break, you catch a cold or the flu? Well, that's because every stomach-churning, stressful moment we put ourselves through is damaging our defences.

Our immune system is constantly under attack and most of the time we stay healthy because the trillions of cells inside the body are always at work to keep us safe.

But when our bodies encounter too many chemicals – and that includes the hormones released during periods of excess stress – our defence system, which is quite strong, can falter if put under too much pressure, and this malfunction results in prolonged inflammation.

As I explained in yesterday's Daily Mail, when any kind of threat – bacteria, toxins, trauma, even extremes of temperature – injures our tissues, they become 'inflamed' as part of the immune response.

This is usually only temporary and the inflammation is crucial in triggering the process by which the body protects and heals itself.

But in some situations, the inflammation lasts too long and can result in DNA damage because too many defence cells (white blood cells) heed the body's call and join the fight.

Sometimes these cells attack our own organs or otherwise healthy tissues and cells.

Those attacks age our tissues, eroding our overall health and can, in some cases, lead to autoimmune conditions such as coeliac disease or multiple sclerosis. Researchers call this reaction 'inflammaging' (inflammation plus ageing).


In as little as 30 minutes, anxious thoughts can weaken your immune response

In as little as 30 minutes, anxious thoughts can weaken your immune response

When stressed, your body produces the stress hormone cortisol. In short spurts, cortisol limits inflammation. However, if you are continually stressed and develop high levels of cortisol, your body adjusts to the high level of this hormone and it ultimately leads to an increase in inflammation – and so, inflammaging. This lowers your ability to fight infections.

In as little as 30 minutes, anxious thoughts can weaken your immune response.

The raised cortisol involved in chronic stress also correlates with increased appetite and weight gain. It can lead to binge-eating unhealthy snacks or excessive alcohol consumption, both of which can cause nutritional deficiencies and a further weakened immune system. That's why maintaining cortisol balance is essential for health.

Cortisol is your body's emergency department, there for momentary crises but not a substitute for daily good habits. Managing stress by reducing its triggers – toxic thoughts, places, people – can help unlock the secrets to better immune health and lowered inflammation.

Everyone experiences stress differently, so you can decrease it in a variety of ways, including breathing exercises and meditation.

Try these proven techniques to help deal with it.



Called simhasana in Sanskrit, the deep-breathing technique Lion's Breath can help relax your face and jaw muscles, relieve stress and improve your cardiovascular function.

Sit, leaning forward slightly, with your hands on your knees or the floor. Spread your fingers as wide as possible across your knees.

Inhale through your nose. Open your mouth wide, stick out your tongue and point it down toward your chin.

Exhale forcefully, carrying the breath across the root of your tongue. While exhaling, make a 'ha' sound from deep within your abdomen.

Breathe normally for a few moments. Repeat up to seven times.

Meditation turns off what psychologists call the 'monkey mind', that constant loop of anxiety and worries that creates mental chaos. When you meditate, you sweep that disorder away. The goal is to become unseen, unreachable – even if only for ten minutes a day.

Your body already has the tools to meditate and uses them. The reticular activating system (RAS) – a network of neurons located in the brain – determines how you perceive and react to the external world. In broad terms, it controls your consciousness, gatekeeping all the data you collect through your senses.

For example, in a loud restaurant, with a friend or partner, you can tune out all the extraneous noise to concentrate on your conversation. That's your RAS in action. It allows your mind to work in the background, keeping your systems active without bombarding them with constant sensory input.

Your RAS creates an intentional filter for your focus of choice. It sorts through the sensory input and displays only what's relevant. You can harness the power of your RAS to concentrate on the moment.


Candle meditation is great for beginners. Light a candle and dim the lights so the flame becomes the focal point of the room. Place the candle at eye level on a table, and sit in front of it, 2ft away. Keep your back straight to allow your diaphragm a full range of motion.

Set a timer for ten or 15 minutes. Take a couple of deep, slow breaths. Relax and release any tension in your body.

Focus solely on the flame. Observe as it flickers, changes shape, emits a halo and flashes a variety of colours. If your mind wanders, don't worry. Just lead it back to the flame.

You may have to corral your mind several times. The more you practise it, the easier it becomes.


When you breathe in, blood cells receive oxygen and release carbon dioxide, the waste product you exhale

When you breathe in, blood cells receive oxygen and release carbon dioxide, the waste product you exhale

When you breathe in, blood cells receive oxygen and release carbon dioxide, the waste product you exhale. When you take a deep breath, air fills your lungs and your lower belly rises. But many of us don't breathe deeply enough and this limits the diaphragm's range of motion, resulting in the bottom part of the lungs not receiving enough oxygenated air.

You may feel out of breath or anxious as a result. Breathing problems can also cause fatigue, panic attacks and other physical and emotional problems because they disrupt the exchange of oxygen and carbon dioxide.

Deep breathing, on the other hand, can lower or stabilise your blood pressure while also slowing your heartbeat. To do this, you need to breathe deeply and slowly.


This exercise naturally relaxes your nervous system. Until you master it, do it seated with your back straight. After that, you can do it while lying in bed.

Place the tip of your tongue against the ridge of tissue behind your upper front teeth. Completely exhale through your mouth, making a whoosh sound.

Close your mouth and inhale quietly through your nose to a mental count of four.

Hold your breath for a count of seven. Exhale completely through your mouth, making a whoosh sound again, to a count of eight. Repeat three times.


Sleep might not feel like a priority sometimes, but a lot of critical activity takes place in your body when you rest, including the production of molecules that fight infections. Sleep is just as important as food and water for the best physical and mental health.

Fewer than seven hours risks all the negative outcomes you can imagine: while more than seven hours gives your body enough time to reset.

The threefold increase in sleep deficits in recent decades has contributed to the obesity epidemic, partly due to the disruption of hormones – including those that govern hunger – that occurs when our sleep is interrupted.

Unfortunately, obesity impairs the immune system, which in turn opens the door to infections and disease.

A few nights of bad sleep won't destroy your overall health but a chronic pattern of poor sleep can lead to increased calorie intake, weight gain, obesity, type 2 diabetes, and other problems.

Think of a road with ruts carved over centuries by countless wheels. If one vehicle goes slightly east, it won't change the ruts. If several thousand cars drive east, they'll form a new rut that will take future drivers to a different destination.

When it's time for you to sleep, your circadian clock sets the process in motion.

At various points in your sleep-wake cycle, your brain also releases a variety of hormones, including adrenaline, cortisol, histamine and norepinephrine, which counter sleep to help you wake up, but if you are under chronic stress, your body produces too much of these hormones, especially cortisol.

Studies show that sleep deprivation harms memory, motor skills and the brain. But you have the power to change all that.

The following daily habits will lead to better rest at night:


Daylight has a strong influence on circadian rhythms. Daily exposure to sunlight will help synchronise your internal clock.


Exercise benefits cardiovascular health and sleep quality. You don't need to be a triathlete to reap the benefits. Even a moderate walk can help and it's also a great way to get some daylight exposure.


Turn off the TV an hour before you want to be asleep. Dim indoor lighting with a dimmer or use a low-watt lamp.

If you spend too much time in front of a computer screen or smartphone, consider getting eyeglasses that protect you from blue light, as it can cause retinal damage.


This includes caffeine, alcohol and a wide range of medications containing psychoactive substances. Talk to your doctor about any medications that might be interfering with your rest.


It sounds simple, but in our go-go-go world we often forget to relax. A warm bath or yoga can help you unwind, as can meditation and deep breathing.

Before bed, avoid intense reading material. You want to unplug rather than activate your intellect.

© Dr Leo Nissola 2023

  • Adapted by Libby Galvin from The Immunity Solution: Seven Weeks To Living Healthier And Longer by Dr Leo Nissola, to be published by Countryman Press on February 10 at £23.99. To order a copy for £21.59 (offer valid to February 12, 2023; UK p&p free on orders over £20), visit or call 020 3176 2937.

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Grounding techniques are ways of calming yourself down by creating a connection to the here and now. It literally means to "ground" and anchor yourself to the concreteness of the present.

Before we can talk about the value of grounding techniques, we need to understand anxiety and its role in our lives. According to marriage and family therapist Emily Maynard, LMFT, "Anxiety is an adaptive process in our nervous systems necessary for human survival. Your anxiety triggers are unique to you based on your upbringing, experiences, personality, and physicality, but often anxiety comes in a moment of risk or fear." When anxiety becomes disordered, the frantic emotions can pull you toward upsetting flashbacks, dissociation, rumination, and distress.

Although the experience can't be eliminated altogether, it can be managed. That's where grounding techniques come in.

"Grounding techniques are exercises that help us stay in the present moment and are designed to return our bodies back to our baseline," Ernesto Lira de la Rosa, Ph.D., a psychologist and media advisor for the Hope for Depression Research Foundation, tells mbg. By gently turning away from your worries and focusing your attention back on the present, grounding allows you to decrease the intensity of the emotion and reduce bodily stress. 

Anxiety happens through a cascading physiological response. A grounding technique is a natural coping strategy that tells your brain you're safe and OK. "Just as your body knows how to activate panic, it also knows how to return to a state of calm through your parasympathetic nervous system," de la Rosa says.

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Chronic shin splints, stress fractures, muscle spasms—most runners have (or have had) a relationship with pain. Sometimes, as athletes, we tend to ignore aches and live with them, or we spend a lot of time and money finding ways to heal.

To get a better understanding of pain, Runner’s World spoke to Abdul-Ghaaliq Lalkhen, M.D., the author of An Anatomy of Pain: How the Body and the Mind Experience and Endure Physical Suffering about what pain is and how to deal with both chronic and acute types.

Lalkhen has been working in pain-related healthcare for more than two decades. He is a member of the Faculty of Pain Medicine affiliated with the Royal College of Anesthetists and a visiting professor at Manchester Metropolitan University in Manchester, England.

Here, he answers Runner’s World questions about why so many athletes believe they should “push through” pain and whether it’s possible to feel pain even when there isn’t an obvious injury.

Runner’s World: What is pain?

Abdul-Ghaaliq Lalkhen: Pain is the word we use to communicate and describe an unpleasant sensory and emotional experience. It comes from the Greek word, poena, which means punishment. We are designed for survival and when we are exposed to a physical or psychological injury, which threatens that survival, we experience pain.

Pain alerts us to a potential or actual threat and moves us to implementing a set of behaviors designed to protect us. The pain from a broken heart is no less real than the pain from mechanical trauma and lights up the same brain areas on a functional MRI scan.

Let’s say, for example, that you have a broken bone. That broken bone releases chemicals designed to facilitate healing, which we generally refer to as inflammation. These chemicals attach to a harm-sensing receptor, which converts the chemical signal into an electrical impulse that’s transmitted to your spinal cord.

The spinal cord is not passive and acts as a relay station between the injured area and the brain. It sends messages to your brain, which then calls on many different parts of itself, including previous injury experiences, arousal, sleep, mood, sense of danger—among other aspects of thought—in order to create the experience of pain.

The brain can either increase transmission of harm-sensing signals from the spinal cord or reduce the flow of signals, thereby modulating the experience of pain.

The brain makes an assessment: How bad is this injury or threat? So, you experience pain through your unique cognitive and emotional way of experiencing the world. Because our brains are all fundamentally different, so are our experiences of pain. That messiness is not imaginary.

RW: Is that why some of us seem to tolerate pain more easily than others?

Lalkhen: Yes. Pain is an experience, and we experience things in different ways because our brains have developed and formed as a consequence of our unique life experiences. Pain is akin to a car alarm going off. We hear the alarm and we go outside to investigate. Some of us will panic and some will look around and say, “oh, it’s nothing.” Sometimes we react in proportion to the event, and sometimes we don’t.

We do know that different people, when faced with adversity, will react differently and this is partially related to what’s called self-efficacy. That is, they will think, “oh, my foot is broken, but I will be alright in the end.” Individuals with high self-efficacy recover better from injury and are less likely to continue to experience pain over time.

The pain from a broken heart is no less real than the pain from mechanical trauma.

Now, that’s not to say that we should ignore or push through pain. Pain is a message that alerts us to danger. If your knee gives out while you run and you feel pain, then you need to figure out what’s causing the pain. But if, over time, you continue to feel pain after fixing the functional problem, then pain is likely to be due to the fact that the pain alarm system is malfunctioning.

RW: Can pain, therefore, be psychosomatic—that is, all in our heads?

Lalkhen: Well, pain is in our minds—it is an experience created by the brain—but that doesn’t mean it’s imaginary or psychologically-mediated. When people are anxious and depressed, then the pathways from the brain to the spinal cord, which turn down harm signals, are less effective and pain is more severe.

Take, for example, chronic back pain. We don’t really know why we get back pain. We try to link it to changes in discs, but it is often non-specific back pain unrelated to specific damage. That is, we can’t figure out the cause.

When a doctor can’t determine the cause of pain, it’s very distressing to patients (and to some doctors). Chronic back pain is a disease of a malfunctioning pain alarm system. Pain is, therefore, not a symptom in conditions such as chronic low back pain. The disease process is a broken or malfunctioning pain alarm system.

In chronic pain conditions, any stress will turn the volume of the alarm up. We know, for example, that bereavement produces a stress response which will exacerbate chronic pain. We know that when people feel stressed, anxious, or depressed, they are more likely to report pain and to be disabled by pain because they are less able to reduce the volume of the alarm.

So, we need to get to the bottom of the pain. Acute pain might occur because of a disease or injury. Chronic pain may be due to a malfunctioning pain alarm. In both acute and chronic pain, psychological reactions to pain inform distress, disability, and recovery.

RW: Why do some people seem to welcome pain, as in to “push through it” in order to reach a goal? How much should you push back against your body’s natural pain messages to achieve a result?

Lalkhen: Runners and cyclists need to train, and some of that training comes with a cost in terms of inflammation due to tissue damage. Look at American football players who bash themselves every weekend and, to an external observer, don’t seem to feel the pain. They pick themselves up and continue playing and training—the context of the injury modifies the pain experience. Each of us has the ability to sublimate the information about damage we get from our bodies, but that doesn’t always mean we should.

Cyclists and runners shouldn’t ignore pain. Instead, they should get help to determine the cause of the mechanical inflammation precipitating the experience of pain—the wrong shoes, not stretching enough, poor biomechanics—so that they can perform better and not experience pain. Optimizing nutrition and their overall health, as well as engaging in sports-specific conditioning, are an important aspect of being able to perform successfully long-term.

That said, both runners and cyclists, as they age, will likely find their physiological reserve and the ability to recover is compromised. They might need to change their goalposts over time and ask themselves if it’s perhaps more important to exercise to achieve better overall health outcomes, rather than to win a race. They need to ask themselves, “Is reaching this goal going to make my life better?” because sometimes pushing through what they call pain will come with a cost, just as it does with football players.

What’s also important to keep in mind is that pain, because it’s such an individual and unique experience, isn’t the best indicator of disease. Other disease-associated symptoms are better at sending us important messages, including fever, unexplained weight loss, and night sweats. Loss of function is a better indicator of pathology than pain.

RW: You discuss natural pain remedies, such as acupuncture and ayurveda in your book. Some runners and cyclists take natural supplements for pain relief. What do you think of those?

Lalkhen: I work in a pain clinic and people come to me with their medical traditions and the articles they’ve read. There is some truth in everything. However, I operate from the scientific method. Has this treatment been subjected to randomized, controlled trials with the removal of bias? If it has, and the treatment is appropriate for the patient’s condition, then it’s something you can try if the risks of the treatment outweigh the benefits for that individual.

Truthfully, we’re not that advanced when it comes to our pharmacological agents for pain management. We have medications like Tylenol that treat pain for the short-term, but most long-term pain agents, such as opiates, are problematic. We’re quite limited pharmacologically, even in 2023.

RW: Can someone train their mind/body to deal with pain?

Lalkhen: There are a number of psychological techniques to manage chronic pain including education about the stress response, relaxation training, diaphragmatic breathing, and the development of cognitive behavioral therapy skills, among other solutions. Some of my patients learn these techniques and are able to accept and become okay with unpleasant sensations they feel. Of course, we also see people who are not okay with what they’re feeling. People with anxiety, PTSD, and depression interpret pain sensations in a more catastrophic way, and are less able to adopt psychological techniques to manage pain.

Rather than trying to fix the pain or train your brain, it’s more useful to consider taking better care of yourself as a whole person throughout your life and avoid chronic musculoskeletal pain altogether.

Running and biking shouldn’t be painful. Don’t push through it.

We live pro-inflammatory lives. We don’t sleep enough, we smoke, we don’t eat properly, and all of that contributes to a pro-inflammation state, which results in musculoskeletal chronic pain.

If you want to be well and want to function optimally from a musculoskeletal point of view, you need to optimize nutrition and body composition, reduce or stop consuming alcohol, avoid smoking, and take care of your mental health.

There is never going to be a drug solution for chronic musculoskeletal pain. Taking care of yourself to prevent chronic musculoskeletal pain is superior.

RW: You see a lot of patients who are experiencing unrelenting and often unexplained pain. How do you cope with that?

Lalkhen: People are very vulnerable when they’re in pain and they often want a passive solution to their problems. “Please fix me, doctor,” but that rarely works for chronic pain. Even acute injuries require the patient to cooperate with rehabilitation sometimes in the presence of pain.

Patients should always ask the doctor to define the problem as the doctor understands it and in a way that makes sense. If the patient can’t obtain a good understanding of their condition, then they should seek a second opinion.

Ultimately, though, a patient’s overall health is in their own hands. Adults have autonomy and should be collaborated with in a healthcare setting. The doctor should be patient-centered. The patient needs to be invited to consider all of the variables that are important and ask themselves what wellness looks like for them. Then they need to enlist the support and expertise to get themselves there.

Because I sometimes work with highly distressed patients who are in a lot of pain, I engage with psychological supervision at work. This means that I meet with a pain management psychologist to discuss how I felt during these situations so that I can maintain my own mental wellness and learn to be a more effective communicator.

My role, as espoused by Edward Livingston Trudeau, the American physician and public health pioneer, “to cure sometimes, to relieve often, to comfort always.”

Headshot of Donna Raskin

Donna Raskin has had a long career as a health and fitness writer and editor of books and magazine articles. She bikes in a nearby county park, lifts weights, takes Zumba, and loves to walk/run with her dog, Dolly. 

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