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From eye exams to blood tests and surgery: how doctors use light to diagnose disease

<p><em><a href="https://theconversation.com/profiles/matthew-griffith-1539353">Matthew Griffith</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>You’re not feeling well. You’ve had a pounding headache all week, dizzy spells and have vomited up your past few meals.</p> <p>You visit your GP to get some answers and sit while they shine a light in your eyes, order a blood test and request some medical imaging.</p> <p>Everything your GP just did relies on light. These are just some of the optical technologies that have had an enormous impact in how we diagnose disease.</p> <h2>1. On-the-spot tests</h2> <p>Point-of-care diagnostics allow doctors to test patients on the spot and get answers in minutes, rather than sending samples to a lab for analysis.</p> <p>The “flashlight” your GP uses to view the inside of your eye (known as an <a href="https://medlineplus.gov/ency/article/003881.htm">ophthalmoscope</a>) is a great example. This allows doctors to detect abnormal blood flow in the eye, deformations of the cornea (the outermost clear layer of the eye), or swollen optical discs (a round section at the back of the eye where the nerve link to the brain begins). Swollen discs are a sign of elevated pressure inside your head (or in the worst case, a brain tumour) that could be <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/increased-intracranial-pressure-icp-headache">causing your headaches</a>.</p> <p>The invention of <a href="https://openmedscience.com/lighting-the-way-in-healthcare-the-transformative-role-of-lasers-in-medicine/">lasers and LEDs</a> has enabled many other miniaturised technologies to be provided at the bedside or clinic rather than in the lab.</p> <p><a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">Pulse oximetry</a> is a famous example, where a clip attached to your finger reports how well your blood is oxygenated. It does this by <a href="https://www.howequipmentworks.com/pulse_oximeter/">measuring</a> the different responses of oxygenated and de-oxygenated blood to different colours of light.</p> <p>Pulse oximetry is used at hospitals (and <a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">sometimes at home</a>) to monitor your respiratory and heart health. In hospitals, it is also a valuable tool for detecting <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60107-X/fulltext">heart defects in babies</a>.</p> <h2>2. Looking at molecules</h2> <p>Now, back to that blood test. Analysing a small amount of your blood can diagnose <a href="https://theconversation.com/blood-tests-and-diagnosing-illness-what-can-blood-tell-us-about-whats-happening-in-our-body-80327">many different diseases</a>.</p> <p>A machine called an automated “full blood count analyser” tests for general markers of your health. This machine directs focused beams of light through blood samples held in small glass tubes. It counts the number of blood cells, determines their specific type, and reports the level of haemoglobin (the protein in red blood cells that distributes oxygen around your body). In minutes, this machine can provide a <a href="https://www.nuffieldhealth.com/article/inside-the-pathology-lab-what-happens-to-my-blood">snapshot</a> of your overall health.</p> <p>For more specific disease markers, blood serum is separated from the heavier cells by spinning in a rotating instrument called a centrifuge. The serum is then exposed to special chemical stains and enzyme assays that change colour depending on whether specific molecules, which may be the sign of a disease, are present.</p> <p>These colour changes can’t be detected with the naked eye. However, a light beam from an instrument called a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476943/#R88">spectrometer</a> can detect tiny amounts of these substances in the blood and determine if the biomarkers for diseases are present, and at what levels.</p> <h2>3. Medical imaging</h2> <p>Let’s re-visit those medical images your GP ordered. The development of fibre-optic technology, made famous for transforming high-speed digital communications (such as the NBN), allows light to get inside the body. The result? High-resolution optical imaging.</p> <p>A common example is an <a href="https://www.medicalnewstoday.com/articles/153737#risks-and-side-effects">endoscope</a>, where fibres with a tiny camera on the end are inserted into the body’s natural openings (such as your mouth or anus) to examine your gut or respiratory tracts.</p> <p>Surgeons can insert the same technology through tiny cuts to view the inside of the body on a video screen during <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553337/">laparoscopic surgery</a> (also known as keyhole surgery) to diagnose and treat disease.</p> <h2>How about the future?</h2> <p>Progress in nanotechnology and a better understanding of the interactions of light with our tissues are leading to new light-based tools to help diagnose disease. These include:</p> <ul> <li> <p><a href="https://onlinelibrary.wiley.com/doi/full/10.1002/advs.201903441">nanomaterials</a> (materials on an extremely small scale, many thousands of times smaller than the width of a human hair). These are being used in next-generation sensors and new diagnostic tests</p> </li> <li> <p><a href="https://www.nature.com/articles/s41587-019-0045-y">wearable optical biosensors</a> the size of your fingernail can be included in devices such as watches, contact lenses or finger wraps. These devices allow non-invasive measurements of sweat, tears and saliva, in real time</p> </li> <li> <p>AI tools to analyse how blood serum scatters infrared light. This has allowed researchers to build a <a href="https://www.advancedsciencenews.com/powerful-diagnostic-approach-uses-light-to-detect-virtually-all-forms-of-cancer/">comprehensive database</a> of scatter patterns to detect <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/aisy.202300006">any cancer</a></p> </li> <li> <p>a type of non-invasive imaging called <a href="https://www.ncbi.nlm.nih.gov/books/NBK554044/">optical coherence tomography</a> for more detailed imaging of the eye, heart and skin</p> </li> <li> <p>fibre optic technology to deliver a tiny microscope into the body on the <a href="https://www.uwa.edu.au/projects/microscope-in-a-needle">tip of a needle</a>.</p> </li> </ul> <p>So the next time you’re at the GP and they perform (or order) some tests, chances are that at least one of those tests depend on light to help diagnose disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231379/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/matthew-griffith-1539353"><em>Matthew Griffith</em></a><em>, Associate Professor and ARC Future Fellow and Director, UniSA Microscopy and Microanalysis Facilities, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-eye-exams-to-blood-tests-and-surgery-how-doctors-use-light-to-diagnose-disease-231379">original article</a>.</em></p>

Body

Cruise passengers share why you never leave your cabin balcony door open

<p>A couple on a cruise ship have learned the hard way why you should never leave the balcony door in your cruise cabin open and unattended for too long. </p> <p>While on a cruise around the US and docked in the port of Orlando in Florida, the couple took to TikTok to share their "horror" experience of when their cabin filled up with birds. </p> <p>In the video, they opened the door to their room and were swarmed by a flock of birds as they captioned the video, "When you go on a cruise and you come back to a bunch of (bird emoji) everywhere."</p> <p>"Felt like we were living in a horror movie scene. I can breathe now because I can (laugh)about it," the passenger added.</p> <div class="embed" style="font-size: 16px; box-sizing: inherit; margin: 0px; padding: 0px; border: 0px; vertical-align: baseline; outline: currentcolor !important;"><iframe class="embedly-embed" style="border-width: 0px; border-style: none; margin-right: 0px; margin-left: 0px; box-sizing: inherit; padding: 0px; vertical-align: baseline; width: 600px; max-width: 100%; outline: currentcolor !important;" title="tiktok embed" src="https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.tiktok.com%2Fembed%2Fv2%2F7423175328480136491&display_name=tiktok&url=https%3A%2F%2Fwww.tiktok.com%2F%40greedy810%2Fvideo%2F7423175328480136491&image=https%3A%2F%2Fp16-pu-sign-useast8.tiktokcdn-us.com%2Fobj%2Ftos-useast5-p-0068-tx%2FoM5JajVJBIUqbExUAiiApxIM8Af9zqBEi0wBCg%3Flk3s%3Db59d6b55%26x-expires%3D1729123200%26x-signature%3DC%252F8Xte%252FDJymZpHuGaa4Y8zX%252F6AA%253D%26shp%3Db59d6b55%26shcp%3D-&key=59e3ae3acaa649a5a98672932445e203&type=text%2Fhtml&schema=tiktok" width="340" height="700" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></div> <p>The video was taken on the Carnival Freedom cruise ship in the USA, with the couple later posting another video of a room steward catching two birds in a cardboard box.</p> <p>Viewers in the comments were a mix of amused and horrified, as one person wrote, "You're not supposed to leave your balcony door open when you're gone."</p> <p>"You have a whole Alfred Hitchcock movie in your room," another commented, comparing the scene with the film,<em> The Birds</em>.</p> <p>Others speculated that the unusual behaviour of the birds could be impacted by the nearby Hurricane Milton. </p> <p><em>Image credits: TikTok</em></p>

Cruising

Jimmy Barnes shares positive update after surgery

<p>Jimmy Barnes has shared a heartwarming update on his health following his emergency hip surgery in August. </p> <p>While on the New Zealand leg of his tour in early August, the 68-year-old rockstar was taken to <a href="https://oversixty.com.au/health/caring/bad-news-jimmy-barnes-reveals-shocking-health-update" target="_blank" rel="noopener">hospital</a> after complaining of "unbearable pain", telling his fans, "The doctors have recommended a remedial medical procedure ASAP followed by some physio to address the issue."</p> <p>Now back at home with his family, Barnes shared that he is on the road to recovery with an update on his healing journey. </p> <p>Barnes said he has had his PICC line, a thin tube inserted through a vein in your arm to deliver medications and treatments directly to the larger veins near your heart, finally removed, meaning he can gain back some normalcy.</p> <p>Barnes said was living with a PICC line in his arm for the past six weeks to continue his treatment as an out patient.</p> <p>“It’s meant that I could leave hospital and continue most of my recovery at home,” he said on Instagram on Friday.</p> <p>“It’s been restricting and liberating at the same time."</p> <p>“This part of my recovery is now over and with the help of (doctors), nurses, physiotherapists, family, friends, you guys and my Jane, everything is on track.”</p> <p>Posing in front of a calendar with Cold Chisel dates, Barnes said rehearsing with the band again this week has “topped things off”.</p> <p>“I can even get back behind the wheel,” he said. “Aah! FREEDOM.”</p> <p><em>Image credits: Instagram</em></p>

Caring

What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a <a href="https://apnews.com/article/bronny-james-cardiac-arrest-3953eee8789e83f3cccfb6dd798bc54e">cardiac arrest</a>.</p> <p>Many media outlets incorrectly referred to the event as a “<a href="https://en.as.com/nba/lebron-james-son-bronny-plays-for-the-usc-trojans-for-the-first-time-since-suffering-a-heart-attack-n/">heart attack</a>” or used the terms interchangeably.</p> <p>A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart.</p> <p>With some background in <a href="https://www.youtube.com/watch?v=uKrgEv7-rVM&t=16s">how the heart works</a>, we can see how they differ and how they’re related.</p> <h2>Understanding the heart</h2> <p>The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body.</p> <p>For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs.</p> <p>This can cause the heart muscle to become injured or die, and results in the heart not pumping properly.</p> <h2>Heart attack or cardiac arrest?</h2> <p>Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle.</p> <p>A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump.</p> <p>In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other.</p> <h2>Why do they happen? Who’s at risk?</h2> <p>Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease.</p> <p>The underlying cause in about <a href="https://www.ncbi.nlm.nih.gov/books/NBK507799/#:%7E:text=It%20has%20been%20reported%20that,increases%20beyond%20age%2050%20years.">75% of people</a> is a process called <a href="https://youtu.be/jwL4lkSlvSA?si=H2as7dQkhbIqWWkU">atherosclerosis</a>. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot.</p> <p>Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process.</p> <p>Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle.</p> <p>Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="Heart attack vs cardiac arrest" /></a><figcaption><span class="caption">Here’s a simple way to remember the difference.</span> <span class="attribution"><span class="source">Author provided</span></span></figcaption></figure> <p>But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to <a href="https://www.youtube.com/watch?v=M_soKG-Tzh0&t=903s">electrical malfunctions</a> in the heart. There are four distinct types:</p> <ul> <li> <p><strong>ventricular tachycardia:</strong> a rapid and abnormal heart rhythm in which the heartbeat is more than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541285/">100 beats per minute</a> (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately</p> </li> <li> <p><strong>ventricular fibrillation:</strong> instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute</p> </li> <li> <p><strong>pulseless electrical activity:</strong> arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse</p> </li> <li> <p><strong>asystole:</strong> the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart.</p> </li> </ul> <p>Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a <a href="https://www.espn.com.au/mens-college-basketball/story/_/id/38260006/bronny-james-cardiac-arrest-caused-congenital-heart-defect">congenital heart defect</a>, a heart condition he was born with.</p> <p>But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting <a href="https://pubmed.ncbi.nlm.nih.gov/11898927/">for 70%</a> of all cases.</p> <p>So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest.</p> <p>So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack.</p> <h2>What do they look like?</h2> <p>Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin.</p> <p>But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating.</p> <h2>What’s the take-home message?</h2> <p>While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes.</p> <p>A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring.</p> <p>Despite their different nature both conditions can have severe consequences and require immediate medical attention.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229633/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, Associate Professor of Medicine, <em><a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, Senior lecturer, School of Nursing and Midwifery, <em><a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-a-heart-attack-and-cardiac-arrest-ones-about-plumbing-the-other-wiring-229633">original article</a>.</p> </div>

Body

Constipation increases your risk of a heart attack, new study finds – and not just on the toilet

<p><em><a href="https://theconversation.com/profiles/vincent-ho-141549">Vincent Ho</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>If you Google the terms “constipation” and “heart attack” it’s not long before the name Elvis Presley crops up. Elvis had a longstanding history of chronic constipation and <a href="https://www.pbs.org/newshour/health/elvis-addiction-was-the-perfect-prescription-for-an-early-death">it’s believed</a> he was straining very hard to poo, which then led to a fatal heart attack.</p> <p>We don’t know what really happened to the so-called King of Rock “n” Roll back in 1977. There were likely several contributing factors to his death, and this theory is one of many.</p> <p>But after this famous case researchers took a strong interest in the link between constipation and the risk of a heart attack.</p> <p>This includes a recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">study</a> led by Australian researchers involving data from thousands of people.</p> <h2>Are constipation and heart attacks linked?</h2> <p>Large <a href="https://www.nature.com/articles/s41598-023-38068-y">population</a> <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">studies</a> show constipation is linked to an increased risk of heart attacks.</p> <p>For example, an <a href="https://www.nature.com/articles/s41598-023-38068-y">Australian study</a> involved more than 540,000 people over 60 in hospital for a range of conditions. It found constipated patients had a higher risk of high blood pressure, heart attacks and strokes compared to non-constipated patients of the same age.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/32873621/">Danish study</a> of more than 900,000 people from hospitals and hospital outpatient clinics also found that people who were constipated had an increased risk of heart attacks and strokes.</p> <p>It was unclear, however, if this relationship between constipation and an increased risk of heart attacks and strokes would hold true for healthy people outside hospital.</p> <p>These Australian and Danish studies also did not factor in the effects of drugs used to treat high blood pressure (hypertension), which can make you constipated.</p> <h2>How about this new study?</h2> <p>The recent <a href="https://journals.physiology.org/doi/abs/10.1152/ajpheart.00519.2024">international study</a> led by Monash University researchers found a connection between constipation and an increased risk of heart attacks, strokes and heart failure in a general population.</p> <p>The researchers analysed data from the <a href="https://www.ukbiobank.ac.uk">UK Biobank</a>, a database of health-related information from about half a million people in the United Kingdom.</p> <p>The researchers identified more than 23,000 cases of constipation and accounted for the effect of drugs to treat high blood pressure, which can lead to constipation.</p> <p>People with constipation (identified through medical records or via a questionnaire) were twice as likely to have a heart attack, stroke or heart failure as those without constipation.</p> <p>The researchers found a strong link between high blood pressure and constipation. Individuals with hypertension who were also constipated had a 34% increased risk of a major heart event compared to those with just hypertension.</p> <p>The study only looked at the data from people of European ancestry. However, there is good reason to believe the link between constipation and heart attacks applies to other populations.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/26812003/">Japanese study</a> looked at more than 45,000 men and women in the general population. It found people passing a bowel motion once every two to three days had a higher risk of dying from heart disease compared with ones who passed at least one bowel motion a day.</p> <h2>How might constipation cause a heart attack?</h2> <p>Chronic constipation can lead to straining when passing a stool. This can result in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">laboured breathing</a> and can lead to a rise in blood pressure.</p> <p>In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">one Japanese study</a> including ten elderly people, blood pressure was high just before passing a bowel motion and continued to rise during the bowel motion. This increase in blood pressure lasted for an hour afterwards, a pattern not seen in younger Japanese people.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">One theory</a> is that older people have stiffer blood vessels due to atherosclerosis (thickening or hardening of the arteries caused by a build-up of plaque) and other age-related changes. So their high blood pressure can persist for some time after straining. But the blood pressure of younger people returns quickly to normal as they have more elastic blood vessels.</p> <p>As blood pressure rises, the risk of heart disease increases. The risk of developing heart disease <a href="https://pubmed.ncbi.nlm.nih.gov/12493255/">doubles</a> when systolic blood pressure (the top number in your blood pressure reading) rises permanently by 20 mmHg (millimetres of mercury, a standard measure of blood pressure).</p> <p>The systolic blood pressure rise with straining in passing a stool has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030287/">reported to be</a> as high as 70 mmHg. This rise is only temporary but with persistent straining in chronic constipation this could lead to an increased risk of heart attacks.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/22256893/">Some people</a> with chronic constipation may have an impaired function of their vagus nerve, which controls various bodily functions, including digestion, heart rate and breathing.</p> <p>This impaired function can result in abnormalities of heart rate and over-activation of the flight-fight response. This can, in turn, lead to elevated blood pressure.</p> <p>Another intriguing avenue of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399019/">research</a> examines the imbalance in gut bacteria in people with <a href="https://pubmed.ncbi.nlm.nih.gov/3596341/">constipation</a>.</p> <p>This imbalance, known as dysbiosis, can result in microbes and other substances leaking through the gut barrier into the bloodstream and triggering an immune response. This, in turn, can lead to low-grade inflammation in the blood circulation and arteries becoming stiffer, increasing the risk of a heart attack.</p> <p>This latest study also explored genetic links between constipation and heart disease. The researchers found shared genetic factors that underlie both constipation and heart disease.</p> <h2>What can we do about this?</h2> <p>Constipation affects around <a href="https://pubmed.ncbi.nlm.nih.gov/36826591/">19% of the global population</a> aged 60 and older. So there is a substantial portion of the population at an increased risk of heart disease due to their bowel health.</p> <p>Managing chronic constipation through dietary changes (particularly increased dietary fibre), increased physical activity, ensuring adequate hydration and using medications, if necessary, are all important ways to help improve bowel function and reduce the risk of heart disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237209/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/vincent-ho-141549"><em>Vincent Ho</em></a><em>, Associate Professor and clinical academic gastroenterologist, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/constipation-increases-your-risk-of-a-heart-attack-new-study-finds-and-not-just-on-the-toilet-237209">original article</a>.</em></p>

Body

"My heart is broken": Mariah Carey reveals sad double tragedy

<p>Mariah Carey has revealed a devastating double tragedy, as both her mother and sister passed away on the same day. </p> <p>In a heartbreaking statement to <em><a href="https://people.com/mariah-carey-mom-patricia-sister-alison-both-died-same-day-exclusive-8701561" target="_blank" rel="noopener">People</a></em>, the singer announced the deaths of her mum Patricia, 87, and sister Alison, 63, who died over the weekend. </p> <p>Carey's statement read, "My heart is broken that I've lost my mother this past weekend. Sadly, in a tragic turn of events, my sister lost her life on the same day."</p> <p>"I feel blessed that I was able to spend the last week with my mom before she passed."</p> <p>"I appreciate everyone's love and support and respect for my privacy during this impossible time."</p> <p>No cause of death has been revealed for either member of the family. </p> <p>Carey famously had a turbulent relationship with her mother and sister over the years, and was estranged from Alison for three decades before her untimely death.</p> <p>In 2016, Alison, who was a recovering drug addict, made a plea to her famous sister through the Daily Mail to ask for support, saying, "Mariah I love you, I desperately need your help."</p> <p>As well as substance abuse, Alison endured homelessness throughout her life and tested positive for the HIV virus. </p> <p>Mariah opened up about complicated relationships with her mom and sister in her 2020 memoir, <em>The Meaning Of Mariah Carey</em>.</p> <p>"Like many aspects of my life, my journey with my mother has been full of contradictions and competing realities. It's never been only black-and-white — it's been a whole rainbow of emotions," she explained. </p> <p>She said their relationship was a "prickly rope of pride, pain, shame, gratitude, jealousy, admiration, and disappointment", however the book was still dedicated to Patricia.</p> <p>"And to Pat, my mother, who, through it all, I do believe actually did the best she could," the singer penned in the dedication. "I will love you the best I can, always."</p> <p><em>Image credits: Paul Archuleta/Shutterstock Editorial </em></p>

Family & Pets

Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

<p><em><a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">updated treatment guidelines</a> from the Australian Commission on Safety and Quality in Health Care.</p> <p>So what is knee osteoarthritis and what are the best ways to manage it?</p> <h2>More than 2 million Australians have osteoarthritis</h2> <p>Osteoarthritis is the most common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. It <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">costs the economy</a> A$4.3 billion each year.</p> <p>Osteoarthritis commonly <a href="https://pubmed.ncbi.nlm.nih.gov/33560326/">affects</a> the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.</p> <p>Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.</p> <h2>Is it caused by ‘wear and tear’?</h2> <p>Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is <a href="https://pubmed.ncbi.nlm.nih.gov/31192807/">not caused by</a> “wear and tear”.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/21281726/">Research shows</a> the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">not required</a> to diagnose knee osteoarthritis or guide treatment decisions.</p> <p>Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have <a href="https://pubmed.ncbi.nlm.nih.gov/37795555/">shown this</a> in people with osteoarthritis, and other common pain conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545091/">back</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33789444/">shoulder</a> pain.</p> <p>This has led to a global call for a <a href="https://pubmed.ncbi.nlm.nih.gov/38354847/">change in the way</a> we think and communicate about osteoarthritis.</p> <h2>What’s the best way to manage osteoarthritis?</h2> <p>Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">include</a> education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.</p> <p>Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.</p> <p>Health professionals who use positive and reassuring language <a href="https://pubmed.ncbi.nlm.nih.gov/35750241/">can improve</a> people’s knowledge and beliefs about osteoarthritis and its management.</p> <p>Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/36593092/">paracetamol and anti-inflammatories</a> and can <a href="https://pubmed.ncbi.nlm.nih.gov/26488691/">prevent or delay</a> the need for joint replacement surgery in the future.</p> <p>Many types of exercise <a href="https://pubmed.ncbi.nlm.nih.gov/30830561/">are effective</a> for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.</p> <p>Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.</p> <p>Weight management is important for those who are overweight or obese. Weight loss <a href="https://pubmed.ncbi.nlm.nih.gov/34843383/">can reduce knee pain and disability</a>, particularly when combined with exercise. Losing as little as 5–10% of your body weight <a href="https://pubmed.ncbi.nlm.nih.gov/36474793/">can be beneficial</a>.</p> <p>Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. <a href="https://pubmed.ncbi.nlm.nih.gov/33786837/">Recommended medicines</a> include paracetamol and non-steroidal anti-inflammatory drugs.</p> <p>Opioids are <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">not recommended</a>. The risk of harm outweighs any potential benefits.</p> <h2>What about surgery?</h2> <p>People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.</p> <p>Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.</p> <p>However, high-quality research <a href="https://pubmed.ncbi.nlm.nih.gov/24369076/">has shown</a> arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.</p> <p>Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">53,500 Australians</a> had a knee replacement for their osteoarthritis.</p> <p>Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.</p> <p>The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.</p> <h2>I have knee osteoarthritis. What should I do?</h2> <p>The <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> links to free evidence-based resources to support people with osteoarthritis. These include:</p> <ul> <li>education, such as a <a href="https://www.england.nhs.uk/wp-content/uploads/2023/07/making-a-decision-about-knee-osteoarthritis-v1.pdf.pdf">decision aid</a> and <a href="http://www.futurelearn.com/courses/taking-control-hip-and-knee-osteoarthritis">four-week online course</a></li> <li>self-directed <a href="https://healthsciences.unimelb.edu.au/departments/physiotherapy/chesm/patient-resources/my-knee-exercise">online exercise</a> and <a href="https://myjointyoga.com.au/">yoga</a> programs</li> <li><a href="https://www.gethealthynsw.com.au/program/standard-coaching/">weight management support</a></li> <li>pain management strategies, such as <a href="https://www.myjointpain.org.au/">MyJointPain</a> and <a href="http://www.paintrainer.org/">painTRAINER</a>.</li> </ul> <p>If you have osteoarthritis, you can use the <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> to inform discussions with your health-care provider, and to make informed decisions about your care.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236779/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/belinda-lawford-1294188"><em>Belinda Lawford</em></a><em>, Postdoctoral research fellow in physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, Professor in Physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">original article</a>.</em></p>

Body

From maxing out to slowing down, how much do heart rates vary across sports?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/gregory-peoples-1556509">Gregory Peoples</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>A classic image of the Olympics and Paralympics is an athlete at the end of a race struggling for breath, their heart obviously racing.</p> <p>But at the other end of the scale are athletes such as archers and shooters, who need to slow their heart rates down as much as possible.</p> <p>Athletes in speed and endurance events regularly push their heart rate to the maximum. But these athletes usually have low heart rates at rest.</p> <p>What causes our heart rates and respiratory (breathing) rates to change so much, and is this healthy?</p> <h2>When heart rates and respiratory rates rise</h2> <p>If you are still and calm as you read this, your heart is probably beating 60–100 times per minute and you are likely breathing 12–20 times per minute.</p> <p>These are the <a href="https://theconversation.com/what-should-my-heart-rate-be-and-what-affects-it-98945">normal ranges for a resting adult</a>.</p> <p>During physical activity when muscles are contracting, the muscles need more oxygen to provide them with energy to work.</p> <p>To deliver this extra oxygen (<a href="https://theconversation.com/curious-kids-why-is-blood-red-229121#:%7E:text=Haemoglobin%20is%20like%20a%20red,oxygen%2C%20our%20blood%20is%20red.">carried in our blood</a>), our heart pumps blood faster. In other words, our heart rate increases.</p> <p>We also breathe faster to get more oxygen into our lungs to be delivered to the exercising muscles.</p> <figure><iframe src="https://www.youtube.com/embed/3YOap5k0R_8?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Your resting heart rate can tell you plenty about your health and fitness.</span></figcaption></figure> <h2>How fast can our heart rate get during exercise?</h2> <p>Aerobic means “with oxygen”. In <a href="https://my.clevelandclinic.org/health/articles/7050-aerobic-exercise">aerobic exercise</a> (“cardio”) you use large muscles repetitively and rhythmically. For example, walking, running, cycling, swimming and rowing.</p> <p>Muscles that are contracting during aerobic exercise use a lot of energy and need ten times <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551211/">more oxygen than at rest</a>.</p> <p>High intensity aerobic events that involve large muscles or the entire body cause the highest heart rates.</p> <p>An <a href="https://www.heartonline.org.au/resources/calculators/target-heart-rate-calculator">estimate</a> of maximum heart rate (beats per minute) is 220 minus your age. This equates to 195 beats per minute for a 25-year-old – close to the average age of the Australian Olympic team of 26.5 years.</p> <p>Athletes competing in Olympic events of endurance or speed will reach their maximum heart rate.</p> <p>You can usually only maintain maximum heart rate for a few minutes. But in a 2000-metre rowing race, the rowers maintain intense effort at close to maximum heart rate for 6–8 minutes.</p> <p>This is one of the toughest events for the heart. It’s no wonder rowers often collapse in the boat <a href="https://www.bbc.com/news/uk-england-cambridgeshire-68731840">as they cross the finish line</a>.</p> <p>Highly trained endurance athletes can have a maximum heart rate higher than expected for their age. <a href="https://olympics.com/en/athletes/eliud-kipchoge">Eliud Kipchoge</a> from Kenya is considered the greatest marathon runner of all time. During his <a href="https://au.coros.com/stories?world-record">world record run</a> in the 2022 Berlin marathon, he ran with a heart rate of around 180 beats per minute for almost the entire race.</p> <h2>How does breathing change with exercise?</h2> <p>Our breathing changes with exercise to increase oxygen uptake from the air.</p> <p>At low-to-moderate intensity exercise, you start to take deeper breaths. This brings in more air and oxygen with each breath. However, there is a limit to how much the chest can expand.</p> <p>With higher intensity exercise, respiratory rate increases to increase oxygen intake.</p> <p>Elite athletes can breathe <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818249/">more than 50 times</a> per minute. This is driven by <a href="https://theconversation.com/what-is-breathwork-and-do-i-need-to-do-it-231192">our diaphragm</a>, the most important muscle of breathing.</p> <p><a href="https://www.abc.net.au/news/2024-07-28/paris-olympics-grace-brown-cycling-gold-medal-australia/104151466">Grace Brown</a>, Olympic gold medal cyclist in Paris, <a href="https://inscyd.com/article/grace-brown-olympic-gold-physiology/">breathes close to a maximal oxygen uptake</a> when she is cycling at high intensity.</p> <h2>Some athletes need to slow things down</h2> <p>Archery and shooting athletes perform better with a lower heart rate. They time their shots to be <a href="https://pubmed.ncbi.nlm.nih.gov/3580727/#:%7E:text=Results%20showed%20that%20the%20champion,both%20during%20diastole%20and%20systole">between heart beats</a> when the body is the most still.</p> <p>This is easier with a slower heart rate, with more time between beats.</p> <p>Archers consciously lower their heart rate <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441821/">prior to shooting</a> by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721071/">slowing their breathing</a>.</p> <p>Other Olympians use <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224217/#:%7E:text=For%20practicing%20slow%20and%20deep,minutes%20before%20starting%20the%20exercise.">breathing techniques</a> to calm pre-race anticipation and high heart rates.</p> <p>Slowing the breath, <a href="https://theconversation.com/what-is-breathwork-and-do-i-need-to-do-it-231192">especially the exhale</a>, is the best way to lower your heart rate.</p> <p>Beta-blockers also reduce heart rate, by blocking adrenaline. This is why they are on the <a href="https://www.wada-ama.org/en/prohibited-list">prohibited substances list</a> of the World Anti-Doping Agency.</p> <h2>What about resting heart rates?</h2> <p>Athletes often have a <a href="https://www.health.harvard.edu/heart-health/is-a-low-heart-rate-worrisome">low resting heart rate</a>, around 40-50 beats per minute, and slower during sleep.</p> <p>Some are even lower – five time Tour de France winner Miguel Indurain famously had a resting heart rate of <a href="https://www.cyclingweekly.com/fitness/miguel-indurain-vs-your-body-34288">28 beats per minute</a>.</p> <p>Legendary US swimmer Michael Phelps is the <a href="https://olympics.com/en/news/michael-phelps-olympic-medals-record-how-many-gold-swimmer-world-record">most successful Olympian</a> of all time – he had a resting heart rate of <a href="https://www.reanfoundation.org/low-resting-heart-rate-and-lifespan/#:%7E:text=Studies%20on%20Athletes%20and%20Low%20Resting%20Heart%20Rate&text=It%20could%20also%20hint%20at,BPM%20throughout%20his%20professional%20career">less than 40 beats per minute</a>.</p> <p>Regular moderate-to-vigorous intensity aerobic exercise makes the <a href="https://www.medicalnewstoday.com/articles/athletes-heart-rate">heart stronger and more efficient</a>. A stronger heart pumps more blood per beat, which means it doesn’t need to beat as often.</p> <p>Exercise also <a href="https://pubmed.ncbi.nlm.nih.gov/12477376/">increases vagus nerve</a> activity to the heart and <a href="https://www.nature.com/articles/ncomms4775">slows down</a> the heart’s pacemaker cells. These both reduce heart rate.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306777/">A large review</a> found endurance training and yoga were the best exercises to reduce resting heart rate. But training needs to be maintained to keep resting heart rate low.</p> <p>When elite athletes reduced their training volume by half during COVID lockdown, their <a href="https://www.mdpi.com/2071-1050/13/5/2970">resting heart rate increased</a>.</p> <h2>What does this mean for our health?</h2> <p>A slower resting heart rate is linked to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306777/">longer life expectancy and reduced death from cardiovascular disease</a>. Indeed, <a href="https://bjsm.bmj.com/content/55/4/206">a study</a> of more than 8,000 Olympians from the United States found they lived longer than the general population.</p> <p>So it is healthy to do activities that increase your heart rate in the short-term, whether as an Olympian or Paralympian competing, or a fan with your heart racing watching a gold medal event.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235594/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/gregory-peoples-1556509">Gregory Peoples</a>, Senior Lecturer - Physiology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-maxing-out-to-slowing-down-how-much-do-heart-rates-vary-across-sports-235594">original article</a>.</em></p> </div>

Body

"Bad news": Jimmy Barnes reveals shocking health update

<p>Jimmy Barnes has been taken to hospital after complaining of "unbearable pain" while on the New Zealand leg of his tour. </p> <p>The Aussie rock legend took to Instagram to tell his fans that he would be out of action for six weeks after experiencing pain in his hip that requires surgical intervention. </p> <p>"I’ve got some bad news unfortunately," he started the post. "I had a twinge in my hip when I was leaving Dunedin on Thursday morning and by late last night the pain was unbearable so I went off to hospital."</p> <p>"The doctors have recommended a remedial medical procedure ASAP followed by some physio to address the issue. These doctors don’t muck around! Providing all goes to plan, I’m expected to make a full recovery in six weeks."</p> <p>The 68-year-old then clarified that because of the upcoming surgery, his August and September shows on his <em>Hell of a Time</em> tour would be impacted. </p> <p>"Ticket holders will be contacted with further info in the coming days once we have new plans in place," he said.</p> <p>"As you know, I hate to let anyone down, but I’m also never going to compromise the quality of my gigs. I apologise for the inconvenience this will cause everyone – I HATE moving shows! - but thank you for understanding."</p> <p>Just hours after his post, Jimmy's wife Jane took to his social media accounts to tell his fans that he was out the ICU and "recovering well" while he awaits the procedure. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C-PaHMCT78j/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C-PaHMCT78j/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jimmy Barnes (@jimmybarnesofficial)</a></p> </div> </blockquote> <p>"Jimmy is out of ICU and recovering well. I brought in some healing chicken soup and chocolate chip cookies for afternoon tea, a bit of home always helps hospital days," she said. </p> <p>"Our kids always around watching over us. Full of Love."</p> <p>The health shock comes just months after he underwent open heart surgery for a life-threatening infection, while also following on from a hip replacement surgery Barnes underwent in 2022 after experiencing more pain while performing.</p> <p><em>Image credits: Instagram </em></p>

Caring

Meghan Markle opens up about past trauma

<p>Meghan Markle has opened up about her mental health struggle in a new interview. </p> <p>In a joined interview with <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">her husband Prince Harry for <em>CBS Sunday Morning</em>, </span>the Duchess of Sussex admitted that she hasn't "really scraped the surface" on her struggle, as the couple launched their new project <a href="https://archewell.org/theparentsnetwork/" target="_blank" rel="noopener">The Parents' Network</a>. </p> <p>The Parents’ Network aims to support parents who lost or almost lost their child to cyberbullying and other traumas related to social media use. </p> <p>While speaking about online bullying and its effects on young children, <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">the Duchess of Sussex spoke about her own experience and connection to the families, as she also had suicidal thoughts in 2021. </span></p> <p>“When you’ve been through any level of pain or trauma, I believe part of our healing journey — certainly part of mine — is being able to be really open about it,” she told Jane Pauley. </p> <p>"And you know, I haven't really scraped the surface on my experience. But I do think that I would never want someone else to feel that way," she continued.</p> <p>"And I would never want someone else to be making those sort of plans. And I would never want someone else to not be believed."</p> <p>"So, if me voicing what I have overcome will save someone, or encourage someone in their life to really genuinely check in on them and not assume that the appearance is good, so everything's OK, then that's worth it.</p> <p>"I'll take a hit for that."</p> <p>In a 2021 interview with Oprah Winfrey, Meghan revealed that she had suicidal ideation while pregnant with son Archie due to the pressure of life as a royal and the way the British media treated her. </p> <p>“I just didn’t want to be alive anymore,” she said at the time.</p> <p>She also recalled reaching out to palace officials and said that she did not receive any mental health help. </p> <p>The initiative, launched with the couple’s Archewell Foundation, aims to make sure that no other families go through what they did. </p> <p>“Our kids are young; they’re 3 and 5. They’re amazing,” she told Pauley. </p> <p>“But all you want to do as parents is protect them. And so, as we can see what’s happening in the online space, we know that there’s a lot of work to be done there, and we’re just happy to be able to be a part of change for good.”</p> <p><em>Images: CBS Sunday Morning</em></p>

Caring

92-year-old grandma steals hearts in Paris

<p>Australian judo champion Aoife Coughlan stunned Olympic audiences with a tense showdown against German athlete Miriam Butkereit in Paris, but some audience members had their attention drawn elsewhere. </p> <p>The 28-year-old Aussie was holding her own against Butkereit, until sudden-death overtime saw Butkereit, 30, win at the last second in the women's 70kg judo round of 16.</p> <p>Despite the unbelievable scenes inside Grand Palais Éphémère in Champ de Mars in Paris, some spectators were quick to notice a special guest hovering behind the TV cameras, who has since drawn the world's attention. </p> <p>Coughlan's 92-year-old grandmother Pam Coughlan, from Ireland, scored a prime position mat-side to watch her granddaughter compete, with the judoka's cousin explaining just how his grandmother secured her prime, and unusual, spot on social media.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">My 92 year old granny is at the Olympics today to watch her Australian grandchild in the Judo.</p> <p>She persuaded them to let her sit here. Never doubt the Dublin Granny. <a href="https://t.co/XevdsWxKnt">pic.twitter.com/XevdsWxKnt</a></p> <p>— Mark Coughlan (@Mark_Coughlan) <a href="https://twitter.com/Mark_Coughlan/status/1818561337212977605?ref_src=twsrc%5Etfw">July 31, 2024</a></p></blockquote> <p>"She persuaded them to let her sit here. Never doubt the Dublin Granny," Mark Coughlan wrote on X (formerly Twitter). </p> <p>Wearing sunglasses inside and a red, French-style beret to complete her look, Coughlan's grandmother Pam kept a watchful eye on her granddaughter, with Mark commentating from at home. </p> <p>"Judo is quicker than I knew, and harsh," Coughlan's cousin explained to his social media followers. "Round two 20 minutes after round one: Aoife lost on Judo's equivalent of extra time and penalties in the last minute."</p> <p>"Massive pride. What an achievement. Olympian and hugs from Granny afterwards."</p> <p>Pam Coughlan, Mark said, will "have to do the Paris look-around now" as she did eight years ago, when she flew aged 83 to spectate at Rio 2016.</p> <p>Mark's Twitter thread about his grandmother quickly went viral, with many applauding the older woman for her supportive nature. </p> <p>One fan wrote, "Dublin Granny…need you say more??" while another added, "All olympic grannies who can manage to attend in person should be given front row seats."</p> <p><em>Image credits: Nine </em></p>

Family & Pets

Dr Michael Mosley's wife shares heart-breaking tribute to her late husband

<p>Dr Michael Mosley's widow has shared a heart-breaking tribute to her late husband just weeks after his untimely death. </p> <p>Mosley first went missing while holidaying with his wife, Dr Clare Bailey, on the island of Symi on June 4th, and was tragically found dead five days later. </p> <p>Taking to Instagram on Saturday, Dr Bailey thanked the public for the “wonderfully supportive messages” and revealed that her family misses the father of four “so much.”</p> <p>“The outpouring of love from so many people has meant a huge amount to me and my family,” she wrote alongside a photo of her late husband.</p> <p>“I’m going to be quiet for a while. I’m sure you will understand. But I will be back here soon."</p> <p>Sharing her plans for the future, she added, “I very much want to continue with the work that gave Michael and myself so much joy and such a sense of purpose.”</p> <p>“Once more thank you so much for respecting my family’s privacy so kindly. Michael was an amazing man. Thank you for seeing that too. We miss him so much.” </p> <p>Dr Mosley was a popular TV talking head in the UK and in Australia, who regularly appeared on chat shows and presented documentaries about diet and exercise.</p> <p>Michael and Clare married in 1987 and share four adult children – sons, Dan, Alex and Jack, and daughter, Kate.</p> <p><em>Image credits: Instagram </em></p>

Caring

I’ve been given opioids after surgery to take at home. What do I need to know?

<p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p>Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home.</p> <p>These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence.</p> <p>However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery.</p> <h2>Which types of opioids are most common?</h2> <p>The <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">most commonly prescribed</a> opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).</p> <p>In fact, <a href="https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.16063">about half</a> of new oxycodone prescriptions in Australia occur after a recent hospital visit.</p> <p><a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">Most commonly</a>, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain.</p> <p>Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels.</p> <p>Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box.</p> <p>Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery.</p> <p>Controlling your pain after surgery is <a href="https://www.nps.org.au/assets/4811a27845042173-00a4ff09097b-postoperative-pain-management_36-202.pdf">important</a>. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots.</p> <p>Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover.</p> <h2>But there are also risks</h2> <p>As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over.</p> <p>Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use.</p> <p>But up to <a href="https://pubmed.ncbi.nlm.nih.gov/35545810/">one in ten</a> Australians still take them up to four months after surgery. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/msc.1837">One study</a> found people didn’t know how to safely stop taking opioids.</p> <p>Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect.</p> <p>Dependency and side effects are also more common with <a href="https://www.anzca.edu.au/getattachment/535097e6-9f50-4d09-bd7f-ffa8faf02cdd/Prescribing-slow-release-opioids-4-april-2018#:%7E:text=%E2%80%9CSlow%2Drelease%20opioids%20are%20not,its%20Faculty%20of%20Pain%20Medicine.">slow-release opioids</a> than immediate-release opioids. This is because people are usually on slow-release opioids for longer.</p> <p>Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">more than twice</a> the amount they needed.</p> <p>This results in unused opioids at home, which <a href="https://www.anzca.edu.au/getattachment/558316c5-ea93-457c-b51f-d57556b0ffa7/PS41-Guideline-on-acute-pain-management">can be dangerous</a> to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision.</p> <h2>How to mimimise the risks</h2> <p>Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac).</p> <p>These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed.</p> <p>Other techniques to manage pain include physiotherapy, exercise, <a href="https://theconversation.com/hot-pack-or-cold-pack-which-one-to-reach-for-when-youre-injured-or-in-pain-161086">heat packs or ice packs</a>. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most.</p> <p>However, if you do need opioids, there are some ways to make sure you use them <a href="https://www.safetyandquality.gov.au/sites/default/files/2022-04/opioid-analgesic-stewardship-in-acute-pain-clinical-care-standard.pdf">safely and effectively</a>:</p> <ul> <li> <p>ask for <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16085">immediate-release</a> rather than slow-release opioids to lower your risk of side effects</p> </li> <li> <p>do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing</p> </li> <li> <p>as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen</p> </li> <li> <p>before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time.</p> </li> </ul> <h2>If you’re concerned about side effects</h2> <p>If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include:</p> <ul> <li> <p><a href="https://theconversation.com/health-check-what-causes-constipation-114290">constipation</a> – your pharmacist will be able to give you lifestyle advice and recommend laxatives</p> </li> <li> <p>drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor</p> </li> <li> <p>weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately.</p> </li> </ul> <h2>If you’re having trouble stopping opioids</h2> <p>Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose.</p> <p>You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these.</p> <h2>How about leftover opioids?</h2> <p>After you have finished using opioids, take any leftovers to your local pharmacy to <a href="https://theconversation.com/health-check-what-should-you-do-with-your-unused-medicine-81406">dispose of them safely</a>, free of charge.</p> <p>Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children.</p> <hr /> <p><em>For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has <a href="https://www.choosingwisely.org.au/resources/consumers-and-carers/patient-guide-to-managing-pain-and-opioid-medicines">free online information</a> about managing pain and opioid medicines.</em><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228615/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, Professor, Sydney School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, Senior lecturer, School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-been-given-opioids-after-surgery-to-take-at-home-what-do-i-need-to-know-228615">original article</a>.</em></p>

Body

"Heartbroken and blindsided": The Beast's ex-girlfriend opens up about split

<p>The ex-girlfriend of <em>The Chase</em> star Mark Labbett, also known as The Beast, has opened up about her high-profile break-up with the TV star, slamming his behaviour in the last weeks of their relationship. </p> <p>Hayley Palmer, an entertainment news presenter, announced her <a href="https://oversixty.com.au/lifestyle/relationships/mark-the-beast-labbett-s-girlfriend-drops-major-relationship-bombshell" target="_blank" rel="noopener">split</a> from Labbett just days after their one year anniversary, sharing the news on Instagram in May. </p> <p>Now, in an interview with <a href="https://www.thesun.co.uk/tv/28526452/mark-beast-labbett-hayley-palmer-split/" target="_blank" rel="noopener"><em>The Sun</em></a> newspaper, Palmer took aim at Labbett and his alleged handling of their split, saying she had been “blindsided” by their break-up, and shared how he had lived up to his name as The Beast.</p> <p>“It has come as a complete shock. I thought we were really happy,” she said.</p> <p>“I’m heartbroken and blindsided. His behaviour has been beastly.”</p> <p>Palmer went on to say that Labbett dumped her over a callous three-minute phone call, and said their breakup came because The Beast did not want to formally divorce his ex-wife Katie, who is also his second cousin. </p> <p>She went on to say that before their shock split, Mark — who has a seven-year-old son with his former wife — had even suggested they move in together.</p> <p>But in the days following, a phone call came from Labbett to end their relationship. </p> <p>Struggling to hold back tears, Hayley told the publication, “The call started off as a normal conversation. He was spending time with his son and we’d had a conversation about me joining them at a water park."</p> <p>“Then he said, ‘I don’t know how to tell you this, but you were right. I don’t want to divorce my ex-wife’.</p> <div> <div id="articlempu"></div> </div> <p>“The shock of the way he said it was so brutally cold and not the Mark I know. I thought he was a gentle giant, so this was the complete opposite. He was as cold as ice."</p> <p>“The phone went from my hands, I just hung up on him. I ended up walking around for three hours not knowing where I was going."</p> <p>“I’ll never get over the shock of that, I’m still in shock now. It’s such a hurtful way to do it. The fact that he didn’t have the respect for me, and for him to do it over the phone — it was a really low move."</p> <p><em>Image credits: Instagram </em></p>

Relationships

Major TV star's 7-year-old undergoes third open heart surgery

<p>Jimmy Kimmel's seven-year-old son has undergone his third, and hopefully final open heart surgery after being born with congenital heart disease. </p> <p>In 2017, Jimmy <a href="https://www.youtube.com/watch?v=MmWWoMcGmo0" target="_blank" rel="noopener">revealed</a> that Billy was only three days old when had to undergo his first open heart surgery, after doctors found “a hole in the wall of the left and right side of his heart” that was preventing enough oxygen from reaching his blood. </p> <p>Billy was only seven months old when he had to undergo his second open heart surgery, and over the weekend he had to undergo his third major surgery at the Children's Hospital Los Angeles. </p> <p>A few days later, the TV host took to Instagram to share an update following his son's successful surgery. </p> <p>"We went into this experience with a lot of optimism and nearly as much fear and came out with a new valve inside a happy, healthy kid," Kimmel wrote, alongside a picture of his youngest son smiling in a hospital bed. </p> <p>He then thanked all the surgeons, doctors and other medical staff who "came through for us with immeasurable kindness and expertise." </p> <p>"Walking around this hospital, meeting parents at their most vulnerable, children in pain and the miracle workers who do everything in their considerable power to save them is a humbling experience," Kimmel continued.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jimmy Kimmel (@jimmykimmel)</a></p> </div> </blockquote> <p>He then highlighted the hospital's dedication to providing help to families "regardless of their ability to pay". </p> <p>Jimmy then extended his thanks to his family and friends and the "loving strangers who took time to pray for and send positive energy to our baby".</p> <p>He gave a special shout out to his wife Molly – for "being stronger than is reasonable for any Mum to be". The pair also share daughter Jane, nine. </p> <p>The late night TV host then praised his son for being "the toughest (and funniest) 7 year-old we know."</p> <p>"There are so many parents and children who aren't fortunate enough to go home after five days," he added and encouraged his followers to send their thoughts and prayers to these families. </p> <p><em>Image: Instagram/ X</em></p> <p> </p>

Caring

Step up: take the stairs to help your heart

<p>Climbing stairs is associated with a longer life, according to research presented this week at an annual meeting of Europe’s leading cardiologists.</p> <div class="copy"> <p>The systematic review of 9 previous studies covering nearly 500,000 participants investigated whether climbing stairs as a form of physical activity could play a role in reducing the risks of <a href="https://cosmosmagazine.com/science/biology/how-organ-on-a-chip-technology-is-revolutionising-the-way-we-study-cardiovascular-disease/">cardiovascular diseases</a> and premature death.</p> <p>Study author Dr Sophie Paddock, of the Norfolk and Norwich University Hospital Foundation Trust, UK, says: “if you have the choice of taking the stairs or the lift, go for the stairs as it will help your heart”.</p> <p>“Even brief bursts of physical activity have beneficial health impacts, and short bouts of stair climbing should be an achievable target to integrate into daily routines.”</p> <p>Cardiovascular diseases (CVDs) are a group of disorders of the hearth and blood vessels. They are the leading cause of non-communicable disease death globally, with 17.9m people estimated to have died of one in 2019 alone. Physical inactivity is one of the most important behavioural risk factors for developing CVDs. More than 1 in 4 adults do not meet the global <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity" target="_blank" rel="noreferrer noopener">recommended levels</a> of physical activity.</p> <p>The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049418/" target="_blank" rel="noreferrer noopener">meta-analysis</a> on the best available science covered 480,479 individuals aged 35-84 years old. 53% of participants were women.</p> <p>Stair climbing was significantly associated with a 24% reduced risk of dying from any cause and a 39% lower likelihood of dying from cardiovascular disease, compared to not climbing stairs.</p> <p>It was also linked to a reduced <a href="https://cosmosmagazine.com/health/covid-19-impacts-on-cardiac-health/">risk of CVDs</a> including heart attack, heart failure and stroke.</p> <p>“Based on these results, we would encourage people to incorporate stair climbing into their day-to-day lives,” says Paddock.</p> <p>“Our study suggested that the more stairs climbed, the greater the benefits – but this needs to be confirmed. So, whether at work, home, or elsewhere, take the stairs.”</p> <p>The research was presented to <a href="https://www.escardio.org/Congresses-Events/Preventive-Cardiology" target="_blank" rel="noreferrer noopener">ESC Preventive Cardiology 2024</a>, an annual congress of the European Association of Preventive Cardiology in Greece this week.</p> <p><em>Image credits: Shutterstock </em></p> <div> <p align="center"> </p> </div> <p><em><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=302751&title=Step+up%3A+take+the+stairs+to+help+your+heart" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em></div> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/health/body-and-mind/step-up-take-the-stairs-to-help-your-heart/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto/">Imma Perfetto</a>. </em></p> </div>

Body

Menopause can bring increased cholesterol levels and other heart risks. Here’s why and what to do about it

<p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Menopause is a natural biological process that marks the end of a woman’s reproductive years, typically between 45 and 55. As women approach or experience menopause, common “change of life” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9244939/">concerns</a> include hot flushes, sweats and mood swings, brain fog and fatigue.</p> <p>But many women may not be aware of the <a href="https://pubmed.ncbi.nlm.nih.gov/32705886/">long-term effects</a> of menopause on the heart and blood vessels that make up the cardiovascular system. Heart disease accounts for <a href="http://world-heart-federation.org/what-we-do/women-cvd/">35% of deaths</a> in women each year – more than all cancers combined.</p> <p>What should women – and their doctors – know about these risks?</p> <h2>Hormones protect hearts – until they don’t</h2> <p>As early as 1976, the <a href="https://pubmed.ncbi.nlm.nih.gov/970770/">Framingham Heart Study</a> reported more than twice the rates of cardiovascular events in postmenopausal than pre-menopausal women of the same age. Early menopause (younger than age 40) also <a href="https://pubmed.ncbi.nlm.nih.gov/25331207/">increases heart risk</a>.</p> <p>Before menopause, women tend to be protected by their circulating hormones: oestrogen, to a lesser extent progesterone and low levels of testosterone.</p> <p>These sex hormones help to relax and dilate blood vessels, reduce inflammation and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503403/">improve lipid (cholesterol) levels</a>. From the mid-40s, a decline in these hormone levels can <a href="https://pubmed.ncbi.nlm.nih.gov/10362825/">contribute to unfavourable changes</a> in cholesterol levels, blood pressure and weight gain – all risk factors for heart disease.</p> <h2>4 ways hormone changes impact heart risk</h2> <p><strong>1. Dyslipidaemia</strong>– Menopause often involves <a href="https://pubmed.ncbi.nlm.nih.gov/38002671/">atherogenic changes</a> – an unhealthy imbalance of lipids in the blood, with higher levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL-C), dubbed the “bad” cholesterol. There are also reduced levels of high-density lipoprotein (HDL-C) – the “good” cholesterol that helps remove LDL-C from blood. These changes are a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503403/">major risk factor for heart attack or stroke</a>.</p> <p><strong>2. Hypertension</strong> – Declines in oestrogen and progesterone levels during menopause contribute to narrowing of the large blood vessels on the heart’s surface, arterial stiffness and <a href="https://pubmed.ncbi.nlm.nih.gov/35722103/">raise blood pressure</a>.</p> <p><strong>3. Weight gain</strong> – Females are born with one to two million eggs, which develop in follicles. By the time they <a href="https://www.thewomens.org.au/health-information/fertility-information/getting-pregnant/ovulation-and-conception">stop ovulating</a> in midlife, fewer than 1,000 remain. This depletion progressively changes fat distribution and storage, from the hips to the waist and abdomen. Increased waist circumference (greater than 80–88 cm) has been <a href="https://pubmed.ncbi.nlm.nih.gov/18359190/">reported to contribute to heart risk</a> – though it is <a href="https://theconversation.com/good-news-midlife-health-is-about-more-than-a-waist-measurement-heres-why-226019">not the only factor to consider</a>.</p> <p><strong>4. Comorbidities</strong> – Changes in body composition, sex hormone decline, increased food consumption, weight gain and sedentary lifestyles impair the body’s ability to effectively use insulin. This <a href="https://pubmed.ncbi.nlm.nih.gov/11133069/">increases the risk</a> of developing metabolic syndromes such as type 2 diabetes.</p> <p>While risk factors apply to both genders, hypertension, smoking, obesity and type 2 diabetes confer a greater relative risk for heart disease in women.</p> <h2>So, what can women do?</h2> <p>Every woman has a different level of baseline cardiovascular and metabolic risk pre-menopause. This is based on their genetics and family history, diet, and lifestyle. But all women can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351755/">reduce their post-menopause heart risk with</a>:</p> <ul> <li>regular moderate intensity exercise such as brisk walking, pushing a lawn mower, riding a bike or water aerobics for 30 minutes, four or five times every week</li> <li>a healthy heart diet with smaller portion sizes (try using a smaller plate or bowl) and more low-calorie, nutrient-rich foods such as vegetables, fruit and whole grains</li> <li>plant sterols (unrefined vegetable oil spreads, nuts, seeds and grains) each day. A review of 14 clinical trials found plant sterols, at doses of at least 2 grams a day, produced an average reduction in serum LDL-C (bad cholesterol) of about 9–14%. This could reduce the risk of heart disease by <a href="https://pubmed.ncbi.nlm.nih.gov/10731187/">25% in two years</a></li> <li>less unhealthy (saturated or trans) fats and more low-fat protein sources (lean meat, poultry, fish – especially oily fish high in omega-3 fatty acids), legumes and low-fat dairy</li> <li>less high-calorie, high-sodium foods such as processed or fast foods</li> <li>a reduction or cessation of smoking (nicotine or cannabis) and alcohol</li> <li>weight-gain management or prevention.</li> </ul> <h2>What about hormone therapy medications?</h2> <p>Hormone therapy remains the most effective means of <a href="https://pubmed.ncbi.nlm.nih.gov/15495039/">managing hot flushes and night sweats</a> and is beneficial for <a href="https://pubmed.ncbi.nlm.nih.gov/18418063/">slowing the loss of bone mineral density</a>.</p> <p>The decision to recommend oestrogen alone or a combination of oestrogen plus progesterone hormone therapy depends on whether a woman has had a hysterectomy or not. The choice also depends on whether the hormone therapy benefit outweighs the woman’s disease risks. Where symptoms are bothersome, hormone therapy has <a href="https://pubmed.ncbi.nlm.nih.gov/33841322/">favourable or neutral effects on coronary heart disease risk</a> and medication risks are low for healthy women younger than 60 or within ten years of menopause.</p> <p>Depending on the level of stroke or heart risk and the response to lifestyle strategies, some women may also require medication management to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8351755/">control high blood pressure or elevated cholesterol levels</a>. Up until the early 2000s, women were underrepresented in most outcome trials with lipid-lowering medicines.</p> <p>The <a href="https://pubmed.ncbi.nlm.nih.gov/25579834/">Cholesterol Treatment Trialists’ Collaboration</a> analysed 27 clinical trials of statins (medications commonly prescribed to lower cholesterol) with a total of 174,000 participants, of whom 27% were women. Statins were about as effective in women and men who had similar risk of heart disease in preventing events such as stroke and heart attack.</p> <p>Every woman approaching menopause should ask their GP for a 20-minute <a href="https://www.health.gov.au/news/heart-health">Heart Health Check</a> to help better understand their risk of a heart attack or stroke and get tailored strategies to reduce it.</p> <p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/menopause-can-bring-increased-cholesterol-levels-and-other-heart-risks-heres-why-and-what-to-do-about-it-228010">original article</a>.</em></p>

Body

What are heart rate zones, and how can you incorporate them into your exercise routine?

<p><em><a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>If you spend a lot of time exploring fitness content online, you might have come across the concept of heart rate zones. Heart rate zone training has become more popular in recent years partly because of the boom in wearable technology which, among other functions, allows people to easily track their heart rates.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537749/">Heart rate zones</a> reflect different levels of intensity during aerobic exercise. They’re most often based on a percentage of your maximum heart rate, which is the highest number of beats your heart can achieve per minute.</p> <p>But what are the different heart rate zones, and how can you use these zones to optimise your workout?</p> <h2>The three-zone model</h2> <p>While there are several models used to describe heart rate zones, the most common model in the scientific literature is the <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">three-zone model</a>, where the zones may be categorised as follows:</p> <ul> <li> <p>zone 1: 55%–82% of maximum heart rate</p> </li> <li> <p>zone 2: 82%–87% of maximum heart rate</p> </li> <li> <p>zone 3: 87%–97% of maximum heart rate.</p> </li> </ul> <p>If you’re not sure what your maximum heart rate is, it can be calculated using <a href="https://www.jacc.org/doi/full/10.1016/S0735-1097%2800%2901054-8">this equation</a>: 208 – (0.7 × age in years). For example, I’m 32 years old. 208 – (0.7 x 32) = 185.6, so my predicted maximum heart rate is around 186 beats per minute.</p> <p>There are also other models used to describe heart rate zones, such as the <a href="https://journals.humankinetics.com/view/journals/ijspp/14/8/article-p1151.xml">five-zone model</a> (as its name implies, this one has five distinct zones). These <a href="https://journals.humankinetics.com/view/journals/ijspp/9/1/article-p100.xml">models</a> largely describe the same thing and can mostly be used interchangeably.</p> <h2>What do the different zones involve?</h2> <p>The three zones are based around a person’s <a href="https://link.springer.com/article/10.2165/00007256-200939060-00003">lactate threshold</a>, which describes the point at which exercise intensity moves from being predominantly aerobic, to predominantly anaerobic.</p> <p>Aerobic exercise <a href="https://www.healthline.com/health/fitness-exercise/difference-between-aerobic-and-anaerobic">uses oxygen</a> to help our muscles keep going, ensuring we can continue for a long time without fatiguing. Anaerobic exercise, however, uses stored energy to fuel exercise. Anaerobic exercise also accrues metabolic byproducts (such as lactate) that increase fatigue, meaning we can only produce energy anaerobically for a short time.</p> <p>On average your lactate threshold tends to sit around <a href="https://www.tandfonline.com/doi/full/10.2147/OAJSM.S141657">85% of your maximum heart rate</a>, although this varies from person to person, and can be <a href="https://journals.physiology.org/doi/full/10.1152/japplphysiol.00043.2013">higher in athletes</a>.</p> <p>In the three-zone model, each zone loosely describes <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2015.00295/full">one of three types of training</a>.</p> <p><strong>Zone 1</strong> represents high-volume, low-intensity exercise, usually performed for long periods and at an easy pace, well below lactate threshold. Examples include jogging or cycling at a gentle pace.</p> <p><strong>Zone 2</strong> is threshold training, also known as tempo training, a moderate intensity training method performed for moderate durations, at (or around) lactate threshold. This could be running, rowing or cycling at a speed where it’s difficult to speak full sentences.</p> <p><strong>Zone 3</strong> mostly describes methods of high-intensity interval training, which are performed for shorter durations and at intensities above lactate threshold. For example, any circuit style workout that has you exercising hard for 30 seconds then resting for 30 seconds would be zone 3.</p> <h2>Striking a balance</h2> <p>To maximise endurance performance, you need to strike a balance between doing enough training to elicit positive changes, while avoiding over-training, injury and burnout.</p> <p>While zone 3 is thought to produce the largest improvements in <a href="https://www.sciencedirect.com/science/article/pii/S1440244018309198">maximal oxygen uptake</a> – one of the best predictors of endurance performance and overall health – it’s also the most tiring. This means you can only perform so much of it before it becomes too much.</p> <p>Training in different heart rate zones improves <a href="https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=38c07018c0636422d9d5a77316216efb3c10164f">slightly different physiological qualities</a>, and so by spending time in each zone, you ensure a <a href="https://link.springer.com/article/10.1007/bf00426304">variety of benefits</a> for performance and health.</p> <h2>So how much time should you spend in each zone?</h2> <p>Most <a href="https://www.frontiersin.org/articles/10.3389/fspor.2023.1258585/full">elite endurance athletes</a>, including runners, rowers, and even cross-country skiers, tend to spend most of their training (around 80%) in zone 1, with the rest split between zones 2 and 3.</p> <p>Because elite endurance athletes train a lot, most of it needs to be in zone 1, otherwise they risk injury and burnout. For example, some runners accumulate <a href="https://journals.humankinetics.com/view/journals/ijsnem/22/5/article-p392.xml?content=pdf">more than 250 kilometres per week</a>, which would be impossible to recover from if it was all performed in zone 2 or 3.</p> <p>Of course, most people are not professional athletes. The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization</a> recommends adults aim for 150–300 minutes of moderate intensity exercise per week, or 75–150 minutes of vigorous exercise per week.</p> <p>If you look at this in the context of heart rate zones, you could consider zone 1 training as moderate intensity, and zones 2 and 3 as vigorous. Then, you can use heart rate zones to make sure you’re exercising to meet these guidelines.</p> <h2>What if I don’t have a heart rate monitor?</h2> <p>If you don’t have access to a heart rate tracker, that doesn’t mean you can’t use heart rate zones to guide your training.</p> <p>The three heart rate zones discussed in this article can also be prescribed based on feel using a simple <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2004.00418.x">10-point scale</a>, where 0 indicates no effort, and 10 indicates the maximum amount of effort you can produce.</p> <p>With this system, zone 1 aligns with a 4 or less out of 10, zone 2 with 4.5 to 6.5 out of 10, and zone 3 as a 7 or higher out of 10.</p> <p>Heart rate zones are not a perfect measure of exercise intensity, but can be a useful tool. And if you don’t want to worry about heart rate zones at all, that’s also fine. The most important thing is to simply get moving.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228520/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/hunter-bennett-1053061">Hunter Bennett</a>, Lecturer in Exercise Science, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-heart-rate-zones-and-how-can-you-incorporate-them-into-your-exercise-routine-228520">original article</a>.</em></p>

Body

Surgery won’t fix my chronic back pain, so what will?

<p><em><a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>This week’s ABC Four Corners episode <a href="https://www.abc.net.au/news/2024-04-08/pain-factory/103683180">Pain Factory</a> highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain.</p> <p>The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain.</p> <p><a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">One in five</a> Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated <a href="https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx">A$139 billion a year</a>, including $12 billion in direct health-care costs.</p> <p>The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work?</p> <h2>Opioids and invasive procedures</h2> <p>Treatments offered to people with chronic pain include strong pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/30561481/">opioids</a> and invasive procedures such as <a href="https://pubmed.ncbi.nlm.nih.gov/36878313/">spinal cord stimulators</a> or <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14120">spinal fusion surgery</a>. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm.</p> <p><a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06900-8">Spinal fusion surgery</a> and <a href="https://privatehealthcareaustralia.org.au/consumers-urged-to-be-cautious-about-spinal-cord-stimulators-for-pain/#:%7E:text=Australian%20health%20insurance%20data%20shows,of%20the%20procedure%20is%20%2458%2C377.">spinal cord stimulators</a> are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual.</p> <h2>Addressing the contributors to pain</h2> <p>Recommendations from the latest <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/low-back-pain-clinical-care-standard">Australian</a> and <a href="https://www.who.int/publications/i/item/9789240081789">World Health Organization</a> clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as:</p> <ul> <li>education</li> <li>advice</li> <li>structured exercise programs</li> <li>physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.</li> </ul> <p>Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain.</p> <p>The interventions have minimal side effects and are cost-effective.</p> <p>In the <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">RESOLVE</a> trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move.</p> <p>In the <a href="https://pubmed.ncbi.nlm.nih.gov/37146623/">RESTORE</a> trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it.</p> <h2>Why isn’t everyone with chronic pain getting this care?</h2> <p>While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session <a href="https://www.sira.nsw.gov.au/__data/assets/pdf_file/0005/1122674/Physiotherapy-chiropractic-and-osteopathy-fees-practice-requirements-effective-1-February-2023.pdf">can cost</a> $90–$150.</p> <p>In contrast, <a href="https://www.servicesaustralia.gov.au/chronic-disease-individual-allied-health-services-medicare-items">Medicare</a> provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions.</p> <p>Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs.</p> <p>Access to trained clinicians is another barrier. This problem is particularly evident in <a href="https://www.ruralhealth.org.au/15nrhc/sites/default/files/B2-1_Bennett.pdf">regional and rural Australia</a>, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited.</p> <p>Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/data-file-57-opioid-medicines-dispensing-2016-17-third-atlas-healthcare-variation-2018">rate of opioid use</a>, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas.</p> <h2>So what can we do about it?</h2> <p>We need to reform Australia’s health system, private and <a href="https://www.health.gov.au/sites/default/files/documents/2020/12/taskforce-final-report-pain-management-mbs-items-final-report-on-the-review-of-pain-management-mbs-items.docx">public</a>, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments.</p> <p>Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian <a href="https://pubmed.ncbi.nlm.nih.gov/38461844/">trial</a>, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain.</p> <p>Advocacy and <a href="https://pubmed.ncbi.nlm.nih.gov/37918470/">improving the public’s understanding</a> of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227450/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/christine-lin-346821"><em>Christine Lin</em></a><em>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/fiona-blyth-448021">Fiona Blyth</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/james-mcauley-1526139">James Mcauley</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/surgery-wont-fix-my-chronic-back-pain-so-what-will-227450">original article</a>.</em></p>

Body

“I told him not to open it": Flight attendant forced to hold plane door shut

<p>A flight attendant was forced to hold an emergency exit door shut after an allegedly drunk passenger tried to open it shortly after takeoff. </p> <p>Footage shows a female flight attendant with one hand on the plane’s roof and another holding the lever of the emergency exit, after a man allegedly tried to pull it open during their flight from Qingdao, China on Saturday, according to the <em>New York Post</em>. </p> <p>“I told him not to open it,” the flight attendant said to another colleague in Chinese, according to <em>JAM Press</em>. </p> <p>Her colleague then asks the passenger: “Sir, did you open this?”</p> <p>The male passenger looked confused as he started gesturing at the lever. </p> <p>“Why did you open it? Didn’t you know it is prohibited to open this kind of thing?” the flight attendant asked again. </p> <p>But the passenger ignored him and looked down at his phone, as the male flight attendant continued to question him. </p> <p>The passenger eventually admitted that he had been drinking before he tried to grab the lever, and the man eventually had to change seats with another passenger sitting in the same row. </p> <p>He was allowed to remain on the flight, which managed to land safely at Harbin, China without incident.</p> <p><em>Images: New York Post</em></p> <p> </p>

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Surgery won’t fix my chronic back pain, so what will?

“I told him not to open it": Flight attendant forced to hold plane door shut