Kutlwano Magazine

Health Tips

Heart Attack

11 December, 2012

Article by: Dr Billy M. Tsima The words ‘heart attack’ always instil fear. It signify a medical emergency and a scare for dear life. In many Western countries, heart attacks claim the lives of thousands of people every year and are the commonest cause of death in those countries. In Botswana, heart attacks are overtaken by other diseases and conditions such as HIV/AIDS and road traffic accidents, as leading causes of death. Although the problem does not seem so big in this country, it is still a problem that needs to be recognised. There is still a lot of misconception about heart attacks despite continued efforts to educate people about this disease. A lot of people believe that heart attack is a disease of the developed countries and does not pose any real threat for those in developing countries like Botswana. However, the World Health Organisation (WHO) estimated that of all the deaths caused by diseases such as heart attack and stroke in 2008, four out of five of these deaths occurred in the developing world. These figures are frightening and should be a cause of concern for us in the developing world. What is a heart attack? A heart attack is a sudden damage to the heart muscle. It occurs when blood supply to the heart through the small blood vessels surrounding the heart suddenly and rather abruptly become blocked. When this happens, little or no blood reaches some parts of the heart muscle. As a result of lack of blood supply, the heart muscle gets damaged and begins to die. This is associated with pain felt on the chest. This mechanism is similar to what happens when someone has a stroke where blood supply of the brain is disturbed by either a clot or a bleeding blood vessel. What causes a heart attack? A heart attack is a result of diseases of the blood vessels that supply the heart with nutrients and oxygen. These very important blood vessels are affected by the food we eat and our lifestyles also contribute to the health of the blood vessels. Fat from fatty food becomes deposited inside these blood vessels and cause them to become narrow and hardened. A rupture or cut in the attached fat deposits causes blood clots to form within the walls of the blood vessels. By forming these clots, the size of the blood vessel is reduced and less and less blood is able to pass through. When this occurs suddenly, a heart attack takes place. What are the risk factors for heart attacks? The risk factors for heart attack are many. Most of these risk factors are things we can control. It is thought that more than 80% of the risk factors for heart attack are behavioural. Unhealthy diets including food rich in cholesterol and other fats are generally bad for your health. Lack of exercise is also responsible for developing heart attacks. The benefit of regular exercise is not only on maintaining an ideal body weight but also for the health of your heart. Thirty minutes of moderately intensive exercise such as walking up to five times a week is all that is needed to reap the benefits of physical activity. The use of tobacco from smoking and alcohol also puts you at risk for developing heart attacks. Illegal drugs like cocaine are also known to cause death by heart attack. Other diseases like diabetes and high blood pressure eventually lead to increased risk for having a heart attack. The risk for heart attacks increases with age and men appear to be at greater risk than women. Family history also has an impact. What are the symptoms of heart attack? The main symptom is chest pain. The pain is usually severe, crushing and felt in the centre of the chest. The pain may appear to travel to the back, the neck, the jaw and the left arm. Other people describe the pain as a discomfort rather than pain per se, as if something is sitting on ones chest. Sometimes there is a feeling of nausea as though you are about to vomit. There may also be breathing difficulties and abnormal sweating. In the worst case scenario, there is sudden collapse and death. What should I do if I experience these symptoms? A heart attack is a medical emergency and so medical attention should be sought as soon as possible if one experiences symptoms suggestive of a heart attack. It is imported to go to the nearest hospital or call ambulance emergency number as soon as possible. Chest pain does not always mean that you are having a heart attack. There are many other causes of chest pain that mimic a heart attack. However, if the chest pain or discomfort lasts for more than ten minutes you should assume that it signifies a heart attack and therefore call for help. If you are not allergic to Aspirin and you have it available, you should chew or sallow one tablet while waiting for the ambulance. You should never wait for the next day to seek help if you suspect that your heart could be in trouble. Is it possible to have a heart attack and not realise it? It is possible to have a “silent” heart attack. About 20% of people who have heart attacks are not aware that they are having one as they experience no pain at all. This group of people include those who have diabetes. The damage to the heart may only be picked up from blood tests or a heart tracing called the ECG. Are there any tests to diagnose heart attacks? Usually several tests are done to find out if a heart attack has occurred. These need to be repeated over time. The test may be negative immediately after a heart attack but may become positive as time passes by. The damaged heart muscle releases certain enzymes in to the blood and it is the presence and quantity of these enzymes that suggest that indeed a heart attack has occurred. A heart tracing (ECG) will show characteristic changes if a heart attack has occurred. How can heart attacks be prevented? Prevention is always better than cure. Prevention is often simple and straight forward but also requires discipline and motivation. It is recommended that heart attacks should be prevented by taking part in regular physical activity (exercises) avoiding tobacco as well as second-hand tobacco smoke(non smokers get exposed to tobacco smoke by being in a smoking environment,) eating a diet rich in fruits and vegetables. In addition foods high in fat, sugar and salt should be avoided as much as possible. As our nation strives to be a healthier one by the year 2016, let us all seriously consider exercising and healthy eating habits as part of the map to 2016. We can overcome a lot of health risks like heart attacks by choosing healthier lifestyles.

The sun and its damage to your skin

06 December, 2012

We all occasionally enjoy a bright and sunny day. Many of us would prefer a day out in the sun rather than a gloomy overcast day indoors. Summer is associated with fun-filled and vibrant endless days. It’s a time when most people like to take vacation from work and spend time in the great outdoors to come closer to nature. There is no doubt that the sun helps to sustain our lives. It is hard to imagine life without the brilliance of the sun. Although the sun has so many good things to offer, intensive exposure to sunlight can be a dangerous thing. The skin, which is a natural way of protecting us against the elements, gets the brunt of this sun damage. We therefore need to strike a balance between too much sun exposure and adequate exposure in our day to day life. What is sun damage? Did you know that the skin is the largest organ in the body? It not only the largest organ but is also responsible for many important functions that keeps us alive and healthy. When the skin is exposed regularly and intensely to the sun, it eventually gets damaged. The skin is made up of different layers with different overall functions. Within these layers there is the pigment (colouring) called melanin that is responsible for the colour of your skin. The more melanin there is, the darker the skin appears. Melanin helps to prevent the damage that is done by exposure to sunlight. Whenever the skin is exposed to too much sunlight, it produces more melanin to provide more protection against the sun. This is the reason why the skin turns darker after prolonged exposure to sunlight. This is what is often referred to as suntan. When sun exposure continues repeatedly over time, the skin prematurely begins to show signs of aging. This damage appears as melanin production and deposits in the skin becomes uncontrolled and results as uneven dark spots. The sun also tends to make the skin dry and to look like leather rather its usual smooth texture. Certain rays (Ultraviolent-UV) from the sun can penetrate the deep layers of the skin and damage those parts which are responsible for maintaining the elasticity of the skin. When this happens, the skin tends to fold back on itself and appear to have wrinkles. Naturally wrinkles appear as part of the aging process but with sun damage, it occurs even in young people. Sun damage can also results in skin cancer. Skin cancer is not only limited to the skin as it can spread and affect other organs in the body. Skin cancer is a serious disease and is responsible for many deaths across the world every year. Can people with dark skin get sun damage as well? The answer is yes. People with dark skin have more melanin in their skin and therefore are able to cope better with exposure to the sun than people with light or fair skin. However sun exposure leads to the same results in both groups of people as there is a limit to the level of protection your skin can provide against the sun. In the end in all types of skin, regardless of colour, sun exposure results in painful sunburn and in the long run results in skin damage. In people with dark skin, it may not be easy to notice the colour change caused by sunburn but there is still some underlying damage occurring. What symptoms suggest that I have sunburn or sun damage? All exposed parts of the body can get sunburn or sun damage. The signs and symptoms of sunburn can appear immediately after intense exposure or may appear after a number of days have elapsed since the intensive exposure. The skin may look red or dark pink and may be painful and tender to touch. There may be blisters formed in areas of skin that had been under intense sun exposure. Sometimes the skin feels hot to touch and appears to have some swelling. After a few days following intense sun exposure, the skin attempts to heal itself by shedding off its outer later to allow for new undamaged top layer to regenerate. As the skin peels off in this manner, the colour of the skin becomes irregular with some dark and light patches visible. Can I get sunburn during cloudy days? Indeed, sunburn can occur even when clouds in the sky are covering the sun. Ultraviolet (UV) is responsible for the damage. Although clouds act as barriers to the sun and offer shade against it, up to 90% of the UV light is able to filter through the clouds and still cause sunburn. The UV light can also bounce off reflective surfaces like water and sand, to cause as much damage as direct sunlight. How do I avoid sun damage? The best way of avoiding sun damage is to avoid sun exposure. However this is unrealistic as we also need some sunlight for our health and our day to day living. To strike the balance we can avoid sun exposure during the time when the sun rays are intense. The sun rays are the strongest from 10am to 4pm. If you cannot avoid exposure during this period, it is important to limit the time that you are exposed during these peak times. When working out in the sun during these peak hours, you should cover up your skin as much as possible. You should also wear a hat and sunglasses if you are out in the sun during the peak hours. You should read the labels on the sunglasses to make sure that they offer protection against UV light. This is usually written as 99% or 100% UV protection. Even if your skin is dark, you should use sunscreen if you can afford it, to further protect your skin from UV light. The degree of sun protection given by the type of sunscreen is usually written as an SPF number. SPF stands for “Sun Protection Factor”. The number is an indication of the number of times longer you can stay in the sun with the sunscreen on before your skin becomes red compared to when you don’t have the sunscreen on. For example, an SPF of 5 means that if your skin would normally get red in 15 minutes in the sun without the sunscreen, then with the sunscreen of SPF of 5 it would take 75 minutes (15x5) to get the same degree of redness. Generally, the higher the SPF number, the better the protection against UV light. What should I do if I get sunburn? The first aid approach to most burns is to provide cooling to the affected area. For sunburn, the best way to do this is by applying cold compresses. This can be done by applying a clean towel that has been dipped into cold water over the affected area. Alternatively you can run cold water over the area. You can also apply a moisturising cream over the area. If there are any blisters in the skin, you should avoid breaking them up. Burnt skin looses a lot of water and may cause dehydration. It is important to drink plenty of water to compensate for the water lost through the burnt skin. You should see your health care provider if the symptoms of the sunburn are severe or don’t respond to the simple first aid measures.