Antidepressants Blog

What is it?

A condition of the gums that causes them to become inflamed, resulting in the loosening and eventual loss of teeth.

Three-quarters of those over the age of 35 have gum disease, at least to some degree, and nearly half of all 60-year-olds have lost teeth as a result of it. Tooth decay is what wrecks children’s teeth but in adults gum disease is to blame.

What causes it?

Gum disease, like dental caries, is caused by a bacterial coating of plaque. This collects all the time along the gum line and, if it is not removed once a day, builds up to produce inflammation of the gums. Gums that are affected in this way bleed on brushing (healthy gums never bleed) and start to recede, making the teeth look longer. The fibres that tether the teeth into the jawbone weaken and eventually the affected tooth falls out.

The problem with gum disease is that you often do not even realize you have it until you start to notice bad breath, bleeding gums or loose teeth. Treatment is uncomfortable and time-consuming.

There is one specific cause of gum disease:

• Poor, or insufficient, cleaning of the teeth. Plaque has to be removed at least once a day if it is not to build up and cause gum disease.

Other contributory causes are:

• A lack of vitamin C. There is evidence that this vitamin protects against gum infections but no one knows why. Certainly vitamin Ñ is known to play a vital role in combating infection generally but it seems to be exceptionally valuable in gum disease.

• Certain foods produce a transitory inflammation of the gums which can be very painful indeed. These are usually nitrate-containing foods (preserved meats and other meats that have large amounts of preservative in them). The condition is self-limiting when you stop eating the foods.

• Stress. Some people have serious gum inflammation at a time of high stress in their lives. Drugs and oral surgery can cure the condition but obviously prevention is better.

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A high blood level of fat—the correct medical term for it is hyper-lipidemia—is a broad term covering several conditions in which one or other of the different types of fat in the blood is raised. I have referred throughout the book to cholesterol, but this is a simplification.

It may be helpful here to explain the jargon around cholesterol and blood lipids. Cholesterol and triglycerides, the two prominent fats, or lipids, are carried around in the bloodstream by lipoproteins, which are combinations of protein and fat. The lipoproteins are classified according to their densities, so that very low-density lipoproteins are VLDL, low-density lipoproteins are LDL, intermediate-density lipoproteins are IDL, and high-density lipoproteins are HDL, sometimes called the “good” cholesterol.

The higher the LDL in the blood, the greater the risk of angina and heart attack; it seems that LDL is the substance that carries the cholesterol and triglycerides into the atheromatous plaques. In contrast, the higher the HDL, the lower the risk of heart attack. HDL seems to carry away the cholesterol from the bloodstream into the liver, where it is broken down into bile acids and excreted in the feces. VLDL does not appear to affect coronary risk much, if at all; IDL may make it worse, but LDL is the main villain.

There are at least five different forms of hyperlipidemia, and several different types of lipid-lowering drugs available to correct them. Among them are:

• Bile acid sequestrants

• Niacin and other nicotinic acid derivatives

• Fibrates

• Statins

• Marine triglycerides

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I want to offer a list of the practical benefits of stopping smoking, according to the time since you stopped. It should support your decision, and help to maintain you as a smoke-free zone!

Within 20 minutes of stopping

• Your blood pressure decreases to the normal range.

• Your pulse slows down to a normal rate.

• The temperature of your fingers and toes rises to normal. After eight hours

• Carbon monoxide levels in the blood return to normal.

• Blood oxygen levels return to normal.

After one day

• The chances of your having a heart attack have diminished.

After two days

• Your senses of smell and taste are heightened.

• Your coronary vessels are much wider.

• Your blood is much less likely to clot.

After three days

• Your many branching airways (the bronchi and the bronchioles) are opened up.

• You are breathing easier.

• Your heart is much more efficient and less strained. After two weeks to three months

• Walking is easier.

• You can exercise for much longer.

• Your circulation in your feet and fingers is much improved. After nine months

• Your lungs are free of tars.

• You no longer have a morning cough.

After five years

• Your annual lung cancer death risk has dropped from 137 to 72 per 100,000.

After ten years

• Your annual risk of death from lung cancer has dropped to 12 per 100,000.

• You are also at much less risk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreas.

So enjoy the fact that you are now a nonsmoker. You have probably saved your life by making the decision.

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I wrote about Body Mass Index (BMI) in chapter 4. If you are overweight (with a BMI above 27) and have angina, it is best to lose enough weight to return to the 20-25 BW range.

One reason for losing weight is that your heart then has less work to do at rest and during exercise, so the demand for blood flow through your coronary arteries falls. Even if that drop in demand is slight, every little improvement in the supply-demand equation counts. Fat people are more likely to have angina and a heart attack than thin people, but the relationship is not straightforward. Many thin people also have heart attacks.

Nevertheless, it is better to be of normal weight than to be overweight, even if obesity of itself is not a direct cause of coronary disease. If you are overweight, you are likely to have a higher blood cholesterol level than normal, and your blood pressure is likely to be raised, too. In the process of losing weight, you may return both cholesterol and blood pressure to normal. You will also feel better, and be happier about the way you look. Being at ease with your looks can help to relieve underlying anxieties, which in themselves are an extra demand on the heart.

How should you lose weight? There are only three choices open to you. You must exercise more, eat less, or do both. If your angina is severe, then you must exercise under supervision at first, to the best of your ability, but try to gauge it to a level just below that which brings on angina. Eating less is more difficult for people who have eaten well all their lives. Perhaps the most important advice on eating is to forget about the social convention that you should eat three meals a day. You only need one main meal a day: the rest can be in small snacks taken only when you feel hungry.

Do you think you cannot make this big change? Then consider the problem of the Japanese sumo wrestler when he retires. During his fighting years he builds up his enormous weight by grossly overeating. If he continues to eat in the same way after retirement, his life expectancy is very short. So, he returns to the normal Japanese style of eating, and the extra weight falls away. Within a year, most are not recognizable as former sumo wrestlers! If they can do it, so can you!

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A crucial group within the British Regional Heart Study were those who already had signs of heart disease when they were first enrolled in the survey in 1978. Doctors tended to believe at that time that once a heart attack had occurred, there was little point in trying to reduce the risks by altering lifestyle, because the damage to the heart was already done, and couldn’t be undone or reversed.

The study showed, on the contrary, that the risk factors still mattered. Even after a heart attack, those with higher cholesterol and blood pressure levels were at higher risk than their colleagues in whom they were lower. It was concluded from this that even after an attack it was wise to keep the risks as low as possible, by whatever means possible.

It is often said, mostly by those who do not wish to change their own lives, that many heart attack victims do not have any identifiable risk factors, such as smoking, a high blood cholesterol level, or high blood pressure: the British Regional Heart Study disproved that.

In the study, men with either:

• a serum cholesterol level equal to or above 230mg/dl

• a systolic blood pressure equal to or above 148 mm Hg

• a diastolic blood pressure equal to or above 93 mm Hg or who:

• currently smoked cigarettes

had twice the risk of a heart attack than the others.

Only 5 of the 202 cases of major heart attack in the British Regional Heart Study did not meet one of these criteria, and over two-thirds of them met at least two of them. Of the five men not meeting the criteria, three had evidence of a previous heart attack.

So only one in a hundred of the cases of heart attack possessed none of the risk factors listed, and this does not take into account previous smoking habit, treatment for high blood pressure, or a change in eating habits that might have lowered serum cholesterol. Here is how Professor Shaper (1988), the author of the study, sees it: “It would appear that major coronary heart disease events virtually do not occur in middle-aged British men in the absence of at least one significantly increased risk factor.”

I would add two corollaries to that statement. The first is that it surely applies to women as well. The second is that if anyone with angina wishes to avoid a heart attack, and at the same time lessen his or her angina, then the best way to go about it must surely be to lose any current risk factor. The next chapters show you exactly how to do that.

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Your heart is simply a pump. The left side of the heart pumps blood through your body; the right side pumps blood through your lungs. The principle is easy to understand. Oxygen is picked up by the blood going through the lungs, and distributed to the tissues, where it is used to burn up glucose to give you energy. The waste product of that energy, carbon dioxide, is picked up by the veins and carried to the right side of the heart, where it is pumped to the lungs and exchanged for more oxygen.

These are the straight facts, but they can give us no possible idea of how the heart carries out its job. No mechanical pump could perform as efficiently as the heart. No engineer can yet make a pump that acts around seventy times a minute for more than seventy years, meanwhile maintaining and repairing itself, supplying its own fuel— and not once, in all that time, breaking down or stopping for a rest!

In fact, there is no other muscle in the body like the heart. See how long you can continue to use your hand muscles without stopping. Grip a soft rubber ball in your stronger hand and squeeze it and relax just a little faster than once a second. Keep going for as long as you can. If you can manage five minutes before you tire then this is a good score. A trained athlete might last thirty minutes or more. Think of doing it day and night, without rest or sleep, for seventy years!

Yet that is what the heart does, all through your life. Most people never give it a second thought, but those who become aware of their heart beating can become neurotic about it, and their lives can be ruined. The first man-made heart valves used to ping with every beat, and their owners could hear it plainly, especially when everything was quiet at night. It was, to say the least, disturbing.

Never giving the heart a thought, however, has its downside. Taking it completely for granted can mean letting it become unhealthy. The more you understand about your heart, the better you can take care of it, and the less frightened you will be if things start to go wrong.

The first thing to understand is that the heart is a muscle, the myocardium (myo = muscle, cardia = heart). It differs from all other muscles in the body in its astonishing ability to recover extremely quickly from its previous contraction, or beat. It completes its cycle of shortening and lengthening within a fifth of a second, then has three- or four-fifths of a second to recover, to enable it to contract again..

In that vital resting time, the heart muscle reorganizes itself so that it can shorten again without tiring. In beating, it uses oxygen taken from the blood to convert the glucose within its stores into the energy needed for the contraction. In the rest between beats, each muscle fiber must take up more oxygen and glucose from the blood to replace the amounts lost in the previous contraction, and prepare it for the next contraction.

This constant flow of oxygen and glucose from bloodstream to myocardium is essential to life. Without them, the heart complains—and it usually does that via pain. And if the supply of oxygen and glucose to that particular part of the myocardium is not quickly restored, then that part of the muscle will die. The pain is called angina, but the death of the muscle is called infarction—or, in plain language, a heart attack. Keep the supply of oxygen and glucose enough to fulfill the demands of the heart, and it will keep going for the intended seventy-plus years.

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Here’s an unusual bit of information: according to researchers at William Beaumont Hospital in Royal Oak, Michigan and the University of Michigan at Ann Arbor, older people who drink coffee have more active sex lives than those who don’t.

The researchers surveyed almost 800 men and women age 60 and older and learned that women who drank at least one cup of coffee per day were more likely to be sexually active than those women who drank less or no coffee at all. Men who drank at least one cup of coffee daily were less likely to be impotent, according to the survey.

Researchers say that caffeine, which is a central nervous system stimulant, may be responsible for boosting sexual drive. They also say that older people who are healthy enough to drink coffee may simply be better able to perform sex than those seniors who are in poor health.

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While it’s nice to know that doctors are there when you need them, it’s even better to know that you don’t need to visit them very often. You do have a good deal to say in the matter because, to a large extent, you can control the state of your overall health. By following several guidelines, you can cut down on your trips to the doctor and enjoy good health.

1) Adopt a healthy life-style, and increase your awareness of health risk factors.

2) Maintain a healthful diet with plenty of fruits and vegetables.

3) Get regular exercise— at least 3 or 4 times a week.

4) Don’t smoke or abuse alcohol or drugs.

5) Get regular health check-ups by medical professionals.

6) Ask the nurse for suggestions over the phone for problems that are not serious.

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The U.S. Department of Agriculture (USDA) recently concluded a S1 million study which uncovered some potentially troubling news for margarine users. The study, which was partially funded by the shortening industry, found that oils used in margarine, vegetable shortening and many other products, including cookies, cakes, and crackers, may raise blood cholesterol levels which could in turn promote heart disease.

The potential problem appears to center around trans fatty acids which are produced when food manufacturers convert vegetable oils to margarine or shortenings that are solid or semisolid. According to the Agriculture Department’s study, the trans fatty acids raised blood cholesterol levels in almost the same way as certain saturated fatty acids. An earlier Dutch study had indicated that trans fatty acids tend to increase the harmful elements in cholesterol and lower its protective elements.

While this new data released by the USDA is rather disturbing, experts say it is still too early to make a definite link between the increase in cholesterol levels and heart disease. Researchers caution that the USDA’s findings are preliminary, and should not lead consumers to avoid products such as margarine and vegetable shortening altogether. The best advice is to watch your overall fat intake and eat a balanced diet.

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To prevent hot-water burns when you take a shower or bath, always turn on the cold water first and turn off the hot water first.

If your shower releases a sudden rush of hot water whenever a cold water tap is turned on or a toilet is flushed, you are at risk of a potentially dangerous scalding. Many times fluctuating water temperature is merely a nuisance, but there are times when the resulting thermal shock from a rush of scalding hot water or a burst of cold water can cause serious accidents and injuries.

According to the National SAFE KIDS Campaign, more than 5,000 children are scalded each year with more than two-thirds of those victims under the age of five. Since their skin is so delicate, children who are exposed to 140 degree water for only 3 seconds, can, receive third-degree burns. You can correct fluctuating water temperature and reduce the risk of thermal shock by installing a temperature-control or pressure-balance^ mixing valve.

Pressure balance valves control water temperature and eliminate shocks by compensating for pressure variances in the water line. This type of valve works best if there are no fluctuations in the temperature of the water supply itself.

Thermostatic valves use a thermal element which adjusts water flow based on temperature fluctuations. A thermostatic valve will maintain water temperature regardless of whether a temperature change is due to pressure fluctuations or to a change in the temperature 0f the water supply. If there is a complete loss of either hot or cold water pressure, thermostatic valves will shut down.

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