DEAR DR. ROACH: My very healthy husband collapsed and died on the way to the hospital. They worked on him for a long time but could not revive him. They didn’t do an autopsy, and they declared his death as “atherosclerotic vascular disease.” He was 79 years old and had no health problems. He came into the house and said that something was in his throat and he couldn’t swallow. He tried to cough it up, but nothing came up. He then collapsed. He had no pain. I am still puzzled by that symptom of a heart attack. Have you ever heard of that? I am really curious and still in shock. I hope you can explain. — T.S.
ANSWER: I am very sorry to hear about your husband. I think he likely did have a heart attack, which is the leading cause of death in the industrialized world.
Although many people have symptoms of heart disease that they ignore, some people have no symptoms until sudden death. Atherosclerosis, hardening of the arteries due to cholesterol plaque and calcium in the blood vessels of the heart, almost always is present in people with a heart attack.
The initial symptom of a heart attack varies widely. Throat discomfort is not rare. Cough is a common symptom, as the heart becomes damaged and the pressure in the lungs increases. The classic symptom of chest pain certainly does happen, but there are many variations. Both men and women can have atypical presentations. • • •
DEAR DR. ROACH: My husband has Parkinson’s disease. He also has a stent in his heart. We have been to many doctors to address a breathing problem: fast breathing. He experiences this daily, and we are told that it is anxiety. It is difficult to watch him go through this. It sometimes happens before he is due for his Sinemet, but other times right after taking it.
He has been prescribed Xanax, clonidine, cannabidiol-infused gummies and a few others. One doctor says it is from Parkinson’s, but the rest say it is anxiety. — E.W.
ANSWER: Shortness of breath can have many causes, but someone with Parkinson’s disease has an unusual possibility, called “respiratory dyskinesia” (which just means “abnormal movement of the muscles of breathing”). This is an involuntary rapid breathing that causes distress, and it usually happens an hour after taking a medication like Sinemet. Changing the dose can help with diagnosis, and working with a neurologist to adjust the dose of the Sinemet (which comes in fast-acting and slow-release formulations) can solve the problem. I would start with an expert on Parkinson’s. Keeping a diary of when he takes his medication and when the breathing trouble starts and stops will be helpful, as would a video of what it looks like when happening.
Having Parkinson’s doesn’t make someone less likely to have other causes of shortness of breath, and anyone with a stent in the heart (meaning a history of blockages of at least one heart artery) is at risk of developing further blockages. Poor blood flow to the heart is another potential cause. Get the Parkinson’s evaluation first.
I would not recommend anti-anxiety medications unless there is clear evidence of benefit. Ascribing a physical symptom like shortness of breath to anxiety without a thorough workup is unwise.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
October is Fire Prevention month. This year we celebrate Fire Prevention Week from October 6 – 12. This year’s theme is “Not Every Hero Wears a Cape. Plan and Practice Your Escape.” (NFPA, 2019). Many think of the hero’s only being firefighters or the First Responders. But you can be a hero to your family by simply practicing good fire safety skills in the home. Here are some things that you can do this month to help prevent fires in your home but also be prepared in the event a fire would happen.
First, make sure you have working smoke alarms in your home. You should have a smoke alarm in each sleeping area, the hallway outside the sleeping area and one on each floor. Make sure the smoke alarm is less than 10 years old, if not, replace it. Check the batteries regularly and replace them twice a year. Having working smoke alarms in the home reduce the risk of dying in a fire by half.
Second, make sure you have at least one carbon monoxide detector in the home. It should be centrally located in the home and it too should be less than 10 years old. Check the batteries in it regularly. Change the batteries twice a year. The best way to remember to change batteries in smoke and CO detectors is at the time changes. In the fall when we fall back in time and again in the spring when we spring ahead.
Plan with your family two ways out of every room in the home. Have a meeting place outside where everyone goes to too assure accountability. This allows everyone in the home the comfort of knowing everyone is out and accounted for. Have a fire drill throughout the year. Block a window or a door. Have one at night and time it. This will give you a good idea how long it would take to exit.
By doing these things you are the hero your family needs. If you have any questions or comments I can be reached at Dpaulson@cityofdubuque.org or 563-589-4195.
Get your Flu Shot Brought to you by Delaware County Public Health
Delma Hardin, BSN, RN, Public Health Coordinator
Influenza or the flu is a contagious disease that can be spread by coughing, sneezing, or nasal secretions. Symptoms may include fever, cough, sore throat, headache, muscle aches, fatigue, or a runny or stuffy nose. The flu can cause high fever and pneumonia and make existing health conditions worse.
Getting your yearly flu shot is very important to protect yourself from influenza or “the flu.” All people are at risk but especially adults 65+, children, pregnant women, and those with chronic health issues. There are many flu viruses and they are always changing, which is why getting your annual vaccination is so important.
“We encourage everyone to get their yearly flu shot and to take advantage of public flu shot clinics,” shared Delma Hardin, Delaware County Public Health Coordinator. You can find the schedule of upcoming flu shot clinics at regmedctr.org/flushots.
Enjoying Winter Squash Now and Months to Come
Fall is here, and that means there is a large selection of winter squash in the stores and markets. The yellow and orange colored flesh are rich in vitamins, such as beta-carotene, making them a nutritious addition to any meal. Unlike its summer counterparts, winter squash is harvested at a mature age, which makes the skin hard and inedible. However, the skin is protective and increases the shelf life. Winter squash can be stored for several months. Acorn and spaghetti squash, about 1 month. Butternut, 2 to 3 months. Hubbard and turban types, 3 to 6 months. There are so many different varieties and possibilities!
Selecting Squash:
Look for squash that feels heavy for its size and has a hard, blemish free skin. Skin color variations do not affect the flavor of squash.
Preparing Squash:
Rinse under cool water. Use a sharp knife to cut off the stem end. To cut in half, grasp firmly and slice through the center, lengthwise. Flip over and cut the other side until the squash falls open. Remove seeds. Pierce the rind multiple times with a fork.
Cooking:
Bake— Place cut side down and bake at 350°F for 45 minutes or until tender.
Microwave— Place halves or quarters cut side down in a shallow microwave safe dish. Add ½ cup of water and microwave 5-10 minutes depending on size of squash.
Boil or Steam— Cut into quarters and steam 25 minutes or until tender, or boil like you would potatoes.
Roast— Use a vegetable peeler to peel the halves or carefully use a knife to cut off the peel. Cut into 1-inch cubes. Toss with oil, salt, pepper, garlic powder or other desired seasonings. Place in a single layer on a baking sheet. Roast at 400°F, tossing occasionally, until just tender and golden brown, about 30 minutes.
Try our Butternut Squash Enchiladas recipe today! Visit the Spend Smart Eat Smart website or phone app for recipe and more preparation tips! https://spendsmart.extension.iastate.edu
Adapted from Iowa State University Extension and Outreach Spend Smart Eat Smart - How to Prepare Winter Squash; and AnswerLine Blog Article– Winter Squash
• Here’s a way to remove stickers, especially ones that don’t tear off. Rub labels with straight white vinegar or soak a paper napkin with vinegar and lay it over the label. Let it sit for 10 minutes, then remove. You should be able to rub the adhesive right off. Reapply if necessary. • Mirrors make a room feel larger, because they reflect space, essentially doubling the visual area. But for maximum impact, experts say to hang your mirror on the wall adjacent to your window, not across from it.
• Y.L. in North Carolina writes: “I was sorting out tools in the shed and didn’t realize that rust had gotten all over my T-shirt and shorts. Any tips?” You can try this, Y.L., and remember never to machine dry an item until the stain is gone, as it may set the stain. For rust, apply lemon juice to the stain, and then sprinkle with cream of tartar from your kitchen and rub it into the fabric. Allow the clothing to sit until the stain is gone, and then launder as usual. Good luck!
• “Oh, that grease buildup on top of the cabinets is terrible. But you can make cleaning up a snap with this tip: All you need to do to keep the tops of your cabinets clean is line them with waxed paper. Some people use newspaper, but I like waxed paper.” — W.T. in Kentucky
• “When you shop for shoes, go in the evening. Feet swell and expand throughout the day, so if you buy shoes in the morning, the fit might not feel too good later in the day.” — A.T. in Louisiana
• Can’t seem to get organized in the kitchen? Start with baby steps. For instance, every time you put away groceries, check your fridge and freezer to see if there are any expired items that are ready for the refuse bin. Also, pull items from the freezer that have been in there for a while, and defrost them. Now, that’s what’s for dinner!
• “To give rooms the illusion of extra height, hang curtains from a spot very near the ceiling. The long vertical lines of the fabric draw the eye up. It can be enough to make a very small room look and feel a little more spacious.” — R.
Send your tips to Now Here’s a Tip, 628 Virginia Drive, Orlando, FL 32803.
This quick and easy chicken recipe is ready in less than 30 minutes.
Olive oil nonstick cooking spray 1/2 cup panko (Japanese-style breadcrumbs) 1/8 teaspoon ground red pepper (cayenne) Salt and pepper 1/2 cup walnuts, toasted and cooled 1/4 cup fresh parsley leaves, loosely packed 1 large egg white 1 teaspoon Dijon mustard 1 1/2 pound chicken-breast cutlets, thinly sliced
1. Heat oven to 450 F. Place rack in 15 1/2-by-10 1/2-inch jelly-roll pan; spray pan and rack with cooking spray.
2. On large dinner plate, combine panko, ground red pepper, 1/2 teaspoon salt and 1/4 teaspoon freshly ground black pepper. In food processor with knife blade attached, blend walnuts and parsley until nuts are finely chopped; toss with panko mixture until well-blended. Set aside.
3. In pie plate, whisk egg white and Dijon until well-mixed.
4. One at a time, dip 1 side of each cutlet in egg-white mixture, then into walnut mixture to coat side evenly; press firmly so mixture adheres. Arrange chicken on rack in jelly-roll pan, coated-side up; lightly spray with cooking spray.
5. Bake chicken 10 to 12 minutes or until topping is golden-brown and chicken is no longer pink throughout. Serves 6.
• Each serving: About 215 calories, 8g total fat (1g saturated), 66mg cholesterol, 280mg sodium, 5g total carbohydrate, 1g dietary fiber, 29g protein.
A filling soup is a welcome change from the same old sandwiches, wouldn’t you agree? Well then, spice up your day by savoring a bowl of this at lunchtime!
8 ounces extra-lean ground turkey or beef 1/2 cup chopped green bell pepper 1/2 cup chopped onion 10 ounces (one 16-ounce can) red kidney beans, rinsed and drained 1 cup (one 8-ounce can) tomato sauce 2 cups peeled and chopped fresh tomatoes 2 cups water 2 tablespoons chili seasoning
1. In a large saucepan sprayed with olive oil-flavored cooking spray, brown meat, green pepper and onion. Stir in kidney beans, tomato sauce, tomatoes and water. Add chili seasoning. Mix well to combine.
2. Bring mixture to a boil. Lower heat and simmer for 15 to 20 minutes, stirring occasionally. Freezes well. Makes 4 (1-1/2 cup) servings.
