Breathing exercises

We breathe in and out roughly 25,000 a day, but most of us breathe too rapidly and too shallowly. Experts say that doing a better job of breathing can improve your health and well-being. Specifically, it can help reduce blood pressure, regulate your heart, and lift your mood. You can even reduce chronic pain, stress, depression, and bolster fitness and energy levels. One study found that breath work helped recovering Covid-19 patients return to healthy respiratory rates. Another found that breathing exercises were as effective as drugs to treat anxiety disorders.

At rest, your breathing should be slow and steady—between 12 and 20 breaths per minute. Slowing it to between five and seven breaths per minute at rest provides the benefits listed above. By slowing your breathing down, the parasympathetic system—the ‘rest and digest system—takes over and helps calm you down.

Here are three recommended exercises:

4-4-8 breathing (good for when you’re anxious or scared): Take a breath in for four counts, hold your breath for four counts, then exhale for eight counts. Repeat. The long exhale quickly slows your heart rate and brings your blood pressure down. (Apparently, extending the exhale is something your body naturally does every five minutes or so as a way to reset the breathing rhythm and calm down.)

Alternate nostril breathing (helps improve focus): Close your right nostril and breathe in through your left nostril for a count of four; then close your left nostril and breathe out from your right nostril for a count of four. Apparently the right nostril is connected to the sympathetic system (fight or flight), while the left nostril is connected to the calmer parasympathetic system.

Box breathing (enhances cognitive focus): Breathe in for a count of four, hold your breath for a count of four, exhale for a count of four and hold your breath again for a count of four. This method forces your breathing into a steady rhythm, keeping you alert and energized. The U.S. Navy Seals use this technique before combat.

I’m a believer in this breathing stuff and use the 4-4-8 method when the situation calls for it. For more on why deep breathing calms us, click this link.

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New, improved treatment for strokes

 To begin with, there are two kinds of stroke: 1)  ischemic, which is a clot in one of the brain’s blood vessels that’s blocking oxygen to parts of the brain; 2) hemorrhagic, which is blood flowing where it shouldn’t be, causing brain cells to die. Eighty-five percent of all strokes are the ischemic variety and are the type of strokes I’m talking about here.

The new treatment is called endovascular thrombectomy (EVT). A thrombectomy is the removal of a clot. To perform the thrombectomy, the physician opens the femoral artery in the patient’s groin and threads a microcatheter through the body and up into the patient’s brain. The device grabs the clot and drags it out. In the most successful cases, the patient—who may have been partially paralyzed—recovers within hours. The procedure more than doubles the odds of a stroke patients’ returning to an independent life, and nearly triples the odds of making a complete recovery.

The trick to getting the best results are a combination of quick action, a coordinated effort, and the facilities and expertise to perform the procedure. In the best situations, someone has quickly called an ambulance, and the paramedics are trained to identify the scope of the problem, starting with asking questions such as “Can you smile for me?” and “Can you raise both your arms in the air?” Depending on the answers, the paramedic can determine if the stroke is likely to be a large vessel occlusion, making the patient a strong contender for EVT. (About five to 15 percent of stroke patients turn out to be candidates for an endovascular thrombectomy.) Once in the hospital’s stroke center, specialized teams perform the necessary procedures, beginning with a CT scan to locate the clot.

Traditionally, stroke patients have been treated with clot-busting drugs, which increase the risk of brain bleeds and which need to be given within about four hours of the stroke. Clot-busting drugs improve the long-term outcome for one in three stroke patients. The new, EVT, treatment is superior, but it’s not available everywhere. (John Fetterman had the procedure.)

I was curious to see if our local hospital’s stroke center performed the procedure. First, I went to their website and couldn’t find the information. Then I tried calling, and was never able to reach a person. I went back to their website and finally found, under “excellence awards,” an award for their “endovascular interventions.” Good to know, but I hope I never need the "intervention."

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Masks unmasked

 The Cochrane group recently produced a report that includes the following words: “Wearing masks in the community probably makes little or no difference to the outcome of laboratory-confirmed influenza/SARS-CoV-2 compared to not wearing masks.” The Cochrane group is a global network of scientists and others who study the best evidence from research to determine whether treatments actually work. They have 37,000 contributors from more than 130 countries who work together to produce credible health information free from commercial sponsorship.

For the mask study, the researchers pored through published studies, selecting only those that meet their requirements for reliability. They select only randomized controlled trials—a way to examine cause-effect relationships between an intervention and outcome. For the mask trials, the researchers used 12 trials (276,917 participants) that compared those who wore medical/surgical masks with those who did not.

One of he report’s authors told a reporter that “there is just no evidence that they make any difference.” The Cochrane report itself includes the following statement: “There is uncertainty about the effects of face masks. The low to moderate certainty of evidence means our confidence in the effect estimate is limited.” Nevertheless, the report does, finally, state, “The pooled results of randomized controlled trials did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks.” In the end, they say, more and better studies are needed.

As you can imagine, there's been blowback about this result, which appeared in The New York Times. Some people involved with the Cochrane organization have issued qualifying statements, saying that the wording in the report was open to misinterpretation, and that the review couldn't arrive at a firm conclusion because there weren't enough high-quality randomized trials with high rates of mask adherence. 

As one who wears a mask only when required, I rather like the study’s conclusion. On the other hand, I have no gripe with those who have mandated mask-wearing. They were working with the best information available and were taking no chances. Maybe they were right, maybe not.

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Do you need to detox?

 “Wellness” entrepreneurs, such as Gwyneth Paltrow, sell products that supposedly cleanse your body of harmful toxins. (According to MedlinePlus, toxins are substances created by plants and animals that are poisonous to humans, including bacteria, lead, and other chemicals.) Most detoxing regimens consist of liquid diets consisting mainly of vegetable and fruit juices. (Paltrow’s includes milk thistle extract.) As a professor of medicine at Johns Hopkins says, “People have this magical impression that what’s in the body are weapons of mass destruction, and somehow flushing them out is going to make them better.”

One popular cleanse, the Master Cleanse, combines lemon juice, cayenne pepper, and maple syrup. As the promoter of this cleanse reports on his Web site, “If you experience symptoms like cravings, fatigue, irritability, headaches, pains, nausea, vomiting, hot bowel movements... congratulations! That means you were supertoxic, and the cleanse is working.”

Judith Newman, a New York Times journalist tried a juice cleanse: “I believed that for $65 a day, BluePrintCleanse would set me right. …That green juice? It was like drinking everything bad that ever happened to me in high school. …The next three days could be summed up thus: 1. I need food. 2. Hey, this isn’t bad! 3. Kill me now.”

The thing is, we don’t need to cleanse and detoxify. As a dietician at Cleveland Clinic tells us, “Our body’s such a beautiful machine that it self-regulates.” Our bodies have plenty of filters. Our kidneys livers, skin and bladders all work to remove toxins and waste. Dr. David Colbert, New York interest says, “You have to ask yourself this question: With a juice cleanse, what are you really cleaning? Really, nothing. The bowel self-cleans. It’s evolved over millions of years to do this.” Besides, our bodies want and expect food.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.