Ask Dr. H: Coughing is no help for heart attack
Question: I received an e-mail that describes coughing as a way of saving your life in the event of a heart attack. Does that actually work?
Question:
I received an e-mail that describes coughing as a way of saving your life in the event of a heart attack. Does that actually work?
Answer: No, with very rare exceptions. What you read is an e-mail that's been circulating since 1999. Not only will it not work in most instances when a person is experiencing a possible heart attack, but it could make things much worse.
The idea is that if a person was in cardiac arrest with a life-threatening heart arrhythmia, the act of forceful and repeated coughing could, in theory, increase pressure inside the chest cavity and assist the heart's pumping of blood, briefly preventing a loss of consciousness.
The American Heart Association does not endorse this technique for several reasons: First, it only works in the setting of a life-threatening heart arrhythmia; since most people experiencing chest pain do not know if they're about to pass out, the act of coughing will increase the heart rate and add stress to an already injured heart.
Second, chewing and swallowing one adult-strength (325 mg.) aspirin at the moment of a suspected heart attack is a far more effective strategy; it can help prevent a massive clot from clogging a cardiac artery.
Third, even if an experienced person knew he was having a heart arrhythmia where the coughing effort might help, coughing at an incorrect time during the cardiac cycle might make the situation lethal.
Fourth, calling for help and resting quietly is a much safer general approach.
For more details about the cough-CPR e-mail you got, go to www.snopes.com and search for "cough."
No evidence that glucosamine heightens risk of diabetes
Q:
Is there any link between taking glucosamine sulfate for arthritis and a higher risk of developing diabetes or a worsening of one's blood sugar? I've read conflicting articles about whether glucosamine can cause insulin resistance and subsequently raise blood sugar. I'd like to know because of my personal history of diabetes.
A: While research in rats has shown some evidence that taking glucosamine sulfate can worsen insulin resistance and lead to slightly higher blood sugars, this effect has not been shown to occur in any human studies. Insulin resistance means that the body has a decreased sensitivity to the effect of the blood-sugar-lowering hormone insulin. This effect is what occurs in type 2 diabetes and pre-diabetes.
The National Institutes of Health recently published the results of a large study - 1,583 participants at 16 centers - of the effectiveness of glucosamine and chondroitin in treating the pain of osteoarthritis of the knees. While glucosamine/chondroitin did not show any overall benefit in either slowing the destruction of knee cartilage or reducing arthritis pain compared to a placebo pill, it did show superiority over placebo in relieving pain in a small subset of moderate/severe arthritis sufferers.
Although the two-year Glucosamine/Chondroitin Arthritis Intervention Trial, known as GAIT, was not designed to evaluate glucose, no meaningful change in blood sugar or insulin resistance was seen.