How to Talk to Your Doctor About Statin Intolerance
(Family Features) If your doctor has concerns about your cholesterol levels, you may be familiar with statins. This is a class of medications that can help reduce your body’s cholesterol production, lowering your risk of heart attack or stroke. However, up to 30% of adults in the United States have some degree of statin intolerance, according to research published in the “Journal of Clinical Lipidology.” Possible signs or symptoms of statin intolerance are muscle aches and cramps, fatigue, weakness, elevated liver enzymes and the onset of diabetes or impaired glucose tolerance. As a result, nearly one-third of patients (29%) discontinue their statin within the first year, according to findings published in the “American Journal of Cardiology.” Unfortunately, patients with statin intolerance are at an increased risk of cardiovascular disease, including higher rates of coronary heart disease and recurrent heart attack. Lowering Bad Cholesterol A diagnosis of high cholesterol involves measuring low-density lipoprotein (LDL) cholesterol, which is commonly referred to as “bad” cholesterol because it leads to the accumulation of plaque in your arteries. Plaque reduces your blood flow, which can cause damage to your cardiovascular system. Bloodwork is the best indicator of your cholesterol levels, since you may not experience any symptoms of high cholesterol until you already have damage and buildup in your arteries. To help create your treatment plan, talk to your doctor about your medical history, including whether you’ve had a heart attack or any heart procedures, such as a stent placement or bypass surgery. You’ll also review current medications, recent lab results and notes on any symptoms you may be experiencing. Your doctor is likely to recommend a series of steps to reduce your cholesterol. Some common recommendations include a healthy diet low in saturated and trans fats and high in fiber, especially fruits, vegetables and whole grains. If you’re not already getting regular physical activity, your doctor will likely encourage you to get at least 30 minutes of exercise daily, find ways to include more movement in your everyday lifestyle and, if necessary, work toward shedding extra weight. Lifestyle changes can help but may not make a big enough impact to reduce cholesterol to a recommended level. In those cases, doctors rely on cholesterol-lowering medications such as statins. Statins can be highly effective at reducing bad cholesterol, making them a powerful tool to reduce the risks associated with heart disease. When Statins Are Intolerable or Aren’t Enough For a variety of reasons, including intolerance to the medication, other health conditions or interactions with other medications, statins may not be the right choice for everyone. “While statins remain the gold standard for cholesterol lowering, I often see patients who either can’t or won’t take a statin, as well as patients who require further LDL cholesterol reduction,” said Guy L. Mintz, Director of Cardiovascular Health & Lipidolology at Northwell Health System. “For those patients, I prescribe non-statin medications, such as NEXLETOL (an oral prescription medication with the cholesterol lowering agent bempedoic acid) and NEXLIZET (a combination of cholesterol-lowering medicines bempedoic acid and ezetimibe). I am comfortable using NEXLETOL and NEXLIZET, along with a healthy diet and exercise, to reduce LDL cholesterol in adults with high blood cholesterol levels and to reduce risk of heart events. Non-statins are another important therapeutic tool in our lipid lowering toolbox.” To learn more visit Nexlizet.com. Photo courtesy of Shutterstock IMPORTANT SAFETY INFORMATION What are NEXLIZET tablets and NEXLETOL tablets?
Along with a diet:
NEXLETOL is used, with other cholesterol-lowering medicines, or alone when use with other cholesterol-lowering medicines is not possible, to reduce low-density lipoprotein (LDL, or bad cholesterol) in adults with high blood cholesterol levels called primary hyperlipidemia, including a type of high blood cholesterol called heterozygous familial hypercholesterolemia (HeFH).
NEXLIZET is used, with or without other cholesterol-lowering medicines, to reduce low- density lipoprotein (LDL, or bad cholesterol) in adults with high blood cholesterol levels called primary hyperlipidemia, including a type of high cholesterol called heterozygous familial hypercholesterolemia (HeFH).
The bempedoic acid portion of NEXLIZET and NEXLETOL is used to lower the risk of heart attack and heart procedures like stent placement or bypass surgery, in adults who are unable to take recommended statin treatment (a cholesterol-lowering medicine), or are not taking a statin, who:
have known heart disease, or
are at high risk for heart disease but without known heart disease.
Do not take NEXLIZET if you are allergic to ezetimibe or bempedoic acid, or any ingredients in NEXLIZET or NEXLETOL. If you have any of the following signs and symptoms of a serious allergic reaction, call your healthcare provider or go to the nearest hospital emergency room:
swelling of your face, lips, mouth, or tongue
wheezing
severe itching
fast heartbeat or pounding in your chest
trouble breathing
skin rashes, redness, or swelling
dizziness or fainting
What should I tell my healthcare provider before taking NEXLIZET or NEXLETOL? Tell your healthcare provider if you:
have, or had, gout
have or had tendon problems
are pregnant or breastfeeding or may become pregnant or plan to breastfeed. It is not known if NEXLIZET or NEXLETOL passes into your breastmilk
have severe kidney or severe liver problems
Tell your healthcare provider about all the medicines you take, including prescription and over-the- counter medicines, vitamins and herbal supplements. Especially tell your healthcare provider if you take or plan to take simvastatin or pravastatin, as taking either with bempedoic acid may increase your risk of developing muscle pain or weakness. If you take NEXLIZET, tell your doctor if you take cyclosporine, fibrates, or cholestyramine. What is the most important safety information I should know about NEXLIZET and NEXLETOL? NEXLIZET and NEXLETOL can cause serious side effects, including:
increased levels of uric acid in the blood, which can lead to gout, a painful joint condition. Call your doctor if you have any of the following symptoms: severe foot pain especially in the toe joint, warm joints, swelling, tender joints or joint redness.
tendon rupture or injury. Tendon problems can happen in people who take bempedoic acid, one of the medicines in NEXLIZET or NEXLETOL. The risk of getting tendon problems while you take NEXLIZET or NEXLETOL is higher if you: are over 60 years of age, are taking steroids, are taking antibiotics called fluoroquinolones, have renal failure, or have had tendon problems in the past. Stop taking NEXLIZET or NEXLETOL immediately and get medical help if you experience signs of tendon rupture such as snap or pop in tendon area, bruising after an injury in a tendon area, or unable to move or put weight on the affected area.
The most common side effects in people with primary hyperlipidemia:
NEXLETOL includes symptoms of the common cold or flu-like symptoms, muscle spasms, back pain, stomach pain, bronchitis, pain in shoulder, legs, or arms, anemia and increased liver enzymes.
NEXLIZET includes symptoms of the common cold or flu-like symptoms, muscle spasms, back pain, stomach pain, bronchitis, pain in shoulder, legs, or arms, anemia, increased liver enzymes, diarrhea, joint pain, swelling of sinuses and fatigue.
The most common side effects of bempedoic acid, a component of NEXLIZET and NEXLETOL, in people with heart problems include kidney problems, anemia, increased liver enzymes, muscle spasms, and gallstones. These are not all the possible side effects of NEXLIZET and NEXLETOL. For more information, ask your healthcare provider or pharmacist for more information. Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.SOURCE:Esperion
Writing builds resilience by changing your brain, helping you face everyday challenges
Writing builds resilience: Discover how writing changes your brain and strengthens resilience. Learn 5 science-backed writing techniques to process emotions, reduce stress, and navigate everyday challenges with clarity and purpose.
Writing builds resilience by changing your brain, helping you face everyday challenges
Emily Ronay Johnston, University of California, Merced Ordinary and universal, the act of writing changes the brain. From dashing off a heated text message to composing an op-ed, writing allows you to, at once, name your pain and create distance from it. Writing can shift your mental state from overwhelm and despair to grounded clarity — a shift that reflects resilience. Psychology, the media and the wellness industry shape public perceptions of resilience: Social scientists study it, journalists celebrate it, and wellness brands sell it. They all tell a similar story: Resilience is an individual quality that people can strengthen with effort. The American Psychological Association defines resilience as an ongoing process of personal growth through life’s challenges. News headlines routinely praise individuals who refuse to give up or find silver linings in times of hardship. The wellness industry promotes relentless self-improvement as the path to resilience. In my work as a professor of writing studies, I research how people use writing to navigate trauma and practice resilience. I have witnessed thousands of students turn to the written word to work through emotions and find a sense of belonging. Their writing habits suggest that writing fosters resilience. Insights from psychology and neuroscience can help explain how.
Writing rewires the brain
In the 1980s, psychologist James Pennebaker developed a therapeutic technique called expressive writing to help patients process trauma and psychological challenges. With this technique, continuously journaling about something painful helps create mental distance from the experience and eases its cognitive load. In other words, externalizing emotional distress through writing fosters safety. Expressive writing turns pain into a metaphorical book on a shelf, ready to be reopened with intention. It signals the brain, “You don’t need to carry this anymore.”Sometimes you can write your way through difficult emotions.Grace Cary/Moment via Getty Images Translating emotions and thoughts into words on paper is a complex mental task. It involves retrieving memories and planning what to do with them, engaging brain areas associated with memory and decision-making. It also involves putting those memories into language, activating the brain’s visual and motor systems. Writing things down supports memory consolidation — the brain’s conversion of short-term memories into long-term ones. The process of integration makes it possible for people to reframe painful experiences and manage their emotions. In essence, writing can help free the mind to be in the here and now.
Taking action through writing
The state of presence that writing can elicit is not just an abstract feeling; it reflects complex activity in the nervous system. Brain imaging studies show that putting feelings into words helps regulate emotions. Labeling emotions — whether through expletives and emojis or carefully chosen words — has multiple benefits. It calms the amygdala, a cluster of neurons that detects threat and triggers the fear response: fight, flight, freeze or fawn. It also engages the prefrontal cortex, a part of the brain that supports goal-setting and problem-solving. In other words, the simple act of naming your emotions can help you shift from reaction to response. Instead of identifying with your feelings and mistaking them for facts, writing can help you simply become aware of what’s arising and prepare for deliberate action. Even mundane writing tasks like making a to-do list stimulate parts of the brain involved in reasoning and decision-making, helping you regain focus.
Making meaning through writing
Choosing to write is also choosing to make meaning. Studies suggest that having a sense of agency is both a prerequisite for, and an outcome of, writing. Researchers have long documented how writing is a cognitive activity — one that people use to communicate, yes, but also to understand the human experience. As many in the field of writing studies recognize, writing is a form of thinking — a practice that people never stop learning. With that, writing has the potential to continually reshape the mind. Writing not only expresses but actively creates identity. Writing also regulates your psychological state. And the words you write are themselves proof of regulation — the evidence of resilience. Popular coverage of human resilience often presents it as extraordinary endurance. News coverage of natural disasters implies that the more severe the trauma, the greater the personal growth. Pop psychology often equates resilience with unwavering optimism. Such representations can obscure ordinary forms of adaptation. Strategies people already use to cope with everyday life — from rage-texting to drafting a resignation letter — signify transformation.
Building resilience through writing
These research-backed tips can help you develop a writing practice conducive to resilience: 1. Write by hand whenever possible. In contrast to typing or tapping on a device, handwriting requires greater cognitive coordination. It slows your thinking, allowing you to process information, form connections and make meaning. 2. Write daily. Start small and make it regular. Even jotting brief notes about your day — what happened, what you’re feeling, what you’re planning or intending — can help you get thoughts out of your head and ease rumination. 3. Write before reacting. When strong feelings surge, write them down first. Keep a notebook within reach and make it a habit to write it before you say it. Doing so can support reflective thinking, helping you act with purpose and clarity. 4. Write a letter you never send. Don’t just write down your feelings — address them to the person or situation that’s troubling you. Even writing a letter to yourself can provide a safe space for release without the pressure of someone else’s reaction. 5. Treat writing as a process. Any time you draft something and ask for feedback on it, you practice stepping back to consider alternative perspectives. Applying that feedback through revision can strengthen self-awareness and build confidence. Resilience may be as ordinary as the journal entries people scribble, the emails they exchange, the task lists they create — even the essays students pound out for professors. The act of writing is adaptation in progress.Emily Ronay Johnston, Assistant Teaching Professor of Global Arts, Media and Writing Studies, University of California, Merced This article is republished from The Conversation under a Creative Commons license. Read the original article.
Wishing you all a Happy Thanksgiving! As we gather with loved ones to express gratitude and share a meal, let’s take a moment to appreciate the blessings in our lives. It’s a time to reflect on the goodness that surrounds us and cherish the moments of joy and togetherness. Whether you’re celebrating with family, friends, or even virtually, may this Thanksgiving be filled with warmth, love, and laughter. Let’s remember to extend kindness and lend a helping hand to those in need, spreading the spirit of gratitude and generosity. Enjoy the holiday and create beautiful memories. Happy Thanksgiving!
Rod: A creative force, blending words, images, and flavors. Blogger, writer, filmmaker, and photographer. Cooking enthusiast with a sci-fi vision. Passionate about his upcoming series and dedicated to TNC Network. Partnered with Rebecca Washington for a shared journey of love and art.
Don’t let food poisoning crash your Thanksgiving dinner
Safe thanksgiving dinner: Protect your Thanksgiving guests from foodborne illness with these expert food safety tips. Learn why you shouldn’t wash your turkey, how to avoid the danger zone, and essential prep strategies to prevent the 48 million annual cases of food poisoning in the U.S.
Don’t let food poisoning crash your Thanksgiving dinner
Lisa Cuchara, Quinnipiac University Thanksgiving is a time for family, friends and feasting. However, amid the joy of gathering and indulging in delicious food, it is essential to keep food safety in mind. Foodborne illnesses can quickly put a damper on your celebrations. As an immunologist and infectious disease specialist, I study how germs spread – and how to prevent them from doing so. In my courses, I teach my students how to reduce microbial risks, including those tied to activities such as hosting a big Thanksgiving gathering, without becoming germophobes. Foodborne illnesses sicken 48 million Americans – 1 in 6 people – each year. Holiday meals such as Thanksgiving pose special risks because these spreads often involve large quantities, long prep times, buffet-style serving and mingling guests. Such conditions create many opportunities for germs to spread. This, in turn, invites a slew of microbial guests such as Salmonella and Clostridium perfringens. Most people recover from infections with foodborne bacteria, but each year around 3,000 Americans die from the illnesses they cause. More routinely, these bugs can cause nausea, vomiting, stomach cramps and diarrhea within hours to a couple of days after being consumed – which are no fun at a holiday celebration.
Foods most likely to cause holiday illness
Most foodborne illnesses come from raw or undercooked food and foods left in the so-called danger zone of cooking temperature – 40 degrees to 140 degrees Fahrenheit – in which bacteria multiply rapidly. Large-batch cooking without proper reheating or storage as well as cross contamination of foods during preparation can also cause disease.Put that bird right in the oven as soon as you’ve stuffed it to keep bacteria from multiplying inside.kajakiki/E+ via Getty Images Not all dishes pose the same risk. Turkey can harbor Salmonella, Campylobacter and Clostridium perfringens. Undercooked turkey remains a leading cause of Thanksgiving-related illness. Raw turkey drippings can also easily spread bacteria onto hands, utensils and counters. And don’t forget the stuffing inside the bird. While the turkey may reach a safe internal temperature, the stuffing often does not, making it a higher-risk dish. Leftovers stored too long, reheated improperly or cooled slowly also bring hazards. If large pieces of roasted turkey aren’t divided and cooled quickly, any Clostridium perfringens they contain might have time to produce toxins. This increases the risk of getting sick from snacking on leftovers – even reheated leftovers, since these toxins are not killed by heat. Indeed, each November and December outbreaks involving this bacterium spike, often due to encounters with turkey and roast beef leftovers.
Don’t wash the turkey!
Washing anything makes it cleaner and safer, right? Not necessarily. Many people think washing their turkey will remove bacteria. However, it’s pretty much impossible to wash bacteria off a raw bird, and attempting to do so actually increases cross contamination and your risk of foodborne illness. Since 2005, federal food safety agencies have advised against washing turkey or chicken. Despite this, a 2020 survey found that 78% of people still reported rinsing their turkey before cooking – often because older recipes or family habits encourage it. When you rinse raw poultry, water can splash harmful bacteria around your kitchen, contaminating counter tops, utensils and nearby foods. If you do choose to wash turkey, it’s critical to immediately clean and disinfect the sink and surrounding area. A 2019 USDA study found that 60% of people who washed their poultry had bacteria in their sink afterward – and 14% had bacteria in the sink even after cleaning it.A few food prep precautions can help keep the holiday free of gastrointestinal distress.Drazen Zigic/iStock via Getty Images Plus
Food prep tips for a safe and healthy Thanksgiving
Wash your hands regularly. Before cooking and after touching raw meat, poultry or eggs, wash your hands thoroughly with soap and water for at least 20 seconds. Improper handwashing by people handling food is a major source of bacterial contamination with Staphylococcus aureus. This bacterium’s toxins are hard to break down, even after cooking or reheating. Thaw turkey safely. The safest way to thaw a turkey is in the refrigerator. Allow 24 hours per 4-5 pounds. There’s also a faster method, which involves submerging the turkey in cold water and changing the water every 30 minutes – but it’s not as safe because it requires constant attention to ensure the water temperature stays below 40 F in order to prevent swift bacteria growth. Stuff your turkey immediately before cooking it. Stuffing the turkey the night before is risky because it allows bacteria in the stuffing to multiply overnight. The toxins produced by those bacteria do not break down upon cooking, and the interior of the stuffing may not get hot enough to kill those bacteria. The USDA specifically warns against prestuffing. So cook stuffing separately, if possible, or if you prefer it inside the bird, stuff immediately before roasting, making sure it reaches 165 F. Cook food to the right temperature. A thermometer is your best friend – use it to ensure turkey and stuffing both reach 165 F. Check casseroles and other dishes too. It’s best not to rely on an internal pop-up thermometer, since they can be inaccurate, imprecise and could even malfunction. Avoid cross contamination. Use separate cutting boards for raw meat, vegetables and bread. Change utensils and plates after handling raw meat before using them for cooked foods. Keep food at safe temperatures.Serve hot foods immediately, and make sure hot foods are served above 140 F and cold dishes below 40 F to keep them out of the microbial danger zone. Be cautious with buffet-style serving. Limit food time on the table to two hours or less – longer than that, any bacteria present can double every 20 minutes. Provide dedicated serving utensils, and avoid letting guests serve with utensils they have eaten from. Be mindful of expiration dates. Don’t forget to check dates on food items to make sure that what you are serving isn’t expired or left from last Thanksgiving. Educate guests on food safety. Remind guests to wash their hands before preparing or serving food, and politely discourage double-dipping or tasting directly from communal dishes. Thanksgiving should be a time of gratitude, not gastrointestinal distress. By following these simple food safety tips, you can help ensure a safe and healthy holiday. Lisa Cuchara, Professor of Biomedical Sciences, Quinnipiac University This article is republished from The Conversation under a Creative Commons license. Read the original article.
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