Does Elevated Troponin Always Mean a Heart Attack?
A person who’s diagnosed with a heart attack in the ER based on an elevated troponin result may not have had a heart attack after all.
The European Heart Journal has a 2018 study (Thygesen et al) that says “many doctors have not understood that elevated troponin levels in the blood are not sufficient to diagnose a heart attack.”
The paper explains that a heart attack causes injury to cardiac muscle. The protein troponin is used for cardiac muscle contraction.
But it’s released into the bloodstream upon injury to that specialized muscle.
A highly sensitive blood test will tell if there’s even the must subtle rise in troponin.
The reason that an abnormal level of troponin doesn’t always mean a heart attack is because there are other situations that injure cardiac muscle.
Does elevated troponin automatically mean the patient has had a heart attack?
“Not always, but the most common reason to order a troponin level is usually to rule out a heart attack,” says Christopher J. Hanifin, PA-C, who was previously a physician assistant in open heart surgery with Cardiothoracic Surgery of South Bend in South Bend, IN.
“Anything that severely stresses or damages the heart can cause an elevation of troponin, though not usually to the extent seen in a heart attack.
“Heart failure, trauma, pulmonary embolism and even kidney failure can lead to elevated troponin levels.” So can a body-wide infection (sepsis).
Correct identification for the reason of a rising troponin level is crucial because even different types of ischemia to the heart have different causes. Different causes mean different treatments.
One type might require antiplatelet drugs, while another treatment (for a different cause) may require beta blocker drugs.
In some cases, the cause of an elevated troponin result is not known, though the cause may be strongly suspected, such as chronic heart failure in an elderly patient.
Christopher J. Hanifin, PA-C, is currently Department Chair and Assistant Professor, Department of Physician Assistant, Seton Hall University, NJ.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Robert Kneschke–
Source: sciencedaily.com/releases/2018/08/180825081713.htm
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Skin Cancer Risk from Wearing a Bikini to Feel Confident
It’s not about self-love. Perhaps some plus-size women want to be covered up at the beach to protect against skin cancer.
Maybe the next full size woman you see covered up at the beach already has had skin cancer!
Body confidence influencers who keep pushing the idea that plus size women need to bare more skin are not taking into consideration the possibility that some overweight women — as well as thinner women — prefer to keep “covered up” to protect their skin from sun damage.
This not only includes cancer, but also precancerous lesions, sun splotches and premature wrinkles.
Those who are skin-health-conscious are apt to ask themselves the following:
Will there be a surge in skin cancer diagnoses 20 years from now, or even 10 years, due to all the women wearing bikinis to the beach because their favorite body image influencers keep encouraging this?
If there’s an uptick in skin cancer diagnoses years from now, there’ll be no way to prove that it was caused solely by the influx of women wearing bikinis who, in the absence of the body positive movement, would have worn cover-ups.
“The ‘self-love’ movement for abandoning cover-ups for bikinis at the beach will definitely have its consequences,” begins Erum Ilyas, MD, a board certified dermatologist who performs adult and pediatric medical dermatology, cosmetic dermatology and skin cancer treatment with Schweiger Dermatology Group.
“However, with the right guidance, this is not inevitable,” continues Dr. Ilyas.
“The bottom line is that the exposure to UV rays, especially when most intense during peak sun hours, damages the DNA of our cells.
“The effects of this damage are not always seen immediately.”
Body image influencers have a tendency to believe that if a large woman is in cover-ups at the beach, she lacks self-confidence, lacks self-love and needs to shed the cover-up.
She looks as confident as a same-size woman in a string bikini. Source: venus.com
Cover-ups to Protect from Skin Cancer
Some cover-ups are only for the hips and below. Others cover both the lower body and upper body.
Even if only the legs are covered, this is better than no shielding protection at all.
Depending on the heat and potential activities at the beach, a woman who wants to lower her risk of skin cancer may wear more than one variety of cover-up.
Or maybe the beachwear tunic is to shield the sun’s rays from a sensitive back.
Some body love influencers seem to think that every single overweight woman should toss out the cover-ups and don a two-piece swimsuit.
They associate cover-ups with a body image disorder or low self-confidence.
This is extremely backward thinking, especially since many slender women wear cover-ups.
Cover-ups at the beach are very handy for women — regardless of size — who burn easily and don’t want to hassle with smearing smelly sunscreen all over their back or middle.
Self-Love = Guarding Your Body Against Skin Cancer
This doesn’t mean you must give up bikinis if you normally wear them.
“This body positive messaging should not just be about body type but also being positive messaging about our innate melanin production!” says Dr. Ilyas.
“This would mean that I welcome the movement as long as it means putting sunblock on from head to toe and everywhere in between before putting your bikini on for a day at the beach! And, of course, reapply.”
Maybe that fat woman who’s “all covered up” was once diagnosed with melanoma, which — when not caught early, has a very poor prognosis.
There’s no shame in “keeping it covered up.” Source: rosegal.com
Or … maybe she’s never had melanoma — but has risk factors such as family history, childhood sunburns, very fair skin or freckles, and blue eyes.
Don’t be so quick to pass judgement on every plus size woman who won’t wear a bikini or keeps one-half of her body covered up in the sun.
She may have medical reasons for this that are not obvious to the onlookers sunning themselves with barely anything on their bodies.
It’s not fair to make assumptions about a woman based on what she wears to the beach.
For all you know, she’s an avid hiker, horseback rider, inline skater, skier, skydiver or competitive powerlifter.
Protecting your skin from melanoma or other forms of skin cancer is FAR more important than a social statement on the beach.
“If we consider the full picture on safe body positive messaging, then we will not necessarily see spikes in skin cancer,” says Dr. Ilyas.
Dr. Ilyas has practiced dermatology in the Philadelphia area and Boston for 15+ years and has served as Assistant Professor of Dermatology at Drexel University College of Medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Erica Smi
Does Posing for IG Photos Mean Plus Size Women Are Confident?
“I wish I had your confidence!”
Now wait a minute here.
Do you really think you can tell that a plus size woman is confident simply because she posted an Instagram image showing a lot of skin?
A body positive influencer who has 100,000 followers may earn over a thousand dollars per post if that individual has a partnership with a leading company or brand.
“I wish I had your confidence!”
For what? To pose for a shot that she knows will help pay next month’s rent? Who needs confidence for THAT?
It’s a safe bet that if a woman had the the face of Chucky and weighed 280 pounds — but knew that she’d get paid handsomely every time she posted an image of herself in a bikini or a crop top and short-shorts – she’d do it in a heartbeat.
Especially if she has a few young kids to take care of, car payments, mortgage, etc.
What body image influencer of large size is thinking, “I really gotta muster up my confidence for this photoshoot,” when she knows just three posts will reel in enough money for a new car?
Shutterstock/Kletr
But certainly, they had to start from ground zero. At some point, Instagram stars with plus size bodies were earning nothing for their posts.
One might argue that at that point, they needed major confidence to put up pictures in swimsuits, lingerie and mini skirts.
But the “I wish I had your confidence!” comments continue to pour in every time an influencer with well-known collaborations puts up a shot of herself in a bikini, tight leather mini skirt or some other “daring” attire.
Don’t loyal followers realize that these images of so-called confidence are, to the Instagram star, a gravy train?
There comes a point where a body confidence and self-love influencer is raking in so much money on Instagram that the belief that these women need confidence to post even more images is just plain madness.
The Jealousy Factor
Those who see my point may be labeled as jealous by the Instagram star’s adoring followers.
Hey, who isn’t jealous of anyone who makes good money by posting selfies?
One particular red-head Instagram influencer appears to be around 350 pounds and may not need a single ounce of confidence to post several thousand images that have generated megabucks for her.
© Lorra Garrick
Plus, who needs confidence to post on Instagram when you have a gorgeous face?
Yet follower after follower posts on her pages, “I wish I had your confidence!”
It would make more sense if they posted, “I wish I had your face!”
What about influencers with under 100,000 followers?
In general, companies are not interested in accounts with fewer than 100,000 followers.
Does this mean that plus-size account holders with only 48,000 or 400 followers have great confidence because the pictures of themselves baring a lot of skin are unpaid?
Of course not. Some women like to put up images of themselves no matter what they look like. This is not a barometer for self-confidence.
They may also be doing it to gain followers so that one day they can snag paid sponsorships.
Also … we all have known at least one woman in our life (any size) who looks wonderful and supremely photogenic in pictures — yet outside of that posed snapshot in time — she’s drowning in self-pity and feelings of worthlessness.
Smiling for a photo on Instagram in “daring” outfits should not be equated with confidence.
What Confidence Isn’t
Roberto Hund, Pexels
“As both an RN and someone who has struggled with her weight, I often find myself scratching my head when I see some of the advertising, corporate branding and social media advocacy surrounding the body positivity movement,” says Sarah Johnson, an RN and health ambassador for FamilyAssets, an online eldercare and senior living resource.
“Despite the superficially feminist presentation of much of it, there are still a lot of women in their underwear showing off their bodies and giving themselves permission to feel ‘sexy’ (i.e., to conceive of themselves primarily as sexual objects).
“Confidence is often portrayed as a woman’s willingness to shamelessly and proudly flaunt her body in public, regardless of its shape, size or proportions.
“It is a very narrow definition of what it means to be a confident person and leaves out confidence in much more important contexts, including one’s abilities, one’s opinions, one’s decisions, one’s morality.
“The most counterproductive and outright irresponsible part of this new movement, however, is its advocacy of cavalier attitudes towards healthy weights, BMI and lifestyles.
“Some of the women appearing in these campaigns are quite clearly at a very unhealthy weight, which puts them at risk for cardiovascular disease, diabetes, joint problems, reproductive problems and even early death.
“They deceive women who see these advertisements and leave with a false sense of security and normalcy.”
FamilyAssets connects families with leading senior care providers using data and technology. Individuals can select goals and preferences to create a customized list of senior care options including assisted living, memory care and skilled nursing.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/staras
Do Beach Cover-ups Mean a Plus Size Woman Lacks Confidence?
Is it fair to assume that when a plus size woman wears cover-ups at the beach, that she lacks confidence?
Should how much confidence a plus size woman has be measured by how much skin she shows when at the beach or anywhere else in public?
Really now — is this an accurate barometer?
Truth is, there is absolutely no evidence of a correlation between self-confidence or self-love and the willingness to bare your belly, cleavage or every millimeter of your thighs on the beach by wearing a bikini.
That plus size woman — who’s strolling along the boardwalk in a swimsuit with flowing attire wrapped around her waist to shield the massive cellulite and fat deposits on her legs — can very well be as self-loving and confident as her same-size counterpart who regularly visits the beach in only a bikini or posts bikini selfies on Instagram.
Unfortunately, in this mad world, more and more women (usually overweight) seem to be associating confidence with scant clothing.
Where are the studies by psychologists proving – or even remotely suggesting – that wanting to keep a fat body “covered up” in public is a sign of low self-confidence and not loving oneself?
And how do we know that the very large women who pose in bikinis and crop tops and post to Instagram really DO have all this self-love that they proclaim?
It can be argued that there’s many ways to exhibit self-love other than how much fabric is on one’s body.
Skimpy attire is not the be-all end-all for measuring a large woman’s confidence.
And if a woman, even at 125 pounds, feels “uncomfortable” wearing a two piece suit to the beach, and instead opts for a one-piecer, who the hell are the body positive influencers to call out this woman on her alleged lack of self-love?
- Maybe her self-love arises from the love and adoration she gets from her two young kids and doting husband.
- Perhaps it’s rooted in how valued her parents made her feel when she was growing up.
If she wants to keep her tummy stretch marks concealed and doesn’t want people to see her muffin top, SO WHAT. Leave her alone.
Shutterstock/liseykina
If she decides to wrap a piece of fabric or oversized towel around her waist to hide the cellulite, flab and stretch marks on her legs, who are the bopo influencers to brand her as having poor self-confidence?
Quite frankly, how dare they?
If you feel at ease sprawling on the beach with your larger than life body in a tight bikini, then fine. Do what makes you feel comfortable.
But hear this: If indeed you prefer a bikini despite being very plus size, you deserve no more accolades than the big – or trimmer – woman who “keeps it covered up” who’s enjoying the ocean breeze 50 feet from you.
Full-figured influencers are in no position to judge a woman’s confidence based on how little or how much skin is showing.
Followers need to realize that ANYONE can look “confident” in a photo.
But when followers post, “I wish I had your confidence!” it seems as though these followers actually believe that exposing skin means confidence in all areas of life.
In short, a picture isn’t always worth a thousand words.
If you follow one of these influencer, and especially if you’ve ever posted, “I wish I had your confidence!” you should truly wonder just what goes on in that influencer’s life beyond the smiling images or “power poses.”
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
Top Image source: venus.com
Can Chronic Heart Failure Lead to Liver Failure?
The kidneys get all the attention as the organ that fails secondary to chronic heart failure.
However, the liver, which the heart pumps 25 percent of its blood flow to, will also decline with chronic heart failure. Usually, the decline does not impair day-to-day function. (more…)
