The Way Heart Works-By Dr. Harold Gunatillake

Keep your heart rate between 60 to 80 beats per minute

If you use an average of 80 beats per minute, your heart beats about 4,800 times per hour. That’s a whopping 115,200 times per day. Over the course of a year, your heart would beat about 42,048,000 times!

Let’s listen to a healthy steady heartbeat.

That is the way you must keep your heart beating through life. Take care of your heart and your heart will give you a healthy good lifespan.

Athletes and others who do strenuous exercises, may bring down their heart rate according to the extent of training. Olympic athletes bring down their heart rate to 40 beats per minute, for competitive performance

If you are sedentary, your heart rate may go up to 90 per minute, or more

If your heart rate is more than 90 beats per minute you need to see your doctor to check the reason. In such a situation if you neglect your heart may go into failure without your knowing or may have a stroke or sudden arrest and death.

To be on the safe side, please check your pulse at your wrist, or side of neck, regularly at rest. During exercise it raises physiologically.

When the heart rate is rapid, we call it ‘tachycardia’ Sinus tachycardia is when the heart rate increases due to physical activities. In such situations, the increased rate does not harm your heart

Your heart rate may be regular or irregular. It may be irregular due to a dropped beat. Please see your doctor early.

Your heart rate gets rapid if you are malnourished and anaemic. This is the commonest cause of tachycardia among many rural people in Sri Lanka. They need a nourishing diet to make the heart work healthily.

Frequent coffee drinkers have a rapid heart rate. If you eat chocolate bars daily, your heart becomes rapid due to the stimulation by the caffeine in the chocolate,There is a term called inappropriate sinus tachycardia. About half of the time, this phenomenon occurs after recovery from a serious illness, usually a viral illness. And most often, those affected are women in their 20s and 30s.

Inappropriate sinus tachycardia does not damage your heart.

The commonest cause of rapid heart rate is Atrial fibrillation. The term atrial or atrium is used for the upper two chambers of the heart and the term ventricle is used to the lower two chambers.

When you go for your blood pressure check- up, in addition to upper and lower readings, the pulse rate is as important in the management of high blood pressure So, remember to know your pulse rate i.e. your heart rate, when you next visit you doctor.

Atrial fibrillation may be due to irregular electrical impulses in the two upper chambers or atria.

This raised irregular heart rate may be due to some heart disease, high blood pressure, heart valve disorder, increased thyroxine hormone liberated from your thyroid glands in your neck, we call it hyperthyroid state.

If you have an over-active thyroid there are other symptoms like, loss of weight even when eating lot of food, thin and moist skin, bulging eyes, loose motions, tremors in your fingers and so on.

Heavy alcohol abuse is another cause of rapid heart rate. Now let’s talk about irregular heartbeats- doctors call it Arrythmia.
You may feel that you are skipping a beat, or having added a beat When there are added beats, we call it “flutter”

When the beat is irregular the rhythm may be fast or slow or too early. Many arrythmias are harmless and many people live with it.

It could be harmful too-then it is serious-may be due to damaged heart and you must see your doctor immediately.

With irregular heartbeat if you feel dizzy, breathless or feel rapid heartbeats we call
palpitations – then it is serious. The causes of irregular heat-beats are:
• alcohol abuse
• diabetes

• drug abuse
• excessive coffee consumption
• heart disease like congestive heart failure
• hypertension (high blood pressure)
• hyperthyroidism (an overactive thyroid gland)
• mental stress
• scarring of the heart, often the result of a heart attack
• smoking
• some dietary supplements
• some herbal treatments
• some medications7
• \
If you feel a burst of fast irregular heartbeats lasting for a few minutes to a few
hours and back to normal – this condition is called Supraventricular tachycardia. For this condition there are medications like beta-blockers and calcium channel blockers. Many people with this condition have a procedure called catheter ablation. The other irregular heartbeats are:

Atrial flutter,AV nodal re-entrant tachycardia
Ventricular tachycardia, ventricular fibrillations, and so on. The bottom line is – you need to check your heartbeat i.e. your pulse rate in your neck or wrist occasionally. You may even experience palpitations, dizziness, fainting attacks.

You need to see your doctor immediately and take remedial measures before your heart goes into failure.

The bottom line is- If you feel that your pulse rate in your wrist or the neck is rapid, very slow, or irregular, you must see your doctor as soon as possible.Hope this talk was useful. Until we meet again, Goodbye.


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Diabetes – can you reverse the malady-Is there a natural therapy? – By Dr Harold Gunatillake

May require headphones

Let’s discuss about diabetes briefly before we find the answer to the claim by some authorities that there is a cure for diabetes.

Let’s keep our discussion to type 2 diabetes only, meaning the type of diabetes healthy people get during adulthood, after the age of 40, for some unknown and known reasons.

The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes* among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014. Diabetes prevalence has been rising more rapidly in middle- and low-income countries.

China, India and the United States top the list for the most cases of diabetes per country; around 24.4 million Americans had the disease in 2013. But islands in the Pacific have the most alarming rates of prevalence, or the number of cases compared to the country’s population overall.

Sri Lanka too is seeing an increase in the cases of diabetes. According to recent statistics by the International Diabetes Federation (IDF), the prevalence of diabetes among adults in Sri Lanka is 8.5%. At present, one in 12 adults in the country suffers from diabetes, which totals to 1.16 million.

What happens to the carbs like rice, bread, sodas and fruit drinks, you consume daily in your body?

Your body breaks down carbs and starches you eat into sugar called glucose in your gut, used for quick energy. Insulin, which is made by your pancreas, helps keep the right amount of glucose in your blood stream.

If you do not have enough insulin manufactured in the pancreas, your blood sugar level will rise.

Blood sugar level is less than 100 mg/dL after not eating (fasting) for at least 8 hours. And is less than 140 mg/dL 2 hours after eating. During the day, levels tend to be at their lowest just before meals. For most people without diabetes, blood sugar levels before meals hover around 70 to 80 mg/dL.

A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.

Insulin which controls the blood sugar level is manufactured in the beta cells in the pancreas.

With dysfunction of the beta cells due to known and unknown factors, less insulin will be secreted, and the sugar level will remain high in your blood.

Normal function of insulin is to courier the blood glucose to various tissues, cells, including the liver for storage and use for energy.

In certain situations, if you eat too much of carbs, and drinks with added sugars you may stress the beta cells and cause insulin resistance.

Insulin resistance

In insulin resistance your beta cells manufacture more insulin to control your blood sugar. This is a very stressful situation for the beta cells. The resistance increases with age and how can your reduce the resistance to insulin.

Normally, your doctor will increase your insulin injections to lower the blood glucose level with insulin resistance.

This situation is like giving more alcohol to an alcoholic to cure the disease.

The solution is to take measures to reduce insulin resistance, and not increase your

The measures that are available to reduce insulin resistance are:
Exercise daily to burn more blood glucose.

Consume low GI foods, like unprocessed carbs, vegetables, nuts, lentils.

Limit your alcohol consumption.
Take measures to reduce weight, if you are overweight.

Such measures will reduce insulin resistance, and your doctor will get the opportunity to reduce your dose of insulin, rather than increasing.

Unchecked high blood sugar can cause health problems like heart disease, nerve and kidney damage, and eye conditions

Alcohol stops your liver from making glucose. Women with diabetes should have no more than one drink a day and men should have no more than two. Don’t drink on an empty stomach or when your blood sugar is already low. Check your blood sugar before, during, and for the next 24 hours after drinking

Can you cure diabetes?

The answer is with change of lifestyle, and medication, reducing risk factors, weight loss, including stress you could achieve normal blood sugar levels, but permanent reversing is not a possibility.

During the prediabetic phase, you could reverse diabetes by strict dietetic control and daily exercise. Again, reversing the malady is not curing.

Type 2 diabetes is an ongoing disease. Even if you’re in remission, which means you aren’t taking medication and your blood sugar levels stay in a healthy range, there’s always a chance that symptoms will return.

So how can you reverse diabetes? The key seems to be weight loss. Not only can shedding pounds help you manage your diabetes, sometimes losing enough weight could help you live diabetes-free — especially if you’ve only had the disease for a few years and haven’t needed insulin.

With all the research on diabetes and advances in diabetes treatments, it’s tempting to think someone has surely found a diabetes cure by now. But the reality is that there is no cure for diabetes — neither type 1 diabetes nor type 2 diabetes. (Although lifestyle changes can achieve remission in type 2 diabetes in some cases.)

Is there a natural therapy that can cure diabetes?

No. Natural therapies such as deep abdominal breathing, progressive muscle relaxation, guided imagery, and biofeedback can help relieve stress. And emotional stress affects your blood sugar levels. So, learning to relax is important in managing your diabetes.

Supplements don’t cure diabetes, either. Some natural supplements may interact dangerously with your diabetes medication. Others have been shown to help improve your diabetes, but always check with your doctor before taking any supplement.

Be sceptical about claims of a diabetes cure. A genuine cure will have been tested repeatedly in clinical trials with clear success.

When the beta cells start deteriorating in its function, you cannot rejuvenate and revert to normal function.

Supplements don’t cure diabetes, either. Some natural supplements may interact dangerously with your diabetes medication. Others have been shown to help improve your diabetes, but always check with your doctor before taking any supplement.

Be sceptical about claims of a diabetes cure. A genuine cure will have been tested repeatedly in clinical trials with clear success.

Hope this video gave you good advice on the subject.

Thank you for watching.

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Looking after your Diabetes to prevent complications

Written by Dr Harold Gunatillake FRCS, FIACS, FICS, AM (Sing), MB,BS-Health writer

Diabetes is a condition where the glucose absorbed in the gut through the digestion of carbs, seem to remain in the blood stream, as the hormone insulin responsible for the control of glucose is impaired from the Islet cells of the pancreas resulting in abnormal metabolism of carbs and elevated levels of glucose in the blood.

When you have diabetes, your blood glucose levels tend to be consistently high unless properly controlled with medication, diet and exercise. Overtime, such increased levels of blood sugar damage your body and lead to many other problems.

Normally, your blood sugar should be maintained fasting for 8 hours to an average level of about 100mg/dl. When it reaches the upper limit of 126 mg/dl you get into the stage of ‘Pre-diabetes”, a stage you could reverse to normal situation with diet alone. After eating a non-diabetic will reach a level of 140mg /dl and diabetics should aim to keep the blood sugar level at about the same level.

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Alcoholic drinks when having diabetes

Written by Dr Harold Gunatillake-Health writer

Yes, true, people having raised blood sugar need to be careful drinking alcohol. They still can enjoy a drink or two without guilt, but intelligent drinking is the solution. Men with diabetes can still enjoy two drinks a day, just like the non-diabetics and women too can have just one drink a day.

A sugary drink like a cocktail can raise your blood sugar, and if you are on insulin medication you could whack small insulin shot to maintain a steady blood sugar level. Those on anti-diabetic tablets unfortunately may not have this flexibility.

If you drink on empty stomach, on the other hand a strong alcohol drink will bring your blood sugar level too low.

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