Archive for heart disease
The question of the benefit of cholesterol medication is a much talked about topic of discussion these days in health and medicine. There are two camps; those who follow the guidelines produced by experts after analysis of medical studies, and those who believe that these guidelines are polluted by the influence of pharmaceutical companies. There are traditional medical providers in both groups, but most nontraditional practitioners would opt for the second group.
You may wonder which group your medical provider belongs to. Many patients believe that physicians who prescribe these medications get a kick back from the drug companies for prescribing these medications.They are therefor leery of the actual need or benefit for themselves.
While it is true that many prescriptions for statin drugs, the class of drugs that can lower cholesterol, are written yearly; this is not because of a financial incentive.
Why so many statin drugs prescribed?
In 3 short words: the American diet! As a medical provider who regularly checks the cholesterol levels of patients, I am disheartened on how many abnormal lab results I see. I am convinced the number one reason for these elevations is the food choices people make. It is true that genetics play a role, but what you put in your mouth plays more of a role.
Not everyone with high cholesterol will have illness from this elevation. Medical research is trying to figure out what the differences are between people who develop heart disease from their elevated cholesterol and those that do not. Researcher do not have all the answers, and sometimes they argue amongst themselves as see with the newest guidelines and risk calculator tool!
What we do know is that a diet high in sugar and fatty meats, as well as highly processed foods, raises cholesterol. A diet low in these items and high in fruits and vegetables tends not to raise the cholesterol. Some people are more genetically predisposed to have high cholesterol. A bad diet can make this happen, whereas a more vegetarian or Mediterranean diet, will help to prevent cholesterol elevations.
We all need some degree of cholesterol, as this is used in cell repair and nerve health. Too much however, collects along the walls of the arteries as it has to go somewhere. Some cholesterol can be broken down and taken out of the body, but not all. Exercise can help with this breakdown, thereby lowering the cholesterol.
It is strongly felt and supported in medical research that cholesterol plaques in the artery walls are capable of growing until they rupture, causing a heart attack. This happens in many people but not all, and unfortunately we do not have the capability of predicting with accuracy who will have this happen. In some people it is a given, others it is more elusive a risk. So for now, medical providers have to go by the odds with their suggestion and recommendations regarding statin therapy.
But you do have some choices. You can decide to ignore the advise to take statins, and take a chance that you will not have a cardiac event; play the odds in other words. If you are wrong however, you may lose big time.
You can chose to address your lifestyle instead of take medication, or do both. Changing your diet profoundly and for good, as well as exercising may make the need for statins a moot point. For me, as a patient and medical provider, is the approach I recommend regardless of whether statin therapy is also used. A healthy diet can do so much more than just lower cholesterol.
So for now, if your medical provider is recommending statin therapy; it is not so they can get a kick back from the drug company. Most likely your cholesterol level is high enough and your risk factors numerous enough that you are at risk for a cardiac event. And now you have a choice: take the medicine, change your diet, do both or do neither and take your chances.
Menopause is well known to interfere with aspects of our lives that we would like to remain stable and routine. Talking about sleep problems during menopause leads most women to think about their disruptive, night time hot flashes. These are certainly a major cause of sleep deprivation for women as they age.
A more insidious cause of insomnia may be present though, and this cause has far more serious health implications. I am talking about Obstructive Sleep Apnea.
Nobody wants to sleep with a mask over their face, attached to a pump making noise throughout the night. Many women do not want to even discuss, much less get tested for OSA because of this device, called a CPAP machine.
There is a surprising prevalence of OSA, with 1:7 women aged 55-70 having severe sleep apnea. This is in part because of weight gain that typically occurs as we age as well as when we go through menopause. It is also caused by the aging process itself, weakening the muscles in the roof of the oral cavity which suspend the tissues.
The typical symptoms of OSA are snoring and sometimes breathing cessation following by a loud gasp; then resumption of snoring. This is often diagnosed by sleeping partners! Fatigue during the day and not awakening feeling refreshed is a common complaint among people with undiagnosed or treated OSA.
You may wonder what the big deal is, so you snore a little!
According to a recent article published in Sleep; women will have more health problems from their sleep apnea than men. Studies have shown an increase in depression, as well as more damage to parts of the brain associated with mood and decision making. This has been demonstrated in studies by alterations on MRI scans. OSA can also eventually cause enlargement of the heart, hypertension, and lung disease.
How can you prevent sleep apnea? The biggest prevention is weight control. Weight gain in the neck, face and shoulders can place increased pressure on the muscles that help suspend the roof of the mouth. As we lay down to sleep, gravity can cause the soft tissues of the roof of the mouth to partially collapse and obstruct or block the airway. This decrease of air, and more importantly oxygen, reaching the outer portions of the lungs can put a strain on the heart.
As a part of weight control is exercise which also helps the sleep cycle. Adopting as healthy a lifestyle as possible will help strengthen heart and lungs.
What if you have done all this and your sleep test still shows OSA. The CPAP machine helps to increase the pressure on the roof of your mouth and throat, preventing collapse of tissues. There are many devices, and luckily technology advancement has created some very small and quiet devices.
Using a CPAP machine can dramatically improve your health through lowering the blood pressure, reducing stress on the heart and improving the function of the lung. All of this results in improved energy, better sleep, reduction of headaches. It can even help facilitate weight loss.
Many people imagine treatment of OSA to resemble sleeping with a gas mask, but this is not the case any longer. I encourage you to share with your provider any symptoms or suspicions that you may have sleep apnea.
Heart disease claims the lives of 1 in 4 women. It continues to be a significant issue for women and unfortunately, often presents in different ways as compared to men. For this reason, it is often overlooked as a potential problem for menopausal women.
The factors that contribute to heart disease for women are still unknown. It is felt that lack of natural estrogen somehow potentiates plaque formation in the large and small arteries supplying heart muscle.
Recent analysis of date from a nurses study has also highlighted the increased degree of heart disease in depressed women. Again, the mechanisms for this are not yet fully understood. There has long been observation and knowledge that depression can occur after a heart attack or heart surgery. The question remains, which came first and is this a coincidental association or is there a link?
It is not new that menopause can be a challenging time! With sleep deprivation, fatigue, problems with concentration; it is no surprise that women feel over whelmed and at times moody and depressed. Not every women however, becomes clinically depressed.
The unknown however, is whether the estrogen fluctuations of menopause can cause someone to experience depression for the first time. And if experiencing depression for the first time, do you have an increased risk of heart disease? There is 2 fold increase in the rates of depression known to occur during menopause; and depression has been shown to increase rate of cardiovascular disease.
There is currently a study undergoing at UNC called the PERT study, the Peri menopausal Estrogen Replacement Trial; to look at this issue further. This study is evaluating the (hopefully) beneficial effect of the use of estrogen in treating a new, or newly recurrent depression in perimenopausal women. They will be evaluating the incidence of heart disease for women being treated for depression with estrogen, to determine the efficacy of this treatment for both depression and heart disease in depressed women.
If you are interested in participating in this trial, or would like to know more; click on this link: UNC PERT study.
Knowing the potential cause of a woman’s depression can help tailor treatment, as well as determine what sort of pharmacological treatment may be most beneficial in alleviating symptoms. Knowing the link between depression and heart disease may help dictate surveillance testing for heart disease as you transition through menopause.
Because this is a major cause of illness and death in post menopausal women, it is important to educate yourself regarding your risk factors for heart disease. Many factors are known to contribute to heart disease, such as diabetes, elevated cholesterol, smoking, obesity and family history. It important for women to now understand that depression is now added to the list of risk factors.
Know your risks, know the symptoms of heart disease; and change what you can!
Have you ever heard that song by Sting, Still My Beating Heart? Going through menopause has brought that song up from my memory recesses. Many a night I have been left to wonder what the heck was going on in there!
I make light of it, but the truth is that a pounding and flip flopping heart is a very scary thing to feel. Add to this a poor diet and lack of exercise, and many a women might think they are having a heart attack.
While heart disease is the number one killer of women, chances are what you are experiencing is from menopause. Yes, you heard me-MENOPAUSE.
Having said that, it is still important to see your medical provider if you experience these symptoms. You need to have an EKG which can determine an abnormal heart rhythm. You also need to have your cholesterol checked as this can alert you to a possible danger of heart disease if it is very high. Blood pressure, glucose, electrolytes and thyroid can also be contributing factors to an irregular heart beat.
Heart disease causes 1 in 3 deaths for women yearly as compared to breast cancer claiming 1 in 31 lives yearly! Not all women are susceptible, and knowing your risk factors can help guide you.
Family history of heart disease, smoking, diabetes, age are some of the major risk factors. Relative inactivity and being overweight, having high blood pressure and cholesterol factor in also.
Most likely your symptoms on palpitations do not represent any serious medical condition; but it is important to have your heart health evaluated as you enter menopause.
The American Heart Association campaign: goredforwomen is designed to educate women regarding heart disease and has a wealth of information.
This is one issue of aging that is important to be knowledgeable of!
Do you feel you are a slave to pumping in those large calcium pills morning and night? Perhaps you forget them then worry about your bone health. If you can identify with this, I have good news for you. Recent studies and articles are questioning the safety of high dose calcium supplementation.
Several months ago, a study published and talked about in the news shows, make the claim that vitamins can cause heart disease. Perhaps you remember your favorite evening anchor person warning you to be careful about taking those vitamins. At that time, this study from Germany showed a relationship between increased heart attacks and consumption of high dose calcium supplement. It did not show the same events for calcium intake through foods rich in calcium.
Many of us want to maintain strong bones as we age and are in a quandary on what to do regarding calcium. Your may be lactose intolerant and cannot take dairy. Or, like me, you may not like greens. So what to do?
A recent study out of Sweden gives a different picture to the health of calcium supplements. These researchers looked at data from more than 60,000 women that had been enrolled in a different study. They took anywhere from 500 mg to 21oo mg of calcium. It was found that the highest percentage of death from heart events occurred with consumption of more that 1400 mg daily and less than 600 mg daily. Women taking more than 1400 mg of calcium daily from both supplements and through diet were found to have a higher risk of death from cardiovascular causes.
Now the big question is why heart disease can occur with something as benign as a vitamin or supplement like calcium tablets. Calcium can collect in walls of arteries and in cholesterol plaque which is also within the walls. This calcium deposition can make artery walls stiff, leading to problems with blood flow through them.
Calcium supplements create a dose of calcium absorbed at one time, theoretically flooding the system with calcium. What is not taken up by bones will have to go somewhere, and that may be the artery wall. Calcium consumed through food is generally not as high a dose, is absorbed more slowly as other nutrients and fiber can be associated with its absorption. This may have a different dynamic to the management of calcium. Researchers in the Swedish study postulate that too little or too much calcium throws off calcium homeostasis and therefor is not metabolized as well.
What should you do with this information?
I would glean from these 2 studies that consuming calcium a few hundred mg at a time, say 200-300 mg is safe. Perhaps do this 3, maybe 4 times a day. Try to get at least half of this through food. Do not take large doses in one sitting to get taking it out of the way.
Whether or not you have any osteopenia or osteoporosis, staying active with weight bearing activity as much as you can is wise. Take the stairs several times a day. Park one place and walk from store to store when doing errands, if safe to do so! Take vitamin D or eat Vitamin D rich foods.
Its’ hard figuring out what to do as we age. There seems to be conflicting information daily on what to and not to do. Sticking with whole, natural foods; and using some common sense and restraint with other unhealthy foods is a lose rule that is generally reliable to stick to!
It would seem incredible that one meal could cause a heart attack, but that actually could be the case! You may already grasp the concept that fatty foods can harm your health in addition to causing weight gain.
But did you know that a meal high in fat can potentiate coronary artery disease?
Researchers have long understood this and have done study after study to associate the two. A recent research project done at University of California at Davis has possibly shown the correlation between these two events. They took a group of volunteers with varying waist circumferences and triglyceride levels and measured their blood levels of a substance-triglyceride rich lipoprotein (TRGL) after these volunteers had consumed a high fat breakfast from a major fast food chain. They exposed lab created endothelial tissue to this TRGL and measured the inflammatory response. It is this inflammatory response that can cause and lead to heart disease and stroke. Not all of us have much systemic inflammation or high TRGL levels. The endothelial cells which had the highest inflammatory response also had an immune trigger which helped to cause this response. These factors were more plentiful in people with larger waist circumferences, and did not occur to the same degree in people with normal waist circumferences.
So what exactly does this mean to you?
If you are overweight or even normal weight, and your waist is disproportionately larger; then you are at risk for developing heart disease. You have systemic inflammation and difficulty with fat and glucose metabolism. This could lead to higher levels of triglycerides and TRGL. When the TRGL is flowing through your blood stream after consumption of a high fat fast food meal, it will attach to your blood vessel walls and trigger inflammation. The body then sends out white blood cells to deal with this inflammation and that is how atherosclerosis occurs.
When the atherosclerosis is in coronary arteries, that can lead to a heart attack.
When the atherosclerosis is in blood vessels leading to or contained in the brain, a stroke can occur.
When the atherosclerosis occurs in arteries leading to your kidneys, intestines or liver; these organs do not work well.
And when it occurs in the blood vessels supplying your legs, you can have pain with walking, ulcers or even loss of extremities.
So is the fast food meal really worth all that damage and illness?
February is heart health month for women and a good opportunity for you to discuss your cardiovascular health with your medical provider. It is well known that heart disease in women presents differently than heart disease in men.
You may think that because you do not have chest pain, you don’t have any heart disease. WRONG!
The signs of heart disease for women may be very subtle. Some of the signs include:
- chest heaviness
- an increased difficulty breathing especially when exercising
- heartburn like symptoms
- aching or cramping in your legs when you are walking
The most classic sign of heart disease is left sided chest pressure with pain in left shoulder, jaw and/or radiation down left arm. Heart disease in women can be more subtle and present with fatigue, shortness of breath and heartburn. These symptoms occur when plaque from cholesterol and other substances naturally occurring within the blood stream collect along the artery walls and eventually block the flow of oxygen rick blood through these narrowed areas. This can occur in the blood vessels that feed the heart as well as blood vessels that travel to the extremities, even your kidneys and stomach, and to your brain.
What can you do to prevent heart disease and atherosclerosis?
It is important to see your provider to establish both your risk factors for heart disease, as well as what your health markers are. These would include:
- your blood pressure,
- lipid analysis to include total cholesterol, HDL and LDL cholesterol and triglyceride levels
- your glucose level to exclude diabetes
- your BMI and weight
- your family history
- your lifestyle history to include cigarette smoking and level of activity
Take this month to evaluate all the risk factors listed above.
What can you do to improve your risk factors?
There are some things you cannot control such as your family history, but many items listed above are within your control!
Talk to your provider about beginning an exercise program which will improve your blood pressure, blood sugar and cholesterol levels, and will help to reduce what you weigh to your ideal level, if needed. Consider meeting with a nutritionist to improve your diet, especially if your cholesterol, triglycerides and glucose are at all elevated.
It has been well documented in studies that even a modest sustained weight loss can add years to your life! Ask yourself, What am I going to do to improve my health as I age?
- heart disease,
- peripheral vascular disease;
It is imperative to improve your diet, stop smoking, and add more activity to your daily routine. We know so much more about health than our mothers and grandmothers knew, and we owe it to them and our daughters to improve how we live our lives.
We have talked about cortisol in prior posts, and many of you may be wondering why this particular
hormone is so important during menopause. We often think the cause of all our problems is from low estrogen. This is only part of the reason for your symptoms.
Cortisol is the stress hormone that we need when our bodies are under stress.The problem comes when our bodies have been under prolonged stress such as caused by hectic lives lacking adequate sleep and relaxation.
- Cortisol increases heart rate,
- slows digestion,
- slows cell repair and regeneration,
- breaks down healthy muscle and bone
- weakens the immune system.
This increase in cortisol can wreck havoc on the balance of the different hormones that has been maintained. The falling estrogen levels also contribute to the stress response, as estrogen is involved in many functions within the body.
Cortisol is produced in the adrenal glands along with other hormones such as progesterone, some forms of estrogen, adrenaline, and testosterone. These hormones all come from the same parent hormones. What this means is that one hormone can be produced in excess at the expense of other hormones. When the body is under stress, the adrenals will cause the progesterone to be broken down to cortisol alone which leads to a reduction of DHEA (parent compound of estrogen and testosterone).
This cortisol then helps the liver to produce glucose because the body is anticipating the need for action and is providing the energy for this. In our modern day world, this kind of physical action rarely occurs, so what happens to all that excess glucose (sugar)? You guessed it, it is stored as fat. Usually visceral fat.
The adrenals also play a role in attempting to maintain estrogen levels as the ovaries are declining in function. The elevated cortisol levels will cause visceral fat to be made and stored in the abdomen. This visceral fat produces estrone, which is a form of estrogen. The adrenals produce estrone and belly fat produces estrone. This may very well be why all of a sudden, around the time of menopause, you have belly fat (or more belly fat)!
The adrenals do not act on their own, they have help from the brain. The brain, specifically the hypothalamus and pituitary, are the master controllers of our endocrine functions. Without these areas controlling and regulating, the separate organs may produce too much or too little of whatever hormone they are responsible for. During stress, the brain is attempting to reduce reproductive capacity, growth and thyroid function. This is done to help with survival. In this country and in this day and age, we are rarely in a position of having our very survival threatened. So the stress of our lives are unnecessarily causing all these problems.
So what do you do?
Reduce stress, reduce stress, reduce stress. This will reduce cortisol, which will hopefully reduce visceral fat production and reduce glucose production. This in turn will reduce heart disease, insulin resistance, and improve endocrine function of the non-stress hormones produced in the adrenals.
Reduce stress in a way that is enjoyable to you. Therefore you will be likely to make this part of your daily routine. Exercise, mediation, yoga. You must get adequate sleep, at least 7 hours a night. Your diet is important also, reduce sugar, alcohol, caffeine as these items can contribute to elevated cortisol levels.
Start with little changes, pick one new thing you will do and do it daily for a few weeks. When that is a common practice for you, pick another item you want to change. Change can be slow, this is often the more effective way to make changes that stick.
Write in the comments section and tell us your stories on changes you have made. Your story will most likely help and inspire someone else to make a change!
What is Heart Disease?
The heart is a pump for blood. Blood carries the nutrients we need to our cells and hauls waste products away for elimination mainly through the liver and kidneys. The heart starts beating in our chest while we are in the uterus and if we live to age 75 our heart will beat about 2.7 BILLION times. It is tough and
resilient but it can be injured. Sometimes because of an accident, poisoning whether accidental or self-inflicted like too much alcohol, genetics and other reasons outside our control, it doesn’t beat that long or that well. The heart disease that killed over 430 thousand U.S. women in 2006 and continues to do so each year is not well understood.
Heart disease causes inflammation of the lining of the circulatory system. After a certain point that is poorly understood right now, the body begins to loose that battle and resorts to plan B. It uses small dense particles of cholesterol to shore up the inflamed weakened lining of the arteries. This is usually a slow process but it eventually closes some of those arteries. The inflammation itself causes other problems in other organs but none so insidious as in the arterial lining.
When the inflammation reaches a certain point, the body begins to calcify these cholesterol deposits. This creates hard plaques and circulation troubles. When plaques rupture inside arteries, clots cut off blood flow to brain, heart muscle, skeletal muscle as in peripheral vascular disease or intestines. This causes pain, sometimes death of some of the muscle and maybe death of the person.
What is a risk factor?
It is a measurable fact that taken together with your total risk factors, indicates the level of risk for a certain health problem. RISK FACTORS are not DISEASES. They do not predict you will have heart disease, they indicate a level of risk, a percentage chance that a disease, in this case heart disease, will occur.
What risk factors can I control?
Risk factors over which you have no control are:
- your sex
- your age
- your family history
- your own history of heart attack, stroke or TIA previously.
Risk factors you do control are:
- Use of tobacco products
- Your level of activity
- Your cholesterol particle size
- Your blood pressure
- Your weight
- Your control of your blood sugar
- Your Triglyceride level
- Your response to Stress
- Good Dental Health
What do we really know about preventing heart disease?
We know a lot about heart disease but our knowledge isn’t perfect. We like gadgets, operations, pills and the latest thing when the oldest thing really matters.
We know when we are fit, trim and eating a healthy diet we are less likely to have any disease. We are less likely to respond negatively to stress when we exercise regularly. What is it that we can do that will reduce our response to disease onset within our body?
Don’t eat too much, eat as much local food as possible and avoid processed food. Pay attention to your body and keep some records. Be aware of how much you eat and its affect on your energy, weight and thinking. Be proactive but not obsessive.
Have a large group of friends, read instead of watch TV and screen out the negative junk in movies, TV shows and the news. Get enough sleep. Your body is made to do work long and slow. Investigate various kinds of activity that mimic work if you don’t have land to work or activities that are fun. I favor for myself Nordic Walking, Swing dancing, the “Shovel Glove” workouts you can find on YouTube.com and some light weight lifting along with lifting my Grandfather’s Blacksmith Anvil I inherited. What are your favorites?
As far as eating and supplements go – grass fed beef has an omega 6 to 3 ratio of 4-1. This is similar to ideal in our own muscles. Grain fed beef have a ratio of 16 or 20 to 1. This is a cause of inflammation. I supplement with a krill oil capsule (500mg) daily to boost my omega 3 fatty acids which help brain, joints, reduce triglycerides, raise HDL cholesterol and help decrease inflammation. Put a live bacteria back into your gut with a probiotic supplement ( I use Jarrow products). I don’t take it daily but will share a bottle of 100 and we each take 3 at bedtime for a couple of weeks a couple of times a year. I take vitamin D3 made from sheep wool lanolin about 1000IU most days of the year since I am inside most days.
Don’t forget to laugh a lot and be a source of laughter.
I can’t say you should do these things. I do them because my research has indicated that they are beneficial. Talk to your doctor, chiropractor, naturopath etc… Consider their motivation for giving you great advice.
I hope you will come back, become a subscriber , leave comments and tell your friends about us. So, I have a motive. Some people want to tell you something and others just like to be right. What do you think mine is?
Tell me your thoughts. Ask me a question. What have I missed? Where do you think I am wrong? If you think it is the meat thing and want me to be a vegetarian like you I am for it. I just want the animal to eat them first and I will eat the animal.
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What is Heart Disease?
Humans in the United States die or have their life altered by diseases of the heart and arteries more than any other disease. Obesity and its problems may over-take heart disease as a cause of morbidity and mortality. Obesity is a risk factor for the development of heart disease.
In general terms, heart disease is an inflammation of the lining of the arteries of the body but especially of the heart and brain. This inflammation causes your body to try to protect the arterial lining with fats and calcium when it is prolonged. This can occlude or plug the circulation. When this happens in the heart or brain you have an “ATTACK” that can kill or maim one of those vital organs and thus end your life as you like it or completely.
You can live with a leg with poor circulation or without that leg if necessary but obviously if your heart and/or brain circulation is severely compromised, so is your life. The life of a woman with these problems is compromised and shorter than it might have been without them. One in three women will experience heart disease sometime in their lives. Twice as many women die of heart disease than from all sources of cancer including breast cancer. More women than men die of heart disease each year.
What are the statistics for heart disease in women.
I have included a link to a PDF on heart disease statistics in women at the end of this section but let me quote you a few stats from it in case you don’t want to download it.
In 2006, the most recent year for which stats are available 432,709 women died of heart disease. This was 52.1% of all deaths from cardiovascular diseases.
In that same year 40,821 women died of Breast Cancer and 69,385 from lung cancer.
64% of women who die from cardiovascular disease had no previous symptoms.
WomenCVDStats the link to the left is the AHA pdf
What do I need to do?
The fact that you are a female gives you an advantage over men. Women live longer and have these problems later in life than men do. This is why more first heart attacks are fatal in women than in men. The fact that 64% had no warning symptoms seems to lend itself to some other hypothesis for cause than eating too much fat. That alone can not explain these statistics. Cholesterol lowering medications are not going to change these stats much either.
Inflammation is the cause of most diseases. Inflammation seems to increase with age. It seems like a no brainer that we want to keep inflammation to a minimum. How do you do this?
My short list of reducing the risk for inflammation looks like this:
- learn to control your response to stress – practice some sort of meditation
- drink more water than any other fluid – I really believe in home water filtration if you can afford it
- Eat to live – stay away from processed foods – if it needs a label for ingredients – don’t eat it
- Move – your body was made to walk long distances – practice this daily
- Sleep – the bed room is for sex and sleep and nothing else – shut off the TV by 8 PM, and don’t watch from bed!
- Screen out the junk of life – decide what news you need – learn how to use the Internet to alert you to those topics and stop listening to the rest. You can make a difference to your family and some of your friends and co-workers – concentrate your effort there.
- laugh with family and friends frequently
- set aside a percentage of your time for service to others you choose to serve, but keep a strict limit on this time – you need time for you first
- Get a pet – owning a cat or especially a dog increases your lifespan more than any medication according to WebMD
What do you think? Leave us a comment – tell us if you think I am crazy or if you agree. We want your opinion and your story.