text:
When he died on Oct. 5, Steve Jobs was eulogized as the tech visionary who put elegantly designed gadgets into the lives of people who often hadn't realized the devices were essential — until Jobs, and Apple, created them. This week, Jobs' admirers will have another chance to hear him speak, thanks to the film Steve Jobs: The Lost Interview.
Only a small portion of the footage, which was once thought to have been lost, has been seen before. Ten minutes of it aired on TV in 1995; in late October, 60 Minutes used excerpts from the tape to flesh out its interview of Walter Isaacson, Jobs' official biographer.
Taped toward the end of Jobs' tenure at NeXT, where he took a nearly 12-year timeout after his ouster from Apple in 1985, the interview was conducted by Robert Cringely, a veteran technology writer and documentary filmmaker, for his PBS show Triumph of the Nerds.
Within two years of the interview, Jobs would return to Apple.
Watching the footage is like seeing a time-capsule version of Jobs, who wears glasses and (what else?) a black mock turtleneck. He is, by turns, playful, defensive and brutally honest — sometimes within the span of one story.
Here's a trailer for the film:
Jobs' topics include IBM, Xerox, Microsoft and Adobe — in fact, he says, he talked Adobe's founders into developing software instead of hardware.
The master tape of the hourlong interview was lost — but in early October, Cringely's director found some VHS copies of the interview, stashed away in his garage in Britain. On Twitter and his blog, Cringely asked his followers what he should do with the footage.
No one, he says, suggested a theatrical release. But Cringely says he wanted to create "a social experience" for people viewing the interview. For now, it's being given very short runs of between two and three days in about 20 U.S. theaters operated by Landmark.
"The idea came to me late at night so I e-mailed Landmark owner Mark Cuban who replied in five minutes," Cringely writes, "proving insomnia has its virtues."
With a running time of a little more than an hour, the documentary is a straightforward affair, showing one camera angle of Jobs, who sits in the museum-like room, with a large monitor in the background. Sitting in front of the camera, Jobs does pretty much what a fan would want him to do: He tells stories, prodded along by Cringely.
Early Project Centers On Phones
One of Jobs' stories is about meeting his longtime collaborator Steve Wozniak, when Jobs was around 14 or 15 years old. Wozniak was five years older; he had been kicked out of his first college for playing pranks, Jobs says.
But Jobs also calls Wozniak "the first person I met that knew more about electronics than I did."
The first big project by the men who would go on to found Apple involved two things that, with hindsight, make an elaborate prank seem prescient. Those things were telephones and AT&T.
Jobs and Wozniak were inspired by a story in Esquire about a man named "Captain Crunch," who had built a device that let him make free telephone calls. The idea was to use a device called a Blue Box to mimic the sounds used by phone companies.
So in 1971, the two friends hit the library, Jobs says, "looking for the secret tones that would allow you to do this."
To be precise, the coveted tones were similar to those produced by a touchtone phone — but in a different, and specific, frequency.
"And it turned out that we were at Stanford Linear Accelerator Center one night," Jobs said — and after looking deep in the bowels of the center's technical library, they found a copy of an AT&T technical journal, which contained all they ever wanted to know about the special phone company tones.
"AT&T made a fatal flaw when they designed... the original digital telephone network," Jobs said. "They put the signaling from computer to computer in the same band as your voice. Which meant that if you could make those same signals, you could put it right in through the handset. And literally, the entire AT&T international phone network would think you were an AT&T computer."
It took Jobs and Wozniak three weeks to make their first box. And then they made their first long-distance call — "for free!" Jobs said.
With their device in hand, Jobs and Wozniak learned all the codes they needed to route phone calls through cables, networks and satellites.
"You could go around the world five or six times," Jobs says, "and then you could call the payphone next door. So, you could shout into the phone, and after about a minute, it would come out the other phone. It was miraculous."
That might not sound like the best use of anyone's time — let alone that of two creative, industrious young men. But Jobs says it's important to remember just how young they were.
"What we learned was, that we could build something ourselves — that could control billions of dollars' worth of infrastructure in the world," he said. "That was what we learned, was that us two — you know, we didn't know much — we could build a little thing that could control a giant thing."
And the experience led them to take up more projects.
"I don't think there would ever have been an Apple Computer had there not been blue-boxing," Jobs says — a somewhat jarring thing to hear in 2011, when Apple reigns as one of the world's most valuable companies.
The two even put a small logo on the bottom of their blue boxes, Jobs says. It read, "He's got the whole world in his hands."
And they eventually used their blue box — bragging a bit, Jobs says that it was completely digital, and the best on the market — to make an international prank call to the Vatican.
With Wozniak doing his best imitation of Henry Kissinger, Jobs said, "We got the number of the Vatican and called the pope."
Their call went through, and the request from the man claiming to be the U.S. secretary of state began making its way through the hierarchy.
"They actually sent someone to wake up the pope," Jobs said, "when finally, we just burst out laughing, and they realized that we weren't Henry Kissinger. So, we never got to talk to the pope. But it was very funny."
The Missteps Of Tech Giants
Some of Jobs' harshest words are for companies that gain a monopoly position, but "forget what it means to make great products." He's harsh on the companies — and the people who run them.
In those cases, "the people that can make the company more successful are sales and marketing people," Jobs says, "and they end up running the companies" while people tied to product development are shut out of the decision-making process.
"The product sensibility, and the product genius that brought them to that monopolistic position, gets rotted out by people running these companies who have no conception of a good product versus a bad product," he says. "They have no conception of the craftsmanship that's required, to take a good idea and turn it into a good product."
But he's not done there: "And they really have no feeling in their hearts, usually, about wanting to really help the customers."
That's a scenario that might give some unwelcome food for thought to investors and fans of Apple, which has lost its most visible, and product-obsessed, innovator.
But in this scenario, Jobs is discussing Xerox, where, Jobs says, innovative engineers had invented a template for where the personal computer was going. But Xerox famously failed to capitalize on it — something Jobs blames on the company being run by "toner heads" who were preoccupied by maintaining its printing business, instead of exploiting the possibilities represented by the computer.
"So, they just grabbed defeat from the greatest victory in the computer industry," Jobs says. "Xerox could have owned the entire computer industry today."
"But anyway, that's all ancient history," Jobs adds. "It doesn't really matter anymore."
A Reputation For Design, And Being Demanding
Of course, Jobs' ability to be acerbic and blunt has become part of the lore that has surrounded the late CEO. And the lost tape shows signs of his demanding, design-oriented side, as well — an aspect of his personality that is highlighted by Malcolm Gladwell's recent article for The New Yorker.
Titled "The Tweaker," the article draws from stories and anecdotes in Isaacson's biography — and effectively ensconces Jobs in the hall of fame of inventors and craftsmen that extends back to the early days of the Industrial Revolution.
Discussing innovators and product craftsmen in the Lost Interview, Jobs stresses the vital role they play in companies.
To illustrate his point, he recalls how difficult it was to produce something that has since become ubiquitous: the mouse. He knew what he wanted. But others at Apple insisted that they couldn't build one for less than $300 — and it would take five years to do it.
"The problem was that we'd hired a bunch of people from Hewlett-Packard," Jobs said. "And they didn't get this idea. They didn't get it."
Among their shortcomings, he says, was having "no concept of proportionally spaced fonts" or the mouse.
"I finally got fed up," Jobs says. He went to an outside design firm, run by David Kelley.
"And in 90 days, we had a mouse we could build for 15 bucks, that was phenomenally reliable," he says.
Of course, thanks in part to Apple's advances in touch-screen and swiping technology, the mouse is now in danger of being made obsolete.
For anyone who believes that the many stories about Jobs' obsession with detail, how he edits ideas down to an elegant, and efficient, state, are blustery sales pitches — the Apple co-founder has a rebuttal.
He begins by noting that often, the difference between the absolute best things in the world, and similar things that are merely average, isn't very extreme.
Jobs says that in "most things in life, the difference in dynamic range between 'average' and 'the best' is, at most, 2 to 1." And often, they're only separated by a 20 percent gap, he says.
"In software," Jobs says, "the difference between average and the best is 50 to 1. Maybe 100 to 1. Very few things in life are like this. But what I was lucky enough to spend my life in, is like this."
Copyright 2021 NPR. To see more, visit https://www.npr.org.


text:
Did you see Jimi Hendrix in concert? Did you meet Jimi Hendrix or have the opportunity to interview him or have some other unique, first-person encounter with Jimi Hendrix? If so, Experience Hendrix wants to hear from you.
Jimi Hendrix
Did you see Jimi Hendrix in concert? Did you meet Jimi Hendrix or have the opportunity to interview him or have some other unique, first-person encounter with Jimi Hendrix? If so, Experience Hendrix wants to hear from you.
Joined by Billy Cox, Hendrix and Miles returned to the Record Plant studios in New York City to continue work on several new tracks including "Room Full Of Mirrors," "Stepping Stone," and "Ezy Rider." Second engineer Tom Erdelyi recalls additional recordings being worked on including "Izabella," "Machine Gun," "Dolly Dagger," and "Message To Love." During this session, Hendrix brought in Albert and Arthur Allen (the Ghetto Fighters) to provide backing vocals for "Room Full Of Mirrors." The basic track of "Room Full Of Mirrors" is the foundation for the recording heard on 1997's First Ray s Of The New Rising Sun (Experience Hendrix/ MCA, 11599). Afterwards, Hendrix and the Allen twins visited Studio B where Mountain was recording their latest hit, "Mississippi Queen." Thrilled by the chance meeting, Hendrix invited Leslie West back to his studio for a jam.
billy cox Dolly Dagger Ezy Rider Izabella Machine Gun Message To Love Miles Recording Room Full Of Mirrors Stepping Stone
Back at the Record Plant several spirited recordings were put to tape this evening, including six takes of Buddy Miles signature track, "Them Changes" plus a dozen meandering takes of "Burning Desire." Hendrix was troubled by the tone of his guitar, resulting in few memorable highlights from the night's session. Despite some technical problems the group continued recording, pressing through two takes of "Lover Man," described here as "Here Comes Your Lover Man," plus three lack-luster renditions of "Hear My Train A Comin'." Prior to the session collapsing, Hendrix returned the group to "Burning Desire" and "Them Changes," both of which were met with genuine disinterest.
Buddy Miles Burning Desire lover man Record Plant Recording Them Changes
Overcoming the lagging spirits of the previous night, Alan Douglas and Stefan Bright brought Tony Bongiovi back into the control room as engineer to help spur on Hendrix's musical style. As intended, Hendrix lead the group through a high-spirited session of recordings including nineteen takes of "Izabella" of which takes 1, 2, 4, 10, 12, 16, and 19 were tagged 'complete.' After a quick change of tape reels, one final take the 20th of "Izabella" was put to tape and flagged as the basic track. With the success of "Izabella" filling the studio air, the group turned to "Burning Desire" although none of the 24 takes featured the emotional intensity of the later. The marathon session continued with additional recordings of "Machine Gun" the fourth and final take was marked complete. Afterwards Hendrix guided the session through 24 takes (without vocals) of "Power Of Soul" which he then described as "Paper Airplanes."
Alan Douglas Paper Airplanes Power Of Soul Recording Stefan Bright Tony Bongiovi

subset: commoncrawl


text:
4th International Scientific Forum, ISF 2015
Education, Climate Change and Economic Development
University of Oxford, United Kingdom, Sept 2-4, 2015
European Scientific Institute, ESI – Interdisciplinary science on 5 continents
The European Scientific Institute, ESI is a global academic platform, connecting thousands of researchers from around the globe. ESI cooperates with universities and academic centres on 5 continents, organizing interdisciplinary conferences, forums and workshops. These academic events gather researchers from different disciplines, giving them an opportunity to present their papers, transfer knowledge and share best practices.
ESI has bases in Former Yugoslav Republic of Macedonia, Portugal and Argentina and is an official partner of UNESCO's World Science Day celebration and a United Nations' Academic Impact member.
WAAS collaborated with the European Scientific Institute at the above international forum. Ivo Šlaus, Honorary President of WAAS was the keynote speaker.
The Institute is an active supporter of the open access concept, publishing one of the largest open access interdisciplinary journals in Europe – the European Scientific Journal (ESJ). The journal promotes an agile and high-quality review procedure due to the excellent editorial team, composed of researchers from over 150 universities worldwide. Journal content is freely available to the public, contributing to the international dissemination of knowledge. ESJ's website is visited by more than 2 million researchers annually.
Visit http://isfoxford.com/ for more information


text:
Friday, June 27, 2008
I'll Take My Chances
Friday, June 27, 2008
And lest you think the odds are 1 in 6, like I initially did, look again. There are actually bon-bons ringing the whole cake, so your odds are more like 1 in 30. Well, assuming you only eat one, of course, which we all know would be against the laws of nature.
Aside from the possible poisoning attempt, this cake also breaks the laws of good taste by employing a sporadic color palette, sickly-looking yellow "flowers" (I use the term loosely), and a general over-use of the star tip: it looks like someone decorated the whole thing with a Redi-Whip can. Also, if we're to assume those red things are berries (see, John? I'm giving it the benefit of the doubt!), why are most of them centered on the "leaves"?
30 comments | Post a Comment
- Laura said...
Those "creepy yellow" flowers? I'm thinking they're pasta. Nothing says love like death and noodles.
- July 22, 2008 at 4:07 PM
While I suspect they mean one of the many Bon Bons on the cake is poisoned, I chose to read it as: "One Bon Bon is poison" so you must eat many!"
- July 22, 2008 at 10:33 PM
Maybe a song lyric? http://www.amazon.com/Bon-Bon-Love-Token-Allyson-Shaw/dp/0974822914
I think it's pretty! And I love the handwriting! I would totally hesitate to eat it, tho. - July 23, 2008 at 5:20 PM
- Uncle Vinny said...
Yea, I'm with laurie on this one. The cake overall is a tragedy, but I really like the handwriting!
- July 24, 2008 at 2:54 PM
- Megan said...
As an amateur baker/cake decorator who JUST started out selling my stuff, I'm SO glad to see that even if I screw up, it CAN'T be as bad as some of these!!!
LOVE the blog!!!! - July 25, 2008 at 10:05 AM
Maybe it was Christmas and those are holly berries......Maybe?
- July 27, 2008 at 10:23 AM
- Indigo said...
While my first thought is to agree with anonymous, that the idea is not to eat only one bonbon...
...I also have this notion that they served this cake at one of those Dinner and a Murder parties. - July 28, 2008 at 11:26 PM
A cake worthy of (movie-verse) Wednesday Addams ;)
- July 28, 2008 at 11:47 PM
- Momof4 said...
While the multi-colored icing rosettes were a bad choice, I think the cake idea and wording is hilarious. I plan to copy the idea at some point for a birthday cake for a family member w/ a good sense of humor & a sweet tooth for bon bons. :-)
- July 29, 2008 at 5:39 PM
That cake looks absolutely delicious. You fools who are making fun of it because of some malformed flowers, you're just leaving more for me!
- August 6, 2008 at 1:05 PM
The comments on this cake made me cry I was laughing so hard I could not talk. And yes, I would be that person eating the Bon-Bons too late to realize they were poison. Great writting. I laughed for 30minutes
- August 14, 2008 at 11:45 PM
The old joke goes like this:
A woman who did not like to have people stealing bon bons from her candy dish put a sign on it that read "One Bon Bon is poison" to deter thieves.
The next day, the sign had been changed to "Two Bon Bons are poison" - August 15, 2008 at 4:01 PM
- Kate said...
Oh good lord, I find the cake while not exactly attractive somehow deliciously wicked, in a non-literal sense (having not tasted it myself). I'd love a cake with a wicked sense of humor.
- August 16, 2008 at 6:18 PM
- Justin said...
I love this handwriting, though. The best I've seen on any of them as I peruse your blog. I've had to label it "time burglar" as it is wasting much productive time.
- August 20, 2008 at 2:39 PM
I would put Poison Control on Speed Dial and then eat them all anyway.
I actually find that cake hilarious and besides the slightly disturbing message, a very acceptable dessert :D I think you might be over-criticising this one. - August 24, 2008 at 5:50 PM
- Wendy said...
Would love to know the true story behind the cake. I also love the handwriting
- August 26, 2008 at 3:34 PM
- elesa said...
Fran probably had this cake made up for her birthday at the office and included this clever little inscription to deter some of the cake hogs so that they wouldn't eat it all before she got a piece. It was a pretty good trick too, because those aren't even bon bons. Those are Cream Puffs.
- August 29, 2008 at 1:25 AM
I kinda want this cake for my next birthday...
- September 13, 2008 at 10:45 AM
- The Howe Family said...
At least the handwriting is nice ... Yikes.
- September 18, 2008 at 3:54 PM
I think it'd be better if it said "one bon-bon isn't poision" then you really help dieters *snicker*
- September 20, 2008 at 6:24 PM
When I first read it, I read "poison" as "poisson". It made the whole thing that much more ridiculous and confusing. I want someone to put that many cream puffs on my birthday cake!
- November 8, 2008 at 12:48 PM
- Brandy said...
It's ok, I was planning on leaving one. *grin*
- November 29, 2008 at 4:29 AM
Laurie said...
Maybe a song lyric? http://www.amazon.com/Bon-Bon-Love-Token-Allyson-Shaw/dp/0974822914
my friend wrote that book! how odd to find a reference to it here. - November 29, 2008 at 4:56 AM
I feel like I ought to wait till nobody's looking, then add "Now there are two" to the message. (You know the old joke?)
- December 28, 2008 at 7:56 PM
Maybe it possibly was supposed to be "One Bon Bon Per Person"?
Just a guess.
Rocky - January 7, 2009 at 1:41 PM
I was wondering about the words being a reference. I couldn't find the contents of the Allyson Shaw book Bon Bon Love Token.
What I did find is lyrics to a song by Swedish group A Camp:
"Who told you love is the alpha and omega?
And that your heart will lead you to the only one?
It`s a curse, it`s the hammer that will break you,
It`s a poison hidden in a bon bon."
Are the friends of a heartbroken recipient encouraging her to try again using the sweetest medicine known?
The video is available on youtube, http://www.youtube.com/watch?v=wUVMpluF7kQ - January 11, 2009 at 3:18 PM
- Vermin the cat said...
Actually, the cake itself is not horrendous and I adore the dark humour behind the inscription. I'm sure it must be a theme cake for a party--I know my daughter had me make a cake for her eighteenth birthday that said "Cake or Death?" on it in a reference to an Eddie Izzard sketch.
- February 9, 2009 at 7:04 PM
"Nothing says love like death and noodles."
I think this is the best comment on the entire page. I'm still laughing. Thank you, Laura! - October 12, 2009 at 9:37 PM
Maybe it was supposed to say, "One Bonbon is Passion."
- November 27, 2009 at 2:55 PM
The bakery? http://engrishfunny.files.wordpress.com/2010/01/engrish-funny-poison-bakery.jpg
- February 8, 2010 at 6:52 PM
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It may have something to do with all those Brontosaurus burgers everyone's favorite modern stone-age family ate, but when you think of a giant dinosaur with a tiny head and long, swooping tail, the Brontosaurus is probably what you're seeing in your mind.
Well hold on: Scientifically speaking, there's no such thing as a Brontosaurus.
Even if you knew that, you may not know how the fictional dinosaur came to star in the prehistoric landscape of popular imagination for so long.
It dates back 130 years, to a period of early U.S. paleontology known as the Bone Wars, says Matt Lamanna, curator at the Carnegie Museum of Natural History in Pittsburgh.
The Bone Wars was the name given to a bitter competition between two paleontologists, Yale's O.C. Marsh and Edward Drinker Cope of Philadelphia. Lamanna says their mutual dislike, paired with their scientific ambition, led them to race dinosaur names into publication, each trying to outdo the other.
"There are stories of either Cope or Marsh telling their fossil collectors to smash skeletons that were still in the ground, just so the other guy couldn't get them," Lamanna tells Guy Raz, host of weekends on All Things Considered. "It was definitely a bitter, bitter rivalry."
The two burned through money, and were as much fame-hungry trailblazers as scientists.
It was in the heat of this competition, in 1877, that Marsh discovered the partial skeleton of a long-necked, long-tailed, leaf-eating dinosaur he dubbed Apatosaurus. It was missing a skull, so in 1883 when Marsh published a reconstruction of his Apatosaurus, Lamanna says he used the head of another dinosaur — thought to be a Camarasaurus — to complete the skeleton.
"Two years later," Lamanna says, "his fossil collectors that were working out West sent him a second skeleton that he thought belonged to a different dinosaur that he named Brontosaurus."
But it wasn't a different dinosaur. It was simply a more complete Apatosaurus — one that Marsh, in his rush to one-up Cope, carelessly and quickly mistook for something new.
Although the mistake was spotted by scientists by 1903, the Brontosaurus lived on, in movies, books and children's imaginations. The Carnegie Museum in Pittsburgh even topped its Apatosaurus skeleton with the wrong head in 1932. The apathy of the scientific community and a dearth of well-preserved Apatosaurus skulls kept it there for nearly 50 years.
That Brontosaurus finally met its end in the 1970s when two Carnegie researchers took a second look at the controversy. They determined a skull found in a quarry in Utah in 1910 was the true Apatosaurus skull. In 1979 the correct head was placed atop the museum's skeleton.
The Brontosaurus was gone at last, but Lamanna suggests the name stuck in part because it was given at a time when the Bone Wars fueled intense public interest in the discovery of new dinosaurs. And, he says, it's just a better name.
"Brontosaurus means 'thunder lizard,'" he says. "It's a big, evocative name, whereas Apatosaurus means 'deceptive lizard.' It's quite a bit more boring."
Copyright 2020 NPR. To see more, visit https://www.npr.org.


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• Remember that herbal remedies are medicines. As with any other medicine they are likely to have an effect on the body and should be used with care. • Herbal remedies may sometimes interact with other medicines. This makes it particularly important to tell your doctor or pharmacist if you are taking a herbal remedy with other medicines such as prescribed medicines (those provided through your doctor or dentist). • Treat with caution any suggestion that a herbal remedy is '100% safe' or is 'safe because it is natural'. Many plants, trees, fungi and algae can be poisonous to humans. It is worth remembering that many pharmaceuticals have been developed or derived from these sources because of the powerful compounds they contain. Any medicine, including herbal remedies, which have an effect on the body should be used with care. • Treat with caution any herbalist or other person who supplies herbal remedies if they are unwilling or unable to provide written information, in English, listing the ingredients of the herbal remedy they are providing. • If you are due to have a surgical operation you should always remember to tell your doctor about any herbal remedy that you are taking. • Anyone who has previously experienced any liver complaint, or any other serious health complaint is advised not to take any herbal remedy without speaking to their doctor first.
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Few conventional medicines have been established as safe to take during pregnancy and it is generally recognised that no medicine should be taken unless the benefit to the mother outweighs any possible risk to the foetus. This rule should also be applied to herbal medicinal products. However, herbal products are often promoted to the public as being "natural" and completely "safe" alternatives to conventional medicines. Some herbal ingredients that specifically should be avoided or used with caution during pregnancy. As with conventional medicines, no herbal products should be taken during pregnancy unless the benefit outweighs the potential risk.
Volatile Oils
Many herbs are traditionally reputed to be abortifacient and for some this reputation can be attributed to their volatile oil component.(6) A number of volatile oils are irritant to the genito-urinary tract if ingested and may induce uterine contractions. Herbs that contain irritant volatile oils include ground ivy, juniper, parsley, pennyroyal, sage, tansy and yarrow. Some of these oils contain the terpenoid constituent, thujone, which is known to be abortifacient. Pennyroyal oil also contains the hepatotoxic terpenoid constituent, pulegone. A case of liver failure in a woman who ingested pennyroyal oil as an abortifacient has been documented.
A stimulant or spasmolytic action on uterine muscle has been documented for some herbal ingredients including blue cohosh, burdock, fenugreek, golden seal, hawthorn, jamaica dogwood, motherwort, nettle, raspberry, and vervain. Herbal Teas Increased awareness of the harmful effects associated with excessive tea and coffee consumption has prompted many individuals to switch to herbal teas. Whilst some herbal teas may offer pleasant alternatives to tea and coffee, some contain pharmacologically active herbal ingredients, which may have unpredictable effects depending on the quantity of tea consumed and strength of the brew. Some herbal teas contain laxative herbal ingredients such as senna, frangula, and cascara. In general stimulant laxative preparations are not recommended during pregnancy and the use of unstandardised laxative preparations is particularly unsuitable. A case of hepatotoxicity in a newborn baby has been documented in which the mother consumed a herbal tea during pregnancy as an expectorant. Following analysis the herbal tea was reported to contain pyrrolizidine alkaloids which are known to be hepatotoxic.
Breast-feeding mothers
A drug substance taken by a breast-feeding mother presents a hazard if it is transferred to the breast milk in pharmacologically or toxicologically significant amounts. Limited information is available regarding the safety of conventional medicines taken during breast-feeding. Much less information exists for herbal ingredients, and generally the use of herbal remedies is not recommended during lactation.
Paediatric Use
Herbal remedies have traditionally been used to treat both adults and children. Herbal remedies may offer a milder alternative to some conventional medicines, although the suitability of a herbal remedy needs to be considered with respect to quality, safety and efficacy. Herbal remedies should be used with caution in children and medical advice should be sought if in doubt. Chamomile is a popular remedy used to treat teething pains in babies. However, chamomile is known to contain allergenic sesquiterpene lactones and should therefore be used with caution. The administration of herbal teas to children needs to be considered carefully and professional advice may be needed.
Perioperative use
The need for patients to discontinue herbal medicinal products prior to surgery has recently been proposed. The authors considered eight commonly used herbal medicinal products (echinacea, ephedra, garlic, ginkgo, ginseng, kava, St John's Wort, valerian). On the evidence available they concluded that the potential existed for direct pharmacological effects, pharmacodynamic interactions and pharmacokinetic interactions. The need for physicians to have a clear understanding of the herbal medicinal products being used by patients and to take a detailed history was highlighted. The American Society of Anaesthesiologists (ASA) has advised patients to tell their doctor if they are taking herbal products before surgery and has reported that a number of anaesthesiologists have reported significant changes in heart rate or blood pressure in some patients who have been taking herbal medicinal products including St John's Wort, ginkgo and ginseng. MCA is currently investigating a serious adverse reaction associated with the use of ginkgo prior to surgery. In this case, the patient who was undergoing hip replacement experienced uncontrolled bleeding thought to be related to the use of ginkgo.
From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK
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Heart Failure
Topic Overview
What is heart failure?
Heart failure means that your heart muscle doesn't pump as much blood as your body needs. Failure doesn't mean that your heart has stopped. It means that your heart is not pumping as well as it should.
Because your heart cannot pump well, your body tries to make up for it. To do this:
- Your body holds on to salt and water. This increases the amount of blood in your bloodstream.
- Your heart beats faster.
- Your heart may get bigger.
Your body has an amazing ability to make up for heart failure. It may do such a good job that you don't know you have a disease. But at some point, your heart and body will no longer be able to keep up. Then fluid starts to build up in your body, and you have symptoms like feeling weak and out of breath.
This fluid buildup is called congestion. It's why some doctors call the disease congestive heart failure.
Heart failure usually gets worse over time. But treatment can slow the disease and help you feel better and live longer.
What causes heart failure?
Anything that damages your heart or affects how well it pumps can lead to heart failure. Common causes of heart failure are:
- High blood pressure.
- Heart attack.
- Coronary artery disease.
Other conditions that can lead to heart failure include:
- Diabetes.
- Diseases of the heart muscle (cardiomyopathies).
- Heart valve disease.
- Disease of the sac around the heart (pericardial disease), such as pericarditis.
- A slow, fast, or uneven heart rhythm (arrhythmia).
- A heart problem that you were born with (congenital heart defect).
- Long-term heavy alcohol use, which can damage your heart.
What are the symptoms?
Symptoms of heart failure start to happen when your heart cannot pump enough blood to the rest of your body. In the early stages, you may:
- Feel tired easily.
- Be short of breath when you exert yourself.
- Feel like your heart is pounding or racing (palpitations).
- Feel weak or dizzy.
As heart failure gets worse, fluid starts to build up in your lungs and other parts of your body. This may cause you to:
- Feel short of breath even at rest.
- Have swelling (edema), especially in your legs, ankles, and feet.
- Gain weight. This may happen over just a day or two, or more slowly.
- Cough or wheeze, especially when you lie down.
- Feel bloated or sick to your stomach.
If your symptoms suddenly get worse, you will need emergency care.
How is heart failure diagnosed?
Your doctor may diagnose heart failure based on your symptoms and a physical exam. But you will need tests to find the cause and type of heart failure so that you can get the right treatment. These tests may include:
- Blood tests.
- A chest X-ray.
- An electrocardiogram (EKG or ECG) to check your heart's electrical system.
- An echocardiogram to see the size and shape of your heart and how well it is pumping.
- Magnetic resonance imaging (MRI) to see the structure of your heart and check how well it is pumping.
An echocardiogram can help show if you have heart failure, what type it is, and what is causing it. Your doctor can also use it to see if your heart failure is getting worse.
This test can measure how much blood your heart pumps to your body. This measurement is called the ejection fraction. If your ejection fraction gets lower and you are having more symptoms, it means that your heart failure is getting worse.
How is it treated?
Most people with heart failure need to take several medicines. Your doctor may prescribe medicines to:
- Help keep heart failure from getting worse. These drugs include ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, and vasodilators like hydralazine and a nitrate.
- Reduce symptoms so you feel better. These drugs include diuretics (water pills) and digoxin.
- Treat the cause of your heart failure.
It is very important to take your medicines exactly as your doctor tells you to. If you don't, your heart failure could get worse.
Pacemaker or defibrillator
A pacemaker or a defibrillator (such as an ICD) may be an option for you if you have a problem with your heart rhythm. A pacemaker can help your heart pump blood better. A defibrillator can prevent a dangerous heart-rhythm problem.
Care at home
Lifestyle changes are an important part of treatment. They can help slow down heart failure. They may also help control other diseases that make heart failure worse, such as high blood pressure, diabetes, and coronary artery disease.
The best steps you can take are to:
- Eat less sodium. Sodium causes your body to hold on to water and may make symptoms worse. Your doctor may also ask you to limit how much fluid you drink.
- Get regular exercise. Your doctor can tell you what level of exercise is safe for you, how to check your pulse, and how to know if you are doing too much.
- Take rest breaks during the day.
- Lose weight if you are overweight. Even a few pounds can make a difference.
- Stop smoking. Smoking damages your heart and makes exercise harder to do.
- Limit alcohol. Ask your doctor how much, if any, is safe.
Ask your doctor if cardiac rehab is right for you. Rehab can give you education and support that help you learn self-care and build new healthy habits, such as exercise and healthy eating.
To stay as healthy as possible, work closely with your doctor. Have all your tests, and go to all your appointments. It is also important to:
- Talk to your doctor before you take any new medicine, including nonprescription and prescription drugs, vitamins, and herbs. Some of them may make your heart failure worse.
- Keep track of your symptoms. Weigh yourself at the same time every day, and write down your weight. Call your doctor if you have a sudden weight gain, a change in your ability to exercise, or any sudden change in your symptoms.
What can you expect if you have heart failure?
Medicines and lifestyle changes can slow or even reverse heart failure for some people. But heart failure often gets worse over time.
Early on, your symptoms may not be too bad. As heart failure gets worse, you may need to limit your activities. Treatment can often help reduce symptoms, but it usually doesn't get rid of them.
Heart failure can also lead to other health problems. These may include:
- Trouble with your heart rhythm (arrhythmia).
- Stroke.
- Heart attack.
- Mitral valve regurgitation.
- Blood clots in your legs (deep vein thrombosis) or lungs (pulmonary embolism).
Your doctor may be able to give you medicine or other treatment to prevent or treat these problems.
Heart failure can get worse suddenly. If this happens, you will need emergency care. To prevent sudden heart failure, you need to avoid things that can trigger it. These include eating too much salt, missing a dose of your medicine, and exercising too hard.
Knowing that your health may get worse can be hard. It is normal to sometimes feel sad or hopeless. But if these feelings last, talk to your doctor. Antidepressant medicines, counseling, or both may help you cope.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health problems.
Actionsets are designed to help people take an active role in managing a health condition.
- Anxiety: Stop Negative Thoughts
- Blood Thinners Other Than Warfarin: Taking Them Safely
- Depression: Stop Negative Thoughts
- Healthy Eating: Eating Less Sodium
- Heart Failure: Activity and Exercise
- Heart Failure: Avoiding Medicines That Make Symptoms Worse
- Heart Failure: Avoiding Triggers for Sudden Heart Failure
- Heart Failure: Checking Your Weight
- Heart Failure: Taking Medicines Properly
- Heart Failure: Watching Your Fluids
- Insomnia: Improving Your Sleep
- Low-Salt Diets: Eating Out
- Stop Negative Thoughts: Getting Started
- Stress Management: Breathing Exercises for Relaxation
- Stress Management: Doing Guided Imagery to Relax
- Stress Management: Doing Meditation
- Stress Management: Doing Progressive Muscle Relaxation
- Stress Management: Managing Your Time
- Stress Management: Practicing Yoga to Relax
- Warfarin: Taking Your Medicine Safely
Heart failure can be caused by any problem that damages your heart or affects how well it works.
Problems that damage the heart muscle
- High blood pressure
- Heart attack
- Coronary artery disease
- Diabetes that isn't controlled
- Alcohol, illegal drugs (such as cocaine), and some prescription medicines (such as those for chemotherapy)
- Heart problems you've had from birth (congenital heart disease)
- Infection or inflammation of the heart muscle (such as myocarditis)
Things that damage the heart's valves
- Valve problems you've had since birth
- Infection of a heart valve (endocarditis)
- Aging
- Rheumatic fever
Problems with the heart's electrical system
- Fast, slow, or irregular heart rhythms, including atrial fibrillation
- Electrical signals that don't flow as they should from the upper to the lower part of the heart (heart block)
Other problems
- Disease of the sac around the heart (pericarditis)
- Postpartum cardiomyopathy. This rare problem can happen late in a woman's pregnancy or within the first 5 months after delivery.
- Severe anemia
- Hyperthyroidism
Certain triggers, such as too much sodium or not taking medicines the right way, may suddenly make heart failure worse. This can sometimes cause deadly problems such as pulmonary edema or cardiogenic shock.
At first you may not have any symptoms from heart failure. For a while, your heart and body can make up for heart failure. For example, your heart can pump faster and pump more blood with each beat. This is called compensation.
But as your heart has more trouble pumping enough blood to your body, you will likely have symptoms. These symptoms may get worse or change if your heart failure gets worse.
Symptoms of heart failure start to happen when your heart can't pump enough blood to the rest of your body. In the early stages, you may:
- Feel tired easily.
- Be short of breath when you exert yourself.
- Feel like your heart is pounding or racing (palpitations).
- Feel weak or dizzy.
As heart failure gets worse, fluid starts to build up in your lungs and other parts of your body. This may cause you to:
- Feel short of breath even at rest.
- Have swelling (edema), especially in your legs, ankles, and feet.
- Gain weight. This may happen over just a day or two, or more slowly.
- Cough or wheeze, especially when you lie down.
- Feel bloated or sick to your stomach.
How doctors talk about heart failure
There is more than one type of heart failure. Each type is based on what problem in the heart is causing it to not pump as much blood as normal.
Heart failure is grouped—or classified—according to symptoms. Your treatment is based partly on what class of symptoms you have.
There's also another way to define heart failure. It's based on the stages you might go through as your heart failure gets worse. Your doctor also may make treatment choices based on your stage of heart failure.
Symptoms of sudden heart failure
Sometimes your symptoms may get worse very quickly. This is called sudden heart failure. It causes fluid to build up in your lungs, causing congestion. (This is why the problem is often called congestive heart failure.) Symptoms may include:
- Severe shortness of breath.
- An irregular or fast heartbeat.
- Coughing up foamy, pink mucus.
Sudden heart failure is an emergency. You need care right away.
More information
What Increases Your Risk
Your risk for having heart failure is higher if you have certain risk factors. A risk factor is anything that increases your chance of having a particular problem.
Heart failure is usually caused by another health problem, often coronary artery disease or high blood pressure. So anything that increases your risk for one of those problems also increases your risk for heart failure.
- Risk factors for coronary artery disease and heart attack include smoking, having high cholesterol or diabetes, and having a family history of heart disease.
- Risk factors for high blood pressure include being overweight, being inactive, and having a family history of high blood pressure.
- Risk factors for heart valve disease include older age and an infection of the valves.
The risk of heart failure rises as a person gets older.
When to Call a Doctor
Call 911 or other emergency services right away if you have:
- Symptoms of sudden heart failure, such as:
- Severe shortness of breath (trouble getting a breath even when resting).
- Suddenly getting an irregular heartbeat that lasts for a while, or getting a very fast heartbeat along with dizziness, nausea, or fainting.
- Foamy, pink mucus with a cough and shortness of breath.
- Symptoms of a heart attack, such as:
- Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
- Symptoms of a stroke. These include:
- Sudden numbness, tingling, weakness, or paralysis in your face, arm, or leg, especially on only one side of your body.
- Sudden vision changes.
- Sudden trouble speaking.
- Sudden confusion or trouble understanding simple statements.
- Sudden problems with walking or balance.
- A sudden, severe headache that is different from past headaches.
Call your doctor right away if you have a pacemaker or ICD and think you have an infection near the device. Signs of an infection include:
- Changes in the skin around your pacemaker or ICD, such as:
- Swelling.
- Warmth.
- Redness.
- Pain.
- Fever not caused by the flu or another illness.
Call your doctor soon if you have symptoms of heart failure, which include:
- Being very tired or having weakness that prevents you from doing your usual activities.
- Having breathing problems such as:
- Trouble breathing during routine activities or exercise that did not cause problems before.
- Sudden shortness of breath, even if it is mild.
- Shortness of breath when you lie down.
- Waking up at night with shortness of breath or feeling as though you are suffocating.
- A dry, hacking cough, especially when you lie down.
- Sudden weight gain, such as more than 2 lb (0.9 kg) to 3 lb (1.4 kg) in a day or 5 lb (2.3 kg) in a week. (Your doctor may suggest a different range of weight gain.)
- Increased fluid buildup in your body (most often in the legs).
Call your doctor soon if:
- Your heart failure symptoms get worse.
- You have a sudden change in symptoms.
- You're having trouble keeping even minor symptoms under control.
Who to see
Many different types of doctors and nurses can treat you for heart failure, including your family doctor.
Exams and Tests
Heart failure is a complex problem. So you will likely have several different tests over time. These tests can:
- Find out if you have heart failure.
- Find the cause of your heart failure.
- Find the type of heart failure you have.
- Show how bad your heart failure is (class and stage).
- See how well your treatment is working.
If you have symptoms that suggest heart failure, you may have:
- A review of your medical history and a physical exam.
- Blood tests.
- Electrocardiogram (EKG, ECG).
- Chest X-ray.
- Echocardiogram (echo).
- Brain natriuretic peptide (BNP).
- Magnetic resonance imaging (MRI).
- Cardiac blood pool scan.
An echocardiogram may be used to diagnose heart failure. It also can help guide treatment.
Tests also may be done to find areas of the heart that are not getting enough blood. These tests include:
- Cardiac perfusion scan. This test can show poor blood flow to the heart.
- Cardiac catheterization. This test can be used to check for blocked or narrowed heart arteries and to measure pressures inside the heart.
When you're taking medicine for heart failure, you may have regular blood tests to check how the medicine is working. Or you may have a blood test to check the level of medicine in your body.
More information
- How Often You'll See Your Doctor for Heart Failure
- Heart Failure With Reduced Ejection Fraction (Systolic Heart Failure)
- Heart Failure With Preserved Ejection Fraction (Diastolic Heart Failure)
- Right-Sided Heart Failure
- High-Output Heart Failure
Treatment Overview
Your treatment for heart failure depends on:
- The cause of your heart failure.
- Which type of heart failure you have.
- How bad your symptoms are (classification).
- How well your body is able to make up (compensate) for your heart failure.
- Your goals, wishes, and preferences about your treatment.
In the early stages of heart failure, treatment can help your symptoms. It may also prevent more damage to your heart. Treatment may include:
- Taking medicines, such as a diuretic and an ACE inhibitor. To learn more, see Medications.
- Making lifestyle changes, such as eating less salt and being more active. To learn more, see Living With Heart Failure.
As part of your ongoing treatment, your doctor will also try to prevent or treat problems—such as fever, arrhythmia, and anemia—that can lead to sudden heart failure. Treatment may include:
- Getting vaccines. Your doctor may want you to get vaccines against pneumonia and flu. These vaccines can keep you from getting infections that could put you in the hospital.
- Checking your weight. Your doctor will probably give you guidelines for watching fluid buildup and tell you how much weight gain is too much.
- Getting devices to fix heart rhythm problems. In some cases, your doctor may recommend a biventricular pacemaker that can help your heart pump blood better. This is also called cardiac resynchronization therapy (CRT). Or you may have an implantable cardioverter-defibrillator (ICD) to stop a deadly rhythm. Some people get a pacemaker that is combined with an ICD.
- Oxygen treatment. Your doctor may recommend oxygen therapy to reduce your shortness of breath and increase your ability to exercise.
You might take part in a disease management program. These programs include a broad range of services, such as education, home health care, visiting nurses, and rehabilitation.
A very small number of people may have other treatments, including:
- Ventricular assist devices (VADs), which help the heart pump blood.
- Heart transplant, which replaces your heart with a donor heart.
Treatment for causes of heart failure
If you have other heart problems that may have led to heart failure, you might have treatment for those problems:
- Coronary artery bypass surgery or angioplasty.
- Surgery to replace or repair a valve in your heart.
- Cardiac rehabilitation, a supervised program that uses exercise, education, and support to help people live well with heart failure. For more information, see the topic Cardiac Rehabilitation.
Sometimes heart failure can be fixed if another problem can be corrected, such as by treating hyperthyroidism.
Palliative care
Palliative care is a kind of care for people who have a serious illness. It's different from care to cure your illness. Its goal is to improve your quality of life—not just in your body but also in your mind and spirit.
You can have this care along with treatment to cure your illness. You can also have it if treatment to cure your illness no longer seems like a good choice.
Palliative care providers will work to help control pain or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
If you're interested in palliative care, talk to your doctor.
For more information, see the topic Palliative Care.
End-of-life care
Heart failure tends to get worse over time. So you need to decide what kind of care you want at the end of your life.
It can be hard to have talks with your doctor and family about the end of your life. But making these decisions now may bring you and your family peace of mind. Your family won't have to wonder what you want. And you can spend your time focusing on your relationships.
You will need to decide if you want life-support measures if your health gets very bad. An advance directive is a legal document that tells doctors how to care for you at the end of your life. This care includes electronic devices that are used for heart failure, such as pacemakers. You also can say where you want to have care. And you can name someone who can make sure your wishes are followed.
For more information, see the topic Care at the End of Life.
The best way to prevent heart failure is to have a heart-healthy lifestyle and control existing health problems like high blood pressure and diabetes.
To reduce your risk:
- Don't smoke. If you smoke, quit. Avoid secondhand smoke too.
- Eat heart-healthy foods. Eat fruits, vegetables, fish, lean meats, and whole grains. Choose foods that are low in saturated fat and avoid trans fat. Limit sodium, alcohol, and sugar.
- Get regular exercise. Try to do activities that raise your heart rate. Aim for at least 2½ hours of moderate exercise a week.footnote 1
- Stay at a healthy weight. Lose weight if you need to.
- Manage other health problems that can raise your risk of heart disease and heart failure. These include high blood pressure, high cholesterol, and diabetes. You can use heart-healthy lifestyle changes along with medicines to manage these conditions.
Living With Heart Failure
You can feel better when you have heart failure by taking your medicines as directed, having a healthy lifestyle, and avoiding things that make heart failure worse. Know what things you can do every day to stay healthy, what symptoms to watch for, and when to call a doctor.
Ask your doctor if cardiac rehab is right for you. Rehab can give you education and support that help you learn self-care and build new healthy habits, such as exercise and healthy eating.
Taking medicines
- Take your medicines as directed. If you don't, your heart failure may get worse, or you may get sudden heart failure.
- Try to avoid medicines that can make your heart failure worse. Before taking any new medicine, ask your doctor or a pharmacist if it's safe to take it with your heart failure medicines.
Having a healthy lifestyle
- Eat healthy foods.
- Limit sodium. Your doctor might recommend that you limit sodium to less than 2,000 mg a day. Limiting sodium can help you feel better and prevent sudden heart failure. Fluid may build up in your lungs—making it harder for you to breathe—and in your feet, ankles, legs, and belly.
- Exercise regularly. If you aren't already active, your doctor may want you to start exercising. Do not start exercising until you have talked with your doctor to make an exercise program that is safe for you. You could do it in a cardiac rehabilitation program or on your own.
- Check your weight at the same time every day. Checking your weight helps you keep track of your symptoms. Sudden weight gain may mean that fluid is building up in your body because your heart failure is getting worse.
- Try to lose weight if you are overweight. Eating a heart-healthy diet and exercising regularly will help you lose weight. Even a few pounds can make a difference.
- Don't smoke. If you smoke, try to quit. Smoking increases your risk for heart disease and makes it harder to exercise. Avoid secondhand smoke too.
- Limit alcohol. Moderate drinking is no more than 2 drinks a day for men and 1 drink a day for women.
- Limit your fluids if your doctor tells you to. Limiting fluid can help relieve swelling. Limiting fluid helps your body get rid of extra water and sodium.
- Oxygen treatment. Your doctor may recommend oxygen therapy to reduce your shortness of breath and increase your ability to exercise.
Avoiding things that make heart failure worse
Avoid triggers, such as too much salt (sodium) and certain medicines, that can cause sudden heart failure.
Treating your sleep problems
One Man's Story: Pete, 70 "I was having a lot of trouble getting enough sleep. I was snoring so bad that my wife was sleeping in another room. I'd wake up 7 times a night. Sometimes I'd wake up gasping for breath. The next day I'd be so tired that I'd fall asleep while doing my woodworking in the garage. And I was really fuzzy-headed. I couldn't remember anything. "I thought it might be my heart failure. So I decided to talk to my doctor about it, and he suggested a sleep study. I found out that I have sleep apnea. I haven't been getting enough oxygen because of it. He put me on a CPAP machine at night. I've used it for the past 4 months. "It took a little time to get used to sleeping with a mask. But I'm sleeping much better. Now if I wake up, it's only once, and I go right back to sleep. I feel so much better during the day."— Pete This story is based on information gathered from many people living with heart failure. |
Many people with heart failure have trouble sleeping. Your doctor may be able to find out what is causing your sleep problems and help you get a good night's sleep.
Having a healthy sex life
Most people with heart failure can still have an active and safe sex life. Talk with your doctor if you have concerns about having sex.
Unfortunately, sexual problems are common. Your interest may drop, or you may have shortness of breath or other symptoms that limit your ability to have sex. Men may have erection problems.
Talk to your doctor. You can get help for erection problems or other sexual troubles.
Other things you can do to take care of yourself
- Get help for depression and anxiety if you have them. Heart failure can be hard on your emotions. Many people with heart failure feel depressed or anxious. For more information on how to feel better, see Coping With Your Feelings.
- Try sometips for easier breathing, such as propping yourself up with pillows at night.
- Avoid colds and the flu.Stay up to date on vaccines for flu and pneumonia.
- Learn to save your energy to make activities like work, exercise, and travel easier. Talk to your doctor.
- Work with yourteam of health professionals.
Help for caregivers
It can be rewarding to help a loved one with heart failure. But it's also a lot of work. And it can be hard emotionally.
If you are taking care of a loved one, make sure that you also take care of yourself. This can mean taking breaks by getting help from family or friends. You also may be able to use respite care. These services provide someone who will stay with your loved one while you get out of the house for a few hours.
More information
Coping With Your Feelings
Heart failure brings big changes to your life. You may struggle with sadness and worry. You may wonder if you'll still be able to enjoy your life. Coping with your feelings and seeking help when you need it can help you live better with heart failure.
Depression and anxiety
Heart failure can be hard on your emotions. You may feel depressed that you can't do some of the things you used to do. You may worry about your future. And symptoms of heart failure, such as shortness of breath, can make this anxiety worse.
These feelings are common. Talk to your doctor if you have symptoms of depression or are worried a lot. Depression and anxiety can be treated with counseling and medicine.
You also can help yourself feel better by changing your "self-talk." Those are the things you tell yourself about how you're coping. Negative thoughts can make you feel bad. Changing the way you think can change the way you feel.
One Woman's Story: Joan, 54 "I would sit at my kitchen table and feel I was in this cloud of dread. I didn't feel like me. I felt like, 'I'm never going to be me again.' "— Joan Read about how Joan got help for depression and anxiety. |
For more information, see:
The challenges of living with heart failure can increase your stress. And stress can make living with heart failure even harder. Stress also can disturb your sleep and make depression and anxiety worse. Explore ways to relax and manage stress to help your body, mind, and spirit.
- Stress Management: Doing Progressive Muscle Relaxation
- Stress Management: Managing Your Time
- Stress Management: Reducing Stress by Being Assertive
- Stress Management: Breathing Exercises for Relaxation
- Stress Management: Doing Guided Imagery to Relax
- Stress Management: Doing Meditation
- Stress Management: Practicing Yoga to Relax
Getting support
Emotional support from friends and family can help you cope with the struggles of heart failure. You might want to think about joining a heart failure support group. Ask your doctor about the types of support that are available where you live.
Cardiac rehab programs can offer support for you and your family. Ask your doctor if rehab is right for you.
Meeting other people with the same problems can help you know you're not alone. If you're shy or aren't a joiner, you can look at an online support group. Even though people online aren't talking face-to-face, they're sharing their feelings and creating a community.
You probably will need to take several medicines to treat heart failure, even if you don't have symptoms yet.
Medicines don't cure heart failure. But they can help your heart work better and improve symptoms.
Medicines can:
- Relieve or control symptoms.
- Treat other health problems you have, such as coronary artery disease.
- Improve your daily quality of life.
- Slow the rate at which your heart failure gets worse.
- Reduce the chance of other problems from heart failure, such as stroke.
- Reduce hospital stays.
- Help you live as long as possible.
It's very important to take your medicines exactly as your doctor says. If you don't, your heart failure may get worse or you may get sudden heart failure.
The medicines you take will depend on the type of heart failure you have. The most commonly used medicines are listed below.
Medicines for pumping problems (heart failure with reduced ejection fraction, or systolic heart failure)
- ACE inhibitors (angiotensin-converting enzyme inhibitors) relax and widen blood vessels. This makes it easier for blood to flow.
- Aldosterone receptor antagonists, a type of diuretic, make the kidneys get rid of extra fluid.
- ARBs (angiotensin II receptor blockers) make it easier for blood to flow through the vessels.
- ARNI (angiotensin receptor neprilysin inhibitor) medicine makes it easier for blood to flow through the vessels. ARNI medicine may be used instead of an ACE inhibitor or an ARB.
- Beta-blockers slow the heart rate. They also may help the heart fill with blood more completely.
- Digoxin helps the heart pump more blood with each beat.
- Diuretics help relieve symptoms like swelling in the legs.
- Hydralazine taken with a nitrate widens blood vessels. This medicine can lower blood pressure and reduce the workload on the heart.
- Ivabradine slows the heart rate. This medicine may help prevent some people from being hospitalized for heart failure.
Medicines for filling problems (heart failure with preserved ejection fraction, or diastolic heart failure)
Other medicines
You also may take other medicines for health problems that can cause heart failure or for problems caused by heart failure.
- Antiarrhythmics prevent very fast and sometimes irregular heart rhythms.
- Blood thinners, also known as anticoagulants, prevent dangerous blood clots.
Talk to your doctor before you take any over-the-counter medicines. Some of them might make your symptoms worse.
More information
Surgeries for heart failure include:
- Surgery to get a pacemaker, implantable cardioverter-defibrillator (ICD), or ventricular assist device (VAD). For more information, see Other Treatment.
- Heart transplant to replace a failing heart. This is not common.
Other Treatment
Cardiac resynchronization therapy (CRT) uses a biventricular pacemaker, which makes the heart's lower chambers (ventricles) pump together. This can help your heart pump blood better. This type of pacemaker can help you feel better so you can be more active. It also can help keep you out of the hospital and help you live longer.
A pacemaker may be used alone or along with an implantable cardioverter-defibrillator (ICD) for heart failure.
Implantable defibrillators (ICDs)
Implantable cardioverter-defibrillators (ICDs) can prevent sudden death from an abnormal heart rhythm and may help you live longer. An ICD checks the heart for very fast and deadly heart rhythms. If the heart goes into one of these rhythms, the ICD shocks it to stop the deadly rhythm and returns the heart to a normal rhythm.
An ICD may be used alone or along with a pacemaker for heart failure.
Ventricular assist devices (VADs)
Ventricular assist devices (VADs), also known as heart pumps, may be placed into the chest to help the heart pump more blood. VADs can keep people alive until a donor heart is available for transplant. In some cases, VADs may also be used as an alternative to heart transplant for long-term treatment. VADs are used in people who have severe heart failure.
Intra-aortic balloon pump
An intra-aortic balloon pump is sometimes used to help the heart pump more blood during sudden heart failure.
Talk to your doctor before you take any over-the-counter medicine or supplement. They are used along with medical treatments for heart failure, not instead of treatment.
You may hear about supplements, vitamins, or hormones that might improve heart failure symptoms.
Fish oil (omega-3 fatty acid) supplements have been shown to help some heart failure patients. In some studies, fish oil supplements, taken along with other heart failure medicines, helped people stay out of the hospital and live longer.footnote 2
No other supplement, vitamin, or hormone has been shown definitely to relieve heart failure or help you live longer.
Examples include coenzyme Q10 and hawthorn.
- Only some of the studies of coenzyme Q10 showed that it helps heart failure symptoms.footnote 3
- Hawthorn is an herb that is sometimes used in Europe and Asia to try to increase blood flow to the heart.
Related Information
- Heart Attack and Unstable Angina
- High Blood Pressure
- Care at the End of Life
- Reducing Medication Costs
- Quitting Smoking
- Cardiac Rehabilitation
- Coronary Artery Disease
- Questions to Ask About Your Medicines
- Dealing With Medicine Side Effects and Interactions
- Navigating Your Hospital Stay
- Atrial Fibrillation
- U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/guidelines/default.aspx.
- Siscovick DS, et al. (2017). Omega-3 polyunsaturated fatty acid (fish oil) supplementation and the prevention of clinical cardiovascular disease: A science advisory from the American Heart Association. Circulation, 135(15): e867-e884. DOI: 10.1161/CIR.0000000000000482. Accessed April 10, 2017.
- Coenzyme Q10 (2006). Medical Letter on Drugs and Therapeutics, 48(1229): 19–20.
Other Works Consulted
- Allen LA, et al. (2012). Decision making in advanced heart failure: A scientific statement from the American Heart Association. Circulation, 125(15): 1928–1952.
- Drugs for treatment of chronic heart failure (2009). Treatment Guidelines From The Medical Letter, 7(83): 53–56.
- Levine GN, et al. (2012). Sexual activity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation, 125(8): 1058–1072.
- McKelvie R (2011). Heart failure, search date August 2010. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
- Riegel B, et al. (2009). State of the science. Promoting self-care in patients with heart failure. A scientific statement from the American Heart Association. Circulation, 120(12): 1141–1163.
- Rosendorff C, et al. (2015). Treatment of hypertension in patients with coronary artery disease: A scientific statement from the American Heart Association, American College of Cardiology, and American Society of Hypertension. Circulation, 131(19): e435–e470. DOI: 10.1161/CIR.0000000000000207. Accessed March 31, 2015.
- Smith SC, et al. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124(22): 2458–2473. Also available online: http://circ.ahajournals.org/content/124/22/2458.full.
- Somers VK, et al. (2008). Sleep apnea and cardiovascular disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing in collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation, 118(10): 1080–1111.
- Yancy CW, et al. (2013). 2013 ACCF/AHA Guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 62(16): e147–e239.
- Yancy CW, et al. (2016). 2016 ACC/AHA/HFSA Focused update on new pharmacological therapy for heart failure: An update of the 2013 ACCF/AHA guideline for the management of heart failure. Circulation, published online May 20, 2016. DOI: 10.1161/CIR.0000000000000435. Accessed June 10, 2016.
Current as ofApril 9, 2019
Author: Healthwise Staff
Medical Review: Rakesh K. Pai MD, FACC – Cardiology, Electrophysiology
E. Gregory Thompson MD – Internal Medicine
Martin J. Gabica MD – Family Medicine
Elizabeth T. Russo MD – Internal Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
Stephen Fort MD, MRCP, FRCPC – Interventional Cardiology
Current as of: April 9, 2019
Author: Healthwise Staff
Medical Review:Rakesh K. Pai MD, FACC – Cardiology, Electrophysiology & E. Gregory Thompson MD – Internal Medicine & Martin J. Gabica MD – Family Medicine & Elizabeth T. Russo MD – Internal Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine & Stephen Fort MD, MRCP, FRCPC – Interventional Cardiology
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.


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13 Awesome Ways to Carve Your Watermelon
Oh, were you just planning on slicing your watermelon into wedges this Memorial Day weekend? We regret to inform you that plain old wedges are now kind of lame.
It turns out there are so many awesome ways to carve a watermelon that we are probably just not going to buy one ever again, because we are easily overwhelmed by so many options. If this is not a problem for you, here are some awesome carved watermelons, each requiring a different level of artistic talent, to give you some inspiration for your first cookout of the year.


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Mizuno USA, Inc.'s roots stem from its parent company Mizuno Corporation. Mizuno Corporation was established in Osaka, Japan in 1906 by Rihachi Mizuno. Today, Mizuno USA is located in Norcross, GA and continues to manufacture and distribute high quality golf, baseball, softball, running, track & field and volleyball equipment, apparel, and footwear.
Since its founding, Mizuno has taken special pride and pleasure in being able to participate in the exciting world of sports and providing supports equipment of the highest quality. The brand is guided by the idea of true sportsmanship. It is evident in the corporate core philosophy which, simply states, is "Contributing to society through the advancement of sporting goods and the promotion of sports."
Its product development strategy is to create products with features that enhance athlete performance and are unique to only Mizuno. These technological advancements make its sporting equipment and apparel go the extra mile and keep you in tip top playing form no matter the sport or the conditions. Mizuno believes in making products that work in harmony with your body, helping you to be the best athlete you can be.


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3 factors that may impact the sales price of your home
You can make all the necessary repairs to your home, clean it, stage it, maybe even remodel it. But there are some factors that may impact the eventual sales price of your home that are out of your control. So, regardless of how impeccably you've maintained the home and despite its ideal location, one or more of these circumstance may rear its head and dash those dreams of riches at the closing table.
Let's take a look at three of the factors that may impact your home's value.
1. The condition of the current market
You've no doubt heard real estate markets referred to as buyers' sellers' or balanced markets. A buyers' market occurs when there are lots of homes for sale and few buyers competing for them. Since the buyer is in the driver's seat, prices tend to stagnate or fall in this type of market. When the inventory of available homes is tight and there are many buyers seeking homes, we are in a sellers' market and home prices rise.
So, what creates these micro-markets? Many factors affect both national and local housing markets, chief among them is the strength of the economy. When times are good, consumers have money to buy homes and home prices typically increase. In tough times, when unemployment is high and incomes stagnant, the real estate market will feel the pinch.
Then, there are interest rates. When they rise, many are priced out of the housing market and when they fall, folks clamor to buy homes. Therefore, the overall strength of the economy may help dictate the eventual sale price of your home.
2. Neighborhood changes
Your neighborhood, and the surrounding area, may look nothing like it did when you bought the home. Even the most careful research performed before committing to buy a home can't foresee future zoning changes, the neighbor that builds an extra story on his home and blocks your view, or the sex offender that relocates to your neighborhood. All of these events can negatively impact your home's value and, subsequently, how much you'll receive when you sell it.
Suppose a change in zoning allowed a dump or landfill to be placed near your neighborhood. Nearby home values will drop by as much as 7.3 percent according to Business Insider's Mandi Woodruff.
A power plant will ding your value from 4 to 7 percent, a sex offender as a neighbor will drag down your home's value by up to 12 percent and, woe to you if a neighbor forecloses because, according to Woodruff, the national average loss of value of nearby homes is $7,200.
Now, some neighborhood changes should be applauded, at least by nearby homeowners. There's even a name for the phenomenon: The Walmart Effect. The name typically describes the economic impact on local businesses when a big-box store, such as Walmart, moves into the area, but it's been found to apply to home values as well.
So, if a Walmart comes to your neighborhood, rejoice – you may just get a 3 percent increase in home value, according to a study by the University of Chicago and Brigham Young University.
And cheer loudly when you learn that a Starbucks is coming to town and hope that it's within walking distance of your home. Real estate portal Zillow found that between 1997 and 2014, the average increase in home value nationwide was 65 percent. Homes within walking distance of a Starbucks, however, saw a hefty 96 percent increase. Add Trader Joe's and Whole Foods to the list of please-come-to-my-neighborhood" businesses. If they do, your home may see a 17.5 percent increase in value.
3. Your real estate agent
While pricing a home for the market isn't rocket science, it's also not something that the inexperienced can do and meet with success. It takes years to learn how to properly research a real estate market, to learn how to find truly comparable homes and all of the various other factors that go into determining a home's current market value. If your listing agent comes up with the wrong price, your bottom line is impacted.
Overpriced homes are notorious for eventually selling for far less than expected. Buyers' agents know how much homes in a particular area are worth and won't show their clients overpriced homes. So, they sit on the market. The listing becomes stale and agents and buyers think there must be something wrong with the home.
Underpricing is also a gamble. Sure, your agent may tell you that it will create a bidding war, but what if it doesn't? Are you really willing to take rock-bottom dollars for your home?
After pricing a home, the number one job of a listing agent is to market the home to find the buyer that will pay the most amount of money the market will bear. Marketing not only requires know-how, but money as well. How well-positioned financially is your agent? Ensure that the agent you hire has a robust marketing budget and isn't afraid to spend what it takes to get your home sold.
You'll pay the same amount of money for the services of an agent who gives you bare bones service as you will for the professional – so choose wisely.
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Under Dexterity Table I., there's a note that reads in part:
Defensive Adjustment refers to the penalty or bonus applicable to a character's saving throws against certain forms of attack (such as fireball, lightning bolts, etc.) due to dodging ability.As I said,I neither remembered this rules wrinkle nor saw anyone who ever used it. It's interesting to me, because this use of Dexterity precedes the explanation of its effect on armor class, so one likely read it before reading about the AC adjustment. Yet, it never registered with me. Funny that.


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College athletes' honesty caught on security camera
Steroid scandals, murder charges and accusations of autograph peddling. Now how about a good news story from the world of sports?
Four football players from William Paterson University went shopping at a general store in Wayne, N.J., on Sunday afternoon. After spending several minutes trying to locate the store clerk, two of the players who needed sunglasses and batteries were captured on store security cameras leaving money at the register.
Buddy's Small Lots store manager, Marci Lederman, was taken by their honesty.
"They picked up a few items, and they left cash on the counter and waved to the cameras," Lederman told Yahoo News. "Who does that?"
Thomas James, Kell'E Gallimore, Jelani Bruce and Anthony Biondi do that.
The NCAA Division-III Pioneers haven't had a winning season in nearly 20 years, but life's rewards are sometimes sweeter than those earned on a football field.
"It doesn't surprise me that they did what they did," said Jerry Flora, the Pioneers' head coach. "That's the kind of kids we try and recruit in here so we can obviously deal with a lot less headaches if you know what I mean."
As it turns out, the players had unknowingly entered a closed store. Lederman said a lock on the front door had malfunctioned and a half-lit store made it look like Buddy's was open. Police phoned her to say an alarm had been tripped, but she found nothing amiss.
"They could have ransacked the store. They could have really done anything," Lederman said. "They were perfect gentlemen. They were looking to see if anyone was here. They looked in the back to make sure no one was lying on the floor dead."
Lederman was so impressed that she called a local TV station to share the surveillance video, which helped her identify the four young men. On Tuesday, she rewarded each of them with $50 shopping sprees.
"They were just very thankful and grateful," she said. "They're nice kids."
A Heisman candidate might not emerge from Flora's small-school roster, but he has four on the squad who already earned preseason praise off the field.
"For me it's the total product," Flora said. "I'm looking for guys that will come in, be here for four years, learn, develop, graduate, become good alums, give back to the university, give back to the program and along the way hopefully have some fun and set a good example."


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By David Crane defrev at gmail dot com The first three (top three) photographic images contained in this article were taken by DefenseReview.com at SHOT Show 2008, and they are the exclusive property of DefenseReview.com. DefenseReview.com owns the copyright on these photos (from SHOT Show 2008), which were shot with a 7.2-megapixel Sony Cyber-shot digital camera (Model #: DSC-P150). All …
Read More »Tag Archives: bull pup sniper rifles
The DSR-1 Advanced Bullpup Sniper Rifle
by David Crane defrev at gmail dot com June 11, 2001 The AMP Technical Services DSR-1 rifle is currently being billed by its manufacturer as "the most sophisticated and technologically advanced tactical precision rifle in the world." One of its key designers is a Mr. K. G. Kirnstaetter, who was also responsible for the design of Erma's SR-100 rifle.
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By Ashley Bergner
Box Office Buzz
Oliver Queen is a very lucky man. He survives a shipwreck and five years of being marooned on a treacherous island. He is miraculously returned to his family and friends, who assumed he was dead and thought they'd never see him again. He's given a second chance at life — one he doesn't intend to take lightly — and he now has an opportunity to right some of the wrongs he and his family have committed.
Oliver Queen's quest to redeem his family's past is the subject of The CW's new superhero TV series "Arrow," based on the DC Comics character the "Green Arrow." The show airs on Wednesday nights and stars Stephen Amell as the ex-playboy Oliver Queen who now moonlights as a hooded vigilante known as the "Green Arrow."
The show has an intriguing premise, and I believe it has the potential to grow into a strong action/adventure drama. It's a fun show, and I'd definitely encourage fans of superhero stories to give it a try. (Also, I've tried to be as spoiler-free as possible in this review, but if you haven't seen the show yet, there may be some details that give away parts of the plot.)
Oliver Queen wasn't exactly the poster child for responsibility before the shipwreck, but his brush with death and the loss of his father (who sacrificed his life so Oliver could live) sobers him, and he returns to Starling City a changed man. His father has given him a notebook that contains the names of corrupt businessmen and other powerful officials who are hurting the people of Starling City, and Oliver dons a hood and deals justice to these corrupt officials using a bow and arrow, a skill he picked up while stranded on the island.
The show has some similarities to Christopher Nolan's "Batman Begins," but overall, it isn't as dark as the "Dark Knight" trilogy. It's sort of in between "Batman Begins" and "Iron Man" in terms of tone. The Oliver Queen character isn't as flippant or snarky as Tony Stark, but he's also not as brooding as Bruce Wayne. The show also has some Robin Hood parallels (the Green Arrow even wears a hooded jacket that's fairly similar to the look of Robin Hood's costume in the recent BBC series "Robin Hood").
Stephen Amell makes Oliver Queen a likable protagonist. You can see Oliver truly regrets his past mistakes, and he's committed to being a better person. However, he isn't perfect, and he struggles to navigate through the uncertain waters of the ethics of vigilante justice.
There are some nice supporting characters in the show, as well, who help to flesh out the story. David Ramsey is excellent as Oliver's bodyguard John Diggle. When I started watching the show, I had hoped Oliver would eventually tell Diggle about his alter ego and invite him to help him clean up Starling City. Oliver does end up telling Diggle about his secret, and Diggle joins Oliver's crusade. He keeps Oliver accountable, and I'm glad to see the characters working together. Paul Blackthorne is also excellent as Detective Quentin Lance. He doesn't trust the Green Arrow and is concerned about what could happen if his vigilante activities spiral out of control.
The show's format has Oliver investigating a different corrupt official every week, though there are some overarching plot threads that tie everything together. One of the most intriguing parts of the show is that a member of Oliver's family has become involved in a mysterious and sinister conspiracy that could be tied to the boating accident (which may not have been an "accident" after all).
The show isn't quite as iconic yet as "Iron Man" or "Batman Begins," but I do think it has plenty of potential, and it's one I definitely plan to keep watching. It's a nice mix of fun action/adventure scenes and timely social commentary, and I'm looking forward to seeing where they take the show in the future.


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Now, the problem is that today we have thoroughly awesome geek wedding cakes, and I am not, in the strictest sense of the word, a geek. At least, not to the degree which I've married into. However, for your entertainment and enlightenment I will now valiantly attempt to decipher these cakes without the help of Jen OR the interwebs. (May the Shwartz be with me!)
Batman and Wonder Woman! Great colors. And I think the bottom tier is... Metropolis? Maybe?
K, now they're getting harder:
Right. The adorable mushroom toppers are from a Mario game, and the cake is decorated in binary. Booyah. Just don't go asking me to translate it. (And if you do, I'll guess it's something like "In geekiness, and in über geekiness, I thee wed.)
Now we're getting old school:
Look! It's Epcot!
(Why is Jen sighing so loudly behind me? And what is xkcd?)
Oh boy, I'm gonna get in trouble for this next one:
Is it... Zelda? Made of Lego? I don't... I never played it, so...
Look, this is harder than it looks, Ok?
Oh! Oh! I know this! What is that show called?!? It's on the tip of my mind. It's got Bender and... that cyclops lady... Futurama!
Haha! And I've never even seen it!
Also, that crash-landing into the cake thing is genius.
This one I definitely know:
Cake by Queen of Cakes and topper by Sweet Frost Tops
Portal! Jen and I are actually playing the co-op version now.
(Well, not now now. I'm writing this post now. You get the idea.)
On a side note, I just realized something: If you write "The cake is a lie" on a cake, isn't that statement itself a lie? Technically, the lie is a lie since the cake is a cake.
Aaand now my brain hurts.
Let's wrap this up with one of my favorite cakes of all time, made by a baker who made one of our book tour cakes in Austin:
By Coco Paloma Desserts; photo by Sweet Caroline Photography
Ya know, I just realized: I've never seen Godzilla. So Transformer Mrs. Godzilla could totally be in there. Huh.
(And speaking of figures, did you notice the bride is holding the groom? Too funny.)
Well, I hope you enjoyed these geeky wedding Sweets, everyone. And if you have a Sweet of your own you'd like to share, please send it to Sunday Sweets (at) Cake Wrecks (dot) com.
Oh, and have a great Sunday.
I'll be playing Portal.