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Okay, you're reading a page written by a nurse. Here's my nursey type advice and admonitions:

People are always talking about the AIDS epidemic, and this and that exotic disease. But for every person who dies of AIDS, seven people die of cancer. And for every person who dies of cancer, ten people die of heart disease. After that comes stroke.

Pay attention to this, people, Please! You can live the most healthy lifestyle known to man, and still develop problems that lead to heart disease and stroke. Do NOT assume that, because you've given up eating eggs for every breakfast, and because you walk up the two flights of stairs to your office instead of taking the elevator, that you're immune to heart disease or stroke.

People sometimes call me and ask about symptoms they're having that are of concern to them. I ask questions and give advice (always within the scope of my practice as a registered nurse - please note, any regulating agency staff that might read this)

Here's what I'd tell you if you called me:

If your chest, arm, throat, jaw hurts, if you have feelings of pressure or tightness in the these areas, CALL 911 AND HAVE EMS COME AND TAKE TO YOU TO HOSPITAL. I used to say have someone drive you to the emergency room. I don't think that's the best advice anymore. Because if you are having a heart attack and you lo0se consciousness or stop breathing on the way, what is your driver going to be able to do for you? Nothing. Take an aspirin (chew it up), and call your personal doctor on the way, or before you leave.

If you have any kind of chest (arm, jaw, neck) discomfort, AND you are having trouble breathing, if you feel nauseated, light-headed or dizzy, if you are having trouble swallowing, or are very weak, have someone stay with you. Call 911 (in the US) and get an ambulance to take you to the nearest emergency room. Again, I think everybody with any heart attack symptoms should call 911.

Sometimes elderly people or diabetics have what are called "silent" heart attacks. This is an actual heart attack that does not produce the typical discomfort. Sometimes a bout of nausea and vomiting or an episode of dizziness or weakness is the only sign of a "silent" heart attack.

Okay, what if your symptoms are somewhat vague? This might feel like pressure in my chest, but it might be that gastric reflux that bothered me when I was in college.

Guess what? My advice is the same. Call the doctor, pop an aspirin and head for the hospital of his or her choice. Time = (heart) muscle.

What's the worst that can happen if you are having a bad bout of stomach upset? You spend a couple of hours in the emergency room, they give you something for your tummy, and you go home.

What's the worst that can happen if you're having heart problems and stay home, debating on whether it's stomach ache? It doesn't bear thinking about, does it?

Stroke: Symptoms are different, my advice is the same (except don't take an aspirin). Get you to a hospital. If possible, get to a hospital with a really good neuro department. There are new protocols for intervening in a stroke to prevent most of the disability. But you have to get to where you can be treated quickly. Time = BRAIN. Sympoms of a stroke: Headache, blurred vision, numbness or tingling, weakness in one or more extremity or a feeling of that extremity feeling heavier than the other, difficulty speaking, tongue feeling "thick" or difficulty finding words.

Some people experience a feeling of the face growing tight, difficulty keeping an eye open, double or blurred vision. A seizure in a person who has no history of seizures could be a sign of a stroke.

If you suspect someone else is having a stroke, ask them a simple question, or ask them to count to 20. Ask them to stick out their tongue (sometimes it'll deviate or poke out sideways if there's a stroke going on).

So - notice a common thread here? Some of these symptoms could indicate a stroke, or a bad sinus infection, or migrane headache.

Here again... What's the worst thing that could happen if you present to an emerg and it turns out to be a migraine? You learn you have a migraine and how to treat it, and you go home. If you stay home, and it's a stroke? Let's not even consider that!

I'm not going to go over all the typical things for first aid. There are a lot of good places to learn about first aid. I guess the most important thing I can tell you is not to hang around your house, wondering if your symptoms might be of something serious. Don't worry about feeling silly if you seek treatment and it turns out to be nothing!!

Take this to heart, though. One of the major problems with either heart attack or a stroke (brain attack) is that an awful lot of people go into denial that such a thing could be happening to them. So, if you are with someone who is having discomfort, and you don't like the way he or she looks. Gray, or pale, sweaty skin, anxiety, nausea, refusing to discuss the possibility that this might be a heart attack...

Take some initiative. I've taken someone to the hospital saying "No, I don't think this is life-threatening, or I'd be calling 911, don't worry, just get into the car and we'll check this out."

Try to stay calm and make the other person feel confident that you know what you're doing. You are in charge, and you expect the person to comply with your directives. Use a nice, pleasant tone of voice, but be specific and be bossy. Don't say "Do you want to go to the hospital?" Of course he doesn't! Say "Here's your aspirin. Take it now, and here's your jacket. Don't worry about (whatever it is that he's trying to distract your attention with). Get into the car now and I'll take care of it (whatever 'it' was)."

If the person looks like he's going to lose consciousness on you, or if he is in distress (difficulty breathing, severe weakness), Do Not try to drive him to the hospital. Call 911 (in the US) and stay with the him.

You Do know CPR, don't you?

If not, why not? Call the American Red Cross or the American Heart Association to schedule a class. A lot of hospitals offer them to the public. You do have to pay for it, but it seems worth it, to me. Your work place might be interested in offering and/or paying for them.

Have you heard of the Automatic External Defibrillator (AED)? Look around the next time you're in a mall or at the airport. There should be signs showing you where it's kept. This is totally brilliant to have these things in public areas! The AED is the defrillator used to shock a heart in trouble back into a rhythm that will support life. It's similar to the paddles you've seen on "ER" ("charge to 200 - Clear! "Tzzzapp!!") only it's all automated and computer-driven. The AED will totally walk you through using it - So find out if they're in your mall, and find out where they are. I hope you never see somebody have a heart attack at the mall or at the library but you never know.....

If I think of any other dire warnings or pieces of advice, I'll post them here. You can go to my guest page and leave any suggestions that you might care to give me!

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