My husband does nothing half ass. Start a company? Go big, even if it takes 25 years. Learn piano as an adult? Practice an hour a day, even if your job, wife, and kids are constantly competing for that time. So when he got into lifespan, healthspan, and longevity, it was no different. He started reading longevity books several years ago and goes big on every new idea. He sees two longevity doctors, uses a full-body electrical stimulation suit, and takes a variety of longevity medications, including rapamycin and metformin. He also tried platelet-rich plasma (PRP) for hair growth, GLP-1 agonists (like Ozempic), bought a fancy cold plunge, and not one but two saunas—one for indoors and one for outdoors.
Two weeks ago, he sustained a fall coming out of our indoor sauna. I was about 15 feet away and heard what sounded like a bowling ball hitting our bathroom tile. I rushed into the bathroom to find him on the floor, face up, shaking from head to toe. After about 10 seconds, he opened his eyes and tried to get up. That is when the blood started gushing everywhere. I can’t exactly remember the order of events—all I remember was thinking his brains must be falling out the back of his head—but I did call 911. Eleven painfully long minutes later, they arrived and assessed him. He was given fluids and taken to the emergency department. After more fluids, bloodwork, a negative CT (no internal bleeding, no skull fracture), and nine staples in the back of his head, we came home.
When the paramedics first checked, his blood pressure was 74/40. He usually runs 120-130/70-80. It turns out that both of his longevity doctors had recently recommended trazodone, a sedating medication used to enhance sleep quality. It also has a side effect of orthostatic hypotension, which means that blood pressure may drop when changing positions, namely from lying to sitting or standing. My husband was lying in the sauna, stood up, and passed out within seconds. The signaling systems in his body lagged, and his brain did not get the blood flow it needed, resulting in fainting.
Thankfully, he lived to tell the story, but I would like to share some lessons we both learned:
Just because a medicine is prescribed by a licensed professional doesn’t mean it is safe. Many people, my husband included, believe that a doctor’s signature is a stamp of safety. The inconvenient truth is that doctors do not know exactly how every medication is going to interact with whatever else you are taking, especially when some of your medications and supplements are from online platforms. Some professionals try, but even the best doctors cannot predict who will have which of the long list of potential side effects or how drug interactions affect your side effect risk profile.
Young people fall, too. While it is true that fall risks, hip fractures, and head injuries are more likely for the elderly, non-elderly people can have serious falls, too. We are not invincible. Mixing medications with other pharmaceuticals (polypharmacy), recreational drugs, or alcohol all increase fall risk. Women, who tend to be more familiar with syncopal episodes, may learn to get out of bed slowly or avoid jumping up from a seated position. For those who have never dealt with this, please learn from others’ experiences!
Extreme temperature exposure can have a downside. While there is a growing body of research teasing out the potential health effects of heat and cold therapy, I would like to place a warning label on such activities. Alcohol and many medications can worsen the drop in blood pressure associated with moving from hot environments to cooler areas. This is what happened to my husband, and miraculously, he did not have any significant lasting effects. Similarly, cold immersion may have health benefits, but not for everyone, such as people with Raynaud’s phenomenon or susceptibility to arrhythmias or cardiac arrest (which is not always predictable). Even for some seemingly healthy people, cold temperatures may shock the body, resulting in devastating outcomes. This is seen in elderly people shoveling snow off their driveway or 18-year-olds drowning after cold shock in 48-degree bodies of water. The American Heart Association provides recommendations on habituating your body prior to various cold water immersion exercises.
In summary:
- Heed warnings on labels. Mixing medications with one another, alcohol, drugs or supplements can have life-altering effects. With more pills, injections or potions comes a greater risk of side effects and interactions.
- No one is immune to side effect profiles. Age or general health cannot accurately predict how your body metabolizes a drug or interacts with other drugs.
- If you are planning on engaging in cold or heat therapies, review habituation techniques.
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References:
Xu, Qingmei et al. “The risk of falls among the aging population: A systematic review and meta-analysis.” Frontiers in public health vol. 10 902599. 17 Oct. 2022, doi:10.3389/fpubh.2022.902599
Jaffer, Karim Yahia et al. “Trazodone for Insomnia: A Systematic Review.” Innovations in clinical neuroscience vol. 14,7-8 24-34. 1 Aug. 2017
Henderson, Kaemmer N et al. “The Cardiometabolic Health Benefits of Sauna Exposure in Individuals with High-Stress Occupations. A Mechanistic Review.” International journal of environmental research and public health vol. 18,3 1105. 27 Jan. 2021, doi:10.3390/ijerph18031105
Patrick, Rhonda P, and Teresa L Johnson. “Sauna use as a lifestyle practice to extend healthspan.” Experimental gerontology vol. 154 (2021): 111509. doi:10.1016/j.exger.2021.111509
“You’re not a polar bear: The plunge into cold water comes with risks.” American Heart Association News, 2022.https://www.heart.org/en/news/2022/12/09/youre-not-a-polar-bear-the-plunge-into-cold-water-comes-with-risks
Esperland, Didrik et al. “Health effects of voluntary exposure to cold water – a continuing subject of debate.” International journal of circumpolar health vol. 81,1 (2022): 2111789. doi:10.1080/22423982.2022.2111789
https://www.tandfonline.com/doi/full/10.1080/22423982.2022.2111789
