How Not to Drop Dead

By Elizabeth Skenes Millen

   During Dr. Eduardo Chapunoff’s long years of medical practice, he had numerous opportunities to see people who died slowly, and others who died either suddenly (in minutes or up to 24 hours, defined as “sudden death,” or those who expire in two to three days, following an illness or an accident, classifiec as “rapid death.”
   “What called my attention about these often unexpected tragedies is the fact that many of them (actually, most of them) could have been prevented. It is indeed, very sad to see teenagers dying so fast because of drugs, and other people collapsing with heart attacks or strokes that were totally preventable and were induced by neglect or ignorance. Even highly educated individuals, some of them doctors –cardiologists included- often times fail to do a stress test prior to engaging in even moderately strenuous physical activities, or correct more aggressively their obesity, bad cholesterol levels or high blood pressure. To give you another example: A number of ruptured aortic aneurysms could be avoided if they were discovered on time. A simple ultrasound study is sufficient to detect it,” said Dr. Chapunoff, who is Chief of Cardiology at the Doctor’s Medical Center in Miami, Fla.
   Many tend to think that sudden death will occur to others, not themselves. Poor knowledge of basic health issues, or an attitude of inefficiency, personality and character flaws, and defective choices about what is more important or more trivial in our lives, is what often brings the unfortunate ones to funeral homes.
   There are lifestyles that invite sudden death—too much stress, too much unhappiness, too little physical activity, excessive weight, unhealthy foods, neglected hypertension, obesity, smoking, drugs and diabetes. Other less frequent causes of sudden death, like suicide, deserve special attention. A significant depressive state must be addressed immediately. Procrastination may end in disaster.
   Fortunately, Dr. Chapunoff has compiled much of his wisdom on the subject of sudden and rapid death and shared it in his most recent book, How Not to Drop Dead. Intrigued, we caught up with him to find out more.

There are obviously hundreds of ways to suddenly drop dead. What are the top 5 most common ways that cause sudden deaths in adults?

Let me begin by mentioning the most frequent causes of death. All of these causes are also responsible for cases of sudden death. The top 5 causes of death in the United States are:
 Heart disease  Chronic Obstructive  Cancer Pulmonary Disease  Stroke  Unintentional Injuries

Sudden Cardiac Death (SCD) accounts for more than 400,000 deaths yearly in the U.S.. Again, the incidence is much higher in men. Afro-Americans have a higher incidence of SCD than whites.
• 95 percent of sudden cardiac arrest victims die before reaching the Hospital. If no bystander CPR (cardiopulmonary resuscitation) is provided, a victim’s chances of survival are reduced by 7 to 10 percent with every minute of delay until defibrillation.
• Heart disease is the no: 1 cause of death for both men and women.
• More die of heart disease than of AIDS and all cancers combined.
• Nearly half of the heart attacks have no warning symptoms.
• Women account for half of the total heart disease deaths in the U.S. Still many women consider a heart attack as “a man’s disease.”
• 42% of women who have a heart attack die within one year compared to 24% of men.
• Under age 50, women’s heart attacks are twice as likely as men’s to be fatal.

Death among children and adolescents: Accidents are by far, the leading cause of death among children and adolescents. There are almost twice as many deaths in the first year of life than there are in the next 13 years. Then the death rate rises rapidly following puberty because of the large number of deadly accidents, homicides and suicides in the 15-24 year age groups.

Should everyone learn CPR? How important is it in perspective to the most common ways to drop dead?

I believe that CPR knowledge is important and even children should be familiar with the basic technique. A few well performed motions in a cardiac arrest situation can be life-saving.
   It is also advisable to know how to perform the Heimlich maneuver in a case of an acute airway obstruction by a foreign body, often a piece of food, typically a piece of a hot dog in children.

How can people reduce the risks of sudden death?

• Learn about the causes of sudden death
• Apply that knowledge to prevent them as much as possible
• Pay the proper attention to your health. Don’t be casual about it. Casual approaches provide casual results.
• You need radical behavior modification to improve your lifestyle.
• Do not discontinue medications for the blood pressure and cholesterol because they got better or normal.
• If you smoke, either quit or find out the size of your coffin.
• Figure out what your normal weight is and do not give up until
you achieve it.
• It’s time for you to start thinking about self-preservation as a priority, instead of having turbulent ideas about money and social status. Successful entrepreneurs and famous artists suddenly die from heart disease because of neglect and ignorance of basic medical facts.

Based on your experience and what you’ve seen as a physician over the years, what is your plea to us “patients”?

Many of us need to re-evaluate our past and present ideas about what was or is good or bad for us. Our lives are a comedy of errors. Many eat the wrong food (and too much of it), smoke, drink excessively, work more than they should or less than they should, are unhappily married or broken from a catastrophic divorce, have dysfunctional kids, at work supervisors or subordinates make their lives miserable, and frustrations pile up to record levels. It’s no wonder that thousands have volunteered to go to Mars with a one-way ticket!

   Don’t hesitate to dramatically change your life long deficient habits. If you need radical behavior modification, go for it. Some or all aspects of your personal life, (health, personal, intimate) may be in need of substantial changes. In other words, don’t be afraid to re-invent yourself. When you do that, you’ll feel like a much improved version of your former self, and in the process, you’ll become happier and less vulnerable to sudden death.

   Dr. Eduardo Chapunoff is a diplomate of the American Board of Internal Medicine and the American Board of Cardiovascular Disease, a Fellow of the American College of Physician and a Fellow of the American College of Cardiology. He was a Clinical Associate Professor of Medicine at the University of Miami from 1985 to 1997. He has been included in the records of Personalities Of America (American Biographical Institute), The International Who’s Who of Intellectuals and the International Man of the Year 1991-1992 (International Biographical Center, Cambridge, England). The Customers’ Research Council of America, selected him as “One of America’s Top Cardiologists.”
   Dr. Chapunoff is the author of “Answering Your Questions about Heart Disease and Sex”, Morbid Obesity: Will You Allow it to Kill You?, How Not to Drop Dead! A Guide for Prevention of 201 Causes of Sudden or Rapid Death, and The Heart of Psychology: Unraveling the Mysteries of the Mind. This latter work co-authored with Psychologist Dr. Howard Paul. All these books are also available in Spanish and available at your local bookstore and online at Amazon.com, BN.com and E-books can be ordered through Amazon.com, BN.com and Google Books.