Monday, January 23, 2006

Break Your Date With Death


7 Ways to avoid your end
by Jim Gorman, Men's Health; Illustration by Gary Taxali

You're being stalked.

Not by some obsessive ex, who keys your car one day and sends X-rated e-mails the next. Uh-uh, worse. This creep dresses in long black robes and carries around some kind of sharpened farm implement. Goes by the nickname "The Grim One." Says he's dying to meet you. Has you scheduled in his BlackBerry.

We advise blowing him off.

Turns out His Grimness sometimes makes it quite clear when—and where—he prefers to collect his corpses. When we analyzed mortality stats and delved into databases about the various and untimely ways young men die, patterns emerged that tip the Reaper's hand.

No, you can't live forever, but by knowing—and avoiding—some of the deadliest times and places in a man's life, you just might be late for your own funeral.

Monday, 8:30 a.m.

Meet: Your house

Death toll: 3,651 heart-attack victims (Unless otherwise indicated, all death totals are for men ages 25 to 44, during the most recent year for which data are available.)

Some men make their Monday-morning commute in an ambulance instead of an Audi. After reviewing the hospital records of nearly 5,600 heart-attack patients, German researchers observed that the risk of a heart attack is 33 percent higher on Monday than on any other day, possibly because of the stress of starting the work week. And in a separate study published in Circulation, the deadliest time slot on Monday was found to be the first three hours after waking. Why the arterial mayhem in the a.m.? Richard Stein, M.D., a cardiologist at New York City's Beth Israel Medical Center, has a good guess: "There's a clear increase in the stress hormone cortisol in the morning, as well as an increased clotting tendency in the blood."

Survive it: If you have any risk factors for heart desease—diabetes, high cholesterol, a family history—try to schedule your workout for the afternoon, not the morning. Eric S. Williams, M.D., a cardiologist at the Krannert Institute of Cardiology, in Indianapolis, says that strenuous physical activity may amplify the effects of the cortisol spike and increased blood clotting. Next, if you aren't already popping a daily low-dose aspirin—81 milligrams—reconsider: Research shows that this regimen reduces the incidence of a morning heart attack by 59 percent. But skip run-of-the-mill pills and instead pick up a bottle of Bayer Low-Dose Children's Chewable Orange; they'll be easier to chew in the event of an actual attack.

Monday, 11 a.m.

Meet: Your house

Death toll: 9,440 suicides

"Blue Monday" lives up to its billing. Suicides are 10 percent higher on Monday than the weekly average, says John McIntosh, Ph.D., a professor of psychology at Indiana University at South Bend. Using mortality data from the National Center for Health Statistics, McIntosh plotted daily variations in the number of DIY deaths. His finding: "Saturday is the lowest, possibly because there's a buffer from work and stress, and there's self-medication going on. Come Monday, you've gotten through the weekend thinking you'll be better, but you aren't. You have to start this all over again, and you can't take it."

Survive it: Are you depressed, and not just because your team tanked in the Sunday-night game? If the answer's yes, and you own a gun, lock it up—then throw away the key; firearms are why men are four times more likely than women to succeed at suicide. Now, see a psychiatrist about taking a selective serotonin reuptake inhibitor (SSRI). In a new study published in the Archives of General Psychiatry, researchers said that while antidepressants called tricyclics were associated with higher suicide rates, SSRIs were linked to an overall drop. Also, make sure your multivitamin contains 400 milligrams of folic acid; U.K. researchers found that folic acid enhances the depression-fighting effect of SSRIs.

Wednesday, 6 p.m.

Meet: Happy hour

Death toll: 259,494 smokers (all men)

If you thought ditching a cellphone carrier was tough, try quitting nicotine. Each year, 35 million Americans attempt to stop smoking; only 1 million succeed. The reasons to quit are powerfully persuasive—dramatic reductions in risk of stroke, heart disease and certain cancers register within mere years—but logic is no match for tobacco's seduction. "Relapses are most likely to hit in the late afternoon and evening," says Saul Shiffman, Ph.D., a professor of psychology at the University of Pittsburgh's smoking research group. "The classic situation is where there are other smokers and alcohol."

Survive it: Nicotine cravings are short-lived, usually lasting three to four minutes. If you're at a bar (or a party), get through the moment by chugging a glass of water and striking up a conversation with anyone close by, even a complete stranger. "Cold water kills the urge. Talking distracts and delays, and it encourages deeper breathing, which reduces stress," says Alan Peters, M.T.T.S., lead counselor for QuitNet.com. "Try opening a conversation by saying, 'You know, I quit smoking, and right now I'm thinking of having a cigarette.'" And if the person offers you one? Imagine that you-know-who's skeletal hand is proffering the pack.

Saturday, 1:30 a.m.

Meet: Multilane roadway

Death toll: 10,397

When the Grim Reaper places an order, he clearly likes it "to go." Motor-vehicle crashes kill more men between the ages of 25 and 44 than any other accidental cause, continuing a trend that begins when guys get behind the wheel in their teenage years. And where, when and how you drive can significantly stack the odds against you. "Speeding past a bar late at night on the weekend—not a good idea," says Alan Hoskin, a statistician at the National Safety Council. In fact, 1,024 sober men were killed by drunk drivers in 2004.

Survive it: Rule of thumb: If you have to ask yourself whether you're too drunk to drive, you probably are. Need evidence of your inebriation? Consider carrying the AlcoScan AL5000 ($90, alcometer.com), a portable breath-analysis device tested and approved by the National Highway Transportation and Safety Administration.

Or let's say you're driving sober, but the guy coming the other direction isn't, and he veers into your lane. Now what? "Don't bother flashing your lights or honking. You'll only startle him," says Gordon Booth, chief instructor at DriveTrain, a driver-training company in San Jose, California. "Going into the ditch may be your best option. Hit the brakes hard and look where you want to go. Don't fixate on the other car, or you'll unconsciously steer right into him. Even if you put two wheels off the road, that may be enough to get by."

Saturday, 2 p.m.

Meet: Any body of water

Death toll: 1,001 drownings

Here's a swim event guys excel at: the dead man's float. For women, drowning doesn't even make it onto the actuarial tables, but among men ages 25 to 44, it ranks as the eighth leading cause of accidental death, claiming 2,758 victims in three recent years. Any body of water will do—even hot tubs—but we generally prefer to swim with the fishes at lakes, rivers and oceans. So why do we sink so much? After surveying 3,042 people, Boston University researchers concluded that boys and men spend more time in and under water, take greater risks and have an inflated opinion of their abilities. "A lot of males out there don't know they can't swim," says Jonathan Howland, Ph.D., the lead study author.

Survive it: Once you've ascertained that you do, in fact, know how to swim, you then need to recognize the one instance in which this knowledge will be utterly useless: in a rip current. Rip currents account for 80 percent of the rescues performed by lifeguards in Los Angeles County, says lifeguard captain Terry Yamamoto, adding that if you find yourself being swept out to sea, you should relax and float with the current until it slackens. As for the other 20 percent of rescues, he blames those on dehydration. "Cramping is your body saying it needs fluid." And in this case, the best fluid is the one that will boost your electrolytes, such as a bottle of Gatorade spiked with a quarter teaspoon of salt.

Sunday, 1 a.m.

Meet: Parking lot behind a bar

Death toll: 6,055 homicide victims

Saturday night's the night for killer parties, killer dates, and just plain getting killed. Homicide is the fifth leading cause of death among men ages 25 to 44, with business at the morgue picking up on Saturday nights between 10 p.m. and 2 a.m. "Alcohol and drugs play major roles in high rates of murder on weekends, with arguments and felonies like robbery as the major circumstances," says Kevin D. Breault, Ph.D., a professor of sociology at Middle Tennessee State University. But even if you make it out of the bar or club unscathed, you still have to survive the trip to your car. "You're most likely to be mugged or shot in a parking lot," says Marc MacYoung, a crime-avoidance expert and the producer of the video Safe in the Street.

Survive it: Aside from staying ultra-alert as you approach your car, the best way to avoid peril in the parking lot is also the simplest: Spring for valet parking whenever it's offered. Dodging death is a bit more difficult inside a crowded bar, where it's easy to accidentally bump the wrong guy. Next thing you know, he's in your face, veins bulging and fists clenched. What do you do? "Apologize, and mean it. Don't insult him, don't challenge him, don't try a threat display," says MacYoung. "I'd say 999 guys out of 1,000 will accept an apology." If he's the one guy who won't, then just leave the bar. It's really hard to get shot, robbed or beaten if you're not there.

Sunday, 3 p.m.

Meet: Two-lane rural road

Death toll: 1,366 motorcyclists

If Death went retail, he'd open a motorcycle dealership. With sales figures doubling since 1998, bikes are booming—as are visits to the E.R., where staff call the brain-dead Easy Riders "donorcyclists." Fatalities among motorcycle riders and passengers spiked 12 percent in 2003, continuing an upward trend that began eight years ago. In fact, based on miles ridden, a motorcyclist is 21 times more likely to die in a crash than a guy driving a ho-hum Elantra.

Survive it: You're tooling down the road on your motorcycle when an onrushing car turns left in your path. "A lot of guys panic. They lock up the brakes and lay the bike down rather than T-bone the car," says Pat Hahn, a spokesman for the Minnesota Motorcycle Safety Center and the author of Ride Hard, Ride Smart: Ultimate Street Strategies for Advanced Motorcyclists. Bad move. Chrome and flesh slide faster than rubber, so save your skin, literally and figuratively, by staying upright. "It's almost impossible to flip a bike," says Hahn, recommending that you squeeze the front brake lever "like you're squeezing juice out of an orange." Begin soft, then squeeze progressively harder while steering in a straight line. "Your goal," he says, "is to get the speed down to buy yourself one or two seconds for the car to turn."

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