Do You Need to Be Worried Your Kids Are Getting Too Much Caffeine?

Caffeine2-FBIf you’re among the 64 percent of American adults who drinks at least one cup of coffee every morning, you may know exactly how much to drink and what time to stop drinking to avoid any unpleasant caffeine side effects such as jitters and insomnia. What you may not know is that an increasingly wide variety of foods and beverages contain significant amounts of caffeine, making it nearly impossible to accurately gauge yours and your children’s daily intake.

The tragic story of 16-year-old Davis Allen Cripe underscores why counting caffeine milligrams is important. The South Carolina teen, who was found to have no undiagnosed heart condition, died from a rapid, irregular heartbeat called arrhythmia caused by an overdose of caffeine. Cripe’s friends told the coroner that within two hours of his death, he drank a large diet Mountain Dew®, a McDonald’s café latte and an energy drink.

Dale Yoo, MD, a cardiac electrophysiologist at Medical City McKinney, confirmed that caffeinated drinks can absolutely affect your heart rhythm.

“Anything that’s a stimulant or increases the stress on your heart will increase your adrenaline and your heart rate,” Dr. Yoo said. “Things like coffee, tea and herbal supplements will increase your adrenaline and heart rate. Drinks like 5-hour ENERGY®, Red Bull® and Monster Energy® have a lot of taurine and caffeine that can also increase the stimulant effect on your heart and increase the risk of arrhythmia.”

In addition to soft drinks and energy drinks, caffeine is being added to a growing list of products, including marshmallows, oatmeal, jelly beans, waffles, gum, mints, sunflower seeds, syrup and even water. It can be found in chocolate, ice cream (those with chocolate or coffee flavors) weight loss pills and over-the-counter pain relievers  This prompted the FDA last year to announce an investigation into the safety of caffeine in food products, with special attention paid to its effects on children and adolescents.

Because caffeine is not a nutrient, but a naturally occurring chemical found in items such as tea leaves, coffee beans and cacao (used to make chocolate), the FDA does not require the amount in a food or beverage to be listed on nutrition labels unless it is added. Many of these products also contain hidden caffeine or other stimulants. Here’s what to look for:

  • Sugar
  • Guarana
  • Taurine
  • Kola nut
  • Yerba mate
  • Cocoa or cacao

How much caffeine is too much?

According to the FDA, a safe amount of caffeine for healthy adults is up to 400mg a day. That’s anywhere from three to five eight-ounce cups of regular coffee, depending on the bean source and brewing method. For children and adolescents, the American Academy of Pediatrics’ recommendation is to avoid energy drinks entirely — which the CDC says sent 1,499 adolescents to the ER in 2011 — and limit caffeine for ages 12 to 18 to 100mg daily.

We’ll never know for sure exactly how much caffeine Davis Cripe ingested, but we can estimate it thanks to his friends’ report:

Large diet Mountain Dew: “Large” is a relative term, but even if he had a “small large” at 20 ounces, that’s 91mg of caffeine — nearly the AAP-recommended limit of 100mg. A Long John Silver’s large is 40 ounces with a whopping 180mg of caffeine and 7-11 has soda cups much bigger than that.

McDonald’s café latte: These espresso-based drinks come in small, medium and large. Espresso has about 64mg of caffeine per ounce.

Small cafe latte (12 ounces)

Medium café latte (16 ounces)

  • 142mg caffeine, 13g sugar

Large cafe latte (20 ounces)

  • 178mg caffeine, 16g sugar

Red Bull energy drink (12 ounces): The type and size of energy drink Cripe had is unknown, so we’ll use this popular one.

  • 111mg caffeine, 37g sugar

In our example, Cripe would have ingested a minimum of 273mg and a maximum of 468mg of caffeine in a short period. And this may be a very low estimate, as the American Academy of Pediatrics says some energy drinks can contain more than 500mg of caffeine.

Research debunks myth that coffee improves alertness and mood.

We all know the negative effects of caffeine. The FDA says that it can make you:

  • Jittery and shaky
  • Unable to fall asleep, stay asleep or get a good night’s sleep
  • Experience
    • rapid, uneven heart rate (arrhythmia)
    • raised blood pressure
    • headaches, nervousness, anxiety and dizziness
    • dehydration
    • heartburn
    • dependency and the need to drink increasingly more

But other than that, coffee is good for you, right? While coffee in moderation has been shown to reduce the risk of several diseases, including certain cancers and stroke, it’s most likely the health benefits of coffee’s antioxidants that are responsible, not the caffeine. Look for other ways to get antioxidants, including eating lots of healthy fruits and vegetables.

As to coffee’s magical brain-enhancing powers, study results from Johns Hopkins Medical School (featured on show that caffeine-related performance improvement (a boost in mood and alertness) is nonexistent without caffeine withdrawal. In other words, the kick that you get from your morning cup of Joe is really just caffeine taking you back to “normal” for a short time.

If someone in your family is feeling the effects of too much caffeine, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you.

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Miracle Man: Girl Scout Cookies and Quick Thinking Saved His Life

Stroke1-FBJerry Wren, 35, thought he was experiencing vertigo as he answered the door for a prearranged Girl Scout cookie money drop-off. He had agreed to be the go-between for his wife, Rhean, a Girl Scout cookie mom, and another mother from their daughter’s troop. He was right: he was suffering from vertigo, but the dizziness was just one of a number of symptoms of basilar artery thrombosis — the type of stroke that he was having.

“I remember going to answer the door and not being able to walk that well,” Jerry said. “Like my balance was all gone. I thought it was vertigo.”

The woman called Rhean immediately and reported other symptoms.

“She said Jerry was unbalanced, throwing up and slurring a little bit,” Rhean said. “I thought, ok, his speech is slurred … that sounds like a stroke. But he can’t be having a stroke because he’s only 35. When I heard him trying to talk, you couldn’t understand anything he was saying. So I called 911.”

According to the American Heart Association (AHA), someone in the U.S. has a stroke every 40 seconds. It’s about as common as a heart attack, the No. 1 killer of men and women. And while time is a crucial factor — just as with a heart attack — stroke is largely treatable. However, most people don’t recover from a basilar artery thrombosis.

“When Mr. Wren got to the emergency room, he was unresponsive, unable to breathe on his own and wasn’t moving his arms and legs properly,” said Alexander Venizelos, MD, an interventional neurologist at Medical City Forth Worth, a Comprehensive Stroke Center. “He had a blood clot in his basilar artery, which is one of the most important arteries that goes to the brain. Over 85 percent of people who have a basilar thrombosis die.”


“EMS told me they were taking Jerry to Medical City Fort Worth because it’s a stroke hospital,” said Rhean. “It’s what they do.”

A number of factors, including the accessibility of a nearby stroke center, quick thinking on the part of the woman dropping off the cookie money and Rhean’s knowledge of stroke symptoms, likely saved Jerry’s life.

“Anytime there’s damage to the brain, those cells are being lost very quickly,” Dr. Venizelos said. “The faster we’re able to recognize the symptoms and do the appropriate imaging, the better the outcome. We were able to take pictures of the blood vessels going to the brain in real time and deploy small suction devices to remove the clot.”

Think FAST for symptoms of stroke.


Rhean encourages everyone — even younger people — to learn the signs of stroke and don’t discount them because of someone’s age.

Remember the acronym FAST and look for these stroke signs:

  • FACE: facial drooping, especially on one side
  • ARMS: trouble raising arms, also perhaps confined to one side
  • SPEECH: difficulty speaking or slurring words
  • TIME: time equals brain, so act quickly and call 911 or head to the closest ER

Even children can learn the signs of stroke so they can be prepared for what to do in an emergency. Watch as the Medical City Children’s Hospital Puppeteers teach kids how to be stroke heroes.

The AHA says that most strokes are preventable. While some risk factors are not controllable, such as age, gender and ethnicity, many are within your power to change.

The National Stroke Foundation has identified these controllable risk factors for stroke:


  • High blood pressure is the No. 1 cause of stroke and raises your risk by 150%
  • AFib is a leading risk factor for stroke and is often asymptomatic, so be sure you’re in touch with your heart health
  • Other medical factors include high cholesterol, diabetes, circulation problems and carotid artery disease
  • Lifestyle factors, including:
    • Eating healthy
    • Exercising regularly
    • Quitting smoking and tobacco use
    • Limiting alcohol to one drink a day for women and two for men

Miracle Man

Jerry has a nickname around Medical City Fort Worth and it’s one that he and Rhean are pretty happy about.


“When he was in the ICU, people from the ER were coming up and saying, ‘we wanted to see the miracle man.’ Nurses were coming in and saying, ‘we had to see the miracle man.’ I told Jerry that he’s probably the only person who can say Girl Scout cookies saved his life!”

If someone is showing signs of a stroke, dial 911 or go to the nearest ER.

For minor emergencies or major mishaps, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you.

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How to Prevent Your Own Heart Attack

senior-couple-heart-fbHere’s some news to make your heart sing: Cardiovascular diseases are completely preventable for at least 95% of people just by changing diet and lifestyle, according to a study published in the medical journal, the Lancet. And not only preventable, but usually reversible simply by applying these changes.

This is exciting, because it means that your heart health is in your own hands! Everything you eat, drink and do (or don’t do) is either contributing to heart disease or heart health.


Here’s what the Lancet study says are 4 of the top 9 risk factors for heart disease and how you can manage them so that you don’t end up in the ER — or worse.

  1. Smoking

David Engleman, MD, an interventional cardiologist at Medical City Las Colinas, says smoking is not just a major risk factor for lung cancer, but is also a major risk factor for heart attacks and strokes. The problem, Dr. Engleman says, is that smoking causes a number of things that increase your risk for these debilitating and largely preventable diseases.

Smoking causes:

  • An increase in the development of plaque within the arteries of the heart
  • Plaque to become inflamed, fragile and more likely to rupture and break off into the bloodstream
  • Blood to become sticky, increasing the risk of clots developing on the plaque as it moves through arteries, causing heart attacks

“The good news about smoking,” said Dr. Engleman, “is that if you stop, a number of those things can improve very quickly. Within several weeks of quitting, your blood starts to thin out and the plaques start to stabilize. Very quickly, we see a decrease in the incidence of stroke and heart attacks.”

  1. Abdominal obesity
  2. Daily consumption of fruits and vegetables

Being overweight or obese is a significant risk factor for many conditions, including heart disease. Not eating enough fruits and veggies is a risk factor, too, because they contain antioxidants and nutrients most people don’t get enough of. But a healthy diet can help you overcome both of these risk factors.

Adopt a healthy eating plan to help you get to and maintain a healthy weight (ask your doctor what that is for you) and provide your body with powerful nutrition.hearts-of-texas-healthy-heart-graphic_web

  • 4 to 5 servings EACH of fruits and vegetables daily
  • 6 to 8 servings of whole grains daily
  • At least 2 servings of fish high in omega-3s weekly
  • Nuts
  • Legumes (peas, beans, lentils, soybeans, peanuts)
  • Seeds
  • Low-fat dairy
  • Little to no added sugar
  • Little to no red meat (lean cuts if you must eat)
  1. Regular physical activity

Here’s another two-fer: regular exercise will not only strengthen your heart, which is a muscle, but like eating healthfully, it can also help you maintain a healthy weight. Try for 150 minutes of moderate aerobic activity, 75 minutes of vigorous aerobic activity or a combination of both every week. Be sure to include muscle-strengthening activities two or more days a week. Check with your doctor before beginning any exercise program.

(The other 5 risk factors mentioned in the Lancet article are: abnormal lipids, hypertension, diabetes, alcohol consumption and psychosocial factors.) 

Should you have a heart screening?

If you experience any of the symptoms of a heart attack, you should call 911 or seek immediate medical treatment. Kara Bader, RN, a cardiovascular nurse practitioner at Medical City Arlington, explains what to look for.

According to Michael Isaac MD, an interventional cardiologist and Medical City Dallas’ medical director for cardiovascular quality, if you have no symptoms but two or more risk factors, you should follow up with your doctor. These risk factors include:

  • High blood pressure (hypertension)
  • Diabetes
  • High cholesterol
  • Smoking
  • Excess weight
  • Early family history
    • Male family member 40-50 with heart disease
    • Female family member 50-60 with heart disease

Do you know how healthy your heart is? Our free Heart Risk Assessment can help you pinpoint your personal risk factors for heart disease so you can start taking steps to decrease them today.

If you or someone in your family experiences chest pain, one of our many Medical City Healthcare emergency locations or Accredited Chest Pain Centers has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City Healthcare ER near you.

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Heartburn or Heart Attack? How to Save Your Own Life.

heartbrun-v-ha1-fbWould you recognize the difference between heartburn and a heart attack? If you’re not sure, you’re not alone. Both conditions can cause similar chest pain. In fact, heartburn can be a heart attack symptom, especially in women. Almost 40% of female heart attack patients reported experiencing heartburn or indigestion shortly before their attacks.

But don’t lose heart. For 60% of people who seek emergency care because of chest pain, the diagnosis is heartburn. What makes it so difficult to differentiate between the two? The confusion lies within our own bodies. The nerves responsible for sensing and reporting chest pain simply aren’t able to identify the origin and nature of that pain.


Generally speaking, unexplained chest pain is a sign that you need to call 911 (see the American Heart Association’s very convincing Don’t Die of Doubt commercials if you’re hesitant to call an ambulance) or head to the closest ER. Often, medical testing is the only way to know for sure and it’s always better to be safe than sorry. Sadly, the average person having symptoms waits three hours before getting help, which is why many heart attack patients die before reaching the hospital.

“Chest pain is a very serious matter,” said Tim Hartman, DO, medical director at Medical City ER Stonebridge. “It’s something you shouldn’t ignore. It can be very serious, such as a heart attack, or something minor, such as indigestion. But symptoms vary widely and most heart attack sufferers had no previous symptoms. So we recommend that you come to the ER whenever you’re having chest pain and let us evaluate you.”

While you shouldn’t try to diagnose yourself and should always seek medical care if you’re having symptoms, there are clues that can help you distinguish between heartburn and a heart attack.

Suspect heartburn if symptoms include:

  • Sharp, burning pain in the chest area, which may travel upward
  • Discomfort after eating, particularly when lying down and the meal was large, fatty or spicy
  • Bitter or sour taste in the back of the throat
  • Antacids quickly alleviate symptoms

Suspect a heart attack if symptoms include:

  • Fullness, pressure, squeezing, tightness or pain in the center of the chest
  • Pain lasting for more than a few minutes or recurring pain
  • Pain following physical exertion or emotional stress
  • Chest pain that radiates to arms, shoulders, upper abdomen, back, neck or jaw
  • Shortness of breath
  • Rapid heartbeat
  • Breaking out in a cold sweat
  • Lightheadedness or fainting
  • It’s wintertime (no matter where you live), when there’s a more than 30% increase in heart attacks and heart-related problems due to “Christmas coronaries” and “holiday heart”

Other telltale heart attack symptoms (more common in women) include:

  • Extreme, unexplained fatigue
  • Nausea or vomiting
  • Heartburn

Phyllis Turlington, a heart attack survivor who was rushed to Medical City McKinney, has an important message for anyone tempted to dismiss these more subtle symptoms.

“I felt like I was having a low blood sugar attack,” Phyllis said. “I felt a little nauseous, and then I started sweating really bad. My hair got soaking wet in a matter of seconds, and I just knew I was having a heart attack.”

EMS and hospital staff were able to get Phyllis from the ambulance to the cardiac catheterization lab in just 12 minutes, saving her life and precious heart tissue.

“I watch enough doctor shows to know that time is very important when you’re having a heart attack,” said Phyllis. “I want to tell everyone, particularly women: Do not ignore these simple symptoms. Either go to an ER or call 911 immediately.”

Do you know how healthy your heart is? Our free Heart Risk Assessment can help you pinpoint your personal risk factors for heart disease so you can start taking steps to decrease them today.

If you or someone in your family experiences chest pain, one of our many Medical City Healthcare emergency locations or Accredited Chest Pain Centers has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City Healthcare ER near you.

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How to Keep Holiday Stress from Harming Your Heart

Family sleeping on sofa at ChristmasEmergency room doctors have coined the term “Christmas coronary” to describe the more than 30 percent increase in heart attacks and heart-related problems that occur during the winter months — especially on Christmas, the day after Christmas and on New Year’s Day.

To find out who is at risk for holiday heart attacks (hint: age and gender don’t factor in), why they happen more frequently and tips to prevent them, we recommend Beware of Binging and Other Tips to Prevent Holiday Heart Attacks.

Holiday Heart
Christmas coronary sounds as bad as it is, but “holiday heart” — another doctor-named seasonal trend — seems as if it could be a Christmas movie (it is) or a description of what happened to the Grinch’s ticker when he gave the presents back.

Unfortunately, it’s not as jolly as it sounds. Dale Yoo, MD, a cardiac electrophysiologist at Medical City McKinney, says that if you leave the symptoms of holiday heart untreated and let it go on too long, it can lead to more serious conditions, including atrial fibrillation (AFIB), stroke and diabetes.

As the leading cause of death for both men and women in the U.S., heart disease should get used to being nicknamed. But you shouldn’t have to suffer with it, no matter which name it goes by.

So we asked Dr. Yoo to explain holiday heart and give his best advice for avoiding it this winter.

“Holiday heart can affect anyone of any age who is under stress. And today, that includes young people as well,” said Dr. Yoo. “If you are experiencing any of the symptoms below, you should make an appointment with your doctor for a checkup.”

 Symptoms of holiday heart can include:

Stress causes holiday heart.

“What do we typically do during the holidays?” said Dr. Yoo. “Our routine is disrupted and we compress a lot of activities into a very short period of time, such as hosting friends and family members, shopping, going to parties, cooking, cleaning and decorating, all of which can put additional stress on our hearts.”

Stress causes a release of hormones, including adrenaline and cortisol, which constrict blood vessels, increase heart rate and raise blood pressure. Over time, chronic stress can enable these conditions to become permanent.

Holiday heart stressors include:

  • Eating rich foods loaded with fat and sugar
  • Eating more food than normal
  • Drinking more alcoholic beverages and less water
  • Drinking more caffeinated beverages and less water
  • Staying up late and not getting enough rest
  • Exercising less than normal (who has time?)
  • Stressing over all of it

Dr. Yoo’s top 3 tips to prevent holiday heart (and other heart problems).

  1. Make sure you get enough sleep based on your age:
  • 12-14 years old / 9-11 hours
  • 15-17 years old / 8-10 hours
  • 18-64 years old / 7-9 hours
  • 65 years old and up / 7-8 hours
  1. Drink lots of water: Drinking 40 ounces of water daily can cut the risk of dying from a heart attack by 41 percent for women and 54 percent for men, versus those who drank less than 16 ounces. But more is better!
  1. Decrease (or eliminate) additional sources of adrenaline (caffeine), including:
  • Coffee
  • Tea
  • Herbal supplements
  • Energy drinks, such as 5-hour ENERGY® and Red Bull®

Additional ways to keep your heart from doing the holiday Hokey Pokey:

  • Stay well nourished: Maintain a healthy diet and indulge in just a few seasonal treats.
  • Move as much as you can: If you can’t get to the gym, take the stairs at work or find a place to walk at lunch.
  • Be happy! For a list of 10 holiday stress-busters from Radhika Vayani, DO, an internal medicine physician at Medical City Alliance, watch the video below:

Find out your risks for heart disease and start taking steps to decrease them today with our free Heart Risk Assessment.

We wish you and your family a very safe and happy holiday season, but if your heart skips a beat, one of our many Medical City Healthcare emergency locations has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Visit to find a fast Medical City Healthcare ER near you.

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