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Man cannot help friend who doesn't want to help himself

Dear Annie: I'm at my wits' end dealing with my friend's glum, woe-is-me attitude. I've known "Max" since we worked together at a restaurant when I was in college. He was in his early 20s and had grown up in the town. He said he regretted not getting a bachelor's degree. As we became better friends and he saw the projects I was doing for my classes (I was an art major), he became inspired and started making plans to go to community college and then transfer. A year passed; then two. That never happened. (Not a big deal in itself, but I mention it as part of a pattern.)

Six years ago, I graduated and got a job in New York. Max and I have stayed in touch, and he visits about once a year. He's still in the same town, working at a different restaurant. I don't say that judgmentally. I don't think there's anything wrong with it. The problem is that Max does. He's been talking about wanting to change his life for years now, but he takes no steps to do so. I've tried every approach I can think of. I did the supportive thing at first -- building up his self-esteem, encouraging him to try therapy, helping him research schools, offering to help get him a restaurant job in New York, etc.

After a couple of years, I realized he wouldn't act on any of this, so I stopped offering solutions and have just shown tough love. For example, when he complains about how none of his friends calls to hang out, I tell him that he can't expect people to always be thinking of him. But nothing seems to get through to him.

Max never asks about what's up in my life, and when I try to tell him, somehow he finds a way of bringing the conversation back to him. I'm starting to feel used and a little resentful, if you couldn't tell. I care about Max and think he's a good guy. But how can you help someone who doesn't really want to help himself? -- Eeyore's Friend

Dear Eeyore's Friend: You can't. At this point, the kindest thing you can do for Max is to refuse to be his dumping ground any longer. Only after he's got nowhere to unload will he be forced to confront the weight of his problem. A therapist could most likely help him a great deal, and you can encourage him to seek counseling one more time -- but disengage and take space after that. Your friendship with Max can only be healthy after he's purged that toxic mindset.

Dear Annie: I enjoy your column, and you have great advice. In the case of the "bad" milk, though, not so much. Spoiled milk tastes bad but doesn't make you sick. Sour cream, yogurt, cheese and other dairy products are made from spoiled milk.

I have never thrown away milk. "Bad" milk makes the best pancakes, biscuits, banana bread, coffee cake, muffins and more. If I'm not able to use the spoiled milk right away, I freeze it in small containers for later use. I use it whenever a baking recipe calls for buttermilk. I couldn't bake without it! -- Never Wasteful

Dear Never Wasteful: You make a great point that I failed to bring up. Milk can be used in baked goods after it's no longer good to drink. Waste not, want not.


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'Broken-heart syndrome' not all that uncommon

Dear Doctor: I've heard that people can die from a broken heart. Is that really possible?

Dear Reader: We think you're referring to a condition known as "broken-heart syndrome," which has been in the news recently thanks to the unique backstory of an otherwise technical and wonky article published in The New England Journal of Medicine. The scientific name for broken-heart syndrome is "Takotsubo cardiomyopathy," also referred to as stress cardiomyopathy. Most people who experience broken-heart syndrome will recover. In some rare cases, though, it can lead to death.

The article that got so much attention examined the case of a 61-year-old woman in Texas who, upon waking up one morning, had such bad chest pain that she went to her local emergency room. Because her symptoms seemed to indicate a heart attack, she was promptly airlifted to a cardiac care hospital in Houston. However, a series of medical tests there took an unusual turn.

Although the woman's blood chemistry findings and altered heart rhythms were consistent with a heart attack due to coronary artery disease, doctors were startled by the scans of the woman's heart. Unlike in a heart attack, in which the heart muscle is starved of oxygen due to blockages in the major arteries, this woman's arteries were clear. What further tests did suggest was a classic case of Takotsubo cardiomyopathy.

The patient's left ventricle, the main pumping chamber of the heart that sends blood throughout the body, had stopped working properly. Instead of working at 100 percent capacity, the blood flow from the left ventricle was significantly compromised. The precise reasons for this phenomenon aren't yet known. Researchers suspect that a combination of stress hormones released during a particularly difficult physical or emotional incident stun the heart and alter its function.

The truth is the condition isn't all that rare. Up to 2 percent of the 735,000 Americans who have a heart attack each year go on to get a diagnosis of stress cardiomyopathy. The vast majority are women over the age of 50. The thinking is that after menopause, vanishing protection offered by estrogen leaves women more susceptible to this type of heart condition.

While taking the Texas woman's medical history, the hospital team learned what had pushed her into an emergency situation. Already worried about her son's upcoming back surgery and a son-in-law's recent job loss, the woman was left inconsolable after the death of one of her closest companions, her Yorkshire terrier. She and her husband considered the little dog to be a family member. When the Yorkie passed away, it broke her heart.

Once the diagnosis was made, the path to appropriate treatment became clear. Doctors put the woman on a medication called an ACE inhibitor, which widens the blood vessels. They also prescribed a beta-blocker to address her high blood pressure. A month later, tests showed significant improvement. And the very good news is that, a year later, the woman's symptoms have not returned.