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Preventing a stroke is a crucial aspect of healthcare, as about 80% of all strokes are preventable. The focus is on managing risk factors to reduce the long-term risk of stroke.

A stroke results from a blocked or torn blood vessel that decreases blood flow to the brain. In the U.S., stroke is a leading cause of death and disability.

“Because about 80% of all strokes are preventable, we really focus on prevention,” says Dr. Stephen English, a Mayo Clinic neurologist.

Preventing stroke risks

Tips for lowering stroke risk include maintaining blood pressure under 130/80 and keeping cholesterol and blood glucose at appropriate levels.

"(Other modifiable risks include) things like smoking cessation, treatment of sleep apnea with a CPAP device, and some other potential treatments," he says. "We want to make sure that the risk factors are mitigated to help reduce the long-term risk of stroke."

There are risk factors for stroke that cannot be changed. These include age, sex, race and family history. “There are four nonmodifiable risk factors we typically think about. The first is age, so age greater than 55; males; people that have a family history of prior stroke; and then people that are of African American descent,” says Dr. English.

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DEAR MAYO CLINIC: My husband and son are constantly coming home with an energy drink in hand. I tell them that they are bad for you, but I don't know enough to make a strong case. What are the effects of energy drinks on the body?

ANSWER: Energy drinks are a multibillion-dollar industry and are the most consumed supplement not under the control of the Food and Drug Administration other than multivitamins. It's a bit like the "Wild West" in the sense that energy drinks and their stimulating ingredients are under no FDA regulation and are not classified as a food or a drug but as a supplement. 

Energy drinks contain ingredients such as caffeine, taurine and guarana that affect the heart, the heart's electrical system and the heart's muscular pump. When our bodies react to these chemicals, the heart rate and blood pressure can change. The heart's recharging of the electrical system can be affected by these chemicals. For most people with a healthy heart, the consumption of an energy drink would have no serious impact on our health. However, if you have a genetic heart condition that predisposes you to sudden cardiac death, exposure to an energy drink may not be as harmless. 

People with underlying genetic heart disease or adults with coronary artery disease or weaker heart pumps can be more vulnerable to the chemicals in energy drinks. About one in 200 people have a sudden death-predisposing genetic heart disease, including hypertrophic cardiomyopathy, long QT syndrome, arrhythmogenic cardiomyopathy and catecholaminergic polymorphic ventricular tachycardia. A healthy heart can handle caffeine in moderation, but a fragile heart may not be able to. 

Consuming up to 400 mg of caffeine a day is safe for most adults — some energy drinks contain over half this amount in a single can. Depending on the age of your son, he may need to stay under 100 mg of caffeine per day, which is the recommended amount for adolescents ages 12-18. 

In addition to heart risk, studies have suggested an increased risk of stroke with energy drink consumption. Long-term exposure to these substances over time affects how the blood vessels and heart react to the chemicals. Our blood vessels that control our blood pressure are reacting to these chemicals, and the potential reason behind stroke risk is the tightening of our blood vessels. 

For the 199 out of 200 people who have a healthy heart and who do not have a genetic heart disease, energy drink consumption in moderation is safe. However, you might want to ask yourself: Can you go three days without it? If not, you may be experiencing some dependency on the chemicals in the energy drink. Heavy caffeine consumption can cause physical and psychological dependence, restlessness and insomnia. 

Overall, there is very little health value to energy drinks. Listen to your body — Are they making you feel shaky or causing you to experience withdrawals? Can you be satisfied with your morning coffee or tea instead? 

There is a lot of room for future research on these beverages. Consuming the wrong thing at the wrong time in the wrong person is a setup for the perfect storm. Caffeine may also interact with a person's medications. Tell your healthcare team that you are consuming energy drinks and the unregulated supplements they contain, and you can decide together what the right choice is for you. — Michael Ackerman, M.D., Ph.D., Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota

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Mayo Clinic Healthcare cardiologist shares tips to safely get your blood pumping again

LONDON — Around the world, people are starting to engage in outdoor activities after a winter spent largely indoors and perhaps with less physical activity than during more temperate seasons. In other climates, people may be starting an indoor, less-active time. Gosia Wamil, M.D., Ph.D., a cardiologist at Mayo Clinic Healthcare in London, offers five tips to protect your heart when you spring into action after a sedentary period.  

It may be tempting to immediately move garden equipment and furniture out of storage, start a landscaping project, go on a long hike or engage in other physically demanding activities that were on hold due to poor weather.

"Spring is a great time to reconnect with nature and enjoy movement, but it’s vital to respect your body’s limits," Dr. Wamil says. "Even light daily activity can have meaningful benefits for heart health. Consistency matters more than intensity."

Busy lifestyles and, for many people, long days spent working at a desk, compound seasonal challenges that may mean less activity. Together, the lack of movement may decondition your body, requiring a bit of time before you return to more optimal shape. Stress can further compound demands on the heart.

Dr. Wamil's first tip: Ease into physical activity gradually.

"After a long season of reduced activity, it's important not to jump straight into strenuous tasks," she explains. "Start with light activities like walking or gentle stretching and gradually build up intensity. This helps reduce the risk of injury or sudden cardiac stress."

2. Warm up before and cool down after physical activity.

"Whether you’re gardening or going for a hike, taking five to 10 minutes to warm up prepares your muscles and heart for the activity ahead," Dr. Wamil says. "A proper cooldown helps your body return to baseline and prevents dizziness or blood pressure drops."

3. Listen to your body — and don’t ignore warning signs.

"If you feel chest discomfort, unusual shortness of breath, dizziness, or palpitations, stop immediately and seek medical attention," Dr. Wamil advises. "These symptoms could signal a heart problem, especially in people who haven’t been active for a while."

4. Stay hydrated and dress appropriately for the weather.

"Dehydration and overheating can put extra strain on the heart, especially in older adults," Dr. Wamil says. "Wear layers you can remove as you warm up, and drink water regularly even if you don’t feel thirsty."

5. If you have known heart disease or risk factors, talk to your doctor before starting a new physical-demanding activity.

"People with high blood pressure, diabetes, or a history of heart conditions should check in with their healthcare provider before beginning more vigorous outdoor tasks," explains Dr. Wamil, whose tools to diagnose a variety of heart diseases include cardiac magnetic resonance imaging (cardiac MRI). "A tailored plan can keep you safe and active."

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About Mayo Clinic Healthcare
Mayo Clinic Healthcare, located in London, is a wholly owned subsidiary of Mayo Clinic, a not-for-profit academic medical center. Mayo Clinic is top ranked by U.S. News & World Report in more specialties than any other hospital for a reason: quality of care. Mayo Clinic Healthcare is the U.K.'s front door to that unparalleled experience. Visit Mayo Clinic Healthcare for more information.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

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ROCHESTER, Minn. — Every year, some mothers die after giving birth due to heart problems, and many of these deaths could be prevented. The ability to screen for heart weakness before pregnancy could play a crucial role in identifying women who may need additional care to improve pregnancy outcomes. Mayo Clinic researchers, led by Anja Kinaszczuk, D.O., and Demilade Adedinsewo, M.D., tested artificial intelligence (AI) tools, using recordings from an electrocardiogram (ECG) and a digital stethoscope, to find unknown heart problems in women of childbearing age seen in primary care.   

Study findings published in the Annals of Family Medicine show high diagnostic performance of these technologies to detect left ventricular ejection fraction below 50%, indicating heart muscle weakness. These tools were tested on two groups of women aged 18 to 49.  

• Group 1: 100 women already scheduled for an echocardiogram (the best test to evaluate heart muscle function). They also had a standard clinical ECG and digital stethoscope recording of the heart’s electrical activity and heart sounds.  

• Group 2: 100 women seen for routine primary care visits to see how often the AI tools would find heart problems.   

The AI-ECG demonstrated an area under the curve (AUC) of .94 while the AI digital stethoscope, Eko DUO, achieved an even higher AUC of 0.98, indicating strong diagnostic accuracy. In the second cohort, the prevalence of positive AI screening results was 1% for the AI-ECG and 3.2% for the AI-stethoscope. 

"Statistically, nearly half of pregnancies in this country are unplanned, and approximately 1% to 2% of women may have heart problems they don't know about. Our research findings suggest that these AI tools could be used to screen women before pregnancy, allowing for improved pregnancy planning and risk stratification, early treatment, and better health outcomes which addresses a critical gap in current maternal care," says Dr. Adedinsewo, a cardiologist and senior author of the study.  

This research builds upon earlier published studies, including a pilot prospective study evaluating AI digital tools to detect pregnancy-related cardiomyopathy among obstetric patients in the U.S. and a pragmatic randomized clinical trial of women in Nigeria who were pregnant or had recently given birth. Collectively, this research highlights the potential of AI to modernize cardiovascular screening, enabling earlier identification and management of heart muscle weakness in women of reproductive age. Further research is underway to explore the potential of using these technologies to screen for heart weakness in broader populations.  

Mayo Clinic has licensed the underlying technology to EKO Health for its digital stethoscope with embedded ECG electrodes and to Anumana for the 12-lead ECG. Mayo Clinic and some study authors have a financial interest in this technology. Mayo Clinic will use any revenue it receives to support its not-for-profit mission in patient care, education and research. 

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About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.  

Media contact: 

• Terri Malloy, Mayo Clinic Communications, newsbureau@mayo.edu 

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Hailing from the historic town of Natchitoches, Louisiana, Roderick Baptiste has spent the last 17 years in Columbus, Georgia. His journey, marked by unexpected health challenges, began to unfold when he moved to Georgia in 2008. During a routine visit to his local primary care physician, an underlying heart issue and high blood pressure were discovered. This led to a diagnosis of congestive heart failure and stage 3 kidney failure.

The path to Mayo Clinic

For several years, Roderick made efforts to manage his condition. "I was treated and was being sustained with changes in medications and many prayers," says Roderick. "In August of 2014, my cardiologist referred me to Mayo Clinic in Florida, and this began my Mayo Clinic experience." At that time, his heart function had declined to a mere 10% ejection fraction, a measurement of the heart’s ability to pump oxygen-rich blood to the body.

The waiting game

Life took a slower pace in 2014 as daily activities became increasingly challenging. "Walking, talking, and normal, day-to-day routines slowly became more and more difficult to manage on my own," says Roderick. By August 2019, he had entered total kidney failure and required dialysis. Despite being listed for a heart and kidney transplant in December 2014, the wait extended for five long years, filled with monthly travels to Mayo Clinic for testing and assessments. Spring of 2019 brought multiple hospital admissions, and by December, his health had significantly deteriorated. In January 2020, Mayo Clinic admitted Roderick as an inpatient until a transplant could be performed. After a 23-day wait, he received a new heart and kidney on Feb. 22, 2020.

A connection beyond surgery

Six months after his transplant, Roderick reached out to his donor's family. His donor's mother responded, and since then, they have built a strong relationship, maintaining contact through visits, phone calls, texts and video conferencing.

Living his best life

Today, Roderick says he feels amazing, living his best life with no health issues to report. His story is a testament to the lifesaving effect of organ donation and transplantation. To those considering becoming organ donors, Roderick offers heartfelt encouragement: "If you check the box as a donor, you could help save so many lives."

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DEAR MAYO CLINIC: My friend swears by intermittent fasting since her recent weight loss. I know it works for some people, but is it actually healthy? 
 
ANSWER: Although it may appear to be a new trend, intermittent fasting has been popular for over 1,500 years. While we know that it works for some people to lose weight, the reality is that whether or not it helps organs such as the heart is still to be determined. Early research presented at a recent scientific meeting suggested that intermittent fasting might be harmful or risky in general. It showed that people practicing intermittent fasting are twice as likely to die from heart disease or die in general than those who don't practice. 
 
The main problem is that intermittent fasting is not standardized. There are many ways to do intermittent fasting. Over the past few decades, it has been popularized in the UK as "eat whatever you want for five days, then don't eat for two full days other than fluids and soups." People were losing weight, and from that point on, people started adapting to fasting in very different ways. Some people will restrict their time for eating to 10 a.m. to 3 p.m., for example. The most common form of intermittent fasting I have seen is that people just skip breakfast.
 
Whether breakfast is "the most important meal of the day" is still under debate. Skipping breakfast historically hasn't been something necessarily healthy. It is not fully understood why, but there are numerous studies showing that people who skip breakfast have an increased risk for heart disease and other ailments. Early morning is the time when people have the most heart attacks. Part of the reason for that is the high-adrenaline state that occurs early in the morning. If you match that with no food, no calories at all, that might be the reason why studies show that people practicing intermittent fasting are not necessarily healthier or safer. I think that's important to keep in mind.
 
People who lose weight through intermittent fasting can benefit their overall health, but that doesn’t necessarily mean that they have to continue forever. We have to consider many other factors when people don't have breakfast or other meals. Stress hormones go up, which may increase blood pressure and adrenaline, causing many changes in our system that might actually be more harmful than beneficial.
 
When patients ask if intermittent fasting is healthy, the response should be, "It all depends." If they start skipping dinner, having very light dinners or just trying not to have dinner too late, that's an excellent way to practice. Or perhaps having a very light lunch or skipping lunch altogether — just not necessarily going for too long with no food.
 
Studies show that having multiple small meals throughout the day versus just two big meals results in better cholesterol and many other positive changes in the metabolism. So, this idea of not having any food or calories for long periods of time is still under debate. Based on recent evidence, intermittent fasting is particularly unsafe for patients with heart disease or with a history of heart disease. Practicing intermittent fasting can be safer with supervision from your healthcare team. — Francisco Lopez-Jimenez, M.D., Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
 

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Heart disease is the No. 1 cause of death in women in the U.S. African American women have an even higher risk of dying from heart disease ― and at a younger age ― than white women, according to the National Heart, Lung and Blood Institute. Each year, more African American women die from heart disease than breast cancer, lung cancer and strokes — combined.

This serious issue is compounded by the fact that less than half of African American women are aware of their risk.

Factors that increase their risk of developing heart disease include:

• Having the highest rates of high blood pressure, or hypertension, among non-Hispanic Black women.
• Having the highest rates of obesity among non-Hispanic Black and Hispanic women.
• Being the least physically active group of women in the U.S.
• Experiencing early onset of menstruation at less than 11 years of age.
• Experiencing premature menopause at less than 40 years of age.
• Developing polycystic ovary syndrome.
• Developing disorders related to high blood pressure during pregnancy.
• Developing gestational diabetes.
• Being prone to preterm delivery and having low- or high-birth weight babies.
• Using oral contraceptives and hormone replacement.

Being aware of and addressing these risk factors is important in preventing heart disease.

Another step toward making a healthy heart a priority is to follow the American Heart Association's "Life's Essential 8" lifestyle changes:

1. Manage blood pressure.
2. Control cholesterol.
3. Reduce blood sugar.
4. Get active.
5. Eat better.
6. Lose weight.
7. Quit tobacco.
8. Get healthy sleep

Campaigns, such as Go Red for Women, also help raise awareness about heart disease in women, risks and how-tos for healthy living.

If you have concerns about your heart health or would like to start your healthy-heart journey, consult your healthcare professional.

Monique Freund, M.D., is a cardiologist in La Crosse, Onalaska and Tomah, Wisconsin.

This article first published on the Mayo Clinic Health System blog.

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A general manager of a professional sports team is a job that inherently comes with a high amount of stress, difficulty and demand — making important decisions that affect the future of a franchise.

But recently at Mayo Clinic, Chicago Blackhawks GM Kyle Davidson made a crucial choice about his personal health that affects his own future — undergo another open-heart surgery or have a less invasive procedure to repair his heart.

Watch: Kyle Davidson's story

Journalists: Broadcast-quality video pkg (4:08) is in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Read the script.

It's something Chicago Blackhawks General Manager Kyle Davidson has had to deal with all his life.

"I was born with tetralogy of Fallot. It's a congenital heart defect. I needed two open-heart surgeries right around when I was a year old," Kyle says.

Five years ago, at the age of 31, Kyle had another open-heart surgery to place a new pulmonary valve inside his heart.

"It's pretty heavy surgery and long recovery. It was about one and a half, two months," he says.

But five years later, he's having trouble with his heart again.

"I've had a couple, you know, I'd call them episodes over the last number of months, where it didn't feel normal," Kyle says.

And at 36 years old, he's back in the hospital.

"I've learned that that valve is no longer working properly again, and intervention was needed," Kyle says.

"He was noticing a limitation in his ability to exercise to his peak potential. And when we hear a limitation for exercise tolerance, to me, that is a big red flag," says Dr. Jason Anderson, an interventional cardiologist at Mayo Clinic. "His valve was regurgitant, meaning he would send the blood forward. Part of the blood would come backward, and part would go forward. So every heartbeat, he's having some wasted flow that he's trying to keep up with. So your body compensates for that by trying to go faster and beat harder."

A replacement pulmonary valve is needed. There are two options: another open-heart surgery or a less invasive transcatheter procedure.

"With all things being equal and having the two options on the table, I certainly preferred and was happy that the transcatheter approach was something that was applicable to my case," Kyle says.

"Compared to 2019 when I had my open-heart surgery, I'm just at a very different point in my life, you know. I do have the general manager's job. I do have two kids that weren't around five years ago. You have to make sure that you're putting yourself in the best situation, from a health standpoint, to be there for them for a long time," he adds.

At Mayo Clinic, pulmonary valve replacement can be performed on eligible patients as a same-day transcatheter procedure — meaning no open-heart surgery and, typically, no hospital stay. It requires only a mild form of sedation and usually takes under an hour to perform.

"The procedure is basically to give him a new valve within his existing, surgically placed valve. We do that through a catheter method, where you place equipment into the heart. We work through a large tube that goes through the vein in his leg," says Dr. Allison Cabalka, an interventional cardiologist at Mayo Clinic.

"When that valve is deployed and opened, in the next heartbeat, he has his new valve functioning brand-new, right out of the box," says Dr. Anderson.

Another aspect of this procedure that sets Mayo apart is that it’s done in tandem by two Mayo Clinic cardiologists through a method called co-scrubbing.

"When Dr Anderson and I are working together, we often think of it as two co-pilots," says Dr. Cabalka. "If we have anything that's unexpected, we have collaborative decision, we have immediate response, and we have the ability to take care of any potential complications or any potential barriers to success to make that procedure go as smoothly as possible."

And just a few hours after the procedure, Kyle is out of the hospital, heading home and back to work.

"I'm very fortunate that there are medical advances to the point where I don't have to step away, I don't have to miss any significant time," Kyle says.

Kyle’s experience is typical for patients at Mayo Clinic undergoing this procedure.

"It's not an exception that he went home the same day, that is now the norm," says Dr. Anderson. "His body is now able to achieve the same amount of forward flow with less stress and less exertion."

"Now that we're a couple weeks out and I'm back to my normal routine, I feel 100%. I feel great," Kyle says.

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DEAR MAYO CLINIC: One of the biggest things I have missed since my office went remote is going on walks with my coworkers throughout the day. With so many added responsibilities at work, I can hardly find time to leave my desk. How is all this sitting affecting me? How can I find a balance?

ANSWER: We understand the reality is that people have less and less time to exercise. While exercising before or after work is extremely important, it is just as important to stay active throughout the day. You may be surprised to hear that sitting for eight or more hours a day is comparable to smoking a pack of cigarettes a day in terms of heart risk. Sitting for too long throughout the day is one of the major risk factors for heart disease, cancer and many medical conditions. The solution? An active office can empower you to break out of a sedentary lifestyle. 

An active workstation is essentially a desk where you are not sitting. This can mean a standing desk or one where you move around, such as biking, walking or using a step machine. An active workstation has many benefits. The main benefit is that it allows the user to be productive while burning calories at the same time. Walking pads or treadmills allow you to walk at a slow speed and answer emails, work on a project or participate in a video conference call.

An active workstation does not mean that you need to be moving all the time. And you don't have to be active for too long to reap the benefits of activity. It has been shown that even when you are standing, you are more likely to be spontaneously mobile than when you are sitting. This is important to keep in mind. Overall, sitting for less than three or four hours throughout the day is a good goal for those who are able.

Another concept that is gaining popularity is the idea of "snack" activities. A "snack" is doing something for two or three minutes after sitting for an hour. This helps you break the sedentary status of your body by taking the stairs for a few flights, doing some pushups or something meaningful in terms of activity for just a few minutes, and then coming back and continuing your work. These little episodes of activity reset your metabolic clock. Activity snacks can cause significant biological changes in your cells, metabolism and cholesterol. You may notice your mind feeling sharper for the next half hour. 

While "activity snacking" is an affordable way to implement movement into your daily routine, you don't need a lot of money or a big investment to switch up your office furniture. There are some adapters out there that you put on top of your desk to raise or lower your monitor or laptop computer, allowing you to stand. Some people get creative and use a stack of books or other existing items. The bottom line is that everyone should feel motivated to redesign their home offices in order to be active longer throughout the day. This leaves us with less room for excuses. And, if you have days where you’re stuck going into the office, you still have options. Consider taking the stairs instead of the elevator. — Francisco Lopez-Jimenez, M.D., Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

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Phoenix — Heart disease is the leading cause of death worldwide. One of the most common types of cardiovascular disease is a heart attack. In the United States alone, it is estimated that every 40 seconds, someone has a heart attack. One of those people is country rap music artist Colt Ford.

"I couldn't have been anymore on death's door. I died twice that day," recalls Colt, describing the massive heart attack that nearly claimed his life following a concert performance last year. "When one of the top heart doctors in the world looks at you and goes, 'You're 1% of 1%,' it can't get more dire than that."

The 55-year-old musician was performing a sold-out show with his band in Gilbert, Arizona, last April. After what Colt describes as "one of the band's best shows ever," he walked backstage, and moments later, he was found slumped over in a chair due to a massive heart attack. Colt says he was feeling great during the concert. "When I played the show that night, I could do anything," he recalls. Emergency crews quickly responded to the scene and rushed Colt to the hospital. "I woke up eight days later, and I couldn't pick up a cup with ice in it and feed it to myself," he says.

Colt went into cardiac arrest twice. He was revived with electric shocks from a defibrillator to restart his heart in both instances. "He would simply not have survived in most parts of the world that don't have access to such a high level of cardiogenic shock care. Most people do not survive globally," says Kwan Lee, M.B., B.Ch., M.D., interventional cardiologist at Mayo Clinic. Colt also underwent a 10-hour surgery and, for a time, was placed in a medically induced coma.

Doctors often warn about the signs and symptoms of a heart attack, such as chest pain or pressure, shortness of breath, and fatigue. However, roughly 21% of heart attacks in the U.S. occur with minimal or even no symptoms, according to the American Heart Association. These "silent" heart attacks are known as silent ischemia or a silent myocardial infarction.

"This is the unfortunate nature of heart attacks. It is possible to have tests which don't show blockages, but the nature of blockages is that they can behave unpredictably and suddenly occur," says Dr. Lee. "Despite our best efforts, on a populational level, heart attacks can still occur in patients out of the blue."

Eight months after suffering his heart attack, tests show Colt is healing well and on the road to recovery. Exercise combined with a heart-healthy diet has helped him shed 60 pounds. While his strength improves, Colt admits the health scare has left him with anxiety and panic attacks. "For me to say I'm having anxiety and panic attacks, that's even hard for me to say because I ain't scared of nothing," Colt says. "But I'm having to deal with that, and share my feelings and all that kind of stuff. So, if you're feeling something, advocate for yourself. Don't just tough it out. Tell somebody."

Colt is back to writing his signature blend of music that combines country, rap and hip-hop. The Georgia-born singer just released a new song and is about embark on a new tour. He's hoping his music and his story will serve as inspiration for others. "Be happy that you're here and you're alive and you get a chance," Colt says. "I get a second chance, and I want to do something positive with it. I hope I can make a difference in somebody else's life."

You can watch more about Colt's story here.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network to learn more.

Media contact:

• Marty Velasco Hames, Mayo Clinic Communications, newsbureau@mayo.edu

Media kit including interviews, video and photos available for download here.

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