WHAT’S YOUR VISION?

WHAT’S YOUR VISION?

At the last meeting of our WomenHeart Group, we gathered stacks of old magazines, pictures, postcards, quotations, scissors, glue, and used our imaginations to create individual Vision Boards.  Andee and Annie brought some 9 x 12 boards that, when finished, could be hung on the wall.  We had an hour and a half to create a vision of our lives.

Better than a resolution, a Vision Board is a reminder of what’s essential in your life.  The idea came to us via our HeartSister Caridad.  In addition to heart disease, Cari had several other serious health issues. She told us about her Vision Board. It had words of encouragement, pictures of loved ones, and a photograph of the beach – a place Cari associated with peace and serenity. The first thing every morning, she would look at it.  It would lighten her load and help her start her day with feelings of thankfulness.

In January 2017, we had our first VB party.  At the end of a delightful evening,  we shared our completed projects.  Here is Cari with her Vision Board along with Annie de Velasco, Andee Weiner, and me.  What a lovely moment.

This year, the inspiration for my Vision Board started with two books.  Simple Abundance: A Daybook of Comfort and Joy, by Sarah Ban Breathnach, is a book I read years ago and decided to revisit.  Each day there is a passage to read, and each month she suggests small activities to enrich the reader’s life, called “Joyful Simplicities.”  The second book by Jennifer Ashton, M.D, was published recently and titled, “The Self-Care Solution.”  Dr. Ashton set in motion personal monthly challenges, which would help improve her life.

Why these books?  For years I’ve been reading “how-to” books.  And, yes, I often learned how to do something better.  Alternatively, these books dived into how to better care for me, physically, emotionally, and even spiritually.

My vision board (shown below) is hanging in my office, which is currently filled with clutter.  Is it any wonder it has the words “less clutter” prominently displayed?  Looking like a title at the top of a page, I’m reminded to “Enjoy Life.  It has an expiration date.”  My blog is noted, as are the two books starting me on my journey, and my self-care monthly challenges.  In my first month, I delved into meditation.  That was so satisfying, I’m continuing it daily.

One thing that’s difficult to read in this picture, but really spoke to me are the words, “Instead of focusing on a to-do list, start a to be list.  Things I want to be:  Happy, Calm, Loving, Healthy, Awesome.”  As an A-Type personality,  I’m thinking not being driven by my to-do list is going to take some extra work.

So there is my vision for 2020.  It is said, visualization is a powerful mind exercise.  I’ll have to get back to you next year and let you know how strong my vision is.

In the meantime, here are some suggestions for your Vision Board.  Focus more on how you want to feel — not merely on things you want.  Use pictures, words, photographs, even trinkets.  There aren’t any rules.  Come back next year and let me know how you did.

It’s Heart Month!

It’s Heart Month!

Editor’s Note:  As a WomenHeart Champion, I tell “My Heart Story” to educate women about heart disease.  The following message was delivered at the Alpha Kappa Alpha Professional Women’s Sorority in Miami Gardens, Florida.

On Martin Luther King’s birthday in 2016, I awoke at about 12:30 am with a horrific toothache. I got out of bed and meandered into the kitchen to get some water. I was incredibly tired. After a few moments, the pain began to subside. In my exhaustion, I thought, “I must have imagined that,” and I headed back to bed. I had just experienced two symptoms of a heart attack — referred pain in my jaw and extreme fatigue.

About 4 to 5 hours later, the “toothache” returned. I wondered, “Could this be heart-related?” My birth mother had died of a heart attack at the age of 48.  It was early in the morning, but in this marvelous age of technology, Dr. Google is an on-call go to. My diagnosis was that I may be or may not be having a heart attack. Deciding not to rely on indecision, I contacted my physician as soon as her office opened. She said, “Go to the ER and don’t drive yourself.”  The Emergency Room physician confirmed I had indeed had a heart attack.

Fast forward almost one year to the date. I was exercising in Cardiac Rehab when I noticed some pressure in my jaw. It wasn’t pain — just pressure or heaviness in my lower jaw. I asked a nurse to take my blood pressure. It was elevated, but for someone who was working out, that would be expected. I explained what had happened and was told to contact my cardiologist.

Within a week, I was in the Cardiac Cath lab again, my left anterior descending artery (sometimes referred to as the widow maker) was 95% occluded and was stented. I had avoided a second heart attack.

Our bodies are truly remarkable.  They talk to us — sometimes in unusual ways.  Heart attacks vary in intensity and symptomatically.  While some come on suddenly, many have warning signs, hours, days, or even weeks in advance. Here are some symptoms:

    • Pressure, pain or tightness in your chest, arms, neck, or jaw
    • Nausea, indigestion, heartburn, or abdominal pain
    • Shortness of breath
    • Cold sweat
    • Fatigue
    • Lightheadedness or sudden dizziness

Do not ignore these signs.

I get it, we are all busy. Perhaps you have a stressful job, or you’re taking care of the family (often both), and for many in the sandwich generation, you’re taking care of parents.  Women find themselves focused on everyone and everything else, disregarding signals our bodies are sending.

Here is my message to all of you. The next time your body speaks to you, pay attention, whether it’s SHOUTING at, or whispering to you, LISTEN! You may not get a second chance.

Health Care and the Warm Fuzzies

Health Care and the Warm Fuzzies

You’ve undoubtedly seen the commercials on TV for healthcare insurance.  I call them the “warm fuzzies,” since that’s the feeling they hope to exude.  The actors are smiling, deliriously happy, content and thrilled with their coverage.

Let’s step back a bit and take a realistic look at what happens.  Today, I had an appointment with my cardiologist.  It was made 6 months ago.  I know this because he expressly set up a 6-month follow-up with me.  He’d also made an appointment for some tests which I’d had a week ago.  I received a call last week from the doctor’s office, reminding me of my appointment.

I arrived, signed in and had a seat.  After a moment the lady at the front desk called my name.  It seems there was some question about my appointment.  The staff was missing a referral.  I explained the date had been made months ago and I’d even received a reminder from this office within the last week.  “But we don’t have a referral from your primary.”

I decided to call my internist to find out if they could send a referral.  The receptionist said she’d check on it and put me on hold.  While the “elevator music” was entertaining, after several minutes I decided to call back.  The receptionist explained the person that takes care of referrals was not in.  I’ve seen a note in my internist’s office that there is a 5-day wait on referrals.  I can understand last minute requests need to be discouraged.  On the other hand, I was standing in the cardiologist’s office waiting for my appointment.

I explained to the staff that I could not get the referral.   They were checking with the insurance company and finally offered to have me set up another appointment.  By this time, 45 minutes had passed.  My frustration was palpable, my blood pressure had risen and rather than have a cardiac event in the office, I left.

Once home, I called the insurance company — those people whose biggest thrill in life is to make me deliriously happy.  The member engagement individual attempted to reassure me as she explained what is at best a convoluted system.  When I make an appointment, like this one, 6 months in advance, I have to remember to have my internist send a referral.  However, she can’t do that 6 months out, because it will expire after 3 months.  That’s right folks, I have to wait 3 months and then have my primary doctor send a referral.  My headache was increasing.

I have CVD, a diagnosis that isn’t going away anytime soon.  One might even say it’s a chronic condition.  It’s vital that I see a cardiologist at least once or twice a year.  Apparently, my health insurance company knows better than my doctors, the American Heart Association, and the AMA.

My next call was to my internist.  I explained I needed a referral so I could make an appointment with my cardiologist.  “We need to have the date of the appointment.”

“I don’t have an appointment yet.”

“But we need the date before we can do the referral.”

OMG.  There appears to be a conspiracy.  The medical establishment has decided to do me in.  Mind you, they are all very polite.  If anyone was losing it, it was me – not them.  They all told me how they regretted my plight, but as the words, “I’m sorry….” were uttered, a pause trailed off as if they knew to add the word “but” would indicate their total lack of empathy.

It was time to call the cardiologists office.  I spoke with someone briefly, explaining what had happened.  He put me on hold for a few minutes and then said, the first appointment we have with your doctor is in July.

“Do you not understand he wanted to see me today, six months ago?  Maybe 3 months more won’t hurt, or on the other hand, maybe I’ll be dead by then.”

“I’m sorry, let me check further.”  When he returned to the line, he said he was going to do some more work on this and would call me again in the afternoon.  “Let me see if I have all your information…Oh, I just realized today is your birthday.”

“Yes, it is.  And so far today, the medical establishment seems to be determined it will be my last!”

My 9:45 am appointment has long since passed.  I received a call from the cardiologist’s office.  I have an appointment on May 23rd.  I’ve contacted my internist with the date so a referral can be prepared.  The insurance company assured me that I can verify everything online.  The time is 5 pm.  What a fantastic way to celebrate a birthday.

Like George Bush, I remember a kinder, gentler time, when you could just make an appointment with a doctor and go see him or her.  But now we have warm fuzzies — that only exist in your mind.

 

BODY LANGUAGE

BODY LANGUAGE

The definition of body language is, “the process of communicating nonverbally through conscious or unconscious gestures and movements.”  But, I’m thinking of something different.  I’m here to discuss how your body speaks to you.  If you are sick, your body might ache, and your temperature rise.  These are straightforward messages from your body.  However, sometimes, the language is more subtle.  Let me tell you a story to illustrate what I mean.  It’s Martin Luther King’s birthday, 2016 about 12:39 am.

I awoke in extreme pain.  I had a toothache.  It’s the kind of pain you feel when you require a root canal.  I got out of bed, walked into the kitchen and got a drink of water.  As I wandered around the house, the pain began to subside.  I was exhausted and asked myself, “Did I really feel that?”  I finally convinced myself it was my imagination and went back to bed.

A few hours later, the pain returned.  I’ve undergone a root canal, and I know the pain doesn’t come and go.  I was also aware that when having a heart attack, one can experience referred pain.  Instead of feeling pain in your chest, it can be in your head, neck, arms, or back.  I figured I’d better check this out — and I did.  I went straight to Dr. Google.  I looked up angina.  There’s stable and unstable angina, the latter indicating a heart attack.

Not having graduated from medical school, but considering myself an excellent diagnostician, I determined I did NOT have a heart attack.  Mind you, I had just read on the Mayo Clinic site that unstable angina occurs even at rest (I was asleep) and often is unexpected.

My doctor’s office would be open in a couple of hours, and I decided to call her.  In the meantime, I took a shower, dressed, and worked in my office.

I explained to the receptionist I believed I might be having angina.  The doctor got on the phone and asked for my symptoms.  I told her what had occurred and she said, “Go to the Emergency Room.”

I countered with, “Well, I thought I’d just come to your office.”

“I don’t have time to drive you to the ER.  Go to the hospital … and don’t drive yourself.”

After some blood tests, chest x-rays, and EKGs, a young ER doctor came to the room I was in and said, “You’ve had a heart attack.”  Quite frankly, he looked to me to be about 19.  What could he possibly know?  Apparently, more than I.  Within minutes a very tall cardiologist walked in and said, “You’ve had a heart attack.  We won’t know the severity until you have a cardiac catheterization.”

Ten hours had passed since I felt the first pain.  Also, I’d experienced fatigue, another symptom of a heart attack.  What did I do as I was having a heart attack?  I went back to bed, diagnosed myself, worked in my office, and yes, took a shower!  Had my occlusion been in a different artery, those decisions could have been fatal.

Like many victims of a heart attack, I looked at the event and my quick recovery and figured, that’s it — I’m well.  I actually thought, “Is that all there is to a heart attack?”  What I didn’t consider is the cause and effect aspect.   The heart attack was fixed with a stent. However, the underlying cause, cardiovascular disease, was still with me.

Almost one year to the date of my event, I was exercising more rigorously than usual in Cardiac Rehab when I began feeling some pressure in my jaw.  No pain, just pressure.  I stopped and asked someone to take my blood pressure.  It was elevated from exercise, but nothing concerning.  So I continued my routine.  As I was leaving, I mentioned what had happened to a nurse.  She said to call my doctor.  I did and was told to come right in.  My doctor, in turn, called my cardiologist and within a week I was back in the cath lab.

I had somehow avoided a second heart attack.  However, my Left Anterior Descending Artery  (a/k/a WidowMaker) was 95% occluded.  This event was potentially worse than the earlier heart attack.

Your body speaks to you.  I pretty much ignored my first cardiac encounter.  Fortunately, even though the second message was much more subtle, I listened.  Quick action saved my life.

Here are my rules to live by.  First, listen to your body.  Second, know your numbers:

Blood Pressure:  The new “Normal” is less than 120/80

Triglycerides:  Normal is less than 150mg/dl

Cholesterol:  LDL less than 70 (it was 100); HDL more than 40

Third, get some exercise.  You don’t need a gym.  Go for a walk in the park or if the weather is not conducive, go to a mall.  The American Heart Association recommends 30 minutes of exercise daily.

Oh, and if you’re still smoking, STOP!

Our bodies speak to us when something is wrong, in a language that is sometimes confusing or subtle.  In our busy worlds, we tend to ignore the message or pull a Scarlett O’Hara saying, “I just can’t think about this now.  I’ll think about it tomorrow.”  But here’s the rub: tomorrows aren’t guaranteed.

Editors Note:  This was a speech given at Miracle Mile Toastmasters on March 7, 2019.

 

Fred & Ginger Had Rhythm, Do You?

Fred & Ginger Had Rhythm, Do You?

We’re talking about circadian rhythm.  From the Latin circa (around) and diem (day), circadian rhythm is any biological process that displays an endogenous, entrainable oscillation of about 24-hours.  These 24-hour rhythms have been widely observed in plants and animals (including we humans).  So, while we all have an inert rhythm – why don’t we “dance” to it?

In the suprachiasmatic nucleus of the brain, we have a “clock,”  which governs when we sleep and rise, taking (in part) its cues from light sources to govern our 24-hour day.  Doctors Michael Roizen and Michael Crupain suggest in their new book, “What to Eat When,” this biological rhythm affects our digestion and hormonal levels,  and it dictates when it’s best to exercise and to eat.  In fact, they propose that “when we eat, is just as important as what we eat.”

Two weight loss studies conducted by Dr. Jakubowicz, of Tel Aviv University, include the effects of circadian rhythm.

In a 12-week study, 93 obese women, were divided into two groups.  The objective for all was to lose weight on a 1400 calorie per day diet consisting of moderate-carb and moderate-fat intake.  The food consumed was the same, except that one group’s breakfast was composed of 700 calories, lunch 500 calories, and dinner 200 calories.  Group 2 did the reverse, 200 calories at breakfast, 500 at lunch and 700 at dinner.

Everyone lost weight.  The big breakfast group lost an average of 17.8 pounds and 3 inches off their waistline. The big dinner group lost 7.3 pounds and 1.4 inches off their waistline.  The more abundant breakfast group also showed significantly lower levels of ghrelin (often referred to as the hunger hormone), and a decrease in insulin, glucose and triglyceride levels.

In another study, 193 obese, non-diabetic adults participated in a 32-week study.  Again, they were divided into two groups.  Men had 1600 calories per day, women 1400 calories.  One group had a low carbohydrate diet with a 300 calorie breakfast; the other was high in both proteins and carbohydrates and always included a dessert for breakfast.  This meal came in at 600 calories.  After the study, the group with the big breakfast lost, on average, 40 pounds more than their peers.  Part of the problem for the low carb, small breakfast group was the participants didn’t endure denial well for 32 weeks.  As mentioned in an earlier post, when faced with deprivation, one can sometimes become depraved.

While the Israeli studies results are compelling, they are supervised diets, and I wouldn’t advise something so drastic without direction from a professional.

In urban America, our days are filled with work, school, and other activities.  We leave homes at different times, not having breakfast as a family unit.  During the day, there is work, school, after-school activities, and appointments.  Our calendars are full.  At the end of the day a family, hopefully, can sit down as a unit for what is usually their largest meal.  Complicating our lives, even more, is the control technology has over us.

So I asked myself, “how can I incorporate a better “when” into my diet day?”  I figured this would be a relatively easy process.  I  was wrong.  Even following the book’s four guidelines can be problematic.  I get up early and have a substantial breakfast (which includes fat, protein and whole grains) by 8 am.  I plan lunch between 12 and 1 pm.  Dinner is my smallest meal, and I try to eat it between 5 and 6 pm.  This is fairly compatible with the guidelines.  However, keeping a consistent mealtime schedule is not as easy as I’d thought.  It’s here the adage, “make plans and life happens,” comes in to play.

The doctors also discuss what to eat when you’re experiencing stress or grief, how to handle health issues and other everyday life challenges that arise.  Importantly, they do speak to “mindful” eating.  Enjoying a meal without phone or text interruption, and eliminating television programming while dining is recommended.

There is science to aligning our circadian clock with our hunger clock.  Do you want to figure out how you can incorporate the “when” into your day?  Read “What to Eat When.”  Some suggestions may be easier to integrate into your life than others, but there is no doubt, better positioning the two rhythms can be beneficial to your well-being.

 

 

 

 

 

 

 

 

 

NAVIGATING THE DIET MELANGE

NAVIGATING THE DIET MELANGE

This is the time of year when diet companies and weight loss plans, make promises to transform you — producing a better, fitter, and more amazing you.  Many suggest these remarkable changes will occur almost overnight, with little or no effort.  As with anything in life, if it sounds too good to be true, it probably is.  I decided to do some research.  Every year U.S. News & World Reports puts out a list of the best diets.  I checked out those top rated.  Here is a link to the article:  https://health.usnews.com/best-diet/best-diets-overall.

The left-hand column of the article provides ways you can customize a diet.  There are rankings (kinds of programs), or you can modify the type of regime, as well as specific preferences you desire.

When I started on my weight loss journey, I had 2 objectives:  1) Lose weight and 2) Not ever have another heart attack.  To be honest, there is no guarantee of the second goal. The reality is I have cardiovascular disease (CVD).  After my myocardial infarction (MI), stents were inserted, and it resolved an immediate problem.  It did not take away the CVD.  For me, this is a good-news, bad-news scenario.  The bad news is I could experience (and almost did) another cardiac event, the good news is I have learned and continue to learn how to listen to my body and take better care of it.

The top 3 diets overall, at U.S. News were:  1) The Mediterranean Diet, 2) The Dash Diet, 3) The Flexitarian Diet.  In all 3 plans, you do the shopping at your local market  — there are no premade meals to buy.  While they all recommend fresh fruits and vegetables, you might consider frozen vegetables, which are generally harvested in their prime and quick-frozen.  Be sure you get the veggies without sauces, butter, etc.  Plant-based proteins are advocated (legumes, beans, nuts), but you don’t have to give up lean meat.  There are hundreds of recipes available online and cookbooks dedicated to all 3.

I was listening to Dr. Jen Ashton, the Chief Health and Medical Editor, and Chief Medical Correspondent for ABC News and Good Morning America, discuss the finding from U.S. News.  In addition to being a physician, Dr. Ashton received a Master’s Degree in Nutrition from Columbia University in 2016.  Credentials in nutrition are a rarity among physicians.  One thing Dr. Ashton emphasized is that any diet has to be “sustainable.”  If any program is not easy to follow you will likely give up.  All 3 of these diets are easy to follow.

Since a primary reason for researching diets was because of my concern over heart health, I feel compelled to mention the Ornish Diet, which tied for #1 with the Mediterranean Diet in the Heart Healthy category.  A preeminent difference between this and the Mediterranean Diet is that it is incredibly restrictive with the use of oils (even unsaturated), foods containing cholesterol, animal products, etc.  The plan emphasizes stress management and exercise in addition to diet.  Both are essential to maintaining a healthy heart.

While I don’t follow it flawlessly, my diet most resembles the Mediterranean Diet.  Hell, I am Italian after all.  Of course, if you look at the European portion of the Mediterranean Sea, it encompasses Greece, Italy, France, Turkey, and Croatia — all with different kinds of cuisine.  Yet they all share a similar pyramid.  All meals include the base (this is where most of your food will come from) encompassing fruits, grains, vegetables, beans, nuts, legumes, seeds, along with herbs and spices.  Next up on the pyramid is fish and seafood.  These you have at least 2 times per week.  Next up is poultry, eggs, cheese and yogurt which you have in moderate portions daily to weekly.  The tip of the pyramid contains meats and sweets — these foods, of course, are in limited quantities.

There is one other thing we must consider when discussing the Mediterranean Diet.  People from that region, do not hop in the car to go to the mall or market.  They walk just about everywhere or ride bikes (how un-American).  In other words, they are not couch-potatoes, they are active.  Don’t expect to lose weight, if you aren’t moving.  Think at least 30 minutes a day of moderate to vigorous exercise.  If you’ve been inactive, start off incorporating physical activity 3 days a week, increasing your workout as you can.

So there you have it.  The top diets, according to U.S. News.  There are more.  Under best weight loss diets, you can find Weight Watchers, Volumetrics Diet; Best Fast Weight Loss Diets gives us HMR Diet, Atkins Program and Keto Diet; Best Commercial Diets include Jenny Craig and Nutritarian.  OMG, it goes on and on.

There are additional charges to join many of the Weight Loss and Commercial Diet Plans, plus monthly fees.  Some have group meetings, meetings with counselors (or a combination of both) and some are available online You need to choose what works for you.  Prepared food can be purchased directly from the company or at your local market, reducing preparation time for the user.  Just remember Dr. Ashton’s advice, whatever you select, IT MUST BE SUSTAINABLE.

Early on I tried Weight Watchers and dropped it because while it offered portion control and a pretty healthy approach, I didn’t know how many macro and micronutrients I was getting per meal or per day.  Was I getting too many carbs, too much fat?  It simply didn’t follow the lifestyle of a control freak.  However, others swear by it and if it’s working for you, stick with it.

Finally, I judge my diet results, not on a number on the scale, nor a dress size.  I look at my waist size (more on this in a future post) and most importantly on lab results, and maintaining healthy blood pressure.

Our obsession with diet has created a multi-million dollar industry, which is difficult to navigate.  We need to have a “buyer beware,” sign out there as we evaluate what’s in our best interests.

What do you do?  How do you measure your success?  There was a lot to this post.  I hope I didn’t discourage you.  Let me know your thoughts.

 

Taking the Die Out of Diet!

Taking the Die Out of Diet!

“Hey, I’m depraved on account I’m deprived.” Dear Officer Krupke, West Side Story

You’ve decided it’s time.  You’ve literally eaten your way through Thanksgiving, Christmas, Hanukkah, and New Year’s.  If that wasn’t enough — you consumed enormous quantities of calories attending all those holiday parties.  You are left with a widening waistline, little or no energy, and quite often a dip in your self-esteem.

When you think of the word “diet,” what comes to mind?  How about:

  1. Low fat (or no fat)
  2. No pasta, no bread, no sweets –NO CARBS
  3. Limited calories
  4. No Alcohol
  5. Salads, salads, salads (OMG, I hate green food)
  6. Gluten-free foods — What the hell is gluten?
  7. Starvation

If you can say “Yes” to one or more of the above, you are in deprivation mode.  Trust me, that inevitably leads to becoming depraved.  An example of this kind of depravity is simple.  I do not like coconut.  I’m not fond of the aroma, the taste, or the texture of those shavings placed on top of desserts.  If I am told I cannot have coconut, I will begin to crave it.  In anticipation of expected deprivation, I become depraved!

Like many of you, I’ve tried so many weight loss plans and had little or no success.  Maybe I lost some pounds, but stop the diet, and they would miraculously reappear.  In surrender, I’d thrown my arms in the air figuring, I’d never win in the diet arena.  As I stated in my previous blog post, what finally got my attention was a heart attack.  This weight problem was no longer a vague idea of looking better, my life was on the line.

My life is so often serendipitous.  It took 2 years to find my primary physician.  Incredibly, she is board certified in obesity medicine and has more than a nodding acquaintance with nutrition.  She provides seminars for her patients which include professional dietitians, psychologists, and physical therapists.  She started me on the path of my weight loss journey.  To date, I’ve said goodbye to 35 pounds.

In addition, I’ve taken on-line nutrition courses through edtogo.com.  This does not make me an expert, but I’ve found some things that have worked for me — and that may work for you.  Perhaps you can share some of your experiences that will help other readers.

There is no “one size fits all” diet out there.  Wish there was — bet you do too.  However, sharing what’s worked and what hasn’t might give someone else a “leg-up.”

The “Food for Thought” section of my blog will include suggestions, ideas, recipes (if from another source, there will be links to them).  I hope you are as excited about this section in my blog, as I.  Let me hear from you.