Update On Alcohol Consumption and a Challenge

Recent studies have come out adding more confusion for heart attack survivors with regard to wine consumption. A recent small study found that test subjects who drank non-alcoholic wine more effective in reducing blood pressure for men at high risk of developing heart disease. Alcohol, as most know, raises triglyceride levels which for those with heart disease (and those at high risk) is a very bad thing. Plus alcohol can have negative effects with some medications.

Researchers said the health benefits of red wine come from polyphenols, which are antioxidants that also have anti-inflammatory properties. Polyphenols are in the non-alcoholic part of red wine. In the study, both the red wine with and without alcohol contained equal amounts of polyphenols.

The researchers linked polyphenol levels to an increase in the subject’s levels of nitric oxide, which relaxes blood vessels. Nitric oxide then lowers blood pressure and allows more blood to reach the heart and organs. In the study, it turned out that the men drinking the non-alcoholic red wine had lower blood pressures than those drinking the red wine with alcohol.

It worth noting the study used a very small sample, so the findings are not concrete. That said, it did piqué my interest. What if non-alcoholic (N-A) red wine is someday proven more beneficial? How easy is it to find N-A wine? And once its found,is it any good? I’m mean it’s basically grape juice, but how has the structure of the wine been altered by the method and/or process to remove the alcohol? Interesting questions I’m intrigued enough to explore.

THE CHALLENGE

Having read this study I’ve taken on the quest to find non-alcoholic wines and see how they fare. I’ve been an avid wine drinker ever since moving to Northern California. Prior to my heart attack I would take three to four trips annually to Sonoma and Napa along with keeping multiple memberships to wine clubs. Typically I’d keep 6-8 cases of wine at any one time in dedicated wine refrigerators in our garage.

I’m by no means a sommelier, but instead someone who admired the craft and learning about the amazingly complex process of turning harvested grapes into wine. Unfortunately that all changed after my heart attack as I’ve drastically cut back on my wine consumption. My wine collection is now down to 3-4 case as I no longer trek up to wine country anymore and cancelled all but one club membership.

My plan is to report on a new non-alcohol wine every week or so. Even though studies focus on the beneficial polyphenols found in red wine I will expand out to whites and sparkling wine. I’ll document the ease at which to acquire the wine, my tasting notes and if I’m really ambitious give my suggestions for food pairing. I’m looking forward to this challenge as it will test my knowledge of wines but more importantly I hope to find some hidden gems as the holiday season is around the corner. The holidays have always been a difficult time to abstain from consuming wine and having an alternative will be more than welcomed.

Stay tuned for my first report…

 

Paranoia

I was listening to Pandora the other day and the Kinks Destroyer came on the station I was listening to. In it there is a verse that resonated with me.

Silly boy you got so much to live for

So much to aim for, so much to try for

You blowing it all with paranoia

You’re so insecure you self-destroyer

Besides the thought that I could not remember the last time I heard that song, it got me thinking about how after getting home from the hospital how paranoia quickly sets in. I found myself getting overly sensitive to anything going on with my chest. It’s understandable; a critical organ has gone through a traumatic experience. But like in the song, paranoia can lead to a self-destroyer. Worrying about that weird pain or feeling does nothing more than fuel unnecessary stress and anxiety which is the last thing a body (and heart) needs when recovering. So what to do? One technique I’ve found effective in lowering anxiety is developing “action plans.” An action plan is what I would do IF a particular heart event happens. I logically list out the steps I would follow if something where to happen. When I start to sense a feeling of heightened anxiety I mentally go to my list and remember, “If X happens I know what I’m going to do, keep calm and go to step one.” Knowing I have this already thought out I can then start to think to myself, “I’m not going to let this impact what I’m doing/enjoying, I will continue and check back later to see if it’s changed or gotten any worse.” If the condition continues I now have a plan to enact to deal with the symptoms, diagnose and seek treatment. If it was nothing I haven’t let it control me and unnecessarily elevate my stress level.

Now I’m not advocating ignoring your body, actually it’s the opposite it’s how one reacts to the signals causing the alarm bells to go off. How we react and quickly deal with the situation can make a difference in resulting stress. Listening to your body is important, but so is talking back. Tell your body it’s not going to disrupt the great dinner you’re enjoying or the fun playing with your kids. After a heart attack our bodies go through a lot of changes. New medications are flowing through our blood, the heart is dealing with the trauma and has to align to the “new” normal of working around muscle tissue no longer able to function as it use to. All of this leads to feelings and sensations we are not accustomed to and this lasts many months after leaving the hospital. I’ve found not letting the feelings and worry overtake my thoughts and what I’m doing is allowing me to enjoy living. I’m not letting the stress and anxiety of paranoia win.

Life Might Not Be A Marathon

Longtime runners are familiar with the training technique of LSD (Long Slow Distance) it seems there’s a new study challenging the concept of “more is better” when it comes to the amount of weekly mileage is most beneficial to runners. The study found evidence less is better when it comes to mortality benefits and running. The study concluded there is a peak where the risk of mortality is minimized from running is achieved with as little as 20 miles per week. For those who think that achieving the maximum benefits from running requires hours of pounding pavement every week or training for a marathon there is new hope.

The key with this study is it looks at all-cause mortality and running not just focusing on the cardiovascular elements. Its key finding is, contrary to popular belief, running longer distances does not offer an increase in benefits to reducing mortality rates than someone who runs shorter distances per week. This should be encouraging to those who would like to start running but are afraid to start do to the perception a lot of miles need to be logged in order to gain any health benefits. In the study the largest benefits observed where from subjects running 10-15 miles per week. Also pace was considered with the group running 6 to 7 miles per hour (8:30 – 10:00 minutes per mile) benefited the most over those running at a faster pace. The researchers concluded from the study that running as a form of exercise is linked to a 19% lower risk in death compared to individuals who did not.

It should be noted that all the 52,000 men and women participants in the study were free from cardiovascular disease, cancer, electrocardiographic abnormalities, and diabetes at baseline. The results do not apply to individuals with known chronic conditions.

Source:    Lee DC, Pate RR, Lavie CJ, et al. Running and all-cause mortality risk—is more better? American College of Sports Medicine 2012 Annual Meeting; June 2, 2012; San Francisco, CA. Presentation 3471.

A New Beginning: What I Experienced After My Heart Attack

In the recovery room after my first angioplasty I distinctly remember the first question from the cardiologist who performed my procedure as he reviewed my chart, “How much time are you planning to take off from work for your recovery?” I was a little dumbfounded by his question mainly because I hadn’t thought about it. I paused and said, “Two weeks I suppose.” I assumed this was the default answer. Staring at his clipboard and not even looking up he said, “You really should take a month, two if you can swing it. I’m a workaholic and would take two weeks, but I strongly suggest you take at least a month.”

That was the moment the seriousness of what I’d been through started to really sink in and the realization I was not prepared for what I was in for when the automatic doors closed behind me and I took that first breath of fresh air. Surviving a heart attack is a Ctrl+Alt+Delete to every aspect of life going forward. Since the vast majority of us are not medical professional we really have a hard time grasping all the physiological changes and modifications that happen after surviving a heart attack. When the cardiologist said a month to recover, as thrown back as I was I would soon realize that was just the beginning.

After the pain in my groin from the angiogram/angioplasty catheter “puncture” insertion point subsided the only thing I could think about was wanting to start getting myself back to where I could run again. For the first six to eight weeks I focused on walking on the treadmill slowly building back stamina and strength. Surprisingly it was not hard to reset my mind to slow down as I walked since the paranoia is still high and my senses even more tuned in to any sign or signal my heart might give off. I eventually was able to get my pace back to a steady jog (sub-8:00 min./mile pace) and eventually graduated from the treadmill to getting outside and on the roads. Do expect to rest a lot, whenever possible the first month. I tell people that during my month off I rediscovered the lost art of napping, our newborn daughter and I both had our nap schedules. I really miss daily afternoon naps.

I was given a lot of information about the necessary changes to my diet now I was diagnosed with heart disease. Fortunately my HMO had a cardiac rehabilitation program to go through the good, bad and the ugly when it comes to nutrition. If your health network offers these, go to them, all of them.  They really help to quickly educate you and your spouse/caregiver on your new diet restrictions.

One thing to know is about a quarter of patients feel depressed and angry after a heart attack. This was certainly true in my case. Thoughts about, “Why me?” and reliving lifestyle choices that could have contributed to my heart attack where very common and almost a daily occurrence. I find out this is  normal but its important to deal with the reality that the past can’t be changed. The heart attack is over, nothing can be done to change that. What can be changed is focusing on the future and the prevention of the next heart attack. It’s important to get back into a routine and if necessary set goals to keep motivated. For me I wanted to get back to running again to show that I wasn’t going to let this disease beat me.

I never took medication before my heart attack except for the occasional Tylenol for muscle pain, but that changed forever. Those already on meds this would be more pills to work into the daily routine, but for someone who never took prescribed medication it was another new normal to deal with. I quickly found a good rhythm and have never skipped a dosage.

If I had to give one key bit of advise for the recovery journey it would be get active, exercise. It makes you feel good mentally, its beneficial to your heart, lowers blood pressure, maintain a healthy weight and most importantly exercise helps clear your head and escape from dealing with the daily challenges of being a survivor. It has helped me tremendously all throughout my life and continues to this day.

Exercising With A Heart Rate Monitor

I’ll be honest I’m a tech junkie and when tech meets fitness, count me in. I will admit that I do draw the line at MP3 players and running. The one exception I have to running with music is on a treadmill. Since I’m still being honest I’d rather stick a spoon in my eye than run in place for an hour but if I have music it’s somewhat tolerable. Back in 2006 I started running with a GPS watch from Garmin called the Forerunner 205.  I was stoked I could downloaded my runs to my computer and plot without entering any data manually. After my heart attack and when I started running again I invested in a Garmin Forerunner 305 which included a heart monitor strap.  I now never workout without it. Anyone who was active before their heart attack and plan to start exercising again should invest in one of these devices.  There are many on the market and I plan to do a future post reviewing the options now available.

There are people who dismiss HRM’s as uncomfortable because of the chest strap. I personally find hospital beds and rides in ambulances more uncomfortable. Designs have progressed where HRM straps are light-weight and hardly noticeable along with the devices you wear on your wrists.  Gone also are the days of wearing a brick strapped to your wrist, most HRM are only little thicker than a standard running wristwatch.

A personal real world example if there are still any doubters.  Just the other day I was mounting my bike for my commute to work when I looked down and noticed my resting heart rate was 85-90bpm. Because I’m always “plugged in” when I ride I know my normal resting HR is 46-50bpm.  Sure enough my heart had started into atrial fibrillation. If I didn’t have my HRM I could have easily rode off putting myself at serious risk, not to mention the delay getting to my medication to convert my heart back to sinus rhythm.

 

Sweets For Your Heart

Chocolate is back in the news, or more specifically dark chocolate and its protective qualities.  Researchers in Australia in a new study found more evidence of dark chocolates effects in lowering blood pressure and lipids to be an effective and inexpensive strategy for preventing cardiovascular events in high risk patients.

To clarify, “dark” chocolate needs to be 60% to 70% cocoa or a chocolate enriched with polyphenols.  Apparently dark chocolate (cocoa) is packed with polyphenols and more specifically the flavonoids found to exhibit anti-hypertensive, anti-inflammatory, anti-thrombotic and metabolic effects. The effects of the flavonoids may contribute protective properties to the cardiovascular system.

After my heart attack I was off all chocolate due to the obvious fat and sugar packed into such a small package. I also stopped all caffeine which is additional baggage chocolate carried with it. The challenges I’ve faced with dark chocolate are twofold.  First, there is the high content of saturated fats that need to be considered. Moderation is again the key, especially heart patients on restricted diets, before starting in on that tasty bar of brown gold. Read the label to see what a serving size is and the saturated fat content.  The reality will be your treat maybe two or three squares.  Second, if you’ve never had real dark chocolate (in the 70% cocoa range) the two or three squares might be too much. Remove that thought of it being like the Hershey™ bars you used to love. These are not milk chocolate bars so that first taste will likely be a bitter, but it is chocolate.

It should be noted that the study was not done over a long period of time so the researchers used risk-prediction algorithms and population life tables to estimate the effects of eating dark chocolate daily for 10 years. The researchers stressed that the effects of dark chocolate consumption on blood pressure and total cholesterol, although beneficial, are not as profound as those of drug interventions.

Source:    Zomer E, Owen A, Magliano DJ, Liew D, Reid CM. The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: Best case scenario analysis using a Markov model. BMJ 2012; DOI: 10.1136/bmj.e3657. Available at: http://www.bmj.com/.

Pauline Anderson. More evidence dark chocolate is cardioprotective. theheart.org.

RoadID might save your life

I’ve been a very active runner for most of my life. On a cool January day back in 2007 I had just returned back to work from two weeks of paternity leave. I stopped running during that time to bond with our newborn daughter knowing I would have to be back to work sooner than I would have liked. I usually ran during my lunch hour and this day I was actually looking forward to it. On Fridays I would meet up with a couple of fellow runners for an easy 6-7 mile run and this day there was a good sized group. At first I could tell the two weeks off slowed me down, but this day was especially hard.  I felt weak most for the first half of the run having a difficult time keeping up with the group. After turning around to head back I started to get really bad cramps in both legs, so bad I had to stop and walk. It happened four more times over a  mile to the point I had to walk the rest of the way. What I didn’t know at the time was that this was the beginning of my heart attack. Had I experienced a more severe heart attack I most likely would have died on that trail as I had no one with me or any form of ID in case of emergency.

When I returned to walking/running after my recovery what kept gong through my head was, “What if my heart attack was worse, and I collapsed unconscious?” I didn’t run with a wallet or other forms of ID. Who would speak for me if I couldn’t, especially now being on Plavix/aspirin and new member to the heart attack survivors club? After some searching I found my new voice, and its name is RoadID.

I encourage anyone, not just those with heart conditions, to get a RoadID (www.roadid.com) bracelet. Reasonably priced starting at $15.99 its the most affordable insurance one can buy. Although the product was designed for athletes these bracelets are functional and fashionable enough for anyone to wear everyday.

I currently use the Wrist ID Elite (see image on left) in bright red which I’m very satisfied with. There are multiple version and color options of the bracelet to choose from. I started with their original cloth wrist band (Wrist ID Sport) but found no matter how many times I washed it the odor from sweat the fabric absorbed was unbearable. It got to the point I almost needed to burn it to dispose of it properly. The lettering on all their nameplates is laser etched into the metal so it won’t rub off and RoadID give you lots of room to put vital information on the tag. I’ve been using the bracelets for over five years and can say from experience they are durable and unobtrusive. If any of your vital information changes you can just order the Name Tag. The Wrist ID Elite uses a flexible silicone band material so it won’t absorb odors and is very easy to clean.

Since I started commuting to work by bike I never leave the house without RoadID on my wrist.  Too many things can happen on the road or random accidents unexpectedly arise where seconds or minutes could mean the difference between life and death. I feel better knowing if the unthinkable happens to me I’ll have a voice to assist whoever is trying to help me when I can’t speak for myself.

Turn sweat equity into social capital

Plus 3 was founded back in 2007 to find a way to build a social network of sponsors and causes then collect exercise activities entered by members and assign a value to the activity.  For every mile or minute you earn “points” that are applied to the sponsor and charity you choose.  Every point is assigned a dollar amount so the more points (or Kudos) you accumulate the more you’re donating to the charity.  Being philanthropic while walking on the treadmill? Why YES. Best of all Plus 3 Network is FREE.

You can enter your workouts one of three ways.  First is by fitness GPS devices, e.g. Garmin Forerunner. Second can be by mobile GPS, they have an iOS app that uploads activities for you. Lastly, activities can be hand entered through the Plus 3 website.  Activities entered by GPS are given higher point value as they are verifiable times and distances compared to hand entered activities.

Don’t think that this is for hard core athletes, you can earn Kudos for activities such as; Yoga, walking, yard work, dancing, golf, even surgery rehabilitation.  In fact there are over 85 activities you can choose from.

I know one of the founding partners and so have been using the site since its “alpha” launch back in early 2008. I’ve entered every workout, run and commute to work.  So far I’ve logged over 8,400 miles over the course of 700 hours, 56,776 “Kudos” earned and raised $440.63 for the American Heart Association.  So far to date Plus 3, and its members, has moved over $565,000 for charity. All of it through its members doing what they already planned to do anyway, being active.

One important aspect of the site I should mention is the social networking feature.  You can add friends and create groups.  See what your friends have done, nothing like a little friendly competition or find new friends in your area.  Plus 3 also posts challenges for all member to join which usually have prizes for top finishers and sometimes random drawings. If you’re on Facebook or Twitter Plus 3 can send a feed to your accounts posting your latest accomplishments for more of your friends and family to see.

I know I’m biased but knowing that not only can I easily log and track my activities in one spot, but as the title of the article says I’m turning my sweat equity into a tangible contribution to a cause I believe in really makes this site valuable in my daily battle to prevent my next heart attack.

Plus 3 Network (www.plus3network.com)

Niacin – Friend or Foe?

There are those who are fortunate enough not to have to worry about their HDL levels.  I am not one of them. The two years after having my stents implanted and major modifications to my diet my HDL levels hovered in the low forties, not a desirable score by any measure and certainly in my case after being diagnosed with heart disease. After my second angioplasty my cardiologist recommended I start a niacin supplement therapy as studies at the time showed high doses of niacin boosted HDL levels. I eventually progressed up to a daily dose of 1.25g of niacin with only some discomfort. For those who have not taken niacin in high doses the common side effect is flushing of the skin. I experienced a itching sensation inside my ear canals for 5-10 minutes.  Unpleasant but tolerable.

About six months later I had my semi-annual lipid panel/fasting glucose test. At the time this semiannual blood test was like visiting a parole officer. When the results come back below target its worth another six months of freedom, but without extra time for good behavior. This time was different. Whereas before my HDL was in the low forties, this test came back with a 52. A ten point spike in less than six months, I was impressed and relieved.  Sure enough over the next two years my HDL stayed in the mid-fifties, still not great but a definite improvement.

Around September of last year I noticed a pain in my ankle. It would start as a slight ache that over the course of 24-48 hours feel exactly like I had rolled my ankle in a pot hole while running.  A sensation like really stretched my tendons and ligaments beyond normal but not at the point of tearing. The strange thing was I had not suffered any trauma to my ankle whatsoever. This happened randomly every 6-8 weeks. Fast forward to this last April. I get the same pain in my ankle except this time it is so extreme I can’t put weight on it. My ankle starts to swell and for the first time since these episodes started I’m forced to take a pain reliever as the pain in my ankle is unbearable. This is all over the course of less than four hours and again with no trauma prior.

While I waited for the Tylenol to kick in my wife mentioned her father experienced something similar and it was diagnosed as gout. Gout? It sounds like a STD or something you’d catch in the jungles of the Amazon. Since I obviously had no idea what gout was I turn to WebMD. Sure enough reading through symptoms and causes I find its a condition that can be brought on by too much uric acid in the blood which can attack joints in the foot, mainly toes but in some cases the ankle. So naturally I look up what causes uric acid levels to rise and there is was, right after beer.  Too much niacin.

Right away I made an appointment with my primary care physician who ordered up a uric acid blood test which I took care of right after my appointment. Sure enough when the results came back my 9.4 reading was nowhere close to the high limit of 8.5 still considered elevated but “normal.” Email from my PCP said to cease niacin immediately. Done and so far almost eight weeks in no more flair ups in my ankle. I still have to go back and collect another data-point to insure that my uric acid level is no longer elevated but I’m filled with positive thoughts that will be the case.

I did follow up with my cardiologist who originally prescribed adding niacin with an email telling him I was ending the niacin. His response, “I agree with stopping, I no longer recommend niacin to my patients.”

I realize I’m a data-point of one, but if you are on a similar niacin treatment plan check with your doctor. The treatment of low HDL using niacin widely used in cardiovascular medicine is still being debated. Find out if your doctor is still recommending it to patients and do the risks still outweigh the benefits.

Mozart Influences Blood Pressure Values

In a study out of Italy (Dr Giuseppe Crippa (Ospedale Guglielmo de Saliceto, Piacenza, Italy) , researchers observed that patients listening to Mozart in a doctor’s office lowered blood-pressure levels.  Oddly enough the study found that rock music, specifically Queen(?), raised BP levels.  Automated blood-pressure devices where used while patients sat in a chair listening to classical music, rock music, or no music.  They found that Mozart adagio lowered blood-pressure, while rock music showed opposite results.  I found this study quite amusing and couldn’t help but think of it being used in the SNL Weekend Report segment “Really.” Rock music increases blood pressure… REALLY? Unless it’s a MUZAC version of Pearl Jam or Bohemian Rhapsody  I would never think of rock as ever being relaxing enough to lower my BP. I mean really, if I’m going to try and relax by listening to music I would instinctively be looking for my Amadeus soundtrack and not my copy of Nevermind. According to Dr Crippa, the goal of the study was to show that physician using music in the office to make their patients more comfortable can influence blood-pressure by the type of music played. Unfortunately my site doesn’t have a “No Duh” category, might have to re-think that.