The heart of the matter

A little bigger than a cricket ball and only weighing 250 to 300 grams , our heart is a miraculous work of nature. Every single day it pumps nearly 8300 liters of blood. When you do the right things you are giving it a helping hand to carry out its duties. This also makes your life hassle free and you might find yourself enjoying your life. But when things start going wrong your life can fall apart around you.

Recently I met a 65 year old retired banker Mr G at a family function. He looked extremely healthy and fit with a well maintained figure and for all practical purposes seemed not to have a care in the world. This was until I got talking to him and this what he had to say about his life and health - 30 years ago, three weeks before deepavali Mr G had felt a mild pain in his heart and he did not think that it was anything to really worry about, possibly a mild gastritis that had caused it. But when he spoke to his cousin who was a cardiologist, the doctor persuaded him to go in for some tests, just in case there was some other complication and it is always essential to be very sure...After going over the test results which showed the ECG readings to be normal, he was made to go in for x ray snaps, and, the X ray snap shot showed quite something else. The two arteries feeding his heart were completely blocked. A third vessel was 95% blocked. In the mean time Mr G had also begun to develop a dull nagging ache in his chest which was the main reason why he had agreed to go through all the tests. It was Angina, pain arising out of an oxygen-starved heart muscle and according to cardiologists it must have been in his system since a long period of time, at least 3 or 4 years.

Angina and your heart

 

In fact, the cardiologist had never seen such severe Coronary Heart Disease (CHD) in a young man. He explained to Mr.G that the pre mature coronary heart disease was caused by an inherited disorder called familial hypercholesterolemia (FH) and that people with FH have abnormally high levels of cholesterol in their blood. Mr G’s was twice above the normal level, clogging the coronary arteries with fatty deposits. In fact the condition was so serious that he could not even undergo a bypass surgery. The blockages were so profuse that the his cousin the cardiologist with consultation with other heart specialists felt that, it just gave less that 50 percent chance of success! Since not much was known about FH then, nor were there any effective medications to reduce the sky high cholesterol levels, most FH sufferers died at an early age !So all things considered at 35 years of age Mr G’s chances of survival were very bleak indeed.

But, today at 65 Mr G leads an active life, hiking, biking and travelling on writing assignments and completely Angina free! So what was the secret behind his good health ? Many people with heart disease apparently ask him this and he always tells them the same thing – there isn't one. Anyone with CHD willing to put in the effort can improve his or her quality of life and live longer by doing the right things!

First of all, finding out that you have CHD is frightening enough and brings on all the deadly 3 D’s namely Dread, Despair and Depression. Any little pain in the chest area or missed heart beat can throw one into panic. If you are a sports person , chances are that instead of playing squash, tennis or whatever games you have been actively pursuing you might become a couch ridden cardiac cripple, so to say ! This is because you fear that the exertion would kill you. There have been cases where marriages break up because of the added tension and your whole life and career too could collapse around you because of the inner misery and your own preoccupation with your disease. This in time can lead to a money shortage and more problems and added stress which can become unbearable. People get into smoking and excessive drinking which is only going to cause more harm as they slowly get into depression and thoughts of being failure and some have been known even to go to the extent of committing suicide!

However, according to Mr G , no doubt he did go through all the above told negative experiences , but with the support and help of his cardiologist friend and cousin and his ever supportive family and friends he decided to get a grip on himself. The first thing he did was to go for a short holiday to a nearby beach resort where he went for long walks which cleared his head and also did a lot of reading up on all available material that was there about heart diseases, particularly about CHD. He learnt that there were lots of things he could actually do to help himself. After his holidays he paid a visit to his cardiologist and discussed the matter in a more practical manner and his cardiologist was of the opinion that if Mr G had survived so far it was because of his fitness and general good health, he encouraged him to keep it up. He also gave him an established safe exercise levels, some nitroglycerine tablets for angina and advice on how to monitor the pulse.

So Mr G was , in a month’s time getting back into most of the activities that he had been taking part in before tragedy had stuck and learning to pace himself carefully and also to manage chest pain as and when it occurred. With time, there were days when he hardly thought about his heart condition and literally got back into his old life style, helping himself to boost his morale, self –respect and confidence. He also got back his lost social contacts since he was much more communicative and sociable and they were happy to see him coping with his disease in such a positive manner and were ready to support and help him along with his family and physician.These are all very important when an individual faces a life threatening disease and his life hangs by a thread. The more positive his or her outlook is and the less stressed he or she is , the better they are able to cope with the situation without further damaging their heart.

A few tips on how to handle Heart problems and the stressful period

Take Responsibility

You have to take full responsibility for your ailment since there are things that only you can do to help yourself, like being regular in your fitness and exercise routine and also quit smoking and excessive drinking .According to statistics heart disease rates are 70 percent higher for smokers than non smokers. Smoking more than 20 cigarettes a day increases the chance of dying by 200 to 300 percent. So, if you are unable to quit smoking get help through a outpatient smoking cessation clinic which is found in many heart specialist hospitals. In the mean time, it is important that you have to make up your mind about quitting and not someone else telling you to do so.

You have to take control and take responsibility for your actions and your life so that you can give your heart a fighting chance. Once you make up your mind it is not difficult to find the determination and the discipline to carry out with your decision. This is the first major step taken in the right direction that could save your life and also paves the way for better things to come in the future !

Get help from Family, Friends and your Doctor

Having a strong social network, plenty of friends is an emotional cushion that can ease a person through life’s blows and many stresses. Experts say that close relationships and social contacts remain crucial even when the living is easy. These emotional ties that bind are also the ones that safeguard your health. The need for acceptance is built in, down to the very marrow of our bones and we need constant acknowledgement of any relationship’s enduring strength and when we get it our bodies and hearts virtually tap dance !

Living alone during such stressful ailment can be a very painful experience both physically and emotionally. So never hesitate to turn to supportive family members and friends. Talking out your fears with someone you trust is better for for your heart than bottling up everything inside and suffering alone. According to heart specialists, Heart patients with social support have far better survival rates. Joining a healthy heart program conducted by almost all heart specialty centers is very helpful since you get to meet others who are in the same condition as yourself. Interacting with them and sharing your experiences makes it easier for you to get committed to the program, set goals and stick to them. You get to learn a lot from the experts leading the group, about everything from safer exercising to better stress management and healthy diet ideas.

Similarly, try to learn everything that you could about your ailment which according Mr G was the biggest turning point in his life since he knew where he stood and also knew what steps he could take that would help him. Learning the basics about CHD, how your heart works, what caused the disease, which drugs you are taking and why ? This also means you can form a partnership with your doctor since you are able to discuss intelligently about your condition rather than do it emotionally .It is a good idea to write down questions and queries before you meet your doctor and ask for another appointment without worrying about other patients piling up, this way It makes your interaction with your doctor positive, quicker and more productive.

Fight Depression

Many heart patients including  go into long bouts of depression and it is not easy to come out of it unless you make a very sincere effort. This happened with Mr G as well. At such times it is better to talk it out with your physician who puts you on anti depressant medication and also help you with counseling. A frank self analysis about your heart condition and what can be done that would prove helpful can really help you in coming to grips with yourself. According to Mr G, within weeks after such a session and interactions with his doctor , he felt as if a heavy weight and a burden had been lifted from his shoulders. Most cardiologists are the opinion that if you are depressed, your chances of getting heart attacks and coronary artery disease appear to be much higher. Studies have also shown that depressed heart patients can suffer future cardiac problems – especially when their mental state affects their life style choices. So better to be open about your feelings and share all your inner fears and frustrations with your doctor and also your close family members and friends who could make you look at things differently and once you know that you have people round you ,ready to help you yours whole attitude changes for the better and you are able to coipe better with your condition.

Think positive always

Be an Optimist

Think of it this way – If you have been diagnosed with CHD, you are already a lucky survivor. According to Mr G each time he had been in a coronary intensive-care unit and walks out of it, he felt lucky to have been given another chance. Being grateful for still being alive made it easier for him to do the right things for his heart health. A positive mind and mental attitude does much more than what drugs do to you. Positive thinking doesn't mean that you ignore life's less pleasant or less distressing situations. Positive thinking in fact means that you approach the unpleasantness in a more positive and productive way. You think the best is going to happen, not the worst.

A recent study has shown that older men with a more optimistic attitude have less than half the risk of coronary heart disease of pessimists who give up hoping and refuse to see the brighter side and also make an effort to help themselves. Self talk and being logical and reasonable are all positive attitudes that help us in better stress management, so it is important that you practice thinking positive. According to many researches it has been proved that a positive attitude increases life span, lowers rate of depression and distress, better psychological and physical well being and not but least reduced risk of death from cardio vascular diseases.

Control the Risk Factors

According to many physicians, most people have heart disease from poor lifestyle choices, not genetics. If they change to a heart healthy lifestyle, their risk will diminish and it becomes much easier to normalise the cholesterol levels with drug treatment. In fact poor ife style and diet management is at the base of most life thereatening ailments and with some basic care can easily be rectified.

When you get into a cardiac rehabilitation program , Coronary artery disease risk reduction includes: exercising, smoking cessation, dietary, stress and family counseling, and helping people manage their risk factors , such as getting their cholesterol and blood pressure under control. Making positive changes to reduce risk factors becomes much easier when you tackle them one at a time. But here it is also important to realise that you are taking a life and death decisions. What is more important? Another pack of cigarette, a bottle of liquor or spending another precious year of your life with your loved family?

walk your way to health

Keep Moving

Various studies have shown that those who are physically active have up to a 50 percent lower risk of heart disease than couch potatoes. Besides raising levels of good cholesterol, reducing the risk of high blood pressure, burning fat and strengthening the heart, regular exercise can lead to the development of tiny vessels that carry blood around blocked arteries. This ‘Nature’s Bypass’ as it is termed by cardiologists, can’t replace blocked arteries, but it can rescue starved heart muscles, reduce angina pain, even prevent a heart attack. According to Mr G in three decades after his ailment was discovered and he began his exercise routine with the blocked arteries, there was no evidence that he had even a very minor heart attack or failure. Even after two quadruple bypass surgeries , Mr G still had a normal ECG, which showed no discernible heart damage, thanks in part to the power of exercise. You don’t have to become an athlete to benefit from exercise.

Walking for an hour a day brings in excellent benefits. Make sure that you discuss in detail with your doctor before taking up any new exercise program. However, walking is the best form of exercise there is which has long lasting health benefits and the more you make it a part of your life style the fitter and healthier you become .

Eat healthy and Eat Well

Eating heart-healthy, balanced meals is not like entering a zen monastery. In fact, heart – healthy foods are enjoyable. It is a matter of making gradual changes towards balanced nutrition : more fruits and vegetables, whole grains, lean meats, and fewer deep fried foods and saturated fats like cheese, butter and fatty red meats. Fats and cholesterol are independent substances. Foods high in saturated fat tend also to be rich in cholesterol , some foods are high in one but not the other. Organ meats such as liver and eggs also have lots of cholesterol but only moderate amounts of fat. In contrast vegetable oils and nuts which are rich in fat have no cholesterol since they are not animal products. Fat and cholesterol are often mentioned together because fat affects the body’s production of cholesterol. In fact it is important to note that saturated fat raises blood cholesterol much more than dietary cholesterol does.

You can still eat good fats that actually help your heart, like those found in fish. According to research conducted on more than 80,000 people for a period of 16 years , it was found that those who ate fish two to four times a week had a 31 percent lower risk of coronary heart disease than those who rarely ate fish and preferred meat. If you have difficulty n changing to healthier eating, it is a good idea to seek the help of a dietician , who help you fine tune your diet. Most people tend to think that healthy eating is strict, but it is not. You can still have treats , just not all the time, that’s all ! Some days you might overindulge, after all you are human, put that behind and start again the next day making amends for the previous day’s indulgence!

Eat healthy and stay healthy

Lose Weight

Lose four kilos in ten days, eat what you want and be thinner – this is what some ads come up with the so called wonder drugs that promise to melt fat off you. There is such a lot of nonsense that surrounds weight loss programs that get advertised in magazines and on TV ,simply because we don’t want to accept the truth. Fad diets simply don’t work and the very word diet is not liked by many people. The promised weight loss comes back with a vengeance the moment you give up on the diet program.

Eating balanced meals, exercising and sticking to a healthy life style is the only way you can lose weight and also keep it up. When you find that your clothes are getting tight around your waist and sleeves, you know that you need to pay attention to how much you are eating and exercising. You need to cut down on calories and increase your exercise regime and come back to your normal size again. It is no miracle – Eat more calories than you burn, you will put on weight, burn more calories than you consume, and you lose weight. You don’t have to starve yourself, just keep an eye on what you are consuming. A few planned and necessary changes in your diet and life style are the only requirements to keep your weight steady. Any weight loss should be slow and steady and not fluctuate dangerously.

Take your medicines

It is absolutely necessary that a heart patient should take his or her medication on time and without fail. Every person with CHD should be on Statins, which helps in bringing down the high cholesterol levels and keeps it under control. Drugs definitely help you bring your condition under control and combined with a sensible diet and exercise can help in completely normalising your heart condition.

According to studies taking 40 milligram dose of simvastatin , which is normally recommended to be used only after other measures such as diet, exercise, and weight reduction have not improved cholesterol levels sufficiently, for over five years , experienced at least a 30 percent reduction in heart attacks and strokes.

Aspirin can help reduce the risk of heart attack in patients with CHD by reducing the formation of blood clots. However, studies have shown that in some people the effect of aspirin can be blocked by Adrenaline produced by exercise and stress. So, physicians suggest that taking your aspirin with a purple grape or blueberry juice is more beneficial since they both are natural heart supporters. There are other many other life saving drugs that can reduce risk, such as beta-blockers and ACE inhibitors, so it is important to discuss effective drug therapy with your doctor before taking any. An important thing to note here is not to self medicate and take drugs that other heart patients have been prescribed to take, which can have a dangerous outcome since each heart condition is different given the different situations and body structures.

Conclusions

There are thousands of people living with CHD who are managing their own disease and it is not the fear of death or disability that keeps them motivated. It is the increased self respect and confidence that come from knowing you are doing right and your best. It is how much better you feel and look and how much more energy you have that keeps you heart healthy.

When Mr G went in for his heart tracing after 30 years after he was discovered with his ailment he was in for a great pleasant surprise. The cardiologist compared the very first tracing that was taken 30 years ago to the one that was taken recently and they looked similar, even after going through quadruple by pass surgeries and all the other negative impacts of a weak heart. It was a great experience to note that his tracings were absolutely normal. In fact, his cardiologist is supposed to have told him that if the two tracings were shown to other doctors and told them Mr G’s history, they would find it difficult to believe it.

So, the only conclusion we can draw is that the best person to care for your heart is You!


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