Thursday, July 12, 2012

Warning signs of stroke

  • Weakness: Sudden loss of strength or sudden numbness in the face, arm or leg, even if temporary.
  • Trouble speaking: Sudden difficulty speaking or understanding or sudden confusion, even if temporary.
  • Vision problems: Sudden trouble with vision, even if temporary.
  • Headache: Sudden severe and unusual headache.
  • Dizziness: Sudden loss of balance, especially with any of the above signs.
Call 911 or your local emergency number immediately for help.

Monday, June 18, 2012

Cycling: Cadence vs Workload

I ride my bike every day that I can, to exercise my heart.  It occurred to me recently, while riding, that there is a relationship between cadence and work benefits.

Cadence is the revolutions per minute of your pedals.

When you are in a low gear, your cadence rate is high but the effort is low.  This is an aerobic exercise.

Aerobic exercise (also known as cardio) is physical exercise of relatively low intensity that depends primarily on the aerobic energy-generating process. Aerobic refers to the use of oxygen to adequately meet energy demands during exercise. [ref: Wikipedia].

When you are in a high gear, your cadence rate drops to a lower number but it is harder to pedal.  This exercise is anaerobic.

Anaerobic exercise is one in which oxygen is used up more quickly than the body is able to replenish it inside the working muscle. As a result, muscle fibers have to derive their contractile energy from stored substrates. Weight training is an example of such an activity.

So, I think there must be a way to determine what  the ‘best’ pedal rate is for your heart.  You want a good balance of aerobic and anaerobic benefits.  I don’t have the answers yet but stay tuned.

Why Don’t Heart Recipes Tell the Truth ?

For all of us with heart disease in our history, we have been told to be careful about our sodium intake.  Yet most ‘heart health’ cookbooks and recipes seem to ignore this advice.

The current average daily sodium intake for U.S. men is 3100mg to 4700mg; for women 2300mg to 3100mg.  The recommended amount is 1500mg to 2300mg.  Elsewhere in the world, the recommended intake is 1500mg unless you are over 65 years old. Then the amount is 1200mg.

I won’t even try a recipe that doesn’t give all of the nutrient values.  Sure, I can figure them out but why should I have to do that ?  Surely, the person developing the recipe for the heart-challenged must have these numbers, or else how could they think that their recipe is ‘heart-health’.  So, why don’t they tell us ?

For us, these numbers are a matter of life and death.  Not today. Not tomorrow. But sooner that we want.

When you look at a new book with heart recipes, be very careful to inspect the numbers.  Most of them are not good enough for you.  And there is no reason for that.  You can eat well with the restrictions but most of these published recipes will not help you do that.

Sunday, May 20, 2012

Are You Lucky with Heart Disease ? Yes

Did you ever think about how lucky we are with heart disease, in that we know what it is and how to fight against it.  For the most part, it is a mechanical failure of a part of your body that you can understand.  And you know the lifestyle changes that you need to make in order to increase your chances of continued survival.

Now think of others who have suffered such things as cancer or a concussion. In those cases, the enemy is more difficult to clearly identify and to combat.

And their symptoms and continued annoyances are often not well-defined.  I know our heart disease can have all of these same things but usually ours are better defined.

And with their problems, a transplant is not an option.

Give thanks for what we do have and the advancements being made and don’t stress over what might have been.

Wednesday, May 2, 2012

Wow, I Saw My Father !

I was thinking this morning that it would be great to have the medical attention that the U.S. President gets.  A phalanx of medical specialists there all the time so that you can get answers on any little ache and pain that disturbs you.

But then I realized that every President I’ve ever seen, all the way back to Eisenhower, aged so much during their terms in office.  Stress really does that.

So, I asked my wife if my appearance had aged from before my heart attacks to after.  My wife said yes.  I suggested maybe two years.  She said at least ten years.

That was a sobering thought.

Now, I know why, when I look in the mirror in the morning, I see my Father looking back at me.

Friday, April 27, 2012


Even though you may watch your food intake very carefully, it’s possible, and even probable, that you will make the occasional mistake.

Yesterday, I had lunch at East Side Mario’s.  I do watch my food carefully and even have on my phone what I can eat at most of the restaurants that I frequent. However, I did not have that information with me for that restaurant, although it was on my computer back home. So, I tried to pick items that appeared safe. I chose a garden salad and seafood linguini.  What a mistake !

At the end of the day, my calories, cholesterol and total fat were all within my daily limits.  But the sodium for that day was almost three times my limit.

The fault was not with the restaurant; the food was good and the service was excellent.  The problem was with me.  I should have known what I could eat there.  When managing your health, you must be knowledgeable and vigilant.

So, why was the sodium overdose so important ?  Well, too much sodium causes you to retain fluid and increases your blood pressure.  This retention of fluid will show as puffiness and increased weight. Cardiologists recommend that, if your weight increases by more than two pounds in one day, you should see your physician soon.

The sudden increase in sodium in one meal will likely increase your weight and blood pressure, if only for a short period. But then these indicators are now somewhat inaccurate for the real state of your body.

This website has a good explanation of what is happening:

Saturday, April 14, 2012

Is Your Heart Now the Weak Link in Your Body ?

After a heart attack, most people feel depressed and anxious.  Depressed because it makes them feel that either they are getting old or their body is letting them down. And anxious because, like waiting for the other shoe to drop, they are waiting for the next attack.  Are these reasonable thoughts ?  Maybe not, but they are real and they do happen to most survivors.

“By virtue of the fact that you now have scar tissue on your heart muscle, you may be at higher-than-normal risk for sudden death from heart arrhythmias.” ref Richard N. Fogoros, M.D.

One cardiologist told me that, with proper attention to the Trilogy of Heart (stress, diet, exercise) and careful attention to meds, a heart survivor has a better chance of not having another heart attack than other people do.  For all of us here, we hope that is true.

Thursday, April 12, 2012

Nordic Walking is Great for your Cardio Exercise

You know you need to exercise if you are not going to repeat your heart attack.  

Wouldn’t you like to find an exercise that is:
  • enjoyable, 
  • easy to do, 
  • requires minimal training and 
  • offers great benefits ?  
Nordic Pole Walking is the answer for you.  It is the fastest growing low-impact activity in North America.  It looks like walking with ski poles, but it isn’t quite that. But, once you learn how to do it, it is easy and the benefits are great.
  •     Nordic Pole Walking burns up to 46% more calories than walking.
  •     Increases heart and cardiovascular training up to 22%.
  •     Incorporates 90% of all body muscles.
  •     Helps to eliminate back, shoulder and neck pain.
  •     Less impact on hip, knee and foot joints.
  •     Increases production of “positive” hormones.
  •     Supports stress management and mental disorders.
  •     Develops upright body posture.
It is so popular in Europe that there are approximately 10 - 15 million Nordic Pole walkers there.  And there are hundreds of clinical and scientific reports about the health benefits of Nordic Pole walking available in scientific publications.

It is good training for your upper body because it involves approximately 90% of your muscles and especially engages your upper body and arm muscles.   

It is good for Cardiovascular Training because it increases your heart rate by approximately 15 beats per minute.   
It increases your energy consumption by 20% to 46% and increases burning of calories by up to 46% in comparison to walking exercise without Nordic Poles.
It significantly increases the lateral mobility of your neck and spine.
It reduces the impact on your knee and hip joints by 30% over jogging.
And, it mitigates pain and muscle tension in the neck, shoulder and back regions.

Go to a sports store and purchase your poles. They can likely direct you to some training at a local facility.

Wednesday, April 4, 2012

The Trilogy of Heart

There are several things that must be brought under control if you are going to survive your heart attack(s) (yes plural, many people have multiple attacks).

What you can easily control
  • diet
  • exercise
  • stress

These, I call the Trilogy of Heart.

What you can control, with difficulty

There are some other things that can be controlled but these are more difficulty and usually take much more time. These include . . .
  • poor blood cholesterol and triglyceride levels
  • high blood pressure
  • smoking
  • diabetes (limited)
  • overweight
  • drinking alcohol
  • sleep apnea
  • metabolic syndrome

What can’t you control
  • age
  • gender
  • family history of heart disease
  • race & ethnicity
  • diabetes

You probably already know that to avoid another heart attack, you have to manage your lifestyle and likely change the things that caused you to have this one.  These changes will include the trilogy of diet, exercise and stress reduction. You will have to make changes. 

And, we will talk about these in a later post.

Tuesday, March 27, 2012

Heart Rehabilitation Programs are for Life

About a month after my heart attacks, it was suggested to me that I join the rehabilitation program at the Ottawa Heart Institute ( ). This free program consists of 16 one-hour sessions, 2 a week.

During these sessions, each participant warmed up by walking around the indoor track. 

I was surprised that only about 35% of people who are offered this opportunity at this facility actually do it. There are 15 people in each class. It was my impression that many of this group did not work out seriously. They would go out on the track for a short time and then intersperse the exercise with talking with their friends, getting a drink of water or going to the bathroom. On the other hand, there were some who arrived early to get warmed up, exercised diligently and cooled down afterward.   It wasn't hard to guess who might be candidates for repeat attacks. 

Before I joined the program, I could only walk about one block before I got chest pains and had to rest. This I could do only twice a week. 

At  my first rehab session, they wired me up and sent me onto the track. There was a nurse and a physio watching monitors of my progress. They said to come to them when the pains developed. In five minutes I was back. 

They saw nothing ontoward on the monitors and suggested I raise my arms over my head. "Do the pains feel different with your arms up ?". "Yes". "Then those pains aren’t cardio but likely musculoskeletal".  With that reassurance, I went back to the track and walked for an hour. First time I had been able to walk since the attacks. 

I now walk over an hour a day, every day.  My weekly target is more than 400 minutes a week.

1.    Use everything offered to you to improve
2.    Continue to push to get answers to your unanswered questions
3.    Be adamant about your exercise. Your life depends on it
4.    Search for local programs to help you with your recovery
5.    Your life has changed. Work with it to have many more years

Action Steps:
1.    Find a program today
2.    Sign up
3.    Follow the program diligently

Monday, March 5, 2012

Why Heart Attacks Kill Women

It is now not unusual for a woman (of any age), with no family history of heart disease, to suffer a heart attack and not even know it.

We have been inundated, and rightly so, with messages of what the symptoms are of an impending heart attack.  These are often for the heart attacks that men suffer, but women’s symptoms, and their response to these symptoms, may be far different.

The clutching chest pain and discomfort that we see in the movies may not be the signs for either gender.  Many people, especially women, even when they ‘allow’ themselves to acknowledge the symptoms,  end up in the hospital without ever having felt that telltale symptom (chest pain).  Telltale symptoms are different for men and women.  Women who have heart attacks are more likely than men to present with "atypical" symptoms.  Women also have much busier lives, often involving other family members, than ever before and even busier than many men so they don’t take the time to listen to their body’s complaints.

They have higher rates of mortality in the hospital as well.  This can be a combination of reasons:
  1. they get to the hospital too late (on average, an hour later than men) because:
  • they don’t recognize that they are having a heart attack, because of their symptoms;
  • they don’t think they should take the time from their daily ‘duties’ to others;
  • they don’t want to inconvenient others and so, they try to ignore the symptoms;
  • they have other symptoms from their body, at various times in their lives, that tend to mask , or divert attention from, the real cause this time;
      2.  at the hospital:
  • they don’t present with the expected symptoms (this was also most pronounced in younger heart attack patients);
  • they often experience a delay in diagnosis because they have different symptoms than men and so, their heart attack isn't recognized as such.

Chest pains and/or discomfort are still the expected symptoms but 35% of all patients don’t have them (42% of women; 31% of men). Why hasn’t this new scientific evidence overridden the historical anecdotal evidence ?

Both genders must pay attention to other signs of a heart attack such as pain or discomfort in one or both arms, as well as the back, neck or jaw. Shortness of breath and nausea or vomiting are other possible symptoms.(2)

1.    Journal of the American Medical Association (JAMA)
2.    American Heart Association
3.    Thomas Jefferson University Hospital
4.    Corrigan Women's Heart Health Program at the Massachusetts General Hospital Heart Center

Thursday, February 23, 2012

Coffee and Strokes

I was recently reading an article that talked about the connection between coffee and strokes.  In the past, coffee was linked to increased occurrences of strokes.  Now, according to a study published by Karolinska Institutet of Sweden in the American Journal of Epidemiology, drinking two or three cups of coffee a day can reduce your risk of having a stroke.  This study combined results from eight earlier studies involving almost 500,000 people over the last 50 years. Another study found that women who drink one or more cups of coffee per day have a 22-25% lower risk of having a stroke.

It is thought that the high level of antioxidants in coffee may protect the brain from LDL (the bad cholesterol).  High coffee consumption may still cary the risk of increased blood pressure.

Sunday, January 22, 2012

Low-Sodium Guidelines for Heart Failure

Here is some information to help you start or continue following your heart failure diet.

Planning what you eat and balancing your meals are important ways to manage your health. Eating healthy often means making changes in your current eating habits. A registered dietitian can provide in-depth personalized nutrition education, tailor these general guidelines to meet your needs, and help you begin a personal action plan. There is excellent evidence to suggest that a daily sodium restriction to 1500 milligrams may benefit patients with cardiovascular risks including heart failure, hypertension, African-American ethnicity, and all middle aged and older adults. Here are some basic guidelines:

  • Control the sodium in your diet. Decreasing the total amount of sodium you consume to 1,500 mg per day is one of the most important ways to manage heart failure.
  • Learn to read food labels. Use the label information on food packages to help you to make the best low-sodium selections.
  • Include high-fiber foods such as vegetables, cooked dried peas and beans (legumes), whole-grain foods, bran, cereals, pasta, rice and fresh fruit. Fiber is the indigestible part of plant food that helps move food along the digestive tract, better controls blood glucose levels and may reduce the level of cholesterol in the blood. Foods high in fiber include natural antioxidants, which reduce the risk of cardiovascular disease. The goal for everyone is to consume 25 to 35 grams of fiber per day
  • Carefully follow your fluid management guidelines. Reduce your fluid intake if you have advanced heart failure or if you become more short of breath or notice swelling. General rule: limit fluids to 8 cups or less per day (which is equal to 2 liters or less or 64 ounces or less), even if you feel thirsty. If you sweat a lot with vigorous exercise, you may need to drink one cup of extra fluid. Your health care provider will give you specific fluid guidelines that may be more or less than 64 ounces per day.
  • Maintain a healthy body weight. This includes losing weight if you are overweight. Limit your total daily calories, follow a low-fat diet and exercise regularly to achieve and maintain your ideal body weight.

Sodium Hints:
  • read the labels in the grocery store – there’s a wealth of information on the nutrients that you need to know.
  • don’t have any meats from the deli – these have too much sodium as it is used as a preservative; have the meat cut at the grocery store instead.
  • don’t buy any frozen meats – these also have too much sodium; buy the meat fresh and freeze it at home.
  • eat as close to nature as possible – avoid processed foods
  • be careful of no sodium, low sodium & reduced sodium labels - for you, they're wrong.
  • be careful of all sauces – they tend to be high in sodium
  • avoid commercial & restaurant soups especially in cans – their sodium is much too high.
  • most breads have unacceptable amounts of sodium – weight-watchers bread is the best
  • avoid all pizza and most fast foods as they have too much sodium for you.
  • some salt substitutes have other ingredients that are not good for you – ask your health care professional about which ones would fit your new diet.
  • flavour your foods with substitutes like Mrs. Dash, lemon juice, & herbs
  • beware of heart-friendly recipes and menu items – often they aren’t
  • know your restaurants and pre-plan what you will order (I will cover this topic in detail in a later post).
  • search for reduced sodium offerings from food manufacturers - they do exist.

Guidelines for Reducing Sodium

  • Use fresh ingredients and/or foods with no salt added.
  • Eat foods as close as possible to the way nature made them.
  • For favorite recipes, you may need to use other ingredients and delete or decrease the salt added. Salt can be removed from any recipe except from those containing yeast.
  • Try orange or pineapple juice as a base for meat marinades.
  • Avoid convenience foods such as canned soups, entrees, vegetables, pasta and rice mixes, frozen dinners, instant cereal and puddings and gravy sauce mixes - it's difficult for you to find out what really is in them.
  • Select frozen entrees that contain 400 mg or less of sodium. However, limit to one of these frozen entrees per day. Check the Nutrition Facts label on the package for sodium content.
  • Use fresh, frozen, no added salt canned vegetables, or canned vegetables that have been rinsed before they are prepared.
  • Low sodium canned soups may be used.
  • Avoid mixed seasonings and spice blends that include salt, such as garlic salt

Friday, January 6, 2012

Where Does the Sodium Hide in Your Diet ?

Sodium can be a Killer – Where Does it Hide ?

So, from the previous post, we agree that sodium can kill you.  Let’s see where it hides in your diet and why you must do something about it.

Let’s talk about sodium and your health.

There are some foods that you know have lots of salt:
  • anchovies
  • bacon
  • cheese
  • ham
  • olives
  • pickles
  • prawns

  • salami
  • salted & dry roasted nuts
  • salt fish
  • smoked meat and fish
  • soy sauce
  • stock cubes
  • yeast extract
 However, there are also many foods that have hidden sodium. These include:
  • mayonnaise
  • soy sauce
  • pizza
  • most cheeses
  • breads
  • bagels
  • cakes
  • pies
  • frozen meats
  • sausages

  • hot dogs
  • hamburgers
  • soft drinks
  • cereals
  • sauces
  • canned soups
  • ready-to-eat meals
  • deli meats
  • ketchup & other condiments

 In these foods, the salt content can vary widely between different brands or varieties. That means you can cut down on salt by comparing brands, and choosing the one that is lower in salt. Nutrition labels can help you do this. We will talk later about how to read food labels.

And, we will talk in future posts about the problems of eating in restaurants.

But, at home, how do you reduce your sodium intake ?  Here’s some ideas:
  •  Use fresh or dried herbs and spices to flavour vegetables
  •  Avoid adding salt to your food when eating
  • Use soy sauce sparingly: one teaspoon contains about 0.36g of sodium (equivalent to 0.9g salt)
  • Buy fresh or frozen vegetables, or those canned without salt
  • Rinse canned foods, such as beans, to remove excess salt
  • Choose breakfast cereals that are lower in sodium
  • Buy low or reduced sodium versions, or those with no salt added