Archive for the ‘heart health’ Category

Yellow Split Pea Soup

It was cool this morning and so my mind went to soup…  This is what I came up with.  With sides of good bread, some sauteed broccoli, and a bowl of cherries, I was sooooo happy.

Ingredients

2 tbsp Olive Oil

2 cups chopped celery

1 cup chopped leeks

2 cups chopped carrots

1 1/2 cups dried yellow split peas

1/4 cup chopped celery leaves

4 cups vegetable broth

3 cups water

1/4 cup white wine

1/4 tsp ground cumin

1/4 tsp ground coriander

3/4 tsp kosher salt

1/4 tsp fresh ground pepper

How to:

In soup pot, saute celery, carrots, and leeks in olive oil until just soft.  Add vegetable broth and water, bring to a boil. Add split peas and celery leaves.  Bring to boil again.  Reduce heat and simmer for 45 minutes, until peas and carrots are soft.  Add wine, cumin, coriander, salt, and pepper and cook for another 10-15 minutes.  With immersion blender, blend soup to just smooth/a bit chunky consistency.  Serves 8.

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My Tomato Soup

A couple of sickies in my house inspired my need for soup.  This was such a huge surprise.  I never thought it would taste so good.  I made some bread and we dunked and slurped….

Ingredients

1/2 sweet onion, chopped

1/4 cup olive oil

2 – 28 oz cans really good tomatoes  (I used Wegman’s imported San Marzano – pricey, I know, $3.49 a can)

2 1/2 cups vegetable broth

2 1/2 tsp kosher salt

a few good cranks of fresh ground pepper

1 Tbsp dried basil (I had no fresh available)

In a large pot, lightly saute onions in olive oil until soft, not brown.

Puree the tomatoes in a food processor until just smooth.  Add tomatoes and broth to pot and heat until just boiling, simmer 20 minutes.  Add salt, pepper, and basil.  Let simmer another 10-15 minutes.

I used my immersion blender to puree until smooth.

SLURP.

The Size of a “Real Woman”

I’ll get right to it.

I buy my bras in the girls’ section at Target.  I got nothing going on up top and the thought of spending crazy money on a fancy bra seems ridiculous and wasteful.  I couldn’t care less about the size of my breasts.  They’ve served their purpose.  They were perky when I was young enough to care and when I became a mom, they fed my babies.  And now… eh… whatever.

What kind of irks me, however, is the occasional comment about what a “real woman” looks like.

Now, I don’t expect sympathy.  I know that many women really struggle with weight issues.  However, to characterize a full-figured woman as the “real woman” intimates that people like me aren’t.  I even heard one local radio personality comment that skinny women just look like “little boys.”

So what size should we be?

A healthy size!  A waist under 35″ for women and a BMI under 25 (http://health.msn.com/weight-loss/articlepage.aspx?cp-documentid=100173487) puts you at lower risk for heart disease and diabetes (and, it seems, cancer).  With 70% of the US population currently overweight and headed, by 2020, to being 75% obese (http://www.newsmax.com/Newsfront/202075-PercentAmerica-Obese/2010/09/23/id/371359), we need to think carefully about what we embrace as “real.”  Our children are part of the first generation since the Civil War who have shorter life expectancies than their parents (http://www.nytimes.com/2005/03/17/health/17obese.html).

A “real woman,” I contend, is one who takes her health into her own hands.  She eats well, sleeps well, stays active, and supports other women in her life with understanding and encouragement.  She teaches her daughters to do the same and to strive for health, not some contrived, outward physical ideal.

(On a side note… has anyone noticed Andrea Mitchell’s arms?  She is cut!)

Running and Music

Yesterday, The Tragically Hip saw me through the last hill (and it’s a helluva hill) of my run.  As the song built in intensity, I was inspired to push harder when I could have easily quit and walked.  Today, as I got to the top of that same hill, Jeff Buckley’s Hallelujah finished and my run ended up feeling like some deeply inspired religious experience.

I know that some runners can’t do the music thing.  I totally respect their focus–listening to breathing, being “in” the running and all.  But I can’t do that.  I need to be as distracted as possible.  And my tiny little iPod shuffle, on “shuffle,” magically provides a soundtrack that makes me feel thoughtful, nostalgic, worldly, or powerful, all at the right moments.

Now, we can go into the whole “which came first” q & a:  Do I think I need the song because the song happens to come up?  Or does the iPod know what I need?  But I’d rather think of this as some divinely serendipitous culmination of universal forces feeding my body and soul (how’s that for reaching?) just when I need them.

And while the iPod is predisposed to provide me with music I love (I loaded it, after all) sometimes the order of the songs is so perfect that it really feels like it’s sensing my mood and needs.

Regardless of how or why it all works, I’m grateful for that tiny miracle of music that in all my wildest dreams I couldn’t have dreamed.  Who from the Sony Walkman days could have thought that something as tiny as an iPod Shuffle could provide something so necessary?  I can’t even imagine running without it.  Running without an iPod would be like starting my day without coffee.  I just wouldn’t.  Running changed my life and my iPod made it first tolerable and eventually something I can’t do without.

And so, to the music that fuels me and the tiny device that brings it to me, thank you.

A Fitness Frame of Mind

The time issue seems to be the major reason that so many who struggle with weight seem to have about not getting in shape.

I completely get it.

Working, taking care of kids, and managing a household can all make working out seem expendable.  It’s incredibly logical to think that fitness can happen if it fits.  The problem is that there will always be something that can push working out to the bottom of the to do list and, in turn, completely out of your day.

Depending on how serious you are about getting in shape, though, exercise’s position on the list is ultimately a choice. Being serious means that there are no excuses.

The question, then, is:  Do you really want to do this?  Or don’t you?

If you want it, there are some steps that might help get the ball rolling and keep it rolling.

1. Make a workout schedule.

~Consider the most basic time responsibilities that you have:  work, getting kids off to school, dinner.  Then, find 45 minutes.

I know people who only have time at 5:30 in the morning.  My workout schedule varies, but early weekday mornings are out for me.  I’m up at 5:30 just to get kids out the door and myself to work by 8am.  I fit my work out in somedays at 2pm, other days at 7pm.  On weekends, I do it first thing in the morning.

2.  Be committed.

~You have to make a decision.  Working out must become as much of what you do as eating and showering.  I hate the cliche, but it is a “lifestyle choice.”  I have become a different person with reconfigured priorities.  It isn’t that I think, “I need to do this to stay healthy.”  It’s that I think, “This is just what I do.”

3.  Decide on a routine.

~Do you enjoy a gym?  Ask a fitness instructor to help you put a daily plan together.  Do you like to work out on your own at home?  Put together a plan that includes both cardio and strength training. I hate gyms, so at home I start with a 2-3 mile run, then use a combination of weights and “Acacia Core Fusion” videos (the “Body Sculpt” video is a great one to get you started).  The whole thing takes me about an hour.  I do this at least 5 days a week.

4.  Find a friend to keep you honest.

~When I first settled into my neighborhood, I had a daily 5:30am date with my new friend and neighbor, Sharon, every morning for a brisk 30 minute walk.  There’s nothing like feeling as though you “can’t let your friend down” to get your butt out of bed and out the door.  Additionally, a friend might help you raise the bar.  When I run with a friend, I run longer than I would if I were alone.

5. Get addicted

~It doesn’t take long to get addicted.  It doesn’t take much before you start to feel lousy about not working out.  Both physically and emotionally, you’ll find that you just need to do it.

Heart Attack Reflections – One Year

On March 12th of 2009, my family and I were visiting my brother in Florida, over 1100 miles away from our home in Pennsylvania, and I had a heart attack.  Ten days shy of my 41st birthday, I had a heart attack.

Backstory

The best place to start is probably 2006.  I had been to the doctor for a regular check up and the doctor ordered blood work as a routine measure. The results were surprising.  My cholesterol was outstanding.  My HDL was 72, my LDL was 73, and my triglycerides were 51.  My thyroid, however, was off, indicating hypothyroidism, and I was very anemic.

I started thyroid medication and an iron supplement, and on I went, not happy that I would have to take a pill for the rest of my life.

To treat the anemia, my doctor suggested a birth control pill. It made me feel awful.  I stayed on it for 6 months, tolerating depression and generally feeling bad the whole time.

Near the end of my time on the pill, I started having chest achiness and palpitations like I’ve never had before.   In December I went to a cardiologist for a stress test.  Everything looked fine.  I was happy.

The Heart Attack

In March of 2009 for spring break, my husband, two daughters, and I headed to Tampa to visit my brother and his family in Florida.  Thursday of that week was our last full day there.  We were set to leave the following morning–early.  That would get us back to PA Friday night and we’d have the rest of the weekend to recuperate so the girls would be ready for school, and Don and I, for work.  Besides that, Emily, our older daughter, was supposed to go to New York on Tuesday with her journalism class and she would need to do laundry and repack.

And so, we were making the best of our last few hours in Florida.  About 3:30pm I joined my kids in my brother’s cold pool (it was only March, afterall) and began doing the breaststroke.  Suddenly, I felt a pain in the center of my chest.  It stopped me in my tracks.  Immediately, I thought I pulled a muscle, but quickly decided that wasn’t the case.  Then I felt sick.

I got out of the pool and sat in a chair, sure that it (whatever it was) would pass.  But I continued to feel sick, so went inside and changed into my clothes.  I sat down in the living room and then the tunnel vision set in.  I felt nauseous, put my head between my knees, hoping it would help.  I decided to head to the bedroom to lie down.  It was at this point that I decided I might not be able to ignore the possibility that I was having a heart attack.  But the idea of a hospital, of hurting our chances of leaving the next morning, of being wrong and embarrassed, kept me from doing anything.

Then my left arm started to feel really heavy and my elbow began to ache.  I decided to call my insurance company’s nurse on call (she was terrific).  I described my symptoms.  She said that although it seemed unlikely, my symptoms all pointed to heart attack and she encouraged me to get checked.

By now, about an hour and a half had passed.  I finally told my husband what was going on.  My sister-in-law gave me some aspirin, and off Don and I went to an urgent care facility.  (I still wasn’t completely convinced that it was a heart attack and didn’t want to spend hours in an ER for nothing.)

In the car, the pain in my chest seemed to lessen and my back began to hurt right in the center, between my shoulder blades.  My arm was still heavy, though not as much.  I suggested to Don that maybe whatever it was was over and probably not a big deal.  He made an executive decision and we continued to the urgent care facility.

I got right in.  The EKG came up normal.  The doctor on duty came in to talk to me.  The EKG result seemed to give me some options.  He said that if I were a family member, he’d suggest I go to the hospital to get checked out more thoroughly, but that since the EKG was okay, I could simply go home.  Then he listened with his stethoscope.  My heart started jumping around.  He hurried the EKG machine back in and it showed that something funky was going on.

At this point, it seemed I didn’t have a choice.  He called the EMTs and with what felt like a major production, I was off to the hospital in an ambulance with Don following behind.

Immediately, blood was taken.  I was given nitro.  The headache set in and I started getting tunnel vision and feeling nauseous.  Don found his way to my room just before the doctor came to tell us that I did have a heart attack, though mild.  I would have to stay the night and have a heart catheterization in the morning.  I was upset.  I cried.  So much for getting on the road.

I was taken to intensive care.  The room was awful, but my nurse was nice. I was wired and tubed and tied to all kinds of bags and machines.  And the toilet was in a cupboard.  Literally.

The Heart Catheterization

The next morning, I was taken down for the heart cath (for info see: http://my.clevelandclinic.org/heart/services/tests/invasive/ccath.asp). Again, the nurses were lovely.  They made me a little loopy (which, if I’m being honest, I very much enjoyed) with some meds.  I was able to watch the video screen as the doctor pumped dye through my arteries.  Everything was clear except for a very tiny posterior descending artery that was 90% blocked, but too small to stint.

Following a cath, you’re not allowed to do anything but lie there.  There’s a risk with a cath because the doctor is puncturing and entering a major artery.

I stayed in ICU for another night with my toilet in the cupboard.

Diagnosis – Why a great doctor is important

I was a conundrum.  First, I was a young woman and my estrogen was supposed to protect me.  Second, my cholesterol at the time of the heart attack was 165, which is high for me, but pretty good for most others. Finally, only one tiny little artery all the way down at the bottom of the heart was blocked and everything else was completely clear.

Upon my return home, I went to a highly regarded cardiologist who, I later found out, didn’t even look at the video of my heart cath.  He was patronizing and condescending and when I asked a question about the statin (cholesterol lowering medication) he wanted to prescribe, he replied sarcastically that I clearly wasn’t listening to his explanation just before. Add to that that he never actually wrote a prescription and when I asked the nurses about it on my way out, they seemed afraid to ask him about it; I left completely confused.  Accolades and recommendations or not, I decided to find someone else.

The next doctor I went to came into my appointment well preparead and openly recognized that my case didn’t make sense.  He was curious and asked me questions and watched the cath video.  He ordered a Transesophageal Echo – TEE (see: http://www.asecho.org/i4a/pages/index.cfm?pageid=3327) to see if there might be a hole in my heart.  He ordered blood tests to search for the possibility that I might have a clotting disorder.

Thanks to his efforts, a picture began to come clear.  I have a genetic mutation (MTHFR) that puts me at greater risk of clotting and early atherosclerosis.  I’m also borderline for Antiphospholipid Syndrome (APS), also a condition that can cause clotting.  I have to have blood work on a regular basis to check homocysteine and cardiolipin levels.

In the end, he was sure that my heart attack was not an athero event (not related to cholesterol/plaque build up), but a thrombotic event (the result of a clot).  We can’t be exactly sure about the trigger—was it the MTHFR?  the birth control pill?  a combination?

My Efforts

I never took a statin.  I wanted to manage what I could on my own and have been very successful doing it.  My cholesterol is 143 (HDL – 63 and LDL – 70).  I attribute these numbers to three factors:  regular exercise, a vegan diet, and soy.

I have taken up running on a regular basis.  And while I don’t run for long distances, my 2 to 3 miles 5 times a week has done wonders for me.  I also do strength-building exercises at least 5 times a week.

The vegan diet is the only way to go as far as I can see.  The purposeful ingestion of cholesterol seems entirely counterintuitive, and that’s what you do when you eat animal products.

Finally, soy has been proven to lower cholesterol and I’ve seen it first hand.

Medication

For the past year, I’ve taken the following everyday:

75mg Plavix

81mg aspirin

25mg metoprolol tartrate (this was cut to 12.5 mg in October of 2009)

Multivitamin, Calcium plus D, Folic Acid, B12

(and levothyroxine for my hypothyroidism)

Following my one-year follow-up appointment, I was taken off Plavix and am now taking 162mg aspirin.  The new concern is that my chance of another incident is elevated.  Studies show that when patients stop taking Plavix, risk of heart attack or stroke increases as the platelets adjust. The extra aspirin is intended to make up for this absence, but the risk of stomach and brain bleeding elevate as the dose of aspirin increases.

These things are worries for me.

Emotional and Intellectual Adjustment

Following the heart attack, I was almost constantly worried that I would have another.  Every palpitation and flutter made me stop and think and “listen” closely to any clues my body might be giving me.  Additionally (and I’m not proud of this), I was angry at people who didn’t take care of themselves.  I felt myself to be the victim of an enormous injustice.  I took care of myself.  I ate properly, was the proper weight, and was still 40!

I also thought a lot about my likelihood of living a long, full life.  I want to see my kids grow up and live their adult lives.  That I have a strike against me is upsetting.

A year later, I still worry.  In the end, though, this heart attack was something of a gift.  It was mild, did no real damage, and made me aware of the issues that I have thus enabling me to be as pro-active as possible. Additionally, I’m more appreciative of all that I have and I like the direction my life has taken.

Simple: A Big Bowl of Pasta on a Cold Winter Night

Sometimes there’s nothing better than the simplest of things.  I was so busy today and the weather has been so cold that nothing sounded better to me than a big bowl of pasta.

With a little Joni Mitchell playing and two pots on the stove, I sipped beer and cooked.

In one pot I boiled water for whole wheat penne pasta.  In the other, I sauteed garlic with basil, oregano, thyme and a tiny bit of fennel and red pepper flakes.  With the pasta cooking, I threw a quart of grape tomatoes in with the garlic and herbs and listened to them sizzle and pop until they were cooked soft enough to press them with the back of my big wooden spoon.  Topped with some kosher salt and fresh pepper, they were ready toss together with my pasta and a few handfuls of fresh baby spinach.  I had some bread left from the day before that helped to soak up all the saucy, juicy goodness.

Totally simple.  Totally good.  Reminds me of how lucky I am.  Makes me appreciate simple things.