Update On Me.

Here's my update. I recentley became a proud owner of another ICD. They found some bacteria when they did a swab of the pocket and I've been on antibitics for the last month. No indication that there is actually infection though. The pocket and wound look good and feel good. I have a Cardiologist visit in about ten days and a follow up at the ICD clinic in about twenty.

My new device has a wireless tranmitter that sits next to my bed is brand new technology for me. I have to say that it's about the ugliest thing I have ever seen. I understand that they want to keep it as simple as possible and that there are people out there who are not familar with any technology at all. However this is the most hospital looking thing I have ever seen. I have seen hospital equipment that doesn't look like it belongs in a hospital more than this thing does. I don't know about you folks, but my bed room doesn't look like a hospital room. Speaking of Hospitals I have to go and visit the nurses on the cardiac ward. I promised them that I would and they always go out of there way when I'm there to take extra special care with me. They've done such a good job that it's more like going to visit friends than going to the hospital.

Thanks, Jon

Preventing Heart Disease

In the on going battle of how to prevent Heart Disease we have a new food to help us. The Pomegranite. Here's WEbMD's take on it http://www.webmd.com/food-recipes/news/20050321/pomegranate-juice-may-clear-clogged-arteries
Thanks guys.

Exercise

Been a bit since my last post. I've been busy enjoying the great weather kayaking some of our local lakes. That's my actually the subject for the week. Exercise! We as cardiac patients need to exercise on a regular basis. For those couch potatoes reading this it's not as bad as you think. When I break down exercise I break it into three parts, Cardio, Weights and Fun.

Cardio is important. It's actually the most important and the one were able to while doing the other two. The rule of thumb for a good Cardio work out is to work out at 80% of your maximum heart rate. To find your maximum heart rate you take 220 and subtract your age, then multiply that number by .8. I caution every one to discuss what your maximum heart rate should be with your doctor. Depending on what your Cardiac problems are it may not be a good idea to stress your heart with heavy exercise.

My Cardio work out consists of 30 minutes of walking every day. I call it my penance and it is the least favorite part of my day, so I do it first thing when I get up. It was very difficult for me to get into the habit of walking every day so I did it in steps. I started with 10 minutes every day for a month. Then bumped it up by five minutes every month. A couple of quick pointers. Go outside when you can, walking in the real world is more difficult and more practical, because we live in the real world. When you can't go outside use a treadmill, either at your house or at the gym. If you don't have access to a treadmill march in place anything to get your heart rate up. Because I'm pacemaker dependent I can't go by a maximum heart rate. I use the if you can talk rule of thumb. This is very simple when working out you should be breathing hard but, not so hard that you can't carry on a conversation.

Let's talk about the second form of exercise, weights. I enjoy lifting weights, I've done it since my early twenties to gain strength and keep fit. I unfortunately had to give it up for a few years, but I'm doing it again. I've changed my routine from the way I used to lift. I used to lift to gain strength, that means heavy weights low repetitions. I now train for endurance or stamina. I use a lower weight and much higher repetitions. At some point I will go into greater depth on weight lifting, but I'm not going to do it here. I do want to say however that lifting low weights and concentrating on a full body routine will help you to lose weight and keep it off. It will also help with balance and hand eye coordination.

Lastly let's talk about my third and favorite form of exercise, having fun. This is simple, Fun exercise is anything that you enjoy doing that gets you off your but, out of the house and moving around. This could literally be almost anything. Traditional sports like basketball or softball. Outdoor activities like hiking and kayaking. I count my photography hobby as fun exercise because, I have usually have to walk or paddle to find a subject or a good photo. Like I said it's anything that YOU enjoy.

One last thing. If your not used to exercise it can be a challenge to get in to the habit of doing. Take it slow and remember it may feel like a chore at first, but it will get easier and the more you move the more you'll be able to do.

Thanks Jon

About Me

Maybe I should have started my page with this instead of putting it off. Here it goes my cardiac history thus far.

I was born with an undeveloped pulmonary valve. I had open heart surgery the same day to remove the valve. I had open heart surgery again around the age of 4 to enlarge the opening. I got along fine and was extremely active until the age of 16. I then developed atrial fibrillation. We treated this with several cardioversions, which were unsuccessful. We then used medication to block the rhythm from reaching the ventricles. During this period my activity level was decreased dramatically. Every time I did anything that would raise my heart rate I would break through the block and my heart rate would jump up to 200 beats per minute. Over about a four year period the medication worked less and less. When I was 21 I had an EP Study done to try and correct the bad rhythm this didn't work however so an AV Node Ablation was done to prevent the Ventricles from being affected by the rhythm of the Atria and a pacemaker was put in. I immediately felt much better and was able to return to a very active lifestyle. Everything went along fine until I was about 30. At that time I started having trouble doing the things I loved. We discovered that my heart had begun to enlarge on the right side and it wasn't pumping as efficiently anymore. With in a year I was on diuretics to help remove excess water and I was in CHF(Congestive Heart Failure). Right about that time I started having bouts of Ventricular Tachycardia as well. I was sent to Hartford Hospital where I was run through a series of tests. The results where surprising to me and everyone else. I was in far worse shape than anyone thought. Here's what we found:

• An extremely enlarged Heart
• Myochardiopathy (Thickening of the heart muscle)
• Tricuspid Valve nearly destroyed by the pacemaker lead and the rest of the valves severally leaking
• The heart itself swinging in a pendulum motion decreasing efficiency
• And a left ejection fraction of 15% (percentage of the left ventricles total volume that is squeezed back out)

We changed all my medications immediately to newer, better working meds. I went into the hospital for a "tune up" as my doctors called it, to get rid of any extra fluid. We then put in a Bi-Ventricular ICD(Internal Cardiac Defibrillator), to increase the efficiency of my heart and control my Ventricular Tachycardia. I was lucky enough to be able to take a year off work and concentrate on getting healthy again. I started walking on the treadmill 20 and then 30 minutes every day. I changed to a low sodium heart healthy diet and was able to return to work full time. Over the last few years, with the correct diet and a lot of exercise I have been able to more than double my hearts output and I am as active as ever. Here's a few things that I enjoy:

• Kayaking
• Hiking
• Weight Lifting
• Nature Photography
• Tubing
• Swimming
• Snow Boarding

I manage to live with CHF and maintain an active life and you can to. I'm not saying I don't have bad days, because I do. But those days are few and far between now. Don't stop trying and don't give up hope. They're making huge strides in the fight against Heart Disease every day.

Jon

Putting The Diet Together

So here's where we put the whole thing together. I think that the easiest way to do that is to just show you how I eat in a typical day, by providing you with a menu. Remember the table in the first part of this series.

• Breakfast: 1 Protein, 2 Carbohydrates, 1 Fruit
• Mid Morning: 1 Protein and 1 Carbohydrate or 1 Vegetable
• Lunch: 1 Protein, 2 Carbohydrates, 1 Vegetable
• Mid Afternoon: 1 Carbohydrate or 1 Vegetable
• Dinner: 1 Protein, 2 Carbohydrates, 2 Vegetables and 1 Fruit

Here's how that breaks down into actual food.

• Breakfast: 1 Cup of Yogurt, 2 Cups of Oatmeal, and 1 Orange
• Mid Morning: 1 Tablespoon of Peanut Butter (Protein and A Fat) and 6 Celery Sticks
• Lunch: 3 slices of Turkey, 2 Slices of Bread, 2 Romaine Lettuce Leaves, Table Spoon of Mayo
• Mid Afternoon: 6 Triscuts
• Dinner: 1/2 Chicken Breast Sauteed in a Table Spoon of Olive Oil, A Small Baked Potato with Fat Free Sour Cream, 1 Cup of Rice, 1 Cup of Green Beans, 1 Cup of Corn, 1 Apple

You can see that I eat a lot of food. Probably more than what your eating now. The difference is that my diet is probably lower in fat than what your eating. A lower fat diet is naturally lower in calories. The Menu above is around 2,000 calories.

Now here's a few tricks to keep you on the right track.

• Write out a menu each week, see what you already have and then shop for the rest. Do this until eating this way becomes habit for you and that may take several months.
• Use things like non fat sour cream instead of butter in potato and similar dishes.
• If your a toast person, try skipping the butter and using a table spoon of jam or marmalade instead. You can count your topping as your morning fruit.
• Things like egg, tuna, pasta salads have the fat already added to them. If you eat them you've had your fat with that meal.
• If you can premake some of your meals early in the week, then you should. It helps when you have those days where your likely to stray, because of lack of time.
• Don't beat yourself up if you cheat or skip a meal, just move on to the next meal and let it go. It's not the end of the world and it's gonna happen. I know I've sucked back my share of hot wings or pepperoni pizza.
• Secondly treat yourself. When I started I had a very hard time sticking with things until I learned to treat myself. At first I would have a scoop of ice cream, brownie, slice of pizza, handful of chips, etc. a couple of times a week. Then I went to once a week. Then Every couple of weeks.
• Treat yourself at special events. Things like a friends wedding, birthday parties, super bowl parties. It's to tempting to watch everyone else eating and not partake.
• Lastly remember K.I.S.S. (Keep It Simple Stupid) The easier it is the more likely you are to stick to it.

That's all I have on the topic for the moment. I'm thinking about writing a how to article on substitutions you can make in recipes to keep them heart healthy and still tasting them delicious. That won't be for a while however. My next topic Will be exercise.

Jon

Fats

Fats are the fifth part of my diet. You'll notice if you go back to the first part of this series that fats are not mentioned in any of the meals. That's because they are included already. If you have toast in the morning then the butter you put on it is a fat. If you have a sandwich then your mayo is a fat. I try to add a serving of fat to my 3 main meals and keep it out of my mid morning and mid afternoon snacks.

Let's talk about the confusion of good versus bad fats. Good fats raise your levels of HDL or good cholesterol. Bad fats raise your levels of LDL or bad cholesterol. All fats raise your cholesterol and a high cholesterol level is bad. Ideally you want to have a cholesterol level below 200 with your LDL below 100 and your HDL above 60. Here's the confusing part. People think that if they are not over weight that their cholesterol levels must be good. This is wrong thinking, cholesterol is not a measurement of how fat a person is. Cholesterol can be thought of how much fat is floating around in your blood stream. Think of it like this. The fat that you can physical weigh (your weight) is like lard and the fat that you have to measure (your cholesterol) is like vegetable oil.

Now what makes a fat good or bad. Good fats are typically derived from vegetables with the exception of palm oil, and coconut oil. Things like corn oil, olive oil, flax seed oil, walnut oil, sesame seed oil, sunflower oil, etc. These are good fats. Bad fats come from animals. Things like butter, lard, bacon fat, mayo, sour cream, etc. These are bad fats. To make sure I have the right ratio I simply have 2 servings of a good fat and 1 serving of the bad fat.

That's it for fats. I'll wrap this up in the next blog tonight.

Jon

Vegetables and Fruits

I'd like to talk about Vegetables and Fruits together since they are very similar. They both provide us with essential vitamins and minerals, as well as providing our body with energy. They're both high in fiber and low in fat. The difference is that fruits are higher in simple sugars than vegetables and therefore give us energy more quickly than vegetables.

When buying vegetables and fruit try to get it fresh in the produce section. Frozen is ok if your not buying with a sauce of some sort on it. Avoid canned, most of it is high in sodium and packed in some type of sugary or fatty liquid.

For most vegetables the serving size is a cup. It is different for fruits, because they come in different sizes. Small fruits like berries or grapes are about 1/2 a cup. Medium fruit like apples or oranges it is one piece. Large fruit like grapefruit or cantaloupe is half or a quarter. Very Large fruits like watermelon is a slice. Use your judgement in this. When I size up fruit I try to think about how much of it would equal 1/2 to a cup.

Tomorrow I'll try to wrap everything up and bring it all together so that it makes sense.

Jon