Heart Attack: Rehab 2

A progress report.

When I walked into the Cardiac Fitness Center the other day, I was shocked to see an overweight man in his Sixties sitting in the waiting room happily munching a fast-food hamburger. Obviously, he dismissed the message his cardiologist gave him about a low-animal fat diet. While his action was extreme, many of my fellow patients at the rehab center are repeat heart attack victims who didn’t follow their doctor’s orders. For me, their errors are my inspiration to succeed.

Routine is the name of the cardiac fitness game. Upon entering the center, the first thing you do is sign-in and report your weight; current blood pressure; whether you’ve taken your meds; and how you feel, such as good, fair, or poor. Then you pick up and attach a heart monitor to your body, and record your monitor number, so the cardiac fitness staff can track you during exercise.

Three therapists and a dietician are available to seven of us, three women and four men, while we exercise. One therapists keeps constant surveillance of our heart rate, so we don’t exceed our target heart rate . The other two nurses help us with the machines, keep an eye on our condition, and answer questions we have about our therapy. Part of their routine is to take our blood-pressure during exercise, as well as before, and after a cool down period when we finish. Constant monitoring of our heart-rate and blood pressure helps the staff determine appropriate levels of exercise for us.

During my seventh day at Hamot Cardiac Fitness Center, I achieved new levels of difficulty for my exercise routine. My first exercise is on a stationary bike. After a five minute warm-up at 35 rpms. I increase my speed to 50 rpms for an additional fifteen minutes. Biking is the most taxing of my exercises, and I like to do it first. Blood pressure rises during exercise, and the bike gets my blood pressure and heart-rate pumped. Each outpatient exercises at a pace suitable to his or her condition.

After the exercise bike, the treadmill is next. Initially, I walked at a 2.2 mph pace. Now, my pace is 2.8 mph on a 3% incline. I walk for 20 minutes. My final exercise is ten minutes on a NuStep, a recumbent cross-training machine operated with legs and arms to work all the major muscle groups.

Overall, I’m currently doing fifty (50) minutes of cardiovascular exercise at a heart target rate compatible to my age and heart’s strength. My goal is to strengthen my heart’s pumping ability measured as an “Ejection Factor” (EF). A normal EF is 55. Through systolic failure my EF became 35. Heart muscle damage cannot be repaired, but I can improve my EF to above 40%. As a practical goal, I want to once again be able to play tennis at a high level for my age.

Heart Healthy Cheese Stuffed Chicken & Spaghetti

My wife came up with this recipe for a tasty dinner due to my low animal fat diet. However anyone would enjoy “Cheese Stuffed Chicken and Spaghetti,” a heart healthy dinner served with Montepulciano D'Abruzzo wine.

3/4 teaspoon oregano
2 teaspoons fresh thyme leaves or(1/2 teaspoon dried thyme )
I ½ tablespoons fresh chopped basil or(3/4 teaspoon dried sweet basil)1/4 teaspoon freshly ground black pepper, or to taste

4 boneless chicken breast fillets (approximately 4 ounces each), skinned, all visible fat removed, or use already thin-sliced chicken breasts

4 ounces low-fat cottage cheese, drained

2 ounces grated part-skim mozzarella cheese
2 cups Prego Traditional Healthy Heart spaghetti sauce

In a small bowl, combine oregano, thyme, basil and pepper. Stir to mix well. Set aside.

Meanwhile, rinse chicken and pat dry. Place in a plastic bag and pound to 1/4-inch thickness. Set aside. If using thin-sliced breasts, pounding is unnecessary.

Combine spice mixture with cottage cheese. Spoon mixture onto centers of chicken breasts, leaving a 1/2-inch edge all around. From narrow end, roll each breast jellyroll fashion.

Spray skillet with non-fat spray and preheat over medium heat about I or 2 minutes.Arrange chicken rolls in skillet seam-side up. Cook about 15/20minutes, then gently turn chicken breast over so seams are on the bottom. Pour 2 cups Prego spaghetti sauce over chicken. Cover skillet and cook another 15/20 minutes, or until chicken is tender. During last 5 minutes, sprinkle with grated mozzarella cheese.

Serve on whole grain spaghetti . Sprinkle with grated Parmesan cheese.

Adapted from a recipe for Chicken Manicotti from American Heart Association Cookbook, 5th Edition

The Bill of Rights: Amendment II

“Amendment II

A well regulated militia, being necessary to the security of a free state, the right of the people to keep and bear arms, shall not be infringed.”

One of the great images of the revolutionary war is that of the Minute Man, a farmer, or any colonial citizen opposed to King George and the Red Coats. The Minute Man was ready in a moment’s notice to stop his work, run for his musket, and engage in the battle for freedom. The Minute Man represents an individual’s right to fight for a new government by taking up arms to oppose unfair, oppressive, and uncaring authority. The image of a farmer’s revolution sprang to life on April 19, 1775 at the Lexington, Concord Bridge when the Minute Men fired upon the red coats and a skirmish ensued The colonist’s strong statement for self-government was immortalized by Ralph Waldo Emerson in his poem, The Concord Hymn. The first stanza reads:

By the rude bridge that arched the flood,

Their flag to April's breeze unfurled;

Here once the embattled farmers stood;

And fired the shot heard round the world.

With less poetry, but with greater legality, the framer’s of our Constitution immortalized the Minute Man and the free citizen with “the right of the people to keep and bear arms, . . .” Moreover, the second amendment states that the right to bear arms shall not be denied (infringed).

Citizens have a right to fight for fair, equal, and representative self-government along with the right to have weapons. Amendment II is a precious right that must not be abolished.

However, there is a disparity between the Minute Man and the automatic weapon wielding criminal. We have a large, rapidly expanding population, and our popular culture, as seen on television, at the movies, and in video games, is a reflection of our societal condoning of violence. Criticism of the second amendment has focused on controlling crime, especially murder, without proper regard for the fundamental meaning of the amendment. In turn, the NRA opposes efforts at gun control without enough concern for the lives that are being lost to violence with guns. We need ways to monitor our use of weapons, so that innocent lives may be spared from violent crime. The challenge to those who cherish our second amendment right is to find a creative solution that eliminates killing school children with guns, while protecting our fundament right to bear arms.

Boodlies

A classic rock group, The Boodlies, is hitting the Erie/Edinboro area with great rhythm and high energy lyrical leads. If you like classic rock in the style of Led Zeppelin, and you like listening to music that makes you want to stand up and dance, then follow the Boodlies.

Erie is famous for Train, but there is a high quality garage band renaissance going on that is reminiscence of Mo-town and Chi-town in the late Sixties, when this style of driving psychedelic rock was revolutionary. The Boodlies have recreated this style and make it their own. Classic Rock is as alive now as it was back in the days of The Fillmore. This is no dead head resurrection this is the real thing. These guys are alive and can play! Take it from somebody who’s been there.

Caught The Boodlies at the Fox and Hound. Their fans are young, hip, and dynamic and they mirror the group.

Boost the Boodlies.

The Birthday Girl

Today is my beautiful wife’s birthday!

We picked up at the Bagel shop, and breakfasted while enjoying the view of Lake Edinboro from the beach at Lakeside.

I’m lucky to have such a wonderful wife and mother to my children.

Happy Birthday!

Heart Attack: Rehab

Three and a half weeks ago I was released from Hamot Hospital after suffering a heart attack. My doctor told me at that time that I should be able to return to normal activities, including tennis, in six weeks. This is a progress report.

My rehabilitation has centered on four basic areas: (1) a daily weigh-in, (2) a low-animal fat & low sodium diet, (3) taking my medications, and (4) a gradual return to physical activity. The hospital has provided some educational guides for me including a “Heart Owner’s Manual: Your Personal Guide to a Healthy Heart,” and “Strong Hearts: An Educational Guide for Heart Failure Patients.” While I was in the hospital I received healthy heart education and dietary guidelines. All of this information has helped me understand and follow four basic areas for rehabilitating my heart and my life.

The principal reason for weighing myself each day is to be alert to the possibility of congestive heart failure (CHF). An indicator is a sudden weight gain of two pounds over my weight as I left the hospital. My weight the morning after returning home was 203. Today, after a little Saturday night celebration, it is 200. I have been as low as 198. So, far my weight is doing fine.

Since I had a clot in my left ventricle, the hospital emphasized the importance of following a low animal fat diet. In addition, the “Strong Hearts” book recommends a low sodium diet. Fortunately for me, the transition to a heart-healthy diet has been reasonably easy. Partly because of changes my wife introduced to our diet over the years, and partly because of her devoted effort to prepare food that meets my guidelines and tastes great. Another help is that we both enjoy a variety of foods and like fish. When eating out or choosing food it is easy to make mistakes, especially by eating foods that are too high in sodium, a hidden ingredient in most prepared foods. It’s important to read the Nutrition Facts on pre-packaged foods and choose wisely. Learning the foods to avoid and the foods that are recommended eases the decision making process. I’m still learning, but for the most part I’ve been able to follow my low animal fat-low sodium diet.

I’ve established a routine for taking my medications and have yet to forget. My medications include asprin as a preventive measure; Plavix to prevent blood clots; metoprolol for myocardial infarction; Crestor, for cholesterol; and a blood pressure medication. Within a week I developed a cough from taking the ace inhibitor, Altace. My family physician changed my blood pressure medicine to Diovan, an ARB, two weeks ago and my cough is nearly gone. I cough only occasionally, and this is a great relief to me because coughing is a symptom of congestive heart failure. Now I know my cough was a side effect of the ACE inhibitor. The cough was also constantly annoying and made some of my activities more difficult, especially playing the clarinet. I take my blood pressure daily and have achieved a desirable range. My medications are doing their job.

In addition to the basic three steps to survival of diet, medications, and weigh-ins, I’ve started exercising. On the day after leaving the hospital I took a slow, twelve-minute walk. I gradually increased the tempo, length, and time of my walk. Today I walked three miles. Last Wednesday, three weeks to the day after leaving the hospital, I started therapy at the Hamot Cardiac Fitness Center.

“A medically supervised, insurance based, monitored exercise program designed to restore one’s strength and stamina. Walking, biking, strength training and education on heart risk factor reduction are offered. Physician referral required.”

A monitored exercise program restores my confidence that I’m progressing at an appropriate pace. I’ve started doing more chores around the house and yard, and I’m gradually returning to normal activities.

My rehabilitation appears to be progressing according to plan. I’ve been fortunate in my health care from the time I left my front porch with the medics dispatched from our 911call through my restoration at Hamot Hospital, one of the best hospitals in the nation for cardiac treatment, to my wife’s loving care at home. Half of the people who have a heart attack, such as the one I experienced, die. The care I received has already extended my life, and by following the “doctor’s orders,“ I will have more good years to come.

The Bill of Rights: Amendment I

The first in a series

"Amendment I

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances.”

Constitutional scholars, politicians, lobbyists, and lawyers will tell us what “Amendment I” means, but we should all read, understand, and interpret the entirety of the Bill of Rights for ourselves. With this in mind, I’ve decided to put forth my own understanding of each amendment, starting with the first.

The first amendment says a lot, perhaps, too much for a single amendment given the great significance of every part. However, each component makes sense as part of a comprehensive whole concerned with thought, communication, and the law. To me, the words and meaning of the amendment are straight forward and should need no interpretation, but, alas, nearly every section of the first amendment has come under attack in recent years. My understanding of the first amendment is as follows.

First, congress shall make no law respecting an establishment of religion. In it’s simplest terms, this means that their will not be, by law, an official national religion, ether in general, such as Christian, Jewish, or Muslim, or specifically, such as The Episcopal Church or The Baptist Church, of The Catholic Church, or any church you can name. Further, the lack of establishing a national church, is linked with the thought that congress shall make no law “prohibiting the free exercise thereof,” meaning you may freely practice your faith, even if is not shared by the majority. Therefore, one individual has just as much “right” to worship according to his religious beliefs as anyone else does. So, if you are Jewish, you have the same right to your religious beliefs as a Catholic, and so forth. Furthermore, by not establishing a national religion and by further allowing the free practice of religious thought, even the belief that religion is irrational is protected, and an individual has the “right” to be an atheist. Therefore we each have the right to be Catholic, Jewish, Muslim, Mormon, Baptist, Lutheran, Methodist, Atheist, etc, without fear of having the practice of our religion denied, or by being subjected to a religion of the majority.

Government sponsorship of Faith Based and Community Initiatives are attempts to make laws that establish religion, in incremental amounts, and, as such, are against our First Amendment Right to be free of religious government. The First Amendment is sound in conception and clear in language. As citizens we must guard against politicians who take advantage of our faith to obscure their purpose of establishing a national religion, even if it seems a harmless charitable service asking us to love our neighbors. There are government programs that can and do offer the same service. As individuals we are free to practice the religion of our choice. Let us keep this precious right.

Congress shall make no laws abridging our freedom of speech. Certainly, this part of the First Amendment is equally clear, although modern interpretation has tended to obscure our important right to express our thoughts regarding political issues. Our Founding Fathers had just freed a new nation from the tyranny of a King, and understood the importance of being able to speak their minds about government without fear of reprisal. As citizens we have a “right” to express our opposition to laws that appear to be against the best interests of ourselves and of our country, or to speak up for those we believe will best serve us as a nation. Furthermore, our freedom to speak is extended to our “press.” (media) so that our opposition or support may receive widespread circulation and discussion.

Governmental wiretapping, listening in on private conversations, and reading private emails are examples of abridging freedom of speech. The Patriot Act reads, in part, as follows: “Title II: Enhanced Surveillance Procedures - Amends the Federal criminal code to authorize the interception of wire, oral, and electronic communications for the production of evidence of: (1) specified chemical weapons or terrorism offenses; and (2) computer fraud and abuse.” True patriots will note that such acts are against our “Amendment I” rights. Those who attempt to muzzle our right to speak and write about the issues that are meaningful to us, diminish our freedom of speech as guaranteed by the First Amendment.

Finally, we have the right to peacefully assemble and let injustices be known and to petition the government to redress our grievances. We have the right to protest and petition for change to make our laws fair and equal. The Civil Rights movement led by Martin Luther King is an excellent example of this right put into practice.

All in all, the First Amendment protects our right to think freely, without religious or political constraint, and to freely express our thoughts without fear of governmental reprisal. Moreover, when we have found inequity, and others are in agreement, we may assemble as a group to express our concern and to request that fundamental wrongs be addressed and made right.

The First Amendment stands first in our minds and our hearts as a right worth fighting for and a right that goes toward making the United States of America the greatest country on earth. Let’s keep it that way.