This is a printer friendly version of two articles featuring Heartbeats for Life in Your Health, a Rochester Democrat and Chronicle supplement, September 26, 2007. www.democratandchronicle.com Our HFL chair, Bob Klein, wrote the essay. HFL members, Mary and Jon Clark, were interviewed by Chris Swingle for her article on prevention. Our 2005 speaker, Dr. T. Colin Campbell's photo was used and our 2006 speaker, Dr. Caldwell B. Esselstyn, was quoted. Thanks to the D & C and to all who participated.

Doctor takes charge of his own heart

by Dr. Robert Klein
 

Fourteen years ago, about one year into my retirement from a full-time position as a medical faculty member at the University of Rochester Medical Center, I began to experience chest pain with exertion.

I suspected the cause was angina but kept my thoughts to myself for about two weeks while retesting my exercise to see if it recurred. I remember my sense of anxiety when telling my wife. When my physician diagnosed the symptom as angina (chest pain or discomfort due to coronary heart disease), he referred me to a cardiologist for exercise echo-testing, which confirmed the diagnosis, and also showed my aortic heart valve was calcified and narrower than normal. The doctors considered this a possible factor causing the angina.

Within a few months, my pain became more frequent. I was found to have blockage (stenosis) in several arteries, which led to angioplasty. As often happens, the arteries restenosed in two months, and this soon led to cardiac surgery with replacement of the aortic valve and quadruple bypass.

I was home within a week but was psychologically stunned, very anxious and unsure of myself. The new mechanical valve was always either audible or palpable, my sleep was interrupted, and I cried easily and frequently. When I entered cardiac rehab, I felt reassured by the presence of others in the same state who had similar emotional stories. I invited several to form a group where we could meet at our homes and discuss our stories and feelings along with our spouses.

After the operation, my son mailed me a book by Dr. Dean Ornish entitled Dr. Dean Ornish's Program for Reversing Heart Disease. I devoured the book, which was a multifaceted approach to the lifestyle factors that are known to cause coronary disease. I knew immediately that I could and would do that program in order to prevent further progression of my heart disease.

One incident stands clear in my mind. About one month after my surgery, my wife and I attended a meeting of the Mended Hearts Group in Rochester.

The topic that evening was "The Second Time Around," with a local surgeon discussing why and how soon second bypass surgeries are needed in many people. I broke into a cold sweat, nudged Connie and said, "Let's get outta here! There's no way I'm going through that again."

Earlier in that meeting, I had asked the presiding officer if he knew anyone following the Ornish program. He said no, but he would ask around. Soon I had a call from a woman who said she and her husband had followed the program for several years with wonderful results, and that she knew another couple who were following the program. I was then put in touch with Edward Ehlers of Rochester, who had just returned from a one week retreat in California where he had learned Dr. Ornish's program of lifestyle modification. Ed was inspired to form a local support group that was at first called The Ornish Support Group but is now called Heartbeats For Life.

Since then, I have been very involved in following Ornish's intensive lifestyle modification program. This includes a low-fat (10 percent), plant-based diet, daily exercise of at least 45 minutes, the practice of stress-reduction techniques such as meditation and yoga for one hour a day, and strong support in this effort by regular meetings with many new friends. I take prescribed medications, see my doctors annually, have no cardiac symptoms, and enjoy a full active life.

Robert Klein, 78, of Rochester is semi-retired. He still teaches first-year medical students and volunteers at clinics in the community.

September 26, 2007

Striving for healthy hearts

Wise changes to diet and lifestyle improve your chances of avoiding cardiac disease

story by Chris Swingle, staff writer CSWINGLE@DemocratandChronicle.com

Mary Clark of Brighton grew up eating lots of meatloaf, potatoes and even brown sugar on white bread sandwiches. But after learning about cholesterol and seeing relatives hurt by stroke and heart problems, she and her husband, Jon, converted to a low-sugar, vegetarian, caffeine-free, no-added-fat diet.

Vincent Alexander of Rochester, likewise, fears developing the heart problems that killed his father. Alexander quit smoking eight years ago when he was diagnosed with emphysema and a damaged heart valve that had to be surgically replaced. He attends free Soul Fitness aerobics classes in the city and has reformed his cooking to bake instead of fry and to boil vegetables instead of using cooking oil and butter.

Heart disease is the leading cause of death for both men and women in the United States. It's also a major cause of disability. Men older than 45 and women older than 55 are most at risk.

But the majority of heart trouble can be prevented. The challenge for each individual is to make the eating, activity and other lifestyle changes that protect the heart and overall health.

Clark and Alexander have found it helps to get support. Clark is part of Heartbeats for Life, a local support group that advocates the Dr. Dean Ornish approach to prevent or reverse heart disease. Alexander gets encouragement and information at his exercise classes — where instructor Tamiko "Miss Tee" Byrd also shares healthy eating information — and from his physician.

The changes are a struggle, Alexander admits. He says he still drinks too much Kool-Aid, hasn't switched to wheat bread because he doesn't like the taste and sometimes can't get to exercise class when his car breaks down.

"My goal is to stay fit, stay in contact with my doctor and do what he says to take care of my health," says Alexander, who's 65. "I want to live."

Sharon Feldman of Irondequoit has benefited from support, too, both from her husband and from Mended Hearts support group for heart disease patients and their families. Feldman, now 63, had an aortic valve replaced 10 years ago. Now she supports others through Mended Hearts, which is affiliated with the American Heart Association.

"We all know what we're supposed to do to keep our hearts healthy," says Feldman. But habits are hard to break. Feldman's advice: "Reach out to the community, to organizations that can help you."

Having a heart problem was very frightening, says Feldman, local president of Mended Hearts. After surgery, she felt depressed. It helped to keep busy, doing things for herself and for others, she says.

Heart disease typically develops silently, without symptoms. Fatty buildups of plaque may be narrowing your coronary arteries, restricting the movement of blood and oxygen. The disease is far along by the time you start to feel chest pain — if you even have that symptom of damage — or when congestive heart failure leaves you constantly short of breath. When the heart's pumping function is that damaged, you're left constantly tired, have to sleep while sitting up, suffer frequent leg swelling and face serious risk of kidney and liver failure.

Quitting smoking is the biggest change you can make to protect your heart, says Dr. Michael Fong, cardiologist and senior instructor of medicine at University of Rochester Medical Center. "No amount is safe," he says. Smoking damages blood vessels and raises heart rate and blood pressure.

Exercise is also critical. Walking for 30 to 60 minutes a few times a week drops your risk of fatal heart disease by nearly 25 percent, Fong says.

Managing stress well is protective, because stress can chronically elevate blood pressure.

Eat right, which means limiting saturated fats and trans fats and choosing more fruits, vegetables and whole grains, Fong advises. Even a 10 percent weight reduction can lower the risk to your heart if you're overweight.

Dr. Caldwell B. Esselstyn Jr., a retired general surgeon from Cleveland Clinic, believes it takes more dramatic change to your diet to prevent heart disease. He closely advised and monitored 24 patients who had advanced coronary artery disease — people whose cardiologists gave them less than a year to live — as they switched from the traditional, fatty American diet to a plant-based, oil-free diet. Nearly all of those who stayed on the strict diet improved their cholesterol, stopped their chest pain and were still alive 12 years later, says Esselstyn, author of Prevent and Reverse Heart Disease (Avery, $24.95).

When he spoke in Rochester last year, someone in the audience suggested the diet was too hard to stick to. Esselstyn said having to undergo rib-cracking heart surgery is harder.

Fong says it's true that a very low-fat, vegetarian diet will improve your health. But, "a lot of people just can't do it," he said. "A lot of people have difficulty with the simple things."

Others caution against any extreme diet and point to proven health benefits of certain oils and essential fatty oils.

Mary Clark, now 52, started moving away from the typical American diet in her 30s, because her brother and her husband's brother had heart attacks at age 50.

Fully adopting the Ornish plan of eating, exercise, social interaction and stress reduction took years, but Clark believes it's worth the effort. The obstacles included having to relearn how to eat, explaining it to others, dealing with her own and others' resistance and discovering that she was more dependent on caffeine and sugar than she knew. "It's like moving to a different country," she says.

She and her husband find it easiest to take their own food to group meals and they've learned which restaurants have the food they want, such as the brown rice and steamed vegetable dumplings at P.F. Chang's China Bistro at Eastview Mall.

The Clarks walk and run in their basement and do home exercises such as jumping jacks. Mary Clark, a storyteller, said she finds ways to intersperse activity into her day, such as walking up and down the stairs in her home each time she walks by them. Throughout it all, she cultivates a joyful attitude, seeing everything as an adventure to tackle step by step.

"I do feel better — mentally, physically, spiritually," says Clark. She can lift groceries and move with ease. "It feels good to eat well," she says.

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