Broken Hearts and Octopus Traps

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Broken heart syndrome (BHS) has several names, such as stress-induced cardiomyopathy. One you’ve probably never heard is takotsubo cardiomyopathy.

BHS is similar to other forms of cardiomyopathy in that the heart gets significantly weaker. If you view the appearance of the heart during echocardiography, the bottom of the heart, specifically the left ventricle, is weaker and balloons out more than normal when the heart contracts. Healthcare professionals in Japan thought it looked like the takotsubo, a pot used by Japanese fishermen for trapping octopus, thus the name.

The symptoms of BHS are severe pain deep in the chest along with shortness of breath. For some, there may be a build-up of fluid in the lungs that causes coughing and an inability to sleep lying down. It feels like a heart attack. Some of the changes in the EKG may look like a heart attack, but an angiogram will show no blockages causing a heart attack. Enzymes that rise during a heart attack will not follow the same pattern. The diagnosis can be confirmed by an echocardiogram which will show the ballooning effect.

On Saturday, I’ll finish up the treatment of BHS and what may help to prevent it.

What are you prepared to do today?

Dr. Chet

 

Broken Heart Syndrome

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This week’s focus is on American Heart Month and specifically heart disease in women. While heart disease is the leading cause of death in both men and women, there’s one type of heart disease that affects more women than men: broken heart syndrome. Can you die from a broken heart? Absolutely. We’ll find out how this week.

Cardiomyopathy is a weakening of the muscle tissue of the heart. There are four major forms of cardiomyopathy and several minor ones that can affect men, women, and even children. Cardiomyopathy affects up to one in five people and most don’t know that they have it until serious symptoms start to develop. Shortness of breath, fatigue, and swelling in the ankles are the first symptoms people may notice, and the symptoms get more severe as the heart continues to weaken. Treatment can range from medications to a heart transplant in severe cases.

Broken heart syndrome is a special type of cardiomyopathy. The primary cause is severe stress such as the death of a loved one, hence the name. It’s not limited to extreme bad news; extreme good news can initiate the process as well. I’ll explain what happens to the heart in Thursday’s post. Until then, give your loved ones extra hugs and kisses today. More than anything, give them the most important thing above all else: time.

What are you prepared to do today?

Dr. Chet

 

Reference: http://bit.ly/2kWCbsT

 

The Way Things Used to Be

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On the radio, I heard a woman say, “I just want things to be the way they used to be!” That mirrors the frustration that I read from emails people send about being older. I don’t necessarily mean those over 60; I get the same type of frustration from 30-year-olds who find that their bodies don’t respond the way they did in their teens.

Things can’t be the way they used to be. Your body is a miracle, plain and simple, but it’s designed to run its course. It’s the original planned obsolescence. Hormones change. Joints wear. On top of that, we don’t do ourselves any favors with our lifestyle.

Things can’t be the way they used to be and that’s good. We remember what was good about those times, but we forget what wasn’t good and idealize the rest; we don’t remember the zits, the braces, and the awkwardness of inhabiting a body we weren’t used to using.

This goes back to the last two messages. You have to decide who’s in charge and then work to be the best version of you that you can be. Forget about the way things used to be—make your body the best that it can be today.

Spend some time examining your health habits. You may think you’re eating well, but it may not be enough of the right nutrients and that’s keeping you too thin or too heavy. The exercise you do may not be the best for the body you have today. It’s going to be trial and error, but you’ll do your research, consult the experts, and figure it out one piece at a time.

Stop wishing for a body gone by. Make what you have the best it can be right now. Who knows? It may just be better than you ever imagined it could be.

What are you prepared to do today?

Dr. Chet

 

Who’s in Charge?

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“Make sure you define the disease; it doesn’t define you.”

That quote is from physician Dr. Louis Papa in a video I recently watched. What a powerful statement. While the discussion was about heart disease, he said it applies to any disease.

We all have health challenges; you won’t escape. Even if you have the best genetics, you can still have an accident that can disrupt your body. The key is how we respond to these health challenges.

There seems to be no end to the problems that ail us. I hear from people with an amazing litany of health problems: heart disease, diabetes, cancer, autoimmune disease, and so on. Some people seem to take a defensive position; they take treatments but allow the disease to define their life. They limit their world, not because they have to, but because they don’t believe they can live their life to the fullest. They allow the disease to define them.

I think it’s because they haven’t decided who’s in charge. As I said, we all will face some serious diseases and conditions in our life. Some are our own doing, others for reasons we just don’t understand right now. Just make sure you understand that you’re in charge. Talk with your doctor. Find out what you should and should not do. Like the doctor said, you define your disease. Then get about living your life again.

What are you prepared to do today?

Dr. Chet

 

Reference: https://youtu.be/4DJVLVwWwIY

 

Training Pays Off

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Tom Brady is the best quarterback in the history of the National Football League. Ouch—that’s tough for a guy from Buffalo to say, but after this past weekend, it’s true. I talked about how his dedication to training and attention to detail give him the energy and focus to perform. But after all the training, you actually have to go out and perform, no matter what life throws at you. And the Falcons threw everything they had at him. He never quit and brought his team back to win Super Bowl LI. That makes five Super Bowl rings for Brady, the most of any quarterback ever.

Right now, the health goals you set are starting to appear in your rear-view mirror. Weight loss. Exercise. Quitting smoking. They’re beginning to fade. Life has thrown obstacles in your way, no doubt. How have you responded? We’re not talking about winning a game here. We’re talking about winning back your life.

It all begins with your willingness to train. For us, that’s how we perform day in and day out. Work towards being the best version of you that you can be. Get out those goals. Adjust them. Then get back after it. Just ask yourself one question:

What are you prepared to do today?

Dr. Chet

 

 

Energy Thieves: Stress

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The final energy thief is stress. It can range from everyday stress such as the traffic on the way to work to your kid having the flu and you have to find someone to watch him or miss work. We adapt to those types of stress, but what about the big stressors? Illness, for you or a loved one, or worse, death. A bad boss. Divorce. Or one that I think affects more of us than we want to admit: the fear that you’re not accomplishing what you wanted to in your life or that your future is precarious. These can steal your energy. Stress can make you sick.

The first step is to get your mind right. This has nothing to do with grief or other emotions that you’re going to feel; those are natural and necessary. But your kids still need braces or your spouse may need extended rehabilitation after surgery. Those are stressful. And you will still have to put food on the table and pay the rent or mortgage in addition to those stresses. With all that, you may be facing the busiest time at work or in your business. You may feel overburdened, but you don’t have the luxury of sitting and feeling bad for yourself. This is when you have to dig deep and step up.

You cannot let this thief called stress steal your energy just when you need it the most. It’s not going to be easy, but you can do it. You can’t perform at full throttle all the time, but you can pick the times during a day, a week, or a month and match your energy levels with the demand to accomplish those tasks. You have to perform at your best to get the job done, and you can train to do that. But before you begin, you have to get your head right to deal with stress.

One way to begin is to identify when you have to perform your best. In Tuesday’s post, I told you I chose this week to perform at a high level all week. I trained for it. Now I’m using the strategy to perform 14 hours per day this week until I finish the webinar tomorrow. I didn’t have to have maximal energy all 14 hours per day; just when the task at the moment required it. Most of the time, I needed to have the mental clarity to read, write, and speak at my best.

It began with deciding what I had to do this week. I wrote it all on the white board in my office to keep my focus. I wrote it in my planner so I can see it. I eliminated all the distractions I could to focus on this week. Once you have your mind right, you have to know what you have to do and when you’re going to do it. And just getting that figured out helps relieve the stress because the problems have been defined and you’ve decided to act. The training to achieve that will seem easy.

What are you prepared to do today?

Dr. Chet

 

Energy Thieves: Medications

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Another class of energy thieves is medications. This may not apply to everyone but based on the latest CDC stats, close to 50% of all American adults take at least one prescription drug and almost one-quarter take three medications or more. There are three ways medications can steal your energy when you need it to perform your best.

  • Some medications can directly affect energy levels. Beta-blockers used for hypertension are an example; they’re supposed to slow down heart rate. They can also affect beta-receptors in other areas of your body. The net effect saps energy.
  • Other medications indirectly steal energy. An extreme example would be chemotherapy and radiation during cancer treatment, but some medications such as statins can cause muscle discomfort which can also steal energy levels.
  • Not taking the medications as directed can also steal energy. The simplest example is thyroid medication for hypothyroidism. It’s designed to be taken in the morning (unless otherwise specified by your doctor). If it’s not taken when it’s supposed to be taken, it can’t help with energy levels.

There are numerous medications that can impact energy. The first step is a discussion with your physician to address your concerns; schedule that today. I’ll be discussing strategies to minimize energy loss due to medications in the Super Bowl Webinar on Sunday, but it all begins with a discussion with your doctor.

What are you prepared to do today?

Dr. Chet

 

Reference: https://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm

 

Energy Thieves: Food

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This week I’m focusing on potential energy thieves, and I’ve identified three areas that can hinder performance; one of those is the foods we eat. The two primary food thieves that affect me and many others are refined carbohydrates and deep-fat fried food, but the reasons are polar opposites:

  • Refined carbohydrates and some starchy foods raise blood sugar quickly, but then you suffer a rebound drop. Eating too many refined carbs can put you in a carb coma.
  • High-fat foods, especially deep-fat fried foods, can take hours to digest, redirecting blood from the rest of the body to the digestive system to digest and absorb the fatty foods. Less blood to the brain means your mental acuity drops.

All this week, I’m using the techniques I developed for Energy on Demand in the Optimal Performance Program to have all the energy I need to focus and work 14-hour days through the end of the next webinar. My goal is to eat to perform at a high level, and part of that is knowing what not to eat. If you participate, either live or by listening within the following week, you’ll get the complete story.

Spend some time thinking about how the foods you eat affect your energy levels. There may other foods and dietary factors that affect you in addition to the two I’ve listed; for example, maybe it’s not so much which foods as when you eat them. How food affects energy for the times you really need to be at your best will be one of the topics this Sunday in the Super Bowl Webinar. I hope you’ll join me.

What are you prepared to do today?

Dr. Chet

 

Paula’s Turn: I’m a Survivor!

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For a week in October, I had breast cancer. But maybe I should start at the beginning.

In September I got my usual mammogram and was called back for more images, which had happened before so I wasn’t worried. But this time, the radiologist saw something and recommended a biopsy. An ultrasound-guided core biopsy was done September 30; I love to know how things work, so the best part for me was watching the procedure on ultrasound. The worst part was the dozen or so mammograms done just before the biopsy to pinpoint the tumor’s location. These were done on a mammogram machine that produces more detailed images, but the most interesting part of that was the machine’s pressure read-out. Almost 30 pounds, ladies: stack three 10-pound bags of sugar on your—well, let’s move on.

The following Monday, we got the results: it was cancer, an invasive ductal carcinoma. Friday we saw the surgeon who recommended breast-sparing surgery, commonly called a lumpectomy. She said, “I’ve got a cancellation Monday,” and I said, “I’ll take it!” I lived with the knowledge that I had cancer only from Monday October 6 to Monday the 13th, just a week, and then it was gone. What’s amazing is that something that sounds so major can be accomplished with outpatient surgery; I was at the hospital only a few hours and then home. The pain was minimal.

I was lucky in many ways: the tumor was small, only 0.9 centimeters (about the size of a frozen pea), and slow growing; it was minimally invasive, just starting to breach the duct walls. It was also estrogen-positive, which means I have a good chance of heading off recurrences by taking Femara, an estrogen-blocking medication; years ago, my mother was part of a clinical trial for Femara and took it for five years after her lumpectomy, so I have no qualms about taking it as well. The pathology report showed that the margins were clear—doctor-speak for “We got it all!” In addition, my cancer was in my right breast, which kept the radiation farther away from my heart, and that’s a plus.

Next step: radiation. I was fortunate to qualify for hypofractionated radiation therapy as has been in the news recently and in Chet’s Tuesday message; it’s a shorter course of higher doses resulting in less overall radiation. My radiation oncologist recommended 16 general breast radiation treatments, followed by seven more-concentrated treatments. I asked him if radiation improved the survival rate, and he said, “Not really, but it’s been shown to reduce recurrence of cancer.” Good enough for me; I’d rather go through the radiation regimen than worry about whether any of the little varmints escaped and were setting up shop elsewhere. Radiation started mid-November and was done before Christmas. The treatments themselves are quick—in the room and out again in 15 minutes or less—and even though I felt fine all through the process, it’s an every-day schedule, Monday through Friday, so it gets wearing after a few weeks. I pushed my way through the schedule and only after it was done did I realize how exhausted I was; much napping ensued.

There are three reasons I’m telling you my story. First, I want you to know that if you’re going through breast cancer treatment, you know one more person who made it through just fine, and odds are you will, too.

The second is to remind you to do your monthly self exams. Since my tumor was in the back of my breast, I never felt it, but many women find their tumors themselves. And if your significant other wants to help, that’s good, too; a small but significant number of tumors are found by husbands, so let’s take all the help we can get.

Third, I want to encourage you to get your mammograms regularly and on time so if anything goes wrong you catch it early—for several reasons:

  • You’ll want the tumor to be tiny so the whole process will be as small and fast as possible—shorter, less complicated surgery, less radiation, and so on, but the best reason is to avoid chemotherapy, which takes a much greater toll than radiation. Luckily I didn’t need chemotherapy.
  • The larger the tumor, the more tissue is removed, and thus the larger the divot in your breast; mine was close to the chest wall and small enough to blend in without leaving a noticeable dent. It also left a relatively small scar; very low necklines are out, but I don’t wear them anyway. I hope I don’t seem vain, but appearances matter to women; the less damaged we feel, the better we feel about ourselves.
  • You want to minimize the amount of radiation needed because the effect is like a sunburn, and in some areas, a really severe sunburn. Now I know why pink is the color associated with breast cancer: that’s what color your skin is after they’ve zapped it several times. But like a sunburn, it clears up quickly.
  • Most important you want to catch it while it’s small enough to be detected but hasn’t spread. According to the information I was given (and there was a lot), 100 days is the estimated average time it takes for breast cancer cells to double in number; the range is from 23 days to 209. At 100 days to double, it would take nine years to reach 0.5 centimeter, and only one more year to reach 1.0 centimeter. I’m living proof that a tumor can be caught in that interval and eliminated, but I’m glad I didn’t wait another year.

I was also lucky to get treatment by Betty Ford Breast Cancer Services and their associates at Lemmen-Holton Cancer Pavilion in Betty Ford’s hometown of Grand Rapids, and it was phenomenal; the people were especially friendly and helpful, and I’ve never gotten so much information and emotional support for a health issue. Let me add that we all owe an incredible debt to Betty Ford because breast cancer treatment wouldn’t be nearly as advanced as it is now if she hadn’t spoken up: weeks after becoming First Lady, she had a mastectomy for breast cancer on September 28, 1974. Her openness about her cancer and treatment opened a national dialog about a disease that we’d all been reluctant to talk about.

So I’m a breast cancer survivor, and you may be wondering why I’m wearing red, not pink. Here’s why: as much as I appreciate and have benefited from the work of all the women in pink who’ve helped advance the state of breast cancer research and treatment, more women still die of heart disease—so I’ll continue to Go Red because I think that’s where more attention needs to go. When you talk to your doctor about scheduling your mammogram, ask her about a cardiac stress test as well. It’s no more fun than a mammogram, but it’s important for living the best life you can for as long as possible.

Paula

 

P.S. Now for something lighter: check out this link to “An Open Letter to the Mammogram Machine at Beth Israel Hospital” by Amelia Blanquera; all of us who’ve encountered one can appreciate this humorous look at her “relationship” with the machine.

 

Special Message: Enough!

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You may have seen the news that actor and comedian Robin Williams reportedly took his own life on Monday. I was on a plane when I heard, and the guy next to me just kept saying over and over, “He was only 63!” That was my seatmate’s age and mine as well. One of the contributing factors was depression. I know it was severe depression and needed to be treated by physicians, but there’s plenty of mild to moderate depression going around.

We don’t know all the details, but I’ve had enough—enough of men, especially baby boomer men, who refuse to acknowledge they might be depressed. They certainly won’t bother to get an actual diagnosis. They walk around fatigued, tired, and unable to accomplish anything. Those are signs of depression? Yes!

I don’t want any more tragedies especially for men in my age group! I want them to become productive again and be able to have the vigor they used to have.

Many people, especially men, don’t want to address depression because they believe there’s a stigma attached. That’s why Paula talks about her battle with depression and urges me to talk about it, too: the more people open up about it, the less effective the stigma becomes.

My mother-in-law spent years living half a life. We always suspected she was depressed, but she refused to take that medication. When she moved into continuing care, she was given an antidepressant along with her other meds, and she came alive—more like the person Paula and Steve remembered from childhood. Her last few years were some of her best. If you suspect you may be depressed, don’t wait until you’re in a nursing home to treat it. I guess the other side of that coin is that it’s never too late to feel better.

Not everyone will need an antidepressant, but that’s getting ahead of the game. I don’t want any more tragedies but even more, I want men and women in my age group—baby boomers—and of all ages to really live every day they’re alive. If you have a friend or family member in trouble, speak up. I know you don’t want to meddle, and neither do I, but meddling is a whole lot better than watching people fritter their life away.

For men only: quit playing games. I always say you can’t walk off a heart attack. Well, you can’t walk off depression without some guidance. So get off it and get after it. Today!

What are you prepared to do today?

Dr. Chet