February 14, 2005

2:25 PM

The other kind of Valentine's Day heart: My 40-year-old brother was diagnosed today with congestive heart failure. Bad heart genes run in our family, and I'm taking this as a wake-up call to get my own bod in order. [+]
posted by mudpuppie to (20 comments total)

I know all the rules -- eat right, exercise, don't smoke, don't drink too much. But how does one actually put this in practice? Any tips or routines you can share? Discounting the health-fad-of-the-month, what can one do to invest in and accomplish long-term health?

I'm in my early 30s. If you're my age, what have you started to do differently? If you're older, what would you go back and change? (If you're younger, just you wait. You'll get yours....)
posted by mudpuppie at 2:25 PM on February 14, 2005

People have said it in other threads, but the best advice is: don't try to do everything at once. If you try to stop smoking, start exercising regularly, and eat perfectly at the same time, you will lose your mind (and drive your family crazy, I imagine). Do one thing at a time; stopping smoking, if you smoke, should probably be the first priority on the list.
posted by ThePinkSuperhero at 2:31 PM on February 14, 2005 [1 favorite]

I am your age and my doctor basically told me "once you pass 30 if you keep doing the same stuff you were doing, you'll get fat and out of shape because your metabolism is slowing down" I am, however, resistant to aggressive exercise or diet changes. Here is what is so far working for me:

- I took yoga for a while and loved in, but now am really far from a yoga studio. I got a book on stretching called, I think Stretching, and do stretches in the morning to stay limber and mostly to acquaint myself with my body before I punish it by sitting in a chair all day
- I changed to lowfat milk over whole milk, frozen yogurt over ice cream, chicken and TVP over red meat, fruit over junk food, olive oil over butter, juice over soda, tea over juice [when I can] and I try to limit eating out to once a week and there I eat what I want. I keep nuts and veggies and fruits I like around the house [costs more, that seems reasonable to me] so I've got food to grab when I'm feeling peckish. I try to pack lunch to work. I try to eat smaller portions of stuff I know is bad for me.
- I really try to go for a long heart-pumping walk a few times a week, every other day if possible, more like once during the week and once on weekends. Exercise is good, but you should get your blood pumping to have healthy heart benefits. Anything you do can help: snow shovelling, hauling wood/boxes/furniture around. The trick is to remember that it's a very teeny time-commitment with really great results. Even truly heinous exercise can be dealt with for less than two hours a week. If you're an obsessive type, get a pedometer and try to up the number of steps you take per day as you're starting out. Anything that gets you less sedentary is a step towards being healthier.
- I already don't drink or smoke much but I have grown to be a lot more selective when I do drink and smoke. Buy better beer, switch to red wine, indulge in the fruity cocktails of your choice. Try to drink tea instead of coffee after your first cup or two of the day if you're a coffee fanatic. Drink a lot of water all day long.

The best tip is to find a buddy who you can do some of this with, especially exercise, but also tracking eating and generally being fitter. Get your weight, cholesterol, and blood pressure measured and do what you can to see if you can get those numbers into the healthy range if they're not already. SEE A DOCTOR and get some medical advice. Being proactive before you have problems is really the way to get started, good luck.
posted by jessamyn at 3:05 PM on February 14, 2005

First thing you should do is see your doctor and get baselines on a bunch of stuff. Blood pressure, EKG, a stress test, cholesteral, etc. Mention your brother and your family history. Your doctor will probably order specific tests for things you mention.

Having this baseline is critical for knowing what you need to do and well as will help you tremendously if/when bad things start to happen.
posted by ..ooOOoo....ooOOoo.. at 3:06 PM on February 14, 2005

Baby steps. Heart problems and cancer run rampant in my family so I decided that if I wanted to live a healthy life, I had to change my lifestyle. Like you though, reading through a lot of what was recommended seemed rather drastic and at face value, seemed to suck the fun out of most of what I enjoyed.

So, short answer... I didn't do it. At least, not in the way that it was recommended. Time and again, cold turkey has been proven unreliable because people cannot resist certain temptations - especially if they become habitual (the list of reasons and arguments are long, so no need to cover them here).

I decided that I would start small. Set incremental goals that would not detract from what I considered a relatively good time. So, here is how I started:

1. Read ingredients. Get to know what certain unpronounceable elements are that make up what you are eating. Perhaps even easier is stick to foods that do not need ingredient labels (fresh fruits, vegetables) and find interesting ways to combine them that tastes good. It might involve more time in the kitchen, but at least you know exactly what you're ingesting. Join a cooking class! They're a lot of fun.

2. Exercise. Most exercise regimens deterred me since a lot of them seem to require a certain amount of commitment that I'm far too lazy to commit to. Find ways that either a car or public transit are not needed and walk more. Do some stretches, push-ups, and sit-ups in the morning. If you spend most of your day sitting at an office chair, take 5-10 minutes an hour to go for a small walk or do some stretches in your office/cubicle.

3. Last, but probably most importantly, vices. Drinking/smoking/drugs etc. are hard mistresses to quit and/or avoid regardless of your social situation that may, or may not, directly influence your involvement with said vices. Get an organizer and each time you spend money on a vice, write down the exact amount each one costs and at the end of a month tally up how much money was spent on the particular habits. If you are like me, the amount of cash "wasted" (and that is subjective) was shocking. This realization helped influence later decisions (although, not necessarily avoid them) to the point where I realize that I need to cut back. The health benefits will naturally follow.

IANAD, so there are probably much better ways to address some of the concerns you mentioned, but I realized that once I started with these simple changes, more followed. I now exercise more, I've completely cut-out fast food and enjoy making my own meals. I drink a lot, so I've decided to set a savings goal for a vacation by using the money I normally spend on alcohol and setting it aside. In the long run, the vacation is probably much better for my health, and each drink I buy now is one less I can have while I am actually on vacation. ;)

On preview: ooOOoo is 100% correct. If you are unsure of where to start, get a physical. A doctor will usually recommend changes based on the results and it is probably the best way to target specific problem areas.
posted by purephase at 3:09 PM on February 14, 2005

Think about adopting an adult dog from your local shelter. The dog needs to be walked twice a day, and our dog gets us out of the house on a walk or a hike more regularly than we otherwise might. Plus, pets may help relieve stress.

People have mixed opinions about Andrew Weil, but 8 Weeks to Optimum Health lays out a series of healthy changes over time, and might be a good place for you to start.
posted by ambrosia at 3:31 PM on February 14, 2005

Reference the doctor visit/blood work: I would request a check of your Homocystine level. I believe that elevated levels are directly related to the incidence of coronary artery disease (Per my Internist). It is possible to have low cholesterol and elevated Homocystine. Not all doctors will order this test so be sure to ask the doctor about it. Folic acid lowered the level in my case.
posted by MLIS at 4:47 PM on February 14, 2005

A friend of mine recently went to the doctor and the conversation went like this:

Him: "I do cocaine, E or mushrooms once or twice a week, sometimes a LOT of cocaine. I drink a lot -- maybe five or six nights a week I drink more than four or five drinks, sometimes a lot more. I smoke about 3/4 of a pack of cigarettes a day. I don't exercise at all and I eat mostly junk food."

Doctor: "Quit smoking."

Speaking from experience, though (and my theory is that this is where the doctor was coming from), I can tell you that once you quit smoking a lot of other things will begin to fall into place. It will become easier and MUCH more pleasureable to exercise, eating food that is healthy for you will taste much better because you'll get about 50% of your tasting ability on top of what you already have, and life in general, once you get the chemicals out of your system, will begin looking a whole lot brighter.

Quitting is the hardest part of anything you will have to do, though. Try to quit, then try again, then try again. Try every gum, patch, snack, friend, method you can until you're quit. Keep quitting until you just don't smoke anymore. Don't even TRY social smoking -- that way lies ruin.

Most of all, good luck. You're doing this for the right reasons.
posted by jennyjenny at 5:36 PM on February 14, 2005

I experienced the symptoms of congestive heart failure when I responded poorly to a drug for high blood pressure. My ankles swelled and and I was starved for oxygen. It was very disturbing. Quitting smoking was very easy after that vision of the possible future.
posted by JohnR at 6:06 PM on February 14, 2005

IAAD.

Quit smoking first, if you smoke (it seems like you maybe do?). Do whatever you need to do to stop, including nicotine gum, Zyban, lollipops, whatever. Think of it as a gift to the people who love you, if it helps you to stop.

Go see a doctor - preferably a cardiologist; let her know straight-away the full scoop about your brother's precocious CHF. 40 is very early to have CHF for the 'usual' reasons; the more data said doctor has about your brother's problems, the easier it'll be to discover whether you share those problems.

Homocysteine (not homocystine) levels are useful as noted by another poster, but honestly, let a cardiologist figure out what to test for - that's why they get the big bucks, right?

If I had the magic secret of diet and exercise, not only would I be rich, I'd be skinny and fit (I consider myself neither, sadly.) What has been helpful to me is to discover things that meet two criteria: 1) They are healthy. 2) I'd make time/room for them even if they weren't.

For me, fresh fruits and vegetables, and bicycling, definitely meet both criteria. Things that don't, don't work - I keep teaching myself that lesson.
posted by ikkyu2 at 6:55 PM on February 14, 2005

Jesus H Cardiogram.

I'd like to mark an answer as 'best,' but they're all helpful. If nothing else, you've all given me some perspective that I most definitely needed.

I know that "go see a doctor" is good advice. It is, of course, the obvious answer. But here's the deal: I've been a vegetarian for 12 years, I don't smoke (but I luvvvv beer), I'm not overweight. I'm not an athelete, but I walk several times a week and occasionally ride my bike around town.

I've been on meds for a rapid heartbeat for 13 years, and on hypertension meds for 1 year. C'est la vie.

Maybe I'm worrying over nothing. Thanks to you all, I feel like I'm maybe doing things okay after all.

Thanks for all the tips. Consider yourselves all "best" answers.
posted by mudpuppie at 7:56 PM on February 14, 2005

(oops, turns out you can mark multiple 'bests'. sorry.)
posted by mudpuppie at 7:59 PM on February 14, 2005

Discounting the health-fad-of-the-month,

Ummmm.... Well, South Beach and a daily lunchtime walk have helped me lose 30 lbs., 4" off my waist, and 10 points off both numbers of my blood pressure... all since Jan. 1. But since you don't want a fad diet, nevermind.

Seriously, just go to the bookstore and read the South Beach book (especially the chapters called "Is it Diabetes Yet?" and "Back to Cardiology") and see if what he's talking about applies to you. If so, you may be interested in reading the rest of the book.
posted by Doohickie at 8:05 PM on February 14, 2005

Oh... and I'm 42. I wish I would have started taking care of myself at 30 or 35, so you have the right idea. If you want to talk to me more about how I rolled out South Beach, email me.
posted by Doohickie at 8:12 PM on February 14, 2005

supplementwatch
mentions CoQ10 helping CHF, as do 100's of other sites (most sell it too)
No first hand info, but I hear lots of reco's for it., even some doctors on TV.
Not cheap, check the web for discounts.
posted by Charles the Friend at 8:18 PM on February 14, 2005

Small additional advice: Get in the habit of reading food labels, whatever diet direction you decide to go in.
posted by gimonca at 8:39 PM on February 14, 2005

gimonca- You're 123% right. There are lots of bad things disguised as good things. Breakfast cereals are among the worst (at least for the diet I'm on), and the "adult" ones all seem so wholesome. What I've learned in the last couple of months is why overprocessed food is bad, and how overprocessed much of our food is.
posted by Doohickie at 9:14 PM on February 14, 2005

Cut certain nasty extra things completely -- condiments, salt, butter, sugar, fried foods, sweet drinks -- because reducing them will come to nought after a few months. When you make a meal, add no butter or salt, no mayonnaise or ketchup. When you make tea or coffee, add no sugar. No oil. No frying. No fast food. No instant meals. No sweet drinks (not even fruit juice). This is a long-term practice -- you give up these things forever, not as part of a fad diet. And you give them up completely, you don't try to reduce them a little and end up overusing them after you get lazy with your diet. (Adding just a little salt is like smoking just a little.)

You will find that you like the taste of the food itself, and that you don't need to hide the taste in extras. Now when you have a ham sandwich, maybe with fresh tomato or cucumber (no pickles, no salt, no mayonnaise), you will taste the ham and the vegetables and the bread. When you have coffee without the cream and sugar, you will taste the coffee. Things you thought were bland will turn out to have taste. (And you will start to taste all of that salt and sugar the manufacturers have already sneaked into your foods.)

If you need to add something, try vinegar or pepper.

And fill up on fresh fruits and vegetables. Keep lots of what you like in the kitchen -- lots of apples or oranges or celery or tomatoes or whatever -- and pig out on them rather than on whatever else you would have wolfed down. When you make a salad, make that the biggest part of the meal, sometimes the only part of the meal, and don't put anything on it except maybe vinegar and pepper.
posted by pracowity at 5:49 AM on February 15, 2005

All the good advice has been given, but I'll add a few things anyway:

--It has really helped me to have goals for exercise. For example, I started running, which was ok for a while on its own, but then I started racing and that makes all the difference. I'm not fast or a winner or anything, but the future races give me a reason for each days workout. It's harder not to do it when I know that there will be results to skipping the workout down the line. And, I love to go to running races of all distances. In HS, when I was on the x-country team, I hated racing, but something about all of those people having a good time makes me happy.

--In terms of losing weight, high intensity interval training has been shown to burn the most calories, although it might not get you into shape for anything specific. Basically, rather than exercising at a steady state, you alternate periods of base line exercise with high intensity exercise during the same workout. You can do this on anything, running, a bike, elliptical or rowing machine, whatever.

--Fitday is a good web resource for tracking calories and energy expenditure for exercise and then graphing them against each other. It's easy to use and free, and even without a specific goal, it can help you to get a sense of what is coming in and going out.

--Small meals more frequently can really help to control appetite and prevent bingeing.

I realize that many of these things suggestions are about losing weight, which is not exactly what you said that you needed to do, but I think that controlling calories and energy expenditure can be a useful proxy for tracking fitness, which can be more difficult to measure on its own.
posted by OmieWise at 6:08 AM on February 15, 2005

I had a quadruple bypass at 40. At 44, I got an Implanted Cardiac Defibrillator.

My advice is to establish a support network between yourself and your brother, even long distance, and resolve that the two of you will keep the other going well into your retirements. Talk to each other at least twice a week and don't let the other one slack off.
posted by mischief at 9:25 AM on February 15, 2005