A Silver Lining... actually it's usually red!

Stick with me folks - once we get past all the medical talk and informational stuff, it gets interesting.

Before Jeremy was discharged from the hospital his cardiologist, Dr. Hess (he went to medical school at Tulane and interned in New Orleans as well - what's not to love???), came in to talk to us about all kinds of things. While he was there, he went over Jeremy's blood work with us. Predictably, his total cholesterol count was high, his LDL (bad cholesterol) was high and his HDL (good cholesterol) was low. I already knew that to lower his LDL level he'd need to start exercising, watch his fat intake and cut out as much transfat and saturated fat as possible. But I didn't know much about increasing his HDL - so let me tell you what we learned.

Your HDL kind works like a janitorial service for your blood vessels. It scours the excess cholesterol from the walls of your blood vessels and transports it to your liver for processing and disposal. So when your HDL level is taken, it's a reflection of how thoroughly your blood vessel walls are being scrubbed. HDL levels between 40 and 60 mg/L are considered the normal range. And here's the best part - an HDL level greater than 60 mg/L is now thought to actually PROTECT AGAINST HEART DISEASE. Let me repeat that part - PROTECT AGAINST HEART DISEASE. For those of you at home that aren't taking notes, let me spell it out for you - this is a very good thing.

Jeremy's HDL level on the day of his surgery was 37 mg/L. We just received his lab results from the physical he had the week prior to his surgery and it was 40 mg/L in that report. Anyway - not good enough. Dr. Hess said he wants Jeremy's HDL at 60 mg/L. He also said that raising your HDL isn't an easy process. Here's what you can do:

• Aerobic exercise, more specifically, at least 20 to 30 minutes of aerobic exercise that raises your heart rate. But that's a minimum. Recent research shows that it's the duration of the exercise that counts as far as raising your HDL, rather than the intensity. So as far as our desired outcome goes, it's better to jog for 40 minutes than it is to run for 20. Done deal - he bought tennis shoes, we're walking an hour every day and just as soon as Dr. Hess clears him to work out he's going to start jogging/biking.
• Lose weight. Obesity contributes to both raised LDL and a low HDL. So losing weight can improve things for folks that are overweight (Why hello there, mirror!). But Jeremy was blessed with a genetic metabolism that makes me want to punch him in the kidneys. Suffice it to say that Jeremy isn't obese and he is well within the normal BMI range. Shrug.
• Cut trans fat from your diet. Cut. Them. Out. An explanation of what trans fatty acids are would be even more boring than learning how to calculate cash flows from a company's annual report (guess what I'm studying...). So if you want to know, go here. But basically trans fat is liquid oil that's had hydrogen added to it to create a solid fat - this gives processed food a longer shelf life... but gives you a much shorter shelf life. Suffice it to say that they're mostly man-made (very small amounts occur naturally), and there's nothing good about them. Check your labels. Avoid fast food. Cut. Them. Out. Done deal.
• Alcohol. And here, ladies and gentlemen, we've come to our silver lining. While the American Heart Association doesn't want doctors encouraging their patients to start drinking, if you already drink - here's the scoop. One drink a day for women and two drinks a day for men can significantly increase your HDL levels. Again, I'll repeat that for those of you who aren't taking notes... can significantly increase your HDL levels. Particularly red wine. And I will directly quote Dr. Hess here, "So a glass or two of red wine every night would be a great idea." I love Dr. Hess. (I will note, however, that going over that moderate amount has the opposite effect - so don't try to rationalize that if 2 is good then 3 is great. Jeremy.) And of course, if you already have health issues related to alcohol - ignore this one.
• Increase the monounsaturated fats. This means more canola oil, avocado oil, olive oil, avocados and peanut butter! Yay. This doesn't suck.
• Add soluble fiber to your diet. Really this means you need to eat a lot more fruits, vegetables and legumes than most of us do now. The American diet is totally effed up. Meat should be an occasional side dish - not the main course of every meal. And by occasional I mean once or twice a week. Red meat and processed meat also contributes to colon cancer as well as horrendous cholesterol levels. We're working on this one, and it's going pretty well, shockingly enough. Especially for the hunting-obsessed...
• Increase Omega-3 fatty acids. This means oily fish (halibut, tuna, salmon, etc) - so we're trying to get at least two serving a week in. We're getting more than that so far. We both love fish and seafood - so it's not a burden, trust me.

So now all the teaching and stuff is over. Let's get back to bullet #4 - DRINK RED WINE! We like this one. Neither of us were particularly fond of red wine before, we both liked dry whites. However, some sacrifices must be made... Sigh. (/snerk)

So the Saturday after his surgery, we hit The Wine Cellar with our friends, Dan and Juliet. And I think it's fair to say we tasted every single red wine they had. Every. Single. One. Keep in mind though, there were only 8 or 9. Anyway, we took home a couple of bottles to get us started. We bought a bottle of Jeunette Rouge from Les Bourgeois Winery. It's a mild, medium bodied blend of Chambourcin, St. Vincent and Syrah with a fruity character and a soft finish suitable for an array of occasions. No I did NOT just copy that from the website. Leave me alone. Okay, maybe a I did - but you don't know that stuff either. Anyway, we also bought a bottle of Charleville Chambourcin. We'd just been in Saint Genevieve (where Charleville Winery is) to visit the wineries the weekend before this for my birthday, so we already knew about that one. But we're going to become red wine connoisseurs. It's a tough job, but somebody's gotta do it.

Tonight we're having Gascon Malbec while Skyping with Roy and Cathy (Jeremy's mom and stepdad). So far this one is our favorite - but it's pretty full-bodied. It's much more an occasional sipping wine rather than a regular rotation wine.

So that's Jeremy's silver lining. He has official permission to have two glasses of red wine every night before bed. But that's no the only silver lining - we've reconnected with several friends, our relationship has always been strong but it's stronger than ever, we're both improving our health, many friends have been inspired to get their butts to the doctor, etc. There are good things that have come of this - and as cliche as it sounds, we have many reasons to count our blessings!

Jeremy's Heart... and Mine (Part 2)

As most of you already know, Jeremy had emergency heart surgery two weeks ago. Here's the story of that day... So that brings everyone up to date. While we were in the hospital I was leafing through St. Louis Magazine. And the August issue just happened to be the Best Doctors 2010 edition. And sure enough here was our primary care physician, Dr. Maureen Stoffa; as well as both of his cardiologists, Dr. Hess and Dr. Lite. That provided a bit of comfort.

We decided before we even left the hospital that our lives were going to change from that day that hour that minute forward. This is a whole new lifestyle and we're going to do it together. It wasn't my decision, it was Jeremy's. I've been running for the last few months and had asked Jeremy to join me repeatedly - now I finally have the workout partner I wanted! As I said in the other blog, we stopped at Border's and bought heart healthy cookbooks on the way home from the hospital - we weren't wasting a single minute.

That first day I was scared to death to give him anything to eat. I didn't know if we had anything in the house that I wanted him to have! I love to cook, but we've never watched sodium or cholesterol. We've watched fat content now and again - but not in many, many years. We got home and I began pouring through all the nutritional information they sent us home with and my new cookbooks. Jeremy's cardiologist wants him to keep his sodium intake below 2,000 milligrams a day, cholesterol below 200 milligrams a day, and fat at about fifty grams a day - but transfats and saturated fat at an aboslute minimum, and plenty of fiber. I dug around in the pantry and found foil packets of flavored tuna. So Jeremy's first meal at home was a foil packet of StarKist Tomato Pesto Tuna Creation! At least I knew it'd be okay for him to have while I found a few recipes, made a shopping list and hit the grocery store.

That first night I made low fat spaghetti with whole wheat pasta and ground antelope from his Wyoming hunt last winter. AFTER dinner we looked up the nutritional information for antelope. Uh... we probably should have done that before dinner. We just assumed (as we'd discussed with the nutritionist that morning before we left the hospital) that wild game is more or less really good for you. Turns out antelope is the exception to the rule when it comes to cholesterol content. So that serving of spaghetti with ground antelope had all 200 milligrams of his daily cholesterol intake for the day. Great job, Heather, big FAIL on day one.

The books I bought have been wonderful - especially the The New American Heart Association Cookbook, 7th Edition and The Healthy Heart Cookbook: Over 700 Recipes for Every Day and Every Occasion by Dr. Joseph Piscatella. So many people have given us information, helpful hints and great ideas. One of Dad's friends gave a whole packet of information he'd collected online to Mom and Dad to pass on to Jeremy (thanks Hubert!). And Jeremy sat down and read the entire thing from beginning to end as soon as Mom handed it to him. Jeremy and Michelle Moring came over to visit that very first weekend and made a heart healthy dinner for us - that was a really special treat.

We've had a lot of friends stop by to visit since he got home from the hospital. Everyone kept asking if we needed anything, or what they could do for us - so Jeremy said to tell them all to come see us. This was incredibly scary and it makes you want to surround yourself with the people you care about.
Jeremy had his first follow up visit with Dr. Stoffa (our PCP) last Monday. I went with him and had a nice long list of questions. We were happy with most of her answers and I think that visit made Jeremy feel a lot better about everything. She was pleased with what she saw and didn't really have any further concerns. We talked about his upcoming antelope hunting trip to Wyoming (she said no), another upcoming tropical trip (she said yes), firing high powered rifles (she said maybe), hunting in extreme cold (she said no if it's below freezing)... I'm sure you can guess who asked those questions. I asked about his limitations regarding exercise (start walking now, but wait until Dr. Hess clears you for anything strenuous), sex (none of your business), and his carotid arteries. His heart was checked during the angiogram, and since Dr. Hess felt this had a lot to do with diet - I wanted to make sure his carotids were clear. Dr. Stoffa thought that was an awfully good idea too - so we scheduled an ultrasound of his carotid arteries for later that afternoon. When we left we were both feeling about a hundred pounds lighter as we walked out of her office.

In the last two weeks Jeremy's returned to work, we've explored the heart healthy options at the grocery store, we've been out to eat a couple of times, we've had several new recipes, Jeremy's been taking his lunch to work, we've started walking and we've learned a lot. A lot about our health and a lot about the strength of our relationship. I'll start tackling all of that material in the next few posts.

So I hope you all join us, not only in reading about what we're up to -  but in making some healthier choices in your own lives. Stop smoking. Start moving. Eat better. Manage your stress levels. I know it's easier said than done. Doing something because "it's good for your health" is such an abstract concept when you're in your twenties. But now we've had MS, cancer and heart disease touch us on a very personal level - it hits home. For all of us.