AUGUST 5, 2010 IT is ONLY a NUMBER - 85

Although in my opinion most people would do well if they follow a 12 step program for life, not limited to addictions--there are three important steps to life within the 7 important lifestyle changes this blog always talks about. The 3 steps are:
Step 1: Identify the problem
Step 2: Identify the solution
Step 3: Identify the action.

Notice I did not say the reaction to the problem, but the second half of that word --"ACTION"
The seven lifestyle changes I believe are so vital are:
1. Dietary Lifestyle
2. Exercise
3. Addictions
4. Meditation
5. Self Esteem
6. Anger and Resentment
7. Self Love
To the best of my ability I have tried to live up to this. I am no saint, no God, nor perfect. Remember there is no perfection, only progress.

Today is a special day. Today is Marie Fratellone Maimoni's 85th Birthday. This is my dear Aunt Mary. Some of my fondest childhood memories were spent at Aunt Mary's and Uncle Joe's house on 75 Morsemere Avenue in Yonkers New York. It was a splendid house built and refurbished by Masoner Joe Maimoni. My Uncle Joe met Marie Fratellone because my father did not write letters to his sister and parents during WWII. My dad and Joe were bunk mates on the USS Monterey. My dad didn't write, but Joe did. This Navy man from Rhode Island proposed to Marie so when I was born in 1960, I had not only an aunt but an uncle.

I loved their house--a fireplace, a great backyard (we call it backyards in the North), not only one kitchen, but two, and a great sewing/recreational room where my brother, Paul, their daughter Regina and I played as children. Aunt Mary was the baker in the family. Always trying new things, watching Julia Child and always learning new innovations. She loved animals, like me --always rescuing- even to this day. During one Thanksgiving while we played dodge ball, I slipped on the grass and broke my left forearm. My childhood at Morsemere Avenue was always fun.

After my mom died Aunt Mary was always there. After my Uncle Joe died in January 1994 my own life started to change. I remember the sound of the thunder as we were in church in Toms River, New Jersey during his funeral. She wrote letters to me in Medical School and was a constant buffer between me and my Dad. She even visited me in Rehab. She has always understood me and for that I will be forever grateful. I love you, Aunt Mary.

So why wouldn't I talk about the Heart again...since Aunt Mary has a loving, compassionate heart.
I discussed leaky and stenotic valves yesterday--only briefly. Today we hardly see the stenotic mitral valve - called Mitral Stenosis. Sometimes we do see it in a very elderly patient who had rheumatic fever as a child. Due to the advent of antibiotics in the 1940's, patients born after that time should not have had rheumatic fever nor the late sequalae of the valve disorder. If you know someone who has MS (mitral stenosis not Multiple Sclerosis) there are some symptoms. The first is shortness of breath called Dyspnea. Also, a patient with MS might develop paroxysmal Nocturnal Dyspnea which is severe shortness of breath after several hours of sleep. Since the left atrium wall gets severely enlarged if the blood cannot pass from left atrium to left ventricle (due to the valve being tight)- there is rare possibility that the enlargement will press on the lung vessels and cause bleeding. This will result in the patient coughing up blood. This is called hemopysis. Palpitations or arrhythmia is likely. The most common rhythm disturbance in mitral valve stenosis and even a leaky mitral valve is atrial fibrillation. This is the most common arrhythmia a cardiologist will see in his practice.

So let's deviate to the causes of atrial fibrillation - an irregular rhythm. The most common conventional causes are
1. Valvular Heart Disease - as discussed above
2. Corornary artery disease - as discussed previously
3. Overactive Thyroid - hyperthyroidism

Let me discuss the non conventional or the integrative causes of palpitations like atrial fibrillation.
1. Food Allergies
2. Unstable blood sugar- when the blood sugar level starts to drop in a patient with hypoglycemia ( low blood sugar), the body as usual will compensate. The compensation is a release of epinephrine (adrenaline) which will speed up the heart resulting in an arrhythmia (or extra heart beats)
3. Chronic infection - I usually measure the High Sensitive C- reactive protein and search for causes
4. Heavy metal intoxication - I have seen many individuals with high levels of mercury, cadmium and aluminum have abnormal heart rates
5. Anxiety
6. High intake of Caffeine

One of the above is usually the reason a patient has this abnormal heart rhythm, even though all conventional causes have been negative.

Until tomorrow...
The above photographs are some of my Aunt Mary. One with my Dad is from my 40th birthday, one with my Dad alone, one giving advice/talk to my children at my 50th and then Aunt Mary with her daughter Regina and son-in-law, Paul at my 50th