AUGUST 11, 2010 YOU HAVE A FRIEND IN FOXGLOVE

"Friends are people who help you be more yourself, more the person you are intended to be."
- Merle Shain

Thanks Karen. You are one of those people.

What does it mean to be a friend to someone? Is your partner your best friend? How many true friends can you count? We all change as we find our own place in the world, our purpose. There is something emotional about knowing when the tears fall or the smile spreads across our face, we'll come to each other. Because that's what friends do! You have to know that no matter where this crazy world takes us, we will still be friends. Sometimes you get together with a friend you haven't seen in years and start up right where you left off. That is a true friend.

It is when you get together and have nothing to talk about except the old days that the friendship has moved on without each other in your respective lives. That is why I have a select group of friends. Some are new friends, but I know deeply that it will be forever. Why? Because we communicate our feelings, and when you develop friends at this stage of life--you know it is not because you need more friends. Friends come and go with each period of our lives. I blogged about friends during grade school, high school, college, and post graduate school. There are friends from your old neighborhood. There are many acquaintances in my life. Some I thought were friends, but it didn't turn out that way. Some want to be your friend because you have something to give--that they may want. This is the 'taker' friend.

I used to have an expectation in time to be friends with ex- love partners. Sometimes it is possible and other times it is not. I see more ex - partners becoming friends within the gay community unlike the straight community. Personally, I think this can only happen when you let go of all resentments and anger. This is the 5th lifestyle change according to my life pyramid. I have been ready for some time with 'old' flames and even have tried, but it just didn't work out. So I moved on.

There is always your best, best friend. Can you think of one? I know I have a best friend in my life partner and always will. He is the most important friend. Then there is your best friend whom you do not live and share life with. I am fortunate to have one of those friends too. We have been through the good and bad times. We are from different backgrounds, but share a common bond. The bond of knowing how we each feel as we have been in recovery together. I have been blessed and I am grateful for my friends.


Back to the foxglove (Digitalis)... I found it odd that I couldn't find foxglove in Duke's Handbook of Medicinal Plants of the Bible. I was sure it would be there- but it wasn't . When you read about herbal remedies for Heart Problems and circulatory problems, digoxin or foxglove is not discussed. Possibly because it is used in clinical allopathic or conventional medicine. What you read about is Hawthrone (Crataegus), Garlic (Allium) or Ginger (Zingiber).

What I find interesting is that I only knew there were purple or red foxglove plants. In my reading I have encountered a yellow-foxglove species. These are Digitalis ambigua and Digitalis lutea. You see at any age you can learn new things. I also found out about other plants that contain a similar cardiac glycoside. I will reserve this for another discussion. The other glycosides are called strophanthin. Then there are other plants that are not digitalis nor strophanthin glycosides but have some similar properties. These are called digitaloids. This is where my favorite plant, Convallaria will be placed. The common name is Lily of the Valley. The red fruit of this plant is highly poisonous. I have seen a lot of Lilly of the Valley's in Fire Island as it likes the damp woods.

Although foxglove exerts its effects on the heart by increasing the contractility in a positive way, it also can be used for cardiac rhythm abnormalities, aka cardiac arrhythmias. It is most commonly used to slow the heart rate for those individuals with an irregular rhythm called atrial fibrillation. These herbs will have to be discussed another time as these include motherwort, scotch broom and even yellow jasmine.

Foxglove should be collected in the woods. There are professional herb gatherers still working in areas such as the Harz mountains. Where are the Harz mountains? The Harz mountains, 90 kilometers (56 miles) long, 30 kilometers wide, and some 400 million years old, straddle the border between what was once East and West Germany, in the central part of the country. In the Harz mountains is Bildunterschrift: Großansicht des Bildes mit der Bildunterschrift: Brocken at 1,142 meters. The 1,142 meter (3,747 feet) peak called the Brockenberg, or Brocken Mountain, has an ancient reputation of being a haunting ground for witches, goblins and other creatures in the pagan pantheon. I must find a book on the hisory of this area because I am sure it will be interesting. I do know that any digitalis collected from this area is said to be valuable. I wonder why?

The clinical use of digitalis has a fine line. Both its use and toxic effects are very close. This means that the dose used for therapy is so close to the toxic dose that it must be managed with care. This is why blood levels are done for patients who take digoxin. The dose must also be adjusted if the patient has kidney disease as the drug is excreted through the kidney.


That's What Friends Are For

And I
Never thought I'd feel this way
And as far as I'm concerned I'm glad I got the chance to say
That I do believe I love you

And if I should ever go away
Well then close your eyes and try to feel the way we do today
And than if you can't remember.....

Keep smilin'
Keep shinin'

Knowin' you can always count on me
for sure
that's what friends are for

In good times
And bad times
I'll be on your side forever more
That's what friends are for

Well you came and open me
And now there's so much more I see
And so by the way I thank you....

Ohhh and then
For the times when we're apart
Well just close your eyes and know
These words are comming from my heart

Until tomorrow...
And then if you can't remember....Ohhhhh

And there are friend photographs...

AUGUST 10, 2010 Warming the Heart--with Herbs!

"A THOUGHTFUL GESTURE CAN ACCOMPLISH SO MUCH AND CAN EVEN BE THE BEGINNING OF A MIRACLE. GOD HELP US TO WARM THE HEART OF JUST ONE PERSON TODAY."

Thank you, Karen.

The above quote reminds me of a saying in AA. "Get three hugs every day!" It helped so much at the beginning of my sobriety. Depending on the patient, I try to do this as much as possible. Sometimes doctors put a distance between their patients, especially in the 'legal' climate. However, a doctor is a human being also. I feel doctors should try to show some emotion to their patients. Get your doctor to know you better. Doctors are not GOD. Doctors are on this earth just like you. I try to warm a heart every day. I am not perfect. Remember there is no perfection.

I know to the best of my ability I have accomplished some miracles. Miracles that I am proud of. I have had the support of a loving partner who is always by my side, but does not always agree with me. I like that--can you believe what I just wrote? I would rather have the honesty and open daily communication for us to discuss the miracles-- some do not live up to our expectations. We wouldn't be so disappointed if we never had the expectations to begin with. But after all we are human. We are givers. There are two groups of people in life- givers and takers. I give now because I want to. Givers also have to give to themselves. I am a better giver now because I give to myself. I give from the heart.

Speaking of the heart, we have discussed 3 valve conditions: Aortic valve disorders, and Mitral valve disorders including Mitral Valve Prolapse.

Today I want to discuss plants for the heart. There are many plants used for the heart. Relating to the topic of organic heart disease, or what is generally called valvular heart disease,--only one herb comes to mind. We need not treat valvular heart disease unless it causes decompensation.

Let me tell you what this means. For example, a 52 year old female had rheumatic fever at age 13. There were no problems until at age 45 she developed mild shortness of breath. It was discovered that she has mild to moderate mitral leakage. By age 50, she was short of breath at mild exertion. Since we have made enormous strides with surgery over the last two decades, she was considered for a valve replacement.

For the treatment of her heart failure due to her organic valve disease, a plant should be considered. Not any plant, but the Foxglove. This is also known as Digitalis or Digoxin. The Latin name is Digitalis purpurea. Digitalis is a cardiac glycoside. There are other plants that have similar properties to digitalis, but are not as effective. Why would we search the plant kingdom for another 'digitalis' like drug, when this one works just fine? We must thank William Withering.

Dr. Withering was born in Wellington, Shropshire. He studied at the University of Edinburgh and trained as a physician. He worked at Birmingham General Hospital beginning in 1779. I did 8 months of training in the Black Country where Birmingham General Hospital is located. I did more medical training in Dudley,and Kingswinford in the same geographical area. The story is that he noticed a person with dropsy (swelling from congestive heart failure) improve remarkably after taking a traditional herbal remedy. Withering became famous for recognising that the active ingredient in the mixture came from the foxglove plant.The active ingredient is now known as digitalis, after the plant's scientific name. In 1785, Withering published An Account of the Foxglove and some of its Medical Uses, which contained reports on clinical trials and notes on digitalis's effects and toxicity.

His clinical skills were excellent. He described digitalis toxicity as we know it today. He noted the toxic effects of vomiting, diarrhea, visual disturbances with a green and yellow hue, and seizures.
We do know that foxglove grown in the wild has the best medicinal properties. There is another form of foxglove. This is Woolly or Austrian Foxglove. Its Latin name is Digitalis lanata. The only advantage I find of lanata over purpurea is that lanata can be cultivated on a much larger scale.

I find that the most interesting property of this herb is that it can restore a weakened heart to a stronger, better functioning heart. During my clinical clerkship years in England, I used more digitalis than when I returned to the United States. When I was in cardiology training the use of digitalis started to wane. At one point with the technological advance in other medications for heart failure--digitalis use basically ceased. I started to use it again about 6-7 years ago.

Let's discuss the plant.
Foxglove (Digitalis purpurea) is one of the loveliest, most important plant species that has been introduced from Europe and naturalized in various parts of North America. The foxglove is a member of the Figwort Family. The name is the Scrophulariaceae. It grows wild in the woods and mountains in Europe. The flowers are numerous, on a spike, and range from a deep purple to lilac with conspicuous spots interlining the throat of the tubular flower. As a biennial, the leaves form a rosette the first year followed by the flower spike the next year. It prefers a nitrogen-rich sandy loam soil, and partial sun to full shade.

Digoxin (Digitalin) is a drug that is extracted from Digitalis lanata. This is the Woolly or Austrian Foxglove. Upon reading about this foxglove, I see it has a different family. I must ask my professor in two weeks about this Family change. It is used to treat some heart conditions such as congestive heart failure. It has a tonic effect on heart disease. Digitalin was not discovered until the mid 1800s by two French scientists Homolle Ouevenne and Theodore Ouevenne.

More digitalis tomorrow... since it is fascinating. I find it fascinating because my favorite, Convallaria is in the same family----I think. I need to find a foxglove in the wild to photograph.

Top Photograph : Dr. W W
Middle: 2 photographs of digitalis purpurea
Bottom: 2 photographs Digitalis lanata