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Next Steps Program

For those of you looking for an ongoing connection with an Exercise Therapist, easily accessible education modules and ongoing informative information you should seriously consider joining the Next Steps Alumni Program offered by the Central East LHIN Cardiac Rehab Team. Think of this as a continuance of your rehab program, an additional tool to help you stay on track with your heart healthy lifestyle.

The video below is a Utube presentation on the program. I strongly encourage you to register. We will be working in tandem with Next Steps, combining local programming from our peer group with the capabilities of the wider Next Steps regional program.

Stay tuned for more information on our evolving relationship with the Central East LHIN program.

Reduce risk of severe Covid-19 with regular activity, study says

I always thought “staying fit and healthy” would turn out to be a real plus in avoiding more serious outcomes from Covid-19 if you caught it. Turns out physical inactivity is strongly associated with more severe Covid infection and a heightened risk of dying from the disease. This information is found in a large US study published online in the British Journal of Sports Medicine. The article can be found at the link below, along with ideas for staying active in just 22 minutes a day.

https://apple.news/AOrug–TNQhmsuhZzTF-z1A

These 7 Sports Are Associated With Living Longer, According to Research

Racket sports for the win!

Well this news got me angry especially when we are well aware of the power of walking and socializing (safely) on heart health. I would have thought golf was number one. A four hour round of golf carrying your clubs or pulling a cart come in at 1100 calories burned. Alas; here are the top seven according to “The Copenhagen City Heart Study” following 8,500 citizens. The chart shows expected increases in life span by sport.

  1. Tennis: 9.7 years
  2. Badminton: 6.2 years
  3. Soccer: 4.7 years
  4. Cycling: 3.7 years
  5. Swimming: 3.4 years
  6. Jogging: 3.2 years
  7. Calisthenics: 3.1 years

I guess it is really all about staying active and getting at minimum 150 minutes of moderate intensity aerobic exercise, or 75 minutes of vigorous activity, each week. And in the final analysis it is not about adding years to our lives, it is about adding life to our years. Keep walking (and golfing but don’t sit in that cart!)

Special Meeting – April 14th at 2:00 PM

It has been over a year since we had the opportunity for a live meeting of the peer group. It has also been over a year since the Cardiac Rehab Program was forced into the on line world. This means there have been many graduates of the Rehab Program who have never had the opportunity to be part of our group. We want to try to share with them as best we can, who we are and what we do to help each other stay on track. We are inviting grads from the last year to this special meeting.

We will have a very special guest speaker at the meeting. Dr. Joe Ricci. Dr. Ricci is the Program Director for the Central east LHIN Cardiac Rehab Program and a Cardiologists many of us know personally. Dr. Ricci is going to share insights into how maintaining a heart healthy lifestyle leads to improved health outcomes and adding life to our years. Put this in your calendar and join us on April 14th.

As usual you will be sent a link to the meeting.

7 ways to reduce stress and keep blood pressure down and Covid coping strategies

I came across this graphic the other day and it reminded me of some of the advice I was given when going through rehab. These tips were timely then and seem to make sense now as we grapple with this “never ending story” called Covid-19. Hang in there!

Heads Up – March Zoom Meeting

Let’s Meet -Still Zooming but things are looking up!

Mark your calendar for March 15 at 2:00 PM. You will receive a meeting invite by e-mail from Peter Z, as well as a link to a quick survey about your website. Please complete the survey even if you cannot attend the meeting.

Looking forward to “seeing” everyone and hearing your stories about pandemic coping.

NEW TOOL ADDED TO LIVE LIFE WELL PAGE ON THE WEBSITE

myfitnesspal

This is a free application website that can be used to monitor not only the amount of food you are eating but also the quality of that food. You can use the tool to assist in weight management. The tool helps you determine what your daily calorie intake should be to maintain your weight. It adjusts the “budget” for calories allowed by factoring in the amount of exercise you are doing. It goes way beyond calories though and helps you with budgets for things like protein, sugar, carbs, fat and so on.

The true power of the website is that it will help you set realistic goals for weight management and also highlight where you may have opportunity for improved nutrition. I offer my example. I have been using it for a few weeks and it has helped me to lose 11 ponds, but perhaps more importantly it helped me to identify;

  1. A surplus of “sugar” in my diet
  2. A deficit of protein

I highly recommend that you at least check it out by visiting the Live Life Well page on the website. https://cardiorehabgrads.com/live-life-well-tools/

Be aware of hidden heart risks in your medicine cabinet

Nonsteroidal anti-inflammatory drugs (NSAIDs), take up a large portion of pharmacy shelves and many of us have examples of these drugs sitting in our bathroom medicine cabinets. Examples such as Advil, Aleve, Anaprox, Celebrex, Motrin and Voltaren can be purchased without a prescription, are promoted for a range of conditions including pain relief, reduction of fever and relief from inflammation, and consequently many people will pop one or two casually at the slightest sign of need in a number of the above areas. However, NSAIDs can increase the risk of heart attack, with the level of risk tied to the type of NSAID, how much is taken, and for how long. This doesn’t mean you should stop taking them altogether, but understanding their risk is important when assessing whether they are needed. There are about 20 different Non-Steroidal Anti-inflammatory Drugs or NSAID’s available in Canada. If you did not know better you might think there is little difference amongst this group of NSAID’s but in fact there are significant differences.

Looking back, the NSAID and pain killer of choice for many years was Acetylsalicylic Acid (ASA) or good old Bayer Aspirin (the one with the cross symbol) which has been around since 1899. Salicylates in various forms have been used since 400BC to reduce pain and fever with indigenous peoples using Willow Bark extracts long before the synthesis of ASA by the German company. Many of our peer group use a low dose coated ASA (81mg) on a daily basis to help prevent heart attacks and stroke because of its ability to function as an anti-coagulant. If you take daily aspirin, make sure you know why and understand the small but real bleeding risk. Taking low-dose aspirin for “secondary prevention” is not controversial. Secondary prevention is for people who already have had a heart attack, certain kinds of strokes, or other diagnosed cardiovascular disease that puts them at high risk of additional problems. The risk of serious bleeding is outweighed 6:1 by incidence of preventing heart attacks, strokes, and sudden death. Taking daily low-dose aspirin does not have the same risk/benefit profile for “primary prevention” where bleeding risk is outweighed by potential benefit in prevention.

The term “Non-Steroidal” is used to distinguish these drugs from steroid anti-inflammatory drugs like Prednisone and also to ensure no confusion with the stigma of “Anabolic Steroids”. NSAIDs block two enzymes (Cox-1 and Cox-2) that are part of the production of substances involved in the process of inflammation and blood clotting. Some NSAID’s are Cox-2 selective so less able to reduce inflammation but are useful to reduce pain. Note that Acetaminophen (Tylenol) is not considered to be a NSAID since it has minor anti-inflammatory activity but does block COX-2 to effectively treat pain. If taken regularly in appropriate doses Acetaminophen is also useful in reducing acute or chronic pain.

Acetaminophen is not an NSAID but is effective at pain relief

In general terms all NSAID’s can reduce the blood’s ability to clot and also increase the risk of gastrointestinal ulcers/bleeds. There are differences in their actions and side effects. The COX-2 inhibitors have less stomach upsetting side effects but can cause thrombosis, kidney damage and substantially increase the risk of a heart attack.

The NSAID group of drugs has had a somewhat chequered history since their introduction in the 1990’s. In 2004 Merck voluntarily withdrew Rofecoxib (Vioxx) from the market due to concerns of increased incidence of cardiovascular adverse events (MI/stroke). Vioxx was used by patients seeking relief from arthritic joint pain and inflammation. In 2005 Pfizer suspended sales of Valdecoxib (Bextra) due to concerns of increased serious skin reactions. NSAID’s are generally promoted for symptom control in patients with inflammatory arthritis and osteoarthritis (OA), muscle pain, dysmenorrhea, gout, migraines and as opioid-sparing agents in acute pain. Patients may have to cycle through several courses of treatment with different drugs to determine which works best for them. Note that some NSAID’s are available for topical use, example, Diclofenac Gel (Voltaren).

The contraindications and warnings which come with all the NSAID’s make scary reading including warnings about hypersensitivity reactions, history of allergic-type reactions, use during pregnancy, uncontrolled heart failure, gastric irritation/ulceration, bleeding disorders, liver/kidney damage and increasing blood pressure, however like all medications, if this class of drugs is used sparingly and for short courses the side effects should be minimal.

The takeaway here should be to check with your MD or pharmacist before taking any NSAID’s, be aware of possible side effects, use only short courses at the lowest dose that works for you and use the longer acting daily dose products if possible, example, Naproxen (Aleve). Also consider using CBD in an appropriate dose as a safe alternative to NSAID’s and don’t discount the use of targeted exercises to ease pain and improve mobility.

This article is written and posted by our guest contributor, Bryce Miller. Bryce is a peer group member and a practicing Pharmacist. Bryce will be contributing to our website from time to time and will also be part of our “Experts Panel” when this feature is launched in May,2021.

Use the Reply box below if you have questions

Increasing Metabolism

I am always keeping my eyes open for helpful tips on this subject. I am told that our metabolism slows as we age and that even if we eat the same we will probably gain weight over time. Conversely if we eat the same but increase our metabolism we should lose weight? Well not so fast depends how we increase metabolism. One way is to gain muscle (which as an aside is pretty important as we age). You could start an RT program and find that you gain weight due to increased muscle mass. Your clothes will probably fit better.

I came across this short video clip on Global News. Watch it for the key messages around metabolism, avoiding crash diets and the importance of RT.

https://globalnews.ca/video/7642809/increasing-metabolism-after-40/

Mindful Eating in Support of Weight Management

A family member of mine has lost over 30 pounds in the last seven months and contributes part of her success to mindful eating. Well I had to look to up and came cross this article.

Courtesy of Harvard Medical

Research reveals that the very act of eating quickly may contribute to overweight and obesity.

Here’s how: As you eat and drink, your stomach fills, activating stretch receptors in your stomach. These receptors send satiety messages to your brain via the vagus nerve, which connects the brain to the stomach. Then, as food enters your small intestine, appetite hormones are released, sending additional fullness messages to your brain. This process doesn’t happen immediately, though. It can take 20 minutes—or longer—for your brain to realize it’s time to put down your fork. Eating too quickly doesn’t allow this intricate system sufficient time to work, making it easy to overeat without even realizing it.

There’s another downside to distracted eating that has nothing to do with speed. Eating while you’re busy doing other things robs you of the opportunity to fully enjoy your food, so you may not feel completely satisfied—and may keep on eating in an attempt to gain satisfaction.

Enter mindful eating

Mindful eating is the act of fully focusing on your food as you eat. It encourages you to pay closer attention to the tastes, smells, and textures of your food as well as your body’s hunger and satiety cues. As basic as it sounds, this practice is surprisingly powerful. In one small study, 10 obese volunteers enrolled in weekly mindful eating classes that focused on listening to their feelings of hunger and fullness. They also paid close attention to their cravings and emotions. Not only did the participants drop an average of 9 pounds by the end of the three-month program, but they also reported less hunger, stress, anxiety, depression, and binge eating.

In addition to savoring the flavors and aromas of your food, the following techniques can help you attain more mindful eating:

  • Create a calm, beautiful space for eating. A cluttered table does not create the sense of inner tranquility you need in order to cultivate a peaceful mindset.
  • At the beginning of your meal, set a timer for 20 minutes. Then pace yourself to make your meal last until the timer goes off.
  • Let the answering machine take care of incoming phone calls.
  • Put away all computers, phones, and reading materials, so you can concentrate on your food.
  • Turn off the television, another source of distraction.
  • Eat only at the kitchen or dining room table to minimize distractions.
  • Think only about the bite of food you’re actually eating at that moment. It’s all too easy to think ahead to the next bite without focusing on the food that’s actually in your mouth.
  • Put your fork down between bites.
  • Chew each mouthful 30 times.
  • Before you help yourself to seconds or dessert, ask yourself if you’re really hungry.