DOCSLIB.ORG

Intensive Lifestyle Changes for Reversal of Coronary Heart Disease

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Intensive Lifestyle Changes for Reversal of Coronary Heart Disease Intensive Lifestyle Changes for Reversal of Coronary Heart Disease Dean Ornish, MD; Larry W. Scherwitz, PhD; James H. Billings, PhD, MPH; K. Lance Gould, MD; Terri A. Merritt, MS; Stephen Sparler, MA; William T. Armstrong, MD; Thomas A. Ports, MD; Richard L. Kirkeeide, PhD; Charissa Hogeboom, PhD; Richard J. Brand, PhD Context.—The Lifestyle Heart Trial demonstrated that intensive lifestyle THE LIFESTYLE Heart Trial was the changes may lead to regression of coronary atherosclerosis after 1 year. first randomized clinical trial to investi- Objectives.—To determine the feasibility of patients to sustain intensive lifestyle gate whether ambulatory patients could changes for a total of 5 years and the effects of these lifestyle changes (without be motivated to make and sustain com- lipid-lowering drugs) on coronary heart disease. prehensive lifestyle changes and, if so, whether the progression of coronary Design.—Randomized controlled trial conducted from 1986 to 1992 using a atherosclerosis could be stopped or re- randomized invitational design. versed without using lipid-lowering Patients.—Forty-eight patients with moderate to severe coronary heart disease drugs as measured by computer-as- were randomized to an intensive lifestyle change group or to a usual-care control sisted quantitative coronary arteriogra- group, and 35 completed the 5-year follow-up quantitative coronary arteriography. phy. This study derived from earlier Setting.—Two tertiary care university medical centers. studies that used noninvasive mea- Intervention.—Intensive lifestyle changes (10% fat whole foods vegetarian diet, sures.1,2 aerobic exercise, stress management training, smoking cessation, group psycho- After 1 year, we found that experi- social support) for 5 years. mental group participants were able to Main Outcome Measures.—Adherence to intensive lifestyle changes, changes make and maintain intensive lifestyle changes and had a 37.2% reduction in in coronary artery percent diameter stenosis, and cardiac events. low-density lipoprotein (LDL) choles- Results.—Experimental group patients (20 [71%] of 28 patients completed terol levels and a 91% reduction in the 5-year follow-up) made and maintained comprehensive lifestyle changes for 5 frequency of anginal episodes.3 Average years, whereas control group patients (15 [75%] of 20 patients completed 5-year percent diameter stenosis regressed follow-up) made more moderate changes. In the experimental group, the average from 40.0% at baseline to 37.8% 1 year percent diameter stenosis at baseline decreased 1.75 absolute percentage points later, a change that was correlated with after 1 year (a 4.5% relative improvement) and by 3.1 absolute percentage points the degree of lifestyle change. In con- after 5 years (a 7.9% relative improvement). In contrast, the average percent diam- trast, patients in the usual-care control eter stenosis in the control group increased by 2.3 percentage points after 1 year group made more moderate changes in (a 5.4% relative worsening) and by 11.8 percentage points after 5 years (a 27.7% lifestyle, reduced LDL cholesterol lev- els by 6%, and had a 165% increase in the relative worsening) (P = .001 between groups. Twenty-five cardiac events occurred frequency of reported anginal episodes. in 28 experimental group patients vs 45 events in 20 control group patients during Average percent diameter stenosis pro- the 5-year follow-up (risk ratio for any event for the control group, 2.47 [95% con- gressed from 42.7% to 46.1%. fidence interval, 1.48-4.20]). Given these encouraging findings, Conclusions.—More regression of coronary atherosclerosis occurred after 5 we extended the study for an additional years than after 1 year in the experimental group. In contrast, in the control group, 4 years to determine (1) the feasibility coronary atherosclerosis continued to progress and more than twice as many car- of patients sustaining intensive changes diac events occurred. in diet and lifestyle for a much longer JAMA. 1998;280:2001-2007 time, and (2) the effects of these changes on risk factors, coronary atherosclero- sis, myocardial perfusion, and cardiac From the Department of Medicine (Dr Ornish), and Division of Cardiology, University of Texas Medical events after 4 additional years. the Division of Cardiology (Dr Armstrong), California School, Houston (Drs Gould and Kirkeeide); and the Pacific Medical Center, San Francisco; the Department Preventive Medicine Research Institue, Sausalito, Calif of Medicine (Dr Ornish), the Division of Cardiology, (Drs Ornish Scherwitz, and Billings, Mr Sparler, and METHODS Cardiac Catheterization Laboratory, Cardiovascular Ms Merritt). The design, recruitment, and study Research Institute (Dr Ports), and the Division of Reprints: Dean Ornish, MD, Preventive Medicine Re- 3-5 Biostatistics (Drs Brand and Hogeboom), School of search Institute, 900 Bridgeway, Suite 1, Sausalito, CA population were previously described. Medicine, University of California, San Francisco; the 94965 (e-mail: [email protected]). In brief, we recruited men and women JAMA, December 16, 1998—Vol 280, No. 23 Lifestyle Heart Trial—Ornish et al 2001 ©1998 American Medical Association. All rights reserved. Table 1.—Baseline Characteristics of Experimental and Control Groups* form after being fully informed of the Experimental Control P study requirements. Characteristic (n = 20) (n = 15) Value Patients completed a 3-day diet diary Men, No. 20 12 at baseline and after 1 and 5 years to .07 Women, No. 0 3 assess nutrient intake and dietary ad- 6 Age, mean (SD), y 57.4 (6.4) 61.8 (7.5) .08 herence. Methods of lipid assays were 3 Education, mean (SD), y 15.5 (2.7) 14.5 (3.4) .29 the same as previously reported. These Employed, No. 14 6 .10 3-day diet diaries were analyzed with a Body mass index, mean (SD), kg/m2 28.4 (4.1) 25.4 (3.5) .03 software package (CBORD Diet Ana- No. with history of myocardial infarction 12 5 .17 lyzer; CBORD Group Inc; Ithaca, NY) Average No. of lesions studied, mean (SD) 5.3 (2.7) 5.3 (3.2) .93 using the US Department of Agricul- No. with history of percutaneous transluminal 54..99 turedatabase.Also,patientswereasked coronary angioplasty to complete a questionnaire reporting No. with history of coronary artery bypass graft 1 0 ..99 the frequency and duration of exercise Reported angina, No. (%) 11 (55) 6 (40) .49 and of each stress management tech- *Values are statistics unless otherwise indicated. P values are 2-tailed. nique. Information from these sources wasquantifiedintocontinuousscoresus- with coronary atherosclerosis docu- to 5-year comparisons. ing an a priori determined formula. The mented by quantitative coronary arte- Four experimental and 4 control pa- adherence measure was a continuous riography. tients who had an angiogram at 1 year did score reflecting daily intake of choles- We identified 193 patients as poten- not have a third angiogram after 5 years. terol (in milligrams), fat (in grams), tially eligible for our study who agreed Three of these 4 patients in the experi- frequency and duration of exercise, fre- to undergo quantitative coronary angi- mental group refused a third angiogram quency and duration of stress manage- ography. Following angiography, 93 (patients only volunteered for a 1-year ment techniques, and smoking. A score patients remained eligible and were ran- study that was subsequently extended), of 1.0 equalled 100% adherence but domly assigned to experimental or con- and 1 died between years 1 and 4; of the 4 scores could be greater than 1.0 if par- trol groups using a randomized invita- control group patients who did not un- ticipants exceeded the recommended in- tional design to minimize crossover, dergo a third angiogram, 1 died, 2 under- tensive lifestyle changes. ethical concerns, nocebo effects, and went revascularization of the arterial The technicians responsible for per- dropout. Of these 93 patients who were lesions under study, and 1 developed forming all medical tests were blinded to eligible, 53 were randomly assigned to Parkinson disease and became too ill to patient group assignment. Also, different the experimental group and 40 to the be safely tested. Cine arteriograms made personnel implemented the lifestyle in- usual-care control group. Patients were in San Francisco, Calif, were sent to the tervention, conducted the tests, and com- thencontactedandinvitedtoparticipate University of Texas Medical School, putedstatisticalanalyses,althoughthedi- in the study; 28 (53%) and 20 (50%) Houston, for blinded quantitative analy- etitian was made aware of the nutrient agreed to participate in the experimen- ses as previously described in detail.4 analysis to monitor patients’ safety and tal and control groups, respectively. The All results, except lesion changes at 1 adherence. Quantitative coronary arte- primary reason for refusal in the experi- year (18 experimental and 15 control riograms were blindly analyzed without mental group was not wanting to un- subjects) and cardiac events after 5 knowledge of group assignment. dergo intensive lifestyle changes and/or years (all 28 experimental and 20 control not wanting a second coronary angio- subjects), are based on the total of 35 Program Intervention gram; control patients refused primarily patients (20 experimental and 15 control Experimental group patients were because they did not want to undergo a subjects) who had both baseline and 5- prescribed an intensive lifestyle pro- secondangiogram.Todetectpossiblese- year angiograms. From these 35 pa- gram that included
Load more

Recommended publications
  • The Truth About Fat: the Latest Update February 24Th 2016 Cathy Mazanec, MPH, RDN, CSSD, LDN
    The Truth about Fat: The Latest Update February 24th 2016 Cathy Mazanec, MPH, RDN, CSSD, LDN I recently attended a Fat Summit hosted by Integrative and Functional Medicine physician, Mark Hyman, MD, Director of the Center for Functional Medicine at the Cleveland Clinic. Dr. Hyman invited some of the most prestigious U.S. researchers to join this online Summit to share their individual research data. This academic bench of researchers and thought leaders was deep, some of whom included: Ronald Krause, MD; Daniel Amen, MD; Jeffrey Bland, PhD; Michael Roizen, MD; Chris Kresser, MS, LAc; Walter Willett, MD; David Perlmutter, MD; Dean Ornish, MD. I was so excited to finally hear the latest update about dietary fats and end the great fat debate once and for all. What a long awaited relief this would be…… This could not have been further from the truth!! Consistent with the pattern I’ve seen over my 37 year career, nutrition research from highly respected scholars often conflicts. The reason for this is each researcher is looking at a different piece of the same puzzle. In this case, the effect of a certain dietary fat on one piece of the puzzle may be very different from the effect that fat has on another piece of the puzzle. Hence, each researcher may have a different viewpoint and recommendation about the dietary fat being studied. So a lot of questions still remain unanswered but some information is very clear. Here's a snippet of the latest research regarding dietary fat and what we need to know ……….
    [Show full text]
  • Psychocardiology: Recognizing and Addressing the Profound Impact of Psychosocial Factors on Cardiac Health
    RESEARCH PAPER Medical Science Volume : 3 | Issue : 8 | Aug 2013 | ISSN - 2249-555X Psychocardiology: Recognizing and Addressing the Profound Impact of Psychosocial Factors on Cardiac Health Psycho-cardiology, Non cardiac chest pain, psycho social factors, Risk management and KEYWORDS psychological intervention G. H. Bindu Srinivas Dr. K. Jayashankar Reddy PhD Research Scholar In Psychology, DEPARTMENT Principal & Prof. of Psychology, CMR CMMS COLLEGE, OF PSYCHOLOGY, J.C. ROAD, JAIN UNIVERSITY, NO.5, BHUVANAGIRI, OMBR LAYOUT, BANASWADI, BANGALORE BANGALORE-560043 ABSTRACT Psycho-Cardiology is one of the fields which is playing a very important role in investigation, management, treatment and therapy for both cardiac and non-cardiac disease and issues related to pain with cardiac and non-cardiac ailments. Psychosocial issues are important variables that need to be addressed in patients with cardiac ail- ment or issues related to heart disease. Unfortunately, these issues are often overlooked. Depression, anxiety, stress and lack of social support have been shown to have a negative impact on patients. Patients with heart disease who are anxious, stressed , depressed or who lack social support have been shown to have increased morbidity and hospital readmission rates, to be less adherent to their medical regimen, and to have an overall increase in cost of care. The variables are often interrelated, as high levels of social support may lessen the impact of depression on mortality. In addition, certain bio- logic factors may influence the impact of psychosocial factors in patients. This review addresses the issues related to risk management and addressing the importance of psychological intervention on treatment adherence, and social support in patients with cardiac issues and suggests interventions targeted to these problems.
    [Show full text]
  • Read Book Heart and Mind : the Practice of Cardiac Psychology Kindle
    HEART AND MIND : THE PRACTICE OF CARDIAC PSYCHOLOGY PDF, EPUB, EBOOK Robert Allan | 496 pages | 15 Sep 2011 | American Psychological Association | 9781433810138 | English | Washington DC, United States Heart and Mind : The Practice of Cardiac Psychology PDF Book Impact of Transcendental Meditation on cardiovascular function at rest and during acute stress in adolescents with high normal blood pressure. Castelnuovo G 2. Look after your health at harvest time slideshow Farmer health, wellbeing and safety are often neglected when facing the pressures of harvest. About this article. Epub Sep 7, Post by:. Behavioral treatment of hypertensive heart disease in African Americans: rationale and design of a randomized controlled trial. You may feel uncertain about the future and anxious about your long-term health. Give your child opportunities to appreciate their body for what it can do, rather than what it looks like Heat, 13 , — In EH Johnson et al. Type a minimum of three characters then press UP or DOWN on the keyboard to navigate the autocompleted search results. Article Inclusion and Exclusion Criteria. For a copy of patient file on adaptive strategies for young patients with cardiac devices, click here. Psychosom Med ;80 6 — The number of the statements may be higher than the number of citations provided by EuropePMC if one paper cites another multiple times or lower if scite has not yet processed some of the citing articles. Health Psychol ;28 3 — Womens Health Issues ;22 2 :e—8. Initial results suggested that emotional support was not significantly associated with clinical characteristics; however, in a 1-year follow-up study, lack of emotional support was significantly associated with risk of fatal and nonfatal cardiovascular outcomes.
    [Show full text]
  • Behavioral Medicine Course Tuesday 4-7Pm at Briarwood Preliminary Outline Drs. Peter Trask and Steven Schwartz Week Topic 1
    Behavioral Medicine Course Tuesday 4-7pm at Briarwood Preliminary Outline Drs. Peter Trask and Steven Schwartz Week Topic 1. Peter, Steve Introduction to Behavioral Medicine -- goals and aims of the course, history, definitions of beh. med./psychosomatic med. -- biology of stress reactions 2. Peter Chronic Pain -- include gate control theory, acute v. chronic pain, self-management of pain, CBT model, therapy 3. Peter Cancer -- include smoking cessation 4. Steve Cardiovascular Disease -- include hypertension, Type A, depression, lifestyle 5. Peter, Steve Diabetes and Asthma -- include issues of comliance 6. Peter Gastrointestinal Disorders -- Crohn’s, IBS, GI reflux 7. Steve Transplants 8. Peter Psychosomatic illnesses 9. Steve Structure and Authority of Hospitals -- politics, medical subculture 10. Steve Consultation/liaison Work 11. Peter, Steve Research in Medical Settings 12. Steve Financial Efficacy of Psychologists in Medical Settings -- marketing of psych. services in hospitals 13. Peter Ethics in Medical Settings 14. TBA Note: Throughout the course we need to include gender differences, ethnic/racial differences, incidence/prevalence of disease, biological and physiological issue about disease and tx., psychological factors contributing to disease outcomes, case examples, and visual demonstrations. Structure of class: Class will be reading intensive and in seminar style. The class itself will consist of 30- 60 minutes of lecture, and then class discussion with several (3-4) pointed questions on each topic being a source for focusing the discussion to get students to think about the disease and issues. Grading: Grading will be based on class participation, a paper which can either be a literature review of a disease or topic area, or a study proposal in NIH format that includes bibliography and copies of all measures along with a proposed budget outlining personnel and costs.
    [Show full text]
  • Vegetarianism’ Is a Case for Returning to Our Essence As Beings Created in the Image and Likeness of God
    “This important pamphlet helps us advance the supreme Jewish goals of tikkun olam (healing and improving our world) and kiddush haShem (sanctifying the Divine Name).” —RABBI DAVID ROSEN, FORMER CHIEF RABBI OF IRELAND “The authors have powerfully united scientific and spiritual perspectives on why we—as Jews, as human beings, and as members of the global commons—should ‘go vegetarian.’” —RABBI FRED SCHERLINDER DOBB, COALITION ON THE ENVIRONMENT AND JEWISH LIFE A CASE FOR ‘“A Case for Jewish Vegetarianism’ is a case for returning to our essence as beings created in the image and likeness of God. It is a guide to be ... read and a guideline to be followed.” —RABBI RAMI M. SHAPIRO, SIMPLY JEWISH AND ONE RIVER FOUNDATION EWISH “Judaism … inspires and compels us to think before we eat. ‘A Case for J Jewish Vegetarianism’ provides many powerful reasons for us to be even VEGETARIANISM more compassionate through the foods we choose to consume.” —RABBI JONATHAN K. CRANE, HARVARD HILLEL “The case for Jewish vegetarianism is increasingly compelling, for ethical, environmental and health reasons--this provocative and important booklet makes that case lucidly from all three perspectives.” —RABBI BARRY SCHWARTZ, CENTRAL CONFERENCE OF AMERICAN RABBIS TASK FORCE ON KASHRUT FOR ANIMALS, FOR YOURSELF, AND FOR THE ENVIRONMENT People for the Ethical Treatment of Animals • GoVeg.com VEG314 1/05 RABBINIC STATEMENTS OF SUPPORT INTRODUCTION The Variety of Jewish Arguments for Vegetarianism “In contemporary society, more than ever before, vegetarianism should be an imperative Vegetarianism is becoming more and more popular in North for Jews who seek to live in accordance with Judaism’s most sublime teachings.
    [Show full text]
  • Change Your Diet, Go Plant Based 3 1
    go plant based International Society for Cow Protection ISCOWP.ORG Radhika and Devaki on front cover. Priya, in the photo above, is the king of the ISCOWP herd. International Society for Cow Protection ISCOWP Profile Dear Friends, The International Society for Cow Protection, Inc. (ISCOWP) was incorporated in the USA, We believe that rescuing cows from being sold March 1990, as a 501 (c) (3) non-profit, tax for meat and then caring for them their entire exempt organization. William and Irene Dove lives (a cow can live for 25 years or more) until (Balabhadra das and Chayadevi dasi) are its their natural death is a humane, compassionate managing directors. They are disciples of His Divine Grace A.C. Bhaktivedanta Swami act and can only help the planet towards a more Prabhupada, the Founder Acharya of the Inter- peaceful existence. national Society for Krishna Consciousness (ISKCON). Through their spiritual master's Besides having our local sanctuary we teachings, they have imbibed the practices and encourage and educate others how they too can benefits, both spiritual and material, of lifetime care for cows. William E. Dove, ISCOWP cow protection. Cow protection means enabling president, has traveled widely to counsel future cows to live out their natural lives with love and and current cow protection programs. We also affection. The tenets of cow protection are offer assistance through conference calls, universal and nonsectarian, available to all seminars and literature. regardless of race, creed, or nationality. Mailing Address ISCOWP Compared to the numbers of cows bred 7016 SE 92 Terrace worldwide each day, what we are doing, both Gainesville FL, USA, 32641 locally and beyond, is less than a mere drop in Phone the bucket.
    [Show full text]
  • The Great Olive Oil Misconception -- Dr
    The Great Olive Oil Misconception -- Dr. Ornish Responds | Heart-Healthy Food | Reader's Digest | Print Version Print | Close X The Great Olive Oil Misconception -- Dr. Ornish Responds Dr. Ornish answers questions about the health value of canola oil versus olive oil. By Dean Ornish, MD The Truth About Olive Oil In his September column, Dr. Dean Ornish reported that olive oil is not as healthy as everyone thinks it is. A number of readers were dismayed and disbelieving of this news, and others thought canola oil, which Dr. Ornish recommends, is unhealthy. Dr. Ornish addresses these concerns: First of all, on the health benefits of canola oil versus olive oil: Olive oil, like all oils, is 100% fat. Since fat has 9 calories per gram, whereas protein and carbohydrates have only 4 calories per gram, people consuming a lot of olive oil are also consuming a lot of extra calories. As I wrote in my column, olive oil “lowers” cholesterol only when substituted in equal amounts for foods that are higher in saturated fat. In other words, if you replace 60 grams of butter with 60 grams of olive oil, your LDL cholesterol level is likely to decrease—not because olive oil lowered your cholesterol level but because it didn’t raise it as much. This is a very common misconception, causing many people to consume a lot of olive oil in the belief that it will somehow magically lower their cholesterol levels. Studies comparing the effects of canola oil versus olive oil show that canola oil consumption results in lower LDL cholesterol levels.
    [Show full text]
  • Vegetarian Starter Kit You from a Family Every Time Hold in Your Hands Today
    inside: Vegetarian recipes tips Starter info Kit everything you need to know to adopt a healthy and compassionate diet the of how story i became vegetarian Chinese, Indian, Thai, and Middle Eastern dishes were vegetarian. I now know that being a vegetarian is as simple as choosing your dinner from a different section of the menu and shopping in a different aisle of the MFA’s Executive Director Nathan Runkle. grocery store. Though the animals were my initial reason for Dear Friend, eliminating meat, dairy and eggs from my diet, the health benefi ts of my I became a vegetarian when I was 11 years old, after choice were soon picking up and taking to heart the content of a piece apparent. Coming of literature very similar to this Vegetarian Starter Kit you from a family every time hold in your hands today. plagued with cancer we eat we Growing up on a small farm off the back country and heart disease, roads of Saint Paris, Ohio, I was surrounded by which drastically cut are making animals since the day I was born. Like most children, short the lives of I grew up with a natural affi nity for animals, and over both my mother and time I developed strong bonds and friendships with grandfather, I was a powerful our family’s dogs and cats with whom we shared our all too familiar with home. the effect diet can choice have on one’s health. However, it wasn’t until later in life that I made the connection between my beloved dog, Sadie, for whom The fruits, vegetables, beans, and whole grains my diet I would do anything to protect her from abuse and now revolved around made me feel healthier and gave discomfort, and the nameless pigs, cows, and chickens me more energy than ever before.
    [Show full text]
  • Interview with Michelle Mcmacken, MD
    Interview with Michelle McMacken, MD Michelle McMacken, MD discusses the importance of nutrition and lifestyle, the best way to lose and manage weight, and why she recommends plant-based vegan diets. Dr. McMacken is an honors graduate of Yale University and Columbia University College of Physicians and Surgeons, board- certified internal medicine physician, assistant professor of medicine at NYU School of Medicine, and the director of the Bellevue Hospital Weight Management Clinic in New York City. Some excellent articles written by Dr. McMacken can also be found here. A short excerpt of the interview is above at the top of this post, and two more excerpts, the extended full interview (about 35 minutes), and transcript are below. PART 2 OF THE INTERVIEW HIGHLIGHTS: PART 3 OF THE INTERVIEW HIGHLIGHTS: EXTENDED FULL INTERVIEW: Interview Transcript DR. PINEDA OCHOA: Dr. McMacken, thank you so much for making time to meet with us. DR. MCMACKEN: Oh, my pleasure, happy to be here. DR. PINEDA OCHOA: So Dr. McMacken, tell us please a little bit about your background and about your training, what you do, what your interests are. DR. MCMACKEN: Sure. So my background is — well, I was one of those English majors that never thought I would go to medical school, never took a science class, found myself working at the Centers for Disease Control in Atlanta as a writer/editor actually, and decided I wanted to go into public health. Took all my pre-med requirements and was fortunate enough to go to medical school here in New York at Columbia.
    [Show full text]
  • A Cardiac Rehabilitation Follow-Up Program by Tamara H. Bisbee BSN, University O
    Running Head: HEART TO HEART Heart to Heart: A Cardiac Rehabilitation Follow-up Program by Tamara H. Bisbee B.S.N., University of Minnesota, 1979 M.A., St. Michael’s College, 1993 DISSERTATION Submitted in partial fulfillment of the requirements for the degree of Doctor of Psychology in the Department of Clinical Psychology of Antioch University New England, 2012 Keene, New Hampshire Department of Clinical Psychology DISSERTATION COMMITTEE PAGE The undersigned have examined the dissertation entitled: HEART TO HEART: A CARDIAC REHABILITATION FOLLOW‐UP PROGRAM presented on June 29, 2012 by Tamara H. Bisbee Candidate for the degree of Doctor of Psychology and hereby certify that it is accepted*. Dissertation Committee Chairperson: Susan Hawes, PhD Dissertation Committee members: Victor Pantesco, EdD Thomas Stearns, PhD Accepted by the Department of Clinical Psychology Chairperson Kathi A. Borden, PhD on 6/29/12 * Signatures are on file with the Registrar’s Office at Antioch University New England. HEART TO HEART ii Dedication This dissertation is lovingly dedicated to my grandfather, Max Vaughn Hammitt who, hours before his heart failed, dreamt me up to query “if not now, when?” And to my grandchildren Sophia and Carter whose pure love and aliveness has awakened me to the extraordinarily loving nature of my Grandfather’s final quest. HEART TO HEART iii Acknowledgments The care of several individuals has enabled me to finally complete this project during a difficult and complicated time in my life. I am grateful to my dissertation committee members who hung in with me to the end. Thanks to Dr. Susan Hawes for unending support and evenly hovering attention, and to Dr.
    [Show full text]
  • Advocate Thevegan
    th year! Our 29 THE veGan aDVoCaTe Volume XXIX, Number 1 February 2018 - April 2018 Rochester, NY USA THE VEGAN WORLD IS HERE. A VEGAN DIET spoke on the topic “Veganism is What is it, and Why? Every day seems to bring a new Environmentalism.” Robin Helfrich Maratos and Erin Marcus introduced the Vegan If you are not a vegetarian or a member milestone for plant-based eating and vegan living. Living Program, a free 5-week vegan of the Rochester Area Vegan Society mentorship which started in Baltimore and (RAVS), this column is for you. Here are VEGAN 10-DAY JUMPSTART! Long Island, and will be launched in some of the basics. Doug Schmidt already has one claim to Rochester at the RVCC in April; http:// A vegetarian is someone who eats no vegan fame: in 2017, he was voted PETA’s www.openthecages.org/vlp. In the evening animal flesh: no meat, poultry or fish. A “Sexiest Vegan Man over 50.” But Doug, a there was a dinner catered by Everyday vegan is a vegetarian who goes further and heart attack survivor who credits a plant- Gourmet Café in Sodus, NY, with a musical eats no animal products at all: no eggs, based diet with saving his life, also tries to performance of “The Animal Show” by cheese, milk, or honey. RAVS recommends spread veganism in more concrete ways. Michael Harren. a vegan diet as the optimal diet. Since 2015, Doug and his wife Shari The Rochester Vegan Community What are the reasons to go vegan? It have run small-scale vegan Jumpstarts in the Center will be a dedicated space for vegans, comes down to these: for your health, for Victor school district where they are both a wonderful gift to the Rochester community the animals, and for the planet.
    [Show full text]
  • A Psychologist on the Step-Down Coronary Care Unit Robert Allan Division of Cardiology, Weill Cornell Medical College, New York, NY, USA
    Journal of Integrative Cardiology Translational Research ISSN: 2058-3702 A Psychologist on the Step-down Coronary Care Unit Robert Allan Division of Cardiology, Weill Cornell Medical College, New York, NY, USA The phone rang at 2:30 a.m. “I’m calling to discuss my platelets,” Despite the vast epidemiological evidence base linking adverse the voice at the other end stated clearly. Mr. S had been a patient of my psychosocial factors to the onset and poor outcome from CHD, there mentor, cardiologist Stephen Scheidt, who brought me to Weill Cornell are scarcely any healthcare practitioners helping cardiac patients with Medical Center/New York-Presbyterian Hospital and graciously psychosocial issues. shared his office for 25 years. Dr. Scheidt died several years ago and I Although I have conducted cardiac support groups over several felt a special bond with Mr. S because of the connection. We met the decades, it has only been in the past few years that I have become a part day before on the step-down Coronary Care Unit (CCU) and I had of the treatment team on the step-down CCU. My work was initially encouraged him to call if he was distraught. I was certain Mr. S was not championed by Erica Cargill Jones, then Director of the Inpatient just calling about his platelets and he seemed reassured that someone Telemetry Unit. Dr. Jones is an extraordinarily intelligent and was there for him in the middle of the night. Subsequently, I treated sensitive human being who identified patients in need of psychological Mr. S over several hospitalizations.
    [Show full text]