We used to hear coronary heart disease described as “hardening of the arteries”, or atherosclerosis. I pictured this as some kind of clogged drain under an old sink, plugged up with years of disgustingly hard gunk. But it turns out that only about three out of every 10 heart attacks are actually caused by this kind of hardened coronary artery blockage.
When my little sister Bev was booked to have her tonsils removed at age six, our family doctor declared that I must have mine out at the same time – not because there was anything at all wrong with them, but because I was already 12 years old and, for some inexplicable reason, I still had my tonsils intact! (Back then, kids with tonsils were apparently an endangered species. As New York ear/nose/throat specialist Dr. Steven Parkdescribed the historical take on tonsils: “In the 50s to 70s, it was a given that if you had tonsils, they were removed.”)
On our designated procedure date, Bev and I were admitted to the pediatric ward at St. Catharines’ Hotel Dieu Hospital together. I remember this experience vividly because the archaic rule at the Hotel Dieu back then was that all pediatric patients had to wear diapers overnight. DIAPERS! As a humiliated almost-teenager, I pleaded with my mother to convince the ward nurses that I most certainly did NOT need to wear diapers at my mature age! But rules were rules, and I somehow managed to survive both an unwarranted surgical procedure and its associated diaper humiliation.
It turns out I wasn’t the only person questioning the wisdom of taking out a perfectly fine pair of tonsils based on flimsy if any medical evidence. Decades later, many researchers – including in this U.K. study published in the journal Archives of Disease in Childhood (1) – blamed not only the physicians who recommended the routine surgical removal of tonsils (and often adenoid glands at the same time) to treat childhood sore throat, but also “parental enthusiasm” as the factors influencing an entire generation of higher-than-necessary rates of surgery.
“Despite the enthusiasm with which tonsillectomy is offered and sought, there is little evidence of efficacy.”
I like this tonsil analogy to illustrate how medical attitudes, no matter how pervasive, can indeed change over time as our physicians rethink the status quo in order to embrace evidence-based medicine.
“Physicians, get out your prescription pads and prescribe this book to every one of your heart patients. This encouraging, common sense and easy-to-read book deserves to be in the hands of all freshly-diagnosed heart patients and those who love them.”
That’s the little blurb I wrote for Oregon cardiologist Dr. James Beckerman’s new book,Heart To Start.* As explained in last week’s book excerpt published here, Dr. B believes that heart disease is essentially a sitting disease. To rally against that, he embraces a profound belief that “exercise is medicine” – and this is especially important for all of us heart patients. In fact, he believes that physical exercise is the least prescribed yet most effective heart treatment. Far too many of us, however, get little or no regular physical activity – particularly while recuperating from a cardiac event – and instead insist on doing something that just might be dangerous to our health: we sit.
But Dr. Beckerman believes that what we most need to do is to move more. We were “born to walk”, he reminds us. And even if we weren’t born to walk, we sure weren’t born to be sitting around all day. Continue reading “Were you “born to walk”?”→
It’s not about your cholesterol numbers, and it’s not even about big fat blockages clogging up your coronary arteries. Did you know that inflammation is likely the culprit in most heart attacks? As cardiologist Dr. John Mandrola neatly describes it:
“Heart disease is about inflammation. The same mechanisms that cause the throat to swell from an infection, the skin to redden after an insect bite, and a scar to form after a cut are what cause heart problems.”
When I gently scolded Kentucky cardiologist Dr. John Mandrola recently over his cheeky criticism of diet soda (he’s a bike racer, what can I say?), we began a subsequent exchange of emails that led me to his blog. There I found the simplest, clearest explanation of heart disease that I have yet discovered – particularly on the role that inflammation plays in causing our cardiac events. With the permission of this cardiac electrophysiologist (thanks, Dr. John), I’m reprinting his essay here, including his Primary Prevention Strategies, or “what regular people call healthy living”: Continue reading “Do you know what causes heart disease?”→