cardiac disease

Are your Bragging Rights killing you?

Personal note

A lovely relaxed long week-end with a dear friend prompted me to think about how I am dealing with my own life, as well as about my clients who are abusing their bodies in the name of busy-ness.

We had an urban staycation, with ample time to chat about our lives and the choices we are making. It was a time of great clarification; no vacation to Hawaii or another paradise could have brought as much peace and serenity to me.

Here we are, relaxing on my front porch.

Are your Bragging Rights killing you?

“I never eat lunch,” “I work 12 hours a day,” “I only get about 4 hours of sleep a night – oh, I don’t need any more; I feel just fine.” “Weekend? What’s a weekend?”

I hear these statements all the time from people whose body language and facial expressions show that they are pleased, even smug about their habits. They protest, with overly bright eyes, that they are just fine.

They have drunk the kool-aid; the flavor that tells them that bad things such as heart attacks and strokes only happen to other people – old people.

They don’t know that skipping meals leads to stress, which leads to craving all those things that are bad for you – sugar, fats, and salts. They really don’t grasp that these things are bad for you. And although they may have heard that sleep is necessary for repair of muscles, including the heart muscle, healthy functioning of the immune system, and weight & appetite control, they don’t really feel threatened by their behavior.

They may attribute their anxious or depressed moods to what’s going on in life rather than what’s going on in their bodies. When their memory suffers and they make mistakes, they believe it’s a temporary problem due to overload – which of course will be gone any day now. Only somehow it’s not.

Perhaps they don’t know that cardiac disease is the leading cause of death for both men and women, with the death rate rising for women ages 35 to 50. I recently heard a cardiologist at the Minneapolis Heart Institute remark that sleep deprivation is a greater precursor of cardiac disease than high blood pressure and diabetes – together.

In the meantime, while waiting for a surprising attack that will finally get your attention, you can be forgetful, irritable, frequently ill, and overweight. Sound like a good life to you?

What exactly is the prize that many of these health scofflaws are pursuing so vigorously? 

When you start bragging about this kind of hardiness, it’s a good idea to stop and ask yourself the following questions:

  • What did I really want when I started out on this race I now seem to be in?
In the heat of the race, it’s easy to forget what originally motivated you.
  • Is this prize any nearer now that I have worked so hard?
Sometimes it seems as if the end is farther and farther away, more and more
  • Is there another way to get to this same prize?
If what you were pursuing is the good life, maybe you could stop right now,
look around you, and enjoy what is already there.
  • Is the prize worth the price I am paying?

Missing key events in the life of your loved ones, especially growing children, is an extraordinarily high price to pay for success which may or may not be coming to you in this manner and in this place.

End of life counselors tell us that people on their deathbeds don’t sigh with satisfaction and say, “At last I got that Beamer,” or “My greatest satisfaction in life was that I got that second home on the lake.”

The Confident Introvert

“What are they afraid of?” my department manager used to ask after meetings in which a number of department members sat, silent and resentful, while he was unaware that his habit of springing surprise agenda items and asking for an immediate decision was very upsetting to these talented, educated introverts. Understanding, appreciating and utilizing the skills of introversion are foreign ideas to some – even to introverts. Now you can read about it in
The Confident Introvert.
Order now at

The Power of “Yet”

Personal note

I first wrote this article in July 15, 2011. The concept is just as true now as it was then. If we all followed this advice, our happiness would increase.

As a writer, I believe in the power of words. Words can heal and bring hope. They can also destroy hope. This week’s article is about one little word that can carry a lot of power.

The Power of “Yet”

When I had a heart attack a little over five years ago, I asked, “Why?

And my doctor told me that I had a high level of a rare form of cholesterol that sticks to itself and to artery walls like Velcro, making me three times more liable to have a heart attack than the average person. Furthermore, my doctor told me there was no medication, diet, or exercise – nothing I could do – that would lower this level. I felt nothing but despair. It sounded like a death sentence to me.

Nothing I could do? I fired the doctor. And found a new one. The new one said, “We don’t have a solution for that…yet.” What healing those three little letters brought to me! They suggested that my doctor believed:

  • Someone somewhere in the world was working on this problem;
  • There would be a solution…sometime;
  • She would be aware of that solution because she believed it was possible; and
  • She would pass that solution on to me.

My level of hope rose steadily. Today, neither my doctor nor I believe I will have another heart attack. All because of one little powerful word – “yet.” Well, not just this one word: energized by the hope this word aroused in me, I also took all kinds of action designed to lead to great health.

I then started to play with this three-letter word. For instance, what if we all started to add “yet” to our conversations with ourselves and with others:

I don’t have a job…yet.
I don’t have my dream house…yet.
I haven’t become an expert in (fill in the blank)…yet.

Moving on, I thought of:
I haven’t mastered a double Axel in figure skating…yet (ok, I’m not working too hard on this).

Feeling heady with all the possibilities, I began to soar even higher:
I don’t speak fluent French…yet.
I haven’t quite grasped quantum physics…yet.
I haven’t met the love of my life…yet.

The only time we (or anyone) can make definitive final statements about our lives is when the comment can be chiseled on our tombstones:

Never won the World Chess Tournament.
Never really got calculus.

Until then, anything is possible, but we will never know it if we are not open to the possibilities. For good ideas are like birds carrying good news, circling excitedly for a place to land, then flying away disappointed at the lack of a landing field.

Our openness to possibilities of which we haven’t even dreamed yet is what provides that landing field.

Keeping your eyes open to possibilities only works if you have hope in your heart. As the song says, “It ain’t over ‘til it’s over.”

Despair is a destroyer.

Hope is a healer.

The Confident Introvert

“What are they afraid of?” my department manager used to ask after meetings in which a number of department members sat, silent and resentful, while he was unaware that his habit of springing surprise agenda items and asking for an immediate decision was very upsetting to these talented, educated introverts. Understanding, appreciating and utilizing the skills of introversion are foreign ideas to some – even to introverts. Now you can read about it in
The Confident Introvert.
Order now at

What does confidence have to do with your heart?

Personal note

In keeping with the fact that February is National Heart Month, I am presenting another article that deals with cardiac disease.

But it does more than that; it deals with daily life and how well we live it. To be slightly (but chronically) anxious is not only dangerous to your health but also leads to a limited life in terms of pleasures and fulfillment.

So long as the heart is beating, we are alive, even if we are brain dead. But when the heart stops, all is lost. It seems to me that to be fully alive we should be dedicated to taking care of our hearts.

What does confidence have to do with your heart?7968714_s


Confident people know when to be afraid; they then take action – to run away from the saber-toothed tiger, leave the burning building, or whatever. Unconfident, or socially anxious, people, on the other hand, are wracked by numerous anxieties over what are called “paper tigers”:  fears about how they are perceived. If they speak or act, are others silently (or not so silently) going to criticize them? Do they appear foolish, awkward, unstylish…? The list goes on and on.

In fact, unconfident people fit the description of the Type A, or heart-attack prone personality, proposed by cardiologists Friedman and Rosenman: someone who is engaged in a relatively chronic struggle to obtain an unlimited number of poorly defined “things” in the shortest possible time, and if necessary, against opposition. In other words, they’re constantly fighting paper tigers.

The absurdity of this, of course, is that the events which they fear most – meeting new people, going to new events, speaking up in public – don’t call for the tremendous spurt of strength or speed that the stress response gives them. So they simply endure these events, stewing in their own chemical juices that have been released in response to what they perceive to be a threat.

Researchers in the United Kingdom evaluated ten studies of men and women enrolled in the Health Survey for England from 1994 to 2004. The data (published in the British Medical Journal), which involved more than 68,000 adults aged 35 or older, not only showed an association between psychological distress and mortality, but also showed that even mild anxiety or depression raised the overall risk of death from any cause by 29%.  The risk of death specifically from cardiac disease increased by 29%. So even the mild but chronically anxious were putting themselves at risk for serious consequences.

Therefore, it’s worthwhile to notice how often you feel attacked by paper tigers.

Whenever you feel even a little uncomfortable (and there’s no real tiger on the horizon), use the StressBuster Formula – Pause, Breathe, Choose.

Start by noticing the paper tigers, and then pausing to breathe. When you pay attention to your breathing, you are becoming aware of your body.

As you reflect, notice when the tension rises – in response to what events, key words, memories?

Where does it affect your body? That may be a clue to a chronic discomfort or illness that you are developing, because stressing your body regularly is a great way to break down physical systems.

Ask yourself, “Is there really a tiger out there?”  

People who suffer frequently from social anxiety often have more reactive nervous systems than do cooler, more confident people. If that is true of you, does that mean you’re stuck forever being intimidated by life situations and other people?   No, but it does mean that you need to take time every day to calm your mind and your body.

You can unlearn these maladaptive responses, become calmer, and learn to respond powerfully and well to real tigers.

In fact, your life may depend on it.

Be Careful, It’s Your Heart: Warning Signs of a Heart Attack

Personal note

This week’s article is a repeat of an article I do every year in February, National Heart Month.

Over the past few years, I have done countless presentations of my talk, now called “The Angina Monologue,”   during which I have not only delivered life-saving information, but I have listened, too, and gotten important information from my audiences.

If you’ve read it before, read again, and remember always to pay attention to the organ that the ancients believed was the seat of consciousness, and which we know as the center of our lives.

Be Careful, It’s Your Heart: Warning Signs of a Heart Attack

February is National Heart Month, and I have been more than ordinarily busy giving my talk, “The Angina Monologue,” in which I describe women’s heart attacks and give preventive advice.  Seeing all the “red” clothing and decorations, hearing of all the “Wear Red” events is exciting – except that cardiac disease occurs all year long, not just in February.

In fact, cardiac disease is the #1 killer of both men and women in the United States; but while the rates for men are declining, the rates for women, particularly in the age 35-54 age group, are rising.

We are surrounded by information about cardiac disease in newspapers, magazines, on the radio and on television, yet most people remain surprisingly ignorant about some of the simple facts of cardiac disease.  So I am once again providing a fuller description of the symptoms, as experienced by real people I have known, including myself.

The “Hollywood Heart Attack,” where the character, clutching his chest,heart slumps to the floor immediately, does sometimes happen.  But many heart attacks do not mimic this model.  In particular, women’s symptoms of heart attack may be very different from men’s in both quality and severity.

(Note:  since first writing this article, I have heard from  some audience members that their husbands also displayed these subtle symptoms, and never progressed to the more typical male symptoms.  Luckily, they paid attention and got help. But, I do think that women are more likely to have these subtle symptoms. No one should overlook them, however.)

It can be too easy to brush these more subtle symptoms aside; as one woman in my cardiac support group said, “Compared to childbirth, this is nothing!”  But of course, they are something.  And the sooner you pay attention and get help, the better the outcome.

Because I paid attention to a small signal, and took action immediately, I have almost no heart damage and was able to return to a full life immediately.

So I’m going to provide some descriptions here that might give women a clearer picture of what to look for.

Chest discomfort:

Men typically experience crushing chest pain and pain radiating down one arm.  Some women do also, but many women do not. I only experienced one second of pressure in the middle of my chest, accompanied by a complete lack of breath – once again for one second only.  Luckily, I paid attention.

Another woman I know reports that she felt as if her chest were on fire.

Any pressure, squeezing or burning in the center of the chest that lasts for more than a few minutes or comes and goes is a warning sign.

Upper body discomfort in one or both arms, back, neck, jaw or stomach:

One woman I knew had pain in her jaw; another was awakened in the middle of the night by very painful elbows, which she fortunately recognized as being related to her heart.  Others tell of pain in the neck, the shoulder or across the shoulder blades.

At a talk I gave recently, a woman told me of a pain in her jaw.  She had been checked for both a dental problem and a tempero-mandibular joint problem, but no evidence of either had been found.  Should she see a cardiologist, she asked?  I almost shouted, “Yes!”

Any pain in the upper body that can’t be explained should be suspect and you should take action.  See a cardiologist; if the pain is marked or persistent, dial 9-1-1 and go to the ER.

Shortness of breath, with or without chest discomfort:

Once again, when there is no rational explanation, such as allergy problems or just having run up a flight of stairs, you should be suspicious of shortness of breath.

Dizziness, lightheadedness or fainting, nausea and vomiting, cold sweats:

I began to experience nausea and lightheadedness a few days after my experience with pressure (I had already seen a doctor, who found nothing wrong with me). It could have been a virus, but I had no temperature. Taking your temperature is a good idea before you decide it is a virus and dismiss the idea of a heart attack.

After I got to the hospital, I began to experience severe gastric distress, a little like the commercials for acid reflux disease, with figurative nuts and bolts revolving around in my stomach!  A doctor asked me, in fact, if I did have acid reflex disease, and when I said no, it was another factor on which they decided to do angioplasty (go in and see if there was blockage).

I know of a young woman athlete who began to faint after she finished races.  She, in fact, had an undiagnosed congenital defect of a heart valve for which she needed surgery.

So, once again, if there isn’t a good explanation for the symptom, seek help.

Feelings of anxiety, fatigue or weakness — unexplained or on exertion:

I have met at least one woman heart patient who tells of being overwhelmed by inexplicable anxiety as her major symptom. Once again, there was no precipitating event in her life, so it was a very suspicious episode.

The extreme fatigue that a heart attack sufferer experiences is like having a hole in your “fuel tank” from which all the energy has drained out.  One woman I know told me that she was so tired she lay down on her bed, and, feeling cold, wanted to pull the covers up but she couldn’t because it was too much effort.  That was when she realized she needed to get to a hospital.

Take Action

There is an e-mail that keeps circulating on the internet, with advice about heart attacks.  Some of it is good advice: carry an aspirin and take it immediately if you believe you are having a heart attack.  In fact, crunch down on it and wash it down with a full glass of water.

But this e-mail always ends with dangerous advice: “Call and friend or relative and wait by the door,” presumably to have that person take you to the hospital.

This is the message health care providers want you to hear: Do not drive yourself or ask a friend or family member to drive you.

If you have any of the above symptoms, dial 9-1-1.  If you are having a heart attack, emergency responders can start treatment in the ambulance. This can be crucial.

Women, who are often reluctant to have a fuss made about themselves, will dial 9-1-1 in a minute if a loved one is threatened, but will not do so for themselves.

Those few minutes in which you wait for help can make all the difference in the world between life and death, or between a quality life and an impaired life.  One of the possible consequences of heart attack is loss of oxygen to the brain, causing irreversible damage.  You could survive, but only as someone very dependent on others.

The last message I like to leave women with is this:  strive to live the heart-healthy life, and you will feel better than you have in years.  Would you like to wake up every morning eager to start the day, with the kind of zest you had as a child? You can do it!  The women in my support group, cardiac survivors all, glow with health.

The path to  is the path to joy.  And who doesn’t want joy?

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