*

Saturday, April 21, 2018

Journalists should not be storytellers

Recently I read a tweet from a former editor at my local paper who is now delivering his thoughts on journalism to students at a nearby college. He tweeted that he was training young people to be storytellers. I replied: Journalists are not storytellers but reporters.

He disagreed. A story lies at the heart of what a reporter tries to convey, he tweeted. Who's right?

According to Lee Wilkins, professor and communications department chair at Wayne State University in Detroit, and faculty emeritus and curator’s teaching professor at the University of Missouri:

Journalists are not storytellers but reporters.

That said, according to Wilkins, a local government reporter before she began teaching. "When we started thinking of ourselves as storytellers was when we ran into a problem." The problem? Journalism changed from an "objective process" to one focused on "storytelling." Wilkins believes this emphasis on story over reporting entered American newsrooms in the 1980s.

Sadly, when a journalist puts the story first, all too often it means facts become subservient to the story. I can give a solid example of this but, if I do, I risk losing you. You will immediately know I am wrong because you have seen and heard the story on television, maybe on 60 Minutes, or CBC Marketplace. You have read it in your local paper and in magazines. You know the truth. You know the story. And I will have a damn near impossible time changing your mind.

The story? The threat posed by the urea formaldehyde foam insulation or UFFI was created by the media. Before you quit reading, think about this:

Source: The London Free Press, Saturday Homes Section

When homes with UFFI were tested, the homes were found, on average, to have formaldehyde levels slightly below that of home of similar age without UFFI. Also, there was no UFFI caused damage to house framing or other materials found.

Why was the true story not told until years after the damage had been done? Because stories, good stories have legs and when told by good storytellers, journalists, such stories are hard to resist. I believe it was 60 Minutes in the States that originally broke the erroneous scare story. Then CBC's Marketplace, not to be outdone, did their take on the same story. And the UFFI wildfire was lit and fanned. Newspapers across North American felt forced to run UFFI stories as well.

I covered a lot of UFFI stories and I am ashamed of the part I played in promoting that story. I met a lot of people, many seniors, who had the majority of their life savings tied up in their homes and the media was spreading a myth that was destroying the equity they had built up in their family home. All too sad. Now, there is a story. Will it displace the mythical stories? I doubt it. Marketplace is still bragging about their major contribution to the original UFFI coverage.

Marketplace is proud of the part it played in the banning of urea formaldehyde foam insulation.
As I edited this, I wondered if scare stories involving UFFI were still being printed. It took but a moment to turn up this story from the Cornwall-Standard Freeholder on "toxic spray foam insulation."

I shake my head and a feeling of shame washes over me. I had a hand in pushing this story and the story is still influencing decision making. This is despite the fact that, and this is from the Freeholder story, that "Canada is one of the only countries in the world that bans the use of UFFI . . . it (is) being used widely in many other countries including the United States."

If the reporter every decides to focus on that last sentence and explain why a "toxic" foam is only toxic in Canada, the reporter might have an award winning story and an easy one to tell.

According to CMHC, "UFFI is not a source of over-exposure to formaldehyde . . . Houses with UFFI show no higher formaldehyde levels than those without it."

So, are high levels of formaldehyde ever found in homes in Canada today? Not often but, again according to CMHC, "in new or other well-sealed houses, significant indoor formaldehyde levels may still occur (thanks to) new carpets." If the folk in the justice building are worried, maybe they should concentrate on new carpeting and not decades-old insulation.

Sunday, March 4, 2018

How not to report a story: The Current goes for false balance with negative overtones

Weight Watchers promotes healthy eating. The accent is not on weight loss.
The Current on CBC radio, featuring host Anna Maria Tremonti, recently claimed to be examining the offer of six weeks of free Weight Watchers memberships this summer to teens between the ages of 13 and 17.

It was not much of an examination. To learn more, I googled the offer, but I failed to find the original announcement. It would have been so much more professional if CBC had simply posted a link.

Weight Watchers apparently stated right up front that this offer was not about dieting and not about weight loss. No, Weight Watchers is offering to help teens develop the healthy eating habits so necessary at this time of life. And let's make one thing clear: today, this is very important. There is an serious problem with how our kids are learning to eat.

For the most part, the CBC and Anna Maria Tremonti ignored this very important and very believable claim by WW. I can understand why; there was a time that I, too, believed Weight Watchers was just a dieting program, using dieting in the sense of a weight loss program.

Then, in 2010 I had a heart event that changed my life forever. I suffered a V-tach event, my heart went into overdrive hitting 300 beats per minute and I was rushed to the hospital. There, doctors placed defibrillator paddles on my chest and jolted my heart back into sinus rhythm. I now have an ICD/pacemaker in my chest. ICD stands for implantable cardioverter defibrillator. If my heart rate heads for the stratosphere again, and it has, my ICD shocks it back into its proper rhythm.

Roasted Madras Curry Cauliflower with Raita
I take oodles of meds and watch my diet carefully. At one point, I weighed almost 220 pounds. Not good. My doctors told me to get my weight down. Something under 170 pounds would be fine goal.

My stroke doctor gave me a package of recipes and told me not to think of this not as a diet but as a whole new way of eating and quite possibly a better, more enjoyable, way of eating.

Coincidentally my wife was starting Weight Watchers at the same time. It was immediately clear that her diet and mine were quite similar. We embarked on the Weight Watchers approach to dining together.

We counted points, don't ask, and slowly we lost weight. It took a lot of months, more than a year, but I got down to 165 pounds and I've stayed close to this weight ever since. And this success is, in no small measure, thanks to the Weight Watchers program. We didn't feel we had to cutback on our food but instead we expanded our food choices. We learned to eat wisely and well.

Following my doctors' and Weight Watchers instructions, we have discovered  a whole new way of eating, just as promised. I wish I'd been offered this program when I was a teen. I've always loved food and I find our new approach to dining is for food lovers.

So, how did CBC handle this story. Well, the broadcaster almost immediately cut to an interview with a holistic health coach, trained at the Institute for Integrative Nutrition. And what exactly is the INN? I googled it and learned many call the online school a diploma mill.

The accusations must be awfully common as the INN defends itself by stating clearly online that they are not a scam. They point out that much of the criticism of the school is of the strawman variety. Their health coach graduates are not registered dietitians and do not claim to be. A search of the U.S. Dep't of Education database confirms the IIN is telling the truth: its graduates are not registered dietitians.

There is a story here. The Weight Watchers offer deserves examination. That said, I don't find the debate, if not manufactured by the CBC, certainly promoted by it, to be the correct angle. Journalists can do better. I know. I worked for almost four decades in the media.

This is an important matter and our public broadcaster let us down. Just today I saw an article in The Harvard Gazette: a "comprehensive national strategy (is needed) across all relevant segments of society to prevent a looming public health disaster." This was written for Americans but the problem is also prevalent in Canada. In my lifetime, obesity among the young has increased two, possibly even three fold in Canada.

The CBC should have sent reporters to numerous Weight Watcher centres across the country. They should have learned whether or not a consistent approach is going to be taken by all WW leaders. As the Harvard article points out:

We have deep knowledge of the biological drivers of obesity, which include:

  • poor diet quality
  • excessive sedentary time
  • inadequate physical activity
  • stress
  • leep deprivation
  • perinatal factors
  • and probably environmental endocrine-disrupting chemicals


What is lacking is an effective strategy to address these drivers with sufficient intensity, consistency, and persistence, according to David Ludwig, professor in Department of Nutrition at Harvard T.H. Chan School of Public Health and founding director of the Optimal Weight for Life program at Boston Children’s Hospital.

CBC had a chance to be part of the solution; they chose to be part of the problem.

Monday, January 29, 2018

Fake News (Tweets) and CBC Ontario Morning

Donald Trump likes to call the mainstream media "fake news." He's wrong but that doesn't mean the MSM can ignore his charge. Those in the media must take those words to heart and attempt to never lend any credence to Trump's accusation.

Sadly, almost all of us have had a contact with the media that went poorly. I have often met folk who have told me that a story with which they were closely associated was reported incorrectly. They may have even talked directly to the reporter behind the story. By the time the reporter condensed the story to a sound bite for television or radio, or boiled the information down to an eight-inch story in the daily paper, the story was corrupted, changed, shaded with error.

Check out this tweet from CBC Ontario Morning:

It makes the claim that giving a child "a taste" or "even a sip" of alcohol is "not a good idea." It is important to note the shortness of this tweet. No attempt has been made to convey the complexities of the story.

This is a story that has been reported in the past and sometimes it has been reported very poorly. That said, let's cut right to the chase.

New Orleans magazine reported on this story. Allow me to quote a paragraph from that article.


“First sipping isn’t an early indicator of issues that would be of concern to parents,” wrote one of the psychologists in an August 2014 press release about an updated look at the same group of children. They showed that taking the first sip before age 12 correlated with a family’s permissiveness towards alcohol rather than predicting that a child was slated for abuse problems in young adulthood. There is no evidence that earlier sippers have more alcohol dependence, delinquent behavior, marijuana smoking, misuse of other illicit drugs, risky sexual behavior, car crashes or interruption of planned schooling than the late sippers."

If you want to stop reading now, you can. But, for those who want to read more, please, read on as I take a look at what some of the studies actually say:

For instance: adolescents who have consumed at least a full glass of alcohol or more are significantly different from adolescents who have simply had a sip of alcohol. And one might ask what the researchers define as a sip. But the important point is that adolescents benefiting from greater parental discipline, living with better rule enforcement and more comprehensive monitoring and enjoying positive family relations are less likely to have consumed a full glass of alcohol. 

And just how extensive is the problem of children consuming full glasses of wine, similar what is shown in the picture accompanying the tweet? According to the studies I found, it is not as extensive as we might expect. Many children consume no alcohol at all: almost 40% at 11 years of age have never tried alcohol and almost 60% have had only a sip or less. The little girl shown represents a little more than 2% of 11 year olds. If she is less than 11, she represents an even smaller proportion of children from her age group. Perhaps we should pity the little girl pictured. She appears to need improved parental monitoring. Going by the studies that I have found, there is a good chance her parents are not even aware she is engaging in a toast.

Screen grab: story discusses taking an early sip of alcohol.
So, if sipping, and only sipping, has not been implicated in future dangerous behaviour, why are we even discussing sipping. The answer is simple: the children who have had only a sip of alcohol and those who have had a full glass or more, have been combined in some reports into a single category. The whole issue has been muddied.

It appears there may be only one study explicitly investigating sipping of wine and beer in early adolesecence and that is Children’s Introduction to Alcohol Use: Sips and Tastes. And what was the conclusion of this study?

A young child’s sipping/tasting of alcohol . . . appears NOT to be an early indicator of the likelihood of future problem behavior.

It actually appears that parents are doing a fine job of keep alcohol away from their kids. There may well be no problem here. Most children only get to sip alcohol but once or twice, implying that this was opportunistic behavior rather than an attempt by parents to introduce their children’s to alcohol use. It may not be the sip that is the problem but the parental attitude.

Bolstering this interpretation is this fact: fully a third of the mothers and over half of the fathers did not even know that their child had ever had a sip or a taste of alcohol. Most sippers either sneaked their solitary sip when their parents were not watching or were given the single sip on the sly by someone such as an older brother or sister.

The public deserves better than this tweet. Our media must take advantage of every one of the 280 characters Twitter tweets offer. Teenage abuse of alcohol is a problem. The link between a young child having had a taste or a sip and having problems as a teen with alcohol is a link that researchers are still disputing.

Lastly, here is a link to the Lancet article that has been causing the recent stir. Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study.

The Lancet article has a lot of negative things to say about parents supplying drinks to their children and this should come as no surprise. What is interesting is that the article reports under "Findings":

"Parental supply of alcohol was not significantly associated with the odds of reporting symptoms of either alcohol abuse or dependence, compared with no supply from any source."

I have to admit, I found the above statement out of place in the context of the Lancet article considered in its entirety. Putting all the info together is the job of the media, the job of the journalist. Sadly, all too often, the media handles complexity very poorly. (I would guess that Ontario Morning did not spend a number of days, possibly weeks, putting together their take on the research into underage drinking. It's an interesting story and I bet that it was sent to air as quickly as possible.)

Maybe in a future broadcast, Ontario Morning can investigate the role of the media in underage drinking. Yes, in researching this post I came across research claiming the depiction of alcohol in movies, on television and in social media can be linked to early alcohol abuse. This sounds like a great scare story. 

I can see the tweet now: "Let your child watch CBC dramas? We reveal why this is not a good idea, not even a glimpse. Research shows it could lead to alcohol abuse."

The above is a screen grab from the Huffington Post, Australian Edition.

Tuesday, November 28, 2017

Out of 11 Countries Surveyed, U.S. Seniors the Most Likely to be Both Sick and Unable to Afford Care


Despite Medicare coverage, older adults in the United States are sicker than those in other countries and face more financial barriers to health care. Note: When it comes to the problem of high cost preventing access to treatment, Canada rates 6th out of 11 countries surveyed. The U.S. is last by a good margin.

Read more: Commonwealth Fund 2017 International Health Policy Seniors Survey

Monday, November 27, 2017

VW Jetta TDI buyback completed and VW made an I'm-sorry-payment, as well.

 Before going on, let's cut right to the chase. Here are the figures most folk are seeking.
______________________________________________________________________

Important Numbers: VW Jetta TSI Wolfsburg Edition: as of June 11, 2018

  • Fuel cost per km: .10 cents (Canada, southwestern Ontario)
  • Total cost to run car per km: $0.78*
  • Fuel consumption: 8.66 litres/100 kms
Present distance traveled: 6495 kms
Fuel used: 562.577 litres
Fuel cost: $657.91
Total out-of-pocket expenses: $5084.76*
(* The above includes car payments, fuel costs, all maintenance charges, car washes, parking, etc.)
* Will change over time as distance traveled increases.
______________________________________________________________________

Now, to my original post...

It's gone. VW has repurchased my 2011 VW Jetta TDI. Plus, the German automobile maker paid me a cash penalty to make amends for their TDI sins. All in all, I got $16,700. I put it all into the purchase of a 2017 VW Jetta Wolfsburg Edition TSI.

Fuel economy: 5.74 litres/100 kms at 2084 kms.
My new car comes complete with Wolfsburg Edition badges on the sides, a TSI badge on the rear of the trunk lid and a TSI four-cylinder engine under the hood. TSI stands for turbocharged stratified injection. This is a technically sophisticated 1.4 litre turbocharged direct injection engine. VW claims it is state-of-the-art engineering. Hmmm. I recall similar claims when I bought my TDI clean diesel.

So, let's cut to the chase. What was the total out-of-pocket cost to put a Wolfsburg VW in my garage and send the oil-burner packing? The short answer: $2500. That's it. And what will it cost to keep it there? That's a good question. For a start, as a gasoline tends to cost more than diesel in London, I expect my fuel bill to grow. As well, I now have a monthly $139.44 car payment for the next 84 months. This payment also includes an extended warranty option. No unforeseen charges for the life of the car.

Originally, I had agreed to an interest rate of .99% with a shorter payback period. But, when the deal was finalized the interest rate rate had fallen to zero. I decided to keep my money in the bank where it can earn some interest in a ScotiaBank Momentum account. I can see no advantage in tying up cash to purchase this car.

What are my first impressions of my new Jetta? Good but then I liked my old Jetta. The two cars are very similar. Where there is a difference, often I see little advantage in the new vs. the old. For instance, I can see no great advantage to the keyless door lock system. And there are some dangers. See: Deadly Convenience: Keyless Cars and Their Carbon Monoxide Toll.

My new radio seems to have possible safety issues as well. It encourages a driver to play with the touch-control screen rather than paying complete attention to the road. To change the sound system volume, a set of controls can be found on the steering wheel. This encourages more gadget fiddling. If the government thinks cell phones are bad, they should take a look at radios like this one in my new Jetta.

Professor David Strayer, at the University of Utah, found in-vehicle information systems — including SatNav, MP3 players, radios, cellphones and messaging devices — take drivers’ attention off the road for too long to be safe, much like texting.

In the following weeks and months, I'll keep my readers posted as to the total cost to keep my VW Jetta on the road. (If you notice anything amiss, feel free to question my figures. I can make errors. I'm not perfect.)

Paint and Clear Coat Warning

If you own, or are buying a VW, pay careful attention to the paint. Mine is terrible. I knew I had a problem right from the moment my wife and I picked up the car. It was almost a day late in being delivered as it took a lot of effort by the dealer to get my new car into ready-for-delivery condition.


Swirls, holograms and oxidation mar surface of my new VW.
The paint has swirls in the finish, left, I assume, by the power buffer used to quickly detail the car before delivery. I thought I could polish these out in the spring. It is now spring and I'm finding removing these difficult.

But there's more. The top of the rear bumper has faulty paint. It looks like there are dried water marks etched into the surface. It won't wash off. I'm worried it may be oxidization.

And it gets worse. There are small, pinhead sized spots that I thought were rust appearing on the lower, passenger-side door. I took the car to a local paint shop for an evaluation. The owner said it was the worst detailing of a new car that he had ever seen. He noted swirls in the paint from the front bumper to the back, plus hundreds of ugly, dull spots in the surface of the paint. On the bright side he said the rust was not rust but large, flecks of dirt deeply embedded into the paint finish. I told him that VW had sent me a block of clay for detailing the car. He said he had never heard of a car manufacturer doing this. Very odd.

Insurance

When I got the auto insurance bill for my new car, I was in for a pleasant surprise. My annual insurance bill went down $86.00. This left a December insurance installment of $272.50.
_____________________________________________________________________________

I have opened a spread sheet for tracking and calculating all costs. This is far easier and more accurate than trying to do it with pencil and paper as I was doing. The latest numbers are at the top of the post.

Saturday, October 21, 2017

CBC Marketplace and Busting Superfoods


Superfood: a term too good to be true? I thought so. I never bought into the hype. But I guess some folks do and CBC Marketplace set out to burst their bubble: Busting Superfoods.

For the most part, it seemed to be a good show but there were statements that I questioned and not because I am a believer in superfoods. For instance, the program presented a Canadian alternative to some superfood. And what was the alternative: the potato.

I was once a big booster of the potato. Hey, the Irish apparently got by quite nicely on potatoes until the potato famine struck. The lesson seemed to be: oodles of potatoes good, no potatoes, or anything else for that matter, bad.

Well, I was wrong. Oodles of potatoes are not good. One should have a balanced diet. No surprise here. But, and here comes the surprise, potatoes do not necessarily make up a large portion of a correctly balanced diet.

Read this article from the Harvard T. H. Chan School of Public Health: The problem with potatoes.

The article, to which I linked, warns "a cup of potatoes has a similar effect on blood sugar as a can of cola or a handful of jelly beans." This is something that I've been told during my visits to various doctors related to my fight against heart disease. Go easy on the potatoes, I'm told.

I'm 70. My body does not need more stress and potatoes, especially a good helping of potatoes without the skins, could put my body under stress as it struggles to cope with the resulting surge in blood sugar level.

So, do I avoid potatoes? No. Potatoes, especially with the skins, are a good source of potassium, vitamin C, fibre and magnesium, plus potatoes are low in fat and inexpensive. Just go lightly on the full fat sour cream and pats of butter. Berkeley Wellness, University of California, has a good article looking at the positive side of the potato debate: Don't Drop the Potato.

CBC Marketplace, like potatoes, not bad, but not super either.

Sunday, September 24, 2017

Does the Watchman LAA closure device offer a new approach to fighting strokes?

Remember, I am just a heart patient sharing his story, plus some info gathered during my recent medical treatment. I am NOT providing medical advice. Talk with your doctor if you find anything here of interest. Cheers! 

When I first posted this, I was slated to have a Watchman left atrial appendage (LAA) closure device implanted. To prepare for this heart procedure, I had a transesophageal echocardiogram (TEE) performed last Friday. The doctors discovered my LAA has already been modified. It has been surgically "obliterated." Clearly, I am no longer a candidate for a Watchman. It is impossible to insert the device into my surgically modified LAA.

I was the first person in Canada to have a leaking mitral valve repaired with the aid of a DaVinci robot. I now know that my surgeon not only repaired my valve but, at the same time, he "obliterated" my LAA as well. This was done in the belief that modifying the LAA would lesson my chances of having a stroke caused by a blood clot originating in the left atrial appendage. Up to 90% of blood clots originating from the heart form in the LAA to be exact..

I was facing LAA closure to lessen my chance of suffering more transient ischemic attacks (TIAs). Over the last few years, I have suffered a lot of TIAs, also known as mini-strokes. I take Pradaxa, an anticoagulant, plus Aspirin, an antiplatelet drug. This dual drug approach has worked wonderfully at preventimg serious blood clot related problems. I must compliment my doctor at the Stroke Prevention & Atherosclerosis Research Centre (SPARC).

So, if my drug therapy is working so well, why implant a Watchman, a foreign object, in my heart? Because I also suffer from cerebral microbleeds (MBs). These are small, bleeding areas in the brain that raise the risk of hemorrhagic stroke. And a hemorrhagic brain event in the presence of an anticoagulant is fatal in many cases. For this reason, all my doctors agree: stopping my anticoagualant therapy must be a goal.

After a lot of consultation among my many specialists, if was decided to put the Watchman Left Atrial Appendage closure device into my heart. A lot of risks and benefits were weighed and everyone was unanimous in approving the Watchman. Now, that route is closed. Here is an interesting link: Summing up the current data, LAA occlusion is a very promising treatment to prevent AF-related strokes due to its safety, cost-effectiveness and therapeutic success.

Discovering that my appendage has been "obliterated" raises a big question: Why am I having so many TIAs if the surgical alteration of my LAA lowered my risk? One answer: my surgical closure may not have been 100% successful. Many now believe that incomplete LAA closure can actually increase the risk of clots forming in the heart, in what remains of the LAA. And how often do surgical closures fail? Answer: In some studies the failure rate has hit 80%. The LAA has proven to be a tough beast to tame. Read: Incomplete surgical ligation of the left atrial appendage—time for a new look at an old problem.

Am I worried? Surprisingly, no. I have gone years suffering numerous TIAs and have not had one full-blown stroke. Maybe the attempted "obliteration" of my LAA has had some beneficial affect. I think it is impossible to say anything for certain. It's Christmas and I'm going to go with an upbeat view.

Problems are the price you pay for progress.”—Wesley Branch Rickey


_______________________________________________________________________

The following is my original post, written before I learned I would have a Watchman implanted and then learned I wouldn't, and couldn't, have one implanted.



I have TIAs. TIA stands for Transient Ischemic Attack. And what, you may ask, is that? Let's just call a TIA a mini-stroke and leave it at that.

My attacks usually last less than five minutes and do not amount to much, at least not individually. But, if one has enough TIAs, the damage can be additive. I have suffered minor memory loss as a result of my numerous mini-strokes. 

Having a TIA can be frightening, and rightly so. One particular attack, called an amaurosis fugax, leaves one or both eyes blind or partially blind for a number of minutes. Although there is usually no permanent brain damage, the blindness is temporary, such an event can be a precursor to a full-blown, life-altering, stroke. I've had close to a dozen of these dramatic, visual events.

TIAs and strokes are often caused by small blood clots, formed in the heart, traveling to the brain and lodging there. These small clots can block the blood flow to the brain. With TIAs the clot is unstable and quickly disintegrates. Blood flow is soon restored. With a brain-damaging stroke, the clot does not break-up and medical attention is needed immediately to prevent permanent brain damage.

Attempting to prevent the formation of these small blood clots is the usual response to frequent TIAs. This can mean taking an anti-coagulant for life. This, of course, comes with its own host of associated risks. 

And ironically, one of the increased risks from taking anti-coagulants can be a type of stroke - a hemorrhagic stroke. A stroke resulting from bleeding in the brain: a hemorrhage.

I take Pradaxa, one of the newer anti-coagulants. Many people rely on warfarin. That's right, the chemical used in rat poison.

I am not an ideal candidate for Pradaxa, or any anticoagulant, as I have micro-bleeding in the brain. I live with threats from both types of strokes mentioned previously. 

Now, there is a new approach to fighting the blood clots that have traveled from my heart to my brain and caused my TIAs. It's a surgical solution but minimally invasive. I learned about this new method of combating TIAs, in cases such as mine, from one of my doctors at the London Health Sciences Centre.

Because I have micro-bleeding in the brain, I am not a great candidate for anti-coagulants. That's why I don't take warfarin, also known as Coumadin. Pradaxa is not as prone to causing a hemorrhagic stroke as warfarin but, that said, there is still an increased risk of bleeding. Not good. And, of the two types of stroke, hemorrhagic strokes are more often fatal and, if one survives, the lasting damage more severe.

Why do some hearts generate clots and not others? Often the answer is atrial fibrillation or AFib. Some hearts, the ones producing clots, often have a quivering, irregular heartbeat. The blood tends to pool and swirl inside the heart before being pumped out to the body. This pooling and swirling in the heart encourages the formation of blood clots.

It is now believe the clots coming from the heart are originating, for the most part, in a small sack on the left side of the heart known as the left atrial appendage (LAA). Blood gets into the small sack and remains trapped there long enough for small but dangerous clots to form. These clots eventually leave the LAA to be pumped out of the heart and to the brain where they may cause a TIA or stroke.

If this theory is right, and there appears to be good reason to believe it is, then preventing blood from collecting in the LAA appears to be a partial answer. 

Some cardiac surgeons are now plugging the LAA with a small closure device. There are a number of competing implants, among them is the Watchman from Boston Scientific Corporation.

This is what the FDA, U.S. Food and Drug Administration, has to say:

The Watchman LAA Closure Device is permanently implanted in the left atrial appendage (LAA) of the heart to prevent LAA blood clots from entering the bloodstream and potentially causing a stroke.

The cardiac-surgeon inserts the delivery catheter into the body through a vein in the leg. The catheter is threaded through the body until it reaches the right atrium of the heart. The physician makes a small hole through the wall between the two upper chambers of the heart (atrial septum) so the catheter can reach the LAA. The physician then pushes the device through the delivery catheter into the LAA where it opens up like an umbrella and is permanently implanted. Once in place, a thin layer of tissue grows over it in about 45 days.

The FDA notes that the device is used in patients who have atrial fibrillation, AFib, that is not related to heart valve disease.

Some time after the insertion of the device,  a patient may be taken off the riskiest anti-coagulants. This action should cut the patient's risk of having a hemorrhagic stroke. I believe this is the big benefit from having an LAA closure device implanted.

I understand that even with the Watchman implanted, taking baby Aspirin, ASA in Canada, may be necessary for the rest of the patient's life. ASA is a far less risky drug than warfarin, Pradaxa, Xarelto and the other common anti-coagulants. And it is far less costly. My Pradaxa therapy is not cheap. Taking sophisticated drugs for life can be awfully expensive.

Will I have a Watchman or similar device inserted in my LAA? I don't know. The idea has been raised and my doctors are in consultation. I would not be surprised to have this new solution to AFib caused TIAs and strokes applied in my case. The Watchman is not a perfect solution. One can still suffer a stroke from a clot originating in another part of the heart. The Watchman only stops the clots coming from the LAA.

As I have made clear, the use of anticoagulants is contraindicated in folk like me. For that reason, the Watchman looks good despite its shortcomings.

I was the first person in Canada to have a failed mitral valve repaired robotically using the da Vinci system, and I was one of the first patients to benefit from the use of the experimental T7 MRI unit at LHSC. I've had good luck with new procedures in the past.

As I learn more, I'll repost or add to this post. Cheers!

Let me end with this final video. If you have AFib but are not an ideal candidate for anticoagulants, for whatever reason, you might find the following video interesting. Talk with you cardiologist.

Remember, I am just a heart patient sharing his story. This is NOT medical advice. Cheers!