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Monday, April 14, 2014

Can arterial plaque build-up be halted? Reversed? Maybe.


In keeping with my doctor's orders, I am now eating meat every other day. Red meat will only hit my plate once a month, if that. Fish is about to play a big role in my diet and chicken and turkey will fill in the remaining holes in my menus.

It sounds extreme, at least it did to me but it isn't. According to an article in the Huffington Post, President Bill Clinton is now on on a plant-based diet. He has cut all meat from his diet, except for the occasional fish, as well as dairy. Clinton told CNN that he lives on "beans, legumes, vegetables, fruit."

My doctor, Dr. J. David Spence, made no wild promises to me but he is clearly trying to arrest the build-up of plaque that is taking place in my arteries. He is confident the Mediterranean diet he recommends will be part of the answer. Dr. Spence is not alone in his thinking, there are many in the medical profession who agree with my London, Ontario, doctor. They all believe a plant-based diet can help put the brakes on the insidious growth of arterial plaque.

In the United States, Dr. Dean Ornish and Dr. Caldwell Esselstyn are two doctors gaining fame for the plant-based diets they promote. I believe, Bill Clinton is following Dr. Ornish's dietary advice. Another doctor publicizing a plant-based diet, this one with a bit of a twist, is Dr. Joel Fuhrman.

Dr. Fuhrman has gone so far as to write a cookbook, Eat to  Live, making the claim on the cover that inside are 200 recipes for "reversing disease." My doctor, Dr. Spence, has also written a book, How to Prevent Your Stroke. Dr. Spence makes it clear that although diet plays a major role in fighting stroke, once one is suffering from TIAs (mini-strokes) and has measurable amounts of plaque collecting in the arteries, a change in diet is not the compete answer.

Today doctors have a growing number of weapons in their arsenal for fighting stroke. But stroke research is showing that long before someone at risk sees a doctor, there are actions they could have taken on their own to cut their risk.

  • Don't smoke
  • Don't drink (to excess)
  • Exercise daily
  • If overweight, lose it
  • Adopt a healthy diet to keep the weight off

I have never smoked. I have one 5 oz. glass of wine with dinner. But until recently, I didn't exercise enough, I was clearly overweight and that was partially because my diet was in need of a major overhaul. Would a better diet have kept my arteries free of plaque? Maybe.

According to a Harvard Medical School publication, "Visceral fat is directly linked with higher total cholesterol and LDL (bad) cholesterol, lower HDL (good) cholesterol . . . " And what would have kept that fat at bay? The Harvard publication says exercise and diet.

Pay attention to portion size, and emphasize complex carbohydrates (fruits, vegetables, and whole grains) and lean protein over simple carbohydrates such as white bread, refined-grain pasta, and sugary drinks. Replacing saturated fats and trans fats with polyunsaturated fats can also help.

In keeping with my new approach to eating, tonight I prepared curried vegetables on a bed of rice for dinner. The rice was white because, at the moment, all we have in our pantry is Indian basmati rice. As soon as this is gone, we will be switching to brown rice. It has a nice nutty flavour and I will make the switch with no fuss.

Recipe
  • I put three teaspoons of extra virgin olive oil in a large, deep frying pan.
  • I heated the oil for about 30 seconds and then added two teaspoons of mild curry and swirled the heating mixture around in the bottom of the pan. The next time I make this I will add three teaspoons of mild curry to give this dish a little extra pop.
  • When the aroma of the heated curry could be clearly noted, I added two chopped onions and two diced garlic cloves to the oil.
  • When the onions began to turn translucent, I added 10 oz. of cauliflowers florets and let the cauliflower absorb lots of the flavour of the curry.
  • After a couple of minutes I added a 28 oz. can of diced tomatoes, 18 oz. of salt reduced chicken stock, four peeled, sliced carrots, a sliced zucchini about 8 oz. in size and one  medium sized potato cubed.
  • I let the whole concoction simmer for about fifteen minutes.
  • I added 8 oz. of sliced green beans, a 14 oz. can of chick peas and a small container of heritage cherry tomatoes which had been halved or quartered.
  • I ground a little pepper on top and sprinkled some salt onto the bubbling mix and left all to gently simmer.
  • Another fifteen minutes and the curried vegetables were ready to be spooned onto a bed of rice along with a little of the light sauce.

Was it good? Honestly, it needed a little more punch. As I said earlier, next time I'll add a third teaspoon of mild curry. The chicken stock I used was low in both sodium and fat but the next time I make this I will experiment with low salt vegetable stock, and I will keep an eye on the salt I add. Many of us consume too much salt.

So, was it healthy? Yes! It was a good choice for a meatless Monday. Will eating like this stop the build-up of plaque in my arteries from continuing? I can't say for sure but I have my fingers crossed and my spare tire on notice.

Treasures



For my 4-year-old granddaughter the world is a wonderful place filled with treasures. She has a little pink tricycle she calls her scooter. At the back there is a small tray — the trunk. Whenever we go to the park, the short journey is stretched by frequent stops to investigate a treasure.

The crabapple tree in front of my home is the source of many treasures. In the spring, the tree is covered with small, pink flowers attracting dozens of bumblebees bees at any one time. She stops, I hold her high and she picks the pretty, little flowers. Treasures.

The flowers disappear, leaving the ground littered with pink petals, more treasures. Soon little green apples replace the flowers and grown in size and number throughout the summer. By fall the boughs hang low with the weight of the fruit. The tree emits a low, steady hum, the result of hundreds of yellow jackets attracted by the fragrant, juice-filled fruit.

My granddaughter will stop her scooter and I will hold her high in order to pick the biggest, roundest, reddest apples. The ones undamaged by the wasps. She is careful not to bother the buzzing, yellow and black striped insects which appear to understand that we are not a threat. There are enough apples, enough treasures, for all.

Of course, a crabapple tree is not the only treasure to be found. I have two, small, smooth, flat, oval stones discovered by Fiona. They too are treasures and she gave them to me. I treasure them. I will make one into a broach, encircling it with a decorative band of silver. It will be a treasure for all forever.

What I find amazing, startling, even a little sad, is that as we grow older, as we mature, we don't see more treasures in our world but less. Fiona has opened my eyes to the treasures in my world and for this I thank her. I believe I can say, and most would agree, Fiona herself is a little treasure.

Sunday, April 13, 2014

The Mediterranean diet is part of the answer

There is a misconception, often spread in the media, that dietary fats are no longer linked to cardiovascular disease. I have heard folks admit to great confusion when it comes to the question of diet as a result of all the conflicting stories boldly featured in the media.

One week it is reported doctors are claiming fat is bad for you and then the very next week, or so it seems, the reports flip, reporting dietary fat is of no consequence. The heart-disease-and-dietary-fat story flip flops in the media as often as a fish out of water.

According to one of my London, Ontario, doctors, J. David Spence, "Patients at risk of cardiovascular disease should limit their intake of cholesterol." Period. For Spence, this is not debatable. The well respected doctor and his co-researchers are certain that "Despite widespread belief to the contrary, it is simply not true that dietary cholesterol is harmless."

Instead of reading newspaper reports, I would suggest reading "Dietary cholesterol and egg yolks: Not for patients at risk of vascular disease." This report can be found in Pulse: The Canadian Journal of Cardiology and found posted online by the U.S. National Library of Medicine.

This report states, "A widespread misconception has been developing among the Canadian public and among physicians. It is increasingly believed that consumption of dietary cholesterol and egg yolks is harmless. There are good reasons for long-standing recommendations that dietary cholesterol should be limited to less than 200 mg/day; a single large egg yolk contains approximately 275 mg of cholesterol (more than a day’s worth of cholesterol)."

The report blames the confusing media stories on "the remarkable effectiveness of the sustained propaganda campaign of the egg producers' lobby. . . . In the past year, two studies funded by egg marketing agencies led to media reports promoting the benefits of eggs." Although Spence et al. agree egg white is a valuable source of high-quality protein, egg yolk, on the other hand, should not be eaten indiscriminately.

If eggs are bad, what about butter? I've had friends say that they once ate margarine for health reasons but have now switched back to butter. They honestly believe the fat in butter is superior to the fat used to produce soft margarine. Despite the media stories, this isn't the case.

One friend loves to say margarine is made from petroleum products, oil sands oil. It's plastic he says and he makes these false claims in front of his young granddaughter. This is a pointless urban legend according to Melissa Wdowik, a nutrition specialist at Colorado State University.

As a man battling arteriosclerosis, I shake my head. People are ignorant about the true position of most doctors when it comes to dietary fat. I lay the blame for this squarely on the media. Take this headline from the Daily Mail in Britain. "At last, the truth: Butter is GOOD for you - and margarine is chemical gunk" The story claims the public has been conned by profit-grabbing manufacturers ignoring decades of scientific evidence in order to peddle their tubs of margarine.

I'd list more links to media stories but I'll let you do the googling. You will be swamped. But approach this search by looking for university supported data rather than media stories. If you do this, you will learn that soft, non-hydrogenated margarine is best -- but like any fat that is being used as spread, it must be used sparingly.

Life is complicated and the media hates a complicated story. No one would dispute the fact that fat is essential in our diets. Medical researchers are concerned with both the total amount of fat in our diets and the type of fat. The recommendation is to avoid trans fats completely. This bans hard margarine from our diets

After eliminating trans fats, one should choose unsaturated fats over saturated ones. This cuts butter from our diets and severely restricts consumption of red meats. According to the American Heart Association, "In general, red meats (beef, pork and lamb) have more cholesterol and saturated (bad) fat than chicken and fish.

I like the attitude of Dr. J. David Spence. I first met Spence while covering a medical story for the local paper. I met Spence again recently when he sat down with my wife and me to discuss the plaque discovered in the arteries leading to my brain.

Dr. Spence laid out a battle plan for us to follow in fighting my increasing stroke risk. I don't want to give anyone the idea that the only weapon in our arsenal is a change in diet. Diet is but one arrow in a large and growing guiver. But, an improved diet, with the accompanying loss of excess weight will play an important role in the coming fight. I quote from Dr. Spence's book: How to Prevent Your Stroke.

"I encourage people to take a positive attitude, thinking of their meatless day every other day not as their punishment day but as their gourmet cooking-class day. You can learn to make chili, pasta, stir-fries, barbecued vegetables, and other dishes without meat, and to make them delicious not with butter and cheese, but with herbs, spices, onions, green peppers, lemon juice, balsamic vinegar, and so on."

The doctor swayed me. My wife and I are going to try the Mediterranean diet made famous by the cooks on the Isle of Crete. Before we head off for Chapters to find a Med-diet cookbook, I'm going to check out the foodie recipes posted by Elena Paravantes on her website "Olive Tomato." But my first foray into Mediterranean cooking will be one of recipes given to me and my wife by Dr. Spence. Stay tuned.


My first attempt at Mediterranean cooking, delicious on a bed of brown rice.

Friday, April 11, 2014

C'est la vie or caught between a rock and a hard place

A risky but bold work of art by Fiona, age 4. One cannot escape risk.

Wednesday my wife and I met with a doctor, an expert in stroke treatment. He is associated with both University Hospital and with the Robarts Research Institute. He laid out the detailed findings from the investigation into the health of my arteries down on the desk. He looked at us for a moment and then told me, "You are trapped between a rock and a hard place."

The tests revealed the arteries in my neck are laden with plaque. My arteries hold three times the amount of plaque as that found in healthy men of my age. This plaque can flake and the small bits can be carried in the blood to the brain. This explains the TIAs, transient ischemic attacks, I have been having. TIAs, also known as "mini-strokes", are taken very seriously by doctors as they can be harbingers of a massive stroke in one's future.

I already take some pretty powerful medications. If all had gone well with these recent tests, I might have had some of my meds cutback. Strong meds often carry risks. Instead, I was given another cholesterol fighting drug which will also boost the benefits gained from the statin I am already taking. These drugs can mess with some important chemicals in the body. To counter this I must add 200mg of another drug taken twice a day. Unfortunately, this drug can increase the bleeding potential resulting from taking the anticoagulant Pradaxa. I take Pradaxa.

My history of heart arrhythmia demands I take an anticoagulant. Arrhythmias increase the risk of blood clots forming in the heart. These can then travel to the brain. An anticoagulant cuts this risk. Unfortunately, because micro bleeding was discovered in my brain, I cannot take the common and inexpensive anticoagulant Coumadin. It would increase my risk of having an uncontrolled cranial bleed.

There is an alternative, the anticoagulant Pradaxa. It will lessen my chance of stroke without increasing my risk of bleeding in the brain. The downside is that Pradaxa is expensive, very expensive, and if I should have a serious bleeding problem, for any reason, the blood thinning achieved by Pradaxa cannot be as quickly reversed as it can with Coumadin.

Yes, I am trapped between a rock and a hard place. But, I am not alone. I am trapped there with my doctors. They have no perfect answers to my health problems. Try this and that may go wrong. Try that and this may go wrong. And either answer is accompanied by the risk of some truly awful side effects, of unwanted consequences.

Our blood clots for good reason. There is no mystery as to why anticoagulants carry risks. All my drugs mess with important functions in my body and messing with those functions is risky. Period. Being a doctor is all about balancing risk. Doctors do a damn amazing job at balancing those risks. I am in awe of the talents, the skills, the knowledge and the bold risk-taking of my doctors.

It was more than a decade ago that I had the mitral valve in my heart repaired robotically. I was the first person in Canada to have such an operation. It was risky but it was clearly worth the risk. My ICD/pacemaker was a risk, some doctors questioned whether I actually needed one. Today my heart is being paced 93 percent of the time. I have had my heart rebooted by my built-in defibrillator at least three times. My doctors and I have taken a lot of risks over the years and so far they have made the right calls.

As of today, I am taking a mixture of ten tables and capsules a day. I chew 'em; I wash 'em down with water; I take 'em with food; I take 'em on an empty stomach. I never did a lot of drugs as a young man growing up in the '60s, but as a senior my world is veering toward Jefferson Airplane country and the land of the white rabbit.

One pill makes you larger,
And one pill makes you small,
And the ones that mother gives you,
Don’t do anything at all (maybe but doubtful).

If I should have a stroke, I know my doctors will wonder what could they have done differently. If I am lucid after the event, I will tell them there is nothing they could have done differently. Nothing. They balanced the risks and we lost.

C'est la vie.

Monday, April 7, 2014

It's a wonderful life!

I'm pushing 67. I'm retired. My heart is failing — slowly. This is not the life I expected to be living in my senior years.

I planned on traveling in my retirement. I still long to visit Romania and Bulgaria. Yes, Romania and Bulgaria. Why? It's a long story and not too relevant today as my chances of actually visiting those countries is fading with each passing day. Getting insurance may be impossible and no insurance means no trip.

Still, I'm happy — exceedingly happy. I have found a sweet spot in life of which I had not an inkling when I was young. One's senior years are, to steal the words of Rod Serling, "A dimension not only of sight and sound, but of mind." With a positive outlook, a willingness to take delight in the moment, life is grand.

I have three grandchildren. It doesn't get any better than that — unless you have four.

I've read that we tend to dwell more on unpleasant events in our lives and to use stronger words to describe them than happy ones. Not me. Don't get me wrong. I love a good personal disaster story as much as anyone. Ask me about sailing. I can tell as good a terror-filled sailing tale as the next sailor but press me and I'll slip into wonderful memories from my days of solo sailing. I loved to sit at the front of my boat, legs straddling the sharply pointed bow and dangling so low that my feet got wet from the surge forward as the boat slashed through the waves of Lake Huron. I'd sit leaning forward with arms resting on the stainless steel bow pulpit.

I loved solo sailing. I'd put my one-degree robot at the helm, a black English autopilot, I'd grab a beer and relax. Drinking on a large sailboat was not illegal back then. Trust me, there is nothing like a cold one enjoyed all alone on a sailboat thrust by the wind into a darkening night. (And yes, I did wear a harness. Fall off a boat with Auto at the helm and the boat will simply sail away.)

I also recall my English roadster — a Morgan — another wonderful memory maker. My Morgan didn't just take me places, it took me to new places. Unheard of places. Places in need of discovery. And it didn't just take me there but it also reveled in revealing the people living in those hidden places. My Morgan spent its first years of our life together traveling the American South: Kentucky, Tennessee, Georgia, Alabama, Mississippi were among its favourite destinations.

I vividly recall one of my best Morgan adventures: Corinth, Mississippi. Need I say more? Back then the bars in the Deep South were among the greatest dive bars in the world. Cheap beer, even cheaper burgers, great music — the musicians were often back up players from Nashville earning a little extra cash — and did I say buckets of cheap beer?

I wore my hair long back then and when I entered the bar in Corinth I had just about the longest hair in the place. If it had been possible for the place to go quiet, my entrance would have done it. But it wasn't possible and it didn't. The rock and roll alternated with country and western and both pounded not just one's ear drums but one's whole body. Good time rock and roll pounded down the local's resistance to the long haired foreigner trespassing on their turf. I spent the night drinking and dancing and measuring my hair length against all comers. I bested a lot of women whose tightly bouffanted locks were teased high and tight on top of their heads. There wasn't a man who could compete with me, nor would have wanted to. When the bar closed the party didn't stop; It moved.

Away from the prying eyes at the bar, the women let their hair down, so to speak, and the who-has-the-longest hair contest began anew.

According to the New York Times, Roy F. Baumeister, a professor of social psychology at Florida State University, wrote a paper Bad Is Stronger Than Good after conducting research showing this is a basic and wide-ranging principle. Bad emotional experiences supposedly have more impact than good ones. They are quicker to form and harder to forget than good experiences. It is simply human nature, he claimed.

Not for me. I have to admit that I spent a lifetime rehashing bad times but no more. Time is short and getting shorter. I have discovered that not only do I no longer dwell on the bad stuff, I can hardly remember the worst stuff. It is all fading as well it should. Remembering the past so that history does not repeat itself has its place when one is younger, I guess, but now, in my senior years, there is little danger of repeating those painful missteps.

People make up the biggest chunk of my good memories. My friends from my childhood, my chums from my youth, my school buds. I have good memories of employers and neighbours and even passing acquaintances. As Maude positively tells Harold when talking about people: "They're my species."

I've know a lot of wonderful people. Some are famous and can easily be found by searching the Net — like the super-achieving Denny Wilcher who gained fame as a conscientious objector during the Second World War. I met Wilcher when he and his wife Ida were  living in Berkeley, California, along with their two youngest daughters. Another somewhat well known person from my past was photographer Andy Whipple who recently passed away. He had just completed a fine art book documenting the Columbia River. Another remarkable person I am proud to know is the Canadian author Joan Barfoot, author of numerous best-selling novels. (I first met Joan Barfoot when she was still an editor for The London Free Press.)

And then there are the wonderful people I have had the luck of knowing but who seem to have passed under the Internet radar. Think of John Hoffman, one of the founders of Big V pharmacies in Ontario. Today both Mr. Hoffman and Big V are gone. There is little to be found about Mr. Hoffman despite the role he played in creating one of the biggest, most successful drugstore chains in Ontario history.

For years, I ran a seminar for photojournalists. In my role as chair of the seminar I met people like Pulitzer Prize-winning photojournalist, Eddie Adams, who, in his role as a combat photographer in Vietnam, produced many powerful images of the war. The first evening of the annual seminar I sponsored a speakers' dinner. Sitting next to, and across from, some of the greatest news shooters in the world was an honour and a delight.

I believe my senior years are a time for both enjoying the present and savouring the past. At this late stage in my life, dwelling on the bad is of no value. It is time, as my granddaughter says, to "just let it go." In keeping with this suggestion, I'm going to go open a beer and think good if somewhat alcohol-blurred thoughts.

Cheers!

It's art!


About a month ago Mike Moffatt, an assistant professor at Ivey business school at Western University, in London, Ontario, discovered an apparently coded note tucked into a book in the university library. Curious as to the meaning, Moffatt offered a hundred dollars to anyone who could solve the riddle.

Today the riddle has been solved. The note found by Moffatt is art. Jordan Himelfarb, a member of the Toronto Star editorial board, followed the clues. They led him to the Western University fine art department and Kelly Jazvac.

Himelfarb traveled from Toronto to London to meet Jazvac at a London coffee shop:

She explained that the Weldon code was an art project that came out of a second-year sculpture and installation class she taught in 2012. The artist, then an undergraduate student, placed 121 letters in the Weldon stacks and moved on with her or his (but probably her) life. Jazvac told me the artist was shocked by the project’s recent fame and wished to remain anonymous lest she be treated unkindly in the media.
The reporter discovered the symbols correspond to capital and lower case letters but the order is random, making the code impossible to crack. For the full story read Himelfarb's interesting story in The Star: I cracked the code at the Western University library.

I'm not surprised at the outcome. Using the Internet and social media I contacted visual artists, writers and poets around the globe. Most of those contacted replied to my inquiry. The majority felt the apparently coded works were art. Some suggested that I google "asemic writing." The local paper, The London Free Press, was onto this art lead but failed to pursue this thread to its logical end.

A Free Press story reported Peter Schwenger of Western had contacted the paper. "I’m pretty sure that these are examples of asemic writing ­— that is, art that looks like writing but is not intended to communicate a meaning, only to represent the feel of writing," he told the paper in an e-mail.

A number of the artists I contacted said the works found in the Western library reminded them of the lettrist movement from the '50s. To my surprise, one artist attacked the concept of asemic writing. The works were lettrist as there is no such thing as asemic writing. "It's a philosophic misnomer," I was told.

As a retired newspaper photographer, an old geezer whose free time is being consumed by trips to the hospital as doctors investigate a genetic-based heart condition, I decided that a trip to the fine art department at Western was the next logical step but I simply didn't have the time. The Toronto Star writer did and I doff my hat to his stick-to-intuitiveness.

The big riddle left unanswered is why did it take a Toronto reporter to track down the answer at Western? The Toronto Star broke the story Saturday. The London Free Press reported the riddle was solved Sunday.

There are a number of online newspapers that essentially ripoff the mainstream media for stories, rewrite them and publish them online as their own. I find this practice disgusting but it is not unique to these online journalistic vultures. The MSM has done this for years, ripping off competing media outlets. It appears that Sunday the online version of The Free Press ripped off the Saturday Star and without so much as a credit in passing.

And here is one last riddle: Why are newspapers failing in this electronic age? Hint: There are clues in the media handling of the strange notes found in the Western library.

Thursday, April 3, 2014

OER & Language Learning: Internet Specific Tools

I've mentioned this before but today I got an e-mail that brought the idea of open educational resources back into my mind. If such an online approach was well done, I can envision certain students completing a course online without ever attending a class. Later they could take an exam to prove their competency, earn a credit towards a degree and move on.

I knew a girl who entered high school fluent in at least four languages. Forcing her to take years of high school French was insane. She should have been offered the chance to write all the appropriate exams and put the entire French curriculum behind her. Heck, she spoke French better than some of her teachers. They asked her questions because she not only knew Parisienne French, she new Quebecois. She had lived in France and now that she lived in Canada she was spending her summers in Montreal.

A few years ago, I took a French language course from Western University in London. It was not a good experience. There were too many students and not enough instruction. It was an unfocused course that ran for a number of weeks and then just ended. There was no homework during the course and no exam at the end. The university took my money but gave me little in return. It was a no credit class and with good reason.

That course left me thinking: There must a better way to teach French to English-speaking Canadians. My curiosity led me to The Center for Open Educational Resources & Language Learning (COERLL) at The University of Texas. COERLL is one of 15 National Foreign Language Resource Centers funded by the US Department of Education.

COERLL creates educational materials designed for dissemination over the Internet. Called open educational resources (OERs), the online language tools (courses, reference grammars, assessment tools, etc.) are of great interest to me.

The material is free for anyone to use but may require permission to re-mix, improve, and redistribute. COERLL aims to promote a culture of collaboration. In addition, COERLL stated aims are to reframe foreign language education in terms of bilingualism and/or multilingualism.

I wish the university in London would host something similar. If offered in conjunction with a course such as the one that I took, possibly more could be accomplished. And, at the end of the course there could be an exam. Pass the exam and earn a credit from the university.

If you'd like to see what I am talking about, click the Le Vin de Vouvray link. This will take you to one of the COERLL French exercises posted by the University of Texas. I took the liberty of creating a vocabulary quiz in Quizlet using the vocabulary supplied with the Le Vin de Vouvray post.

I'm going to share a link to this post with one of the teachers at the French public school my granddaughter  attends. I'm seeking feedback on this open educational resource concept. I'm trying to decide whether I should proceed further in my attempt at interesting educators in London to offer something similar.