You Become Your Primary Health Care Provider

Drug companies these days are advertising heavily on TV to get you to buy their remedies for high blood pressure. And why not as 60-million Americans reportedly suffer from it?

One major pharmaceutical house published a throwaway pamphlet I found at my drug store extolling the virtues of their drug to “control” BP. The spiel went: “High blood pressure can’t be cured but it can be controlled”--- so take our drug. Maybe their drug will reduce your BP. But suppose you could reduce your BP to under 120/80 and keep it there without drugs, why wouldn’t it be a cure? This pharmaceutical house won’t call it a “cure” because it wants you to go on buying its product. This article is about improving your health without recourse to drugs, if possible. It’s also about why you should be proactive where your health is concerned.

Blood pressure is a good place to start any discussion about health and taking care of oneself because it tells you so much about your basic condition. Some folks can learn to cut their BP just by relaxation and deep-breathing exercises, as taught at some research hospitals, such as the University of Virginia at Charlottesville. Why pay money for medication and run the risk of side effects if you can learn to lower BP to healthy levels on your own? For most of us, though, reducing BP will mean exercising regularly, laying off the salt, and switching from artery-clogging rich desserts to fruits. Yes, and maybe even taking those BP-control drugs if you have to when natural remedies and exercise are insufficient. ( By the way, if you think you can’t lower your blood pressure by deep breathing, try taking it a drug store machine for free, then taking some deep breaths (in from the belly and out through the mouth) and tensing and relaxing your arms and legs for a few seconds and then repeating the test.) Reducing BP may also mean reducing the rate at which you operate. If you are hyperactive, attempting to do six things at once, you can expect it will push up your BP and take a toll on your body.

If you are really serious about taking primary responsibility for your own health, consider keeping some basic health records. I use my appointments book. Taking and recording your own blood pressure daily will give you a pretty good measure of just where you stand. Buy a blood pressure cuff or, if you’re pinched for dough, find a drug store with a free blood pressure machine and use it regularly. If the machine tells you your BP is higher than 120/80 you need to take action, including paying a visit to your doctor. And if BP is under that standard you can still improve on it. Write down your BP readings daily and you’re weight every few weeks as well. That way, over time, you can note the changes and changes can be significant. Next to your BP readings, record your heart rate. According to his doctor, President Bush’s heart beat is just 46 per minute. That means he keeps himself in excellent shape physically, probably by clearing brush on his Texas ranch. One of your goals should be over time to lower your resting heart beat, which usually indicates you have made your heart more efficient and reduced your chances of heart disease and all the misery that goes with it.

Besides logging your BP, use your appointment book, also, to record how much you exercise each day. You might want to keep a running total of how many minutes you’ve walked or jogged or time spent in the swimming pool or bicycling each week. If you haven’t been exercising, don’t try to be a track star. Take it easy. Maybe you’re obese and can hardly walk. Okay, keep it simple, maybe just walk in place for a while, or walk to the corner and back twice a day, maybe just around the block, and build up to the day when you can walk 15 minutes or a half hour at a clip. Who knows, you may be running 10K’s in a year. After a time, you may notice that high BP starting to come down, and your weight, too. That should give you a lot of satisfaction knowing you have taken the initiative and that it can work.

By the way, when you exercise, keep in mind runners’ magazines have made a fetish of achieving your “personal best.” My suggestion is always to start out striving to do your “personal worst.” I mean that. Always try to walk or jog at your slowest speed. Sooner or later your body will force you to accelerate to a level that won’t drive you nuts with boredom. One goal of exercise is endurance. Runners often fall out because they are out of breath. Consider jogging slowly with your mouth closed, breathing only through your nose. Accelerate just to the point where you don’t have to open your mouth to catch more air. Why? Well, if you don’t let yourself get out of breath you can jog much longer. I’d rather jog four slow smiles than sprint one fast one, although sometimes I do run fast enough to get out of breath to exercise the heart muscle more stringently. But consider putting the emphasis on developing endurance, not speed. Mortality tables show there’s a huge difference between people who don’t exercise and those who walk regularly. What’s interesting is that people who exercise vigorously don’t live all that much longer than those who walk regularly. I’m not saying there’s no benefit from pushing the envelope. I am saying our ancestors spent long hours trekking across the world’s prairies with their clubs in search of dinner. We are walkers by nature. If you dine out, consider walking to and from that restaurant. Walking before a meal will give you an appetite and walking after a meal will recall the old expression, “let’s walk off dinner” popular among families in the days before automobiles. As for drugs to help you fall asleep, you may find an early evening walk is the best prescription of all. Anyway, shouldn’t you be a little tired after a good walk? Yet, there are millions of Americans taking sleeping pills who might save a bundle and not tax their systems by a good walk after dinner. One other thought about exercise: if you’re going to run seriously every day you may expect over time to develop leg problems. So why not vary your jogging, which so many people love, by bringing in a lot of other sports activities for variety such as swimming, and including weight-lifting to develop upper body conditioning?

When I think of exercise, I think of aerobic miles or the equivalent. If you haven’t been exercising regularly, don’t try to morph into an Olympic runner overnight. Start slowly. Let’s say on Monday you walk at the rate of twenty minutes a mile and you cover two miles for a total of forty minutes. Award yourself +2. Let’s say you also do a mile on the rowing machine. Total now equals +3. If you finish off with a 15-minute swim give yourself a total of +4 for Monday. If you find you can’t do even a mile, split the exercise up into a morning and evening session or spread it over two days instead of one. At the end of the first week you might have compiled +5 or +10 points. Try this for a couple of weeks and see if you can’t detect an improvement in your ability to exercise and an improvement in BP and resting pulse without drugs. Hey, you did that yourself! Stick with it and you’ll find your total mileage increasing with less difficulty on your part. One plus about tracking your daily exercise is the good feeling you will get when you look back a few months or a year and note the improvement in miles. You can say, “Hey, at the end of January in 2006 I logged 70 miles and this January I’ve done 90.” Another benefit: you won’t worry about, “Am I going to have a heart attack?” Exercise is a great confidence-builder. Keep in mind, though, you can overdo exercise. If you are pushing too hard your BP will remain high longer and could become chronically elevated over time. One avid squash player of my acquaintance who played three partners a night every night for months spent six weeks in a hospital with elevated BP and a heart rate over 110 beats per minute plus a couple of diseases from having run himself down. (Don’t ask this fool’s name.)

Tracking alcohol and dessert consumption is important because a lot of us are really in the habit of consuming more of these delights than are good for us. By keeping a running total of how many alcoholic beverages you consume it’s tough to lie to yourself. Did you have a drink at lunch and three at dinner or afterwards watching television? Do you average about four drinks a day? Do you put away a six pack? Keep a running total. When your doctor asks, “How much do you drink?” you can look at your book and say, “Well, this is the 100th day of the year and so far I’ve had 400 drinks” or whatever the figure is. An accurate count will be important at a medical exam. As time rolls along, if you are knocking back more than you should, the facts will be there plainly for you to see and you can reduce intake on your own to medically recommended levels. If you find you have to have a lot of alcohol, you need help. AA is always there to provide it. Alcohol, which abused can be really deleterious to your health as well as your safety, has a lot to do with why this country spends $7,000 annually on health for every man, woman and child, yet our life expectancy figures now lag behind many other nations.

As for the desserts, a lot of us are in the habit of devouring one at lunch and dinner, and sometimes snacking on them in between meals, so keep a running total of them. We also eat a lot of food we might not think of as dessert, such as pancakes which has the tipoff word “cakes” in it for a reason. Eat a piece of cake, handful of cookies, and a dish of ice cream during the day, count it as three desserts, and mark it down. In the course of a year, a lot of people keeping count may realize they’ve consumed over a thousand desserts! Doctors say sugar is not good for the heart. And we wonder why our arteries are clogged. My point is if you don’t recognize you’ve got a problem you will never deal with it. And why are we drowning our pancakes in syrup? Is it because we have got a sweet tooth?

As the Cracker Jack boxes of molasses flavored popcorn once reminded us, “The more you eat, the more you want.” And overcoming a craving for sweets isn’t easy. Fruits and cereals, though, are great hunger fighters and can help you overcome your need for confections. Instead of Danish for breakfast, try baked apples with a little nonfat yogurt on them. Instead of a plate of high cholesterol bacon and eggs, switch to oatmeal sprinkled with cinnamon and topped with fruit. Stay away from the fried foods. As for the coffee, try switching to hot cereal beverages or herbal teas that can’t have a negative impact on heart rhythm. Dr. Dean Ornish, a clinical professor of medicine at the University of California, San Francisco, and a major proponent of preventive medicine, told The New York Times on June 11th that more than 90 percent of heart disease is preventable. The Times reported, “Over the years Dr. Ornish has led several projects showing that fundamental changes in diet, exercise and stress management can stop and even reverse heart disease.” In short, there’s a lot you can do for yourself without resorting to, or before considering, drug therapy. If you work in an office building, sneak into the stairwell now and then and climb a few floors. Reaching for the telephone at work? Stretch that arm out and make it taut, then relax it, one of the relaxation tricks that will help lower BP. Get up and visit the water cooler more often. Water is a healthy person’s best friend. Long sessions at the computer or desk can make BP rise. Instead of taking a coffee break, walk around the block for ten minutes.

It’s important to recognize that you are a target --- a target of advertisers peddling their foodstuffs, including potato chips, pizza, cookies, cakes, donuts, high-caloric, high-cholesterol sandwiches, alcohol, and cigarettes. In fact, if you smoke, you can quit reading this right now because there’s nothing I can say to you, except that smoking kills 440,000 Americans annually. Advertisers of cigarettes are out to kill you to make a buck, that’s all there is to it. They know, and have known about the destructive effects of cigarettes for years but concealed it from the public. About a hundred times as many Americans die from cigarette use each year as all the U.S. soldiers killed in four years of fighting in the Iraq war. Of all my friends and acquaintances, the smokers were the first to die. The alcoholics went next. The obese lingered longer but they were truly miserable, having difficulty walking and panting for breath while performing routine activities. Many became diabetics, and are doubly miserable, particularly those that smoke.

If you’re serious about getting healthy, you need to learn to avoid sweet and salty foods. They’re the kind that make you want to go on eating and they rarely satisfy no matter how much you gobble. And the salty fare will elevate your BP, forcing your heart to work harder and, over time, possibly damaging other internal organs as well. The sweet stuff will clog your arteries, too. When you really need a piece of delicious cake with all that sugary icing, remember the cold cereal with berries and skim milk. Wash that breakfast down with a caffeine-free hot beverage. The caffeine in coffee, like that in cola drinks, isn’t going to do your heart a lot of good. Those proliferating chain coffee shops may play a role in making it difficult for you to get an appointment with a cardiologist because so many caffeine imbibers are ahead of you, many suffering from irregular heart rhythms. Try beverages that mimic coffee flavor, such as Postum. (Note: I have no connection with the maker of this product.) These drinks can give you a nice, warm feeling in your belly, which is part of the coffee lift. Whenever you can, keep the kids off the colas. Lemonade has far fewer calories than colas and no caffeine. Try substituting a mix of raisins and peanuts for candy bars. Of course, all rules are made to be broken now and again. In sum, generally speaking, you can lower your weight best by avoiding breads, cakes, rich desserts, most dairy products and, as the nutritionists say, substituting fruits and vegetables whenever possible. We need to face it: we are what we eat. If you think otherwise, drop in at a Golden Corral or other all-you-can-eat place. Follow some of the overweight diners around at a discrete distance and see what they pile onto their plates. Observe the waist lines of the people who are consuming the cakes and puddings and ice cream and compare their waists with the people who are loading up on fresh strawberries and pineapple.

A close senior friend of mine was told by his doctor he had “a little heart disease.” A stress test showed a clogged artery and the physician recommended inserting a probe to clean it out. Instead, the man quit consuming alcohol, whole milk and cream, cheeses, eggs, pizza, ice cream, puddings, and like rich desserts, switched to fruit-topped cereals, and doubled his walking from two to four miles a day. He also took a prescribed prescription drug to lower cholesterol and repeated the stress test in six months. You guessed it: normal, with no blockage. During that period, the man, who had never been told he was overweight, also shed 15 pounds and reports his improved diet, (mainly more cereals,) and added exercise gives him more energy than ever before. People who don’t have time to exercise won’t ever find out that exercise will actually give them more energy and can extend their lives, lives with better quality, too.

By the way, the senior I cited above just raves about the care he receives at his Veterans Administration hospital. If you’re a veteran, you may have discovered VA doctors tend to budget more time for you than practitioners in private practice, ask more questions, and do more thorough examinations. This writer is at a loss to know why the successful VA system should not be a prototype for a national health insurance plan, with private practice remaining as an option for those who don’t care to use it.

Anyway, with proper exercise, eating right, and, oh, yes, a good night’s sleep, Americans could cut their medical bills substantially. Many a savvy corporation has hired health advisers to tell staffers how to find their way to the fourth floor exercise room. That’s because Corporate America has long been aware of how sick employees can cost and cost. All I am saying is to think over the suggestion about becoming more personally involved with your own health, and recording the effort in black-and-white. The biggest part of staying well is up to you. One last piece of advice from a physician who reviewed this article: “Leading an intentional life, volunteering, giving and developing a spiritual heart for the world and for ourselves is paramount to leading a healthy life.” #

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