ALT Medical Guide - Heart

2013 . Heart

M E DIC A L G U IDE

Heart

Go Red for Women is an alarm call to every woman in the world to take care of her heart health.

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2013 Heart /contents

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k / FEATURE STORY

Go Red for Women...

The American Heart Association wants every woman to know the signs and symptoms of heart problems.

F E AT U R E S

2013 / Heart

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Breathing a Sigh of Relief

13

Go Red For Women

16

Leading the Way in Minimally Invasive Surgical Options - Wadley

20

Forget Something?

22

Heart Attack Symptoms

24

Te x a r k a n a H e a r t W a l k

26

Heart Healthy Recipes

30

Depression After A Heart Attack

Publisher and Editor / Debbie Brower Associate Editors / Jaclyn Gooding, Miranda Johnson Photography / Image Forward Photography, Debbie Brower, Jaclyn Gooding, Miranda Johnson Sales & Marketing Manager / Charlie McMurphy Feature Writers / Anne Fruge Contributing Writers / Shelby Brown, Brenda Dudley, Jeannie Carter, Laura Jenkins Advisor / Mike Brower If you have an event you would like to include in our Upcoming Events section, please email us at: info@alt-mag.com.

w w w. a l t - m a g . c o m

info@alt-mag.com 200 Heather Dr., Texarkana, TX 75501 (903) 334-9605

10 Gloria Miller...

Gloria Miller’s shorrtness of breath was a symptom she didn’t associate with a heart attack.

After a visit to her cardiologist, she found that that was exactly what was hapepning.

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ALT Magazine is published the 1st business day of every month. Reproduction in whole or part without written permission of ALT Magazine is strictly prohibited. ALT Magazine is distributed free of charge. Direct mail subscriptions are available for $42.00 per year. Contributions from our readers are welcome. We reserve the right to edit or reject any material.

©2013 ALT Magazine

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EDITOR’S letter

Health...

If you have health, you probably will be happy, and if you have health and happiness, you have all the wealth you need, even if it is not all you want. ~Elbert Hubbard

When I was approached by Shelby Brown about the

years, he was adament that I continue my vacation and he

possibility of doing a magazine in conjunction with the Wadley

would call me with the test results. If I came home, he would

HeartCare Network, I was ecstatic! You see, I have had

put off the tests until the next week. Well, the tests turned

several people I love who have been affected by heart disease. into having a stent put into what is called “The Widowmaker” Although the ones closest to me are men, there are several of

artery! I really wanted to kill him after I knew he was going to

my “girlfriends” who have had heart attacks and strokes.

live! LOL. He is the love of my life and I am so glad he is now

doing great!

Let’s start with my dad, John Hayes, who had heart

problems early in life. At the young age of 52, he was rushed

to surgery, with the result being a quadruple bypass. Years

of a heart attack and men. Chest pain doesn’t necessarily

later, that was followed by a stroke and another fatal heart

become something to expect. My friend Donna Walthall, from

attack, just weeks before the birth of his first highly anticipated

Magnolia, went to the hospital thinking she had a bad stomach

great-granddaughter. The history of his family wasn’t a good

virus. Vomiting and stomach problems had become so bad that

one where heart disease is concerned -- a worry for me now.

a trip to the emergency room was her choice -- bowl in hand!

On my dad’s side of the family, my grandfather, grandmother,

Once there, Donna was told she was, indeed, suffering a heart

aunt, uncle, and many others had either heart attacks or

attack! Two stents later, she felt like a new woman!

strokes, ultimately causing their deaths. Of course, according

to my mom, who is 79 at this time, most of his family never

especially those who may be a high risk. I know that I want

took care of their health -- something she prides herself on

to be alive and kicking when my granddaughter, Skyler, has

doing.

her first child -- or maybe when my daughter, Jaclyn, ever has

As I have grown older, researching heart related

What a difference there is in women’s symptoms

Women everywhere should know the signs to look for,

a child! (Hint, hint!) I love my family and want to live a long,

problems has become a necessity for me. With all of the

healthy, busy life, enjoying every moment! I know where I am

history of heart problems in my family, I am a prime candidate.

going when I leave this earth, and I know God will take me

My husband, Mike, also a prime candidate with a histoiry in his

home when my time is here. I’m just not ready to go just yet!

family, became a statistic. While I was on vacation, he decided

May God bless you!

to cut the grass one Sunday. What followed was what he told me was an “episode.” The “episode” was nothing, just a little indigestion. Dr. James Hurley wanted to do some tests on him -- nothing really bad. Since I hadn’t had a vacation in several 6

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2013 Heart

Publisher/Editor

Because no one should ght alone.

The time is now to stand together and ght the #1 killer of women‌heart disease! For as long as it takes, the women of the Wadley HeartCare Network are committed to ghting heart disease and giving every woman the chance to live!

Because we are women, we know how you feel, we know how you think, we know how you hurt and we know how to treat you. Trust the women of the Wadley HeartCare Network.

&Heart Disease Since 1984, more women than men have died each year from heart disease.

The symptoms of heart disease can be dierent in women and men, and are often misunderstood.

While 1 in 31 American women dies from breast cancer each year, 1 in 3 dies of heart disease. * Source American Heart Association

Pictured left to right:

Poongodhai Ramachandran, MD

Quality. Caring.

Close by.

Cardiology Specialists

Shannon Humphrey, ACNP Cardiology Specialists

903-794-8820 www.wadleyheart.com

Sylwia Karpinski, MD

Heart & Lung Specialists of Texarkana

.

Breathing a Sigh of

Relief

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by Anne Fruge

Shortness of breath, chest pain and difficulty with household tasks that had never been an issue before were the signs that spurred Gloria Miller to make an appointment with her family physician, Dr. Williams. She knew that something was wrong, and her diligence was rewarded with a speedy diagnosis, surgery and rehabilitation all from the talented medical professionals in her hometown of Texarkana.

Gloria was born and raised in Texarkana. After graduation, she attended the University of Arkansas to study elementary education. Right before a Christmas break, Gloria received a call from a friend in Texarkana asking her to consider going on a blind date when she returned home for the holidays.

John Miller was working on his law degree at University of Texas in Austin. Because John’s parents were stationed in Germany for a military assignment, John’s uncle, Ed Miller, who practiced law in Texarkana, invited John to spend Christmas with him. Ed’s secretary knew Gloria and set up the blind date thinking that the two young students would hit it off.

John and Gloria’s first date consisted of going out for coffee, even though Gloria secretly loathed coffee. However, this did not stop Gloria from having a great time with John.

“The fact that I still don’t like coffee is an inside joke now,” Gloria says. “I enjoyed our first date and from there we became friends.”

After a fun holiday together, the two returned to their respective schools. When the

couple met up for the summer, they were basically inseparable.

By August, they decided they wanted to get married.

“We enjoyed being together, and we fell in love,” Gloria says. “We have been together ever since!”

A year and a half later when Gloria had finished her degree, they were married at Hardy Memorial Methodist Church in Texarkana.

“I didn’t get to meet John’s parents until two weeks before the wedding,” Gloria says.

“However, there was a big family, so I knew all of John’s cousins and aunts and uncles that lived here. I was so excited to meet them, and I’ve had a love/love relationship with them ever since.”

John and Gloria moved to Austin so that John could finish his law degree. Gloria taught school in Austin and loved the kids, but the couple knew that they would eventually make their way back to Texarkana. When John was offered a position as the assistant city attorney for Texarkana, Texas, the couple moved home.

Now, after 44 years of marriage, John has held such positions as Bowie County Criminal District Attorney and District Judge of the 102nd District Court. He served public office for 24 years and continues appointed public service as the Judge for Drug Court and Mental Health Court for Bowie County. While Gloria worked for a few years at Beech Street Preschool, she eventually decided to stay home to focus on raising the couple’s three children: John Miller III,

James Miller and Susan Miller Sullivan. They are also the proud grandparents of Alex, Kaelyn, and Shelby.

The family loves to travel together and take trips. They’ve ventured to destinations such as Hawaii, New York, California and Florida. However, one of their favorite things to do is pack up on a Friday and drive to their lakehouse on Lake Greeson in Murphreesboro, AR. They spend Saturday relaxing and then return Saturday night so that they can be in church at Hardy Memorial on Sunday morning. The couple is extremely active in their church, and Gloria also is a member of the Junior League and Texarkana Law Wives.

On one such family vacation to the lake, John drove Gloria and the others to the middle of the lake to see the Fourth of July fireworks on the boat. Gloria was nervous due to the massive crowds of boats in the dark. At the end of the display, John dropped Gloria off in the dark, but she had to walk up a large hill to get the car. On the trek up the hill, Gloria started to realize that something was wrong.

“This was a pain I had not felt this intensely before,” Gloria says. “I knew that I needed to rest. I felt pains at the top of my chest and had to stop every few minutes before I made it to the top of the hill.”

A few months later, Gloria’s chest pain and shortness of breath were becoming more and more apparent while completing basic tasks around the house.

She finally decided to see her physician, Dr. David Williams at Collom and Carney Clinic in Texarkana, in order to make sure 2013 Heart

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L-R: John and Gloria Miller (left and center); Daughter Susan Sullivan, Granddaughter Shelby Sullivan, and Gloria

nothing else was wrong.

When she told Dr. Williams the symptoms and the story of the lake, he said that he was going to make a referral to Dr. James Hurley, a cardiologist at Texarkana Cardiology Associates.

Gloria was Dr. Hurley’s last patient of the day. He listened diligently and then asked her to get on the treadmill. He said, “I’m going to make it feel like you are on a mountain.”

“I only lasted about a minute and 20 seconds,” Gloria says. “He said ‘Whoa! I think we have a problem. We need to do a heart cathether as soon as possible.’ Then he asked me where I wanted to go. I immediately said Wadley.”

Not only was Wadley the hospital that Gloria felt the most comfortable with from her years of growing up here, her sister-inlaw, Janet Akin, was employed there.

Dr. Hurley got out his cell phone and scheduled the appointment for 7:30 the next morning. Based on what they found at Wadley, Gloria was scheduled for surgery at 7:30 the following day. Dr. Billy Parsons, cardiologist, performed four heart bypasses on Gloria just two days 10

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2013 Heart

me and my family.”

After a successful recovery from the bypass surgery, Gloria was diagnosed with breast cancer in the same year.

Though many people after her decision to see her questioned Gloria’s ability to doctor. remain so strong through back to “John had bypass surgery back tribulations, Gloria attributes many years before I did, so her faith, church and family for when I started feeling bad he helping her make it through. encouraged me to get it checked “This whole experience out,” Gloria says. “He had been has made my faith stronger and through the process at Wadley has made me appreciate so much and loved their cardio rehab, so more,” Gloria says. “Texarkana I knew that I would go there as is a great community because of well. I’m so lucky there were no the connections between people complications with my surgery, here. Our church, friends and and everyone on the staff took family really reached out to help such good care of me and were us through that difficult year.” so thoughtful.”

Gloria’s cancer was For the next six weeks, successfully removed and though Gloria attended the cardio rehab she has to go to checkups each at Wadley Hospital in order to aid year, she has received excellent recovery and prevent recurrence news from both doctors. She is of her heart problems currently cancer-free and her “At the cardio rehab, I did heart is working well. lots of running on the treadmill, “The Good Lord was but more than that, those walking with me,” Gloria says. employees gave us an education. “He walked with me through that They talked about diet, exercise, whole year, and it has made and lifestyle. They answered me realize just how much my all our questions and helped us family and John mean to me. change our lives for the better,” This experience just reminds me Gloria says. “The facilities here in to love life and appreciate every Texarkana were just a win/win for minute of it.”

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2013 Heart

This Is Not A Red Dress.

It’s A Red Alert.

Go Red for Women is an alarm call to every woman in the world to take care of her heart health.

About Go Red What is Go Red For Women?

In 2010, the AHA set a strategic goal of reducing death and disability from cardiovascular disease and strokes by 20 percent while improving the cardiovascular health of all Americans by 20 percent by the year 2020.

In 2004, the American Heart Association (AHA) faced a challenge.

Cardiovascular disease claimed the lives of nearly 500,000 American women each year, yet women were not paying attention. In fact, many even dismissed it as an older man’s disease. To dispel the myths and raise awareness of heart disease as the number one killer of women, the American Heart Association created Go Red For Women, a passionate, emotional, social initiative designed to empower women to take charge of their heart health.

Why is the red dress the symbol of women and heart disease?

What is the goal of Go Red For Women?

By working together to advance this important cause, the AHA, NHLBI, and other women’s health groups will have a greater impact than any one group could have alone.

Go Red For Women encourages awareness of the issue of women and heart disease, and also action to save more lives. The movement harnesses the energy, passion and power women have to band together and collectively wipe out heart disease. It challenges them to know their risk for heart disease and take action to reduce their personal risk. It also gives them the tools they need to lead a heart healthy life.

In 2003, the National Heart, Lung and Blood Institute (NHLBI), the AHA and other organizations committed to women’s health joined together to raise awareness of women and heart disease. The NHLBI introduced the red dress as a national symbol for women and heart disease awareness and the AHA adopted this symbol to create synergy among all organizations committed to fighting this cause.

The symbol of the campaign is a red dress: The dress as a universal women’s image and red as the color of health, life and vibrancy... but also of warning.

2013 Heart

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AHA has consistently met the high standards of the Better Business Bureau’s Wise giving Alliance (WGA), the premier organization for evaluating charitable organizations.

How do corporate sponsorships help support Go Red For Women?

Financial support from corporations helps fund the AHA programs and initiatives to advance the mission to build healthier lives, free of cardiovascular diseases and stroke. The AHA is always seeking ways to increase communication with the public and to create tools and resources to help them manage and prevent heart disease.

Sponsorship dollars allow us to improve our educational resources like our website and other materials in order to deliver the information in a way that men, women and children find useful. All corporate relationships In the past, heart disease and heart attack have been predominantly must comply with the associations corporate relations associated with men. Historically, men have been the subjects of the policies and receive approval from two committees research done to understand heart disease and stroke, which has been the representing executive staff and volunteers. Compliance is required basis for treatment guidelines and programs. This led to an oversimplified, in areas such as sponsors’ commercial messages, advertising and brand distorted view of heart disease and risk, which has worked to the detriment of messages so that no endorsement of a company product is implied. women.

Funds donated to Go Red For Women have impacted women across the Because women have been largely ignored as a specific group, their nation. awareness of their risk of this often-preventable disease has suffered. Only 55 percent of women realize heart disease is their No. 1 killer and less than half Over 2 million women have learned their personal risk of developing heart know what are considered healthy levels for cardiovascular risk factors like disease by taking the Go Red Heart CheckUp blood pressure and cholesterol. The Go Red For Women movement works to make sure women know they are at risk so they can take action to protect Over 200,000 healthcare provider offices have received critical patient their health. information on women and heart disease Why do Go Red For Women and other red dress campaigns target women instead of men and women?

How does the AHA use funds raised from Go Red For Women activities?

The AHA uses all revenues from local and National Go Red For Women activities to support awareness, research, education and community programs to benefit women.

These funds allow us to help women by offering educational programs, advancing women’s understanding about their risk for heart disease and providing tools and motivation to help women reduce their risk to protect their health. For example, the Go Red Heart CheckUp has engaged over 2 million women to learn their risk of heart disease. Based on our own research, a woman who Goes Red follows an exercise routine, eats healthier diet, visits her doctor for important tests and influences others by talking about heart health.

Funds raised by Go Red For Women activities also support research to discover scientific knowledge about heart health. We turn this science into materials and tools that healthcare providers and decision- makers can use to help women. Scientific guidelines on women and healthcare providers receive the most up-to-date strategies and treatments tailored to a woman’s individual risk. Toolkits, pocket versions of guidelines for women, and special reports, and continuing medical education give healthcare providers the tools to ensure that women are being treated according to the guidelines.

Through our national sponsor, Merck & Co., over 200,000 healthcare provider offices have received Go Red For Women educational tools to use with patients.

We value the trust placed in us by our donors, supporters and general public.

We make the association’s finance as transparent as possible. In fact, the 14

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Over 900,000 women have joined the fight. Women who join Go Red For Women receive important information that allows them to take action to improve their health:

Women involved in Go Red For Women eat a healthy diet Go Red women are more likely to follow their doctors’ advice – from losing weight to taking medications.

91% of women involved in Go Red For Women visited their doctor in the last 12 months (compared to 73% of all U.S. women) 64% follow a regular exercise routine 84% have talked to friends about their heart health 90% have had their blood pressure checked in the last year 75% have had their cholesterol checked in the last year

Get Involved You know heart disease is the No. 1 killer in women. You know it’s time to fight back. And now it’s time to Go Red. This is a call to action to stand with us. To become success story. A story of survival. To show us your battle scars and to be proud of the warrior you’ve become. Together, we have the power to save our lives. There are many ways you can join in this powerful movement!

Donate to Go Red For Women We couldn’t have made such an impact without the generous donations from individuals like you.

Here’s what you’ve helped us accomplish in the past 10 years: More than 627,000 women have been saved from heart disease, and 330 fewer women die each day.

Women’s guidelines, created by the American Heart Association, have educated millions of healthcare providers to recognize and treat heart disease in women.

The number of women aware of their No. 1 killer has jumped from 22 percent to well over 50 percent.

Help us keep going for another 10 years. Here’s how you can donate: Join our Circle of Red. Fight heart disease with likeminded women. Women in the Circle of Red contribute significant resources and influence to fund lifesaving research, education and advocacy for heart health on a local and national level. For more information, contact your local American Heart Association office.

Fundraise for National Wear Red Day®. Create a fundraising page and use our fundraising materials to help create awareness. Use these tools and resources to help organize and promote your fundraising event, or get together and educate colleagues, friends and family.

Donate in honor of a loved one. Create a page in honor or memory of a loved one.

A memorial page can be a great way to remember and share their legacy.

Plan a gift. Make a contribution from your estate or assets through a will or trust rather than your income. You get the tax break now, and Go Red For Women benefits later.

Charity begins at home. And by the best way to Go Red and get involved in the battle against heart disease in women is to start in your own backyard.

Paint your town red Part of going red is helping us spread the word by having homes, workplaces, buildings, landmarks and even local businesses Go Red. We’re always looking for volunteers to help, especially on National Wear Red Day. If you know any artists, reach out and see if they’d be interested in creating red-inspired pieces for murals, sidewalks, lampposts or anything else they can think of. Do you frequent a certain grocery store? Suggest creating red-themed healthy food displays. You can even ask that boutique on the corner if their window display can feature this season’s most stylish red clothing and accessories. There’s really no end to the possibilities. And because red is so versatile, you can be as creative as you’d like.

For more information, please visit: www.goredforwomen.org 2013 Heart

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by Shelby Brown

Leading the Way in Minimally Invasive Surgical Options

Wadley Regional Medical Center cardiothoracic surgeon Dr. Sylwia (prounounced Sylvia) Karpinski recently performed Texarkana’s first robot-assisted lobe removal to treat lung cancer.

In December, Dr. Karpinski used the da Vinci Si Surgical System® to excise the upper left lobe of the left lung and sample the nearby lymph nodes in 81 yearold patient with early-stage lung cancer.

Besides an appendectomy in her early twenties, Mrs. Tommye Chessir of Nashville, Arkansas was a healthy, active retiree who enjoyed life. Her journey began one Sunday afternoon at the conclusion of a funeral service when she attempted to stand up.

Her left leg would not cooperate and she admits this had nothing to do with her ultimate diagnosis of lung cancer. She went to her local hospital and in the course of her treatment had a chest x-ray that revealed something on her left lung. Her Primary Care Physician referred her to 16

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pulmonologist Dr. Malcom Smith in Texarkana who performed a biopsy to confirm that it was malignant. Dr. Smith then referred her to Dr. Sylwia Karpinski of the Wadley HeartCare Network.

An alternative to traditional open thoracotomy or thoracoscopic lobectomy, the minimally invasive robotic approach offers a more precise resection of the lung and clearance of lymph nodes – resulting in less postoperative pain and a shorter recovery. “The patient was able to leave the hospital in three days and experienced no complications,” Karpinski said. “Although I experienced some pain, I was completely mobile when returning home,” says Chesshir.

Wadley Regional Medical Center cardiothoracic surgeon Dr. Sylwia Karpinski

Karpinski is the only cardiothoracic surgeon in Texarkana and the surrounding region to be trained to utilize the robot in performing lobectomies on lung cancer patients and cardiac procedures. “Offering this technique is important to alleviating the need for patients to leave town,” says Karpinski. Robotic technology provides clear benefits over a traditional thoracotomy approach, such as decreased length of stay, decreased short-term postoperative pain and fewer complications.

In the Wadley tradition of bringing cuttingedge medical technologies and services to the Texarkana community, in 2009 Wadley became Texarkana’s first medical center – and among the first on the region – to offer the da Vinci Si Surgical System. Initially using the robot for prostatectomies and gynecological procedures, Wadley now utilizes the robot for general surgery as well as cardiothoracic surgeries. Wadley has become the leader in robot-assisted surgeries for numerous conditions and exclusively provides robotic assisted cardiothoracic procedures as well as the single site gallbladder removal.

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By Jeannie Carter, MA, CCC-SLP and Laura Jenkins, MS, CCC-SLP HealthSouth Speech Therapy Department

Forget something?

Have you ever laid your keys down and then got ready to go somewhere and guess what? No keys. “Where did I put them?” is going through your head as you search madly for them.

If that has ever happened to you, the topic of memory may be of particular interest to you.

Forgetting things as we grow older is something many of us experience. Like, forgetting where we put our keys or even parked our cars. These lapses in memory are most often completely normal.

The every now and then forgetting is so common because it involves things we do every day and usually don’t spend too much time paying attention to them.

In our 20’s we didn’t pay attention or if we noticed, we called it “scatterbrained.” In our 40’s we noticed some of those “senior moments” and we laid those at the feet of “menopause.” At 60, sometimes there is a feeling of panic. “Could this be the first sign of Alzheimer’s?”

Memory, by definition, is the process of taking information from one’s environment through our senses and organizing and 20

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storing this information in the form of representations. Also, it is the ability to recall these representations at a later time.

So memory has two basic facets, the first being that of encoding.

Encoding is the process of organizing and storing information. This is often how things are alike or different, and relating things to our senses. Retrieval is the ability to recall those experiences.

For information to be retrieved, it first must be stored effectively.

Retrieval cues and reminders can help in this process.

I could get really technical and tell you how the memory is governed by the hippocampus along with the frontal cortex of the brain. And I could discuss how the brain has one hundred trillion synapses, which are where the nerve cells in the human brain connect with

other cells. This would get highly technical, and frankly, we wouldn’t get the how to manage our memory more effectively. So we will leave the technical, and get to “now what?”

There are common warning signs that memory problems may be more than forgetfulness.

•

• • •

• Memory problems that affect your job performance or your everyday function.

Difficulties with language, such as forgetting simple words or substituting inappropriate words.

Disorientation in familiar locales or familiar situations.

Confusion about the time of day, month, season, or decade.

Decreased or unusually poor judgment.

• Memory problems accompanied on the task at hand. Form a by other symptoms such as mental picture, write it down, extreme fatigue, loss of interest repeat it out loud. Attach the in activities, unusual changes item to an emotion or place. in mood, agitation, listlessness, Attach a significance. problems with balance and • Categorize. Placing information coordination, headaches, into categories makes it easier shortness of breath, or chest to remember and simplifies the pain. encoding and retrieval process.

• Associate. Come in through Now keep in mind there are a the back door. Every one variety of factors that can cause experiences blocks to his/her memory problems, from stress and memory on occasion. First depression to vitamin deficiencies relax, and then don’t panic. Use and other medical problems. Not a word that is similar. Allow the all memory problems signify the brain to follow the path. For start of Alzheimer’s. That is why a example, with names think thorough medical exam is needed Jeannie “with the light brown when memory problems are out of hair.” Use whatever pops into the ordinary or cause for concern. your mind. Another example is Tiffany—diamonds or Breakfast Common medical diagnoses that at Tiffany’s. frequently cause memory deficits • Time. When you have difficulty can include, but are not limited remembering something, try to, stroke, head injury, anoxia, to reconstruct the events urinary tract infections, dementia, surrounding the memory and Alzheimer’s disease. Also, you wish to recall. As anesthesia and medications you link memories, other can have an adverse affect on associated memories will memory. A speech pathologist can gradually surface. assess and identify the person’s • Chunking. Coding small strengths and weaknesses with portions of data into regard to language and cognitive a larger, meaningful function. Once completed, you concept and later can then begin strategies to assist, deconstructing the and hopefully restore memory. individual components For dementia and Alzheimer’s back into its original form. disease patients, strategies are Good example is like our to compensate for memory loss social security number and activities to help maintain the pattern. (123-45-6789) function that they have.

• Chaining. Chain words

together with a sentence.

Some specific strategies to cope Remembering a list of words. with memory loss are: (Ex. Beach, sand, shells---I went to the beach, walked • Get organized. Have a central in the sand and picked location to place things you up some shells.) use in your daily routine.

Consistency is the key here.

Get a day planner, calendar or a small note pad.

• Attention. Focus. Pay attention to your attention. Concentrate

• Limit distractions. Chaos breeds confusion. Find a quiet place, limit distraction and allow your memory to work for you.

Memory is the process of taking information, organizing, storing and recalling. Keep in mind you can strengthen your memory through active participation. Utilize strategies and techniques to enhance and maintain. Make wise choices in overall wellness, nutrition and exercise. Use it or lose it. As you exercise your body, so you must exercise your brain. Memory is improved through practice. Get the blood flowing. Do some simple math, read out loud and write a letter or in a journal daily. Stay active and engaged.

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MYTH: Heart disease is for men, and cancer is the real threat for women FACT: Heart disease is a killer that strikes more women than men, and is more deadly than all forms of cancer combined. While one in 31 American women dies from breast cancer each year, heart disease claims the lives of one in three. That’s roughly one death each minute.

MYTH: Heart disease is for old people FACT: Heart disease affects women of all ages. For younger women, the combination of birth control pills and smoking boosts heart disease risks by 20 percent. And while the risks do increase with age, things like overeating 22

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and a sedentary lifestyle can cause plaque to accumulate and lead to clogged arteries later in life. But even if you lead a completely healthy lifestyle, being born with an underlying heart condition can be a risk factor.

MYTH: Heart disease doesn’t affect women who are fit FACT: Even if you’re a yoga-loving, marathon-running workout fiend,

your risk for heart disease isn’t completely eliminated. Factors like cholesterol, eating habits and smoking can counterbalance your other healthy habits. You can be thin and have high cholesterol. The American Heart Association recommends you start getting your cholesterol checked at age 20, or earlier, if your family has a history of heart disease. And while you’re at it, be sure to keep an eye on your blood pressure at your next check-up.

Heart Attack.

Some Symptoms Might Surprise You. Sweating. Pressure. Nausea. Jaw pain.

Believe it or not, these are all symptoms of a heart attack in women.

They are also symptoms that women often brush off as the flu, stress or simply feeling under the weather – which could put their lives in jeopardy.

Whether it’s disbelief, lack of awareness or misdiagnosis, dismissing the symptoms of a heart attack can delay critical, life-saving actions. Being able to recognize the warning signs and act quickly, however, can save a life.

Symptoms of a heart attack: Uncomfortable pressure squeezing, fullness or pain in the center of your chest that lasts more than a few minutes, or goes away and comes back.

Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of breath, with or without chest discomfort.

Other signs such as breaking out in a cold sweat, nausea or lightheadedness.

As with men, the most common heart attack symptom in women is chest pain or discomfort. But it’s important to note that women are more likely to experience the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

MYTH: I don’t have any symptoms FACT: Sixty-four percent of women who die suddenly of coronary

heart disease had no previous symptoms. Because these symptoms vary greatly between men and women, they’re often misunderstood. Media has conditioned us to believe that the telltale sign of a heart attack is extreme chest pain. But in reality, women are somewhat more likely to experience shortness of breath, nausea/vomiting and back or jaw pain. Other symptoms women should look out for are dizziness, lightheadedness or fainting, pain in the lower chest or upper abdomen and extreme fatigue.

FACT: Although women with a family history of heart disease are at

higher risk, there’s plenty you can do to dramatically reduce it. Simply create an action plan to keep your heart healthy.

Because of healthy choices and knowing the signs, more than 627,000 of women have been saved from heart disease, and 330 fewer are dying per day. What’s stopping you from taking action?

The real fact is, relying on these false assumptions can cost you your life.

MYTH: Heart disease runs in my family, so there’s nothing Learn more at www.goredforwomen.org I can do about it 2013 Heart

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a n a k r a

by Brenda Dudley

x e T

Heart Walk

3 1 20

Did you know that cardiovascular disease is the number 1 killer of all Americans?

In fact, someone dies from CVD every 38 seconds! Heart disease also kills more women than all forms of cancer combined. And congenital cardiovascular defects are the most common cause of infant death from birth defects.

You can help. When you join the Texarkana Heart Walk, you join more than a million people in 300+ cities 24

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across America in taking a stand against heart disease and helping save lives!

The Texarkana Heart Walk is scheduled for Saturday, April 13, 2013. This year the walk will be held on the campus of Texarkana Texas A&M. The 5K will start at 8:00 am with the walk starting at 9:00 am.

You can register online at www.

heartwalk.kintera.org/texarkanaar . The funds you raise in the Heart Walk will support projects like these: *Putting up-to-the-minute research into doctors’ hands so they can better prevent and treat heart disease among patients. *Groundbreaking pediatric heart and stroke research: About 36,000 babies are born with heart defect

The most successful walkers use all of the tools available. Most importantly register online, change *Getting life-saving information picture and personalize your story. to those who need it most – Survivors are given red ball caps to information that can save a life, like wear during the Heart Walk to show how to eat better, how to recognize their triumph over heart disease or the warning signs of heart attack, and stroke. You can also wear a sign that how to talk to a doctor about critical shows you are”walking in memory” health options. or” in honor of”. each year-research is the key to saving babies lives.

Anyone can participate in the Heart Walk, whether you are walking alone, with a team or with your company.

Go to the website and you will see a button that says “Register Here.”

Click on that button and accept the terms and conditions by clicking “I agree.” At this point you will see the option to Join the Heart Walk as an individual or start a team.

Some experts predict, today’s children are not expected to live as long as their parents – the first time ever for an entire generation’s life expectancy to drop.

Raising funds through the Heart Walk is a great way to make a difference in the lives of others. There are multichannel ways for fundraising:

The health of the United States has hit a new low, with millions of Americans at risk for heart disease and stroke. The American Heart Association is responding to this crisis with a new national movement designed to change the way American think about their health.

Online Mobile App Offline Social Media

Currently, less than 1% of the population and NO CHILDREN (ages 12-19) meet the AHA criteria for ideal CV Health.

It’s called My Heart, My Life. This movement is a national rallying cry for change – through simple behavior adjustments that help people feel better and live longer.

There are a number of activities under the umbrella of My Heart, My Life. Among them: increased health education, advocacy for better public policy in important health areas such as anti-smoking laws, and helping communities find ways to eat healthier and stay physically active.

Remember, you can stop heart disease before it starts. Start small and keep it simple. Make one change today and then you’re ready to make another. Before you know it you’ve stopped making poor choices, and started making life choices.

If you have questions about joining the walk or sponsoring the event please call Brenda Dudley at 903490-4230 or email Brenda.dudley@ heart.org.

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Heart Healthy Recipes Believe it or not, eating heart healthy can be equally as delicious as it is good for your body. And if you could save your heart by improving you diet, wouldn’t you at least want to give it a try?

Spinach-Stuffed Baked Salmon Ingredients 1 teaspoon olive oil 2 ounces spinach 1 teaspoon grated lemon zest 1/4 cup chopped roasted red bell peppers, rinsed and drained if bottled 1/4 cup fresh basil, coarsely chopped 2 tablespoons chopped walnuts Cooking spray 4 salmon fillets (about 4 ounces each), rinsed and patted dry 2 tablespoons Dijon mustard (lowest sodium available) 2 tablespoons plain dry bread crumbs (lowest sodium available) 1/2 teaspoon dried oregano, crumbled 1/2 teaspoon garlic powder 1/8 teaspoon pepper Preparation 1) In a large skillet, heat the oil over medium heat, swirling to coat the bottom. Cook the spinach and lemon zest for 2 minutes, or until the spinach is wilted, stirring constantly. Transfer to a medium bowl. Stir in the roasted peppers, basil, and walnuts. Let cool for 5 minutes.

2) Preheat the oven to 400°F.

Line a baking sheet with aluminum foil. Lightly spray the foil with cooking spray.

3) Cut a lengthwise slit in the side of each fillet to make a pocket for the stuffing. Be careful to not cut through to the other side. With a spoon or your fingers, carefully stuff a scant 1/2 cup spinach mixture into each fillet. Transfer to the baking sheet. With a pastry brush or spoon, spread the mustard over the fish.

4) In a small bowl, stir together the remaining ingredients. Sprinkle over the fish. Lightly spray the top with cooking spray.

5) Bake for 12 to 13 minutes, or until the fish is the desired doneness and the filling is heated through.

Tuscan Bean Soup Ingredients 1 teaspoon olive oil 1/2 small red onion, chopped 1 medium rib of celery, chopped 1 medium garlic clove, minced 2 cups fat-free, low-sodium chicken broth 1 15.5-ounce can no-salt-added Great Northern beans, rinsed and drained 1 14.5-ounce can no-salt-added diced tomatoes, undrained 1 teaspoon dried oregano, crumbled 1/2 teaspoon dried thyme, crumbled 1/4 teaspoon crushed red pepper flakes 2 cups spinach 1/3 cup shredded or grated Parmesan cheese Preparation 1) In a large saucepan or Dutch oven, heat the oil over medium heat, swirling to coat the bottom. Cook the onion, celery, and garlic for 4 to 5 minutes, or until the onion and celery are soft.

2) Stir in the broth, beans, tomatoes with liquid, oregano, thyme, and red pepper flakes. Increase the heat to medium high and bring to a simmer, stirring occasionally. Reduce the heat and simmer, covered, for 20 minutes so the flavors blend.

3) Stir in the spinach. Simmer, covered, for 2 to 3 minutes, or until the spinach is wilted. Just before serving, sprinkle the soup with the Parmesan.

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Roasted Red Bell Pepper and Artichoke “Tapenade” Ingredients 12 ounces roasted red bell peppers, rinsed and drained if bottled 1/2 14-ounce can quartered artichoke hearts, rinsed and drained 2 ounces sliced button mushrooms 3 tablespoons chopped fresh basil or 1 tablespoon dried basil, crumbled 2 to 3 tablespoons fresh lemon juice or cider vinegar 2 tablespoons chopped red onion 2 medium garlic cloves, halved 2 tablespoons olive oil (extra virgin preferred) 1/4 teaspoon salt Preparation 1) In a food processor or blender, pulse the bell peppers, artichokes, mushrooms, basil, lemon juice, onion, and garlic until coarse.

2) Pour the mixture into a medium bowl. Stir in the oil and salt. *Cook’s Tip: Serve the tapenade on unsalted melba toast rounds, which have little to no sodium. When buying crackers, bagel choose the whole-grain types and check the nutrition labels to make sure you’re buying the lowest sodium available.

chips, or pita chips,

Festive Salad Greens Ingredients: Salad: 8 cups torn romaine 1 cup dried apricot halves, cut into strips 1/3 cup pecan halves or chopped pecans, dry-roasted 1/2 small red onion, thinly sliced into rings and quartered 1 tablespoon plus 1 teaspoon crumbled fat-free feta cheese Dressing: 1/4 cup water 3 tablespoons sugar 3 tablespoons cider vinegar 2 teaspoons canola or corn oil 1/8 teaspoon salt Preparation 1) In a large bowl, toss together the salad ingredients.

2) In a small bowl, whisk

together the dressing ingredients. Pour the dressing over the salad, tossing gently to coat.

*Cook’s Tip on Dry-Roasting Nuts: Dry-roasting nuts intensifies their flavor. In a small skillet, cook the nuts over medium heat for 2 to 4 minutes, or until they just begin to release their fragrance, stirring constantly or shaking the skillet to prevent the nuts from burning. Remove them immediately so they don’t continue to brown.

Chile-Cheese Stuffed Mushrooms Ingredients Cooking spray 24 medium button mushrooms (about 1 pound), stems discarded 1 4-ounce can chopped green chiles, drained Shredded Cheddar Cheese Preparation 1) Preheat the oven to 400°F. Line a baking sheet with aluminum foil.

2) Place the mushrooms with the stem side down on the foil. Lightly spray the mushrooms with cooking spray.

3) Bake for 10 minutes.

4) Transfer the baking sheet to a cooling rack. Turn the mushrooms over. Fill each with the chiles.

Sprinkle with the Cheddar.

5) Bake for 5 minutes, or until the Cheddar is melted. Remove from the oven and let stand for 3 minutes so the flavors

blend.

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Sweet and Spicy Peanut-Pasta Stir-Fry Ingredients 5 ounces dried whole-grain vermicelli or spaghetti, broken in half 1/2 teaspoon grated orange zest 1/3 cup fresh orange juice 3 tablespoons sugar 3 tablespoons soy sauce (lowest sodium available) 1 tablespoon cider vinegar 1 teaspoon grated peeled gingerroot 1/8 teaspoon crushed red pepper flakes (optional) 1/2 cup dry-roasted unsalted peanuts 1 teaspoon toasted sesame oil 2 cups small broccoli florets (no larger than 3/4 inch) 1 medium carrot, cut into matchstick-size strips 1 medium onion, cut into 1/4-inch wedges 1 medium red bell pepper, cut into thin strips Preparation 1) Prepare the pasta using the package directions, omitting the salt. Drain well in a colander. Set aside.

2) Meanwhile, in a small bowl, whisk together the orange zest, orange juice, sugar, soy sauce, vinegar, gingerroot, and red pepper flakes. Set aside.

3) Heat a large nonstick skillet over medium-high heat. Cook the peanuts for 2 minutes, or until they begin to lightly brown, stirring frequently. Transfer to a plate.

4) In the same skillet, heat the oil, swirling to coat the bottom. Cook the broccoli, carrot, onion, and bell pepper for 6 minutes, or until just tender-crisp.

Transfer to a large bowl. Stir in the cooked pasta and peanuts. Cover to keep warm.

5) In the same skillet, still over medium-high heat, bring the orange juice mixture to a boil. Boil for 2 minutes, or until reduced to about 1/3 cup, stirring constantly. Pour over the pasta mixture, stirring to blend. *Cook’s Tip: To make preparing this dish even easier, assemble the orange juice mixture up to 24 hours in advance and use cut fresh produce from your supermarket.

The truth is, there are plenty of creative ways to make a tasty, heart healthy dish. And you don’t have to be a master chef to whip one up, and do it well.

You may even be surprised to learn that the foods you should be eating are things you probably already enjoy!

Roasted Turkey Breast with Herbs Ingredients Cooking spray 1 3 1/2-pound turkey breast half with skin, thawed if frozen 3 tablespoons fresh lime juice 2 tablespoons olive oil 4 medium garlic cloves, minced 1 teaspoon dried oregano, crumbled 1/2 teaspoon dried tarragon, crumbled 1/2 teaspoon salt 1/2 teaspoon red hot-pepper sauce 1/4 teaspoon pepper 1/4 cup finely chopped fresh parsley Preparation 1) Lightly spray a large glass baking dish with cooking spray. Put the turkey in the baking dish.

2) In a small bowl, stir together the remaining ingredients except the parsley. Stir in the parsley.

3) Using a tablespoon or your fingers, gently loosen the skin from the breast meat, creating a pocket. Being careful to not break the skin, spread the parsley mixture as evenly as possible under the skin. Gently pull the skin over any exposed meat. Cover tightly with plastic wrap and refrigerate for 8 to 12 hours.

4) Preheat the oven to 325°F. Remove the plastic wrap from the turkey.

5) Roast the turkey with the skin side up for 1 hour 30 minutes to 1 hour 45 minutes, or until a meat thermometer or instant-read thermometer inserted into the thickest part of the breast registers 170°F and the juices run clear. Transfer to a cutting board. Let stand for 15 minutes for easier slicing and to let the turkey continue cooking (the internal temperature will rise at least 5°). Discard the skin before serving the turkey. * Cook’s Tip: You may have to buy a whole turkey breast. If so, ask the butcher to cut it in half and wrap one of the pieces for freezing.

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by Redford B. Williams, MD

Depression After Heart Attack Why Should I Be Concerned About Depression After a Heart Attack?

Depression is 3 times more common in patients after a heart attack than in the general population, with 15% to 20% of heart attack victims qualifying for a diagnosis of major depressive disorder, and a far greater proportion experiencing increased levels of depressive symptoms. This comes as no surprise, given that major life stressors are known to contribute to the development of depression, and a heart attack certainly qualifies as such a stressor. Depression after a heart attack is bad not only because of the accompanying emotional distress and suffering; it also increases one’s risk of having another heart attack or dying over the ensuing months and years. Listed in Table 1 are several characteristics that have been found in depressed persons that could account for a poorer prognosis after a heart attack.

How Can I Tell if I’m Depressed?

On the basis of this extensive evidence that depression not only causes misery, but is also associated with a poorer prognosis after a heart attack, an American Heart Association Science Advisory panel recently recommended that patients who have had a heart attack be screened for depressive symptoms to identify those “who may require further assessment and treatment. As shown in Table 2, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) specifies 30

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depressed mood (feeling sad, “down,” unhappy, dissatisfied) and a marked reduction in interest or pleasure in activities that one usually enjoys as key indicators of major depressive disorder. Other symptoms include change in appetite or sleep habits, fatigue or loss of energy, feelings of worthlessness or excessive guilt, trouble concentrating, and recurrent thoughts of death or suicide. A diagnosis of major depressive disorder can only be made by a physician or other mental health professional, but if you have been experiencing several of the symptoms just outlined, it would be a good idea to seek evaluation for depression.

What Can Be Done to Reduce the Impact of Depression on My Mental and Physical Health?

There is some good news here. Depression is a treatable disorder, and there is extensive evidence from rigorously conducted clinical trials that both antidepressant medications and certain forms of psychotherapy are effective in reducing depression. Selective serotonin reuptake inhibitors (SSRIs; eg, sertraline, citalopram) are a type of antidepressant medication that has been found to be both effective in reducing depression and relatively safe to use in patients with coronary heart disease. Cognitive behavior therapy is a form of psychological treatment that has been found to be effective in treating depression; it teaches patients to evaluate their thoughts and 32

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feelings in distressing situations in What Can I Do About ways that are less colored by their the Depression I’m depressed mood and outlook.

Given that depression predicts a poorer prognosis after a heart attack and that SSRIs and cognitive behavior therapy reduce depression, it stands to reason that treating depressed heart attack victims with an SSRI, cognitive behavior therapy, or both would not only reduce their depressive symptoms, but also result in reduced heart disease–related morbidity and mortality. Although there are some studies that have found reduced morbidity and mortality in patients treated with an SSRI or cognitive behavior therapy after a heart attack, there are also studies that failed to demonstrate such a clinical benefit. This is not an unusual state of affairs in cardiology. In the late 1970s, there were several clinical trials that tested β-blockers as a means of improving prognosis after a heart attack. As with the treatment of depression, about half the trials showed a clinical benefit, but half did not, and it was not until a large randomized, controlled trial of β-blocker therapy was conducted that it became clear that treatment with a β-blocker after a heart attack results in a 23% to 28% reduction in morbidity/mortality. Similarly, a large randomized, controlled trial evaluating the impact of an SSRI, cognitive behavior therapy, and a combination of the 2 will be required to provide definitive documentation that treatments known to be effective in reducing depression also reduce morbidity and mortality in patients after a heart attack.

Experiencing After My Heart Attack?

Even though we cannot guarantee at this time a reduction in morbidity/mortality when depression is treated after a heart attack, we do know that effective treatment of depression will reduce suffering and improve your quality of life. So it is appropriate for your physician to have you evaluated for depression after a heart attack and to advise treatment if you are found to have clinically significant symptoms of depression. Your physician will also likely refer you to a cardiac rehabilitation program after your heart attack, and many aspects of this program will help reduce those symptoms. It has been shown, for example, that aerobic exercise in the setting of cardiac rehabilitation reduces symptoms of depression in addition to improving your cardiovascular fitness.1 It could also help if you approach the cardiac rehabilitation program with a positive, optimistic attitude that your active participation will help you cope more effectively with your heart disease. A growing body of research is showing that patients with such a positive, optimistic outlook not only have lower levels of depressive symptoms, but also may have reduced morbidity and mortality. By taking an active role in the process of recovery from your heart attack, you may also be not only adhering to a healthenhancing medical regimen, but also fostering the development of such a positive, optimistic outlook.

Here is a summary of some things you can do to reduce the impact of depression on your heart: Don’t be surprised if you are experiencing some feelings of depression after your heart attack. It’s not unusual to feel depressed after such a major stressful life event; you have lots of company.

Welcome your assessment for depressive symptoms by the mental health professional your physician calls in to see you.

After all, depression is a treatable disorder; treatment can reduce your suffering and improve your quality of life; and, even though we can’t be certain given the present state of knowledge, treatment could also increase the quantity of your life.

Be an active participant in your recovery: Take your prescribed medications as directed and be a regular attendee at your cardiac rehabilitation program, following the diet and exercise recommendations.

And finally, seek out the company of supportive friends and family whom you trust. Patients with heart disease who have a trusted confidant with whom they can share distressing thoughts and feelings have been found in prior research to have lower mortality rates.

Sources of Funding Dr Williams is supported by National Heart, Lung, and Blood Institute grant P01HL36587; National Institute on Aging grant

Table 1.

Mechanisms Contributing to Poor Prognosis After Heart Attack Not taking medications as prescribed Continuing to smoke Less physical activity Increased stress hormone levels Increased blood sugar and lipid levels Increased tendency of blood to clot Increased inflammatory cytokine levels Table 2.

DSM-IV Criteria for Major Depressive Disorder Depressed mood Markedly diminished interest or pleasure in nearly all activities most of the day Significant weight loss, or change in appetite Insomnia or hypersomnia Psychomotor agitation or retardation Fatigue or loss of energy Feelings of worthlessness or excessive guilt Diminished ability to think or concentrate, or indecisiveness Recurrent thoughts of death, suicidal ideation DSM-IV indicates the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

R01AG19605, with cofunding by National Institute of Environmental Health Sciences; and the Duke University Behavioral Medicine Research Center.

Disclosures Dr Williams is a founder and major stockholder of Williams Life Skills, Inc, and holds US patent 7,371,522 on the use of the 5HTTLPR L allele as a genetic marker of increased risk of cardiovascular disease in persons exposed to chronic stress.

Footnotes The information contained in this article is not a substitute for medical advice, and the American Heart Association recommends consultation with your doctor or healthcare professional. © 2011 American Heart Association, Inc. 2013 Heart

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