iRhythm "success"

On Thanksgiving 2010, I felt like I was "off" all day.  One of our cats woke me up at 5:30AM.  I have been exhausted over the last few months anyway.  

I hadn't previously shared this via the Internet, but I am pregnant for the first time.  I have only been this exhausted once before:  prior to the myocardial infarction (M.I.) I survived in 2008.  Nausea is also a common theme during this pregnancy.  My nutrition has been non-existent since becoming pregnant (I could tell early on that I was pregnant).  Excitement has carried me through the last few months of pregnancy.  I've done my best to block out the 'what if' ideas and instead think positively about having a healthy baby.  

Back to Thanksgiving.  Preparation in the kitchen kept me busy until about 10AM when I decided to take a nap.  The smell of food cooking woke me up a couple of times, but I fell back asleep unable to get up.  A little before 2PM, I made myself get up even though I still felt tired (I needed to help with the cooking, but it was already all done, hooray!).  After showering and dressing, I tried to set the table, but felt like I was about to faint in addition to palpitations.  My pulse was rapid compared to the usual rate.  I decided to use an electronic blood pressure/heart rate device.  My pulse was on average at 100 which is a high rate for me.  My shoulder blades were also extremely painful (another symptom during the M.I. I had).  Unfortunately I had walked our wild dog the day before and wasn't sure if that was the cause.  When we sat down for dinner at 3PM, I had no appetite.  After dinner, I "retired" to my recliner.  I finally asked my husband to call the on-call cardiologist because I eerily felt similar to the day(s) leading up to my M.I. (heart attack).  Soon I spoke with the on-call cardiologist who told me to record and transmit anything I felt via the iRhythm medical device and assured me that Zio Event Card/IRhythm would contact the cardiologist should something be received that needed immediate attention.  Needless to say, I later found myself at the local emergency room.

Arrival at the ER was a result of using the iRhythm.  I recorded an event later in the evening around 8pm while watching football.  The cause for the recording occurred when I felt a dull, repetitive pain below my left breast.  About an hour later, I phoned iRhythm and transmitted the recording.  I know, I shouldn't have waited.  Unlike previous transmissions, the representative asked me to record another event while they remained on the phone and then transmit the event.  After doing so, I asked why I was instructed to complete the task and was told that the event (that I recorded while watching football an hour earlier) met the criteria to notify the on-call cardiologist.  After waiting about 20 minutes, I called iRhythm back and asked if they had contacted the on-call cardiologist.  The representative stated that they were in the process and that if I wasn't contacted, that would mean the on-call cardiologist deemed the event not an emergency.  Thankful for the fact that I was wearing the Zio Event Card/iRhythm, I asked if it was okay for me to call back if I didn't hear from the on-call cardiologist.  I found it hard to believe that given the fact I had already spoken with the on-call cardiologist, that I wouldn't be contacted.  The representative stated I was welcome to call back.  Fortunately I received a call from the on-call cardiologist about 10-15 minutes later.  I was told that it was a good idea for me to go to the hospital and that the doctor would call ahead of my arrival.  


More on that later.  I'm tired and my husband just handed me a homemade piece of apple pie!  I'm very thankful for every day I have and need to go spend time with the ones I love.

more on the iRhythm monitor

I haven't been wearing the iRhythm monitor since Sunday afternoon.  I got an itchy rash underneath one of the electrode patches.  I'm going to give it a try again today since the area on my stomach where the rash was has dried out.  I've never had a rash before (even when I was going to cardiac rehabilitation and exercising where they monitor you via the use of electrodes) so I hope it was just a fluke occurrence.  

monitor

I'm hooked up to a heart monitor.  I'd been having palpitations earlier this week, so the cardiologist has provided a heart monitor for me to wear for thirty days.  It isn't like the twenty-four hour monitor that I've worn in the past.  With the twenty-four hour monitor, I wore it, recorded palpitations by pressing a button on the device and kept a written diary which included what I was doing at the time of the 'event'.  This thirty day monitor, called a iRhythm (Zio Event Card), is more labor intensive as a patient (which isn't a big deal, just different).  The iRhythm allows the patient to record a total of two events.  After that, the data has to be sent to the company by phoning their toll free number (a land line is mandatory).  After speaking with a representative and verifying your name, date of birth and the last four number from the backside of the Zio Event Card, the device is placed facing up on a flat surface while the phone receiver connected to a land line is held over the telephone icon on the iRhythm device.  Once the telephone is in place, the patient presses send on the iRhythm device.  A series of audible key tones are transmitted (sounding very similar to a facsimile machine) over the land line telephone.  Once the key tones have ended, the patient uses the telephone to continue speaking with a representative who verifies if the data is readable.  One perk to the iRhythm is that the representatives will contact your doctor if the data presents as emergent, whereas the twenty-four hour monitor will be interpreted at a later date.  The iRhythm unit comes with helpful instructions that describe it's usage in more depth.

Dr. Oz: Mehmet C. Oz, M.D.

I've never been a fan of "talk shows", no matter the genre, not to mention the lackluster garbage most television networks produce of late.  Despite my usual lack of interest, the Dr. Oz Show has more than peaked my interest since the initial broadcast in the fall of last year (2009).  I can't get enough of the show.  I find it so adorable that all the women who join Dr. Oz from the audience on stage are so taken with Dr. Oz.  The admiration reminds me of stories I've heard from family about the fanfare that followed Elvis Presley, except instead of teenagers, these are mature women.  Okay, maybe not quite the level of crazed hormonal teenagers, yet it would appear that Dr. Oz, has become, a sex symbol to many.  I digress.  I wish I lived within a reasonable distance to be a patient at New York Presbyterian Hospital, moreover, the Complementary Care Center.  I first learned of the Complementary Care Center in one of the books I am currently enjoying, 'Healing from the Heart' by Mehmet C. Oz, M.D. with Ron Arias and Lisa Oz (1999).  Please take note, this book has a copyright date of 1998.  While the book is now twelve years old, it remains years ahead of Western medicine.  

I bought this book shortly after the myocardial infarction I had two years ago.  I am embarrassed that I only began reading it a couple of weeks ago.  It is an easy read as the saying goes.  I don't know why it took me so long to open; maybe I was scared of the reality.  'Healing from the Heart' is nothing to be frightened of though.  Reading it as a heart attack survivor has brought me comfort.  Every heart attack/disease survivor should read this book.  Dr. Oz isn't just concerned with the mechanics of Western medicine as evident in each chapter.  Factual medical information explaining the "biology of an MI" begins in chapter one, followed by the exploration/comparison of various non-traditional or "complementary medicine" as referenced by the author.  Dr. Oz clearly wishes to treat and benefit patients not only physically, but emotionally as well.  His writing should be required reading for all medical students.  The healing ideas discussed should be heeded by all persons wishing to enter into the medical field, and if not, I myself would never want that person as a physician.  


Please excuse me while I bird-walk over to the topic of health insurance.  It is well past the time that the Western world and insurance companies remain open minded about approaching health as complementary medicine describes - prescription pills and surgeries alone are not the answer.  Perhaps this is why insurance companies continue to deny therapies.  If these therapies were available, they just may heal people to the point that there is no longer the need for a battery of prescription medicine or unnecessary treatment(s)/surgery(s).  Where would the insurance companies be without repeat patients:  having only received traditional medical care, still lacking, universal, whole body and mind care!?  

Personally, I've explored some of the therapies shared in Dr. Oz's book prior to reading it.  While not coming out and labeling the various therapies discussed, it's clear to me that processes such as Reiki are described.  (I'm on page 129, so forgive me if I am wrong.)  When I met with a Reiki practitioner (or energy healer), I felt a tremendous improvement emotionally and physically.  Whether or not this was a placebo effect, what does it matter if overused Western therapies are not proving beneficial?  I honestly don't care if it is in my mind or an actual result of Reiki, I feel better!  I doubt others who experience chronic pain would (having benefited) state, oh no, this might not truly be effective treatment, and return to therapies that produce less satisfactory physical/emotional results.  The same can be said with acupuncture.  I found acupuncture to be very beneficial.  


Again, I fail to understand why insurance companies do not offer coverage for these types of medical therapies (at least mine doesn't).  I can only assume it comes down to their financial situation being more advantageous by having frequent customers.  Since this is the case, I'd like my frequent flyer card issued immediately.  I 'fly' the standard, repetitive, western medicine skies all too much not to receive a freebie or upgrade at some point.  No frequent flyer card available?  Okay, I'd much prefer to have my insurance company cover complementary medical treatments in the end anyway.  It's ridiculous the insurance hoops patients have to jump through to get the health care they desire.  It's a shame in a country that is supposedly so forward thinking.  Dr. Oz is a forward thinker (and that doesn't even give his approach justice).  I could go on about the book, but like many medical situations, suffering a trauma is pretty personal.  Interpretation (by reader) will be individual and personal also.  

If you are cardiac patient or have a loved one who is, don't pass up Dr. Oz's book.  If you want my copy when I'm done, let me know, I'd be happy to pass it along!  If you have television, don't pass up the Dr. Oz Show either, it could positively increase your lifetime.  Incidentally, I'd be irresponsible if I didn't mention talking with your own doctor prior to making changes to your health care.  Everyone is different and your medical providers should always be kept in the know.

New Month

I am so glad June is over, for a variety of reasons.  Various occurrences have kept me mum; I haven't wanted to see/hear the news nor have any contact with people other than those closest to me.  I can't keep my head in the sand forever.  That being said, I am finally 'here'.  

As far as everything medically is concerned, I am still trying to deal with the Medtronic failure situation.  I thought I was getting by okay, however, the actual implant is becoming extremely uncomfortable.  I unfortunately KNOW (chronic) pain, and this isn't pain so much as it is a major annoyance:  the battery continues to protrude more and more from my abdomen.  I feel like Sigourney Weaver from the movie 'Alien' - in my case, I keep waiting for this piece of electronic junk to rip through my skin, out of my stomach.  Dramatic, yes; possible, yes.  I just want it out!  Is this what women in the last days of pregnancy feel like?  Yuck.

I did meet with a new pain specialist doctor who confirmed that the battery has in fact expired.   Previously  my spouse and I traveled 141 miles round trip, to the doctor who implanted the medical device only to find that he couldn't work the monitoring device and opted not to have a Medtronic representative present for my appointment.  The doctor further stated that the other patient had cancelled, so 'he decided not to have the [Medtronic] rep. come in').  Gee, thanks.  Next, he asked me to come back in two days (another 140 miles) following a blatant insult regarding the myocardial infarction I previously suffered.  I have no problem traveling for competent health care, but there was no way I was going back to him.  An office staff member at the new doctor office was able to operate/read the monitoring device.  What a joke that my former doctor couldn't do the same; what a worthless 'pain management' physician.

Decisions, decisions.  I am so sick of hospitals and surgeries.  It could be worse though.  It easily could be worse, and that is what I remind myself every time the 'alien' causes me discomfort or I feel frustrated about the medical device failure.

Medtronic Failure

I feel I would not be a responsible patient if I did not comment regarding the recent failure(s) by Medtronic and the spinal cord stimulator I received in 2008. My spinal cord implant had been an overall happy story until a few weeks ago (less the physician form the get go). I should have listened to my instincts and at least switched to a new physician (I almost cancelled the surgery the day of, even after already receiving the I.V. I began having problems with the medical device (it had protruded); giving me the worst stinging/burning sensation at the implantation site. My 'pain specialist' doctor and Medtronic have not been helpful - they have been the complete opposite. It's as though they consider me an enemy and could care less now that the Medtronic implant is in (though failing). In addition to the shifting of the device, the battery has failed. It hasn't even been two years. I cannot impress upon others considering this life changing event to thoroughly research before going through with the surgery. I was utterly desperate after living with chronic pain for years - I would have done it differently had I known what I am experiencing now. I also had a blood clot form in my heart within three months of my surgery, thus suffering a myocardial infarction, of which I am lucky to be alive.  I am hopeful that my situation stems from an irresponsible physician and Medtronic representative. I truly hope that all who have the devices already implanted have continued success.

Despise Medtronic

I've stopped crying now.  I am sick of hospitals!! & surgeries I can't imagine another surgery - talk about flashbacks and freaking out.  Medtronic medical device is off indefinitely until I get a response from someone who can explain 'wth' went wrong.

Mud

Wow, I demonstrated shocking restraint tonight.  Trader Joe's hasn't carried their Mud Pie in forever.  Of course I was able to spy it immediately.  I honestly walked around the store, continuing to shop, debating in my head about buying it.  I knew if I bought it, it would be gone by the time the weekend is over - I am that bad (no self control).  I never even knew what Mud Pie was until a few years ago - my mom was a health freak with me in my younger years and my dad was a healthy food control freak.  I thought I had discovered this fantastic dessert that you could only get at one restaurant (duh, I have my um, moments).  Oh, how I wish this were true, however as most people know, Mud Pie is everywhere!!!  Long story short, I don't know if I was saved-by-the-bell (the store was closing) or I actually exercised (no pun intended) a little self control for once, but I didn't buy the Mud Pie.  It is still haunting me right now, but I am sharing this with the "world" to keep myself in check - and because I should be a little proud, right?  I mean, Mud Pie to me is eat-in-a-dark-corner-by-myself-good.  I digress; I did buy a substitute to sooth my Mud Pie fervor:  Trader Joe's Gluten Free Brownie Baking Mix (previous link is from BakingBites.com).   I'm curious to see how it turns out.  I've been trying more gluten free items of late.  It seems the girl who can and will eat anything, finally can't (blessing in disguise?).  As I type this I'm realizing I hope my mother doesn't read this - she is convinced I have Celiac Disease (and that there is a correlation between it and the blood clot that lead to my heart attack).

that rock

Where my health is concerned, I've had a solid week of feeling like Sisyphus (thus, the reason for "hybernating" from the world).  I've been doing my best to not let my imagination get the better of me.  Maybe things aren't even as bad as they feel, however, collectively I feel like I am in my twelfth round of a boxing match, having already been knocked out.

Today is the day! April 7th: National Start! Walking Day!!!!!

Wherever you are, sometime before the clock strikes midnight, get out and walk for  thirty minutes today - even twenty minutes if it comes down to squeezing it in while you're at work (on your morning or afternoon break?!).  Start walking for a healthier lifestyle (yup, I stole that last phrase from the American Heart Association website, but it's soooo true and simple).  You have to make the time for yourself.  Your well-being and health are priceless; you'll even feel a little less stressful after going for a thirty minute walk (I can pretty much guarantee it).  The American Heart Association even has a nifty online tracker, if you're like me, and prefer to see your progress in the days and months to come.  There is no time like the present!  I'll be doing the same thing today - I confess, I've slacked off ;-)  Begin the change today.  

More Reasons To Walk, Not Only For Your Heart, But For Your Brain! From HealthDay News

With the American Heart Association's (AHA) National Start! Walking Day fast approaching this Wednesday (just two days away!), read the article below to learn about another great reason to start walking regularly.   Participate in National Start! Walking Day wherever you are this April 7th!  Check out the details here.  When it really comes down to it, all you need is yourself, 30 minutes and a pair of comfortable shoes!!! 

Exercise May Stave Off Mental Decline

Monday,January 11, 2010 (Healthday News)

FRIDAY, Jan. 8 (HealthDay News) -- Exercise appears to help prevent and improve mild cognitive impairment, two new studies show.

Researchers found that people who did moderate physical activity in midlife or later had a reduced risk of mild cognitive impairment and that six months of high-intensity aerobic exercise improved cognitive function in people with mild cognitive impairment.

Mild cognitive impairment is an in-between state between the normal changes in thinking, learning and memory changes that come with age and dementia, one of the studies explained. Up to 15 percent of people with mild cognitive impairment develop dementia each year, compared with 1 percent or 2 percent of the general population.

The first study included 1,324 dementia-free volunteers taking part in the Mayo Clinic Study of Aging. The participants completed a physical exercise questionnaire and were assessed and classified as having normal cognition (1,126) or mild cognitive impairment (198).

Those who said they did moderate exercise -- such as swimming, brisk walking, yoga, aerobics or strength training -- during midlife were 39 percent less likely to have mild cognitive impairment, while those who did moderate exercise later in life were 32 percent less likely to have the condition.

The Mayo team said exercise may guard against mild cognitive impairment through production of nerve-protecting compounds, increased blood flow to the brain, improved development and survival of neurons, and decreased risk of heart and blood vessel diseases.

The second study included 33 adults, average age 70, with mild cognitive impairment. Some were randomly assigned to do high-intensity aerobics for 45 to 60 minutes a day, four days a week. Others were put in a control group that had the same workout schedule, but did stretching exercises and kept their heart rate low.

After six months, the patients who did high-intensity aerobic exercise had improved cognitive function compared to those in the control group. The beneficial effects were more pronounced in women than in men, possibly because the body's use of and production of insulin, glucose and the stress hormone cortisol differed in women and men.

"Aerobic exercise is a cost-effective practice that is associated with numerous physical benefits. The results of this study suggest that exercise also provides a cognitive benefit for some adults with mild cognitive impairment," wrote Laura D. Baker, of the University of Washington School of Medicine and Veterans Affairs Puget Sound Health Care System in Seattle, and colleagues.

The studies appear in the January issue of the Archives of Neurology.

More information

The Alzheimer's Association has more about mild cognitive impairment.

cardiologist appt

went very well all things considered!

Geography of the Vote (link to map) Patient Protection and Affordable Care Act

House Vote 163 - On Agreeing to the Resolution Providing for consideration of the Senate Amendments to H.R. 3590 , Patient Protection and Affordable Care Act, and providing for the consideration of the bill H.R. 4872, Reconciliation Act of 2010. On Agreeing to the Resolution Other Recent Votes MARCH 21, 2010 H.RES.925: On Motion to Suspend the Rules and Agree, as Amended Expressing the sense of the House of Representatives regarding the meritorio... MARCH 21, 2010 On Agreeing to the Resolution: Providing for consideration of the Senate Amendments to H.R. 3590 , Patient ... MARCH 21, 2010 On Ordering the Previous Question: Providing for consideration of the Senate Amendments to H.R. 3590 , Patient ... MARCH 21, 2010 H.RES.900: On Motion to Suspend the Rules and Agree, as Amended Supporting the goals and ideals of a Cold War Veterans Recognition Day to ho... MARCH 21, 2010 Will the House Now Consider the Resolution: Providing for consideration of the Senate Amendments to H.R. 3590 , Patient ... Result: Passed by 18 votes Date of Vote: March 21, 2010 Roll Call Number: 163 Related Story: House Clears Path for Final Health Vote Geography of the Vote Complete Roll Call Yes Votes (224) Member Party Dist. Gary L. Ackerman D N.Y.-5 Jason Altmire D Pa.-4 Robert E. Andrews D N.J.-1 Joe Baca D Calif.-43 Brian Baird D Wash.-3 Tammy Baldwin D Wis.-2 Melissa Bean D Ill.-8 Xavier Becerra D Calif.-31 Shelley Berkley D Nev.-1 Howard L. Berman D Calif.-28 Marion Berry D Ark.-1 Timothy H. Bishop D N.Y.-1 Sanford D. Bishop Jr. D Ga.-2 Earl Blumenauer D Ore.-3 John Boccieri D Ohio-16 Leonard L. Boswell D Iowa-3 Allen Boyd D Fla.-2 Robert A. Brady D Pa.-1 Bruce Braley D Iowa-1 Corrine Brown D Fla.-3 G. K. Butterfield D N.C.-1 Lois Capps D Calif.-23 Michael E. Capuano D Mass.-8 Dennis Cardoza D Calif.-18 Russ Carnahan D Mo.-3 Christopher Carney D Pa.-10 André Carson D Ind.-7 Kathy Castor D Fla.-11 Judy Chu D Calif.-32 Yvette Clarke D N.Y.-11 William Lacy Clay D Mo.-1 Emanuel Cleaver II D Mo.-5 James E. Clyburn D S.C.-6 Steve Cohen D Tenn.-9 Gerald E. Connolly D Va.-11 John Conyers Jr. D Mich.-14 Jim Cooper D Tenn.-5 Jim Costa D Calif.-20 Jerry F. Costello D Ill.-12 Joe Courtney D Conn.-2 Joseph Crowley D N.Y.-7 Henry Cuellar D Tex.-28 Elijah E. Cummings D Md.-7 Kathy Dahlkemper D Pa.-3 Danny K. Davis D Ill.-7 Susan A. Davis D Calif.-53 Peter A. DeFazio D Ore.-4 Diana DeGette D Colo.-1 Bill Delahunt D Mass.-10 Rosa DeLauro D Conn.-3 Norman D. Dicks D Wash.-6 John D. Dingell D Mich.-15 Lloyd Doggett D Tex.-25 Joe Donnelly D Ind.-2 Mike Doyle D Pa.-14 Steve Driehaus D Ohio-1 Donna Edwards D Md.-4 Keith Ellison D Minn.-5 Brad Ellsworth D Ind.-8 Eliot L. Engel D N.Y.-17 Anna G. Eshoo D Calif.-14 Bob Etheridge D N.C.-2 Sam Farr D Calif.-17 Chaka Fattah D Pa.-2 Bob Filner D Calif.-51 Bill Foster D Ill.-14 Barney Frank D Mass.-4 Marcia L. Fudge D Ohio-11 John Garamendi D Calif.-10 Gabrielle Giffords D Ariz.-8 Charlie Gonzalez D Tex.-20 Bart Gordon D Tenn.-6 Alan Grayson D Fla.-8 Al Green D Tex.-9 Gene Green D Tex.-29 Raúl M. Grijalva D Ariz.-7 Luis V. Gutierrez D Ill.-4 John Hall D N.Y.-19 Debbie Halvorson D Ill.-11 Phil Hare D Ill.-17 Jane Harman D Calif.-36 Alcee L. Hastings D Fla.-23 Martin Heinrich D N.M.-1 Brian Higgins D N.Y.-27 Baron P. Hill D Ind.-9 Jim Himes D Conn.-4 Maurice D. Hinchey D N.Y.-22 Rubén Hinojosa D Tex.-15 Mazie K. Hirono D Hawaii-2 Paul W. Hodes D N.H.-2 Rush Holt D N.J.-12 Michael M. Honda D Calif.-15 Steny H. Hoyer D Md.-5 Jay Inslee D Wash.-1 Steve Israel D N.Y.-2 Jesse L. Jackson Jr. D Ill.-2 Sheila Jackson-Lee D Tex.-18 Eddie Bernice Johnson D Tex.-30 Hank Johnson D Ga.-4 Steve Kagen D Wis.-8 Paul E. Kanjorski D Pa.-11 Marcy Kaptur D Ohio-9 Patrick J. Kennedy D R.I.-1 Dale E. Kildee D Mich.-5 Carolyn Cheeks Kilpatrick D Mich.-13 Mary Jo Kilroy D Ohio-15 Ron Kind D Wis.-3 Ann Kirkpatrick D Ariz.-1 Larry Kissell D N.C.-8 Ron Klein D Fla.-22 Suzanne Kosmas D Fla.-24 Dennis J. Kucinich D Ohio-10 Jim Langevin D R.I.-2 Rick Larsen D Wash.-2 John B. Larson D Conn.-1 Barbara Lee D Calif.-9 Sander M. Levin D Mich.-12 John Lewis D Ga.-5 Dave Loebsack D Iowa-2 Zoe Lofgren D Calif.-16 Nita M. Lowey D N.Y.-18 Ben Ray Lujan D N.M.-3 Dan Maffei D N.Y.-25 Carolyn B. Maloney D N.Y.-14 Betsy Markey D Colo.-4 Edward J. Markey D Mass.-7 Doris Matsui D Calif.-5 Carolyn McCarthy D N.Y.-4 Betty McCollum D Minn.-4 Jim McDermott D Wash.-7 Jim McGovern D Mass.-3 Michael E. McMahon D N.Y.-13 Jerry McNerney D Calif.-11 Kendrick B. Meek D Fla.-17 Gregory W. Meeks D N.Y.-6 Michael H. Michaud D Me.-2 Brad Miller D N.C.-13 George Miller D Calif.-7 Alan B. Mollohan D W.Va.-1 Dennis Moore D Kan.-3 Gwen Moore D Wis.-4 James P. Moran D Va.-8 Christopher S. Murphy D Conn.-5 Patrick J. Murphy D Pa.-8 Scott Murphy D N.Y.-20 Jerrold Nadler D N.Y.-8 Grace F. Napolitano D Calif.-38 Richard E. Neal D Mass.-2 James L. Oberstar D Minn.-8 David R. Obey D Wis.-7 John W. Olver D Mass.-1 Solomon P. Ortiz D Tex.-27 Bill Owens D N.Y.-23 Frank Pallone D N.J.-6 Bill Pascrell Jr. D N.J.-8 Ed Pastor D Ariz.-4 Donald M. Payne D N.J.-10 Ed Perlmutter D Colo.-7 Tom Perriello D Va.-5 Gary Peters D Mich.-9 Collin C. Peterson D Minn.-7 Chellie Pingree D Me.-1 Jared Polis D Colo.-2 Earl Pomeroy D N.D.-1 David E. Price D N.C.-4 Mike Quigley D Ill.-5 Nick J. Rahall II D W.Va.-3 Charles B. Rangel D N.Y.-15 Silvestre Reyes D Tex.-16 Laura Richardson D Calif.-37 Ciro D. Rodriguez D Tex.-23 Steven R. Rothman D N.J.-9 Lucille Roybal-Allard D Calif.-34 C.A. Dutch Ruppersberger D Md.-2 Bobby L. Rush D Ill.-1 Tim Ryan D Ohio-17 John Salazar D Colo.-3 Linda T. Sanchez D Calif.-39 Loretta Sanchez D Calif.-47 John Sarbanes D Md.-3 Jan Schakowsky D Ill.-9 Mark Schauer D Mich.-7 Adam B. Schiff D Calif.-29 Kurt Schrader D Ore.-5 Allyson Y. Schwartz D Pa.-13 David Scott D Ga.-13 Robert C. Scott D Va.-3 José E. Serrano D N.Y.-16 Joe Sestak D Pa.-7 Carol Shea-Porter D N.H.-1 Brad Sherman D Calif.-27 Albio Sires D N.J.-13 Louise M. Slaughter D N.Y.-28 Adam Smith D Wash.-9 Vic Snyder D Ark.-2 Jackie Speier D Calif.-12 John M. Spratt Jr. D S.C.-5 Pete Stark D Calif.-13 Bart Stupak D Mich.-1 Betty Sutton D Ohio-13 John Tanner D Tenn.-8 Harry Teague D N.M.-2 Bennie Thompson D Miss.-2 Mike Thompson D Calif.-1 John F. Tierney D Mass.-6 Dina Titus D Nev.-3 Paul Tonko D N.Y.-21 Edolphus Towns D N.Y.-10 Niki Tsongas D Mass.-5 Chris Van Hollen D Md.-8 Nydia M. Velázquez D N.Y.-12 Peter J. Visclosky D Ind.-1 Tim Walz D Minn.-1 Debbie Wasserman Schultz D Fla.-20 Maxine Waters D Calif.-35 Diane Watson D Calif.-33 Melvin Watt D N.C.-12 Henry A. Waxman D Calif.-30 Anthony Weiner D N.Y.-9 Peter Welch D Vt.-1 Charlie Wilson D Ohio-6 Lynn Woolsey D Calif.-6 David Wu D Ore.-1 John Yarmuth D Ky.-3 No Votes (206) Member Party Dist. Robert B. Aderholt R Ala.-4 John Adler D N.J.-3 Todd Akin R Mo.-2 Rodney Alexander R La.-5 Michael Arcuri D N.Y.-24 Steve Austria R Ohio-7 Michele Bachmann R Minn.-6 Spencer Bachus R Ala.-6 J. Gresham Barrett R S.C.-3 John Barrow D Ga.-12 Roscoe G. Bartlett R Md.-6 Joe L. Barton R Tex.-6 Judy Biggert R Ill.-13 Brian P. Bilbray R Calif.-50 Gus Bilirakis R Fla.-9 Rob Bishop R Utah-1 Marsha Blackburn R Tenn.-7 Roy Blunt R Mo.-7 John A. Boehner R Ohio-8 Jo Bonner R Ala.-1 Mary Bono Mack R Calif.-45 John Boozman R Ark.-3 Dan Boren D Okla.-2 Rick Boucher D Va.-9 Charles Boustany Jr. R La.-7 Kevin Brady R Tex.-8 Bobby Bright D Ala.-2 Paul Broun R Ga.-10 Henry E. Brown Jr. R S.C.-1 Ginny Brown-Waite R Fla.-5 Vern Buchanan R Fla.-13 Michael C. Burgess R Tex.-26 Dan Burton R Ind.-5 Steve Buyer R Ind.-4 Ken Calvert R Calif.-44 Dave Camp R Mich.-4 John Campbell R Calif.-48 Eric Cantor R Va.-7 Anh Cao R La.-2 Shelley Moore Capito R W.Va.-2 John Carter R Tex.-31 Bill Cassidy R La.-6 Michael N. Castle R Del.-1 Jason Chaffetz R Utah-3 Ben Chandler D Ky.-6 Travis Childers D Miss.-1 Howard Coble R N.C.-6 Mike Coffman R Colo.-6 Tom Cole R Okla.-4 K. Michael Conaway R Tex.-11 Ander Crenshaw R Fla.-4 John Culberson R Tex.-7 Artur Davis D Ala.-7 Geoff Davis R Ky.-4 Lincoln Davis D Tenn.-4 Charlie Dent R Pa.-15 Lincoln Diaz-Balart R Fla.-21 Mario Diaz-Balart R Fla.-25 David Dreier R Calif.-26 John J. Duncan Jr. R Tenn.-2 Chet Edwards D Tex.-17 Vernon J. Ehlers R Mich.-3 Jo Ann Emerson R Mo.-8 Mary Fallin R Okla.-5 Jeff Flake R Ariz.-6 John Fleming R La.-4 J. Randy Forbes R Va.-4 Jeff Fortenberry R Neb.-1 Virginia Foxx R N.C.-5 Trent Franks R Ariz.-2 Rodney Frelinghuysen R N.J.-11 Elton Gallegly R Calif.-24 Scott Garrett R N.J.-5 Jim Gerlach R Pa.-6 Phil Gingrey R Ga.-11 Louie Gohmert R Tex.-1 Robert W. Goodlatte R Va.-6 Kay Granger R Tex.-12 Sam Graves R Mo.-6 Parker Griffith R Ala.-5 Brett Guthrie R Ky.-2 Ralph M. Hall R Tex.-4 Gregg Harper R Miss.-3 Doc Hastings R Wash.-4 Dean Heller R Nev.-2 Jeb Hensarling R Tex.-5 Wally Herger R Calif.-2 Stephanie Herseth Sandlin D S.D.-1 Peter Hoekstra R Mich.-2 Tim Holden D Pa.-17 Duncan D. Hunter R Calif.-52 Bob Inglis R S.C.-4 Darrell Issa R Calif.-49 Lynn Jenkins R Kan.-2 Sam Johnson R Tex.-3 Timothy V. Johnson R Ill.-15 Walter B. Jones R N.C.-3 Jim Jordan R Ohio-4 Peter T. King R N.Y.-3 Steve King R Iowa-5 Jack Kingston R Ga.-1 Mark Steven Kirk R Ill.-10 John Kline R Minn.-2 Frank Kratovil Jr. D Md.-1 Doug Lamborn R Colo.-5 Leonard Lance R N.J.-7 Tom Latham R Iowa-4 Steven C. LaTourette R Ohio-14 Robert E. Latta R Ohio-5 Christopher Lee R N.Y.-26 Jerry Lewis R Calif.-41 John Linder R Ga.-7 Daniel Lipinski D Ill.-3 Frank A. LoBiondo R N.J.-2 Frank D. Lucas R Okla.-3 Blaine Luetkemeyer R Mo.-9 Cynthia M. Lummis R Wyo.-1 Dan Lungren R Calif.-3 Stephen F. Lynch D Mass.-9 Connie Mack R Fla.-14 Donald Manzullo R Ill.-16 Kenny Marchant R Tex.-24 Jim Marshall D Ga.-8 Jim Matheson D Utah-2 Kevin McCarthy R Calif.-22 Michael McCaul R Tex.-10 Tom McClintock R Calif.-4 Thaddeus McCotter R Mich.-11 Patrick T. McHenry R N.C.-10 Mike McIntyre D N.C.-7 Howard P. McKeon R Calif.-25 Cathy McMorris Rodgers R Wash.-5 Charlie Melancon D La.-3 John L. Mica R Fla.-7 Candice S. Miller R Mich.-10 Gary G. Miller R Calif.-42 Jeff Miller R Fla.-1 Walt Minnick D Idaho-1 Harry E. Mitchell D Ariz.-5 Jerry Moran R Kan.-1 Tim Murphy R Pa.-18 Sue Myrick R N.C.-9 Randy Neugebauer R Tex.-19 Devin Nunes R Calif.-21 Glenn Nye D Va.-2 Pete Olson R Tex.-22 Ron Paul R Tex.-14 Erik Paulsen R Minn.-3 Mike Pence R Ind.-6 Tom Petri R Wis.-6 Joe Pitts R Pa.-16 Todd R. Platts R Pa.-19 Ted Poe R Tex.-2 Bill Posey R Fla.-15 Tom Price R Ga.-6 Adam H. Putnam R Fla.-12 George P. Radanovich R Calif.-19 Denny Rehberg R Mont.-1 Dave Reichert R Wash.-8 Phil Roe R Tenn.-1 Harold Rogers R Ky.-5 Mike Rogers R Mich.-8 Mike D. Rogers R Ala.-3 Dana Rohrabacher R Calif.-46 Tom Rooney R Fla.-16 Ileana Ros-Lehtinen R Fla.-18 Peter Roskam R Ill.-6 Mike Ross D Ark.-4 Ed Royce R Calif.-40 Paul D. Ryan R Wis.-1 Steve Scalise R La.-1 Jean Schmidt R Ohio-2 Aaron Schock R Ill.-18 F. James Sensenbrenner R Wis.-5 Pete Sessions R Tex.-32 John Shadegg R Ariz.-3 John Shimkus R Ill.-19 Heath Shuler D N.C.-11 Bill Shuster R Pa.-9 Mike Simpson R Idaho-2 Ike Skelton D Mo.-4 Adrian Smith R Neb.-3 Christopher H. Smith R N.J.-4 Lamar Smith R Tex.-21 Mark Souder R Ind.-3 Zack Space D Ohio-18 Cliff Stearns R Fla.-6 John Sullivan R Okla.-1 Gene Taylor D Miss.-4 Lee Terry R Neb.-2 Glenn Thompson R Pa.-5 William M. Thornberry R Tex.-13 Todd Tiahrt R Kan.-4 Pat Tiberi R Ohio-12 Michael R. Turner R Ohio-3 Fred Upton R Mich.-6 Greg Walden R Ore.-2 Zach Wamp R Tenn.-3 Lynn Westmoreland R Ga.-3 Edward Whitfield R Ky.-1 Joe Wilson R S.C.-2 Robert J. Wittman R Va.-1 Frank R. Wolf R Va.-10 C. W. Bill Young R Fla.-10 Don Young R Alaska-1 Did Not Vote (0) Member Party Dist. Nancy Pelosi D Calif.-8 Present (0) Member Party Dist. From New York Times

Geographic Primary-Stroke-Center Placement

I've noticed several comments from heart attack and/or stroke survivors lately regarding the lack of available facilities where they reside.  The article below (courtesy of International Media News Group http://egmnblog.wordpress.com ) peaked my interest; heck, there is a map included which would explain exactly why survivors are expressing frustration about lack of facilities.  Look at all of the gaping white spaces on the map pictured below - I'm very thankful to the writer, Mitchel Zoler, for making this information available:

The Uncoordinated U.S. Primary Stroke Centers

From the International Stroke Conference in San Antonio

The good news for U.S. stroke patients is that in March 2010, 685 certified primary stroke centers existed in America. The bad news is that no one makes sure they’re optimally placed to maximize coverage of the U.S. population.

The Joint Commission, a U.S. hospital accreditation organization, began certifying primary stroke centers in December 2003. The idea was that these centers would specialize in state-of-the-art stroke care and become the prime locations for acute stroke patients to receive care.

The concept has certainly taken root. According to Dr. Karen C. Albright, a neurologist at the University of California, San Diego, 524 certified American primary stroke centers existed by November 2008, and another 102 came on board during the following year, through late September, 2009. The pace for new center certifications has held steady, with another 59 centers added to the list during a little more than another 5 months.

Stroke patients who live in the white areas have a greater than 60 minute trip to their nearest primary stroke center (photo by Mitchel Zoler).

But according to Dr. Albright, many of the new centers added during Nov. 2008-Sept. 2009 were “in proximity to existing centers.” No person or group controls where new stroke centers open, and they’ve left big gaps of uncovered population. Based on the centers that existed last September, Dr. Albright estimated that roughly 63 million to 135 million Americans lived more than 60 minutes away from the closest primary stroke center (see map). The upper end number, 135 million, applied if all emergency stroke transport was by ambulance. The number fell to 63 million if all centers had helicopter transport available, but that’s a big if because in reality many centers don’t use air transport.

Some excellent models exist for better emergency-care coordination, most notably the way trauma care is integrated and delivered across the U.S., particularly by regional systems like the Southeast Texas Trauma Regional Advisory Council.  Recently, SETTRAC set up regional coordination of emergency stroke care in the Houston area.

Now all that has to happen is for this approach to spread through the rest of Texas, and then the rest of the United States.

—Mitchel Zoler

Are You Properly Storing Vitamins & Supplements?

I'm guilty! Vitamins and prescriptions that I take on a daily basis have been in a basket on a kitchen counter (I don't have children in my home). Fortunately, I had already moved items everyone hopes to avoid anyway - you've got bigger problems if you need any of these - (cough drops, tablets, cold medicine tablets) used on a non-regular basis into a hallway storage area. That was the germ freak in me in action. Who knows that happened to the germ freak who didn't worry about the daily vitamins and prescriptions and all that takes place in the kitchen, go figure!

Kitchens, Bathrooms No Place for Vitamins

By Jennifer Warner
WebMD Health News

Reviewed by Laura J. Martin, MD

Humidity in Kitchens and Bathrooms Degrades Shelf Life of Vitamins, Study Finds

March 4, 2010 -- The kitchen or bathroom may be the worst place in the house to store your vitamins.

A new study shows high humidity and temperatures, such as those found in the bathroom and kitchen, can quickly degrade the potency of vitamin C and shorten the shelf life of vitamin supplements -- even if the bottle cap is on tightly.

Researchers found the most common types of vitamin C used in vitamin supplements and other fortified products are prone to a process called deliquescence, in which humidity causes a water-soluble substance to dissolve.

"Opening and closing a package will change the atmosphere in it. If you open and close a package in a bathroom, you add a little bit of humidity and moisture each time," researcher Lisa Mauer, associate professor of food science at Purdue University, says in a news release. "The humidity in your kitchen or bathroom can cycle up quite high, depending on how long of a shower you take, for example, and can get higher than 98%."

"If you get some moisture present or ingredients dissolve, they'll decrease the quality and shelf life of the product and decrease the nutrient delivery," Mauer says. "Within a very short time -- in a week -- you can get complete loss of vitamin C in some products that have deliquesced."

Humidity and Vitamin C Don't Mix

Powdered vitamin C is a popular ingredient for food fortification and is one of the most commonly added nutrients to vitamin supplements. Researchers say because vitamin C is very unstable and its content must be declared on nutrient labels, it is commonly used as an indication of the shelf life of foods and supplements.

For example, monitoring deterioration of vitamin C until it no longer meets its declared label value is one way to determine a product's shelf life.

Researchers say temperature and water are the two most frequently cited factors affecting shelf life. But information on deterioration and shelf life of vitamin C is based on models in which temperature and relative humidity were varied at the same time.

In contrast, this study looked at how various changes in relative humidity and temperature, such as those found in a bathroom or kitchen, affect the deterioration of two common forms of powdered vitamin C, ascorbic acid and sodium ascorbate.

The results, published in the Journal of Agricultural and Food Chemistry, showed relative humidity had the largest impact on vitamin C degradation, and this effect was magnified at elevated storage temperatures.

The study showed that at room temperature, sodium ascorbate and ascorbic acid deliquesce at 86% and 98% humidity, respectively. Once the humidity or temperature level was brought back down, the product will solidify again, but researchers say the damage has already been done.

"Any chemical changes or degradation that have occurred before resolidification don't reverse. You don't regain a vitamin C content after the product resolidifies or is moved to a lower humidity," Mauer says. "The chemical changes we've observed are not reversible."

They say keeping vitamin supplements away from warm, humid environments is the first step to maintaining their effectiveness.

The first signs of nutrient degradation are usually brown spots, especially on children's vitamins. Maurer recommends discarding any vitamin supplement that is showing signs of moisture in the container or browning.

"They're not necessarily unsafe, but why give a vitamin to a kid if it doesn't have the vitamin content you're hoping to give them?" Mauer says. "You're just giving them candy at that point with a high sugar content."

Warning: Attention Grabbing Headline Below

Who's at risk of dropping dead?
Take the test online:

The HeartAware test is a free online screening available to anyone but especially recommended for men over 40 and women over 50. It takes about seven minutes. Those who test at higher risk of heart disease can receive a free screening from the University of Miami. You can take the test at www.umiamihospital.com.

BY TERESA MEARStmears@mindspring.com

Everyone seems to know someone who appeared healthy and then suffered a sudden fatal heart attack. The death of celebrities such as NBC news commentator Tim Russert at 58 and TV product pitchman Billie Mays at 50 has brought new attention to the issue of sudden cardiac death.

It's an issue we're likely to hear about more as more Baby Boomers reach the vulnerable age for heart problems, 40 for men and 50 for women.

Dr. William W. O'Neill is executive dean for clinical affairs, professor of medicine and chief medical officer of the University of Miami Health System. He is a leader in interventional cardiology and in research into the diagnosis and treatment of obstructed heart arteries.

He also has a personal interest in heart disease. His father had a heart attack at 47, and his mother suffered from heart problems. When he and his three brothers underwent CT screening, three of them were fine but his youngest brother needed heart surgery, even though he had suffered no symptoms.

We asked O'Neill about sudden cardiac death. His answers have been edited for space.

Q: Everybody seems to know someone who appeared healthy and one day dropped dead of a heart attack. How common is that?

A: It's not surprising that everybody knows somebody because in the United States about 300,000 people a year drop over dead with sudden cardiac death.

Q: What causes sudden cardiac death?

A: The overwhelming culprit, in 90 percent of cases, is blockages of coronary arteries and a plaque rupture. The sudden rupture of a plaque in a blood vessel causes blood flow to lessen acutely in one of the arteries and leads to a severe irregularity of the heartbeat called ventricular fibrillation. The plaque ruptures, a severe arrhythmia occurs, and the people drop over dead. In about 10 percent of cases, there are other abnormalities, such as congenital problems or myocarditis, an intense inflammation of the heart muscle.

Q: Are there any symptoms?

A: About a third of the time, people have described symptoms that they ignored: pressure in the chest or discomfort while exercising. Unfortunately, more than half the time the first manifestation of the problem is sudden death.

Q: Are some people more at risk than others?

A: This is an illness of middle-aged people. In men it starts around age 40 and in women it starts around age 50. The risk factors for sudden death are the same as the risk factors for coronary artery disease: diabetes, high blood pressure, family history of heart disease, smoking, high cholesterol.

Q: What causes some people with those risk factors to suffer sudden cardiac death while others live a long life?

A: In people who drop over dead, blockages occur at very specific locations in the arteries that supply blood to the heart, the left main coronary artery and the anterior descending artery. We don't know why some people with coronary disease develop these plaques in these specific locations and other people in less dangerous locations. We think there may be some genes that predispose people to develop blockages in particular areas.

Q: What should people do if they fall into the high-risk group?

A: The best thing you can do is try to control risk factors. If you're got high blood pressure, be on medication. If your cholesterol is high, get it down with pills. If you're smoking, stop. If you're not exercising, try to do moderate regular exercise. It's not sexy. But those are the things you can do to dramatically lessen your risk. If you really have a concern, I'm a very strong advocate of CT angiography, a noninvasive procedure that puts dye in the veins to look specifically at the coronary arteries to see if there is plaque in dangerous locations.

Q: For which patients do you recommend CT angiography?

A: People who have three or more risk factors for heart disease.

Q: What is the HeartAware program?

A: There are a lot of people who don't even know they have risk factors for heart disease. We offer this online test and we offer a free screening where a nurse will actually check a blood pressure and do some other very simple things to let people know whether they have a risk for heart disease. If they're at medium or high risk for heart disease, then more screening can be performed.

Q: Beyond research into a genetic link, what other research is under way?

A: The holy grail that cardiology is facing now is to try to predict why a plaque would rupture. There are lots of plaques in the blood supply. Inexplicably, some of these plaques break open. If they break open in a dangerous location, people drop over dead. There is a lot of interest in trying to identify people with these vulnerable plaques.

Q: What's the most important thing for people to know?

A: Get to know your risk factors and modify them. There are a lot of risk factors that can be very easily modified while we're waiting for the major answer and the magic cure for sudden cardiac death.

Health Q&A runs every other week.

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