iRhythm "success", Part II

Exhaustion has been my best friend since the hospitalization in November 2010.  Being instructed to go to the local emergency room is where I left off in my last entry regarding the iRhythm, so here is the rest of the story, as Paul Harvey would say.

We arrived at the local emergency room (after having to walk through several cigarette smokers at the entrance - who does that!?).  Unlike past trips to the emergency room (E.R.), as soon as I told the staff my name they took me directly into a bed.  My spouse found it amusing (for lack of a better word) that as the E.R. staff were taking me back, I found it necessary to make them aware of the aforementioned smokers.  I have zero tolerance for smokers, much less individuals huddled around the entrance to a hospital.  We live in California for heaven's sake, so it's not as though it was freezing outside (not that it would matter to me if it were a blizzard; get away from the building!).  

It was a long night.  We arrived before midnight and I was finally moved to a hospital bed around 4:30 A.M.  I always feel so guilty being moved into a room in the middle of the night where another patient is already sleeping.  Fortunately I was sharing a room with a woman who didn't seem to mind my arrival as she began to talk to my non-stop asking who I was and what was wrong with me.  I could write a coffee table book regarding some of the odd roommates I've had in hospitals (I'm sure many have plenty of stories!).  Once I had a woman who kept meowing like a cat.  I digress...


The only negative experience I had at the hospital was with the radiology technician.  Around 2:00A.M. the radiology technician arrived and stated he would be taking images of my heart.  He turned around, at which time I assumed he was reaching to get an apron for our baby, but instead he pushed the button on the mobile x-ray device.  At the same moment my spouse tried to stop him, exclaiming, "She's pregnant".  I was speechless.  It takes a lot to leave me speechless.  The radiology technician told us that nobody had told him I was pregnant.  So, my new rule is to tell everyone I am pregnant.  I don't know why he didn't ask the obligatory, 'Are you pregnant?  Is there a chance you could be pregnant?', which are the two questions I have been asked every time I've had x-rays (including dental) since young adulthood.  I try to tell medical personnel everything I can think of as a rule.  Now I state what should be obvious, "I'm pregnant!".   My spouse has tried to reassure me that no harm was done to our baby as have the doctors I told following the incident.

I was very happy with the nursing staff, they have been wonderful at my local hospital.  I am thankful for them and everything they do.  My heart (and vitals) in addition to our baby were monitored the entire time at the hospital.  To my knowledge, Ventricular Tachycardia (V-Tach) was not detected once at the hospital.  Good news!  In layman's terms, my body/heart had automatically reset itself following the V-Tach detected using the iRhythm.  I am so thankful my cardiologist provided me with the iRhythm!  I struggle on a daily basis with wondering if something I am experiencing is or isn't life threatening.  I imagine other's feel the same way trying to decipher the signals being sent to the good old central nervous system.  While I have never solely depended on a diagnostic device such as the iRhythm to alert me to a medical emergency, it does give me a sense of relief.


It has been two and a half years since the myocardial infarction (heart attack) I had and until Thanksgiving, there had not been any detection of V-Tach from my heart.   As I understand it, an anti nausea medication (Ondansetron) prescribed by my Obstetrics/Gynecology physician is to blame for the V-Tach.  I only took the medication as needed rather than full strength as prescribed, so I can't imagine if I'd taken it full strength how my heart would have felt.  I don't like to take medications period, so I have really tried to avoid everything (including over the counter remedies such as Tylenol).  I don't drink coffee or consume caffeine (I don't even like chocolate unless it is hot cocoa).  Following the myocardial infarction, the hospital nutritionist and nurse practitioner at the cardiology office went down a list of things I should avoid.  [Un]fortunately, I already avoided them.
   
I was released from the hospital and continued to use the iRhythm heart monitoring device for a couple of weeks.  I've continued to experience palpitations since November.  My cardiologist has partnered with another cardiologist who was on-call over Thanksgiving.  I greatly admire both cardiologists.  The newer cardiologist came to the hospital to run tests prior to releasing me.  I was re-prescribed a beta-blocker (I had stopped taking Sotalol due to the pregnancy).  I don't have high blood pressure, in fact my blood pressure has always been very good, if not on the low side.  The beta-blocker is prescribed for other reasons.  The same evening, before my new prescription was ready, the cardiologist phoned my spouse to say that he didn't want me to take what he had prescribed as he had spoken with an electrophysicist who didn't believe it was a good medication during pregnancy.  I greatly respect the new cardiologist for following up, as well as being forthcoming regarding changing to a different medication due to my pregnancy.  It's wonderful to have physicians who aren't afraid to admit that they are human!  

Pssst... Tell 5, Pass It Along!

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.

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.

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).

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!

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

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.

© 2009 Miami Herald Media Company. All Rights Reserved.
http://www.miamiherald.com

Quick Chest Pain Test Simplifies Discharge Decision

Hallelujah!  Which of my local hospitals will be offering this 'simple, inexpensive test'?  Moreover, will it be available at my cardiologist's office?!  It's so frustrating being told to go to the emergency room (where the emergency room doctor's call my cardiologist and ask what to do...).  A lot of waste (especially when I've gone in at night, they automatically admit me into the hospital overnight, no if's, and's or but's.  Quite a lot of expense in the end.  I don't want it to sound like I make a bee line for the ER every time my heart skips a beat (I've gone twice since my heart attack, for my heart).  I'm very happy for all heart patients about this new test!  Article below:

Quick Chest Pain Test Simplifies Discharge Decision

Thursday, February 11, 2010

CT scan lets doctors see any blockage in arteries, study finds

A simple, inexpensive test can tell doctors whether it's safe to discharge a patient who has come to the emergency room with chest pain, a new study shows.

The coronary artery calcium scoring (CACS) test detects coronary artery disease. A CT scan is used to quickly provide doctors with a detailed image of the heart that shows calcium build-up in the coronary arteries.

This study of 1,031 chest pain patients found that those with a CACS score of zero can be safely sent home without further heart testing. Of the patients in the study, 61 percent had a CACS of zero.

"It is imperative to accurately diagnose patients who come to the emergency department with chest pain. Unfortunately, diagnosing chest pain is often expensive and time-consuming. This new data could save millions of health-care dollars and countless hours spent waiting on unnecessary tests," principal investigator Dr. John Mahmarian, a cardiologist at the Methodist DeBakey Heart & Vascular Institute in Houston, said in a news release.

The study was published online Feb. 8 in the Annals of Emergency Medicine.

Thank You for Spreading Heart Disease Awareness, Better Homes & Gardens!

Article (2004) below republished online at Better Homes and Gardens magazine, regarding nutrition and heart disease.  I love viewing media in non-health specific magazines regarding heart disease:  thank you for getting the word out to a larger audience!  From one heart attack survivor, thank you, Better Homes and Gardens!  

Now, a 'recipe':  I've always loved oatmeal.  I'd say 97% of my life, my mornings have begun with oatmeal.  Since my heart attack, I've made it even healthier by no longer having honey (I used to have honey - no butter, but tons of honey).  My favorite recipe now is to begin with Trader Joe's Pumpkin Pie Spice and add a hefty scoop of old fashioned oatmeal (not instant).  Add water.  Microwave for approximately 1 to 2 minutes (depending on amount of oatmeal).  While microwaving, dice up whichever fresh fruit is in season.  My favorite are pears!  Amazing flavor paired with the pumpkin pie spice.  Once the oatmeal is done, add the fresh fruit and sprinkle in a few dried cranberries for color & taste.  Last, top it all off with a few walnut pieces (or your favorite heart friendly nut).  Give it a try for what I consider a heart healthy breakfast.  You can even make it ahead of time and take to work and reheat (or eat cold if you are a diehard fan like me).  Try other fresh fruits - let me know what you come up with!!!

10 Superfoods for Heart Disease

Nutritious foods for lower cholesterol and a healthy heart.

By Dorie Eisenstein

Heart disease is the leading cause of death among women and men in the United States. We all know a healthy diet can help reduce your risk, especially when coupled with regular exercise and maintaining a reasonable weight. But what really are the best foods to include on your weekly menu to keep your heart healthy and strong?

"When it comes to prevention, increasing total dietary fiber and unsaturated fats is the way to go," according to Linda Van Horn, PhD, registered dietitian (RD), member of the American Heart Association's nutrition committee, and professor of Preventive Medicine at Northwestern Medical School in Chicago.

Eating unsaturated fats, like omega-3 fatty acids and olive oil, can help to reduce triglycerides, which inhibit blood from clotting and our arteries from becoming clogged with plaque. And a diet rich in soluble fiber, which is often found in legumes and some fruits and vegetables, helps to lower your LDL cholesterol. Here are 10 foods that are rich in heart-healthy nutrients.

Sardines

Although these little fish tend to have a bad reputation, they are a great source of omega-3 fatty acids, along with calcium and niacin. Try them fresh on the grill or use canned sardines packed in oil on salads, in sandwiches, or in sauces.

Recommended serving size: Fresh, 3 whole sardines: 281 calories Canned in oil, 3.5 ounces drained: 220 calories

Oatmeal

If you're looking for a comforting breakfast, start your day off with oatmeal for an instant boost of fiber. Oatmeal also has a low glycemic index, which helps to provide lasting energy and keeps hunger at bay. Look for rolled oats, and add some raisins, apples, and honey for flavor. Try to avoid instant oatmeal, since it is loaded with sugars that you don't need.

Recommended serving size: Raw, 1/3 cup: 113 calories Made with water, heaping 3/4 cup: 98 calories

Mackerel

Sick of salmon, but always eating it for the health benefit? Try mackerel instead. An excellent source of omega-3s, mackerel is also packed with the antioxidant mineral selenium, which may help protect the body from heart disease and cancer.

Recommended serving size: 3.5-ounce fillet: 220 calories

Walnuts

Women who are looking for an easy way to get omega-3s on the go can grab a small handful of walnuts for an afternoon snack. "Although they are high in fat, most of it is polyunsaturated fat, which is considered a 'good fat' and, thus, they are fine to eat in moderation," says Rachel Brandeis, a registered dietitian in Atlanta, Georgia, and spokesperson for American Dietetic Association. Add some to your green salad, or give chicken salad a nutrition boost by adding ground walnuts.

Recommended serving size: Shelled, scant 1/2 cup: 344 calories

Tofu

Tofu is made from soybeans, which have been shown to reduce cardiovascular disease risk by lowering LDL cholesterol, says Brandeis. A diet containing 25 grams of soy protein and 50 to 60 milligrams of soy isoflavones can reduce LDL cholesterol levels. Tofu usually absorbs the flavor of whatever else you're cooking with it, so add it to a chicken or beef stir-fry dish, salad, or chili.

Recommended serving size: Firm, 3.5 ounces: 73 calories

Plums/Prunes

Known for their laxative effect, prunes are an excellent source of fiber and iron, and regular consumption has been shown to reduce LDL cholesterol in the blood. Prunes may also help protect you against colon cancer. If you're not a prune fan, plums are also a decent source of fiber and beta-carotene.

Recommended serving size: Plums, two: 34 calories Pitted prunes, five: 71 calories

Kidney Beans/Chickpeas

Like many legumes, kidney beans are a low-fat, high-soluble fiber protein source. These vitamin-rich beans also have a low glycemic index and are cholesterol-free. Add them to salads and chili, as they truly are almost a perfect health food. Both the canned and dried beans are equally high in fiber, but canned varieties are likely to have a higher salt content, so stick with dried varieties for maximum heart benefits.

Recommended serving size: Kidney beans, dry, 1/4 cup: 133 calories Kidney beans, canned, heaping 1/3 cup, drained: 100 calories Chickpeas, dry, 1/4 cup: 160 calories Chickpeas, canned, heaping 1/3 cup, drained: 160 calories

Barley

Whole-grain barley is rich in soluble fiber and insoluble fiber, which is good for combating constipation. A decent protein source, barley also contains a good supply of iron and minerals. Beware when choosing which barley to buy. So-called "pearl barely" lacks the outer husk, and thus, most of the nutrients are removed. Look for whole-grain barley cereals, or substitute whole-grain barley for rice and pasta side dishes once a week.

Recommended serving size: Dry, 1/4 cup: 151 calories

Published on BHG.com, October 2004.