Levaquin, Azithromycin, And Cindy #21

Levaquin is a drug prescribed by a family practice doctor I go to when I need to see a general practitioner.  I have been to this particular doctor 3 times in the last 16 months, including last week.  I have had an on and off again sore throat and mild cough every few weeks or so for the last 4 months.  My ears and throat were again bothering me and this doctor found that I had a bacterial infection and needed an antibiotic.  Me being allergic to penicillin brought the doctor to giving me a prescription for Levaquin, an antibiotic.   At Walgreens I found out that Levaquin is an expensive drug ($135.00 for 7 pills) there is no generic, and my insurance will not pay anything towards the cost.  My health insurance is pretty good.  Normally I pay $10.00 or less on most medications I take, my insurance paying the rest.  When questioned, our pharmacist told us although there was no generic available there were several other less expensive alternatives to Levaquin. Well, my medical advocate (Cindy), called this doctors office around noon telling them I had been in earlier and the rest of the story and could the doctor call in an alternative medication to Walgreens. The nurse said "sure."  About  6:00 pm still no prescription had been called in.  My ears and throat were getting worse, I was achy and was not feeling too well.  Cindy calls the office and gets the after hours answering service, goes through the complete story and gets the "our doctors don't do prescriptions on the phone after hours" answer.  My advocate reminds them of the doctor 6 hours earlier was suppose to be taking care of this, so therefore we are not asking for "after hours, against protocol prescription service". "Sorry we can't do that".  My advocate,   "You have the on duty doctor call me."   I won't drag this out any further but I was feeling pretty miserable, it took Cindy another hour or so but she got me an alternative (Azithromycin) to the expensive stuff Levaquin. Within an hour of taking it I was feeling much better and slept well.  Thank you Cindy.  

There is really a lot more to this story than my praising Cindy and continuing to go on about having an advocate.  Too many people take what is sent their way by their medical providers without questioning why, what, or where.  I was one of those people.  I ended up paying $10.00 for the Azithromycin versus $135.00 for the other.  There is some reason this doctor I used was prescribing that expensive medication. It is not the first time that has happened to me there, but it is the last time. I won't be going back to that doctor. That will be my choice, not my insurance company or someone else.  I am sure many of you out there are as dogged, determined, and involved as my wife in seeing that they, or their families, get the best medical treatment as possible.   Many more of you are like me, believing everything a doctor or nurse does for me is always in my best interest, and we are wrong.  It is not that they are looking to mistreat you, or take advantage of you. They are just like most of us, they are busy, under pressure, stress, and make decisions that are not always the best decision for you....or me. 

Since having a heart attack, my wife has shielded me from having to deal with a lot of stress. We have discussed earlier about stress and what part that plays over the years in leading up to heart failure and poor health. How you deal with it afterwards being a part of recovery, and living a heart healthy lifestyle.

I hope my encouragement has led some of you to exercising regularly as part of your recovery.  Next time we will get more into exercising.

Still Improving #20

I had my check up a few days ago and was pleased with my test and examination results.  My total cholesterol was 105, about the same as 6 months ago.  HDL had risen 5 points, Triglycerides and LDL remained low, which is the benefit of healthy diet and regular exercise.  My cardiologist says if my cholesterol and heart health continue to improve, I will be able to discontinue taking some cholesterol medication and a blood thinner.  He reviewed the charts I keep of my blood pressure readings since my last office visit.  He
feels my continuing to exercise daily and a healthy diet will have a lot to do reducing the amounts of medication I will need to take.  I'm taking vitamin B12 daily to increase my energy and stamina.  My B12 level had gotten low.  I'm not sure how or for how long.  It can affect your energy level and central nervous system.  Normal consumption of meats, fish, poultry, shellfish, and dairy products should provide healthy B12 levels.  I have read that there are either none, or very few vegetables, that are a source of vitamin B12.   Calves liver, sardines, venison are supposedly very good B12 sources. Since I eat almost no red meat he felt I should take supplemental B12

I still look forward to my daily workouts.  The new exercises are working well into my routine and I am improving my posture from doing those. Some of my new routine involves stretching and that has really helped stiffness I have felt in the mornings.

Cindy and I have started spending time at the outdoor pool at our fitness center.  I am beginning to notice a lot of seniors, (my age group) are attending swimming classes in the lap pool before it opens for family time.  You know swimming laps is considered excellent cardio exercise, maybe that's something I should look into doing.

My exercise routine includes the elliptical. I had told you feeling comfortable with it had been a problem in the beginning.  I now do my 15 minutes, after doing 30-40 minutes on the treadmill.  Took a little time but I guess being consistent increased my elliptical stamina comfort level.  In the beginning about 6 minutes seemed to be my limit, I just kept trying daily to increase just a minute or so.

Medications #19

It's summertime and it is hot. I spend a lot of time outside doing yard stuff, mowing grass, trimming tree limbs, keeping driveway clean.  Exciting huh? Do I miss those tension and stress filled days of running a business?  Did it so long I pretty much knew what was going to go wrong each day before it went wrong.  So and so is not going to be here today, oh really, I'm shocked. What delivery truck broke down? And which phones lines are the irritated customers wanting to talk to me?  I've been lucky in no longer having to deal with intense stress on a daily basis, that has had a lot to do with my becoming healthy again.  Yeah give me some nice stress free yard work, and a 4 year old partner to help me.

When I am working  outside, in the heat, I wear long sleeve jersey style tee-shirts.  I stay very cool when inside and wear long sleeves inside and outside, 99 degrees outside. I may infrequently perspire, not sweat, perspire a little.  Cindy keeps the house inside temperature cool,  and does not like the outside heat. We are very opposite in our outside and inside temperature comfort zones.  When workingout, I exercise very vigorously, and do not get hot enough to sweat much. I wear long sleeves there too.  I may perspire just a little.  To me sweating is when you have gotten so hot it is very obvious.   Perspiring is completely different, it is some dampness.  I think the being cool nature, and no perspiration is part of taking medications that lower my heart rate and blood thinners.  When on the treadmill or elliptical, I push myself pretty well now.  My heart rate still stays low.  I'm beside someone going at same level, their heart rate monitor shows 145-155, I'm at 115.    Cindy is concerned I am over doing it by being in outside heat, but it doesn't bother me. Next week I'll tell my cardiologist about all of this and see what he thinks.  I'll let you know what he says.  When we go, Cindy goes with me, we will give him daily blood pressure readings for the last few months.  Here is some more advise for you: the benefit of having a good medical advocate and administrator.  I know there are some of you saying right now, what's up with this guy, he can't go to the doctor without his wife.  As a heart attack, and heart surgery patient under the care of a cardiologist like me you are probably taking a lot of medication.  I am taking 13 different prescription pills daily.  Since being released from the hospital and being under cardiologist care, the number of different daily medications, dosage, and the frequency, of medication has changed. In some instances, perhaps one medication was stopped and replaced with another, or stopped completely. I may no longer take it.  With all of that being said most of you now know where I'm headed because you have to do the same.   Back to my advise. We don't leave anything to chance when it comes to medication and neither should you.  Cindy will also have a complete chart on medications and any changes since my last appointment.  She will give the doctor and his assistant a copy to compare their records with ours. Your doctor is seeing a lot of patients and looking at a lot of charts.  I have had it over looked that a particular medication was stopped, or changed. My cardiologist certainly has no problem with us keeping records and giving him a list of what I currently take and dosage.  You know you also have to be sure your doctor is prescribing in correct refill amounts and time span to meet your insurance medication drug policy requirements.

 Cindy wants all of you to know she available for advocacy or administrative advice on your behalf.   I'll give her a good reference.........

Bananas, Posture, #18

We talked about training last time, and I want to follow up on that.  I hope some of you who were not exercising are considering it.  I am assuming you're physically able.  When I began my very short walks my daughter Michelle and wife were very encouraging of me being proactive in exercising. They didn't push or nag on about it, just kind of one little step at a time until I progressed to wanting to join a fitness center.  Some of you new to exercise and fitness might be apprehensive about how to get started, what equipment to use, just everything about it being strange to you.  Don't let that hold you back or you will never get started. I would think most of us who have had heart attacks and heart problems were not much on exercise so you are not by yourself.  I'll be surprised if once you get started you don't enjoy it and feel better about yourself.  Heck if I miss a day I feel like I've let myself down.  One of the things I discussed last time was getting  in an exercise routine, which I firmly believe in.  One  mistake I have made is not changing the exercises I am doing.  I didn't realize I had gotten into a rut.  I told you about me making quite a few changes in my exercises, mostly because I wanted to improve my posture.  Well I've been into it for almost two weeks and I can tell a big difference, plus I'm enjoying having some new exercises to do.

Following are some of most healthy fruits according to World's Healthiest Foods listing.  Cantaloupe, bananas, oranges, pears, apples, grapes, raspberries, watermelon, blueberries, and strawberries. During any given week I will eat all of these varieties when available.  Daily I eat strawberries, oranges,and bananas.  I have looked at several websites for the recommended daily allowance of fruit and have found nothing definitive.   A lot of depending on your age, sex, physical activity and some recommending up to 400-600 grams per day.  We don't have a gram-o-meter at my house so I eat 1 cup of strawberries, or more.  One banana, and one orange.  I am somewhat confused about bananas.  I enjoy having a banana daily, know that they are high in potassium, vitamin B-6, low in sodium and benefit regulating your blood pressure.  But I have read some, not a lot but some, negative articles about effects of eating too many bananas.   One being that bananas are high in sugar and are not a good diet food.  The other is more serious and that is eating too many high potassium foods and the affects of elevated potassium level.  Being high potassium can effect your nerve functions, and cause your heart to decrease activity.  Meaning it could lead to cardiac arrest.  I had an experience about 8  weeks after my heart attack.  I had a blood test taken at my cardiologist office and they called  frantically the next day telling me to cease taking a medication and to stop eating any foods with potassium.  It seems my potassium level was very high.  They changed the medication and told me to stay off the bananas for 2 weeks.

I had a great work out today.  I really got into the elliptical and treadmill with a lot of vigor.  My new floor exercises and pull ups are working.  I can actually see and feel my posture improving, hallelujah, and Cindy agreed in seeing a difference. I can now lay completely flat on the floor, lowering my head all the way down.  In effect being completely flat from back of my head to my heels.  One straight line.  Sad isn't it, being excited about laying my head back all the way flat.  Before I couldn't do it.  That was part of my posture problem, wasn't or couldn't stand erect.  I'm not there yet but I am making good progress.

Next time we will talk about medications and some more about fitness.

Fitness Center, Ellipticals, Treadmills #17

Last post I ask if you were working out, or a member of a fitness club yet?  I'm trying to re-invent myself, workout rigor that is.  I'm hoping to take my workout up a notch or two.  I told you I am now using an elliptical trainer. Most of you know what that is.  It simulates the motion of running without your feet, knees, and legs having to absorb the impact of meeting a hard surface.  It is a way for old timers, like some of us, to exercise the upper and lower body muscles used in running and not having our feet, joints, and knees taking the punishment.  A lot of guys my age run and have been running for years and have kept their body in shape.  A lot of guys and gals our age use an elliptical for exercising those muscles, plus it is excellent cardio exercise.  I only go about 12 - 15 minutes on the elliptical and I'm done.  There is some difference of opinion about the elliptical offering more benefits than the treadmill.  One being there is not much difference in the muscles exercised, which is probably true in the lower body, waist and hips, but I get so much more rigorous upper body movement on the elliptical rather than the treadmill.  Another difference is the rate of calories burned or used.  Some say the two machines are virtually the same.  In my personal use I have found the treadmill to be very good at burning off calories, fat, and working the cardio system.  The elliptical does the same but I use a lot more calories on the elliptical than treadmill.  I use the treadmill first and when finished go directly to the elliptical.  There are several styles of elliptical, rear driven, front driven, different style platforms, handles, and motions.  There are 4 different styles at my fitness center.  Three of which I can not use.  I feel uncomfortable and can't stay on them more than a couple of minutes without feeling awkward and tired.  I finally found one I could get use to. It is a Precor, think the model is 1001.  It has yellow trim.  Anyway,  I am enjoying more each day using the elliptical. The first week I had to really push myself to stay on it, just didn't like it, but as you watch those calories burning off and can feel it pumping your cardio system, you feel better about it.  If I could use only one of the two it would be the treadmill.  I credit it with having a lot to do with my success in rebuilding strength and stamina.

Only occasionally do I use a trainer.  First, they can be expensive, $50.00 - $100.00 per hour.  My membership includes accruing free funds.  I can use for personal training, or classroom group sessions.  I do both, but only when I have accrued free dollars to spend.  Man, I hate for you to figure out I'm cheap......I prefer to think of me as being economical, a complete spending opposite of the person with the Droid Smartphone I live with.

Having a trainer on a regular basis, I believe, is not  necessary. Some folks use a trainer almost every time they work out.  Please don't be offended, I know there are a lot of circumstances where using a personal trainer is important and beneficial.  I'm speaking based on my personal experiences and health circumstances.   As I have said, using a trainer for an orientation, to get you started and to develop an initial exercise routine is important, very important.  You need a thought through plan and a goal of what you need to accomplish.  Remember I put a lot of emphasis on having your cardiologist involved in this stage, before you pick up one pound or take one step on a treadmill.  Your cardiologist needs to advise you in establishing what you can and can not do.  Then talk to your fitness center, tell them of your heart condition, perhaps they have a trainer who works with cardiovascular patients like you .  Once you get all of this done, you will begin to develop a basic routine of the exercises, training machines, and strength equipment you use.  How many repetitions, and how much weight to use. How long to use a treadmill, or elliptical.  Once you do this, then my advice is to establish a routine of in what order and how much time you will spend on each individual segment of your exercise routine.  When I'm doing my routine I stay on course, don't visit with the person beside me or stop and say hello, how are you? and all that stuff.  I complete each segment, and don't vary repetitions, or the order in which I go through my exercise routine.  I save the socializing for when I've finished.  You will find most other people serious about working out will be the same way, they don't want to be interrupted.

Good luck I'm sure you will do well.....

Tuna, Salads, Good Health #16

I have talked about needing to eat more fish for the benefit of omega 3, protein and to better my HDL cholesterol. Tuna is my fish of choice and is a nutrient full food.  It is high in omega 3, protein, and contains several beneficial nutrients and minerals which include; magnesium, selenium, potassium, vitamins B3, B6, and B1.  The omega 3 in tuna is very beneficial to your cardiovascular system and good health.  It reduces the possibility of blood clots in arteries, increases HDL cholesterol, and lessens inflammation which is a cause of plaques that block your arteries.  Tuna and its omega 3 can also lower your triglycerides.  I am now eating tuna at least 3 times a week, normally canned tuna (packed in water), and I eat it with a lettuce and tomato salad for lunch.   For me tuna has been a versatile food much like oatmeal.  Flavorful, filling, satisfying, and healthful.  Much like the benefits of oatmeal, tuna was a mainstay of my weight loss, and I am again enjoying tuna regularly for lunch.

My last triglyceride test result level was 45.  Less than 150 is considered normal, or good.  Triglycerides are calories, or fat not used by your body, which is stored in your bloodstream until needed as energy.  However high levels are unhealthy, and are associated with high cholesterol and heart disease.  I have read that causes of high triglycerides are eating more calories than you use, excessive drinking of alcohol, lack of adequate exercise, and being overweight.  To reduce your triglycerides to normal, or good levels, lose excess weight, eat healthier low calorie foods, such as vegetables, and fruits.  Reduce the amounts of alcohol you drink, and begin to exercise on a regular basis.

I have been reading some about the health benefits of olive oil, eating more foods using olive oil, and the healthy lifestyle of the Mediterranean people.  I am going to try some basic salads and see what I think of them.  I have to admit I'm a little cautious about the calories and amounts of fat in the olive oil or eating any fish cooked in oil.   I just don't want to gain weight or go the wrong way in keeping my cholesterol under control because of the olive oil.  I do intend on trying some Mediterranean salads. 

Three years ago  Cindy and I went to Hawaii, just before the Christmas Holidays. Anthony Bourdain who does a food and travel program, "No Reservations" and his production crew were there and stayed 10 days at the same resort as we did.  His wife was traveling with him and early one morning I went down for coffee and she was seated next to me.  I introduced myself and told her that I had been a fan of her husband's program for quite some time.   She was born on the island of Sardinia and a lot of her family is still there. Bourdain later did a program from Sardinia and went in depth about the healthy lifestyle and health benefits of the local foods they eat.  Obviously olive oil, salads, pasta, cheese, and fresh fish being an important part of  their daily menu. Sardinian's credit their diet with their having such a low rate of cardiovascular health problems.  Tonight we are going to try a new salad, Mediterranean pasta salad.  I may take the pasta out of mine, if it is good I'll post all of the ingredients.  I have been a fan of Anthony Bourdain since he was on the food channel.  I especially like his sort of off-beat sense of humor, and his being quite frank with his opinions.  If you have never seen the program "No Reservations" it is fun to watch and is on the Travel Channel.   Caution, it is not about eating good healthy cholesterol free foods for heart attack survivors.
 I get hungry each time I watch it.............

Are you working out yet?  Have you joined a fitness center?

Next time we will talk about working out, trainers, weight loss and maybe review some new healthy food ideas.