Thursday, June 28, 2012

Heart Attack And Stroke Similarities #116

A stroke or "brain attack" occurs when a blood clot blocks an artery, or a blood vessel breaks, interrupting blood flow to an area of the brain.  When either of these things happen, brain cells begin to die and brain damage occurs.  The preceding being a quote from the National Stroke Association.

I thought we might look into the similarities of heart attack and stroke and the causes. To me, stroke sometimes carries some terrible consequences to the survivors that are much more difficult to overcome than we heart attack survivors have to deal with.

There are two types of strokes.  Iscehemic, being when arteries are blocked restricting blood flow to the brain.  Hemorrhagic stroke is a blood vessel in the brain breaks leaking blood into the brain.  If one of these two occur, brain cells begin to die and other body function are affected.  These include the movement and use of arms and legs.  The ability to speak, and memory recall can be affected.  Stroke survivors can  suffer long term disabilities from the loss of normal physical abilities and mental functions.

Some warning signs of a stroke are the occurrence of unusually strange or slurred speech, a droop in the face when attempting to smile, disorientation, difficulty holding arms in a raised position.  High cholesterol or high blood pressure are stroke risk factors. Smoking and being overweight are also high risk factors. Just as a heart attack victim having a mild pre-attack event not realizing the symptoms, it can be much the same for a mild stroke victim. Not knowing at the time they are having a stroke.

From posting Heart Attack #84 we know heart attack symptoms and causes, but what are the differences between a heart attack and stroke?  The heart is damaged when flow in an artery providing blood to the heart is blocked resulting in a heart attack.   When a similar blockage restricts blood in an artery to the brain, the affected section of the brain begins to die from a lack of adequate blood.  That results in the loss of function controlled by those brain cells, are known as a stroke.  Both most often but not always, are the result of an unhealthy lifestyle.  Inadequate exercise smoking, poor diet, or eating habits, being overweight, and stress are all high risk factors for heart attack or stroke.

Now on to healthy food ideas. Edamame are steamed or boiled in the pod soybeans.  We  live in a geographical area of the country where soybeans are a major farm crop.   Soybeans are normally left on the vine until fully ripened and dried.  Once dry, the pods begin to break open and the dried beans will begin to fall to the ground.  Farmers will wait until fully dried and then harvest before the beans fall from the pods.  Edamame is a young soybean cut from the plant while still green and fresh.   Left in the pod, the beans are steamed or boiled and then eaten as you would an appetizer or snack.  At least that has been my experience. They are very nutritious, high in protein, and omega-3 fatty acids.  Our granddaughter likes them and introduced them to us when we took her to an oriental style restaurant.   You might be thinking, wow, what is this about?   Edamame, yeah sure, I am going to run out and buy some.  I thought I should pass this along to you as we search for more variety in healthy vegetables.  It is not a regular part of my diet, but we do eat them.   I have gotten into somewhat of a rut when it comes to vegetables and I am trying to have more variety and more often.  Last night we had an old farm style fresh vegetable dinner from what Cindy had gotten at a farmer's market.  Squash, tomatoes, cucumbers, vadalia onions, country peas, cayenne peppers and corn on the cob.  It was all freshly bought that day from the market, prepared and cooked without any unhealthy add to's and it was great.  

Next time short discussion about weight loss and exercise.

Sunday, June 24, 2012

Heart Healthy Diet Advice #115

The Mediterranean diet remains what I have attempted to most closely use as a guide in determining healthy foods for me.   I am not saying I am a strict follower of the Mediterranean diet.  I would if I could.  I do not cook, and do not do the grocery shopping.  I don't eat much poultry and almost no fish. The salads, olive oil, vegetables, cheese, yogurt, fresh fruits, foods of the Mediterranean diet I do incorporate into my diet.  Especially the cheese, yogurt, olive oil  and salads.   What the Mediterranean diet has in common with the French Paradox, or French diet, is the high amount of fat that is consumed.  Yet cardiovascular disease rates remain low.  One reason is thought to be the good health effects of olive oil.  Another variable is the difference in the fat based foods consumed.  The Mediterranean diet consisting mostly of monounsaturated fats and the absence of large amounts of fat from fried fast foods, processed snack foods and the such.  Also, eating smaller portions and a more physically active oriented lifestyle is a part of the diet of the people of the Mediterranean.

There seems to be one common thread I have found in researching the French and Mediterranean diets.  More emphasis in the culture of enjoying the meal, and dining experience as much as the food itself.  They seem to have the same greater enjoyment of freshly prepared, simpler foods and dishes.  I think we all will agree that before we changed our eating habits and lifestyle, the quality and dining experience were not necessarily important.  It was more about satisfying our desire for instant gratification through food, followed by when and what are we going to eat next.  Sound familiar?  Any regrets?  I know I do.  I sometimes think about for how long I abused and neglected my body and health for my personal gratifications. 

Snacking is another problem for me.   More so than anything else I have changed in my eating habits, is the desire to snack between meals. That has been the most difficult.   I hope I have mastered that by taking advantage of snacking.  Having smaller meals and eating small amounts of fruit in between meals to lessen the desire for the foods I use to have for snacks.   If I have a larger meal for dinner, then I make sure I eat nothing afterwards.  I still will drink a very small glass of skim milk before bedtime, if I am hungry, rather than eating something.   I will repeat what I have told you before about changing your total eating habits to healthy.  For me, I do not see the desire to go back to the old ways to ever completely go away.  There will always be that hunger battle inside yourself. Some small parts of the food desire that is.  I do not ever think about having a hamburger, fries, a beef steak dinner or food like that.  I don't dream about an extravagant Thanksgiving turkey dinner.   It is the small things I miss.  The candy bar, popcorn at a movie, my private supply of butter pecan ice cream, chocolate milk, or a pecan pie.  Yes, in some ways I think it will be like being on a diet from now until I go away, or give in.  And I definitely do not plan on giving in.  Very early in the beginning of this blog I discussed that to me, in my past eating was like being addicted to drugs.  The desire will never ever go away and there is no, "well maybe just once won't hurt."  Once you go back, there is no turning around.

Cindy says I should never end these on a downside.  Easy for her to say. She can eat Cheetos and Snickers candy bars.  I need to tell you a while back she brought home a Snickers for me which I left lying on the kitchen counter for days until it magically disappeared. I ask about it and she said she had gotten mad at me and ate the Snickers to teach me a lesson...................  Don't ask.  I have absolutely no idea.

Thursday, June 21, 2012

Resveratrol In Grapes And Wine #114

Yes, you read it correctly. The last posting number was #112 and this is #114.  There is no #113.  How quickly you have forgotten.  There was no posting #13.  Go back and read #15 getting back on track.  We must not test or tempt the dark forces of 13.  Not that I am superstitious, I just don't want to put you in a uncomfortable situation knowing how you feel about the dark forces of number 13 and all.

Grapes are a favorite of mine which we discussed in an earlier posting.  I have long eaten grapes and consider them a regular part of my current heart healthy diet.  Grapes are a low glycemic index food, which is good.  See #103 Good Carbohydrates.  If you are eating grapes you should know to eat the skin of the grapes.  The grape skin contains some very healthy phytonutrients such as resveratol which researchers believe play a major role in your longevity genes.  Few foods rank as highly as grapes in their amount and variety of healthy nutrients.  In general terms, the health benefits derived from eating grapes include, cardiovascular, protects from free radicals, blood sugar regulation, cholesterol control, anti-aging and longevity, lowers the risk of some forms of cancer.

Drinking red wine and the French Paradox.  I was not at all familiar with, nor had ever heard this term until I begin to do more research on grapes.  I read several sources and most agreed with what I initially found. "French Paradox is a description of the low occurrence of heart disease in French people who have a diet containing high amounts of saturated fats."  Some medical studies indicate that this low incidence may be the result of the regular consumption of red wine.  This has chiefly lead to the theory that moderate regular drinking of red wine, as the French do, will reduce the risk of heart disease.  The theory is somewhat based on the effects of resveratrol from the grapes found in the wine.  Several articles I have read state that red wines are a source of "low levels" of resveratrol and contradict the cardiovascular benefits of drinking wine.  They dispute the positive effects of resveratrol, not in the grapes, but in the low levels found in wine.  Grape skins are rich in resveratrol content but apparently are not fully processed in wine making.  The health benefits from eating grapes are not challenged, only how strong the benefits of red wine. Therefore, you can decide for yourself.  I do not think it would stop me from drinking red wine (which I do not) for possible health benefits or enjoyment.

Now, for what I found more interesting for us as heart patients, and more practical.  Two books and authors offer the following reasons for the French being more heart healthy.  The Fat Fallacy by Will Clower, and French Women Don't Get Fat by Mireille Guiliano.   Good fats versus bad fats.  Most of the fats (80%) found in the diet of the French are dairy and vegetable based.  Cheese, yogurt, whole milk.  They eat more fish.  Their full fat foods have a lower sugar content.  Americans eat low fat and no fat foods which tend to contain much more sugar.  The French diet avoids snacks between meals.  French consume less food items as soda, snack foods, and deep fat fried foods.  Smaller portion sizes.  French tend to savor food at a meal along with the pleasure and satisfaction of the meal.  More emphasis on freshness, quality, and variety of food consumed.  The following is what I got from all of this:    Mark out the word French everywhere you see it, and enter heart healthy.  No offense to the French please. This is all about eating the foods, and living the heart healthy lifestyle we have been talking about for months.

We have readers from around the globe and we all share the same heart difficulties and desires to be healthy.  You do not have to be French and have access to fine dining and expensive wines to eat healthy.  Americans are probably the worst when it comes to having a choice of eating good healthy food or the complete opposite fast food way.  We all have some amount of capacity and reasoning power to research and determine what healthy food choices and alternatives are best for us.  Quite frankly, I write with little or no knowledge of what foods are easily available in other countries.  But I will bet most of you do your homework like I do and find the foods that work best for you.

Thanks for your interest and sharing with the rest of us in striving to be heart healthy individuals.  A word of caution. Grapes are noted for being one of the most insecticide applied on during growth, fruits or vegetables. Grapes should be thoroughly washed to rid them of all pesticide residue before eating.

Sunday, June 17, 2012

Exercising For Heart Patient Conditioning #112

I would like to make some changes to my workout routine.  This comes not long after I have told you how settled into my current routine I am.   I may want to do more cardiovascular exercises.  Specifically I am thinking about adding 15-20 minutes a day on a cycling machine.  At the same time I may not do all of the strength exercises I do.  Maybe reduce the number of chin ups, pull ups, and push ups.  One reason is I am beginning to show some upper body strength as the result and that is not what I need or want to do.  I really would like to be more muscle tone as a runner and not strength oriented.  Now I think this is a good example of  directing my efforts on what is good for my heart health circumstances.  Which is of course what you, as a heart patient should also be doing.  We are sharing what has worked for us individually.  I really think my efforts, presently, should be more about maintaining a healthy weight.  Not weight loss.  Continuing to build cardiovascular strength.  Not muscles.  Increasing my stamina and endurance, much like a distance runner.  As we have discussed before, as a heart patient and accepting the effects of age, I am not pushing myself to be a runner.  Running is what I would like my next step in exercise becoming, but I am afraid it is too late for me to begin running.  Now before you tell me otherwise, I know some of you probably do run and you are probably long past being a spring chicken. I would think you have been running for quite some time and your body, muscles, bones, and joints are in shape and conditioned for running.  But to start running at this point I am not so sure about in my circumstances.  I am certain I could run a respectful pace and distance for my age and not hurt my heart.  I truly believe my heart would be up to a moderate level of running. I am quite sure my bones and joints however would not be up to the task.   You know my daughter Michelle and her husband are still competing in triathlons and those events do have an age class and competitors who are well past 65 and  into the 70's years of age.  But most of these folks are seasoned athletes and are not newcomers.  I am sure there are some who have started late in life, but more than likely they have lived a pretty healthy lifestyle for most of it.   Now, with all of that being said, it is never too late, as far as age is concerned, and especially for us heart patients, to completely change to a heart healthy lifestyle.

Michelle and her husband remain highly competitive within their respective triathlon classes.  They will normally finish within the top 6 and it is not unusual for them to place in the top 3.  Whoever finishes the highest has "bragging rights" and it motivates them to train that much harder for the next event. 

I just finished reading the book 'Unbroken' by Laura Hillenbrand.   It is an amazing story about the life of an Olympian runner of the 1930's,  Louie Zamperini.   He is 95 years old and continues to live an active and athletic life.  If you are still suffering from the effects of heart surgery, the loss of your normalcy and maybe feeling sort of sorry for yourself, read this book.  Surely it will  inspire you to reclaim your health and better your heart health lifestyle.

Wednesday, June 13, 2012

Low Blood Pressure Part 2 #111

"Low blood pressure would seem to be something to strive for.  However in severe cases, low blood pressure can be life-threatening."  This according to an article by the Mayo Clinic staff.

There has been much interest from readers concerning low blood pressure and its effects.  Most of this in response to posting "Low Blood Pressure" #98.  I have been surprised how many have experienced dizziness and feeling lightheaded.  Based from what I have seen, I suspect a lot of those people do not take their blood pressure reading on a daily basis.   Some have not been able to associate the symptoms with their blood pressure.  As an example, when I first began feeling the symptoms it was not always near a time when I was taking my blood pressure. Therefore I did not put the two together in the beginning.  My blood pressure was and is fluctuating from readings of 125/75 to 97/50 or lower.   Only after talking to my cardiologist did I confirm low pressure being my problem.  Although by then I had begin to have readings well below normal and into the very low ranges.  I also begin to take my blood pressure immediately after I would experience the symptoms.  Taking all of that into consideration, I thought today we would go a little bit further into understanding more about low blood pressure.

A reading of 90 or below systolic (top reading), or 60 or less diastolic (bottom reading), is considered low blood pressure. Some symptoms are dizziness, light-headedness, fainting, lack of concentration, blurred vision, fatigue, depression.  My blood pressure this morning was 94/47 which is somewhat better than it has been. The top reading systolic, measures the pressure your heart generates pumping blood through the arteries. The bottom reading diastolic, is the pressure in your arteries when the heart rest between beats.   Many medical experts consider 115/75 to be the ideal blood pressure.  This being the opinion of the Mayo Clinic article on low blood pressure.  Your blood pressure is usually the lowest at night as you sleep and rest, and rises sharply as you wake up and in the mornings.

There are many conditions that can lead to low blood pressure as it relates to heart patients and heart attack survivors.  We will exclude the conditions of trauma, major loss of blood, dehydration. severe infection and others. Low heart rates, heart valve problems, diuretics, alpha blockers, and beta blockers, can all be causes associated with low blood pressure. That is why you should see your cardiologist if you are experiencing  low readings and the symptoms.  Drops in blood pressure on standing from a lower position are more common to those over 65 years of age.  Those taking certain high blood pressure medications have a greater risk of low blood pressure.

My most common and often symptom is when I stand from a sitting, stooped, or bent over position as you would in working in your yard or garden.   When this occurs, which is not now uncommon for me, it is more often as I stand from being bent down to a low position.  As I stand, I feel lightheaded and as if a tremendous weight or G-force is pushing against my body.  It normally lasts for no more than 5-10 seconds at the most and slowly you can feel the return to normal.   I have seen my cardiologist twice very recently about this problem.  Two of my blood pressure medications have been lowered and currently my pressure readings are being monitored every few weeks.  When I exercise there are some movements I do that are the same as going from a low or bent over position to a standing position.   I can recall only one time while exercising that I experienced the symptom of low blood pressure.  The conclusion I make from that is my heart is working harder and pumping with more force as I exercise and therefore my blood pressure is more in the normal range.  

If left untreated, continued low blood pressure can be a serious risk to your health.  Severe low blood pressure can deprive your body of enough oxygen to carry out its normal functions, leading to possible damage to your heart and or brain.

Well, I don't like to end on such a low note, however that's about all I have to go over.  Next time we will go into exercising for our heart health.

Sunday, June 10, 2012

Florida, Butter Pecan Ice Cream, and Twinkies #110

Cindy has gone to Florida with our children and grandchildren for a week or so.  I stayed home not feeling like going.  My low blood pressure and tiring easily has been sort of all over the place.  Meaning, I feel good for a while, then may go for three or four days and not feel like doing much of anything.  Sometimes I have to really push myself to go workout.  And yes, I do take it easy when working out.  Back to the vacation.  I really just did not care much for going while feeling as badly as I do, and honestly, I did not want to be around a lot of people and all the commotion that goes with that.  They are all going to have a good time and I would be looking for solitude and rest.  You know from your experiences when you have all your family together going out to eat at night is usually something everyone looks forward to.   And they  would  want to be going to where the food is good, there is a big crowd, and it is a noisy and fun place. I would be looking for a healthy food place with no crowd that is quiet and slow paced. And I understand each of them want to have some fun and sun.  They have worked hard, want some leisure time, to enjoy themselves and family.  The dining and being with family are a big part of most peoples vacations.  Cindy likes relaxing out by the pool and getting a good sun tan.  She told me she was not going to Florida to be the resident cook and baby-sitter.  I will miss not being there, Cindy and I will probably go on our own later this summer.

My workouts have been a contradiction to how I have felt the last couple of weeks.  I really feel good and invigorated during and after working out.   Cindy seems to think my medication changes, combined with my health improvement have something to do with my feeling sort of lackadaisical.  She thinks my cardiovascular health and heart have improved so much that the quantity of medication I am taking is having a negative effect on me.  At one point yesterday my blood pressure was 81/47.   That is not good.  Even for a young athletic person that would be too low.

I have had this question ask by readers more than once in various forms.  "Is it okay for me to eat twinkies?" Or "can I eat a twinkie after having a heart attack?"   There is more than one answer to that question.  Such as. Have you ask your cardiologist?  What do you think he would tell you?  Was your heart attacks basic cause high cholesterol caused by an unhealthy diet?   Based on your weight, do you think you should be eating twinkies? Yes, I guess you could stuff some twinkies down while you're laying up there in the hospital's cardiac care ward with needles, tubes, and warning sensors attached to you.  Before you try to hit me, understand I have probably eaten more twinkies than you ever will, and I my urge to eat one more twinkie is greater than yours.  But I am not going to eat another one.  Why?  Because it will break the chain of eating to be heart healthy for me.  So yes, it is okay to eat a twinkie or two after a heart attack, but where and when do you stop?

Listen, if I gave up butter pecan ice cream, you have to give up twinkies.......

Friday, June 8, 2012

Which Healthy Food Diet For Me.... or Cheetos? #109

One health food I don't discuss is Tofu. Why?  Because it is not part of my diet and I do not know much about it.  I should try some in a few dishes that I eat.   Really for me it is getting to the point that I may stop eating chicken and turkey and go more with a pure vegetarian diet of which Tofu would be part of.  Now remember, I said "may stop eating chicken."

I have read several articles about Tofu.  What I have found it to be is, "highly nutritious, protein-rich, low in calories, and high in omega-3 fatty acids."  Many medical studies indicate Tofu based diets lower cholesterol and reduce the risk of heart disease.  Tofu is made from the curd of soy milk and is neutral in flavor.   It absorbs the flavor of other ingredients it is prepared with.

I am not an advocate of a vegetarian diet, it is only that I have slowly moved in that direction as I completely changed my eating habits and lifestyle.   I enjoy the feeling I now have after a meal.   Being full and satisfied after eating probably less than half of what the 'use to be me' would eat.   I like not having to eat meat to feel satisfied at a meal.   Someone I am very close to  recently went on a short, quick weight loss diet.  You know the kind of diet I consider useless. To lose weight real quickly after punishing yourself and suffering for a few days.  And in a couple of weeks you have gained back what you lost.  I ask her why don't you just work on changing your eating habits to more healthier foods and not be concerned about going on a diet?  Her answer.  "you don't include foods like Cheetos in your diet as good to eat."  Which is true, but there is no avoiding the truth in going on a diet as being a temporary method of losing weight, most often as quickly as possible.  A committed change of eating habits over to healthy foods being a longer term, slower weight loss results. But it is permanent change to a healthy lifestyle.   Many studies have shown that those people changing to a vegetarian diet lost an average of 24 pounds after the first year and continued to lose weight and keep it off after 5 years.

Read up on President Bill Clinton.  Hey, he is one of us.  Heart problems, terrible eating habits, on and off quickie diets to lose weight, and finally faced the reality like us, that he too was a lucky guy and had dodged a life ending heart event.   I am sure most of you know he changed to a vegan lifestyle diet and has become fit and trim.   And more importantly, we hope, he has become heart healthy.   Going back to #34 Healthy Food And President Clinton you can get more info on the vegan diet.

As a heart attack survivor and heart patient, you are learning how important diet is to you and your health.  It is not for me to say, other than based on my own experiences, what specific foods are best for me.  The point is to be focused on eating foods that will improve your cholesterol levels to where your cardiologist wants them.  And to be eating a diet that will meet your healthy weight goals.

Monday, June 4, 2012

Exercise And Pace Yourself #108

I am going to continue discussing more about healthy foods than exercising for a while.  It has become more difficult for me to really discuss much in detail about exercising simply because my workouts have become very routine.  I will continue to go over exercise importance to you out there who are heart patients.  I do believe in you developing a regular workout routine and that being very important to your overall recovery and health.   When I say workout routine I am speaking about the exercises you do.  It can be nothing more than walking your neighborhood, doing aerobics in front of the TV, whatever you can do.  It does not have to be at a fitness center, health club, or gym.   I really would hope you could evolve it to a formal program, but it is more important to you and your family that you become as active as you can in order to return to a normal for you lifestyle.   Now speaking only for myself I am not sure that I will ever be as totally active as before.   Maybe a better way to say it is I have limits on what I can do in terms of the more effort exerted, the more tiring it becomes for me. You have to keep in mind I workout at least 5 days a week, most weeks 6 days.  And these are cardiovascular and strength building exercises.  Most of my strength building exercises are designed and performed to increase and improve my total heart and blood circulation.   The point I am attempting to make is without all the effort I have put into cardiovascular exercise I am not sure how I would really be doing, and what activities I consider normal would be possible for me to do.  One thing that has helped me is that I now know my physical limitations and can recognize and accept the point in time when I should stop and rest.   Yesterday my grandson and I spent some time working outside trimming  tree limbs and clearing some overgrowth.   We really enjoy doing that together.  I paced myself and took several short breaks.  We sometimes will sit and talk about whatever comes to mind as I rest.  He seems to enjoy that as much as I.  And when I reach the point that I call "I'm done," we put all of our tools up and save the rest of the work for another day.   I realize most of you have similar activities you once enjoyed doing that you want to be able to continue to do.   Hopefully your weight, healthy food, and exercise goals will help you to do those things again.

Molasses are a sweet food that is actually good for you.  Molasses contain significant amounts of a variety of minerals.   Are they an important part of my diet?  No, but I do eat molasses and it does serve a good purpose for me.  When I get that urge for a sweet snack and I will pour a small amount of molasses over sunflower seeds, almonds, walnuts, uncooked oatmeal and mix in a small bowl and eat it and enjoy it as much as I would a chocolate candy bar.   Molasses is a good source of iron, calcium, copper, manganese, potassium, magnesium and is fat-free.  Sulphur is sometimes used in the processing, so be sure and select "unsulphured molasses," to avoid that chemical.

More about heart healthy diets next time.

Friday, June 1, 2012

General Health Information #107

Many times I wonder if I should be making the effort to research some of the details of what I consider to be important to our health.   Example? What are carbohydrates,  which we researched in an earlier posting?  I just think it is important to know what we are talking about, and how it affects your health.  We already knew carbohydrates were starchy and sugary. But I did not know what they were and how they affected me.   That is why I break down some of these terms that relate to our health. To understand more about them, and make our own personal decisions in what we consume and how and what we do to maintain good cardiovascular health.  

From post #103 you know I eat avocados because I consider them to be healthy.   They are a fruit, which I did not know. That led me to what is the difference in a fruit and a vegetable?  It is not that important and will not make any difference in do I eat it or do I not eat it.  I just want to know.   Well I am not sure there is any exact answer other than if it contains a seed or seeds it is a fruit.   If it does not, it is what we consider a vegetable.  I researched several sources and here is what I found.  A vegetable is the edible part of a plant.  Stem, root, leaf, flower, bulb, tuber.  "Vegetable" is a grocery industry term, not a botanist term to describe or mean a plant.  A vegetable is a plant product cultivated for an edible part.  Vegetables are "savory plant parts" prepared or cooked with other dishes.   A fruit is the ripened ovary of a flowery plant.  The seeds of the plant are always found inside of the fruit.  Fruit plant products have a high sugar content or taste.  Fruits have seeds, vegetables do not.  There, that is it. Does it mean something to us about our heart health?  Of course not you say.   Hold on just a second.  It could mean something to me.   I have thought for some time that I am eating too much fruit and that has led to my high sugar levels and being borderline diabetic.  Read Eat Healthy And Exercise #74 January 2012.   It is difficult to say I was wrong, but I really think I should lean more to vegetables and less to fruits in my circumstances. I relied on bananas and oranges as replacement snacks, and ingredients in my salads especially for weight loss purposes.  I also still consider them to be healthy foods.  The fact is I eat a lot of fruit and should reduce that, and begin eating more vegetables.

I have not had much to mention about exercises in a while.  Reason being nothing has changed for me in my workout routine.  I am sure you get tired of hearing it is going great, or how much I enjoy it. I am back to a more strict workout schedule.  I do feel better after exercising.  I do feel good about myself for exercising, and if you are not yet exercising you may be missing out on a great healthier heart opportunity.  I have varied my times of going to my workout a lot.  From early morning to late evening.  Workouts from 8:30 p.m. - 10:00 p.m. as an example.  Why?  Because as you know I have continued to get tired too easily, need to take short 10 minute naps or just relax and rest for a while.   I wanted to be sure working out early was not the culprit.  And it is not.  I don't know if my change in medication has effected me.  I definitely need more sleep. I have no difficulty in going to sleep and when I wake up I tend to stay in bed for another 10-15 minutes before getting up.  Now for most of my adult life and until very recently I would wake up early and when I woke up I felt rested, not drowsy or still sleepy.  I would immediately get out of bed, shower, shave, be alert and ready regardless of the hour.   Not now.  I have become a want to stay in bed person and be drowsy for the first 30 minutes or so after waking up.   I think medication has something to do with this change in sleep habits, and my tiring easily.  Plus I think this all is connected with low blood pressure.  Strange isn't it.  A heart patient not complaining about or struggling with high blood pressure.  If a cardiologist is out there reading this, I would appreciate your opinion.