What Does Katy Butler's "My Father's Broken Heart" Have to Do With Following a Heart Disease Prevention Diet, Meditation, Yoga, Osteoporosis & Movies?

 

photo by Eugene Richards for the New York Times

"The pacemaker bought my parents two years of limbo, two of purgatory and two of hell.  In 2005, the age-related degeneration that had slowed my father's heart, attacked his eyes, lung, bladder, and bowels. 

Clots as narrow as a single human hair lodged in tiny blood vessels in his brain, killing clusters of neurons by depriving them of oxygen...A few months later, he forgot his way home from the university pool.  He grew incontinent.  He was collapsing physically, like an ancient, shored up house."

Katy Butler, "My Father's Broken Heart: How Putting in a Pacemaker Wrecked My Family"  New York Times Sunday Magazine, June 20, 2010

If you've received this post via email, click here to get the web version with all the links.

Two weeks ago while I was still vacationing in Maine I received an email from Katy Butler, the author of this not-to-be-missed memoir in the New York Times.  Click here to read it.

Hi there, thanks for your comments on my piece for MORE on silence.
You sound like a kindred spirit.

Please read my upcoming piece next Sunday online if you don't get the Times.
Food for thought. warmly, Katy

"My Father's Broken Heart: How Putting in a Pacemaker Wrecked My Family," runs June 20 in the New York Times magazine.  I hope you get to read it, especially if you have elderly parents."

"One October afternoon three years ago, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in her birdbath in the weak Connecticut sunlight.  Her white hair was gathered at the nape of her neck, and her voice was low. "Please help me get Jeff's pacemaker turned off," she said. I nodded, and my heart knocked.
Upstairs, my 85-year-old father Jeffrey, a retired Wesleyan University professor who suffered from dementia, lay napping in what was once their shared bedroom. Sewn into a hump of skin and muscle below his right clavicle was the pacemaker that had helped his heart outlive his brain....."

Uh. I had to think long & hard to remember who Katy Butler was, & what I had written about her.  Aha!  It was her brilliant piece about silence, "How to Access Your Inner Calm"--her experience at a 6 day silent meditation retreat back in 2008.  To read her thoughtful piece that appeared in More, click here and the article is on pgs. 96-100. 

Little did I know what difficulties, sadness, and frustrations were going on in Katy's life at the time she wrote that article.  No wonder she was at a meditation retreat.  

And speaking of meditation--yesterday evening I had a chance to listen to the podcast of Diane Rehm's NPR broadcast on the Power of Meditation.   Click here  to listen to her hour-long interview of three top meditation researchers, experts, & practitioners--or just download it through iTunes and listen to it on a nice relaxing meditative walk.  Thanks to hubby for the tip about Diane's show.

"Millions of Americans practice some form of meditation to promote relaxation and reduce stress. But claims for greater health benefits are in need of further study." 

So, Why Am I Recommending That You Read Katy's Memoir?

"When people tell me my diet's extreme, or too strict, I ask them, 'How would you like to spend your last years in a nursing home, sitting in a wheelchair, incontinent, immobile, unaware, with saliva dribbling out of the side of your mouth?'"

The paraphrase of comment Dr. Caldwell Esselstyn made to me a few months ago.

Katy's story is a variation of my family's story.  My dad survived a massive stroke at age 69, just as life was starting to get nice-and-easy for him.  Both daughters were married, he could work less, and his first grandson (my now 30 year old son) was just 9 months old. Time for the travel my parents had always put off.

He lived on for 16 years after that initial stroke, until age 85, without being able to speak, read, or understand language--and reading was his joy--especially the New York Times.  He lost mobility, and everything else that makes life worth living.  My dad was kept alive by powerful anti-seizure medicines that prevented the severe seizures that were caused by the strokes' damage to his brain.  Later, he was kept alive with the help of a feeding tube.

My mom lovingly and without a single complaint took care of my dad at home for over 10 years, seeing her own health decline, and her world close in. Care-giving stress brought her weight loss, friend-loss, and unknown to her at the time, she was having her own silent imperceptible micro-strokes, as well as angina, osteoporosis and high blood pressure.  A year after my dad passed away those tiny strokes had started to take their toll on both her physical balance & memory.  After a number of falls, bone fractures, and full-blown strokes she spent her last year in that wheelchair, just as Dr. Esselstyn had described.

Read Katy's story if you have older parents, or an older spouse.  Read it for yourself, for goodness sakes.  Read it if you want the motivation to finally take your health into your own hands.  Read it if you want to understand why our medical system and Medicare lean toward expensive medical devices and expensive interventions that aren't always in our best interests. 

As for me, if there is anything that I can do that will prevent me from experiencing the same slow half-dead-half-alive fate that my parents had to experience in their final years, I'm going to give it my best shot.  Cheeseburgers & sausage pizza aren't worth the price.  And if I can prevent my husband & children from experiencing the incredible stress of care-taking--I'm going to give that a shot, too.

"It doesn't take a scientist to figure out that the possibility of death has been holding pretty steady at 100% for quite some time.  There's only one thing that we have to do in life, and that is to die.

I have often met people who use this fact to justify their ambivalence toward health information.  But I take a different view.  I have never pursued health hoping for immortality.

Good health is about being able to fully enjoy the time we do have.  It is about being as functional as possible throughout our entire lives and avoiding crippling, painful and lengthy battles with disease.

There are many better ways to die, and to live."

-Dr. T. Colin Campbell, "The China Study"  Dallas, TX: Benbella Books, 2006, pg. 75-

Katy's story expertly weaves together her families' most private emotions, with an explanation of how 21st century medicine has come to trap us into a cascade of expensive procedures, devices, and drugs at the end of our lives, that often extends our years, but not the quality of our lives.  She's a beautiful, poetic writer and has shared the most intimate details of her families' life to benefit others.  Read it!

Excerpts from "My Father's Broken Heart":

• I don't like describing what dementia did to my father--and indirectly to my mother--without telling you first that my parents loved each other, and I loved them.
• Anton Chekov, who died of tuberculosis in 1904, wrote:  "Whenever there is someone in a family who has long been ill, and hopelessly ill, there come painful moments when all timidly, secretly, at the bottom of their heart long for his death."  A century later, my mother and I had come to long for the machine in my father's chest to fail.
• I watched (my parents) lose control of their lives to a set of perverse financial incentives--for cardiologists, hospitals and especially the manufacturers of advanced medical devices--skewed to promote maximum treatment.
• Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the "oldest old" have become the nation's most rapidly growing age group.  Nearly a third of Americans over 85 have dementia. 
• (M)y 77-year-old mother found herself on duty more than 80 hours a week.  Her blood pressure rose and her weight fell.  On a routine visit to Dr. Fales, she burst into tears.  She was put on sleeping pills and anti-depressants.
• If (Dr. Fales) had had a chance to sit down with my parents, he could have explained that the pacemaker's battery would last 10 years and asked whether my father wanted to live to be 89 in his nearly mute and dependent state.
• In a fee-for-service medical economy...communication is haphazard...thinking is often short-term.  Nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.
• Medicare rewards doctors far better for doing procedures than for assessing whether they should be done at all.  The incentives for overtreatment continue...because those who profit from them--specialists, hospitals, drug companies and the medical-device manufacturers--spend money lobbying Congress and the public to keep it that way.
• And so my father's electronically managed heart--now requiring frequent monitoring, paid by Medicare--became part of the $24 billion worldwide cardiac-device industry and an indirect subsidizer of the fiscal health of American hospitals.
• The pacemaker bought my parents two years of limbo, two of purgatory and two of hell.
• Of the 17 cardiologists who wrote the 2008 guidelines on pacemakers for the American College of Cardiology, 11 received financing from cardiac-device makers or worked at institutions receiving it.  Seven, due to the extent of their financial connections, were recused from voting on the guidelines they helped write.
• We learned that if we called 911, emergency medical technicians would not honor my father's do-not-resuscitate order unless he wore a state-issued orange hospital bracelet.
• More than half of heart-bypass patients suffer at least a 20% reduction in mental function.

Yikes, I started out writing this post as a brief segue into my first week following Dr. Esselstyn's heart-disease-reversal-and-prevention diet, and it just morphed into something else. Can you tell how much I adored Katy's article?

Sorry,  more about the Tips, Tricks, How-Tos of the Diet tomorrow, or later this week.  My son, daughter-in-law and adorable grandson arrive here late on Monday night, so I guess blogging may once more take a back seat.

Quick Diet Update:  So far so good.  This is definitely a lot easier than I thought it would be, thanks to all of Ann Esselstyn's amazing tips.  I have noticed that I definitely need to eat before I get hungry--because when I get hungry--I'm ravenous.  I'm noticing that I'm staying up about one hour longer each day than before.  No idea if that's diet related or not.  Loving fat free roasted red pepper humus, Ezekiel wraps & English muffins.

Sample Menu This Week

Breakfast:  Steel-cut oats, with dried apples and flaxmeal.  I never get tired of this!

Snack split over mid-morning & mid-afternoon:  My green smoothie made with kale or chard, apple, grapefruit, berries, and carrots.

Lunch: Giant salad of mesclun greens, roasted corn, steamed lentils (Trader Joe's precooked), tomatoes, cucumbers, Trader Joe's Corn Salsa & balsamic vinegar.  Plus, an Ezekiel-brand sprouted grain English muffin.

Dinner: Bok Choy with portobello mushrooms, carrots, ginger, pea pods, barbecued seitan, and soba noodles.  Fabulous!  A variation of Rip Esselstyn's recipe.

Additional snacks:  Cherries, watermelon, whole wheat pita, baby carrots, cucumbers with fat-free red pepper hummus

Update on Dr. Loren Fishman's Osteoporosis Study

The study is still open if you are interested in participating, and you will receive Fishman's DVD of 10 minutes of daily poses. Details on the study are here.

To enroll, email Dr. Fishman at:  [email protected]

You will need to send copies of the SMA-18 (electrolytes & blood chemistry); CBC (complete blood count);  TSH (thyroid-stimulating hormone); Vitamin D 1,25-dihydroxy;  ESR (erythrocyte sedimentation rate); parathyroid hormone test, and DEXA scan results, before you can enroll and receive the DVD.

I'm planning to enroll as soon as I can get together all the tests results.

I still don't have an answer about whether 2 or 3 times a week of hour-long classes would provide the same positive results as the 10-minute every day practice.

Movies I've Loved This Summer

City Island--do not pay attention to negative reviews.  This is a winner.  Everyone I know who has seen it has loved it.

Please Give with Catherine Keener--more than meets the eye.

Enjoy this lovely weekend!

Comments

[Betsy]

This article is heartbreaking, and very compelling. I sent the link to everyone in my immediate family, and it's made me revise my living will to include a special proviso if I have dementia.

This post and your previous one got me thinking about the kind of death one might have if one were to follow Esselstyn's prescription. Did you happen to discuss that or maybe it's in one of their books?

Looking forward to seeing your great numbers after the 3 week Esselstyn diet.

Thanks for all your work.

Betsy

[Gael in Vermont]

My own mother is in a rehab facility after having a bout with pneumonia last month and a short hospital stay. Reading Katy's piece, there is so much I can connect with. There are no easy decisions here. I see the assortment of pills she takes, the regimented and boring physical therapy (for her previous stroke)and the cold, young doctor who is relegated to her case. I do not want that sort of life. I am trying my best to eat well, exercise, and keep up with your terrific blog! You're an amazing role model! I'm with you, Deb!

PS...City Island was wonderful!
And, I signed up for Fishman's study.

[Maria]

This was a great post. I also saw City Island and I thought it was great movie. You'll appreciate it even more if you are a New Yorker!

[Ken Leebow]

That is an incredible article. My grandmother had a pacemaker...she lived to almost 104. That sounds wonderful to everyone, however, the last eight years of her life were spent bed-ridden.

Sadly, I believe most aspects of technology have far out-paced our ability to deal with the unintended consequences.

1. Wall Street Fiasco
2. Gulf Disaster
3. Extended Life Health care
4. ???

Kindly,

Ken Leebow
http://www.FeedYourHeadDiet.com

P.S. Thanks for the Trader Joe's product recommendation. I'm a Trader Joe's fanatic! TJ's helped me lose 30 pounds and get healthy. I do have a Trader Joe's shopping list for anyone who is interested: http://www.feedyourheaddiet.com/tj.html

[raye lankford]

This article was heartbreaking. It made me sit down with my husband and have "that talk" about a day that now seems oh so far away, but for all we know could be right around the corner. Thanks for sharing.

[Peggy McLoughlin]

You might be interested in this link to an article that appeared in the July 5th Boston Globe in which Loren Fishman is cited:
http://www.boston.com/news/health/articles/2010/07/05/older_americans_are_as_active_as_ever_and_expecting_their_doctors_to_treat_their_injuries/?comments=all#readerComm

Peggy

[The Healthy Librarian]

Thanks for the Boston Globe article--very interesting, and I especially liked the part about Dr. Fishman! Inspiring, too!

[Katy Butler]

Dear medical librarian -- sorry, I don't seem to be able to find your name this time! I am touched by your family story, and by your comments and those of your readers. Thank you for posting a link to my article. It has been widely circulated and may some good. Warmly, Katy Butler.