Taking on Tobacco

quit smokingMy daughter just wrote a paper on Nicotine for her Psychology class. Fascinating! Even as a cardiologist I never understood the intricacies and power of Nicotine addiction. Nicotine is a drug that influences innumerable neurotransmitters throughout our body and brain. It causes antithetical responses of relaxation/euphoria and alertness/readiness. Nicotine (and therefore cigarettes) is extraordinarily addictive. In fact, a single cigarette causes changes in our bodies that signal the beginning of dependence. And, nicotine/cigarettes clearly promote illnesses such as heart disease and cancer. Four hundred thousand Americans die annually as a direct result of their smoking. Perhaps worse, forty thousand of us die from second hand smoke. Forty thousand innocent children, spouses, siblings, and co-workers are killed each year because they are unwittingly barraged by cigarette smoke. And every day three thousand teenagers join the masses of tobacco-loving Americans. How can this be? How can we stand idly by while so many die from a single preventable cause? Sadly I cannot answer these questions. Surely it has something to do with money and power, and there is likely an element of civil liberties as well.

In light of the toll tobacco takes on so many, I’m particularly perplexed by the recent emphasis on gun control. Yes, guns are often the vehicles that cause untimely death. Murder, suicide, accidental injuries are all consequences of mishandled guns. But what baffles me most is that in a perfect world guns could be harmless. They do not by nature kill. It is their misuse that leads to misfortune. Tobacco on the other hand cannot be separated from death and disease. You can’t use tobacco as a sport (as you can a gun) and get away with it. Even a single cigarette can kill a person if smoked under the wrong circumstances (in the setting of a vulnerable artery feeding the heart or brain for example). So why not turn our attention to something even more devastating than guns? At a time of economic hardship and sweeping medical reform I feel it would be far better to focus our attention on preventing “preventable” disease and death. So I beseech the powers that be in our Capitol to take on tobacco. It is a fight worth fighting.

Please read more about preventive cardiology at www.preventivecardiologyinc.com.

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Carrot Ginger Soup

1 Tbsp. olive oil
1 large Vidalia/sweet onion chopped
2 lbs. carrots, cut into 1/2 -inch pieces
1 tsp. salt
1/2 tsp. black pepper
Dash of ground ginger
2 cups water
2 cups fat-free chicken broth
2 Tbsp. heavy cream, divided

Heat oil in a large pot over medium heat. Add onion and carrots; cook 10 minutes, stirring frequently. Add salt, pepper, and ginger. Add water and broth to pot; bring to a boil.  Cover, reduce heat, simmer 25-30 minutes until carrots are tender.  Remove from heat; cool.  Place half the carrot mixture and 1 Tbsp. cream in a blender or food processor; process about 20 seconds until smooth.  Pour pureed mixture into a large bowl.  Repeat procedure with remaining carrot mixture and 1 Tbsp. cream.  Return mixture to pot and cook over medium heat until thoroughly heated.  Serves 4-6.

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Pasta with Edamame

Edamame (ey-dah-MAH-meh) is a green vegetable more commonly known as a soybean.  In East Asia, the soybean has been used for over two thousand years as a major source of protein. As a snack, the pods are lightly boiled in salted water, and then the seeds are squeezed directly from the pods into the mouth with the fingers.  This has become a popular appetizer in many restaurants and you can find them in the organic frozen foods section at your grocery either in the pods or shelled.  When my daughter was 12 years old she loved this recipe and learned to make it herself;  it’s certainly a step up on the nutrition chart from pasta and butter!

3 cloves garlic, peeled and thinly sliced
2 tablespoons olive oil
1/4 teaspoon red pepper flakes (if you’re not a fan of spicy decrease by half)
12-ounce bag shelled edamame, partially thawed
14 ounces chicken or vegetable broth
12 ounces linguine (or pasta of your choice)
2 tablespoons chopped Italian parsley

In a large skillet, over medium heat, cook the garlic in olive oil until just golden; stir in red pepper flakes.  Add the edamame and broth and simmer until the edamame are tender and the broth is reduced by half, about 10 minutes.  Meanwhile, bring a large pot of lightly salted water to a boil.  Cook the pasta; drain and add to the skillet.  Toss to coat and remove from heat.  Stir in the parsley and serve.  Makes 3-4 servings.

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WomenHeart: a leader in our fight against heart disease in women

woman jogging at sunrise
Today I’m traveling to Washington DC in order to attend the 13th Annual Wenger Award Ceremony. The celebration is hosted by WomenHeart: the National Coalition for Women with Heart Disease. Honorees will include The Honorable Debbie A. Stabenow, U.S. Senator, State of Michigan; Carolyn M. Clancy, M.D., Director, Agency for Healthcare Research and Quality (AHRQ); Abbott Vascular: and Rita Redberg, M.D., M.Sc, the Editor in Chief of the Archives of Internal Medicine.

For me, the event promises to be very exciting; after all, I will have the opportunity to communicate with some of the most important leaders in the national initiative to understand and thus prevent cardiovascular disease in women. But the event means much more than that.  It represents the great strides that are being taken to finally identify and distinguish important aspects of cardiovascular disease between the sexes.

Until about 10 years ago cardiovascular disease was felt to be a man’s problem. We have grown to understand that women too are plagued by this Leviathan of ailments. In fact, cardiovascular disease is the leading cause of death in women, outstripping even breast cancer by 11-fold. Women have differences in their cardiovascular risk factors, their symptoms, and their response to treatments, both invasive and non-invasive. Physicians must learn to evaluate and treat women differently from the way they do men.

The American Society for Preventive Cardiology (ASPC) is also doing its part to “spread the word”. On July 12 and 13 at the spectacular Boca Raton Resort, the ASPC will host its Second Annual Women’s CVD Prevention Conference. Last year was a great success and this year promises to be even better. Sponsored by Boca Raton Regional Hospital and endorsed by such organizations as WomenHeart and Go Red for Women, doctors and physician-extenders will be taught by the best of the best. Professors from Harvard, John’s Hopkins, Duke, the Mayo Clinic, UCSD, Emory, and other prestigious universities will come together in Boca Raton in order to teach clinicians practical aspects of managing their women patients.

The conference, which I will be chairing, is an unprecedented venue for clinicians to elevate their management of cardiovascular disease and its risk factors in women. I would highly encourage practitioners from around the country to attend. To learn more about the program, and sign up for attendance please visit aspconline.org. I promise you will not be disappointed.

Please read more about preventive cardiology at www.preventivecardiologyinc.com.

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Freedom through the Eyes of a Preventive Cardiologist

As an Interventional Cardiologist turned Preventive Cardiologist I understand all too well how much better it is to prevent a disease before it ever has the opportunity to strike. After all, what would you rather experience – a heart attack, angioplasty, stroke, or bypass surgery – or simply a modification of your lifestyle – eating better, exercising regularly and perhaps taking a medicine or two? Most of us would opt for the latter. I’ve yet to meet anyone who has enjoyed the experience of a major cardiac event, but most everyone likes being lean, fit, and energetic. Recently I was struck by the application of “prevention” to politics.

Americans are in the throes of controversy regarding freedom. Daily I listen to my patients as they express their worries that we might be on the road to socialism. Most people would reject such a notion, saying, “it’s impossible; America will always be the land of the free.” Yet, the patients who fret the most are those who actually lived through times of dramatic social change – Cubans, concentration camp survivors, former Eastern Europeans… These individuals have had the misfortune of going from freedom to “captivity”. And what’s truly most terrifying is the unwavering commonality of their views. They all echo the same sentiment declaring, “This is exactly what it looked like before Castro, or Hitler”, or whomever it was that led the movement that ultimately stole their freedom. By “exactly what this looked like “ these patients tell me they mean gun control, governmental intervention in business, loss of certain freedoms of religious expression and the like. They uniformly speak of the insidious nature of freedom’s ebb. Citizens of their former nations had decried the possibility that terrible social change was in the winds believing such a thing could not possibly occur. Listening to them intently I have concluded that freedom is much easier to lose than it is to gain.

Now I understand the need for us all to listen closely to what is happening in Washington as well as wherever we live. We must critically evaluate what we hear on the news, and steadfastly maintain open and circumspect eyes. Everyone would agree our country is in the midst of dramatic change. The question of course remains as to what direction we will take. As in the case of medical prevention it is time for us all to make perhaps our most important decision. Are we willing to do what it takes to prevent the loss of something our forefathers fought so bravely to attain? Will we sit back lazily and let the chips fall where they may? Or, will we get in the game, keep up with national and international events, maintain open but cautious minds, and speak loudly if we believe our freedom to be in jeopardy?  Remember the example of medicine – no one wants a bypass. The best way to avoid a bypass is to be proactive. The same, I believe holds true for remaining free.

Visit vitalremedymd.com for more preventive healthcare solutions.

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