Devout Paleo followers are as diverse as the occupants of NYC.  If yesterday's blog, The Paleo Diet for Fibromyalgia, left you a bit confused and skeptical, you are with good company. As I was listening to my cardiologist talk and leafing through the pamphlet yesterday I proposed a question, "So, what do you eat for breakfast?"  After all, that seemed to be the first obstacle to overcome with my western diet philosophy.  

"1 1/2 cups of UNSWEETENED GREEK YOGURT with blueberries," he replied. "You'll get used to it.  We don't need sugar."

"But, it says limited dairy," I questioned.  "So, you eat dairy everyday?"

"Yes," he answered.

After an internet swipe that evening, I noticed for the first 30 days you should not eat ANY dairy.  Must be an elimination type diet I figured.   As I went through more and more sites I noticed some were eating Quinoa.  Some were eating more starchy vegetables.  

One thing that was across the board however, was NO GRAINS and BEANS.  I guess except for some that want quinoa added to the menu.  I decided to start with the later and remove all grains and beans from my diet.  I did have a small 2 oz. of Kefir in the morning with my powdered probiotic.  That, I decided, would have to stay.  After all, my stomach was still very much the size of a watermelon.

With all the first week's trails and tribulations, The Paleo Diet Solution book really helped me tread lightly in new territory and listen to my body first.    

Four weeks later, eight pounds lighter, and able to see the tops of my thighs for the first time in seven years I am on a new journey.  I have been a forth runner on a vegetarian or vegan lifestyle but have yet to reap any real benefits for myself.  I have come to the conclusion one diet definitely does not work for everyone.

The last few minutes at my recent cardiologist appointment ended with- "You really needed to see me at this time," he spoke softly.  "Your levels are all off. We need to cut carbohydrate consumption drastically."

"How?" I moaned.  "I have already cut out most grains, and I am down to sweet potatoes, brown rice, and quinoa.  I don't even eat that much at a meal!" I swiftly held up the palm of my hand to show him how much I add to my plate in carb use each time. 

He quickly left the room and came back with a pamphlet.  Read this.  Try this.  You've got to do something. "What can it hurt?" he added. "You can't keep on going as you are that's for sure."

Robb Wolf's Quick Start Paleo Guide

 He was still talking, but my mind was registering a blank.  How much more can I do?  I've already slashed my diet to the bare minimum of healthy foods to live as I am now.  I know something wasn't working right - but ANOTHER new journey?  I began leafing through the pages trying to take it all in.  I left the office and stopped at the library on the way home to arm myself with the new knowledge I was going to need to take the Paleo Leap.  

Within four days the following symptoms began subsiding:
bloating
headaches
joint pain
acit reflux
fibro fog
fatigue

On top of that, I had lost four pounds.  How? I wondered. I had researched every possible new "wave" on fibromyalgia.  How had I missed this one tool that I constantly blog on?

I landed on Robb Wolf's site later that week and came upon the following information:

​What Is The Paleo Diet?

The Paleo diet is the healthiest way you can eat because it is the ONLY nutritional approach that works with your genetics to help you stay lean, strong and energetic! Research in biology, biochemistry, Ophthalmology, Dermatology and many other disciplines indicate it is our modern diet, full of refined foods, trans fats and sugar, that is at the root of degenerative diseases such as obesity, cancer, diabetes, heart disease, Parkinson’s, Alzheimer’s, depression and infertility. – Robb Wolf

Building A Healthy Paleo Diet
DIVERSE PROTEINS

Ideally one should eat a wide variety of proteins from as many animal sources as possible. One need not and should not avoid fatty cuts of meat, particularly if consuming pastured sources. An often overlooked piece of the paleo diet in popular culture is an over-reliance on standard cuts of meat, at the expense of organ meats, bone broth and other collagen sources. For more information on the historical and practical aspects of consuming a more balanced protein intake, check out the Weston A. Price Foundation. If weight-loss is a goal, protein makes you feel satisfied between meals.

FRUITS AND VEGETABLES

Fruits and vegetables are rich in antioxidants, vitamins, minerals and phytonutrients that have been shown to decrease the likelihood of developing a number of degenerative diseases including cancer, diabetes and neurological decline.

HEALTHY FATS FROM NUTS, SEEDS, AVOCADOS, OLIVE OIL, FISH OIL AND GRASS-FED MEAT

Scientific research and epidemiological studies show that diets rich in Monounsaturated and Omega-3 fats dramatically reduce the instances of obesity, cancer, diabetes, heart disease and cognitive decline.
Saturated fat has been demonized by our health authorities and media. What is the basis for this position on Saturated fat? Are current recommendations for VERY low saturated fat intake justified? How much saturated fat (and what types), if any should one eat? Without a historical and scientific perspective these questions can be nearly impossible to answer.

Health Benefits of a Paleo Diet

For most people the fact the Paleo diet delivers the best results is all they need. Improved blood lipids, weight loss, and reduced pain from autoimmunity is proof enough.  Many people however are not satisfied with blindly following any recommendations, be they nutrition or exercise related. Some folks like to know WHY they are doing something. Fortunately, the Paleo diet has stood not only the test of time, but also the rigors of scientific scrutiny.

With a very simple shift we not only remove the foods that are at odds with our health (grains, legumes, and dairy) but we also increase our intake of vitamins, minerals, and antioxidants. Here is a great paper from Professor Loren Cordain exploring how to build a modern Paleo diet: The nutritional characteristics of a contemporary diet based upon Paleolithic food groups. This paper also offers significant insight as to the amounts and ratios of protein, carbohydrate and fat in the ancestral diet.

Come on!

Our Ancestors lived short, brutal lives! This Paleo Diet is all bunk, right?The Paleo concept is new for most people and this newness can spark many questions. We like people to not only read about and educate themselves on this topic but also to “get in and do it.” Experience is perhaps the best teacher and often cuts through any confusion surrounding this way of eating. Now, all that considered, there are still some common counter arguments to the Paleo diet that happen with sufficient frequency that a whole paper was written on it. Enjoy: Evolutionary Health Promotion. A consideration of common counter-arguments.
​
Does it work for diabetes?

A great question to ask is “Does the Paleo diet work?” Here we have a head to head comparison between the Paleo diet and Mediterranean diet in insulin resistant Type 2 Diabetics. The results? The Paleo diet group REVERSED the signs and symptoms of insulin resistant, Type 2 diabetes. The Mediterranean diet showed little if any improvements. It is worth noting that the Mediterranean diet is generally held up by our government as “the diet to emulate” despite better alternatives. You can find an abstract and the complete paper here.

Cardio Vascular Disease

According to the CDC, cardiovascular disease is the number one cause of death in the United States. Interestingly however, our Paleolithic ancestors and contemporarily studied hunter-gatherers showed virtually no heart attack or stroke while eating ancestral diets. The references below will explore these facts to better help you understand the heart-healthy benefits of a Paleo diet.

Autoimmunity

Autoimmunity is a process in which our bodies own immune system attacks “us.” Normally the immune system protects us from bacterial, viral, and parasitic infections. The immune system identifies a foreign invader, attacks it, and ideally clears the infection. A good analogy for autoimmunity is the case of tissue rejection after organ donation. If someone requires a new heart, lung kidney or liver due to disease or injury, a donor organ may be an option. The first step in this process is trying to find a tissue “match”. All of us have molecules in our tissues that our immune system uses to recognize self from non-self. If a donated organ is not close enough to the recipient in tissue type the immune system will attack and destroy the organ. In autoimmunity, a similar process occurs in that an individuals own tissue is confused as something foreign and the immune system attacks this “mislabeled” tissue. Common forms of autoimmunity include Multiple Sclerosis, Rheumatoid Arthritis, Lupus, and Vitiligo to name only a tiny fraction of autoimmune diseases. Elements of autoimmunity are likely at play in conditions as seemingly unrelated as Schizophrenia, infertility, and various forms of cancer.

Interestingly, all of these seemingly unrelated diseases share a common cause: damage to the intestinal lining which allows large, undigested food particles to make their way into the body. This is called “leaky gut and the autoimmune response”. Here is a 7-part video series by Prof. Loren Cordain describing the etiology of Multiple Sclerosis. And please watch this TED talk by Dr. Terry Wahls, MD as she describes how she reversed her Multiple Sclerosis with a paleo diet. If you have an autoimmune disease you might consider trying the autoimmune protocol of the paleo diet.  - Robb Wolf
​
Ok, I've given you quite a bit to chew on and digest.  This is going to take some time for those, like me, whom have tried everything and sit staring at the screen here now thinking of all the reasons this diet can't be healthy for them.  After all, how many alternative diets and remedies have you tried already?  The idea of one more journey, at times, can be a bit more than the soul can bare.  I get all this.  I was there four weeks ago.  But, as I get older, life is slipping by without me.  So, take my hand, and let's try one more path.  

It's easy.  Not much to buy other than less grains and beans.  I know you've already checked out the quick guide and thought, "Ok, maybe I can add some of what Robb is saying.  But, where do I start? How do I even begin?"

Here you go:

Robb Wolf's Food Matrix Plan

Then give me a shout back in four days.  For you Vegan/Vegetarians? As long as you are feeling well, keep up the good work!  For those that are flustered because that advantage just kept tipping the scales - I got a new plan, let's dive in.  

I had a reader contact me on Messenger wondering if Dysautonomia is common in Fibromyalgia.  This surfaced memories from my own battle with my central nervous systems disorder and my neurologist.  You see I have many, too numerous to count, disorders of the autonomic nervous system that I am at odds when I speak to my specialist. 

"These recent symptoms seem to be more specifically related to dysautonomia.  Is there something I should be tested for?" I asked.

"No, you do not have an autonomic disorder, " he assures me.

I can tell you being up all night with night sweats and spine burning does not make me feel secure with that answer.  Nor does having liable blood pressure with heart irregularities make me feel any better.  

So What Is Dysautonomia?

Dysautonomia (or autonomic dysfunction) is any disease or malfunction of the autonomic nervous system (ANS). The autonomic nervous system controls a number of functions in the body, such as heart rate, blood pressure, digestive tract peristalsis, and sweating, amongst others. Dysfunction of the ANS can involve any of these functions.

A number of conditions are forms of dysautonomia: postural orthostatic tachycardia syndrome (POTS), inappropriate sinus tachycardia (IST), vasovagal syncope, pure autonomic failure, neurocardiogenic syncope (NCS), neurally mediated hypotension (NMH), orthostatic hypotension, orthostatic hypertension, autonomic instability, and a number of lesser-known disorders such as cerebral salt-wasting syndrome. Dysautonomia may occur as the result of other diseases, such as diabetes mellitus, multiple system atrophy (Shy-Drager syndrome), Guillain-Barré syndrome and a number of other conditions that may affect the nervous system.

Just taking a minute to peruse the above sources lets you know you are dealing with a life-threatening illness.  So, it is clear where many fibromyalgia suffers may get confused when noting such symptoms to their specialist.  

What Are the Symptoms of Dysautonomia?

The symptoms of dysautonomia are numerous and vary widely from person to person. Since dysautonomia is a full-body condition, a large number of symptoms may be present that can greatly alter a person’s quality of life. Each patient with dysautonomia is different—some are affected only mildly, while others are left completely bed-ridden and disabled.
​

• Excessive fatigue
• Excessive thirst (polydipsia)
• Lightheadedness, dizziness or vertigo
• Feelings of anxiety or panic (not mentally induced[citation needed])
• Rapid heart rate or slow heart rate
• Orthostatic hypotension, sometimes resulting in syncope (fainting)
• Gastroparesis (delayed gastric emptying)
• Headaches
• Mydriasis (abnormal dilation of the pupils)
• Salt cravings
• Constipation
• Pallor (unhealthy pale appearance)
• Diarrhea
• Nausea
• Acid reflux
• Visual disturbances
• Orthostatic hypotension
• Numbness
• Nerve pain
• Trouble breathing
• Chest pains

Many of us suffer from at least 75% of the symptoms labeled above.  Hence, it is understandable why we'd be concerned over ANS failure. Then again, it seems as if we all have a tad of any number of ANS disorders, yet, we are not labeled with the diagnosis, but just seem to exhibit varying degrees of symptoms.  

How Is It Diagnosed?

​Autonomic neuropathy is a possible complication of a number of diseases, and the tests you'll need depend on your symptoms and risk factors for autonomic neuropathy.

When you have known risk factors for autonomic neuropathy

If you have conditions that increase your risk of autonomic neuropathy, such as diabetes, and have symptoms of the condition, your doctor will perform a physical exam and ask about your symptoms.

If you are undergoing cancer treatment with a drug known to cause nerve damage, your doctor will check for signs of neuropathy.

When you don't have risk factors for autonomic neuropathy.

If you have symptoms of autonomic neuropathy but no risk factors, the diagnosis can be more involved. Your doctor will probably review your medical history, discuss your symptoms and do a physical exam.
Your doctor might recommend tests to evaluate autonomic functions, including:

• Breathing tests. These tests measure how your heart rate and blood pressure respond during exercises such as forcefully exhaling (Valsalva maneuver).
• Tilt-table test. This test monitors the response of blood pressure and heart rate to changes in posture and position, simulating what occurs when you stand up after lying down. You lie flat on a table, which is then tilted to raise the upper part of your body. Normally, your body narrows blood vessels and increases heart rate to compensate for the drop in blood pressure. This response may be slowed or abnormal if you have autonomic neuropathy.
  A simpler test for this response involves standing for a minute, then squatting for a minute and then standing again while blood pressure and heart rate are monitored.
• Gastrointestinal tests. Gastric-emptying tests are the most common tests to check for digestive abnormalities such as slow digestion and delayed emptying of the stomach (gastroparesis). These tests are usually done by a doctor who specializes in digestive disorders (gastroenterologist).
• Quantitative sudomotor axon reflex test. This test evaluates how the nerves that regulate your sweat glands respond to stimulation. A small electrical current passes through capsules placed on your forearm, upper and lower leg and foot, while a computer analyzes the response of your nerves and sweat glands. You might feel warmth or a tingling sensation during the test.
• Thermoregulatory sweat test. You're coated with a powder that changes color when you sweat. While lying in a chamber with a slowly increasing temperature, digital photos document the results as you begin to sweat. Your sweat pattern might help confirm a diagnosis of autonomic neuropathy or suggest other causes for decreased or increased sweating.
• Urinalysis and bladder function (urodynamic) tests. If you have bladder or urinary signs and symptoms, a series of urine and bladder tests can evaluate bladder function.
• Ultrasound. If you have bladder signs and symptoms, your doctor might do an ultrasound in which high-frequency sound waves create an image of the bladder and other parts of the urinary tract.

Treatment of autonomic neuropathy includes:

• Treating the underlying disease. The first goal of treating autonomic neuropathy is to manage the disease or condition damaging your nerves. For example, if the underlying cause is diabetes, you'll need to tightly control blood sugar to prevent autonomic neuropathy from progressing. About half of the time, no underlying cause for autonomic neuropathy is found.
• Managing specific symptoms. Some treatments can relieve the symptoms of autonomic neuropathy. Treatment is based on what part of your body is most affected by nerve damage.

Digestive (gastrointestinal) symptoms
Your doctor may recommend:

• Diet changes. You might need to increase dietary fiber and fluids. Fiber supplements, such as Metamucil or Citrucel, also might help. Slowly increase fiber to avoid gas and bloating.
• Medication to help your stomach empty. A prescription drug called metoclopramide (Reglan) helps your stomach empty faster by increasing the contractions of the digestive tract. This medication can cause drowsiness and isn't advised for long-term use.
• Medications to ease constipation. Over-the-counter laxatives can help ease constipation. Ask your doctor how often you should use a laxative.
• Medications to ease diarrhea. Antibiotics can help treat diarrhea by preventing excess bacterial growth in the intestines, and over-the-counter antidiarrheal medication might be helpful.

Urinary symptoms
Your doctor may suggest:

• Retraining your bladder. Following a schedule of when to drink fluids and when to urinate can help increase your bladder's capacity and retrain your bladder to empty completely at the appropriate times.
• Medication to help empty the bladder. Bethanechol (Duvoid) is a medication that helps ensure complete bladder emptying. Possible side effects include headache, abdominal cramping, bloating, nausea and flushing.
• Urinary assistance (catheterization). A tube is guided through your urethra to empty your bladder.
• Medications that decrease an overactive bladder. These include tolterodine (Detrol), oxybutynin or similar medications. Possible side effects include dry mouth, headache, fatigue, constipation and abdominal pain.

Sexual dysfunction
For men with erectile dysfunction, your doctor might recommend:

• Medications that enable erections. Drugs such as sildenafil (Viagra, Revatio), vardenafil (Levitra) or tadalafil (Adcirca, Cialis) can help you achieve and maintain an erection. Possible side effects include mild headache, flushing, upset stomach and changes in color vision.
  If you have a history of heart disease, arrhythmia, stroke or high blood pressure, use these medications with caution. Also avoid taking these medications if you are taking any type of organic nitrates. Seek immediate medical assistance if you have an erection that lasts longer than four hours.
• External vacuum pump. This device helps pull blood into the penis using a hand pump. A tension ring helps keep the blood in place, maintaining the erection for up to 30 minutes.

For women with sexual symptoms, your doctor might recommend:

• Vaginal lubricants to decrease dryness and make sexual intercourse more comfortable and enjoyable.
• Flibanserin (Addyi) for premenopausal women with low sexual desire.

Heart rhythm and blood pressure symptoms
Autonomic neuropathy can cause a number of heart rate and blood pressure problems. Your doctor might prescribe:

• Medications to raise your blood pressure. If you feel faint or dizzy when you stand up, your doctor might suggest fludrocortisone. This medication helps your body retain salt, which helps regulate your blood pressure.
  Other drugs that can help raise your blood pressure include midodrine (Orvaten) and pyridostigmine (Mestinon, Regonol). Droxidopa (Northera) also can help raise blood pressure. Midodrine and droxidopa can cause high blood pressure when lying down.
• Medication to regulate your heart rate. A class of medications called beta blockers helps to regulate your heart rate if it goes too high with an activity level.
• A high-salt, high-fluid diet. If your blood pressure drops when you stand up, a high-salt, high- fluid diet can help maintain your blood pressure. This is generally only recommended for severe cases of blood pressure problems, as this treatment may cause blood pressure that is too high or swelling of the feet, ankles or legs and shouldn't be used in patients with heart failure.

Sweating
If you sweat too much, your doctor might prescribe:

• A medication that decreases perspiration. Glycopyrrolate (Cuvposa, Robinul, Robinul Forte, others) can decrease sweating. Side effects can include diarrhea, dry mouth, urinary retention, blurred vision, changes in heart rate, headache, loss of taste and drowsiness. Glycopyrrolate can also increase the risk of heat-related illness, such as heatstroke, from a reduced ability to sweat.
• Surgery to cut the nerves in the sweat glands. It's also possible to remove the sweat glands but only in small areas of increased sweating, such as the palms.

It’s common for fibromyalgia sufferers to experience at least one or more forms of dysautonomia syndrome. We know that with fibromyalgia, there is a dysfunction in the ANS. For many with fibromyalgia, it appears as a delayed and inflated response to stressful situations. The fibromyalgia sufferer may go through a stressful situation without releasing the stress hormones that are typically produced automatically.

Once the stressful encounter is over and the sufferer is able to relax, the release of those stress hormones is triggered. The sufferer is flooded with stress hormones and experiences the anxiety and energy that others felt during the stressful situation, only the sufferer experiences it to an extreme degree long after the stress has subsided. This delayed reaction may make it appear that there is no cause for the sudden onset of severe alarm and discomfort.

Because of this, scientists have identified multiple abnormalities in fibromyalgia, including problems in the central nervous system and the autonomic nervous system. Fibromyalgia can be a result of dysautonomia or dysautonomia may be a result of fibromyalgia, we don’t really know. But there seems to be sufficient evidence to correlate the two. If you have symptoms of dysautonomia, discuss it with your physician. Diagnosis needs to be made in order to explore possible treatments that will ease your symptoms and improve your health.

Kevin Bacon stars as a grieving father who decides to take the law into his own hands when his son is senselessly murdered by a gang member.

​A rancher conspires to murder his wife for financial gain and convinces his teenage son to participate.

A firefighter does something unexpected after a man that he has been ordered to testify against threatens him.

Darcy is a college administrator whose son Walker committed suicide seven years earlier. Her only constants in life are gardening and her best friend, Byrd. After learning that Walker's old buddy Mark stole his idea for a restaurant chain, she packs her bag, picks up Byrd and travels to New Orleans to confront him and settle the score.

Catherine and David Stewart (Julianne Moore, Liam Neeson) are a well-to-do couple living in a posh area of Toronto, but all is not well in paradise. Catherine suspects that David, a music professor, is cheating on her with his students. She hires a prostitute named Chloe (Amanda Seyfried) to meet David and see if he gives in to temptation, but events spin out of control when Chloe spills the details of her torrid encounters.

​Laura McAllan is trying to raise her children on her husband's Mississippi Delta farm, a place she finds foreign and frightening. In the midst of the family's struggles, two young men return from the war to work the land. Jamie McAllan, Laura's brother-in-law, is everything her husband is not - charming and handsome, but he is haunted by his memories of combat. Ronsel Jackson, eldest son of the black sharecroppers who live on the McAllan farm, now battles the prejudice in the Jim Crow South.

​Young sisters Kate and Lisa and travel to Mexico for a vacation filled with sun, fun and adventure. Lisa needs some extra persuasion when Kate suggests that they go diving in shark-infested waters. Safe in their protective cage, the thrill-seeking siblings come face to face with a group of majestic great whites. Their worst fears soon become a reality when the cage breaks away from their boat, sending them plummeting to the ocean floor with a dwindling supply of oxygen.

​Single mother Teena is brutally assaulted by a local gang in front of her 12-year-old daughter Bethie. Despite Bethie being able to identify the attackers, the defense hires a local hot-shot defense attorney who manipulates the law to their advantage. When the criminals are set free, Gulf War veteran and detective John Dromoor is dismayed by the lack of justice and plots revenge against the men on Teena's behalf.

​A vengeful young woman (Julia Stiles) recruits two men (Anthony Hopkins, Alexander Ludwig) to help her track down a former cop (Ray Liotta) who stalked and attacked her.

​A mild-mannered farmer embarks on a bloody quest to avenge his mother's murder. He soon discovers her dark side while wading through the criminal underworld of Belfast, Ireland.

I week later, and the Lexiscan evaluated, I was back in the doctor's office deciphering my results. Pleasantly surprised, I was four pounds lighter!

I had run amok on the library internet resource grabbing and putting on hold all the available books on the Paleo diet.  I wanted to understand EVERYTHING concerning my new nutrient contents that I was ingesting were affecting my body.. Since my system is so hyper sensitive to change, I needed to try and prevent any backlash.    

There were some initial bumps.  Going grain free and very limited on carbs made me feel TOO energetic.  It was quite a dilemma to swallow since I am limited on carbs as it is.  I was shocked to feel these new electrical paths course through my body.  I filled up on many plumb sweet potatoes those first few days which satiated and made me feel comfortable and more sedate.  Surely, filling up on extra tubers wasn't going to have much effect on my weight.  But, I was tickled when I stepped on the scale to find two pounds gone the following morning.  The following day another two pounds.  Then over the rest of the week another two pound loss.  So, when I got to the doctor's office my six pounds turned into four loaded down with more clothes and sandals.  

"Great, you lost a few pounds," my cardiologist chimed.  

"Well, you told me to go on the Paleo.  Actually, this is the first time I had any substantial weight loss in ANYTHING I tried over the last seven years since being diagnosed." I retorted.  "Most importantly, I sleep less in the afternoon, and I'm noticing my pain levels have decreased significantly." 

There were other things flitting through my mind I didn't mention.  Like the first time I hooked my bra the following day - there wasn't uncomfortable shoulder pain.  Or, the fact I hadn't taken my omeprazole for four days because I haven't experienced any heartburn from GERD.  Then there's the fact that I hadn't woken with a headache since I started.  Also, I was taking pain medication less and less because I was forgetting to take it. Most importantly, my kids saw me up and around doing things around the house.  "Are you doing too much? Go lay down, " they'd say.  

"How was your Lexiscan? Looks like there were a few hiccups," he questioned.

"Better than I thought.  I was extremely nervous during the procedure, but I noticed the initial affect after the injection wasn't as horrible as I read on the Internet.  There was only a slight rise in heartbeat.  But, it was afterwards, as the drug was supposed to dissipate that I had issues.  My blood pressure kept climbing and climbing to 247/121.  They had to give me the antidote.  Then it slowly subsided, " I answered.

"Yes, I see.  Stay off the Internet.  Save yourself emotional trouble next time," he replied.

He then thoroughly explained my results.  Due to unwarranted and liable blood pressure I had Left Ventricular Hypertrophy (LVH).  Simply stated, the left side of my heart was enlarging because it had to work harder to keep blood flowing due to my hypertension. "Luckily you came in when you did," he added.

​Left ventricular hypertrophy

LVH is enlargement and thickening (hypertrophy) of the walls of your heart's main pumping chamber (left ventricle).

Left ventricular hypertrophy can develop in response to some factor — such as high blood pressure or a heart condition — that causes the left ventricle to work harder. As the workload increases, the muscle tissue in the chamber wall thickens, and sometimes the size of the chamber itself also increases. The enlarged heart muscle loses elasticity and eventually may fail to pump with as much force as needed.

Left ventricular hypertrophy is more common in people who have uncontrolled high blood pressure. But no matter what your blood pressure is, developing left ventricular hypertrophy puts you at higher risk of a heart attack and stroke.

Treating high blood pressure can help ease your symptoms and may reverse left ventricular hypertrophy.

Symptoms

Left ventricular hypertrophy usually develops gradually. You may experience no signs or symptoms, especially during the early stages of the condition.

As left ventricular hypertrophy progresses, you may experience:

• Shortness of breath
• Fatigue
• Chest pain, often after exercising
• Sensation of rapid, fluttering or pounding heartbeats (palpitations)
• Dizziness or fainting

When to see a doctor

Seek emergency care if:

• You feel chest pain that lasts more than a few minutes
• You have severe difficulty breathing
• You have severe lightheadedness or lose consciousness

If you experience mild shortness of breath or other symptoms, such as palpitations, see your doctor.

If you have high blood pressure or another condition that increases your risk of left ventricular hypertrophy, your doctor is likely to recommend regular appointments to monitor your heart. Even if you feel well, you need to have your blood pressure checked annually, or more often if you:

• Smoke
• Are overweight
• Have other conditions that increase the risk of high blood pressure

​
Causes

Left ventricular hypertrophy can occur when some factor makes your heart work harder than normal to pump blood to your body.

Factors that can cause your heart to work harder include:

• High blood pressure (hypertension). This is the most common cause of left ventricular hypertrophy. More than one-third of people show evidence of left ventricular hypertrophy at the time of their diagnosis with hypertension.
• Aortic valve stenosis. This disease is a narrowing of the aortic valve that separates the left ventricle from the large blood vessel leaving your heart (aorta). The narrowing of the aortic valve requires the left ventricle to work harder to pump blood into the aorta.
• Hypertrophic cardiomyopathy. This genetic disease occurs when the heart muscle becomes abnormally thick, even with completely normal blood pressure, making it harder for the heart to pump blood.
• Athletic training. Intense, prolonged endurance and strength training can cause the heart to adapt to handle the extra workload. It's unclear whether this athletic type of left ventricle hypertrophy can lead to stiffening of the heart muscle and disease.

Risk factors

In addition to hypertension and aortic valve stenosis, factors that increase your risk of left ventricular hypertrophy include:

• Age. Left ventricular hypertrophy is more common in older people.
• Weight. Being overweight increases your risk of high blood pressure and left ventricular hypertrophy.
• Family history. Certain genetic conditions are associated with developing left ventricular hypertrophy.
• Diabetes. Left ventricular hypertrophy has been found to be linked to a higher risk of diabetes.
• Race. African-Americans are at higher risk of left ventricular hypertrophy than are white people with similar blood pressure measurements.
• Sex. Women with hypertension are at higher risk of left ventricular hypertrophy than are men with similar blood pressure measurements.

Complications

Left ventricular hypertrophy changes the structure and working of the heart. The enlarged left ventricle can:

• Weaken
• Stiffen and lose elasticity, preventing the chamber from filling properly and increasing pressure in the heart
• Compress the chamber's blood vessels (coronary arteries) and restrict its supply of blood

As a result of these changes, complications of left ventricular hypertrophy include:

• Reduced blood supply to the heart
• Inability of the heart to pump enough blood to your body (heart failure)
• Abnormal heart rhythm (arrhythmia)
• Irregular, often rapid heartbeat (atrial fibrillation) that decreases blood flow to the body
• Insufficient supply of oxygen to the heart (ischemic heart disease)
• Stroke
• Sudden, unexpected loss of heart function, breathing and consciousness (sudden cardiac arrest)

Prevention

The best way to prevent left ventricular hypertrophy caused by high blood pressure is to maintain healthy blood pressure. To better manage your blood pressure:

• Monitor high blood pressure. Purchase a home blood pressure measuring device and check your blood pressure frequently. Schedule regular checkups with your doctor.
• Make time for physical activity. Regular physical activity helps to lower blood pressure and keep it at normal levels. Aim for 30 minutes of moderate physical activity most days of the week.
• Eat a healthy diet. Avoid foods that are high in saturated fat and salt, and eat more fruits and vegetables. Avoid alcoholic beverages or drink them in moderation.
• Quit smoking. Giving up smoking improves your overall health and prevents heart attacks.

"The weight has to come off, and the blood pressure needs to be below 130," he added.

"The extra BP medicine you gave me raises it sometimes for an hour," I questioned.

"I think it's a fluke because of your chemical sensitives.  Keep working on it.  Your BP is still TOO high," he exclaimed.  

"I get it.  I'm working on it.  I'm off  to a good start.  I think this diet may be the answer.  I feel different.  To be honest, some days not so much as it is a different nutrient composition I'm chewing every day.  But, on the whole something is happening.  I understand I need to lose the weight and make some significant lifestyle changes.  I've not been able to loose more than 4 lbs. in a month before.  This is shedding off amazingly fast.  And, I don't feel deprived.  Just sick of sweet potatoes LOL," I answered.  

"Good, glad to hear it.  I'm going to see you back in three months," he confirmed.  "Keep up the good work.  You're doing great!"

With all the tests completed and in tow, I stepped into my first appointment with my cardiologist feeling nervous and apprehensive.  Surely, this must be a mistake as I feel I take really good care of myself.

Within minutes I was hooked up to the office EKG.  There were murmurs as the staff recorded results, "Yes, that was noted on the 24 hour holster monitor, too."  Sadly, something was astray.  

The cardiologist arrived shortly afterwards and began analyzing my testing results - looking back to previous years testing, too, to piece this all together.  After several minutes he looked up at me and smiled and said, "Yes, this was good timing on your part.  You needed to see me now so that we can get things under control." I can't tell you it was a comforting statement, but at least I knew i wouldn't end up in the ER with a heart attack. 

We went over my recent blood levels.  "These are way too high!" he exclaimed.  "We need to get things under control. Have you tried low-carb eating?" 

"Well, yes, I don't eat many carbs at all to begin with," I attested. "In fact I have been working on more of a vegan approach, but it doesn't seem to be helping with weight reduction.  I've noticed I feel lethargic and steadily gaining a couple of pounds every few months."

"Have you heard of the Paleo diet? No grains?" he asked.

"Well, I barely eat a 1/4 cup with meals to begin with because of weight gain.  I try to round out with wholesome vegetables and good protein sources," I retorted.  "I don't see how eating even less is going to help."

He swiftly walked out of the room and brought back a pamphlet.  "Read this, try it.  See what happens.  You have to do something to take the weight off to stabilize your uncontrollable blood pressure." "You have a Left Bundle Branch Block. Your blood pressure is off the charts throughout the day and causing this. I am going to order a Lexiscan to see how extensive the damage is," he said.  

Left Bundle Branch Block (LBB)

Bundle branch block is a condition in which there's a delay or blockage along the pathway that electrical impulses travel to make your heart beat. It sometimes makes it harder for your heart to pump blood efficiently through your body.

The delay or blockage can occur on the pathway that sends electrical impulses either to the left or the right side of the bottom chambers (ventricles) of your heart.

Bundle branch block might not need treatment. When it does, treatment involves managing the health condition, such as heart disease, that caused bundle branch block.

In most people, bundle branch block doesn't cause symptoms. Some people with the condition don't know they have a bundle branch block.

Signs and symptoms in people who have them might include:

• Fainting (syncope)
• Feeling as if you're going to faint (presyncope)

"But I have severe chemical sensitivities!" I whined.

"We need to be PROACTIVE.  This is something that needs to be done so I can help you.  I can't see what's going on without this test.  You are an educator.  Trust me, I loved my teachers.  I take good care of them. I am going to do the same for you," he exclaimed.  "It's going to be OK."

I was soon whisked off to the scheduling desk in tears knowing that this is not going to be the greatest experience, and it will take numerous days to get well afterwards. 

Lexiscan

A Nuclear Sit Down Stress Test or Lexiscan stress test, or LEXI, is designed to evaluate the condition of your coronary arteries.  These are the arteries that supply the heart itself with blood. This type of stress test is given when the Cardiologist feels that you may not be able to walk to an appropriate level of exercise on a treadmill.  This may be due to: arthritis, poor conditioning, the use of certain blood pressure medications that prevent your heart rate from increasing with exercise,  or the use of devices like a pacemaker of defibrillator.

​Lexiscan is a prescription medication used in a cardiac nuclear stress test. It works by increasing blood flow in the coronary arteries. Lexiscan is given by IV in preparation for a myocardial perfusion imaging (MPI) test. This uses a special camera to take pictures of your heart, giving your doctor detailed information about blood flow into your heart.

Using a special type of imager, a small amount of radioactive tracer is injected into your blood before and after an injection of a medication called Lexiscan, and pictures are taken of your heart muscle.  Lexiscan replaces the physical act of exercise, and elicits the same response from your body that would occur if you were actually exercising. The pictures that are taken before and after the Lexiscan injection are then compared to each other, to see if there are any differences. Such differences in the pictures helps your cardiologist determine whether there are may be any major blockages in your arteries.  They can also see if there has been damage to the heart muscle after a heart attack.  It will also help them determine the best type of treatment you may need to correct any abnormal finding. Treatment options may include medications, dietary and lifestyle modification, or perhaps a cardiac procedure such as an angioplasty or coronary artery bypass surgery.

There are different reasons why your cardiologist may want you to have a LEXI and these may include:

• symptoms or signs suggestive of coronary artery disease (CAD) such as chest pain, shortness of breath
• significant risk factors for CAD such as smoking, high blood pressure, high cholesterol
• assessment of your condition after a cardiac procedure such as bypass surgery or coronary angioplasty
• clearance for certain surgeries that are determined to be of intermediate to high risk

​If your doctor recommends a stress test with Lexiscan, it may reassure you to know that it's a noninvasive test, meaning it doesn't involve a surgical procedure.

Here's how it works:

• You'll be awake the entire time, and either lying down or sitting up in a chair. Your heart rhythm, blood pressure, and oxygen levels will be monitored during the test.
• A catheter (small needle) is placed in a vein in your arm. Lexiscan is injected through the catheter into your bloodstream for about 10 seconds, followed immediately by a saline solution to clear the intravenous (IV) line. Lexiscan dilates the coronary arteries to allow increased blood flow to the heart.
• 10 to 20 seconds after the saline solution, a small dose of radioactive isotope imaging tracer material is injected into the catheter.
• After the tracer is absorbed in your system and distributed in your arteries, a special camera will take detailed pictures of your heart. The pictures will show how well blood flows into your heart and if there are any areas of blockage. While you lie on your back with your arms above your head, the camera will take pictures for about 20 to 40 minutes.
• One set of images will be taken when Lexiscan is active in your system, and a second set of images will be taken when you're considered at rest.

​
The receptionist at the scheduling desk was well-informed and supportive.  "No worries," she stated.  "You can call our nuclear department with any questions.  They will walk you through everything."

I began to leaf through the pamphlet "Robb Wolf's Paleo Diet Quick Start Guide".  Have I been going about it all wrong?  I know a vegan diet is healthy for many individuals.  I've seen the results from readers here.  But, we are all wired differently.  Maybe I am not seeing the vegan results as others because my body does not respond well to grains.  Is this a possibility?  I am always willing to go full-force when trying anything new.  I made a mental note to pick up Paleo living books from the library along with Robb Wolff's The Paleo Solution. I had a week until my Lexiscan - let's see what happens.  I'm game for anything at this point.  

​There are no true roadblocks to traveling with fibromyalgia it's not unsafe and you shouldn't feel excluded from vacationing when you have the condition, says board-certified rheumatologist Marcia Genta, MD, of the Dallas Arthritis Center and the Methodist Dallas Medical Center.

What's tiring for most people on a vacation though can be downright exhausting for someone with fibromyalgia. Why? Dealing with traffic, long lines at the airport, security checks, and getting around in a place you don't know is stressful, and stress can increase the pain of fibromyalgia.
​
Traveling is also physically draining. Carrying around luggage, especially lifting bags into overhead compartments, can lead to injury. Long days of sightseeing without enough rest can also make fibromyalgia symptoms worse.

To enjoy a vacation, take these steps to lessen the impact travel can have on your fibromyalgia.

• Seek out the sunshine. Cold and damp weather has been known to make fibromyalgia pain worse. Summer travel might be a better option than winter.
• Avoid planning trips to arduous terrains. Your destination should be a place that you're interested in visiting, but use common sense when making your plans. "Trekking in high mountains or rafting down rapids, where plenty of repeated traumas are likely to occur, should be avoided," advises Dr. Genta.
• Book a reservation with a modern hotel. A newer hotel with elevators will be easier to navigate than a charming historic hotel that has narrow stairs, Genta says. Even people who are athletic may have trouble carrying luggage up narrow passageways.
• Pack smart. Just as everyone should, try to pack only what you need to avoid having to lug a heavy suitcase. Comfortable walking shoes are a must, Genta adds. And be sure to pack your medication in a carry-on bag (not your checked bag, as it could get delayed or lost).
• Move as much as possible in the plane or car. "A long airplane trip is trying for everyone," Genta says. Moving and stretching in the cabin to avoid stiffness is especially important for people with fibromyalgia. Genta suggests checking in-flight magazines for stretching techniques you can do during your flight. If you're traveling by car, stop as often as needed to stretch.
• Get help with luggage. Always ask flight attendants with help getting a bag into an overhead compartment on an airplane, Genta says. Since picking up a heavy bag from the conveyor belt at baggage claim requires movement that can cause injury, she says, hire a porter to carry your luggage.
• Follow a leisurely itinerary. Although you may want to see as much as you can, don't try packing too many museums or cathedrals into your sightseeing plans in any one day. A stop at a sidewalk café watching the crowds is often more informative (and fun) than a lecture about the place you're visiting, says Genta.

​
After an enjoyable vacation, what's the protocol for getting back to everyday life? You'll probably struggle a bit to get back into your daily routine, just as everyone does, Genta says. If you've thought out your travel plans ahead of time and you didn't overdo activity while you were away, you shouldn't need a vacation from your vacation.

After an abnormal EKG, a referral was sent over to my cardiologist which entailed a 24-hour holster monitor first.  As I was calling to schedule my specialist appointment, the receptionist quickly set in place a holster monitor set-up appointment so that my doctor would have a variety of results before I even stepped into his office.  

​A Holter monitor is a small, battery-powered medical device that measures your heart’s activity, such as rate and rhythm. Your doctor may ask you to use one if they need more information about how your heart functions than a routine electrocardiogram (EKG) can give them.

Twenty-four hour Holter monitoring is a continuous test to record your heart’s rate and rhythm for 24 hours. You wear the Holter monitor for 12 to 48 hours as you go about your normal daily routine. This device has electrodes and electrical leads exactly like a regular EKG, but it has fewer leads. It can pick up not only your heart’s rate and rhythm but also when you feel chest pains or exhibit symptoms of an irregular heartbeat, or arrhythmia.

Holter monitor testing is also sometimes called ambulatory electrocardiography. There are other types of devices that can be used to measure heart activity for longer periods of time.

Uses for Holter monitoring

An EKG is a medical test that’s used to measure your heart rate and rhythm. It’s also used to look for other abnormalities that may affect normal heart function. During an EKG, electrodes are placed on your chest to check your heart’s rhythm. You may experience heart rhythm irregularities that don’t show up at the time the EKG is done because you’re only hooked up to the machine for a very brief amount of time.

Abnormal heart rhythms and other types of cardiac symptoms can come and go. Monitoring for a longer period of time is necessary to record these events. The Holter monitor lets your doctor see how your heart functions on a long-term basis. The recordings made by the monitor help your doctor determine if your heart is getting enough oxygen or if the electrical impulses in the heart are delayed or early. These irregular impulses may be referred to as arrhythmias or abnormal heart rhythms.

If you’re already being treated for heart problems, wearing your monitor can help your doctor determine if your medicine is working or if changes need to be made. It can also help them to see why you might be experiencing other symptoms of irregular heartbeat, such as dizziness, faintness, or feeling like your heart is racing or skipping a beat.

How it works

The Holter monitor is small. It’s slightly larger than a deck of playing cards. Several leads, or wires, are attached to the monitor. The leads connect to electrodes that are placed on the skin of your chest with a glue-like gel. The metal electrodes conduct your heart’s activity through the wires and into the Holter monitor, where it’s recorded.

You wear a small pouch around your neck that holds the monitor itself. It’s important to keep the monitor close to your body during the testing period to make sure the readings are accurate. Your doctor will show you how to reattach electrodes if they become loose or fall off during the testing period.

You’ll get instructions that explain how to take care of your monitor and what not to do while you’re wearing it. It’s important to avoid bathing, showering, and swimming while you’re wearing the monitor.
You’re encouraged to participate in your normal activities during the 24-hour Holter test. You’ll be directed to record your activities in a notebook. This helps your doctor determine if changes in heart activity are related to your behaviors and movements.

Wearing the Holter monitor itself has no risks involved. However, the tape or adhesives that attach the electrodes to your skin can cause mild skin irritation in some people. Make sure to tell the technician that attaches your monitor if you’re allergic to any tapes or adhesives.

A 24-hour Holter monitor test is painless. However, be sure to record any chest pain, rapid heartbeat, or other cardiac symptoms you have during the testing period.

Accuracy of testing

Keep the Holter monitor dry to ensure it functions properly. Take a bath or shower before your appointment to have the monitor fitted and don’t apply any lotions or creams. Avoid activities that might lead to the monitor getting wet.

Magnetic and electrical fields may interfere with the function of the Holter monitor. Avoid areas of high voltage while wearing the monitor.

In an event where misreadings or false-positives do occur, the Holter may need to be applied again.

Understanding the results

After the recommended testing time frame has passed, you’ll return to your doctor’s office to have the Holter monitor removed. Your doctor will read your activity journal and analyze the results of the monitor. Depending on the results of the test, you may need to undergo further testing before a diagnosis is made.

The Holter monitor may reveal that your medicine isn’t working or your dosage needs to be altered if you’re already taking medication for an abnormal heart rhythm. It’s especially useful in detecting abnormal heart rhythms that are painless and unknown to you.

Wearing a Holter monitor is painless and one of the best ways to identify potential heart problems or other issues. - Healtline

Wearing the Holster Monitor was a bit strange and sleeping was a bit cumbersome.  But, compared to the monitor of seven years ago they have made some advances!  This one was much lighter and easier to complete daily living tasks.  Monitor has been returned, and I now await the results.  

​From the creators of the groundbreaking documentary comes the New York Times bestselling diet plan Sanjay Gupta called “the prescription you need to live a long, healthy life”—a plan to transition to a delicious whole-foods, plant-based diet in just twenty-eight days.

The trailblazing film Forks Over Knives helped spark a medical and nutritional revolution. Backed by scientific research, the film’s doctors and expert researchers made a radical but convincing case that modern diseases can be prevented and often reversed by leaving meat, dairy, and highly refined foods off the plate and adopting a whole-food, plant-based diet instead.

Now, The Forks Over Knives Plan shows you how to put this life-saving, delicious diet into practice in your own life. This easy-to-follow, meal-by-meal makeover is the approach Doctors Alona Pulde and Matthew Lederman (featured in the documentary) use every day in their nutritional health practice—a simple plan that focuses on hearty comfort foods and does not involve portion control or worrying about obtaining single nutrients like protein and calcium.

In just four short weeks you’ll learn how to stock your refrigerator, plan meals, combat cravings, and discover all the tips and tricks you’ll need to eat on the go and snack healthily. You’ll also get 100 simple, tasty recipes to keep you on the right track, beautiful photographs, a 28-day eating guide, and advice throughout the book from people just like you.

Whether you’re already a convert and just want a dietary reboot, or you’re trying a plant-based diet for the first time, The Forks Over Knives Plan makes it easier than ever to transition to this healthiest way of eating…and to maintain it for life.

​Forks Over Knives—the book, the film, the movement—is back again in a cookbook. The secret is out: If you want to lose weight, lower your cholesterol, avoid cancer, and prevent (or even reverse) type 2 diabetes and heart disease, the right food is your best medicine. Thousands of people have cut out meat, dairy, and oils and seen amazing results. If you’re among them—or you’d like to be—you need this cookbook.

Del Sroufe, the man behind some of the mouthwatering meals in the landmark documentary, proves that the Forks Over Knives philosophy is not about what you can’t eat, but what you can. Chef Del and his collaborators Julieanna Hever, Judy Micklewright, Darshana Thacker, and Isa Chandra Moskowitz transform wholesome fruits, vegetables, grains, and legumes into hundreds of recipes—classic and unexpected, globally and seasonally inspired, and for every meal of the day, all through the year:
 

• Breakfast: Very Berry Smoothie, Breakfast Quinoa with Apple Compote
• Salads, Soups and Stews: Kale Salad with Maple-Mustard Dressing, Lotsa Vegetable Chowder, Lucky Black-Eyed Pea Stew
• Pasta and Noodle Dishes: Mushroom Stroganoff, Stir-Fried Noodles with Spring Vegetables
• Stir-Fried, Grilled and Hashed Vegetables: Grilled Eggplant “Steaks”
• Baked and Stuffed Vegetables: Millet-Stuffed Chard Rolls
• The Amazing Bean: White Beans and Escarole with Parsnips
• Great Grains: Polenta Pizza with Tomatoes and Basil
• Desserts: Apricot Fig Squares, Bursting with Berries Cobbler . . . and much more!

Simple, affordable, and delicious, the recipes in Forks Over Knives—The Cookbook put the power of real, healthy food in your hands. Start cooking the plant-based way today—it could save your life!