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Berwick Area Heart Support Group
November 2004 Newsletter
NEXT MEETING November 3rd At the DAY HOSPITAL BERWICK INFIRMARY From 7.00pm – 9.00pm Guest Speaker. Sister Janet Punton Prevention of Type 2 Diabetes
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At our last meeting on Oct 6th the advertised speaker Diane Edgar from the Borders Healthcare Trust was unable to come to the meeting, {Diane Edgar will now be the guest speaker for the Dec 1st meeting} Micheal Redican at very short notice stepped in and gave a talk and demonstration on Aromatherapy
Micheal’s emphasis was really about self-treatment, and restricted to arm and hand massage. He demonstrated the technique on himself.
In aromatherapy, the aroma therapist would prepare oil especially for this treatment, but you can now purchase, many “ready made-up” oils which are prepared for various aches and pains
Micheal demonstrated the procedure, oil up the right hand for the left arm and hand {obvious really} Proceed to oil-up the left hand and arm, with sufficient oil to allow smooth running of the massage hand.
Open handed Effleurage- stroking up the hand and arm, with the open hand. Then begin Kneading from the upper arm to the hand including gentle but firm kneading around the elbow with your right thumb. Then whole hand circling the elbow. Continue thumb kneading down the forearm muscle, and circle round the wrist. Drain between the tendons on the back of the hand- particularly the soft tissue at the base of the fingers and thumb. Then knuckle crunch, followed by effleurage up the arm hand and arm. Finally just hold the hand to finish off. Then repeat procedure on the right arm and hand.
Thanks to Micheal for stepping in at such short notice and giving such well prepared talk and demonstration.
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Wally’s yarn
Wally is unavailable to do his report this week and I know you all look forward to “Wally’s Yarn”, I found this little story in the “The Weekly Small Shopkeeper” a daily newspaper published monthly once a year on the 29th Feb.
A guy walked into a little corner shop with a shotgun and demanded all of the cash from the till. After the shopkeeper put the cash in bag, the robber saw a bottle of Scotch that he wanted behind the counter on the shelf. He told the shopkeeper to put it in the bag as well, but the shopkeeper refused and said, "No because I don't believe you are over 18." The robber said he was, but the shopkeeper still refused to give it to him because he didn't believe him. At this point, the robber took his driver's license out of his wallet and gave it to the shopkeeper. The shopkeeper looked it over and agreed that the man was in fact over 18 and he put the Scotch in the bag. The robber then ran from the store with his loot. The shopkeeper promptly called the police and gave the name and address of the robber that he got off the license. They arrested the robber two hours later.
Wally reminded me to tell you that the “Charities Cup” committee had presented a cheque for £400 to Mandy and Michelle at Cardiac Rehab, this money was to go towards equipment that would help cardiac rehab patients. This donation will benefit many of our readers and we would like to join Mandy and Michelle in thanking the Charities Cup Committee for their donation.
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Notes of interest from the newspapers
We know that tinned tuna contains no omega 3s but now researchers at Harvard Medical School in Boston have discovered grilled, canned or baked fish such as Tuna can reduce the risk of arterial fibrillation, a deadly heart condition that affects more than half a million people in the UK. Arterial fibrillation is also a leading cause of strokes among the elderly. Those who ate fish two to four times a week were 28% less likely to develop the condition. But eating fried fish can actually increase the risk
Arterial fibrillation occurs when the two upper chambers of the heart, the atria, beat irregularly. Some blood does not get pumped out and can form a clot. It is estimated that up to 20% of all strokes are triggered by the condition
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Japanese scientists have discovered a gene that causes heart attacks. In what could be a significant step forward in the battle against Britain’s biggest killer, a study found that victims of heart attacks are more likely to have a mutation in the key gene. The discovery could help identify people at greater risk of suffering heart disease from an early age. Because the gene is hereditary, doctors could also spot whole families who may be vulnerable to heart attacks. Professor Jeremy Pearson, associate medical director of the BHF, said the findings were “important scientifically”
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Recipe of the month
Apple and Marmalade Mackerel
Ingredients
2 x 225g (8oz) whole mackerel or herring, fresh or defrosted, cleaned, heads and tails removed
1 large dessert apple, cored and diced
4 x 15ml spoon (4 tablespoons) water
3 x 15ml spoon (3 tablespoons) thick cut marmalade
1 x 15ml spoon (1 tablespoon) whisky
Method
Preheat the grill
Place the apple and water into a saucepan. Bring to the boil and simmer for 3-4 minutes. Stir through the marmalade and whisky.
Grill the mackerel for 6-8 minutes each side, brushing with the apple-marmalade sauce.
Pour over the remaining sauce and serve with seasonal vegetables.
Serves 2
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Terry
What makes the difference?
A little while ago, Terry and Phil met Pat Crowe from the NHS Care Trust, Morpeth, who is Clinical Network Manager (CHD, Diabetes & Stroke). Her job is to make sure that health professionals connect with one another. She came to us because the Trust is keen that the professionals connect with the public as well as with one another. Pat wanted also to tap into Terry’s experience in creating a successful computer website.
Prevention is better than disease and is even more important for those of us with a problem. What has made the difference in lowering the number of people dying of heart disease in the last 20 years? How many of us die from these conditions? How many die young compared with those who have a MI when they are old? We asked her whether we could find out how many people lived with heart problems in our area and whether we could tell how we compared with other places. She has written to us to say that Dr Mike Lavender, who is the Director of Public Health, is willing to be one of our ‘speakers’. We will fix that. Dr Lavender will be the man to explain some of the statistics.
In the meanwhile, Pat sent us some interesting information. Here is a brief digest. Generally, deaths from CHD are decreasing, although for men, CHD and stroke account for more than 40% of all deaths. Men die earlier from these diseases than women. Women are at much lower risk of heart attack when younger but will often die from heart disease in old age. For men, the number of years lost because of CHD / stroke is about the same as those lost because of cancer. In recent years Northumberland has done better than the national average for deaths from CHD and stroke. Berwick’s decrease is in line with the reduction in Northumberland. Alnwick has not seen a reduction. We will ask Dr Lavender, but is it because Alnwick has an increasingly elderly population? It looks like it. Last year, clinics at Infirmary Drive and Rothbury had about double the number of MI per 1000 of the patients on their list, compared with both the Berwick clinics and the Glendale clinic (Wooler). Belford was in between.
Control of blood pressure in CHD and related patients seems patchy across the area.Take up of flu jabs was high (above 78%), but Berwick town did less well than Belford or Glendale.There are more than a thousand heart patients in the Berwick area.
Table. CORONARY HEART DISEASE IN THE BERWICK AREA 2003 / 2004
(Figures were adapted from a printout showing uptake of flu jabs)
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CLINIC
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CHD PATIENTS (approx.)
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PATIENTS having MI during the year
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Well Close
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775
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13
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Union Brae
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352
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8
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Belford
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257
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8
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Glendale
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103
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2
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We can see that our Newsletter is only reaching a small fraction, even though we have doubled the numbers.
The national numbers are worth thinking about. Details have just been published for the 20 years up to 2000. CHD mortality decreased 50% from 1981 to 2000. The biggest single reduction in death from CHD was from people giving up smoking. At least half (50%) of the improvement was down to that. Improvement due to a small drop in cholesterol (on average nationally) reduced deaths from CHD by 5% (accounting for 10% of the 50% reduction) but this was just about wiped out by increases in obesity and diabetes. Overall, improving risk factors accounted for 60% of this large reduction in deaths over the 20 years. All medical treatments put together accounted for only 40% of the reduction. Individual medical treatments were way down the list. Bypasses and angioplasty (‘revascularisation) accounted for about 4% of total reduction and even clot busters (‘thrombolysis’) saved fewer people during MI than emergency aspirin. Treating angina patients with aspirin in the community saved nearly twice as many lives as treating unstable angina patients in hospital. (These details are from B.Unal et al., Circulation. 2004;109:1101-1107 "Explaining the Decline in Coronary Heart Disease Mortality in England and Wales Between 1981 and 2000".)
We know that ‘statins’ are becoming more widely prescribed, so we will expect to see a difference for the 3 years 2001 to 2004.But health out here in the community is what matters. We know that the majority of people have some arterial disease by the time they are 50 - 60, even if they do not show it. Keep taking your aspirin and your statin. Bear in mind, though, that we need all the help we can get in reducing risk factors.
Phil Harris
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Depression and Heart Disease
A fact sheet that summarizes what heart disease patients need to know about depression.
· Persistent sad, anxious, or "empty" mood
· Feelings of hopelessness, pessimism
· Feelings of guilt, worthlessness, helplessness
· Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
· Decreased energy, fatigue, being "slowed down"
· Difficulty concentrating, remembering, making decisions
· Insomnia, early-morning awakening, or oversleeping
· Appetite and/or weight changes
· Thoughts of death or suicide, or suicide attempts
· Restlessness, irritability
If five or more of these symptoms are present every day for at least two weeks and interfere with routine daily activities such as work, self-care, and childcare or social life, seek an evaluation for depression.
Introduction
Depression can strike anyone. However, research over the past two decades has shown that people with heart disease are more likely to suffer from depression than otherwise healthy people, and conversely, that people with depression are at greater risk for developing heart disease. Depression may make it harder to take the medications needed and to carry out the treatment for heart disease. Treatment for depression helps people manage both diseases, thus enhancing survival and quality of life.
Depression and anxiety disorders may affect heart rhythms, increase blood pressure, and alter blood clotting. They can also lead to elevated insulin and cholesterol levels. These risk factors, with obesity, form a group of signs and symptoms that often serve as both a predictor of and a response to heart disease. Furthermore, depression or anxiety may result in chronically elevated levels of stress hormones, such as cortisol and adrenaline. As high levels of stress hormones are signaling a "fight or flight" reaction, the body's metabolism is diverted away from the type of tissue repair needed in heart disease.
Despite the enormous advances in brain research in the past 20 years, depression often goes undiagnosed and untreated. Persons with heart disease, their families and friends, and even their physicians and cardiologists (physicians specializing in heart disease treatment) may misinterpret depression's warning signs, mistaking them for inevitable accompaniments to heart disease. Symptoms of depression may overlap with those of heart disease and other physical illnesses. However, skilled health professionals will recognize the symptoms of depression and inquire about their duration and severity, diagnose the disorder, and suggest appropriate treatment.
Depression Facts
Depression is a serious medical condition that affects thoughts, feelings, and the ability to function in everyday life.
Depression results from abnormal functioning of the brain. The causes of depression are currently a matter of intense research. An interaction between genetic predisposition and life history appear to determine a person's level of risk. Episodes of depression may then be triggered by stress, difficult life events, side effects of medications, or other environmental factors. Whatever its origins, depression can limit the energy needed to keep focused on treatment for other disorders, such as heart disease.
Get Treatment for Depression
Effective treatment for depression is extremely important, as the combination of depression and heart disease is associated with increased sickness. Prescription antidepressant medications, particularly the selective serotonin reuptake inhibitors, are generally well-tolerated and safe for people with heart disease. There are, however, possible interactions among certain medications and side effects that require careful monitoring. Therefore, people being treated for heart disease who develop depression, as well as people in treatment for depression who subsequently develop heart disease, should make sure to tell any physician they visit about the full range of medications they are taking.
Exercise is another potential pathway to reducing both depression and risk of heart disease. A recent study found that participation in an exercise training program was comparable to treatment with an antidepressant medication (a selective serotonin reuptake inhibitor) for improving depressive symptoms in older adults diagnosed with major depression. Exercise, of course, is a major protective factor against heart disease as well.
Use of herbal supplements of any kind should be discussed with a physician before they are tried. Recently, for example, scientists have discovered that St. John's Wort, an herbal remedy sold over-the-counter and promoted as a treatment for mild depression, can have harmful interactions with some other medications.
Treatment for depression in the context of heart disease should be managed by a mental health professional-for example, a psychiatrist, psychologist, or clinical social worker-who is in close communication with the physician providing the heart disease treatment. This is especially important when antidepressant medication is needed or prescribed, so that potentially harmful drug interactions can be avoided. In some cases, a mental health professional that specializes in treating individuals with depression and co-occurring physical illnesses such as heart disease may be available.
While there are many different treatments for depression, they must be carefully chosen by a trained professional based on the circumstances of the person and family. Recovery from depression takes time. Medications for depression can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted. No matter how advanced the heart disease, however, the person does not have to suffer from depression. Treatment can be effective.
Remember, depression is a treatable disorder of the brain. Depression can be treated in addition to whatever other illnesses a person might have, including heart disease. If you think you may be depressed or know someone who is, don't lose hope. Seek help for depression.
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