A Time & A Perfect Season For Change

 

Autumn is a time of natural transformation.  It is a season of change where the leaves on the trees change their colors from warm green to fiery red and vibrant orange, then float away slowly to the ground. Like the leaves, we are in a season of transformation where we can find the courage to change our colors as well.

 

 

 

 

There often come times in our lives (for seasons do change), when we just know deep in our hearts, that is it time for a change. That change may be big or small, related to career,  relationship or place of residence. Or perhaps, when we are quiet, we hear the subtle calls for small but transformative changes in our attitudes and behaviors. Or maybe you just have the feeling that you are not living your life authentically.

For me, this season of transformation is a time of major change. After a long career in medicine as an interventional cardiologist, it is time for a change. Time to retire my stethoscope and discover what else this life has in store for me.

In many ways, this has not been an easy decision. But I have no doubt that it is the right decision. In Yoga, we talk about Dharma. Dharma is our Purpose… Our calling to be of service but more importantly to be authentic and true to our selves. When we are on this path, we find true Joy. This purpose can change with the seasons as well. My Dharma has been to serve others in the practice of medicine. I have been blessed with wisdom and intelligence and put on this particular path of service, and I pray I served it well. Being a physician is a profession that I have been privileged and deeply honored to be a part of.  I believe that I’ve done it well, saving many lives, touching many lives and being touched by even more. As a healer, however, I know that there are many ways to heal and that I can still be of service.

I have spent my entire life following my mind, my thoughts and ideas, of how my life should be, which led me to this life of practicing medicine, specifically cardiology, the science of the heart.

But now, for probably the first time in my life, it is time to follow my heart and not my mind.

I have always envied those people who lived by the mantra/motto…

Do what you love… Love what you do. For these fortunate people, work is not work but joyful Dharma.

Where the road leads, I do not exactly know, but I go there with Faith and Excitement. I do know that my new Dharma is driven by my passion for the healing powers of Yoga. I hope to use all the wisdom I have obtained through the years, practicing Cardiology and Yoga, to continue to be a healing Source for others.

A friend (Anna) referred to this change in career as Chapter 2. We all have many chapters in our book of Life.  Sometimes, when the days get shorter, and the wind blows a cool breeze, we find the courage to shed our leaves and go with the flow of life.

Please follow along as I take this journey as I will most certainly be writing regularly about my lessons and adventures.

Namaste

Dr Millie Lee

Holy Hip Pain – Healing Journey

That’s right .. “Holy” hip pain because pain is often our most divine teacher. This is what I’ve learned.

“Pain is inevitable, Suffering is optional” – Buddha

Needless to say, I was shocked to find that I was having hip pain after my recent pilgrimage to India. I was feeling incredible mentally and emotionally and felt that I had done a lot of personal “healing” through meditation and self-study. I came back home ready to live my life with my new perspective. As a physically active person, I was really ready to jump right back into my workout routines and yoga asana classes, committed (once again) to regular practice. For the most part during my trip to India, there was very little movement (108 degree days), and a lot of sitting and most of the yoga asana practices were very gentle.

Unfortunately, once home, every time I tried to run, I had this nagging hip pain that wrapped around my upper thigh, and by nagging I mean it stopped me in my tracks. Walking on the beach, I noticed the same nagging pain. Flow classes – same. Ugh!!

 

With some new introspective tools from my Yoga pilgrimage to India, I have learned a lot about my body mechanics and my coping mechanisms. As any athletic person will attest to, the worst advice you can be given is to rest.

Finally, nearly 3 months after my return from my spiritual journey in India, I return from a different journey, a healing journey. All in all, I have learned
Perseverance , Patience, Compassion for myself,  and Trust in the timing of the Universe – which means letting go of control

I would stop running for a few days and try again, but there it was. What was driving me crazy, as an inquisitive physician, was that I couldn’t comprehend WHY I was having pain. For god’s sake,  I had done nothing to injure myself – quite the opposite, I essentially was inactive for almost 3 weeks in India. I’ve had issues with my sacroiliac joints in the past, so I got a chiropractic adjustment, which realigned the S-I joint, but the hip pain persisted. Thinking this was all tight muscles, I got several massages, which seemed to help, until I tried to run. A chiropractor thought it could be hip bursitis and an orthopedic surgeon agreed +/- Iliopsoas tendonitis. So, more rest (ugh), ice and NSAIDs. When I tried to run again, at this point a month after my return from India, pain was still there but not as intense.

Time to examine Everything I have been doing in more detail. Before I left for India, I was in pretty good shape, running regularly. I, like many runners, have chronically tight muscles – hamstrings, quads, glutes. But, I would not say that I had pain. Then I went to India and did not run for 3 weeks (108 degrees). Since I wasn’t doing very much, could it be all the sitting? Could it be how was I sitting? For lectures and meditation, I was sitting for hours on the floor or in a chair; I had also sat for hours on long flights and long bus rides. I also started to ask myself “Could it be emotional? Is this all part of my spiritual healing?”

With the help of Dr Clayton, chiropractor extraordinaire, who treats the entire musculoskeletal system,  I think I have some answers, at least on the physical plane. On top of baseline hip rotation and imbalances, prolonged sitting led to shortened and contracted muscles, which led to pain with activities. Prolonged sitting in which muscles are in a shortened state for extended periods can lead to the muscles adapting to this position. Once in an adapted state, muscles have trouble returning to their normal resting length.

This is often the case with the  the Quadriceps, Hamstrings and Iliopsoas muscles. This was the case for me.


The iliopsoas is actually comprised of two muscles: the Psoas muscle and the Iliacus muscle. The Psoas originates from the lower spine (T12 and L1-L5) and inserts into the inner thigh. The Iliacus originates from the iliac fossa then descends to join the Psoas major tendon.

The primary function of both the Psoas and Iliacus is hip flexion, also known as flexion of the thigh. In other words, these muscles lift the knee to take a step in walking & running. Due to its attachment along the spine, the Psoas also plays a major role in maintaining upright posture.

The Hamstrings consist of three muscles in the back of the thigh, originating from the ischial tuberosity (the sit bones) and inserting into the bones of the lower leg below the knee. This large muscle mass plays a key role in knee flexion (bending the knee), extending the thigh and rotating the knee. When tight, contraction can cause the hips and pelvis to rotate back flattening the lower back and causing back problems. Tight hamstrings can also be responsible for postural problems and other back problems such as sacroiliac joint pain (thinking chicken or the egg), as they will tend to pull the pelvis out of normal position.

Consequences of Chronic Muscular Contraction

If a muscle cannot return to its normal resting length, it then resides in a state of chronic contraction and numerous undesirable consequences can result:

1. Ischemia.  A state of low blood flow.  An ischemic muscle is often a painful muscle.

2. Trigger Points which refer pain – felt in the affected muscle or in other parts of the body (radiated pain).

3. Distorted Movement Patterns. A chronically contracted muscle can distort the movement of the joint it crosses. For example, a chronically tight iliacus could reduce movement at the front of the hip.

4. Muscular Compensation.  If a chronically tight iliacus, for example, reduces movement in one hip, then the other hip or the spine or other parts of the body will be called upon to compensate or to change their normal pattern of movement.

5. Nerve Entrapment. A chronically contracted muscle may be responsible for entrapment of nerves, another cause of pain.

So what to do? Sometimes all you need is stretching. But while in India, I was doing yoga stretches everyday. Sometimes you need more aggressive manual therapy in order to enable the muscle to fully lengthen. The reason for this is that the fibers of a muscle can become adhered or stuck together.

Sometimes this “adherence” is within the muscle itself, and sometimes one muscle can become adhered to another muscle. In both cases the attempt of the muscle to fully lengthen or fully contract is impeded. This results in a dysfunctional muscle which can be painful in and of itself, but also can result in compensatory muscle patterns throughout the body.

Once contracted, a muscle cannot lengthen on its own. The contractile units of the muscle (sarcomeres) must be stretched back to their original resting length by an outside force (such as an opposing muscle group) before the muscle is able to actively contract and relax again.

In enters ART – Active Release Therapy (and in my case Dr Clayton).

ART is a patented soft tissue system movement based manipulation technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Every ART session is actually a combination of examination and treatment. The ART provider uses his or her hands to evaluate the texture, tightness and movement of muscles, fascia, tendons, ligaments and nerves. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.

ART is not a cookie-cutter approach. These treatment protocols – over 500 specific moves – are unique to ART. They allow providers to identify and correct the specific problems that are affecting each individual patient. It has been a game changer for my body!
Finally, after much divinely determined rest, during which time I focused on healing, inside and out,
I am back — Running slower, shorter distances but running! 🙂
 

Namaste

 

International Yoga Day and Summer Solstice

It is no coincidence that the International Yoga Day falls on the same day as the Summer Solstice. June 21, 2017 is the Summer Solstice, the longest day of the year in the Northern Hemisphere, when the sun appears to stand still, a perfect opportunity to find “stillness” in our lives through the practice of Yoga.

The Sun is a powerful symbol of Light, of Energy and of Consciousness. Yoga is the practice of connecting with the Light, the Energy, and the Consciousness within us, as when we practice Sun Salutations.

Recognizing it’s appeal and health benefits, the United Nations proclaimed this day of Yoga to increase awareness of yoga’s benefits for healthy body, mind and spirit.

“Yoga is an invaluable gift of India’s ancient tradition. This tradition is 5000 years old. It embodies unity of mind and body; thought and action; restraint and fulfilment; harmony between man and nature; a holistic approach to health and well-being. It is not about exercise but to discover the sense of oneness with yourself, the world and the nature. By changing our lifestyle and creating consciousness, it can help in well being . Let us work towards adopting an International Yoga Day.”

— Narendra Modi, UN General Assembly
Yoga continues to grow in popularity. It is now practiced by over 36 million Americans (up from 20 million four years ago). Of those Americans who don’t practice yoga, 34% of them say they would like to try yoga for the first time over the next 12 months. 
Yoga and the Sun (despite it hiding for many of us today) will be celebrated in iconic locations throughout the word.
Prime Minister  will participate and lead over 50,000 participants (10,000 more than last year) in a  practice in India

The Prime Minister, Shri Narendra Modi participates in the mass yoga demonstration at Rajpath on the occasion of International Yoga Day, in New Delhi on June 21, 2015.
The Prime Minister, Shri Narendra Modi participates in the mass yoga demonstration at Rajpath on the occasion of International Yoga Day, in New Delhi on June 21, 2015.

In Times Square, in Celebration of the Summer Solstice, The 15th annual “Mind Over Madness Yoga” event takes place all day. There are different free yoga classes for people with all different skill levels

times square solstice

 

Here on the beautiful beaches of the Chesapeake Bay in Norfolk,  the donation based Bhav Brigade will have a pop-up Yoga class for the community. http://www.bhavbrigade.org

 

 

sun salutation

How will you celebrate Yoga Day? Maybe, you’ve never done yoga before and are curious – well, there are numerous studios and athletic stores such as Lululemon, around the country offering free classes.

Whatever this day brings for you, live it mindfully and breathe. This is Yoga.

Namaste

Millie

Memorial Day – Warrior Pose

Memorial Day, a day Americans remember and honor those warriors who have given their lives defending and protecting our freedoms that we hold so dear. We must also honor today’s warriors, who have served our country (our veterans), or continue to risk their lives for our country.

A warrior embodies the following characteristics – Courage, Faith and Service. As we honor those brave men and women who have sacrificed their lives in the name of service to this country, we should ask ourselves, “How can we be warriors in our own lives?”

Yoga gives us many opportunities. In Yoga, we often practice various Warrior Poses. But where did they come from? It may seem odd that the peaceful practice of yoga includes postures known as “Warrior”.  As with everything in Yoga, there is a lot of hidden meaning behind it. The meaning is rooted in Hindu mythology. It originated from a story of love, hate, rage, violence, sadness, compassion and forgiveness which begins with the marriage between Lord Shiva, Supreme Ruler of the Universe and his bride Sati.

According to ancient texts, Sati’s father, the powerful King Daksha, did not approve of this marriage. One day, Daksha held a large event known as a Yagna but did not invite Sati and her husband Shiva. Sati found out and decided to go alone to the Yagna. When she arrived, Sati entered into an argument with her father. Unable to withstand his insults, she spoke a vow to her father,

“Since it was you who gave me this body, I no longer wish to be associated with it.”

The story goes that Sati sat down on the floor, went into a meditative trance, and began to increase her inner fire (Agni) until such point that she burst into flames and dies.

When Shiva heard of Sati’s death, he was devastated. He yanked out one of his dreadlocks and beat it into the ground, where upon rose a powerful Warrior. Shiva named this warrior Virabhadra. Vira (hero) + Bhadra (friend) and ordered him to go to the Yagna and destroy Daksha and all his guests.

Here is where the poses come in.

  • Virabhadrasana I (Warrior I): Virabhadra entered the Yagna by thrusting his way up from the deep underground with his sword held over his head in both hands.

  • Virabhadrasana II (Warrior II): Virabhadra sights his opponent, Daksha and steadies himself in preparation to strike.

 

 
  • Virabhadrasana III (Warrior III): Virbhadra lifts his sword (in his hand behind him) into the air, swings forward, and severs the head of King Daksha.

 

 

 

 

 

 

 

 

Shiva then arrives at the Yagna and sees the destruction. Shiva absorbs Virabhadra back into his own form. Filled with sorrow and compassion, Shiva finds Daksha’s body and gives it the head of a goat, which brings him back to life. In the end Sati is also reborn.

MORAL OF THE STORY:

When Virabhadra kills Daksha, one could say the warrior represents an aspect of the higher self that manifests to slay the human ego, represented by Daksha. Then, when Shiva brings Daksha back to life, he reminds us that inner work isn’t as simple as destroying the parts of ourselves we don’t like. Instead, if we extend compassion toward the harmful sides of ourselves, we can invite them to soften and relinquish control. Through our warriorship, we can accept ourselves, even the aspects we wish to discard.

Reverse Warrior

 

Reverse Warrior teaches us to stand strong on our mats, just as we strive to stand strong in the highest, most benevolent truth of who we are. And as we gaze upward, as if toward our potential, we also reach back for support; we are thus encouraged to call upon the tools we need to navigate the inner realms of ego—whether those tools take the form of meditation, self-inquiry, a regular asana practice, or the words of a master teacher.

So, what makes a great warrior?

Courage, Faith and Service.

It is easy to build impervious walls and shield ourselves from “harm”.  It takes Courage to show up in your life, to feel and care for ourselves and those around us. On our mats, we find courage, not only in the challenging postures, but also, and perhaps more so, in the stillness of Shavasana.

Faith is complete trust or belief in someone or something, sometimes trusting something not easily seen or understood. Our warriors serve with absolute faith that what they’re doing is right and in the best interest of our country. Connecting with your warrior requires you to believe in yourself and your unique gifts. When we develop our gifts, we are serving others. It takes faith (and courage) to show up on our mats, to consciously breath,to stand on one foot, to go upside down and to be still in Shavasana.


savasana

 

“Service to others is the rent you pay for your room here on earth”. – Muhammad Ali –

Being a warrior means taking responsibility for your actions as they relate to others and the world around you. We all have a responsibility to live this life to the best of our ability. This means taking care of ourselves, our family, our neighbors, our Earth, our Universe. The principles of Yoga teach us to live a life of loving kindness, on and off the mat.

To all the Warriors,

Namaste

Millie

 

A Yogi’s Pilgrimage to India

Why do so many Yogis make a pilgrimage to India? A pilgrimage is a different kind of journey. It has a deeper, personal purpose. A pilgrimage is a journey of spiritual significance, in search of spiritual growth. My recent trip to India was more of a pilgrimage than a vacation. I went to India in search of wisdom – about Yoga, about myself, believing that Yoga is the path to that wisdom.

It is incredibly challenging to describe India in a few words. When I think of India, 3 phrase come to mind – 1) sensory overload, 2) coexistence, and 3) spirituality.

While in India, every single sense organ was awakened and stimulated – the eyes beheld the vibrant colors, the beautiful people, the spectacle of the overcrowded streets; the ears rang with the constant car horns, the dogs barking, the chanting; the nose smelled the spices, the incense, the flowers; the tongue enjoyed the spicy food, the delicious naan bread; and the skin felt the hot, hot Indian sun. Woven into all the intensity that is India, is an undercurrent of stillness, of peace.

A friend used the term “Peaceful Insanity”.

This is what I mean by coexistence. The streets are … CRAZY, at least to us Westerners, but apparently, completely normal for India. The streets are filled with cars, rickshaws, buses, people, dogs and cows with no apparent order. At first glance, it appears and sounds chaotic, with all drivers having one finger firmly fixed on the horn. Apparently, however, there is a certain pecking order on the street. The pedestrian is at the bottom, giving way to  the bicycle rickshaw, then the auto rickshaw, then the car, then the bus. The bus stopping only…. for the Holy Cow that rules the street. Then you veer off this busy street, make a quick turn, and enter through a gate into a beautiful garden or temple. Complete juxtapositions. The chaos and the peace co-existing.

When I speak of spirituality, I’m not talking about any particular religious worship. Spirituality is a search for meaning, for purpose and direction in life. It fulfils our need to have a foundation for living, a path or way of life in the light of a larger context. It speaks to the need to be “aligned” with something bigger than our body and mind. The religions of India (whether it be Hinduism or Buddhism) and their spirituality are greatly misunderstood in the West. Although there are many statues representing numerous deities, it is not about idol worship. What I’ve learned is that all the deities and their different forms and manifestations represent important values that guide us on our path towards spiritual growth.

From my experience, Indian people live spiritual lives where their daily actions are influenced by their belief in loving kindness and compassion to all beings. Imagine what life would be like here if everyone you came into contact with, greeted you with a heartfelt bow, hands to their heart, saying  Namaste.

Namaste – we say it at the end of every yoga class. What does it really mean? Nama means bow, as means I, and te means you.

Therefore, namaste literally means “I bow to you.” Namaste is usually spoken with a slight bow and hands pressed together, palms touching and fingers pointing upwards, thumbs close to the chest. The gesture represents the belief that there is a Divine spark within each of us that we recognize as One.

My pilgrimage to India included time in Delhi (the capital), Agra (to see the Taj), Khajuraho and Rishikesh. Everywhere I went, I was impressed with the ever-present juxtapositions – from the grand palaces and temples to the poverty in the streets, from the NOISE to silence in meditation.

I had the privilege to stay at the Himalayan Institute (HI) in Khajuraho, founded by the great Swami Rama.  The Institute’s 30-acre campus is the ideal setting for sadhana or spiritual retreat. Surrounded by hills and forest preserves, it is blessed with natural beauty and tranquility. Here, we studied, meditated, practiced asana, chanted and grew together as a beautiful spiritual community.

We studied a book called the Devi Mahatmyam – the Glory of the Goddess, an ancient allegory. Part myth and part philosophy, the text addresses some very important existential questions that have plagued mankind since time immemorial. Its stories can be taken as metaphors relating to our own psycho-spiritual development, as well as the challenges we face in life.

 


 

 

Rishikesh was the exact opposite experience. Rishikesh is a city on the Ganges river that is renowned for being a holy site and a pilgarimage location. Hindu sages have traditionally come here to meditate throughout the centuries.  All of the great yoga masters have their roots here.  The spiritual connections here mean that it is a place that is free of both meat and alcohol.

Rishikesh has also been given the name of “the yoga capital of the world” as students from all over the globe, including myself and the Beatles in the late 1960s, converge here to learn the ancient wisdoms of yoga. YOGA, we learned over and over again, is “simply” a way of life, a way of being and the Wisdom that we seek is found in ourselves. Siddhartha Krishna, a compelling Yoga Philosophy Teacher, that we had the great honor to learn from, told us that the most important component of yoga is Ahimsa, literally translated as nonviolence, which is really all about compassion. Yoga gives us the tools so that we can practice compassion.

In the words of Swami Shivananda who began the Divine Life Society, the goal of Yoga is to:

SERVE       LOVE       GIVE

PURIFY       MEDITATE     REALIZE

With deepest gratitude to my fellow pilgrims and teacher, Indu Arora.


Namaste 

 

Why Yogis Go to India: Spirituality, Curiosity, and Self-discovery

 

As I’m getting ready for my trip to India, I have been asked many times, “WHY are you going to India?

While those who know me, know that I want to see ALL the world and will go anywhere; India, I believe will be a unique journey. The birthplace of Mahatma Gandhi, India is also the birthplace of Yoga. As a yogi, I’ve always been curious about and drawn to the country where it all began.

Yoga has grown very popular in the western world, mostly as a physical exercise. I. personally am thrilled that so many people are now drawn to yoga. However, the yoga of India, which has its roots approximately 2500 years ago, is of a much more spiritual practice.

Yogis go to India to deepen their understanding of this ancient practice because we know that this is the real gift of yoga. There is just something just so exciting about practicing yoga where so many of our legendary yoga leaders -T. Krishnamacharya, K. Pattabhi Jois, B.K.S. Iyengar, Swami Vivekananda have been and practiced.

India, however, will come will its challenges. India is a vast country with over one billion people. I have been told that India is like no other place, a land of tremendous diversity and contrasts which will awaken all of your senses and emotions.

So, here I go! With an open mind and an open heart, I am ready for what I believe will be a journey of a lifetime.

“Where is the delusion when truth is known? Where is the disease when the mind is clear?

 Therefore surrender to Yoga.” – T. Krishnamacharya

Heart Healthy Diet. Navigating through all the confusing diets & plans

What is a heart healthy diet?  Is it high protein? low fat? high carb? low carb? no carb? gluten free?  Is it Vegetarian? Vegan? Mediterranean? Ornish? Paleo? What if you have Diabetes? What if you’re trying to lose weight?

 

To add to the confusion, here are a few more terms we hear all the time and see all the time at the grocery store — sugar free,  whole grains vs enriched grains vs refined grains, good carb, bad carb, saturated fats, trans fats, good fats, bad fats. Yikes…Is your head spinning yet?!

No wonder eating healthy can seem so daunting!

I will do my best to debunk some of the myths and focus on foods that are in general healthy,  and especially heart healthy.

                   The American Heart Association recommends the following for all adults and children greater than 2 as well as for patients with known heart disease:

  • Eat 5 or more servings of fruit & vegetables every day. Dark green, deep orange or yellow fruit and vegetables are especially nutritious. Examples include spinach, carrots, peaches and berries
  • Eat 3 or more whole grain foods every day. Examples include oats, barley, brown rice, 100% whole wheat
  • Eat fish at least twice a week. Oily fish which contain Omega 3 fatty acids are most nutritious, such as salmon, mackerel, herring, trout, sardines and to a lesser extent tuna
  • Eat foods low in saturated fats, trans fat and cholesterol

Sound a little carb heavy? What if you have Diabetes or are trying to lose weight…Should you eat less carbs? First lets take a look at Carbohydrates and Grains as they are often demonized in many popular diet fads.

Let me be clear. Carbohydrates are an important part of a healthy diet!

A carbohydrate is a macronutrient, meaning they are one of the three main ways the body gets energy to support bodily functions and physical activity; the other two being proteins and fats.

The term carbohydrate refers to its chemical structure, consisting of a certain ratio of carbon, oxygen and hydrogen atoms.

Carbohydrates in food come in the form of sugars, starches and fiber.  Carbs are often classified as either simple carbs or complex carbs. A simple carb, again refers to its chemical structure, and how quickly the sugar is absorbed and digested. Simple carbs have one or two sugars and are absorbed and digested quickly. Examples are fructose found in fruit, sucrose-table sugar, and lactose – milk. Simple carbs are also in candy, soda and syrups (obviously, not good).  Complex carbs are the starches and fiber, such as whole grains, beans, peas, lentils, peanuts, potatoes, corn, parsnips.

A better distinction is between good carbs and bad carbs.

Carbs usually considered good are mostly complex carbs, such as whole grains, vegetables, beans and legumes and fruit (which are simple carbs). These are not only digested more slowly, but they also contain many other nutrients, such as vitamins and minerals. They also tend to be high in fiber. There are many studies reporting the health benefits (not just heart) of a diet rich in fiber.

Bad carbs — Think pastries, sodas, highly processed foods, white rice, white bread and other white-flour foods. Bad carbs rarely have any nutritional value. An important definition here is “refined” as in refined flour or refined sugar. While the word “refined” may bring to mind “improved, pure, elegant”, WHERE FOODS ARE CONCERNED, REFINED=BAD. REFINED=PROCESSED. All the goodness (nutrients, fiber) is stripped out of the food.

What about fat? Is there any nutritional role for fat in our diets, especially our heart healthy diets.

Yes! Fats are ESSENTIAL! But, wait, don’t get too excited. I am not suggesting that eating a bacon cheeseburger is Essential or Healthy. As with carbs, there are good fats and bad fats.

Let’s start with the good guys — the unsaturated fats. Unsaturated fats include polyunsaturated fatty acids and monounsaturated fats. Monounsaturated fatty acids (found in olive oil, canola oil, peanut oil, nuts, and avocados) and omega-3 polyunsaturated fatty acids (found in oily fish, canola oil, flaxseed, and walnuts) should be the first choice for fats.Unsaturated fats, when eaten in moderation and used to replace saturated or trans fats, can help lower cholesterol levels and reduce your risk of  heart disease.

Now on to the bad guys. There are two types of fat that should be eaten sparingly: saturated and trans fatty acids. Both can raise cholesterol levels, clog arteries, and increase the risk for heart disease.

Saturated fats are found in animal products (meat, poultry skin, high-fat dairy, and eggs) and in vegetable fats that are liquid at room temperature, such as coconut and palm oils. The 2005 Dietary Guidelines recommend limiting saturated fats to 10% or less of your total calories, while the American Heart Association recommends keeping them to just 7% of total calories.

The real BAD GUY is the artificial trans fats. They’re used extensively in frying, baked goods, cookies, icings, crackers, packaged snack foods, microwave popcorn, and some margarines. Research has shown that even small amounts of artificial trans fats can increase the risk for heart disease by increasing LDL “bad” cholesterol and decreasing HDL “good” cholesterol. Stay away from these as much as possible.

PROTEINS. I probably don’t have to convince the average reader to eat protein. And yes, it is also an important Macronutrient. What I’d like you to think about, however, is the type of protein you consume. Protein is found in animal-based products (meat, poultry, fish, and dairy) as well as vegetable sources such as beans, soy, nuts, whole grains and to a lesser extent green vegetables. Animal protein, unfortunately, also comes with significant saturated fats. The best choices of protein are fish, legumes (beans), nuts and if you must have meat, lean poultry.

Here are a few examples of “Diet Plans” that I would consider Heart Healthy

Mediterranean Diet

The Mediterranean diet is rich in heart-healthy fiber and nutrients, including omega-3 fatty acids and antioxidants. The diet consists of fruits, vegetables, and unsaturated “good” fats, particularly virgin olive oil. Olive oil has been associated with lower blood pressure, a lower risk for heart disease, and possible benefits for people with type 2 diabetes. There are several variations to the Mediterranean diet, but general recommendations include:

  • Limit red meats.
  • Drink one or two glasses of wine each day if alcohol is enjoyable and there are no reasons to restrict its use.
  • Limit whole fat dairy products.
  • Eat moderate amounts of fish and poultry. Fish is the diet’s main protein source.
  • Eat plenty of fresh fruits and vegetables, nuts, legumes, beans, and whole grains.

DASH Diet

The salt-restrictive DASH diet (Dietary Approaches to Stop Hypertension) is proven to help lower blood pressure, and may have additional benefits for preventing heart disease, stroke, and heart failure. Effects on blood pressure are sometimes seen within a few weeks. This diet is rich in important nutrients and fiber. It also provides far more potassium (4,700 mg/day), calcium (1,250 mg/day), and magnesium (500 mg/day) — but much less sodium — than the average American diet.

DASH diet recommendations:

  • Limit sodium (salt) intake to no more than 2,300 mg a day (a maximum intake of 1,500 mg a day is a much better goal and is now endorsed by the American Heart Association).
  • When choosing fats, select monounsaturated oils, such as olive or canola oils.
  • Choose whole grains over white flour or pasta products.
  • Choose fresh fruits and vegetables every day. Many of these foods are rich in potassium, fiber, or both, which may help lower blood pressure.
  • Include nuts, seeds, or legumes (dried beans or peas) daily.
  • Choose modest amounts of protein (no more than 18% of total daily calories). Fish, skinless poultry, and soy products are the best protein sources.
  • Other daily nutrient goals in the DASH diet include limiting carbohydrates to 55% of daily calories and dietary cholesterol to 150 mg. Patients should try to get at least 30 g of daily fiber.

Low-Fat Diets

Dietary guidelines recommend keeping total fat intake to 20 – 30% of total daily calories, with saturated fat less than 10% of calories. Very low-fat diets generally restrict fat intake to 20% or less of total daily calories. The Ornish program, recommended for some heart disease patients, limits fats even more drastically. It aims to reduce saturated fats as much as possible, restricting total fat to 10%, and increasing carbohydrates to 75% of calories. While this program has been scientifically shown to result in  Regression of heart disease, it is a very demanding regimen that is difficult to maintain.

  • It excludes all oils and animal products except nonfat yogurt, nonfat milk, and egg whites.
  • It emphasizes whole grains, legumes, and fresh fruits and vegetables.
  • People in the program exercise for 90 minutes at least three times a week.
  • Stress reduction techniques are used.
  • People do not smoke or drink more than two ounces of alcohol per day.

 

Not so Heart Healthy

Low Carbohydrate Diets

Low carbohydrate diets generally restrict the amount of carbohydrates but do not restrict protein sources, which for many, results in greater meat and saturated fat consumption.

The Atkins diet restricts complex carbohydrates in vegetables and, particularly, fruits that are known to protect against heart disease. The Atkins diet also can cause excessive calcium excretion in urine, which increases the risk for kidney stones and osteoporosis.

The jury is still out on other low-carb diets, such as South Beach, The Zone, and Sugar Busters, and the Paleo diet. Low-carbohydrate diets help with weight loss in the short term, possibly better than diets that allow normal amounts of carbohydrates and restrict fats. However, overall, there is not good evidence showing long-term efficacy for these diets. Likewise, long-term safety and other possible health effects are still a concern, especially since these diets restrict healthy foods such as fruit, vegetables, and grains while not restricting saturated fats.

Take home message . The heart healthiest foods are:

  • Fruit and Vegetables (all of them),
  • “whole” grains such as oats, barley, quinoa, brown rice. If it’s white, don’t eat it!
  • Fish
  • Legumes (beans, peas) and nuts
  • Foods rich in fiber
  • Good fats, such as olive oil and avocado
  • Eat the other stuff sparingly

 

And remember, what we eat is 50% of our health; the other 50% is physical activity.

By Dr Millie Lee

 

Heart Disease – Signs and Symptoms

We continue this month, Heart Month, to learn more about the heart and heart disease.

So how do you know if you or a loved one have heart disease? First of all, what is heart disease? Before we discuss what can go wrong, Let’s begin with a short lesson on the anatomy and function of a normal heart.

Human Heart Anatomy

The heart is a small, beautiful and powerful organ. It is about the size of a large fist and weighs between 10-20 ounces in mean and 8-10 ounces in women.

Heart Function and what can go wrong 

We cardiologists often liken the heart to a house with its structure, plumbing and electricity. The heart is a hard working muscular pump responsible for delivering oxygenated blood to all the bodies tissues and organs, including itself (via the coronary arteries). If the pump (structure) fails to work efficiently, heart failure can result. If the arteries get clogged or blocked (plumbing), Coronary Artery Disease is the result. Irregular heartbeat or arrhythmias is the result of an electrical problem.

Coronary Artery Disease (CAD)

CAD is what most people think of when they hear the term heart disease and it IS the most common form of heart disease and the leading cause of death in our country. Basically, it is the build-up of plaque in the heart (coronary) arteries which lead to symptoms of ANGINA or HEART ATTACK (myocardial infarction).

Angina occurs when the heart muscle doesn’t get enough oxygen rich blood. It generally occurs when the demand on the heart is increased such as with exercise or exertion and resolves with rest (decreased demand). A heart attack is similar pain that persists. It can often be preceded by angina, but not always.

COMMON SYMPTOMS OF CAD

  • Chest pain with or without exertion; dull, pressure, sharp or burning like indigestion
  • Pain in Arms, Neck, Jaw, Back or Abdomen
  • Nausea and vomiting
  • Shortness of Breath
  • Extreme Fatigue
  • Sudden, unexplained sweatiness

Heart Failure

This is a condition in which the heart does not pump normally, either from a weakened pump or a restricted heart muscle. The condition of a weakened heart muscle is referred to as a Cardiomyopathy. When the heart is not able to pump efficiently, blood can back up into the lungs and peripheral veins. As the pressure in the blood vessels of the lungs increase, fluid is pushed into the air spaces, leading to congestion in the lungs, or pulmonary edema. Similarly, fluid can be pushed out of the peripheral veins, leading to swelling or EDEMA of the legs, arms, or abdomen.

COMMON SYMPTOMS OF HEART FAILURE

  • Shortness of Breath with or without activity
  • Shortness of Breath when laying down
  • Fatigue
  • Swelling, in legs, arms, and abdomen

Arrhythmias

An arrhythmia is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm, such as Atrial Fibrillation.

COMMON SYMPTOMS OF ARRHYTHMIAS

  • Palpitations
  • Dizziness, Lightheadedness, Loss of Consciousness
  • Chest pain
  • Shortness of Breath

If you or a loved one have any of the symptoms I’ve discussed here, please see a doctor as soon as possible. I recommend seeing a general doctor first and see if referral to a specialist or further testing is required.

By Dr. Millie Lee

Heart Health Awareness Month

February is Heart Awareness Month – A time when many of us connect with our hearts. This connection is primarily because of the holiday, Valentine’s Day. But along with Valentine’s Day, February also marks American Heart Month, a great time to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health. Heart disease is still the leading cause of death of men and women, despite the tremendous advances we have made in the treatment of heart disease. So, maybe the solution for heart health is prevention. Make heart health the perfect gift you give to yourself and your loved ones this Valentine’s Day.

This month, follow along as we discuss various aspects of heart health, including risk factors, prevention, screening, heart healthy diet and stress management.

Let’s start by asking ourselves: Am I at risk for heart disease?

Common risk factors for heart disease

  • Hypertension or High Blood Pressure
  • Diabetes Mellitus or High Blood Glucose
  • Hypercholesterolemia or High Cholesterol
  • Smoking Cigarettes
  • Stress
  • Age
  • Family History of Premature Heart Disease

The good news is that most of these are preventable, modifiable and treatable with attention to the right foods and regular exercise. Sorry.. can’t do anything about your age or family.

So, let’s get Heart Smart this month and beat heart disease. February 3th is National Wear Red Day to raise national awareness of heart disease. Why not wear red everyday this month to maintain awareness to our heart health.

First tip: WALK. Log those steps. Every step you take is a part of your journey to heart health. Walking briskly can reduce your risk of high blood pressure, diabetes, and high cholesterol. Rx: 150 minutes a week of moderate intensity physical activity (brisk walking) or 75 minutes a week of vigorous intensity physical activity (such as jogging or running) or a combination of both.  Keep me posted on your progress and send pictures of your activities wearing red!

 

Dr Lee signing off…..

 

Inspiring Millenials

It is not often that a Gen Xer  finds inspiration in the younger Millenials. But I had the great pleasure and honor of spending some time this past Sunday with two amazing Millenials – Jessica and Jess, clearly no coincidence. In Hebrew, the name Jessica means: Rich, God Beholds. We came together for a vinyasa yoga class taught by Jessica at the lovely Mermaid Winery in Norfolk, VA.

There is a lot of controversy about the characteristics of a Millenial. Some call it the “Me” Generation and describe them as being lazy and entitled. The first author, however, to coin the term, described them as confident, civic minded achievers. Now this perfectly describes these two beautiful ladies, Jessica and Jess.


Jessica is a beautiful, smart, kind, inspirational young woman who is a yoga teacher, medical student, co-founder of Bhav Brigade, and wise beyond her years. She will graduate medical school in a few months and clearly be one of the most compassionate Emergency physicians I and the world will know. She spent her “free time” as a medical student bringing yoga to the medical school and the community through the Bhav Brigade, a pop-up yoga collective based on donations that go back to the community.

Jess is a beautiful, smart, kind, inspirational, motivational young woman who is a trail blazer, entrepreneur, fitness guru, social media whizz and wonderful friend. She left a well established job to follow her heart. Her heart has led her to be a leader in her “industries”-health & fitness and social media. She is the creator of The Fit Petite and Relay Your Brand. Whatever she does, her heart is always with the community. She is the most motivational person I know. She organized and participated in a huge fundraiser run from Virginia Beach to the White House to raise money for the homeless.

Needless to say, sharing space and time with these women was truly inspirational.

The theme for the class was balance. Not balancing on one toe with the other leg wrapped around your head balance… but balance in our lives. What does that mean to you? Jessica suggested we debunk it … and not give it so much power over our lives. It seems that “balanced” has made its way to the list of things we need to accomplish. Instead, balance should be acceptance of the good and the bad days, our goodness and our imperfections. To prove how challenging that can be, we “practiced” balance on our mats.

Topping off a great, challenging yoga class in a winery, what better for a balanced day, than brunch and mimosas in the winery with Jess. We are both so excited about this new year. Not because 2016 was bad but because we share a common optimism about the future and how we can mold it. I was excited to hear how Jess will guide a women’s workshop on “Never Surrender – Your Roots, Rules and Resolutions.”

So I resolve, and invite you to see everyone we meet, regardless of age, with an open heart and without preconceived judgement. I am grateful to these beautiful souls for their light and their inspiration.

Who inspires you?

Namaste

Millie