HEART By James H. O'Keefe, MD The Great Influenza-the - Saint Luke's Health System
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Winter 2021
FROM THE
HEART Newsletter from
Get the COVID
Silver Linings of the Pandemic
By James H. O’Keefe, MD Vaccine ASAP
T
he Great Influenza—the including 675,000 Americans, at a time By James H. O’Keefe, MD
deadliest pandemic ever— when the world’s population was only
Ever had polio? How about
was first reported in 1918 one-fifth of what it is today.
smallpox, tetanus, or diphtheria?
in the sparsely populated My grandparents were born be- Of course you haven’t, because
county of Haskell, Kan. This was an tween 1903 and 1908. They survived you were vaccinated against these
H1N1 flu virus that likely mutated in a the Great Influenza, and then suffered and other debilitating, often fatal
pig and spread to humans on a farm in through WWI, the Great Depression, diseases as a child. Smallpox was
the southwestern and World War II a common viral illness that killed
corner of Kansas. (WWII). about one in every three people
Subsequently, Tough times who became infected. Over the
a few new recruits don’t last, but past 1,600 years, smallpox ended
from Haskell tough people do. the lives of hundreds of millions
County reported My grandmothers of people around the globe. An
to Camp Funston, always seemed effective vaccine completely eradi-
located within Fort to be happy and cated this disease with the last
Riley, near Manhat- hardy, strong documented case being in 1977.
tan, Kan. At this women of family One of the reasons worldwide
camp, 56,000 U.S. soldiers were in and faith. On the other hand, one of life expectancy surged upward
training, waiting to be shipped out to my grandfathers died of alcoholism over the past half-century is that
Europe to fight in World War I (WWI). shortly after WWII, and alcohol nearly we have developed safe and effec-
At least one of these young volun- killed my other grandfather before he tive vaccines that prevent many of
teers from rural Kansas unknowingly “quit the drink for good.” the most lethal viral and bacterial
carried the novel and lethal virus on In early March 2020, we suddenly illnesses.
arrival to Fort Riley. He went on to in- found ourselves in an unimaginably Now we have vaccines against
fect some of his fellow recruits, many dire worldwide catastrophe, and now the SARS-CoV-2 virus— the cause
of whom fell ill in transit to, or shortly we’re living through perhaps the worst of COVID-19 infection. The two
after arriving in France. “tough time” of our collective lives. The vaccines that have received FDA
From there, the contagious weight of this crisis can crush us—or Emergency Use Authorization
virus spread like wildfire around the it can make us stronger. Look at what thus far are manufactured by the
globe. The Great Influenza eventually our grandparents lived through—it’s American pharmaceutical compa-
infected about 500 million people, or not for nothing that they are called nies Pfizer and Moderna.
one-third of the world’s population. the Greatest Generation.
It killed at least 50 million individuals, Continued on page 7
SU RV IVAL G U I D E
Silver Linings of the Pandemic
Our current pandemic has present- Randy Thompson, MD
ed us with ongoing challenges and “The pandemic has forced me to
disruptions. It’s easy to get dragged slow down my overly busy life. I’ve
down, especially with the sensational- been able to spend more time with
ized negativity on the news. my wife and adult children, to sleep
Alternatively, we can offer ourselves properly and to exercise more regu-
a perspective shift by looking for larly. Despite the stress around us,
things that may have actually changed with respect to our health and sense
for the better, and things for which of well-being we’re doing better than
we are grateful. With this thought in before the pandemic.”
mind, I asked my friends, family, and
co-workers if they had found any silver
linings in the black clouds we’ve been
Andrew Kao, MD Alex & Andy with new family member, Hank.
living under in 2020, and here’s what “One of the biggest impressions or pleasures have always been here, we
they said: surprises for me has been the number just never stopped and noticed them
of patients who go out of their way to until now.”
ask how I am doing and to urge me to
Christina LeGay please stay safe. We have all dedicated
“With gyms closed, my fiancé and I our careers to caring for others, never
Tracy Stevens, MD
turned to the outdoors and at-home expecting anything in return. These “Because of the pandemic, we now
workouts, which have included a lot genuine expressions of concern and have a new member of our family—
of yoga. Through all the uncertainty encouragement from patients have Hank. We lost our family dog over a
at the start of the pandemic, and now been so touching and very much ap- year ago. Our son Alex brought home
the second-wave, yoga has connected preciated. It gives me the extra energy an orphaned shelter dog to foster for
us in a new way and allows us both to keep soldiering on, doing what I am the weekend. Hank stole our hearts
to center ourselves. One of the most trained to do.” and we adopted him for good; he has
empowering quotes from our favor- brought us such laughter and plea-
ite online yoga instructor is, ‘All the sure since then. Brian and I escaped
strength and energy you need resides
Shaun Hamontree to our farm a number of times, and I
within you.’ I have repeated that many “When we, like many others became relearned how to sit quietly and listen
times to myself since and have shared victims of the various financial and to the sounds of nature. I can’t recall
it with friends and family.” social burdens that the pandemic the last time I just stared up at all the
brought, my amazing wife and I chose beautiful stars. The experience has
to embrace the tactile all around us. been the best treatment for my blood
Allen Jetmore, MD The feel of soil. The real smell of a pressure.
“People are riding bikes like crazy, flower. One note on a piano that you As a member of SLCC for over 23
and fishing too. There have not been let completely ring out. Staring at my years, I have never been prouder to
so many kids fishing since the 1950s!” dog’s eyes and noticing her pretty be part of this amazing group. My
chestnut colored speckles. colleagues have shown unmatched
Ryan Holiday Over the past months I’ve noticed resilience in addressing the challenges
“As much as time has blurred to- how we’ve both slowed down and in health care brought on by the
gether for some of us, it’s also slowed relished our moments, both together pandemic. Although we are working
down. Don’t you feel like you’ve been and in our individual endeavors. And harder than ever, we remain commit-
really living lately—even though while the stresses are very much there, ted to our patients, community, and
you’re doing less? You’re more fo- they’re now muted by a home full each other.
cused. You’re more rooted. You know of slow-brewed love and music we
what matters.” are creating ourselves. These simple
2 Saint Luke’s Cardiovascular Consultants | From the Heart
SU RV IVAL G U I D E
The pandemic has also given me an my workload. These changes suddenly
opportunity to visit patients in their provided more time for other activi-
homes via virtual visits. I have been ties—leisurely outdoor lunches, hiking
able to meet other members of their local trails, reading books I’d had no
families, including their four-legged time for, and the opportunity to write
family members who insisted on be- articles for medical journals. We have
ing part of the visit. I have been given this amazing gift—our lives. We can
virtual tours in their homes, have seen live only in the moment. Facing a
the family photos and have heard pandemic with its potential to steal
some of the greatest fishing stories our lives or those of our loved ones,
after seeing the fish mounts on the Katie playing outdoors. can lead to fear and inaction, or can
walls!” enable us to live each day with more
Katie O’Keefe, Licensed awareness and gratitude for what is
Professional Counselor real and meaningful to us...and that
Laura Schmidt, MD
“With my work as a psychotherapist is what I have endeavored to do, and
“My twins, Eva and Vivian, are to more deeply appreciate everything
now on a telehealth platform, I can
getting along so much better now and everyone...each and every day of
work virtually anywhere, which means
than they were pre-pandemic. They my life.”
I can spend weeks at a time with my
used to bicker and pick on each other
mother in North Dakota. And without
constantly; six months at home with
a commute time and a much lighter Peggy Panis
only each other has made them best
‘social calendar,’ I have been able to
friends. We’re cooking more and eat- “Thank God for technology. Video
enjoy more play time — hiking, knit-
ing healthier. We’re now better about chat and FaceTime were a game-
ting, painting, cooking, more time
making a meal plan and grocery list. changer when my dad was in the hos-
outdoors, and even neighborhood
By not traveling and eating out, we pital without visitors. We were able to
pickle ball! Prior to the pandemic,
saved some cash too. Staycations have conversations with the doctors
with life in full swing, it was more of a
meant finding new ways to have fun when they made rounds. Seeing and
challenge to find that healthy work/
at home. I had always wanted to get hearing friends and family made the
life balance. As a society, the bright-
into gardening and didn’t have the pandemic feel less isolating.”
est and most far-reaching silver lining
time to do so. My gardens this year
has been our focus on, and boosting
were the best they’ve ever been, and I
of, wellness efforts. The pandemic has F. Joseph Glynn
learned again how much I love being
exposed just how pervasive our collec- “Pre-COVID, my work required
outside puttering in the garden.”
tive struggles are with anxiety, depres- significant travel. Along with the rest
sion, and substance use. Having been of the world, my business travel came
stigmatized for far too long, we are to a crashing halt. My wife, Kerry, was
now talking much more openly about always working from home, but now
mental health and wellness. The silver our son Daniel was home from college
lining here is how people are sharing, doing virtual classes, and son Jack
seeking out support, and learning new was working from our home too. It
strategies for living and thriving.” was wonderful; we had more together
time as a family. Homemade pizza,
Felice Gersh, MD with everyone helping in a festive
manner, became a Friday norm. At
“As COVID took hold, my career was
quitting time, Jack and Daniel would
ultra-busy, with a full-time medical
have the soccer ball or badminton
practice and frequent lecturing at
rackets out in the backyard. Kerry and
conferences. COVID initially slowed my
I found solitude hiking and biking on
medical practice, and all the confer-
Twins Eva and Vivian are now best friends. obscure trails deeper in the foothills
ences I was slated to speak at went vir-
near our Boulder, Colo., home.”
tual, ending my travels and reducing
saintlukeskc.org/slcc | 816-931-1883 3
H E AR T H E ALTHY LI FE ST Y LE
My Mom’s Recipe for Staying Fit
During and After the Pandemic
By Jessica E. Sturgess, MD, with Mary Sissons
M
y mom, Mary, first • Weight bearing exercise is so im-
became a certified portant for maintaining muscle mass.
aerobics instructor 30 It’s also important to maintain upper
years ago. Four years body strength. Some examples of
later she started teaching physical exercises that are easy to do at home
fitness classes to senior citizens in or in an open space with friends in-
our hometown of Port Perry, Ontario clude squats, stair climbing, push-ups
in Canada and she has been doing against a wall or on the floor with bent
so ever since. She has attended over knees, light weights, and work with a
20 yearly CanFitPro aerobics confer- resistance band. These should all be
ences because she is passionate about done with an emphasis on good form
cardiovascular fitness, mobility, and and joint protection.
nutrition. I am biased, but I would say • Core strength is key. It’s so important Mary out for her daily walk near Port Perry,
that she is truly an inspiration. She for preventing back pain and injuries. Canada.
turned 70 this year, and you would Mat work is avoided by many older
never guess it. She remains dedicated adults because getting down and • Make a point of developing active
to teaching her aerobics classes each back up is a concern. Yoga can help hobbies, such as gardening and mow-
week and getting out in nature every because there are many good transi- ing the lawn. These can become part
day. I asked for her thoughts on how tion poses. Chairs can also be used as of your routine. Take the stairs when-
to keep our older citizens well during props for those who can’t get on the ever possible. Choose the farthest,
the pandemic. ground. Core bed exercises can be not the closest, parking spot when
done each morning while lying in bed shopping. Shop in large stores or
in less than 10 minutes. They will get malls to get in some walking when the
What motivates you to stay active?
your heart rate and blood pressure up, weather is especially bad.
Exercise makes me happy and
and then there are no worries about • Outdoor activities such as biking, ski-
it gives me energy; so does being
blood pressure drops as you get out of ing, snowshoeing, canoeing, kayaking,
outside. Knowing this gets me out
bed. I swear by it. My routine includes and hiking are wonderful, and can be
the door every day, even if it’s rain-
toe touches, dead bug, bicycling the easily done with social distancing.
ing or cold outside. My Fitbit keeps
legs, bridge raises (double or single • If going to an exercise class and
me honest. I get 10,000 steps a day
leg), runner’s hip stretching, and wind- getting outside are not possible, then
at a minimum. I am happiest walking
shield wipers for stretching the hips. simply put on your favorite music and
alone because I can go at my own
pace and listen to my own thoughts. • Balance activities are just as impor- dance or march to it. Music is a great
Group fitness is fun too, especially tant. Yoga is excellent and many online motivator and it can make just about
with good music! videos are available that can be used any activity more fun. Use your arms
on a laptop or smartphone. Check out as you march or dance. Walking in the
Yoga with Adriene—she’s the best! woods or by a lake is always good,
How can seniors keep themselves There are other simple exercises that but walking anywhere is better than
strong and mobile during the pan- can be worked into any schedule, such sitting.
demic? as brushing your teeth while balanc- • Bodywork, such as going to the chi-
• Aim to be active for 30 to 60 min- ing by the sink on one leg, or balanc- ropractor or getting a massage, should
utes every day, ideally outside and ing while working in the kitchen. be used as needed. Aging doesn’t
with good company (your canine best have to be painful.
friend, for example).
4 Saint Luke’s Cardiovascular Consultants | From the Heart
H E AR T H E ALTHY LI FE ST Y LE
What keeps you in good spirits?
Spending time with people who
like to laugh and who make me laugh.
New Research Finds Promising Therapy
I do my best to surround myself with
people who do not spread negativ-
to Prevent Alzheimer’s Disease
A
ity. Family time always brightens my
day, even if it’s by phone or video chat new study authored by
rather than in person. Saint Luke’s Mid America
Heart Institute cardiolo-
Gratitude is important. Every night
gist James O’Keefe, MD, sug-
before sleep, I think of three people or
gests that therapies to block a
things that I’m grateful for.
hormone called tumor necrosis
I love yoga and tai chi, both of factor, or TNF, can greatly reduce
which focus on breath and movement. the risk of developing Alzheimer’s
I stay connected to our community disease.
through volunteering at our hospital Dr. O’Keefe and his fellow researchers—including two of the world’s
auxiliary store. It always feels good to premier Alzheimer’s prevention physicians—Dr. Gary Small from UCLA, and
give back. Dr. Richard Isaacson from Cornell—hypothesized that taking inhibitors to
Never underestimate the power of a reduce chronically elevated levels of TNF could prevent Alzheimer’s disease
good night’s sleep. and improve mental health.
The physicians conducted a comprehensive analysis of all published
What are your top tips for maintain- scientific studies and concluded that TNF-blocking agents are consistently
ing a balanced diet? associated with a decreased risk of Alzheimer’s disease. The most potent
• Water is #1 on my list. I start the day TNF blocking agents are injectable biological drugs including etanercept
with a glass of warm water with half (Enbrel) and adalimumab (Humira) used to treat autoimmune diseases like
a lemon. I drink eight glasses of water rheumatoid arthritis and psoriasis.
a day, plus green or herbal tea. I also Curcumin, the active ingredient in the spice turmeric, is a natural com-
love my daily coffee. pound sold as a supplement that also strongly reduces TNF levels in the
• Eat the most for breakfast, less for body. Theracurmin, a highly absorbable form of curcumin, was effective
lunch, and least at dinner. in improving memory in a small randomized trial in older adults without
dementia. It was also effective for reducing beta amyloid plaques and tau
• Incorporate fresh fruit, vegetables, tangles—the pathologic findings seen in the brains of Alzheimer’s patients.
and lean protein at every meal.
“This is so exciting because inhibiting TNF looks like the most promising
• My favorites are green veggies, like approach for preventing this devastating disease,” Dr. O’Keefe said. “The
kale and swiss chard, colorful berries, data are remarkably consistent from observational studies, small random-
oranges, kiwi, and proteins like tofu, ized trials, and animal data. TNF inhibition is a scientifically plausible strate-
legumes, low-fat cheese, yogurt, fish, gy that could reduce the risk of developing Alzheimer’s disease by 50 to 70
and eggs. percent. I’ve been working on research and education my whole career and
• Save treats for the weekend. My published 423 scientific articles; I don’t think I’ve ever been more excited
must-haves are dark chocolate and red about the potential importance of a new treatment strategy.”
wine, always in moderation. Dr. O’Keefe stated that this is still a hypothesis and he hopes this new
• Avoid soda/pop, juice, and energy scientific analysis will convince researchers and pharmaceutical companies
drinks. It’s better to eat the fruit and to do large clinical trials to further investigate potential brain benefits of
drink pure water instead of downing TNF inhibitors like Enbrel, Humira, and Theracurmin in populations at risk
fruit juice—that way you will get more of Alzheimer’s.
fiber and fewer calories. Herbal teas Disclosure: Dr. James O’Keefe is Chief Medical Officer/Founder of CardioTabs,
are nice alternatives. They are hydrat- a supplement company that sells Theracurmin.
ing, relaxing, and contain no calories.
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H E AR T H E ALTHY LI FE ST Y LE
Menopausal Reflections
By Felice L. Gersh, MD
I
can vividly recall the self; estradiol is its driver love and happiness, we can maintain
sick resignation I felt and regulator. Virtually our metabolic health.
as I looked at the every organ in the body These are the daily rhythms and
lab tests confirming has estrogen receptors protocols that I live by:
what I already knew—at and requires estrogen
• Eat predominantly plant-based
age 43, I had entered for optimal functioning.
foods with only small amounts of
menopause. My periods Without adequate healthy animal products.
had stopped, and I was estrogen, the body can
• Eat a large healthy breakfast, a
getting night sweats and survive, but nothing
medium lunch, and a small early din-
hot flashes. works quite right. This
ner, and stop snacking.
My tests showed body-wide dysfunction
manifests as a state • Keep a regular bedtime and be
that my estrogen level
of chronic low-grade inflammation, sure to get 7-8 hours of sleep.
measured in the low menopausal
range, and FSH, a pituitary hormone referred to as “inflammaging.” We now • Exercise regularly and sweat!
that rises as ovarian estrogen declines, know that menopausal inflammation • Focus on meaningful relationships
was sky high. As the significance of my is the driver of the diseases associated and find purpose in your life.
lab results fully registered, I rapidly al- with aging—osteoarthritis, osteoporo-
Additionally, I believe every meno-
ternated between sadness and fear for sis, Alzheimer’s Disease, and of cancers
pausal woman should seriously con-
my future. As an OB/GYN doctor, I was such as breast, uterine, and colorectal.
sider taking human-identical, often
well-acquainted with this scenario, but Estrogen deficiency also underlies called bio-identical hormones as soon
as a woman, I was devastated. the most common cause of death of as she enters menopause.
Instead of mourning, I became an postmenopausal women—cardiovas-
The pervasive fear of estrogen
expert in the science of ovarian senes- cular disease. Without adequate es-
arose from a large study done by the
cence—aging of the ovaries. During trogen, the lining of arteries becomes
Women’s Health Initiative, which stud-
a woman’s menopausal transition, inflamed, causing hypertension.
ied equine (horse) estrogen combined
the ovaries stop making hormones. Atherosclerosis and unstable plaque
with a synthetic progestin. They gave
Most importantly, they stop making can develop. Cholesterol levels rise
women these hormones that didn’t
estrogen. Estrogen is a hormone, and and oxidation (likened to rusting) of
naturally exist in the female human
hormones are messengers, delivering cholesterol occurs. Insulin resistance
body.
information and instructions to cells. increases, raising the incidence of
prediabetes and diabetes. The heart Of course, the outcomes were
Ovarian estrogen, called estradiol, is different and not as favorable had
muscle can develop a state of energy
the master hormone of female repro- human hormones been studied. Those
deficiency, making it “stiffer,” and its
duction. It turns out that Estradiol is “foreign” hormones do not deliver the
electrical conductivity may falter,
also key to female health—mind and same messages to cells as our “real”
leading to an increasing incidence of
body. In this second role, estradiol is a estrogen. But when women take the
arrhythmias.
master controller of metabolic homeo- hormones naturally found in our bod-
stasis, which is defined as the ability The more I learned about meno-
ies and given the right way to achieve
to maintain a relatively stable internal pause, the more frightened I became.
physiologic hormone levels, the mes-
state that persists despite changes in But I also learned that there is much
sages delivered are the right ones, and
the world outside. we can do to optimize postmeno-
the desired state of metabolic homeo-
pausal health. By eating the right
Estrogen is critical to the produc- stasis can be maintained.
foods, timed to our inborn rhythms, by
tion, maintenance, consumption, and When I went through menopause, I
getting plenty of sleep and exercise,
storage of energy throughout the had to make the same gut-wrenching
by living with the natural rhythms of
body. Energy is the essence of life it- choice that all women face—do I be-
the 24-hour day, and by focusing on
6 Saint Luke’s Cardiovascular Consultants | From the Heart
H E AR T H E ALTHY LI FE ST Y LE
lieve that Mother Nature knows best
and that losing my hormones is what’s
best for me, or do I follow the science
Get the COVID
and choose to maintain youthful hor-
mones even though my body can no
Vaccine ASAP
Continued from page 1
longer produce them?
The natural world is full of events
that are both natural and horrific. Both of these vaccines, which are based on mRNA technology, have been
Salmon die after spawning. Black scientifically proven to be 95% effective in preventing COVID infection. They
widows eat their mates. Menopause is were even more effective in preventing severe and fatal cases. It is remark-
natural, but it does not grant women able that in the 30,000-person Moderna trial, their mRNA vaccine was 100%
enhanced health. Based on my sci- effective in preventing severe COVID disease and death. Importantly, these
entific studies, I chose to replace my vaccines by Pfizer and Moderna have been tested in 75,000 people and were
estrogen and progesterone. found to be very safe, in addition to being highly effective, as judged by an
Throughout menopause, I have independent panel of vaccine experts.
harnessed the innate abilities of my After getting the COVID vaccine, your B-cells learn how to produce anti-
body to stay healthy, combined with bodies custom-made for attaching to and destroying the SARS-CoV-2 virus.
bio-identical hormone therapy. This Your body will also squirrel away a store of long-lived memory B-cells that
has enabled me to live with excellent know how to produce those specific antibodies. So, if your immune system
health throughout the many years ever detects the SARS-CoV-2 virus in your system, it will jump into action,
that have come and gone since I first quickly building up an army of immune cells equipped with weapons tailor-
got the news of my very early meno- made for killing these nasty invaders before they get a foothold.
pause. Despite the heightened health Although these vaccines are very safe, you should expect minor symptoms
risks that come with early menopausal during the first 24 hours after getting the shot. The most common complaints
onset, I suffer from none of the diseas- are fatigue, muscle aches, headaches, and chills. These are not adverse reac-
es and conditions I mentioned earlier, tions—they are evidence that your immune system has detected a foreign
in spite of the fact that I am now well invader and is mounting a defense
into my 60s. against it. These vaccines contain mRNA
Because I am healthy and energetic, that codes for the spike protein on the
I am free to follow my passions. I still surface of the SARS-CoV-2 virus, but
practice full-time integrative women’s they can’t cause an infection. Even so,
health care at my office. I lecture na- your body responds to this potential
tionally and internationally and write threat and learns how to defeat the
prolifically. I am a forensic medical ex- virus should it encounter it in the future.
pert on high-profile cases. I am always In summary, the mRNA vaccines
busy doing work that I find interesting against the SARS-CoV-2 infection are
and fulfilling. And I am not a medical a monumental triumph of American
miracle. I have many patients who science and technology. Astoundingly,
made the same choices I did, and they our scientists in less than one year have
are in excellent health, just like me! produced a game-changing vaccine
A long health span can be achieved. that will keep us safe from COVID-19.
Evan getting his COVID-19 vaccine.
Women statistically live longer than My son Evan, who graduated from medi-
men, but with far more chronic dis- cal school earlier last year, has recently
eases, yet this need not happen. The received the Pfizer vaccine because he is on the front lines caring for COVID
initial shock of learning of my early patients in an Intensive Care Unit. I too have gotten my COVID vaccine, and I
menopause has long since dissipated. will make sure everyone else in my family gets it as soon as they can. You and
By choosing the healthiest lifestyle everyone you care about should also get the vaccine. The sooner we are all
and by taking safe and efficacious vaccinated, the sooner we can resume our normal lives.
hormones, I lead the life I love.
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H E AR T H E ALTHY LI FE ST Y LE
Why Andorrans Have the World’s
Best Life Expectancy
By James H. O’Keefe, MD
I
n early February of 2020, just Our 3-hour road trip from Barce-
before the coronavirus pandemic lona to Andorra was an awe-inspiring
caused the world to grind to a drive through snowcapped peaks and
halt, I had the opportunity to visit alpine lakes. We went through 20 tun-
Andorra—a tiny nation perched high nels, some of them several miles long,
in the Pyrenees Mountains on the and the road was constantly switching
border between Spain and France. back and forth with hairpin curves and
Though just 50,000 in number, An- steep climbs. Thankfully, the highway
dorrans are renowned for their happy was meticulously maintained and
and hardy nature; and they enjoy there were few other vehicles on the
the longest life expectancy of any road. I realized one of the reasons that
Everyone we met was friendly and
country. For this reason, I have always so few people live in Andorra is that it
relaxed and they all seem to know
wanted to visit Andorra to experience would have been nearly impossible to
each other, which may in part ex-
their culture first hand and get a feel get there in centuries past.
plain why there is almost no crime in
for why they have such exceptional Andorra, comprised of a scant 181 Andorra. Their health care system is
longevity. square miles, has always maintained very good, with a strong emphasis on
When I was invited to the Global neutrality, never getting into conflicts prevention.
Omega-3 conference in Spain, I pulled with its neighboring countries. Plus,
Evan and I snowboard, whereas
up a map of Europe and saw that its secluded setting in the middle of
Kathleen prefers to ski, but we all
Andorra was only 135 miles north of snowcapped peaks has allowed them
agreed that our time cruising down
Barcelona—where the meeting was to to live undisturbed for 1,200 years.
the pristine slopes in Andorra was one
be held. I jumped at the opportunity Skiing is their national sport in the of our favorite winter adventure trips
and invited my son Evan and daughter winter. When the days get longer, and ever. There were no lift lines, and the
Kathleen to join me. the bright sun melts the snow, the lift ticket prices were about half of
Andorrans hike along streams, kayak what they are in Vail, Beaver Creek, As-
in lakes, and climb up into the moun- pen, or Keystone. The altitudes at the
tains. In the summer, competitive peaks of the ski areas in Andorra are
cyclists come to Andorra to train on about 8,000 feet, compared to 12,000
the steep and winding roads. feet at the peaks of the Colorado
Though Andorra is a mountainous resorts. This made exercising in the
country, it is only 100 miles from the Pyrenees much less taxing than we
Mediterranean Sea. Through the ages, were used to in the Rocky Mountains.
the Andorrans have followed a ver- According to the World Health Or-
sion of the traditional Mediterranean ganization, the average Andorran lives
diet they call Catalan cuisine, with its for 85 years—the best life expectancy
emphasis on vegetables, nuts, berries, of any country, with Japan coming in a
and olive oil. Fish from the alpine lakes close second.
remains a staple, but the Catalan diet
We got to know one local citizen,
also includes moderate amounts of
Alex, a 36-year-old chef who owns
lamb, chicken, and goat cheese, with a
and operates a superb little restaurant
Evan and Kathleen in Andorra. glass or two of red wine at the evening
called La Cort in the mountain village
meal.
of Soldeu, where we stayed.
8 Saint Luke’s Cardiovascular Consultants | From the Heart
His relatives have generally lived Andorra is not a wealthy nation,
into their 80s and beyond in good but there is virtually no poverty. The
health, and his grandfather lived to economy is based on banking and Take-home
age 96. When I asked him why he
and his fellow Andorrans enjoy such
tourism. The low tax rates encourage
many Europeans to deposit money in
Longevity
remarkable vitality he said, “It’s very Andorran banks, and there is no tax
quiet and relaxed here, with no traffic, on food or liquor, so some locals use Tips from the
honking horns, or stress.” gin as their windshield washer fluid
because they can buy it for about $2
Andorrans:
per liter.
Alex says sometimes Andorrans’ • Get outdoors to get
slow pace of life can irritate some some exercise, sunshine,
visitors. “Grandpas play card games and a dose of nature.
on outdoor tables at restaurants, and
sometimes we take two hours to do • Relax, slow down, and
something that can be done in half an enjoy the company of oth-
hour.” I will have to admit that we no- ers.
ticed the service was not the speedy
pace we are used to in the U.S. • Eat a Mediterranean
He also said, “It is a very nice place diet. By the way, a little
Enjoying Alex’s cooking and his stories were to raise your children. It’s super safe, fresh, red meat won’t kill
highlights of our Andorra trip. which means people are not con- you.
cerned about their security at any
Indeed, we noticed that the people point. If you feel safe and calm, then • Drink lots of clean wa-
strolling around the cobblestone you enjoy your life better.” We cer- ter.
streets never seemed to be in a hurry. tainly enjoyed life while we stayed in
Alex told me, “We breathe fresh air, Andorra, which seems like a long-ago, • Try to avoid polluted air.
and drink pure water.” The mountain surreal dream looking back now from
air did seem crisp and fresh; and their • Surround yourself with
the depths of the pandemic. But this
crystal-clear water comes from glacial people you trust.
too shall pass, and one day soon we
runoff and alpine lakes. Alex told us will all be able to get back out there,
that as a boy he and his friends rou- exploring our amazing planet once
tinely drank water straight from the again.
lakes and streams.
saintlukeskc.org/slcc | 816-931-1883 9
H E AR T H E ALTHY D I E T
Extra-Virgin Olive Oil: Golden Foundation of
the Mediterranean Diet
By Emilio Ros, MD, PhD
E
xtra-virgin olive veggies) plain, without lunch and dinner. This was how my
oil (EVOO) is the EVOO and a dash of salt? father reached age 99 and my mother
flavorsome, tasty, Maybe you use canola, 89. They were in good health and cog-
and nutritious corn oil, or safflower oil, nitively intact, which is no small feat!
culinary fat of the tra- but to we Mediterranean As we shall see, olive oil should get
ditional Mediterranean citizens, these oils are much of the credit for the beneficial
diet—characterized by almost tasteless and do effects of the Mediterranean diet.
a high consumption of not encourage us to eat
olive oil, nuts, fruits, veg- our greens. If you have
etables, legumes, and traveled in Spain, Italy,
whole grains; moderate or Greece, you will have
consumption of fish, noticed that their restau-
poultry, eggs, and fermented dairy rants always have a bottle of EVOO at
products (yogurt and cheese); but low the table to pour generously on your
consumption of red meat, processed foods.
meats, sweets, and sugar-sweetened You’ve probably heard that the
beverages. Alcohol is allowed in mod- Mediterranean style of eating is one of
eration, mostly as wine consumed the healthiest dietary patterns around. Mediterranean Gold
before or during a meal. The scientific evidence is abundant Olive oil is obtained from the fruit of
The Mediterranean diet/lifestyle and irrefutable. There is consistent the olive tree (Olea europaea), which
involves consuming fresh, local, evidence from many large prospective was first cultivated in the Middle
seasonal, and ecologically friendly studies that increasing adherence to East at the dawn of the agricultural
foods (sustainability), eating a variety Mediterranean-style diets by differ- revolution 10,000 years ago. The olive
of foods (biodiversity), limiting serving ent populations is associated with a tree, its fruit and oil were central in
sizes to modest portions (frugality), reduced risk of overall mortality, in the ancient civilizations and trade of
sharing time and food with family and addition to lower rates of cardiovascu- Assyrians, Phoenicians, Egyptians, and
friends in the kitchen and at the table lar diseases (heart attack and stroke), Greeks. The Romans widely cultivated
(conviviality), being physically active high blood pressure, diabetes, and olive trees in all suitable areas with
each day, and prioritizing daily rest neurodegenerative diseases, such a mild climate along the territories
and relaxation. This is not merely a as Alzheimer’s disease. In summary, of the Roman Empire, particularly in
Mediterranean diet; it is the Mediter- people following the true Mediterra- Hispania (known as Spain in modern
ranean culture! nean diet enjoy healthier and longer times), which still is the top olive oil
Unlike most other healthy diets, lives. producer in the world.
the Mediterranean diet encourages a I live in Barcelona, on the shores The Roman emperor Hadrian, born
high-fat content, mostly due to gener- of the Mediterranean Sea, and have in Spain, adopted a branch of the
ous intake of nuts and olive oil. Impor- followed this diet since I was a kid. olive tree as the symbol to represent
tantly, using EVOO for dressing salads At home we have always insisted on Roman Hispania. Much later, after the
and cooking vegetables improves fresh, seasonal Mediterranean prod- devastating wars of the 20th century,
their palatability, thus facilitating ucts. We eat together around a table a white dove carrying an olive branch
consumption of substantial quantities whenever possible, and eat slowly, was chosen as the worldwide recog-
of greens and other veggies. savoring the meal, and enjoying the nized symbol of peace.
Have you tried to eat cooked green company. There is always olive oil at
beans, peas, and carrots (or any other the table and a glass of red wine for
10 Saint Luke’s Cardiovascular Consultants | From the HeartH E AR T H E ALTHY D I E T
tomate,” one half of a ripe tomato antioxidants, had no health benefits.
rubbed on bread toasted until it is red- Antioxidant molecules such as poly-
dish, then topped with a little salt and phenols in extra-virgin olive oil are
olive oil. This is still a favorite treat for believed to underlie many of the ben-
me and my family even today—great efits of olive oil for the heart, including
for breakfast or a light dinner with a lower rates of cardiovascular diseases,
French omelet! atrial fibrillation, and diabetes.
These salutary effects have been
Besides using olive oil as culinary
Olive Oil: Quality is Key confirmed by scientifically sound
fat and for produce preservation, the
As in the Roman times, EVOO is pro- randomized trials, mainly the land-
ancient inhabitants of the Mediter-
duced using a traditional stone mill for mark Prevención con Dieta Mediter-
ranean utilized it as a basic ingredient
cold-pressing fresh-picked olives. This ránea (PREDIMED) study, conducted in
of medicines, skin lotions, perfumes,
is pure “olive juice,” high in oleic acid— Spain, and for which I was privileged
body massage oil, lubrication of ma-
a healthy fat—in addition to potent to design and enforce the dietary
chinery, maintenance of metal tools,
anti-inflammatory and antioxidant intervention.
and for lighting lamps at dusk.
components from olives that imbue This study recruited nearly 7,500
In the 16th century, the Spanish
EVOO with a somewhat bitter taste. older men and women at high cardio-
conquistadors brought olive sprouts
Indeed, the intensity of that black- vascular risk. One-third of the partici-
to the Americas, where olive trees
pepper-like burn at the back of your pants were assigned to a traditional
thrived in areas with a climate similar
palate is proportional to the amount Mediterranean diet supplemented
to the Mediterranean, including parts
of polyphenols present in the olive with EVOO (to consume at least 4
of Argentina, Chile, and California,
oil. You can also perceive this slight tablespoonfuls per day), another third
where high-quality olive oil is still pro-
pungent sensation at the back of your of participants to a Mediterranean diet
duced today. Last but not least, olive
throat due to polyphenols in other supplemented with nuts (30 g/day of
trees, which can live for hundreds of
healthy natural foods like walnuts, pe- a mixture of walnuts, hazelnuts, and
years, are beautiful with their twisted
cans, pomegranate seeds, and some almonds), and the remaining third, to
trunks, silvery leaves, and green/black
berries. a diet low in fat, meaning little olive oil
tantalizing fruits.
and no nuts.
My personal history with olive oil Ordinary or refined olive oil is
obtained from high-acidity, left-over After five years, both groups of the
goes back to 1945, the year of my
olive oil by extraction methods that Mediterranean diet—those consum-
birth. As a boy, my mother used to
use chemical solvents, bleaches, and ing the EVOO, or those consuming the
send me to the local market to buy
deodorizers. Heavily processing the oil nuts, enjoyed a 30% decrease in the
olive oil, sold only in bulk at that
eliminates color, odor, and flavor, mak- incidence of adverse major cardio-
time. So I went with an empty, 1-liter
ing the olive oil taste more neutral, but vascular events. These results provide
green-colored bottle, and I was always
this also removes all of the health-pro- first-level scientific evidence of the
amazed at the contraption that deliv-
moting antioxidant compounds. cardioprotective properties of EVOO
ered the oil. It was like an ancient gas
within the context of the Mediterra-
pump that drew the oil up from a tank
nean diet.
below the floor to fill a glass container Health Benefits of EVOO
with a golden oil alive with awesome Of note, the 30% reduction in heart
When it comes to olive oil, the attack and stroke achieved with the
bubbling. quality is crucial for bestowing health supplemented Mediterranean diets is
When this container was full, the benefits. Astoundingly, a recent study similar to the best results obtained us-
grocer (a gentle graying middle-aged found that, for every 10 grams (about ing drugs such as statins, but without
lady always dressed in dark colors, 1 tablespoon) per day increase in the side effects; and no prescriptions
with a worn grey apron), put a cork consumption of EVOO, there was a needed!
in the bottle, and then I hurried back 10% reduction in the risk of cardiovas-
home, taking extra care not to fall In spite of the high-calorie content
cular complications like heart attack
or spill the precious oil. My prize for of olive oil and nuts, in the PREDIMED
and stroke. In contrast, consumption
the errand was a delicious “pan con of refined olive oil, low in polyphenol Continued on page 13
saintlukeskc.org/slcc | 816-931-1883 11H E AR T H E ALTHY D I E T
Kathleen’s and Leonard’s Secrets to Longevity
By James H. O’Keefe, MD
D
r. Emilio Ros, MD, PhD, is a lemon tree, persimmon tree, guava
brilliant endocrinologist/re- tree, walnut tree, and an almond tree.”
searcher who lives and prac- When Kathleen was a young
tices in Barcelona, Spain. We woman, a doctor mistakenly diag-
have become friends while working nosed her with diabetes. Subsequent
together on various nutrition-related tests reassured her that she was not
endeavors for the American College of diabetic, but Kathleen took that scare
Cardiology. Emilio graciously accepted as a warning and decided she would
my invitation to write an article for take control of her future health by
From the Heart about olive oil—one of learning everything she could about
the best foods for conferring brain and nutrition. Kathleen never went to col-
heart health, as well as for promoting lege, but she was a smart woman who
longevity. became a self-taught authority on
Emilio grew up in Spain on the Med- the topic of nutrition. While Joan was
iterranean coast eating a diet naturally growing up, she recalls often seeing
rich in nuts and extra-virgin olive oil. Leonard and Kathleen. her mother sitting cross-legged on her
He also designed and carried out the bed surrounded by books and articles,
PREDIMED Trial—widely considered Leonard was born in Hawaii in 1911 earnestly poring over all the informa-
perhaps the most important diet to Portuguese immigrants. He was a tion she could find on diet and health.
study ever done. child of nature—always outside play- Leonard worked on the Fisherman’s
The other diet expert who I consider ing barefoot in the sand (he received Wharf and would often bring home
my most trusted source for navigating his first pair of shoes when he was 10 fresh seafood/fish as the day’s catch
the often-confusing world of nutrition years old). For after-school snacks he was being unloaded from the boats.
is my wife, Joan O’Keefe. Like nearly and his friends would pick fruit and Every day, Kathleen would make a
all physicians, I received no education dive for abalone from the beaches of large salad of greens dressed with
about nutrition in medical school or Waikiki on the Pacific Ocean. generous amounts of extra-virgin olive
during my training to be a cardiolo- When he graduated from high oil and red-wine vinegar. She steamed
gist. school, he moved to the mainland vegetables and served only whole
Joan is a regis- where he worked as a longshore- natural fresh foods, salted to taste.
tered dietitian who man in San Francisco. That’s where They never had desert, but they
taught me most of he met Kathleen. The two of them had happy hour every night before
what I know about settled down and built a suburban dinner, during which they would often
nutrition, which is home in Walnut Creek, where Leonard socialize with neighbors on the back
just one of countless turned their yard into an orchard/gar- patio. They virtually NEVER went out
reasons why marry- den. Leonard’s favorite pastime was to restaurants, and when they finished
ing her was the best Joan, age 7, with gardening, and he supplied their little dinner at about 6:30 p.m., they NEVER
thing that ever hap- Gourmet. family with a year-round bounty of ate anything else. Kathleen and Leon-
pened to me. Like vegetables, fruits, berries, and nuts. ard would go to bed early and fast 13
Emilio, Joan has remarkable instincts When I asked Joan what he planted or 14 hours every night, then awaken
about nutrition that run much deeper and harvested, she closed her eyes early the next morning. They were
than her formal education. She grew and visualized her childhood yard. “We joyful, active, mentally sharp folks with
up as an only child of Leonard and had a huge vegetable garden, mul- very good general health until they
Kathleen, eating what in essence was tiple berry bushes, two cherry trees, died of old age rather suddenly—
a traditional Mediterranean diet. an apple tree, apricot tree, plum tree, Leonard at 94, and Kathleen at 99.
12 Saint Luke’s Cardiovascular Consultants | From the HeartH E AR T H E ALTHY D I E T
Kathleen and Leonard developed a Leonard, they derived most of their
nearly ideal diet/lifestyle and followed food from their gardens, orchards,
this for almost a century. Meanwhile vineyards, and the ocean.
the “U.S. diet experts” were advising Gardening is one of my favorite
Americans to avoid all dietary fat and hobbies too; though we purchase our
instead eat 11 daily servings of bread peasant Mediterranean food at the
and other carbs—a diet almost guar- supermarket. Joan prepares meals
anteed to increase belly fat and raise almost exactly like Kathleen taught
the risk of diabetes. her, and I have stopped even suggest-
Fast forward to Joan. Well, the apple ing we go out for dinner—Joan’s a
didn’t fall far from the tree. Joan’s homebody.
unerring intuition on diet and lifestyle As Emilio will enthusiastically tell
arose organically during the first 19 you, the traditional Mediterranean
years of her life while she lived with diet and lifestyle is a delicious way to
Kathleen and Leonard. Joan in her favorite part of the grocery store.
eat and an enjoyable way to live. Give
Luckily for us, our four children and it a try—pretend you’re a Mediter-
quite similar to the traditional diet fol-
I were indoctrinated into that diet and ranean peasant—transported to 21st
lowed by peasants living on the shores
lifestyle, which not coincidentally is century America.
of the Mediterranean Sea. Much like
Extra-Virgin Olive Oil Continued from page 11
study body weight did not increase in the Mediterranean
groups. The reason may be that olive oil and nuts are satiat-
ing, allowing one to eat less of other foods.
Furthermore, the oils in nuts and EVOO are preferentially
burned for energy rather than stored as body fat. I have
never been overweight, despite pouring lots of olive oil on
my food my whole life. My wife, who is also slim, scolds me
for using too much olive oil, but I know that it’s good for me.
Conclusions
The Mediterranean diet best fulfills the need for nour-
ishment, health, and pleasure. Extra-virgin olive oil is the
foundation of this diet, and is obtained by cold pressing ripe
olives so as to retain their healthful antioxidant polyphe-
nols. By the way, olive oil sales increased by 30% during the
COVID lockdown in Spain, meaning that people were doing
more cooking at home the Mediterranean way!
Olive oil is also healthy for the planet. It comes from the
fruit of a tree that can live hundreds of years and catches
CO2 year-round, so olive oil is highly sustainable and helps
to lower greenhouse gases. Hence, olive oil helps mitigate
climate change and fosters planetary health, besides en-
hancing human existence. Use olive oil and let food be thy
medicine!
saintlukeskc.org/slcc | 816-931-1883 13H E ALI N G H E AR T S
Journey from Broken-Heart
Syndrome to Heart of a Healer
By Jessica Love, MSN, APRN, FNP-C
I
n our lives, there are severe illness, or being subo in school, but never in my worst
experiences that the victim of a violent nightmare did I imagine it would
change us forever. crime. nearly end my life.
An unforeseen event Whether it’s fear or I woke up the morning of March 1,
occurs that completely dread, love or affec- 2016 feeling lightheaded, dizzy, and
shifts our perception of tion, envy or sadness, weak. I checked my pulse and found
our internal and external anger or hate, pride or my heart was racing. I skipped my
worlds. And if we open shame—every emotion usual morning coffee and hurried to
our hearts and listen instantaneously registers a clinical training session for my NP
closely, it’s often an op- its effects on your heart. program. The symptoms spontane-
portunity to learn valu- Perhaps you won’t be ously resolved, but suddenly returned
able life lessons. surprised to learn that later that day.
In March 2016, I woke up on life Takotsubo cases have increased 500% The physician I was working with
support in the cardiovascular intensive during the COVID pandemic, even recommended I be evaluated in the
care unit (CV ICU), with a breathing among people who have not had the emergency department. I did not lis-
tube down my throat and multiple IV SARS-CoV-2 infection. ten, as I thought this was perhaps just
lines pumping medications into my The unrelenting and protracted a simple panic attack (though I’d never
body. I remember a physician asking stress of this virus has raised levels had one before).
me to shake my head “yes or no” in of fear, anxiety, and depression to By the time I made it back to my
response to questions and to squeeze unprecedented levels. apartment on the Plaza, I was experi-
her hands. She seemed relieved when
Four-and-one-half years ago, I was a encing severe chest pressure, short-
I was able to follow these commands.
critical care nurse studying to become ness of breath, and heaviness in my
The physician explained to me that a nurse practitioner (NP). I lived at a legs. I was so weak I could not open
my heart had stopped, and it took 7 hectic pace, with anxiety and stress as a can of soup. I kept thinking, “I’m
minutes of full-on resuscitative efforts my constant companions, but this was healthy, there’s no way that this could
before my heartbeat was restored. nothing out of the ordinary for me. I be anything more than a panic attack.
During this time, I had a seizure, which idled on a level of high anxiety, a con- I can run for miles and I eat cleaner
raised concerns about how long my stant worrier, always pushing myself than anyone I know.”
brain was deprived of oxygen. I was to achieve more. I went to my parents’ house in Lee’s
diagnosed with Takotsubo cardio-
I believe that I had become desen- Summit to check my blood pressure as
myopathy, also called stress-induced
sitized to the “fight or flight” response I was unable to get a manual reading
cardiomyopathy, or broken-heart syn-
because I was constantly living with at home. I was also unable to get a
drome. It is one of the most extreme
chronically high adrenaline levels. reading on their machine, and I no-
examples of a stress-induced illness.
Even so, I am a generally happy person ticed my arms were turning very pale.
Approximately 90% of Takotsubo with a wonderful life, supportive I finally checked myself into the
cases occur in females, typically friends and family, and in good physi- emergency department at Saint Luke’s
post-menopausal women. It’s called cal health. I was 30 years old without East and was found to have a heart
broken-heart syndrome because it any of the classic cardiovascular risk rate of over 180 beats per minute and
is often triggered by severe emo- factors like diabetes, high blood systolic blood pressure in the 70s. I
tional and/or physical stress, such as a pressure, high cholesterol, or being watched the emergency department
natural disaster, death of a loved one, overweight. I had learned about Takot- nurses, respiratory therapists, and phy-
14 Saint Luke’s Cardiovascular Consultants | From the HeartH E ALI N G H E AR T S
sicians working quickly with obvious breathing tube suctioned, asking what
concern. the plan was. With time, the lifesav-
My clinical condition deteriorated ing devices and medications were no
despite multiple IV medications. My longer needed, and I was transferred
blood pressure was dropping, my out of the ICU.
heart racing, and I couldn’t catch my Although my body was recovering
breath. The physicians recommended I from cardiogenic shock, I was still very
be intubated and life-flighted to Saint much in shock mentally. I remember
Luke’s Hospital on the Plaza for further walking in the halls, trying to regain
management. I asked to see my par- my strength and realizing I was, by far,
ents one more time and told them I the youngest person on the cardiac
loved them very much. The physicians floor. After suffering from the sudden
then administered the IV sedation and onset of nearly fatal Takotsubo heart
everything went black… failure, in a matter of days my heart
I woke up several days later in the had regained its normal strength.
CV ICU. I was on a ventilator and I My family never left my side. My The NP program recommended I
remember there being so many IV friends came to visit and would say, take the semester off, but I declined.
lines—some in my neck, arms, and “Jess, we didn’t realize you were that I graduated with a 4.0 GPA, as I had
groin. I was afraid to move. I had stressed, you should’ve called us!” The planned, but there was something
worked as a critical care nurse for problem is, I didn’t feel like I was that different: my awareness of the mind-
many years and I could not believe stressed. I was later discharged and body connection. The realization
I was now on the other side of the spent a week at my parents’ house. To that high levels of stress and anxiety
bedrails. be honest, I was afraid to go back to cannot only affect our mental and
Attempting to gain some control of my apartment for fear of dying alone emotional state, but can also severely
a situation in which I felt frightened in my sleep. After some soul-search- impact our physical health.
and powerless, I wrote on paper while ing, courage, and prayer, I returned Caring for our emotional well-being
intubated, asking about my vital signs, home, and things gradually started to is just as important as caring for our
asking to be turned or to have the get back to normal. physical needs. The interconnected-
ness of the mind and body fascinated
Techniques to Reduce Stress and Achieve Relaxation me. I began practicing yoga regularly,
meditating, and reading countless
Meditation Deep breathing exercises
books about the mind-body connec-
Yoga/Tai Chi Being in nature
tion. It became a priority in my life.
Laughter Daily affirmation or spiritual practice
Enjoying a light-hearted book or movie Pets
I would love to tell you that I no
Guided imagery Practicing sleep hygiene
longer have anxiety or stress, but that
is absolutely not the case. What I do
Music, dancing, and art Spending time with friends and family
have are tools to manage it. Some-
times we can’t control the external
Potential Benefits of Practicing Relaxation Techniques
stressors we are experiencing, but
we can change how we perceive and
Slowing heart rate Lowering blood pressure
respond to them.
Slowing your breathing rate Improving digestion
Maintaining normal blood sugars Reducing activity of stress hormones If you take only one thing from my
Increasing blood flow to major Reducing muscle tension and story, please pay attention to your
muscles chronic pain stress level and take healthy steps to
Improving concentration and mood Improving sleep quality support your mental and emotional
Lowering fatigue Reducing anger and frustration health. In this time of heightened
Boosting confidence to handle problems Improved relationships feelings of distress, with extraordinary
saintlukeskc.org/slcc | 816-931-1883 15You can also read
