Transcription:
St Joe’s Cardiology – Mindfulness In Today’s World

Bill Klaproth (Host):  We live in such a fast-paced world, it’s tough sometimes to slow down and enjoy the moments that can make each day truly special. When you are mindful of today, not only does that make life more enjoyable but it also does your heart health a world of good. Paying attention to what makes your heart soar and what brings it down is very important. With us today is Dr. Scott Deron, a board certified cardiologist and a fellow of the American College of Cardiology. He is also the service leader in cardiology at St. Joe’s. Dr. Deron, thank you so much for being on with us today. I’m so excited about this topic. So, if we could just jump right in:  how is heart health and mindfulness connected?

Dr. Scott Deron (Guest):  Excellent question, Bill. Thank you, by the way, for having me. In 2004, the INTERHEART Study was published in The Lancelot. This looked at a large amount of patients scattered across 52 countries and looked at nine modifiable risk factors. Things that are literally under our direct control in terms of our life and found that approaching 90% of all risk of progressive heart disease is linked to the decisions we make on a daily basis. This was a very compelling report indicating that the disease, that is right up there with cancer, that takes our population out well before normal life expectancy, is literally under our direct control. So the question that ran in my mind is, why is it that folks make the decisions that the population makes on a daily basis? And, what is the real root cause analysis of those decisions? That led me to look at my patient population, which was certainly mirroring that of this very large study, and I began to look at some of these issues. It led me to Boston to spend some time at Mind Body Medicine Institute at Harvard and understanding some of these underpinnings of why it is that we make the decisions we make. Some of the physiologic changes that happen with stress are well-categorized. We know that the near-miss car accident being that turning on of our sympathetic nervous system where our mouths go dry and our heart pounds and sometimes aches. That is a very vivid example. But, taking the extreme of the near-miss car accident and looking at it on a daily basis, there is a lot of those almost mini accidents that happen throughout our day and really how we react to them largely determines our physiologic response in terms of adrenalin, the effects of adrenalin on our blood pressure and so forth. It began a new part of my interest in population medicine and how we can really do our due diligence in the medical community in terms of getting the population healthier. This led to looking at some things that had been brought about through University of Massachusetts, some of the work by Jon Kabat-Zinn in mindfulness based stress reduction. He, I would regard as the father of mindfulness in the United States. He started approximately 35 years ago and really has a terrific program. It’s really through his work it ignited an interest and passion in me about all of those things that patients can do in their lives that minimize the effect of the stress that we deal with on a daily basis.

Bill:  So, this discovery of mindfulness and its link to heart health – obviously, it sounds like it’s starting to become accepted in the mainstream medical industry. What can we do to be more mindful, to slow down to take that pressure and stress off of our hearts and our bodies?

Dr. Deron:  That’s an excellent question, Bill.  If you will, for a moment, we live our lives somewhere vacillating between a potentially painful past and fretting about the future. We are pulled backwards by that painful past and we are pulled forward by that concern we have about what’s going to happen. When we do that, we are actually pulled away from the one thing we truly have and that is that present moment. That is the only thing we can really hold in our hand because the future is a question mark. You can’t hold the past in your hand. One of the things that mindfulness-based interventions do is to simply ask us to slow down, to breathe. There are seven tenants to mindfulness-based stress reduction that come to the forefront. One of those things that I ask my patients to do is something simple. It’s to come up with a worry tree. A worry tree is a tree near where they live. They can take the problems they forage throughout their day, take that necklace off, put it on the tree, go into their homes and leave their problems outside. This little parable type exercise is something that can help people realize that they don’t necessarily have to live with their problems. The mind is a wonderful tool, but we need to put it down once in a while. Sometimes this idea of sort of putting your problems over there allows us to simply relax and be. We mutate into becoming human “doings” as opposed to human “beings”. When we simply understand that and do these really simple relaxing type exercises, we can get to a healthier place.

Bill:  So breathe, leave your worries outside on the worry tree. Can you, very quickly, give us a few more steps? Those are really good.    

Dr. Deron:  Sure. There’s four senses that I like people to concentrate on. A sense of perspective; a sense of humor; a sense of wonder about the natural environment and a sense of purpose. I think when we ask ourselves to simply write down some of these things on paper where the one perspective is 100 years from now – you, me, and most everyone we know will be gone. Are the problems I’m really shouldering that important that it should take the fabric of my life in such a way that I need to run to go eat something to calm my stress? Am I going to go to substances or casual relationships that don’t really serve any good long-term purpose to cope with my stress? I think some of the things like understanding that sense of perspective; simply breathing; getting into a quiet place for five minutes. Breathe in, breathe out and tell yourself those words. Simply doing that on a daily basis just for five minutes can have a rather profound effect on our health.

Bill:  So, a sense of humor, a sense of wonder, a sense of perspective – all great advice. Do you see a day where you would prescribe meditation over medication?

Dr. Deron:  I think the best pill is no pill unless there is robust science that the person taking that pill is going to get some benefit from that.  I think when we sense that there is something missing inside, namely our connection with the present moment, we try and fill that void. We try and self-heal ourselves with the easy things and certainly the most easy thing is food. If you think about it, when we are born, we’re absolutely helpless and we are fed four, six, seven times a day. When we are fed we are often kissed, hugged and sung to – loved absolutely unconditionally. That doesn’t happen to us frequently during the day much in this very busy lifestyle, but every time we eat we harken back to that. So, yes, I think meditation over medication associated with physical activity – a simple walking program – our brains produce beta endorphin and that gives us a strong sense of peace and well-being. I prescribe pedometers and literally write out a prescription for 10,000 steps a day. These are very healthy ways that work well with pills when we need them, but ideally before pills. Meditation over medication unless there is robust science for the medicine.

Bill:  You know, this sounds so easy. “Okay. I’m going to have a sense of humor, a sense of wonder, perspective and I’m going to leave my worries on the worry tree.” I think it’s probably more difficult to concentrate and commit to that every day. It sounds easy but I think in reality when we are so busy and so hectic that it is hard to do that. Can you give us any tips to try to give us some thoughts on how we can commit to this and how we can really make this effective in our lives?    

Dr. Deron:  Bill, you are spot on. It is like miniature golf or darts. If you and I went and did those things today, we would be as good as they are, but if we worked at it for 10 or 15 minutes a day for the next month we’re going to be better at those things. It’s like any learned skill. It does take some practice, but it takes commitment. The commitment does need to come from within and, unfortunately, I think our modern medical system has been driven by the prescription or the procedure more often than it should be. It is sometimes easier to recommend those things then it is to actually getting the person to heal from within by doing some of these basic things. It’s a commitment to self. National Public Radio has brought back in the This I Believe, a segment that Edward R. Murrow did some years ago. I think if we all sit down and asked ourselves, “This I believe,” what are those things? I think the ability for us to heal from within complimented by pills and procedures when we need them, is a healthy way to go. But, it takes that quiet conversation with yourself about whether this life is worth it and, obviously, it certainly is. For many, it’s just too busy to simply have that quiet conversation with ourselves but our health absolutely requires it.

Bill:  So, if you want this to work for you, that’s great advice. You’ve got to have that quiet conversation. You’ve got to commit to self and you’ve got to practice it. Dr. Deron, thank you so much. I could talk to you about this for a half hour, but, unfortunately, we don’t have that much time. Thank you so much for your time today, we really appreciate it. For more information visit StJoesHealing.org. That’s StJoesHealing.org. This is St. Joe’s Radio. I’m Bill Klaproth. Thanks for listening.