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‘A Heart Book’

Cardiovascular disease is serious, but don’t let fear immobilize you

So you’ve had a first heart attack ... What do you do with the rest of your life?

Are you on a downward slide to more heart attacks, more medications, less activity? Is heart disease really a “disease?” Can you exercise with problems like heart failure? Are you too old to exercise?

Jennifer Hakkarainen has heard plenty of questions like these in her 20 years as a certified physician assistant, working with Baystate Medical Center since 1998. Also, as a first assistant in brain and spinal cord surgeries, Hakkarainen has seen narrowed and blocked carotid arteries — the arteries that carry blood and oxygen to the brain — along with hemorrhages from stroke.

Now she’s written a book, based both on the questions most commonly asked and on detailed information about the many facets of cardiovascular disease. It’s a simple, 200-page book, called “A Heart Book” and it’s just been published by Levellers Press in Amherst ($17.95).

The book has been four years in the making and Hakkarainen hopes it will be used in doctor’s offices and medical centers to help patients better understand their own medical conditions and what they can do themselves to improve their health.

“I thought about going the academic route,” said Hakkarainen. “Nobody ever mixes the (patients’) questions with the science, but I made this into an ‘everything’ book.’ I want people to know they have the power within themselves to change certain things in their lives.”

Hakkarainen says cardiovascular disease is the leading cause of death and it affects not only the heart but also the arteries that carry blood and oxygen to every major organ system in the body.

“Cardiovascular disease affects the whole body,” she said. “Heart disease may hit people in their 40s and 50s. What I’m hoping to do with this book is show you need to start earlier than when you have the problem. This is a life-long process,” she said of making healthier changes in your life. “It’s not something you should start when you’re 70.”

After writing a first draft, Hakkarainen had it reviewed by medical specialists and colleagues. “Then I went back to the drawing board and rewrote it,” she said.

The first half of the book directly takes on the questions Hakkarainen has heard from patients recovering from cardiac surgery, from a “Healthy Hearts Lipid Clinic” that Hakkarainen started in 1998 and ran at Baystate for people with cholesterol problems. She currently works with Baystate Health Systems in Springfield, assisting patients and out patients in physiatry, traumatic brain injury, spinal cord injury and musculoskeletal sports medicine.

The second half of the book, “The Science of the Heart,” details the heart structure, talks about how the heart beats and defines the disorders of the heart beat, the types of heart blockages and the types of angina, hypertension and other conditions. It also explains how cardiac surgeries are done and why they are necessary.

Hakkarainen said she wrote the book to help patients who are overwhelmed when they first learn they have heart disease. “I feel like patients are getting very, very complicated messages and they don’t have the resources to clarify them,” she said. “Then they go onto the Internet and search out information that’s not scientifically based. And then fear sets in and they shut down and they do what they want.”

“I learned from experience that people have a myriad of questions: What do I eat? What’s heart failure? What’s atrial fibrillation. It becomes obsessing. I thought maybe I should write a book, so they feel empowered to take care.”

“It doesn’t have to be scary,” Hakkarainen says of heart disease. “It can be about learning what’s troubling. We’re managing heart disease but not fixing the underlying problem,” she said. “Some people think arterial narrowing can be reversed with the right diet and exercise. People think it’s very complicated, but it’s not. There’s always something you can do.”

“Mostly, they’re so overwhelmed they don’t know where to start,” she said. “So, you break it down into small tasks and chip away at it. Find out their most burning questions: What is the most important thing to the patient?”

“As medical providers, we think we’re going to start the conversation about what we think is the most important. But it needs to be about what the patient thinks is most important,” Hakkarainen said.

“It (the patient) has multiple problems, you try to get to the bottom of it, to provide some level of clarity and a useful and usable plan that’s within their means.”

What to eat?

Smoking is the number one risk factor for heart disease because it constricts blood vessels and makes them inelastic over time. Smoking tops Hakkarainen’s list of risk factors for heart disease.

But eating more vegetables can reverse some narrowing of arteries and blood vessels over time, she says. Hakkarainen said chewing leafy vegetables releases nitric oxide, a substance that reduces inflammation and improves the cardiovascular system, by causing blood vessels to dilate. Hakkarainen says vegetables don’t get enough respect in our culture.

“Only one in every four adults eats vegetables regularly,” she said. “And only one in every five kids eats vegetables regularly. (Eating) fruits and vegetables is the most simple thing you can do” to improve heart health.

Hakkarainen said combining vegetables creates a biochemical synergy “that allows our cells to become stronger and healthier. These are the things we can do for ourselves that are so simple,” she said. She recommends keeping cleaned, sliced salad vegetables together in a salad spinner in the fridge, so that a salad is within easy reach at all times.

A vegetarian, Hakkarainen recommends that those who eat meat “treat it as a condiment” to a plant-based diet. She recommends higher amounts of plant-based protein and lower amounts of meat and dairy products. She also advises people to reduce the amount of oil, such as olive oil, they use and to stay clear of highly processed foods containing chemicals and high-fructose corn syrup. She also recommends that people stop eating fast foods.

When it comes to exercise, Hakkarainen says that long-term exercise tends to strengthen the heart muscle and reduces the occurrence of heart-beat irregularities. She says that lack of exercise can decrease the heart’s pumping efficiency and may increase blood pressure. It can also decrease bone mass and reduce flexibility and muscle strength over time. For weight lifting, she recommends starting out with hand weights that a patient can easily lift for eight to 12 repetitions. She also recommends that it be done under supervision. She also recommends that those at low fitness levels, or those with cardiovascular disease monitor their heart rates while exercising.

“A Heart Book” publisher Levellers Press was formed by the workers of Collective Copies in Amherst in 2009, and produces works by many western Massachusetts authors. Since then, Levellers has printed books by roughly 50 authors who are Pioneer Valley residents. Other books published through Levellers Press include “Slavery in the Connecticut Valley of Massachusetts” by Robert H. Romer; “Valley Vegetables: Recipes for Forty of the Pioneer Valley’s Vegetables” by Claire Hopley of Leverett, and “Positively Center Street: My Twenty-Five Years at the Iron Horse Music Hall” by Jordi Herold with David Sokol.

“A Heart Book” is available at Off The Common Book Shop at 71 South Pleasant St. Amherst, and at Collective Copies, 93 Main St. in Florence. It can also be ordered online at levellerspress.com

Bulk pricing is also available through the publisher for schools, book stores and medical institutions.

Staff reporter Diane Broncaccio has worked at The Recorder since 1988. Her beat includes west county. She can be reached at: dbronc@recorder.com or: 413-772-0261, ext. 277.

Staff photographer Paul Franz has worked for The Recorder since 1988. He can be reached at pfranz@recorder.com or 413-772-0261, ext. 266. His website is www.franzphoto.com.

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