Wednesday, December 12, 2012

Have been doing some research for an article on Alzheimer's Disease that I am working on... and came across this research from Sweden... The original research for this is published in the BMJ on line and for those interested it can be accessed at the following address:

Basically what is being studied was the impact of a small dose of aspirin on the cardiac function of older women. The low dose aspirin, usually 81mg here in North America had an interesting impact on a completely unexpected aspect of older life... it reduced the potential of contracting Alzheimer's Disease by as much as 55% in this cohort of women.

The subsequent article on the Yahoo Health page was a very good overview of the research, and went on to discuss other aspects of aspirin's impact on people over the past 2,000 years since Hippocrates first wrote about the precursor to aspirin... willow bark! It is an interesting read, and I encourage readers here to look at the articles, and to ensure that we are all accessing this simple treatment.

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Saturday, November 17, 2012

I was looking back through my posts from just after my last open heart surgery and realized that I hadn't really closed the book there...

Once we got home to Niagara-on-the-Lake I started feeling better... Lynnda who has not been a long distance driver in her entire life (unless you call an hour commute to the Oyster Pond from Halifax a long distance) drove the Touareg all the way from Little Rock, Arkansas where I had my surgery, to Niagara in 2.5 days... because I had basically laid back in the car's seat and rested for three days. The soreness wasn't as bad as I had expected from experience, and I healed quickly.

About three months was the limit that I had to go before I really started pushing myself. So, in April when I had some business to attend to in Little Rock with friends from Europe and from the Arkansas Heart Hospital... I decided to take my first bike ride post surgery. I did it with my friends Bruce Murphy and Bart Segers along the Arkansas River. What a great spot to ride, one of the most scenic I have had the pleasure to peddle. It felt great to be back in the saddle, even if the saddle was uncomfortable... strange bike, no padded riding pants, and a couple of guys who decided I was OK to keep up with them!

Well, since that day, I have been back on the bike a lot. I have done over fifteen 100 km or 100 mile days and continue to ride here in Mexico... although here at 5,000 feet, I am still not up to the Century rides... working on it!

So now looking back, my heart is every bit as strong as prior to the surgery. Back then, my aortic valve was starting to shut down again. That was a bovine aortic valve, and it served me very well... 11 years on a prosthesis was pretty good given the many extra heart beats I make it take on the rides. I think that the radiation and chemo along with the surgery did have a detrimental impact, but Edwards Lifesciences can be proud of the service that valve gave me.

It was appropriate I suppose that Dr. CD Williams would use a porcine calve this time... the University of Arkansas uses the Razorback (a hog) as it's mascot... and the Arkansas Heart Hospital is in HogLand. So I got a St. Jude's pig valve. It is the same size as my Edwards valve, but I am over 10 years older... and it really has given me new life. I had some arrhythmia, post surgery, so I have been on a beta blocker that takes care of the beats... but I have tried once to get off of it, and at my one year anniversary, I am going to try again... If I think I can... hard enough, maybe I can... will see.

Lynnda and I will be heading to Viet Nam and Cambodia with friends in February to do some cycling, ending up in Angkor Wat. It will be nine of the more memorable riding days I have ever had... the trip is with Backroads Cycling Tours and I think it will be a life changer for both Lynnda and for me. Being given the extra 12 years (by then) to live and to be able to spend time touring by bike is a great statement about modern medicine. I am truly blessed to be able to do it... I wish more people would. The guys and girls we are riding with in February are new cyclists, and I know it has helped them be healthy...

I ramble again...

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It has now been 34 days since my surgery... not a particularly auspicious day in the count toward when I can get back on the bicycles; lift more than 30 pounds; act like a normal human being... which is 90 days post surgery. However, it is special because I don't feel anymore like I just had surgery. The healing process is progressing nicely. There have been countless uncomfortable moments, lots of painful days where it seems like the nerves in my chest are reconnecting... and they seem to want to let me know they are there.

My front end looks like it has had more than a valve job! It looks like it was in a wreck! I have twin twelve inch scars that overlap in some areas and the "Lazy S" curve in the second one is still a bit of a fiery red in color... they run from my sternum's notch at the top, to the tear drop scar from my feeding tube that I had during the cancer challenge a few years ago. It looks a little like a hang-man's noose. There are a couple of good size scars to either side of the 'tear drop'... from drainage tubes... Lynnda and I joke that they look like the ears on a face with the nose being the tear drop. But the noose kinda ruins the look! 

Of course the long hooked scar on my neck is still visible, but barely. I think the hang-man's noose will disappear to close to the level of my reminder scar on my neck... then of course, there is the large dimple like scar below my 

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Interesting project starting... I have been asked to write an article on Alzheimer's Disease (AD) for the Focus on Mexico web news... it is a hot topic in any area of the world, since over 24 million people have confirmed diagnosis in the world... and many times that are having early symptoms or no symptoms, but already have the beginnings of the disease, up to ten years before symptoms set in...

A couple of weeks ago, when I was first asked to do this, I got into a bit of research on it, and I realized that this disease is an enigma that has so many unsolved questions that it caused me to decide to turn down the project. I don't really think anyone can do it justice.

Unless you try and make it more simple for people to understand... find a common denominator or something like that. Looking at it from a non-emotional point-of-view would be a start. Then subtracting out any clinical instinct my years in the medical device industry have given me, might also be a help... but difficult.

Still I rationalized it out and said no... then I started reading more articles on it, and began to understand that many of the things I had taken fore-granted, were wrong. For example, I didn't know that there was a new very definitive diagnostic test that could give a negative or positive for AD... no if, and, or but... just positive or negative!

I had also heard that there were no real clinical studies happening in the AD arena... wow, was I wrong! There are thousands happening... some are human studies and others are not... but there is a huge amount of work being done all over the world, including in the USA and Canada. The problem is that they are mostly all turning up figments of information... adding and sometimes subtracting from the three or four theories on what the cause of AD is... and what then can be done about it. Certainly some of them have proven that the track clinicians were on over the past ten years... was wrong! Others have sent clinicians down other rabbit holes... but there seems to be a consensus that a combination of several things is contributing to the slippery slope that starts out assymptomatically, then gradually becomes a debilitating and ultimately fatal disease or contributor to the death of the patient.

So, I indicated to Focus yesterday that I would try and do the subject justice... and I will try it out here, first.

Funny, we are getting climatized here in Mexico, and I have been getting into the writing mode so that I can work on my cancer book... and here I am taking on another project... hope it will contribute to my writing. Will ask an long time friend to edit for me... she will get a kick out of it.

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Wednesday, November 14, 2012

This is my first note on the blog from Mexico where we now live... in Ajijic, the state of Jalisco, which is on Lake Chapala, about 40km from Guadalajara. We are at about 5,000 feet above sea level. Our town of about 10,000 people in an area called Lakeside which has about 60,000 people in an area that is about 25km along the lake... of those, 40,000 are Mexican (most full-time although there are a lot of folks from Guadalajara that come up for the weekends) and then there are 20,000 gringos that are split evenly between Canadians and Americans with a smattering of Europeans.

The three main towns making up Lakeside are on the north side of Lake Chapala and include Jocotopec which is at the western end of the lake; Ajijic which is about 12 km to the east; and then Chapala which is about 12km to the east of Ajijic. The area on Lake Chapala has a rich Mexican written history dating into the 15th Century, and the indigenous population goes much further back.

The gringo population began settling here about 40 to 50 years ago, and have build a spectacular infrastructure of homes in Ajijic mainly... this is due in no small way to the climate here which has been rated by National Geographic as the Second Best in the world for human living. The altitude keeps the weather relatively dry most of the year, although the rainy season from June to September can give one a sense of awe when the night time storms come through... mostly rain with spectacular lightening dancing off the many peaks around the lake. It rarely rains in the daytime. Our temperatures here average around 70 degrees, year around... although the average is mis-leading... it ranges, we have found, between night temperatures of 57F to daytime of around 92F at the warmest time... in August.

Lynnda and I moved here because we were enticed by John and Chris Guren to come and look around. This started way back when I was recovering from my rounds of radiation and surgeries for cancer in the mid-2000 time-frame. We finally came here in August, about when we had grown tired of Canada and the USA... and wanted to live elsewhere... the house had sold and we were "homeless". It took a couple of days to look around before the decision was clear... this is the next, and perhaps the last stop on our nomadic trail! Perhaps I should have written "is this the last stop on our nomadic trail". When we sent out this change of address, one of our friends commented that we must be in the "witness protection program", because we seem to move every three or four years... ha, ha... funny!

Other friends and acquaintances indicated that they thought we must have lost our minds... Mexico being a third world country and an extremely dangerous one at that... we were at times hurt by the comments, incredulous at other times... and certainly in denial all of the time. One must look at any part of the world in context... in this case, the context of the USA where the murder rate is around 6 per 100,000 of population  per year. Absent the issue of people wanting to make money selling drugs to Americans and guns to Mexicans, and the thousands of people murdered within the drug "business" culture... Mexico is safer than the USA! This country is the second fastest growing economy in the Western Hemisphere (to Brazil and is expected to bypass Brazil in the next ten years)... and the Stock Market in Mexico was the 2012 leader in the world for growth of equity value, second only to Germany, and far ahead of the USA and Canada. The peso has been very stable for several years (around 13 pesos to both the US and Canadian dollars).

We drove from NOTL to Ajijic with our two animals (Shamus our Golden Doodle and Benny our Abyssinian Cat over a six day trip. We stayed with Hilton Hotels all the way, driving about 600 km per day until we got to Laredo. When we passed through Nuevo Laredo in Mexico, we got onto a toll highway and drove through to Ajijic on highway that would make many of the states and provinces blush... lots of police, gas stations (< $3.00 fuel), and a team of free service vehicles (the green Team) available by cell phone 24 hours a day. We traveled at about 105 km (65 MPH) but we were at that lowered speed because we had a large Thule Pack and two road bikes on the roof rack... we didn't want to lose them. Hilton treated us very well all the way... sometimes we were in a Double Tree Hilton and others in either a full size Hilton or Hilto Suites hotel. The animals were welcome and while we did pay to stay with them, it was so comfortable, we could never doubt that it is worth it, and we will continue to use Hilton when on the road... here in Mexico, as well.

Our hotel when we got here was called Ajijic Suites. Elaine and Luis greeted us at about 1AM and made us welcome. We had a huge suite with separate bedroom, kitchen and so on, in the center of Ajijic. When we were out, they watched over the pets, and Shamus was allowed to spend all of his time off lead in the lobby... the other guests loved having him there. We slept in the first morning, took a deep breath and thought back to all those warnings about driving with pets, driving in Mexico, living in Mexico and so on...  when I said we were "at times hurt by the comments" it was more because the people making them were making two small errors... first, in 64 years Lynnda and I have made good decisions about  what we have done with our lives, and especially with each other. We consider things thoroughly, and while we are nomadic by nature, our travels have been conservative and safe. We just don't like doing the same thing over and over for all our years, and we would not do things that would endanger the other person in our team. Also, most of the people making the comments... and there were many... had only read the US press about Mexico, and if they had been here, they had been in resort towns on the coasts... most had never ventured into the interior of the country, where lies Ajijic. Most had never read about the history of Mexico, and had never visited Guadalajara or Mexico City. I on the other hand had been in both many times, and have been doing business in Mexico for around 25 years. I have had, for years, a deep appreciation for the problems of Mexico... but more for the great opportunities here.

The main problems, beyond the drug issue are based around the class stratification of the people. Like many cultures that were inundated by colonialists, the indigenous Indians were trampled or left in hovels to live on their own. Many stayed on their own, and have retained their culture and if our friends could come and visit those who do not live in the cities, they would be amazed by their culture, especially their music, art and food. Clearly there are problems where the indigenous and the mixed race who evolved from the colonialist's ruinous attitudes toward their progenies (and perhaps the Roman Catholic's attitudes) meet the remnants of the colonialists who retained their wealth, skin color, language and so on... very similar to the situation in Canada and the USA between the European settlers and the Indians... the indigenous Indians and the Metis are still being trampled on and while those that have been able to maintain their roots have the amazing food, art and music, the general condition of the majority of these people is worse or at least as bad as here in Mexico. We will work to help them, as a part of Lynnda and my life here.

Well, I am rambling on, aren't I...

Anyway, we have now survived the decision to move to Mexico... we did the sale of our home in Niagara; sold or gave away much of our furnishings, but not our art, our keep-sakes, and personal 'stuff'; re-organized our finances; dealt with our foundation's needs for this year; said our 'so longs' we will miss you's; shipped what was left and drove to Ajijic where we bought a beautiful two bedroom/den model home in a new yacht club; got our bank accounts set up; got all of our immigration papers in order so that we are permanent residents; got the car imported and the personal shipped stuff moved-in; learned about the markets, the money and so on; started Spanish classes; bought a second home (closes later this month) up in the hills where the views are 300 degrees of "spectacular" and where we will live from July onward, making our first home a rental property in the club; joined the Cruz Roja and am going on the Board of Directors as VP; I have started cycling again... have ridden over 500 miles already; attended a board meeting in Toronto; and done hundreds of things here... including staking my claim to a seat at Brendon's Sports Bar in Ajijic where we watch NFL games with dozens of other like minded guys while drinking Coors or XX or Ticante or one of hundreds of Tequila Anejo brands... makes those touchdowns mean something!

Lots more to say about Mexico... Hasta luego!

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Tuesday, January 17, 2012

Well, it has been exactly one week since my surgery to replace my aortic valve. This is the second time I have had this open heart procedure... I am told I wore out the old valve with several of the activities that required long periods of high intensity heart effort. I am not all that inclined to agree... but it is easier than arguing from my weakened position.

So, here I am, seven days out and (typed while knocking on the wooden table) I feel wonderful. I haven't felt this good in many months. All of my body functions are in order with the exception of my hemoglobin... so I don't have the stamina back yet... but that is a matter of weeks (days if I choose to start eating lots of calves liver). I left the hospital on Sunday and have been walking a lot... stair climbing is already normal. So I can safely say that this recovery is much better than the last... perhaps I was already much sicker in 2001 and it took about a month to get where I am today.

My first replacement valve was made from a bull's heart tissue. I understand now that bovine tissue can be prone to calcification... and my hope for an 18 year valve was cut short by seven years. Of course, it isn't anticipated that an aortic valve prosthesis  is going to be worked as heard as I tend to make mine work. I do stand on my commitment that if one is in good health and shape when ultimately s/he gets sick, it is likely that recovery will go well. I will reduce my intensity and length of my cycling... but certainly will not stop.

My new valve is in fact a pig's aortic valve. It has been specially treated so that it will not be rejected by my immune system but it is roughly the same as a human valve. I can't feel it, but I do feel the difference the larger valve opening is making, especially to my mind. As the old valve was gradually shutting down, I wasn't getting the same profusion as I should have... it happened relatively slowly, so I wasn't noticing it... the surgery was abrupt, and I can clearly feel the improvement. Once my hemoglobin gets back to normal, I think my muscles will react the same way... I am looking forward to getting back into shape and rebuilding the strength/stamina to my best days.

I chose to come to Little Rock and the Arkansas Heart Hospital because I know the people who own the hospital, the physicians, nurses and others who make it work. They only work on the cardio-vascular system, and they do it incredibly well. I know that I could get the work done elsewhere, but I wanted to achieve the best heart function possible for the next 15 year window of Lynnda and my life. We have achieved that by coming here.

It is ironic that I have a pig valve now... and that I got it here in Arkansas. The University of Arkansas uses the Razorback Boar as its mascot... and the refrain "Go HOGS' is likely the most utilized in the state. They are a very successful university and the UAMS Hospital are awesome... I came here for my PET scan five years ago as well.

I believe could not have had the same work done in Canada. It is a failure of the system at home that there is no opportunity to be following the devolution of one's aortic valve, or any other vessel or organ, if you are asymptomatic. I was particularly concerned about my valve situation because there are essentially no perceptible symptoms... until sudden death... when the valve shuts down. I came to Little Rock each year to have an echo cardiogram done of the valve, because it is such a critical heart function.

For the first five years, there was no change in the valve's gradient... a key measurement. The heart was working well, and the blood velocity was normal. Four years ago we saw the first changes... about a 50% increase in the gradient, but no where near critical. It continued to increase and last summer it reached concerning levels, but still not critical. Some times as I was riding the bike I started wondering if this was my last ride, but I handled that by screaming down the other side of the hills... and all was well.

In December though, things had changed... and we scheduled the surgery. We were good to do it, since two of the three leaflets of the valve had fused and while the gradient was still less than critical... we got lucky because the valve was worse than anticipated. In this case, I am happy that it has turned out this way.

Here at the Heart Hospital I am one of 110 patients who occupied a bed each day. The numbers of patients that go through the cath labs and surgical suites is astounding. The hospital has heart failure, peripheral vascular, wound healing and diabetes clinics... all associated with integrated medicine... for a population roughly like that of Niagara and Hamilton. There are three other huge hospitals, all of which also have heart programs... but the AHH thrives through focus, excellence, research and having the best equipment and people available in the industry.

I am reminded of the Shouldice Clinic in Toronto. The excellence there is respected around the world... as is the excellence at the Arkansas Heart Hospital.

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Grad. Saint Mary's University, 1975, got into the medical device business initially in sales, then various management positions up to president, all in Medical Devices. I prefer therapy products over diagnostic, but they are all fun, and in a way have defined my life. I have now evolved, with help from my 35 year partner Lynnda with whom I now share every hour. I am into staying healthy, photography, kayaking, bicycling, gardening and two books a week. I wish I had gotten to this stage earlier!