Meals and Nutrition

Like many people I did a lot of research on the do's and don'ts after surgery. The 2 main elements of my recovery that I decided to focus on were Mobility (Exercise) and Meals (Nutrition). The first part below is for people who have had open heart surgery and are NOT on blood thinners. The second part is for people who are on Coumadin/Warfarin or other blood thinners. Remember to always consult your doctor before making any major changes in your diet. There is so much information out there it is mind blowing but a friend of mine introduced me to Alicia who not only is a great nutritionist but has become a good friend. Her website is www.nourishmysoul.org. She helped get me on track and below is an e mail she sent me after I asked for her advice. 

http://www.choosemyplate.gov/myplate-graphic-resources

“John, water really is the best thing for you to be drinking, and it sounds like you are doing a great job with that! If it gets boring, these are some tips:

 - Add fruits and/or veggies to a pitcher of water and keep in fridge. It adds extra flavor without adding sugar/calories. Favorites in our house are frozen berries (they release lots of flavor as they melt), slices of citrus fruit (lemons, limes, oranges, grapefruit), and cucumber slices with cantaloupe or mint

- Herbal tea - if you need a little pick me up, stick with green tea (plain, no milk or sugar added)

- Occasional seltzer. Don't have it too often, especially with the tendency of kidney stones. (The carbonation will pull calcium from your bones if consumed often). 

Breakfast suggestions:

I am not a big fan of the cereal breakfasts; they are highly processed with very little nutritional benefits. Oatmeal is a good option if you are making it yourself and not using an instant flavored packet. There are some great recipes for overnight oats that you can put in a jar before going to bed and then they are ready for you in the morning. This is a great site with instructions http://hurrythefoodup.com/how-to-make-overnight-oats-in-a-jar/  Remember that a serving of fruit is 1/2 cup - having 1 cup of blueberries isn't necessarily bad, it is just a lot all at once, which could raise your blood sugar. Combining it with high fiber and protein will help curb that effect. Another great breakfast idea is having egg whites (can include a yolk up to 2x/week as well.) Find a neighbor with chickens that you can purchase the eggs from. Free range chickens (not from a large factory farm) have less cholesterol. (Chickens, just like people, get stressed out when in horrible living conditions and as a result, their eggs are of lesser quality - brittle shells, less nutrients, higher cholesterol.) Bulk up your eggs with vegetables - mix in spinach or kale, onions, garlic, peppers, broccoli, etc... You can never have too many vegetables!  

Lunch suggestions:

This is often the area that could use the greatest improvement. Too busy? If you skip meals, it increases the odds that you will make poor choices later on in the day (for most people it happens later in the evening and that is a really bad habit for your heart health.) Personally, I enjoy cooking and will always make a great breakfast and most nights I make a great dinner. But I certainly do not have the time/energy to do that for lunch as well. I recommend that you cook extra at dinner so you have leftovers for a healthy lunch - it is already made, you just need to warm it up (If it even requires that!) You are correct that canned soups are not a good option - they are loaded with sodium and the canning process has taken most of the nutrients. Making soup is actually very simple. Perhaps you can make some in a crockpot and have a few days’ worth of lunches. This is one of my favorite websites to get easy, healthy recipes from http://www.eatingwell.com/search/apachesolr_search/soups. Take a look around the website for things other than soups as well; most of the recipes are delicious and fairly easy to throw together. Meanwhile, if you are sticking with your crackers and hummus, add in some veggies too - they go great with hummus! And that will cut down on the crackers; crackers tend to also have a lot of sodium. If you are looking for a cheese substitute, blend up some (presoaked) raw cashews with nutritional yeast - it has a great cheese flavor & satisfying creaminess. Here is a formal recipe: http://healthyblenderrecipes.com/recipes/raw_vegan_cashew_cheese. 

Dinner Suggestions:

Keep in mind the MyPlate. Half your dinner should consist of vegetables (Since you are likely not having fruit with your dinner). Try having at least one vegetarian meal per week.
Other Suggestions:

- CoQ10. If you are on Lipitor, you should also be taking CoQ10. I suggest 200mg/day. As we age, our ability to produce CoQ10 diminishes. Statin drugs also block the production. CoQ10 is essential not only to heart health, but every cell. Its primary function is to supply oxygen to cells to prevent premature cell death. 

- Magnesium. It is difficult to recommend a particular brand (typically I leave that up to the individual to decide what is best for them and their wallets). However CALM is the name of the brand. http://www.swansonvitamins.com/natural-vitality-natural-calm-raspberry-lemon-16-oz-pwdr. You can get it at many local health food stores or order it online. I recommend starting with 1/2 tsp once a day and increasing to 1 tsp/day if tolerated well. The fact that you have kidney stones as well as heart disease leads me to believe that there is excess calcium in your system. Most times this is not caused by over consumption of calcium, but rather inadequate balance of minerals in the body. There could be an excess of sodium, or not enough magnesium, or both. Magnesium will help restore that balance (as well as restricting sodium intake), help restore regular bowel movements, relax muscles (including the heart muscle), and provide a better sleep (take at night for best results) Magnesium is also great for headaches - reach for this with a tall glass of water and wait 15 minutes before popping pills for a headache. Keep in mind that when you are determining the right dose for you, it may cause some loose stools. If that happens, decrease the amount next time. 

- Make sure your multivitamin is a high quality version that is third party tested for purity. Again ask at your local health food store

_ Omega 3 can be helpful but I really prefer people get it from their foods if possible. Wild caught fish, ground flax seeds, walnuts and chia seeds are great sources. Try to incorporate some of these at least 2x/day.”

So that was her summary and it was a great help keeping me on track. Remember though to make sure you consult with your doctor before you take any Over The Counter drugs in case they have any adverse reaction to your current medications. 

Another question that many people have is can I drink alcohol after heart surgery. I was told by my cardiologist that I could but again check with your own doctor. I am allowed 2 5 oz. glasses of wine a day or one 12 oz. beer and I don’t cheat on the quantities. Whenever I think of cheating I remember the day after surgery and how sorry I felt for myself. I do NOT want to go through that again so that is my motivation!!

NO LONGER EATING:

Cheese

Beer

Bread

Canned soups

Fried foods

Pork ribs

Steaks with any fat in them (Filet Mignons only and even then only once every 2-3 weeks)

Sour cream

Cottage cheese

Chocolate

Croissants

Starbucks coffee with any milk or cream additives

Sugar

Dry rubs on meats (high Sodium)

Soy Sauce (HUGE amount of Sodium)

Deli meats

EATING A LOT MORE OF:

Home-made soups and hummus for snacks

Low fat and sodium crackers

Ezekiel Bread

Only Organic Strawberries

Fruits and nuts

Vegetables and Salads

Olive oil for cooking

Fish twice a week

All fat cut off meats

A lot of liquids

Low sodium meat rubs (yes there are some out there).

Thought this would be a good summary of good or bad fats. Hopefully having everything in one place will help!

Patients on blood thinners.             

Warfarin is a blood-thinning medication that helps treat and prevent blood clots. There is no specific warfarin diet. However, certain foods and beverages can make warfarin less effective in preventing blood clots. It's important to pay attention to what you eat while taking warfarin.

One nutrient that can lessen warfarin's effectiveness is vitamin K. It's important to be consistent in how much vitamin K you get daily. The adequate intake level of vitamin K for adult men is 120 micrograms (mcg). For adult women, it's 90 mcg. While eating small amounts of foods that are rich in vitamin K shouldn't cause a problem, avoid eating or drinking large amounts of:

• Kale
• Spinach
• Brussels sprouts
• Parsley
• Collard greens
• Mustard greens
• Chard
• Green tea

Certain drinks can increase the effect of warfarin, leading to bleeding problems. Avoid or drink only small amounts of these drinks when taking warfarin:

• Cranberry juice
• Alcohol
• Do NOT drink grapefruit juice.

Talk to your doctor before making any major changes in your diet and before starting any over-the-counter medications, vitamins or herbal supplements. If you are unable to eat for several days or have ongoing stomach upset, diarrhea or fever, consult your doctor.