Monday, September 2, 2013

The Five Elements of Heart Health

Talk given at Westminister Manor, Bradenton, FL on August 30, 2013

A patient of mine who had a heart bypass surgery about a year ago, came in last week for a follow up visit. Following her bypass she made an excellent recovery. When asked how she felt, she replied, “physically I feel great, but there is something that is different since my heart surgery”. When asked if she could describe in one word how she felt before her bypass and now a year since her bypass, she replied “ before the operation I felt invincible, now I feel vulnerable”. Although her physical body had healed fully, her psychological body was not healed.

Health and well being is a common goal for one and all. In all our thoughts and actions, we knowingly or unknowingly promote or destroy our health. When the body is healthy, we tend to forget about it and assume that it will stay that way forever. When the body is diseased, it makes a loud announcement in our minds, more severe the illness, the greater is the degree of worry in the mind. This is part of human nature that no one can avoid. Illnesses run the gamut from brief, self limiting colds to serious life threatening problems. It is virtually impossible to live a disease free life. However, by following certain simple principles of healthy living, it is certainly possible to avoid some serious illnesses.

The human heart is a very sturdy organ. The heart has a tremendous workload imposed on it since birth. Despite doing all this work, it never fails us. One may stop eating and drinking for days and still manage to survive, but the heart cannot stop even for a second. For example, when a bone breaks, the limb is rested in a cast while the bone heals. But a diseased heart has to keep working while trying to regain its normal healthy state.

External factors that promote diseases in the body enter like trojan horses. They come in various guises, one such example is what we would call “tasty food”. Once disease causing elements breach the citadel of the body, it is hard to escape the consequences. We have the gift of natural defense mechanisms within the body, without which we would succumb to even a simple cold. Some of these defense mechanisms, like the immune system have been around for millions of years. But we are not immune to the ravages of some of the modern lifestyle related illnesses such as coronary artery disease. Once coronary artery disease sets in, there is no cure to completely eradicate it. The miracles of modern medicine help prolong life by keeping this disease dormant.  

The only real cure for coronary artery disease is to prevent it from taking root in the body in the first place. Unlike vaccine preventable diseases, there is no magic potion that we can take as a precautionary measure. Convincing the mind of the dangers of some of risk factors for coronary artery disease complements taking medicines for some of these risk factors such as diabetes and hypertension. Lifestyle changes begin with the mind. The mind is nothing but a collection of habits, just as a forest is a collection of trees. If you cut one tree, chances are that the tree would have already dispersed seeds that would have sprouted into similar trees elsewhere. Similarly, getting rid of a few thoughts related to bad habits, such as unhealthy eating, does not eliminate the habit. Conversely, a fleeting thought can be fostered to grow into a healthy habit just as a seed grows into a tree.

Traditional risk factors for coronary artery disease include diabetes, hypertension, high cholesterol levels, a family history of cardiovascular diseases and tobacco use. These five disease promoting risk factors can be evaluated and treated in isolation or as a group. This grouping of risk factors for coronary artery disease is also referred to as the metabolic syndrome. These risk factors are interlinked.

The five elements in nature, namely, earth, water, fire, air and space support live as we know it. These are distinctly different, yet they are interrelated. In our everyday life, we work with these five elements. When we are overburdened with stress and worry, we look forward to taking a vacation. Most people find natural surroundings such as mountains, forests and beaches to be places of relaxation. At these places, we find the same five elements that we encounter in our stressful daily lives. What is the difference? Perhaps, in places we consider to be a paradise, the elements are more in harmony with one another.

The human body is also comprised of these five elements. If you take the body as a whole or each individual organ, you see the expression of these elements. For example, the bony skeleton that supports the body represents the earth element. Circulating blood is the water element. A healthy human body maintains a certain temperature which is usually above the ambient temperature. Cellular respiration produces a “fire” that maintains this body temperature. This is the fire element. Every cell in the body is constantly being supplied by oxygen and the air filled lungs are the reservoir from which the body draws this oxygen from. This is the air element. Finally, the mind provides the space element. The physical universe and the invisible mind are comprised of space with no finite boundary. In our daily lives, we are sandwiched between this vast inner and outer space.

The five common risk factors for coronary artery disease enter the body through these elements. For example, excess of solid foods such as meat may increase cholesterol levels, intake of sugary liquids may promote diabetes. We mix clean pure air with pollutants present in cigarettes and these dangerous chemicals are afforded an easy entry through the air we breathe. A fiery temperament leads to loss of mental tranquility and this may raise blood pressure. Genetic factors, through DNA, make the jump “through space” from one generation to another.

One would prefer to go on a relaxing vacation to a spot where the land is scenic, the water clear, the air clean, the temperature just right and the surroundings quiet. When one goes to a place like this, both the body and the mind are relaxed. A healthy disease free body is similar to a place like this. Imagine a state of health where the body is neither too heavy or light, a robust circulation that keeps every cell of the body healthy, the lungs that  fully expand with each breath taking in maximum amounts of oxygen, a digestive fire that turns healthy food into high quality nutrition with very little waste and toxin production and a mind that is always calm and peaceful. This sounds likes an ideal existence, doesn’t it?

In the words of Jacques Cousteau, the famous marine researcher, “Water and air, the two essential things on which life depends, have become global garbage cans.” Similarly, we turn the human body into walking garbage cans by eating foods that are harmful to us. Just as water is important to life on earth, blood is important to life in the body. Almost everything that is absorbed by the body is transported in the blood stream. Every cell in the body is supplied by a blood vessel and has a “waterfront view” of blood flowing through the body. Every cell, therefore is potentially exposed to toxins circulating in the blood stream.

Treating heart disease involves not only keeping the pump (heart muscle) functioning properly, but also keeping the blood stream free of impurities that may clog up the system. The various medicines used to treat ailments of the heart are transported in the bloodstream along with nutrients that supply the heart muscle. As these medications circulate, some of them clean up the blood stream by removing fat, sugar and cholesterol, other prevent blood from getting sticky and forming clots, some of them widen the blood vessel to decrease the impact of a blockage etc. Once medicines get into the cells of the heart. they can also effect changes via mediators such as chemical messengers. Removing the source of harm, is one aspect of treatment.

The other aspect is restoring vitality to the body. The balance between these two factors, that is removing the source of harm and restoring vitality ultimately determines whether we are healthy or sick. All medicines have potential side effects. Therefore by that argument, one cannot say that medicines can both cure the disease and restore vitality. There is a saying, “the cure is worse than the illness”. When a patient suffers a heart attack, along with immediate interventions with medications and procedures such as placing a heart stent, the body is completely rested in an intensive care setting. The mind is also given rest by virtue of limited contact with the outside world in an intensive care unit setting. The quicker the disease process is arrested and reversed, lesser is the damage to the body. Once physical healing occurs by restoring normal organ physiology, psychological healing needs to occur. Medicines provide physical healing, but does not change our mind and psychology related to thoughts about the illness. Once the body is out of danger, we tend forget what happened. The same lifestyle patterns that caused the problems in the first place, if repeated may lead to a recurrence of disease in the body.

The state of the body depends on the state of the mind. The is no greater example of this than the heart. For example, when the mind gets disturbed with anger, the effects are immediately felt in the heart. The mind is linked to the brain, the brain in turn is linked to the heart through the nervous system. The two parts of the nervous system, namely the sympathetic and parasympathetic arms have contrasting effects on the heart. Mental stress activates the sympathetic nervous system and a relaxed mind activates the parasympathetic nervous system. In the long run, repeated activations of the sympathetic nervous system is injurious and the opposite is true of the parasympathetic nervous system.

Just as the five elements are at play in the heart, the five elements are also represented in the mind. A holistic approach to cure involves keeping these five elements in sync and harmony both in the heart of the mind. Similar to blood flowing to and from cells, thoughts flow to and from the mind. Unlike the body, where life giving oxygen flows in one direction towards cells, the mind tends to scatter positive thoughts in different directions. In this process, the mind gets weakened by interacting with polarizing negative thoughts. Imagine if dissolved oxygen and carbon dioxide in the blood stream behaved this way.

Even if everything in our lives is chaotic, whether it be our health, finances, family etc. one process is always orderly in every human being, that is the entry of oxygen into the lungs and the exit of carbon dioxide from the lungs with every breath. This provides a free and immediate real time frame of reference to remind ourselves to apply the same principle to the mind. The body automatically breathes for us. Proper “mental breathing” involves directing positive thoughts towards us and negative thoughts away from us. We follow directions everyday, such as on the roads and highways, but get lost when we enter the mind.

The heart and the mind can be linked via the concept of the five elements. Observing the functioning of the heart can give us practical clues on how to relax the mind. A relaxed mind in turn helps the heart rest. The heart muscle can be considered to be the soil on which the tree of life grows. Every molecule of oxygen that enters the bodily cells, goes through the heart. The heart does not run after oxygen, it only accepts what is delivered to it. The heart does not get attached to this oxygen molecule, it freely gives it up with every heartbeat. The mind is the soil on which the plant of happiness grows. There are so many sources of happiness in the world. Instead of focussing on happiness, we get attached to the objects that provide this happiness. When the mind runs after external objects, it then becomes filled with thoughts of the objective world and not its essence, which is happiness. The negative expression of the earth element in the mind is attachment and greed and a positive expression is detachment and contentment.

There is continuous flow of blood throughout the body. Stagnation of blood may have adverse consequences. In some muscles such as that of the legs, it can lead to accumulation of lactic acid resulting in muscle fatigue. In other areas such as the brain or the heart, it may lead to more serious consequences such as strokes and heart attacks. The heart takes this very seriously and keeps blood flowing throughout our lives. The mind on the other hand, does not always flow with life. Instead of one continuous stream of thought flowing in a beneficial direction, our minds are sometimes filled with stagnant pools full of negative thoughts. Escaping from one pool, we land in another as we try and reach the river of happiness. The negative expression of the water element in the mind is stagnant thinking and fixed ideas and a positive expression is flowing with life.

In the award winning novel, The English Patient, Michael Ondaatje writes, “the heart is the organ of fire...” The fire of emotion resides in the heart. The mind fuels this fire. The negative expression of the fire element in the mind is anger and a positive expression is love and compassion. If one gets too close to fire, one gets burned. If you are far away, you don’t feel its warmth. The heart and the mind are linked in this way. If the objective mind and the emotional heart get too close, it could lead to adverse consequences. If on the other hand, if there are pulled far apart, we start losing compassionate feeling towards others.

The air element is ever present in the heart. After all, the main function of the heart is to transport oxygen. Think of oxygen representing the present and carbon dioxide representing the past. The heart is this way is focused on maintaining the present and getting rid of the past. We do the opposite in the mind. We hold onto the past and don’t enjoy the present. No one can hold onto the present. The moment you think you have done it, it becomes the past at that instant. The negative aspect of the air element in the mind is clinging to the past and a positive aspect is enjoying the present.

Despite being a small organ relative to the size of the human body, the heart plays a vital role in maintaining life. The mind may be invisible, yet it occupies a larger than life presence. It tends to make us believe that we are more important than we really are. In addition to the physical burden borne by the heart, it also deals with an emotional burden imposed by the mind. This makes the work of the heart more difficult. The negative aspect of the space element in the mind leads us to falsely believe that we play a permanent and indispensable role while in reality we are only an indistinct speck in the grand scheme of the universe. A positive aspect of the space element in our mind is understanding our transitory nature thereby using our limited time wisely.

Although heart disease is no joking matter, laughter is the best medicine. Laughter is associated with happiness and we put into practice the positive aspects of the five elements in the mind; non-attachment to negative thoughts, we flow with life, have no anger, stay in the moment and share our inner space with others.

As for my patient, she is in the process of setting up a local chapter of a support group that helps people who have been through heart surgery. She is hopeful about accelerating healing of her psychological body and is excited about helping others that have been through similar circumstances.