Fracking: At our peril

Hydraulic fracturing, which involves injecting millions of gallons of chemical-laden water at high pressure into a well drilled both vertically and horizontally into a rock formation deep within the earth to extract natural gas, is rapidly spreading. There are approximately 500,000 natural gas wells in 34 states, and the industry projects that 19,000 new wells will be drilled this year. Fracking is one of the significant recent technologies through which this nation hopes to attain energy independence.

There are real problems, however. Fumes from drilling rigs and wastewater pits in Colorado and Pennsylvania have caused a variety of alarming symptoms in residents, forcing them from their homes. Spilled drilling fluid containing antifreeze has killed pets and livestock. After fracking has occurred, drinking-water wells have been tainted with barium, arsenic and other toxins. Leakages from large pits, resulting in dangerous chemicals becoming airborne, have poisoned homeowners. Soil at a wastewater impoundment that blew up and burned in Avella, Pennsylvania was found to have dangerously high levels of arsenic and tetrachloroethene, a carcinogen and central-nervous-system suppressor.

Because its end product is a relatively clean fossil fuel, fracking has been touted by industry and government as helping the U.S. achieve energy independence while combating climate change. However, the process itself is so energy-consumptive that some scientists believe it produces more greenhouse gases than the burning of coal.

New York State is one of two states — the other is New Jersey — that has imposed a temporary ban on fracking. The New York State Department of Environmental Conservation (DEC) is in the processing of completing its review of a supplemental environmental impact statement. When it is approved, governor Andrew Cuomo is expected to lift the moratorium.

The DEC must first address the more than 66,000 comments submitted last year in response to the second version of its environmental impact statement and proposed regulations, which DEC commissioner Joe Martens characterized as “a very long and tedious process” at an Albany conference two weeks ago. He said he hoped to complete the process by summer.

An industry publication reported that Martens recently met with Norwegian company Norsk Energy, which has leased 180,000 acres in New York and is particularly keen on Utica Shale, a rock formation underlying the Marcellus that extends into Ulster County. The company, which began applying for drilling permits last summer, was “encouraged by the meeting.” It noted that the commissioner had appeared to backtrack from previous comments that New York would wait until the EPA completes its study of hydraulic fracturing before moving ahead.

Numerous health professionals and environmental groups who found the environmental impact statement’s assessment of fracking’s health risks lacking had requested an independent study. But the New York State Assembly’s proposal for a $100,000 study of fracking’s adverse health impacts was dropped during last month’s budget negotiations.

Fracking injects hundreds of toxic chemicals into the ground, disposes of thousands or millions of gallons of chemical-laden wastewater per well (which may be further contaminated by radionuclides, or radioactive particles, and other harmful substances from deep within the earth), disposes of the even more toxic “brine” fluid that comes up with the gas once the well is in production, and burns up large quantities of diesel fuel.

Fracking was exempted from the oversight of federal environmental laws, such as the Clean Water Act and Safe Drinking Water Act, as a result of the so-called “Halliburton loophole” in the Energy Policy Act of 2005. Government support for the unfounded assertion that hydrofracking was safe has had the effect of shifting the burden of proof of a health impact onto the citizen.

Though the companies, citing proprietary privilege, didn’t reveal the types of chemicals they use, a couple of states now require more disclosure. The industry is failing to comply fully. In Wyoming, for example, Halliburton and other companies have gotten 50 “secrecy” exemptions from the regulatory agency.

Opponents of fracking have charged that the states and local governments have lacked the political will and don’t have the resources to protect public health. Because the companies haven’t revealed the chemicals they use, it’s difficult for citizens, health professionals and municipalities to assess the health risks from drilling.

Residents at risk

In 2004, the EPA released a study claiming that hydrofracking was safe. According to ProPublica, however, information buried in the study did note problems. The EPA identified some of the chemicals as biocides and lubricants that “can cause kidney, liver, heart, blood, and brain damage through prolonged or repeated exposure” and “found that as much as a third of injected fluids, benzene in particular, remains in the ground after drilling and is likely to be transported by groundwater,” reported ProPublica.

According to another ProPublica article, in 2010 the University of Colorado-Denver School of Public Health did a study in Garfield County that concluded benzene and ozone-forming emissions from drilling was carcinogenic, putting residents at risk for respiratory and neurological ailments as well as for birth defects. The analysis found volatile organic chemicals five times above the federal Environmental Protection Agency’s Hazard Index level of acceptable amounts. The school recommended long-term monitoring for a cluster of wells to be drilled in a new area. Instead, the Garfield County board of commissioners ended the researchers’ contract.

Other efforts to track cases and assess the health impacts from fracking have been thwarted. For example, Pennsylvania had planned to budget $2 million this year to create a statewide registry to track respiratory problems, skin ailments, and other illnesses related to gas drilling — data that’s desperately needed to assess and measure the dangers and protect citizens. The funds were withdrawn. Legislators also recently passed a law requiring doctors to sign a confidentiality agreement in return for access to information on chemicals used in fracking that had affected their patients, which prevents valuable information that could protect the public from being disseminated.

However, with thousands of cases of contamination of drinking wells from fracking fluids reported in the past four years, along with alarming increases in air pollution in heavily fracked areas, government can ignore the threat only at its peril. The EPA is currently conducting a review of the health impacts from fracking. The agency has just issued its first rule, a requirement that drilling companies capture the methane gas, a potent greenhouse gas, that’s released when a well is first drilled, and transfer it to pipes for use as fuel. The companies, however, don’t have to comply until 2015. Legislation introduced in Congress to restore EPA oversight and override the 2005 law has failed to pass.


The EPA has confirmed that hydrofracking was the cause of the contamination of drinking-water wells with arsenic and other toxic chemicals in Pennsylvania and Wyoming. Even the Pennsylvania Department of Protection, a sorry excuse for environmental regulation, had to admit after a university study of toxic metals that fracking wastewater trucked to municipal wastewater treatment plants on the Monongahela River was poisoning the drinking water of the people in Pittsburgh. That department asked the fracking companies to stop using sewage plants to treat their waste. But here in New York the DEC’s proposed regulations would allow disposal of fracking waste, which it termed nonhazardous, in municipal sewage treatment plants.

Independent sources have been compiling data on some of the chemicals and products used by the fracking industry, of which the most comprehensive is The Endocrine Disruption Exchange (TEDX). TEDX has compiled an as yet incomplete list of nearly 1000 products and has evaluated the health impact of each chemical. The findings include the following:

Over 78 percent of the chemicals are associated with skin, eye or sensory organ effects, respiratory effects and gastrointestinal or liver effects. The brain and nervous system can be harmed by 55 percent of the chemicals. Usually appearing right after exposure, the symptoms include burning eyes, rashes, coughs, sore throats, asthma-like effects, nausea, vomiting, headaches, dizziness, tremors, and convulsions. Other effects, including cancer, organ damage, and harm to the endocrine system, may not appear for months or years later.

A total of 210 chemicals (58 percent) are water-soluble while 131 (36 percent) are volatile, meaning they can become airborne. Of these volatile chemicals, over 93 percent can harm the eyes, skin, sensory organs, respiratory tract, gastrointestinal tract or liver. Compared with the soluble chemicals, far more of these chemicals (86 percent) can cause harm to the brain and nervous system.

Seventy-two percent of the volatile chemicals can harm the cardiovascular system and blood, and 66 percent can harm the kidneys. Because they can be inhaled, swallowed, and also reach the skin, the potential for exposure to volatile chemicals is greater than exposure to those that are soluble in water.

Many of these chemicals, particularly those that affect the immune systems and reproductive development, are harmful to humans in extremely low doses. The industry argues that the chemical composition of the fluids are too diluted to be dangerous. But some 80 to 330 tons of chemicals are required for each well, according to estimates published on the non-profit organization Earthworks.

When the gas surfaces, produced water, called brine, comes up with it, in a process that continues through the 20- or 30-year life of the well. The brine, which contains a more potent brew of chemicals, is hauled away to evaporation pits. Some municipalities in New York State are using brine from vertically drilled wells, which contain the same harmful substances, as road deicers and dust suppressors on county fairgrounds. (The Ulster County Legislature, which has banned fracking on county property, this month introduced a resolution for a law prohibiting such of the brine on county roads and property.) The DEC doesn’t consider the wastewater and brine to be hazardous waste.
Another concern is depletion of water resources. According to EPA figures, 70 to 140 billion gallons of water are required to frack 35,000 new wells — equal to the annual water consumption of dozens of cities with a population of 50,000. Fracking contaminates fresh water, in some cases withdrawn from municipal drinking sources (such as the Susquehanna River), with chemical waste.

Air pollution is yet another concern. Tons of toxic chemicals, including benzene, toluene, ethylbenzene and methane volatize into the air and mix with nitrogen oxides from the exhaust of diesel-driven equipment and trucks which make thousands of trips per well result in ground-level smog which can spread to a distance of 200 miles, notes TEDX, Fumes from 27,000 wells in formerly pristine areas of Wyoming have caused the state to fail federal standards for air quality for the first time in history in 2009; the levels of smog exceed at times those in Los Angeles.

Pennsylvania to Ithaca

Tom Shelley, a retired chemical safety specialist who formerly worked at Cornell University and New York State, claims air pollution from fracking operations in central Pennsylvania is wafting over his home town of Ithaca. Monitors in the air have identified hydrocarbons and elevated levels of methane, he said.

Shelley said that the rate of asthma among children who live near drilling rigs is six to nine times higher than normal. He fears low-level impacts on fracking chemicals and pollution, experienced over a long period of time, might result in a bigger health impact than a more pronounced one-time exposure — meaning the effects may not show up for years.

Paul Rubin, an outspoken hydrologist based in Ulster County who does consulting work on fracking’s impact for environmental and citizen groups, said the chemicals from drilling could eventually infiltrate the groundwater supplying drinking water to urban populations. “The bottom line is that the cement and steel sealant in the well casing, no matter how thick, will fail. Once the chemicals have entered the groundwater, the chemicals will migrate to the river valleys, where most of the population lives. It may take a long time to get into our valleys, but at the end of the day when you have thousands of wells you end up with contaminated loads. We need to protect our aquifers.”

Rubin said he’s been advocating for tracers in the drilling fluids, which would enable people to track contaminants back to a particular well and operator, establishing the link between the drilling operations and their harmful effects.
Shelley said he was optimistic that fracking won’t make much headway in New York, thanks to a battle being fought at the grass-roots level. “Right now there are almost 100 towns in New York that have passed land-use laws banning industrial activities like hydrofracking,” he noted. “Such a spotty pattern of land use allowed for hydrofracking won’t be profitable. It’s at the town level one can ban industrial uses through zoning. So far, the cases have held up in court.”

A shot in the arm

Bringing our little bundles of joy to the pediatrician to get needles stuck in them that contain elements of a deadly virus might seem an odd concept. But most of us do it, and we do it over and over again. As counterintuitive as it may seem to hold them down as they scream, we go along because we’ve been schooled about the often-fatal and crippling illnesses that immunizations prevent.

Each state has a mandated table of immunizations for children. While the requirements differ from state to state, New York will only exempt from required vaccinations on the basis of medical history, including an adverse vaccine reaction experienced by a family member, or religious belief. In New York State, children are not allowed to attend public school, Head Start, or most private schools, day-care centers and camps without proof of the required number and dosages of vaccines.

Yet a highly vocal war over the safety of vaccinations continues. Much of the medical and scientific community strongly believes that failure to vaccinate children for deadly diseases puts them as well as those around them at great risk. Locally, some pediatric practices are refusing to treat young patients who have not been vaccinated. These physicians believe that government-approved vaccines have been adequately tested and pose no threat to most children.

On the other side is the largely anecdotal evidence of millions of parents who report that their otherwise normal kids seem to have regressed into illness and mental isolation after receiving vaccinations. They believe — and there is some support for them within the scientific community — that certain toxins found in vaccines may be causing autism and other disorders like Asperger’s, ADD (attention deficit disorder) and ADHD (attention deficit, hyperactivity disorder).

Opponents further argue that vaccines, one of the most lucrative areas of the pharmaceutical industry, are often approved by individuals who are close to the industry, a conclusion supported by a congressional investigation report issued in 2000. Critics of the mandated vaccination schedule believe there is a limit to how many viruses and toxins should be introduced to the immature body of a small child.

With the national average of autism cases at one in 150 children and increasing — Minnesota now reports its number of autism cases at one in 81 children — the battle shows no signs of abating.

Some doctors insist on immunizations

Dr. Herschel R. Lessin, of the Children’s Medical Group, one of the larger pediatric practices in the area, said his practice is one that will not provide treatment to children who have not been vaccinated according to the accepted immunization schedule of New York State. “We have 20 pediatricians in our practice and we will not treat children who have not been immunized because we strongly believe that by not vaccinating your child for deadly diseases you not only put them at great risk but you put all of our children at risk,” said Lessin, a former director of the neonatal special-care unit at Vassar Brothers Medical Center in Poughkeepsie. Lessin said his practice will treat children who are on a “delayed immunization schedule” as long as the immunizations they are postponing are not among those used to prevent potentially fatal illnesses.

Strong advocates of immunizations like Lessin believe that herd immunity (the theory that it is more difficult to maintain a chain of infection when large numbers of a population are immune) is key to keeping the population free of many deadly diseases that once spread with plague-like mortality rates. They are concerned about the increasing number of parents refusing to vaccinate their children.

“If less than 95 percent of a population is immunized against a specific disease, then it can return,” said Lessin. “We’re seeing this happen now and it’s terrifying. Measles have returned in 20 states,” he said. “Hib [Haemophilus influenzae type b] has returned locally in a half-dozen states. I haven’t seen that in 20 years, and I don’t want to see it in our children.”

According to Lessin, people who choose not to vaccinate their children are “a danger to your one-month-old and a public health hazard.” While he concedes nothing is 100 percent risk-free, he believes we’re fortunate that polio and diphtheria are no longer threats.

Environmental causes?

Dr. Ken Bock, a founder of the Rhinebeck Health Center, is at the epicenter of the autism debate. The author of Healing The New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies (Random House, 2007), Bock devotes much of his attention to the treatment of these illnesses and regularly lectures on the subject at medical conferences. He believes the spike in autism as well as ADHD, asthma and allergies in the 1990s had to do with the presence of mercury in the Hepatitis B and Hib vaccinations given to young babies starting in the 1990s.

Though the mercury-containing preservative Thimerosol was removed from vaccinations several years ago, it is still present in some seasonal flu vaccines recommended for pregnant women and children over the age of six months. Bock believes it’s not just the toxins in vaccines that are the culprit. Exposure to the toxins emitted from coal-burning plants; the lead from lead paint, as well as that in dust, soil and water; arsenic in non-organic chicken; and the toxins in such things as pressure-treated lumber are responsible too, he believes. He likens a child’s body to a rowboat that finally sinks after taking on too much water.

Removing Thimerosol was important, according to Bock. But studies of umbilical-cord blood have continued to show the presence of metals and other toxins routinely well above safe levels, he noted.

Emphasizing he is very conscious of the “public health concern,” Bock said he has advocated for administering vaccines “in as safe of a way as we can.” His book proposes an amended schedule for immunizations. He believes it may not be one vaccine that is to blame but the overload given to very young infants.

Said Bock, “What I tell any parent is that there are risks involved with not getting your child vaccinated at a very young age. They’re more susceptible to contracting the disease that they would have been protected against. At the same time, I believe that to achieve the optimal immune response children have a better chance if those vaccinations are limited to one per visit and not three at one time …. Everything in life is risk management, and I’m very clear that there are risks involved with whatever choices we make.”

Bock remains wary. “We’ve seen a meteoric increase in the number of children being diagnosed with autism,” he said. It used to be one in 10,000 and is now estimated at one in 150. “That’s astronomical, and epidemics are not genetic,” said Bock. “There are environmental factors at work here, and we as doctors, as parents, clinicians, researchers and as a society need to come together and figure out what is causing this epidemic, who is susceptible, and how we deal with it.”

Dr. Stephen Auerbach of the Highland-based Auerbach Family Chiropractic Center also lectures extensively on the charged issues surrounding immunizations. “I’m not opposed to anyone getting immunized,” said the chiropractor. “I’m very strongly opposed to mandatory vaccinations. I’ve never told anyone not to get vaccinated, but I don’t like [to see] people being forced to make uninformed decisions and having our children be used as guinea pigs.”

Some parents are refusing

Meanwhile, some parents are choosing not to vaccinate, choosing not to allow all the required vaccinations, requesting reduced dosages, or delaying vaccination until their children are older.

Rebecca Stacy of New Paltz is adhering to a modified immunization schedule for her children.

“I want them walking and talking before they receive many of those vaccines,” she said, “and I also want to make sure that the sulfur lining in their stomach is fully developed to be able to better handle any traces of mercury that are still being concealed in many vaccines.”

One mother of four in Hurley who asked that her name not be used is convinced that the cause of her son’s autism was the overload of vaccines he received as an infant and the traces of mercury in the vaccines. “If you look at his eyes in these pictures,” she said, pointing to several closeups of what appeared to be a healthy, normal 2-year-old, “and the one’s shortly after his vaccines, you can see the difference in his expression. It’s distant, unfocused. He was not like that prior to the vaccines.”

As for her other three children, she added, “They will not be getting that flu shot [required for the sixth grade], and I put my younger two on modified immunization schedules after my son was so dramatically affected.”

Poughkeepsie resident and parent Donna Steele is angry for opposite reasons. “What really frustrates me is that these immunizations do not work unless everyone is vaccinated,” Steele said. “I get my kids immunized, but then I find out that many of the children in school with them are not vaccinated. That puts my kids at risk. Those diseases are waiting to come back. Do we want the polio epidemic again? Measles? We have it so good we do not remember a time when child mortality rates were at 50 percent.”

Bock suggested a safer approach to vaccination would be to make sure all vaccines were free of toxins like Thimerosal, aluminum, formaldehyde, Phenol and ethylene glycol.

Lessin is adamant that there is no scientific proof that vaccinations are causing autism. “There is absolutely zero, I mean zero, research out there which concludes that there is any link between vaccinations and autism,” he said. “What we have is a celebrity-driven culture and some celebrities who are not doctors advocating against immunization, which is a real shame. I spend half my day now explaining to people how critical it is that they get their child immunized and debunking these myths.”

Authority is leadership

The TV spot for a bank showed a 30-something mother with her pre-teen daughter and friends. Instead of talking to each other, they were — what else? — both texting. The daughter was hot on the heels of some boy named Chas, while Mom was in pursuit of financial freedom. At one point, the mother became terribly excited and exclaimed (I am paraphrasing) to her daughter: “The bank is texting me about my checking and letting me know how much we have in our account.”

My husband groaned out loud. Was he in pain?

“Only existential pain,” he said as waved his hand at the screen. “I mean how much information do kids need these days?”

“What do you mean?”

“A healthy, happy family is not a democracy,” he said and changed the channel.

At first I thought it was just his formal Montana upbringing that found the new intimacy between parents and children a bit unwieldy, even awkward. In his family it would have been inconceivable for his parents to place themselves on such an equal footing with the four children. There was an abundance of love and involvement (they were all musicians and played together nearly every night after dinner), but not at the expense of a very clear hierarchy of authority. One’s mother or father was not one’s buddy.

Being from the Northeast, where people stood on stoops and yelled down to the other end of the block at dinnertime and where our emotions were as visible as our shirts, I dismissed his disapproval as an archaic remnant.

But over the course of the day, as I watched parents interacting with their children at supermarkets, hardware stores, in therapy sessions and at school yards, I began to see his perspective differently.

Parents as friends

What I saw was that most parents wanted desperately to be friends with their children. They dressed the same, talked the same, giggled the same with them, jockeyed for position to be cool or hip. No topic was out of bounds. They discussed their sex lives, their finances, their politics, and the issues they had in their social and work relationships.

I thought I would be appalled, but I wasn’t. I was embarrassed. It was a feeling not unlike watching someone leave a bathroom with her dress tucked into her pantyhose or seeing a colleague do something horribly revealing or inappropriate at a party. In those situations, I would have felt like covering my face to avoid being a witness the next day.

I took to wondering why. Why are parents so reluctant to be parents? What has happened in our culture and in our families that we are more worried about whether our kids like us than whether we properly prepare them for a life that is almost always challenging and sometimes damned unfair?

Many adults today have a difficult time with true authority. They vacillate between a laxity that is boundary-less and a sporadic struggle for power. I don’t believe there is just one reason for this. Authority for some of these parents may have been excessive, unyielding, irrational or capricious. Those people would certainly confuse authority with dominance and cruelty. Precisely because they love their children, they naturally want neither to be that way nor for their children to suffer as they did. That’s understandable. But I think it is still erroneous.

Authority for others may be antithetical to their more modern understanding of love, which is easygoing, permissive, unconditional (often in the wrong way), and blooming with constant emotional reassurance and validation. In their minds, authority says no when love says yes.

Anyone who has trained dogs knows that love and “no” are not mutually exclusive. In fact, I believe the only way to truly give unconditional love is to be able to say no, to love the person and loathe the behavior.

Still others seem to have misinterpreted biblical injunctions about authority with children. They have rejected them out of hand because they have mistakenly come to associate them with corporal punishment and shame. The most obvious interpretive error is the popular one which reads the Hebrew for “rod” (as in “spare the rod and spoil the child”) for a reed or a stick. That’s a misinterpretation. A biblical authority is not punitive. Parents are given the injunction to educate their children and to hold them accountable to the performance of all the commandments — after the children have been helped to understand them.

Authority is compassionate

It is a shame that authority has earned itself such a miserable reputation because it is perhaps the most essential element of truly effective and loving parenting. Authority can be quite kind and loving even when it is correcting negative behavior.

Nature abhors a vacuum. So do children. When parents do not provide authority, children assume the dominant position. It is not necessarily a bad thing. It is survival. Someone has to be in control.

So what is a parent to do? Start by revisiting ideas on authority. Authority is calm, sure-footed, firm, confident and compassionate. If you are tentative, hesitant, punitive or vacillating, you are giving mixed messages and can no longer be trusted to lead. Authority is leadership. Children naturally gravitate to leaders, to adults who seem to know what they’re doing. Children want someone to guide them while at the same time allow them to make mistakes and learn. Authority says: Follow me. I know what I’m doing. Authority says: I understand what you need. Authority says: I will keep you safe.

Most parents do not give themselves permission to be the boss and loving at the same time and are terribly relieved to hear that they may. So are most children.

When as a therapist I did behavioral contracts with children I always warned parents of the imminent dangers of setting new limits. “One, you may be a bit awkward at first. Be patient with yourself and your adjustment to a new role,” I urge. “Two, the better you get at it the more your child is going to test you. He is going to rebel. He may fly in the face of your authority. Stay still. Let him spin. Research has shown that there is a predictable learning curve to that reaction and that the tumult will pass — if you are consistent and maintain the authority over time.”

I have done a lot of hand-holding with parents as they experience the back draft of their newfound authority. But when it’s all done and the heat has passed, there is a new relationship to be enjoyed, one in which the parent is the parent and the child is able to relax in their loving, sure hands.

The female heart

[wide][/wide]Quick – what’s the number-one killer of women in the U.S.?

Did you say cancer?

The fact is that coronary disease kills more American women every year than any other illness. According to the American Heart Association, 7.2 million women have heart disease. The risk starts to soar after menopause. One in four women over the age of 65 has heart disease. The rate is one in eight among women from 45 to 54. And it’s rising.

But women’s heart disease isn’t the same as men’s. Dr. Amparo Villablanca, a California cardiologist, said the blame can’t be put solely on hormones. We’re facing what she said doctors are calling the “diabesity” epidemic. We’re all getting fatter – and that leads to diabetes. Half the people who are diagnosed with diabetes are also discovered to have heart disease.

“The key is knowing your risks,” Villablanca said. “Know your genetic risks, know your numbers for blood pressure and cholesterol, know your body-mass index. And get them under control. Deaths from heart attacks are going down thanks to efforts to make more people aware of the risk factors. But the rates aren’t going down as fast for young women because they may not know they’re at risk for heart disease.”

That’s information that Dr. Ramin Manshadi, a cardiologist in Stockton, California, hopes to spread in his new book “The Wisdom of Heart Health.” He said the medical establishment was now beginning to understand that women’s heart attacks are very different from men’s. They are often “silent” heart attacks, and they are more likely to be fatal.

“Women do not have the classic chest pain that we equate with heart attack,” wrote Manshadi. “A heart attack, for a woman, may produce profuse sweating, or sudden fatigue that lasts for hours, or palpitations, or light-headedness. The pain might radiate to the center of the chest or even between the shoulder blades. They may not recognize these as symptoms of a heart attack, and it’s possible that a primary doctor might not recognize them, either.”

Those symptoms sound like they could easily be mistaken for symptoms of menopause. That’s why knowing your numbers, as Villablanca calls it, is so important. “If you know you’re at risk for heart disease, you will know that you can’t just ignore these symptoms or tell yourself they’re probably nothing. You know you have to consult with your doctor.”

Dr. Manshadi said women’s hormones were responsible for differences in the way coronary disease manifests. Before menopause, plaque buildup for women tends to erode arteries rather than rupture them as is more common for men and older women. And blockages tend to be more diffuse, making the surgical use of a stent to open blockages useless for many women.

“I’m hoping this book helps make women aware of their risks and makes them more educated about heart disease in general,” said Manashadi, “as they are often the ones who are responsible for health care decisions for their families.” He said he planned to donate the proceeds from the book to purchase defibrilliators for public schools throughout California.

Diet has a lot to do with reducing risk of heart disease. Dr. Dean Ornish proved back in the Eighties that a strict vegan diet combined with exercise and meditation to relieve stress could dramatically reverse existing heart disease. Since his groundbreaking 1982 diet book, “Stress, Diet and Your Heart,” the American diet has become less, rather than more, healthy. Dinner from a box was once advertised as a once-a-week break for a busy homemaker. It’s now the usual fare.

Sandra Lee, better known in New York for her relationship with governor Andrew Cuomo and nationally known for a show called “Semi-Homemade,” is the queen of the I-don’t-have-time-to-cook philosophy. A recipe for Creamy Chicken Noodle Soup on her website calls for a store-roasted chicken and two cans of cream of mushroom soup. Lee’s cooking technique, which favors speed and convenience, utilizes prepackaged foods loaded with sugar, sodium and preservatives.

TV food guru Paula Deen’s deep-fried, butter-soaked style of cooking has left her diabetic. Not exactly the healthy role model we’re looking for.

“Dr. Ornish paved the way,” said Vicki Koenig, a licensed nutritionist in New Paltz. “But there are a lot of ways to address our eating habits, lose weight, and reduce the risk of heart disease.” Koenig argued. She has had dramatic success with overweight clients by combining coaching with low-glycemic meal replacements. “I’ve been doing this a long time,” Koenig said, “and since starting to work with my clients using pre-packaged, pre-portioned meals, I’ve seen an 80% success rate. It’s a teachable moment.”

Dr. Ellis Lader, a cardiologist at MidValley Cardiology in Kingston, said that meal replacements, those pre-packaged you-can’t-get-this-wrong entrees, are successful for patients who have to lose weight and have to lose it now. But they present a challenge once the weight is off. They don’t come with a system to transition off the product and back to the dizzying choices in the local grocery store. That means you need a nutritionist.

Or you can drive to Albany. “Dr. Paul Lemanski [an Albany cardiologist who used to have a practice in Kingston] has a great program,” Lader said. “It gets the weight off, then teaches you how to keep it off.”

CardioFit, Lemanski’s program, utilizes Medifast meals to get the weight off, and also educates patients about the importance of exercise. It teaches them to reduce stress and stop smoking, and even offers cooking classes.

You can also learn to make healthier meals a little closer to home.

Roni Shapiro recently opened Healthy Gourmet To Go in Saugerties after years of offering vegan meals to area clients.

“I’ve worked with many clients with heart disease and hypertension,” said Shapiro. “I am convinced that the most important thing you can do for your heart is switch to a plant-based diet. Dairy and animal protein are full of saturated fat that clogs arteries. I’ve seen a plant-based diet work and I’ve seen people’s health improve. It’s easier to switch than it’s ever been. You can go to any regular grocery store and find meat substitutes.” You can also contact Shapiro at [email protected] to find out about heart healthy cooking classes.

Lader said current science points to a Mediterranean diet as the best for heart health, but he said more research is needed.

Exercise matters, too. “Thirty minutes of aerobic exercise a day. Walking’s plenty,” Lader said. “Jog if you’re up to it, but you don’t have to. Some resistance training. That lowers your blood pressure, lowers your blood sugar, lowers your bad cholesterol, and raises your good cholesterol. Just use common sense. If you have chest discomfort – stop!”

Particularly for women, chest discomfort could indicate another issue – one that your doctor may not consider. “It’s called Syndrome X or Small-Vessel Disease,” said Lader. “It is a narrowing of the little vessels, ones too small to see in most tests. But we can measure the reduction in the blood flow during exertion. It causes chest discomfort. We see it most often in women, particularly diabetic women.”

Lader said routine tests for heart disease won’t find Syndrome X, and some doctors will dismiss a woman’s symptoms if they don’t know about it. “It responds well to angina medication and calls for the same changes in lifestyle that other heart disease patients need to make,” said the local cardiologist. “Lose weight, get cholesterol and blood pressure under control, exercise.”


The local American Heart Association heart walks are scheduled for this month. On Saturday, March 10 the Dutchess County walk will take place at Vassar College in Poughkeepsie. On Saturday, March 24 the Ulster County walk will take place at Dietz Stadium in Kingston. Registration for both events will be at 8:30 a.m., and both walks will begin at ten o’clock.


It’s hard to be glum on a sunny day

Do you notice there’s spring in your step? Do people smile at you more? Are you enjoying an inexplicable sense of optimism?

Thank the weather.

March is not typically when our region enjoys temperatures flirting with the seventies. But whether it’s some permutation of seasonal winds or the inexorable progress of climate change, that’s what’s been happening. And it has a very pleasant effect on people.

Our weekly shopping trip was punctuated by cheery greetings from people we almost know. The conversations all had the same theme.

“How about this weather?”

“Incredible, isn’t it?”

“I couldn’t’ help it. I had to break out my tee shirt/skirt/shorts/sandals and celebrate!”

“Don’t you just feel happier?”

“I do!”

“I know. Weird, huh?”

“We should get together some time (or soon or more often)!”

The guy behind the deli counter was telling anyone who would listen his plans for his garden.

“So I’m working on my deer fence, and this year I want to try pumpkins!”

The bank teller was grinning like the Cheshire Cat.

“I was just out there on my lunch break. I think I’ll get my bike out of the shed after work!”

I found myself rolling up my yoga pants on my daily walk, allowing my sickly white calves to soak up the sunlight. Three cars swerved into the ditch, their drivers blinded by the glare. They weren’t even angry.

“Beautiful day, huh!”

Sure, UV rays contribute to skin cancer. Glare is bad for your eyesight. Solar flares can shut down the power grid.

I do not care.

Sunlight is nature’s little endorphin-jumper. And man, we could all use a few endorphins these days. Sunlight revs up the immune system. It is the essential ingredient in helping the body produce vitamin D. Vitamin D is good for your bones and might even help you live longer.

Sunlight repels those gray, grim little demons that accumulate in the dark corners of your mind even in the mildest of winters. The wee beasts feed off pessimism and latch onto any minor setback, masterfully blowing it out of all proportion.

Sunlight blasts through their distortions.

Sunlight lies, too. But they are benign lies of hope, of possibility, of good news on its way. And if the good news never comes, at least it was a sunny day.