I often discuss my frustration about having too much potassium in my body and my daily battle to find low potassium foods.  I complain about potassium so much that some of you may have wanted to exit the blog without reading the post when you saw the word potassium! 

Well, sorry, but I feel compelled to publish another potassium post.  But this time, the post covers not only the perils of too much potassium – it also discusses how a low potassium level can cause equally dire health problems.

Lest you think I am overreacting, let me share with you some information from two sources.  An article on the Cleveland Clinic website entitled Heart Failure Diet notes that an excess of potassium is serious and should be treated immediately.  The article also states that having too low a level of potassium can be very dangerous.  An article entitled Potassium Primer on the U,S. News website says:  "Very low potassium can kill you, and very high potassium can kill you, so it's very important to get it right in that balance.”  So with two separate articles warning about the hazards of potassium (including death) – do I have your attention regarding the serious consequences that can result from a potassium imbalance in your body?    
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My church currently supports food pantries, both by providing canned goods, cereals and other non-perishable foods to pantries and by working at the food pantries.  I work at one of the food pantries we support a number of times throughout the year, and I always walk away feeling like I have met some incredible people.    The food pantry is open for a few hours each Monday in the late afternoon.  The clients who use the pantry come from jobs or taking care of families, and they are very polite and grateful.

While the pantry has a number of non-perishable items, and even some fresh produce and refrigerated and frozen goods, it is not an endless selection of food.  Whenever I feel sorry for myself and pout over all the foods that I can no longer eat, I stop and put myself in their shoes.   What if a good portion of my groceries came from a location where my choices were limited to the donations to the pantry?  My health might limit what I can eat, but I still have the inventories of several grocery stores with ample food choices that fit within my diet restrictions.
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Sometimes when I am out for dinner at a restaurant, people who are aware of my heart condition make the observation that it should be okay for me to drink wine.  I think this is because there have been a number of studies that indicate that wine is good for the heart.  My recollection is that this started in the 1980’s with a study known as the French Paradox. 

There have been many articles written about the French Paradox since the 1980s, most of the articles analyzing rather than explaining what the paradox is/was.  But I found a good explanation on the website for the American Society for Nutrition (nutrition.org).  According to the first two paragraphs of an article by Stefano Vendrame:  
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For my entire professional career, it seemed like the fuel that drove my ambition and my success was a combination of adrenaline rushes and a steady stream of caffeine.  No wonder I was always in motion and found it hard sometimes to sleep at night!

In previous posts, I have talked about the adrenaline withdrawal pangs I suffered when I started to take beta blockers.  These are drugs that block adrenaline, a substance that damages the heart.  I miss those adrenaline rushes because they made me feel like I could conquer any obstacle in my path.  But I now know that the adrenaline that fed my career achievements also had the unfortunate result of stressing and weakening my heart.
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A while back I wrote a blog post on the perils of potassium.  At the time, my blood had been tested in the office of my family doctor and my potassium reading was 5.1 which is about .1 above the highest end of the range.  The doctor was concerned about this and I remember she instructed me to stop eating things like bananas, avocados, and potatoes.
 
At the time it seemed like a simple thing to do in order to get the reading back to the normal range.  Thankfully the next reading 2 weeks later was back in the normal range at the high end.   I was able to reduce the level by cutting the consumption of the food items the doctor warned me about.  I only had a banana several times a week, and they were smaller bananas.  As for things like potatoes and avocados, while I did not totally cut them out, I definitely made sure they were rare items in my diet.  This approach seemed to keep my potassium in check.

When I was first told that I was limited to 2000 milligrams of sodium each day, I thought my biggest problem would be eating out at restaurants.  I figured I could control how much salt I added to my plate by just taking the salt shaker off the table or away from my kitchen counter.  But how could I control a salt shaker held by a restaurant chef?
 
But really, the issue with restaurant eating has been a bit easier than I thought.  Most restaurants have at least have a fish entrée, and if you ask that the fish be grilled and no salt added by the chef, that is usually a safe bet.  Another safe bet is simple vegetable side dishes without sauces where you can also ask that no salt be added.  I have also had success with salads by just asking for the dressing to be on the side or no dressing at all.  You can also ask for oil and vinegar to dress you salad so that you can add flavor to your salad without the sodium. 

During the first year of treatment with a cardiologist and heart failure nurse, I asked if I could drink coffee.  The answer was yes.  But I decided to exercise moderation, so I limited myself to one cup of coffee a day.  In the years since, I have switched to a half caff version of coffee, but I might also drink a cup of black tea during the day.  The end result is that I have no more than one cup of caffeine a day.

I have also been drinking my fair share of herbal tea during the day.  In the first year, I tried to find some teas that would help me relax before bedtime.  I decided to drink plain old, reliable chamomile tea.  How harmful could that be?
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Ever since I got over my phase of anorexia in my early twenties, I thought I was following a healthy diet.  I ate a lot of vegetables, I did not eat much in the way of fried foods, and I hardly ever ate calorie laden deserts.  But even with my good eating habits, I still had to make some significant changes to my diet once I became a heart failure patient.

If you have read this blog before, you are well aware (and probably sick of the fact) that I had to give up my addiction to salt.  I also have to keep to a heart healthy diet of low fat.  This still gives me a lot of options.  But there are some basic rules that I had to learn early on in the process as I was making over my diet choices to reduce salt.
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I am beginning to feel a positive glow in anticipation of the approaching holiday season.  I look forward to the opportunity to rejoice with family, reflect on the meaning of Christmas and experience spiritual fulfillment.  But at the same time I also have a bit of apprehension.  The holiday season can get a little crazy and demanding with (1) pressure to fill your calendar with parties and traditional activities so that you won’t miss out (2) the pressure to find the right gifts for your loved ones, and (3) trying to avoid an adverse impact on one’s weight.  The last item is troublesome for heart failure patients because of the fluid and diet restrictions we must observe.

The holidays are times where we may temporarily overindulge because we feel we need to be “merry”, or at least what the retail industry would encourage us to believe is merry.  By the time the year ends, one begins to feel as old and out-of-shape as Father Time.  But despite the stress, the worst case scenario for most people is that they may have to diet to shed the holiday pounds they gained when they threw caution to the wind.  But for us who are impacted by significant diet errors, common sense told me that totally ignoring diet concerns could be risky.
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When people initially learn that I have heart failure, reactions are all across the spectrum.  Two of the most interesting reactions I encounter are based on misunderstandings of my Type A nature and my avid fitness habits, and how they evolved. 

So the first reaction is that I am living proof that it is useless to try to follow a health lifestyle.  I can see people thinking – “Geez, if heart failure could happen to someone like Melanie, then what good were all of her efforts.  She might as well have eaten and drank anything she wanted while she sat around watching television.”  Wrong!  Every piece of medical advice I have seen or heard on heart failure preaches eating carefully and getting as much exercise as you can tolerate.  So I will always feel that I am fortunate that my fitness and diet disciplines were in place to help me hit the ground running when I was unwillingly recruited for the battle against heart failure.
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