Posts tagged Low Sodium Cooking

Recently, my cardiologist contacted me about helping other patients adjust to a low sodium diet. In the world of cardiomyopathy and congestive heart failure (CHF), I am a rare success story — a patient who has successfully adopted the radical diet that can help prolong the life of someone with chronic heart disease.

The survival rate for someone with CHF is 7% in the two years following diagnosis. This rate is worse than many aggressive forms of cancer, including lymphoma and breast cancer. Now, this isn’t from a lack of medical solutions — there is a whole host of tried and tested heart medication out there to help patients survive. In addition, there are implanted cardiac defibrillators (ICD’s) that can shock a failing heart back to life and correct dangerous arrhythmia (I have one of these installed); left ventricle assist devices (LVADS), which augment and support a failing heart, and ultimately, heart transplant. Experimental options also exist — the stem cell and artificial organ creation fields offer promising treatments in the future — but they are largely untested and for now are not a viable option.

No, the key problem with CHF patients is their inability to adopt a true low sodium diet. A failing heart is too weak to pump fluid through the body — this results in the accumulation of fluids in the neck, ankles, hands and lungs. The role of CHF medication is to reduce the load on the heart, limit the fluids that accumulate in the body and reduce blood pressure so the heart doesn’t have to work as hard. But as doctors will tell you, heart medication is not enough. Diuretics are not enough. You need to radically reduce the sodium in your diet — without doing so, you will inevitably succumb to the symptoms of CHF.

Reducing sodium in your diet sounds easy enough, but most patients don’t have the medical and dietary knowledge to understand what a low sodium diet entails. In addition, our society depends largely on processed or prepared foods, which are literally contaminated with sodium. The average American is supposed to eat just 2,000 milligrams of sodium a day, but in fact consumes more than 5,000 milligrams. A low sodium diet is vaguely defined as being under 1,500 milligrams of sodium a day, just 500 milligrams shy of the recommended norm. But with many meals containing twice that amount, it’s very difficult, if not impossible, to figure out how to achieve that diet without help.

When I was first diagnosed with CHF in December of 2009 and sent home after a week-long hospitalization, I had completely succumbed to depression. I lay on the couch, I felt horrible, and I was convinced that I was going to die. My wife and mother made various low sodium meals for me, but without a guide on how to do it, I was mostly given unseasoned chicken and plain rice. Low sodium, yes, but akin to eating mushy cardboard.

At this point, patients often give up. They decide they can’t live without regular food, and they pack it in, hoping that they get by on their meds alone. But something happened to me that gave me the inspiration to move on.

As I lay on the couch, contemplating my own mortality, I watched a three-day marathon of Anthony Bourdain’s show, No Reservations, on the Travel Channel. Anthony Bourdain, if you are unaware, is a former chef and author who travels abroad to learn about other cultures through their food. Watching this show, I also watched different types of food being prepared, often in developing world conditions. So many of the dishes I saw looked amazing, and I was struck by how easy they seemed to be to make given the sometimes less-than-ideal conditions in which they were prepared. Now, I had basic cooking utensils in my kitchen, but like many Americans, I ate out every night. I rarely used them. But now I had an idea: I could learn to cook without salt.

I combed the Internet, and found an amazing site — Low Sodium Cooking.com — that contained recipes specifically created for heart patients. Its author, Dick Logue, has survived for 10 years without a heart transplant or LVAD due to his commitment to a low sodium diet. This is five times the expected survival rate of a CHF patient. If Dick Logue could do it, then maybe I could, too.

My favorite food is chips and salsa. With very few exceptions, store bought salsa is filled with sodium. Dick had a recipe for salsa on his site. So, against my better judgement, I hauled myself out of bed and with my family in tow went to the Harris Teeter supermarket in the Adams Morgan neighborhood of Washington, D.C., and bought myself the supplies I needed to make it. This was an incredibly difficult trip — both emotionally and physically. I was sure I was dying. I wept while I was in the store, gathering the vegetables I needed. I had never cooked anything that complicated in my life. But I was going to make something I liked, and I was going to at least go down enjoying food, again.

So I made that salsa — it took me three hours, but I did it. My wife even made low sodium chips for me out of tortilla shells (I would later discover unsalted tortilla chips at Whole Foods that contain 0 mg of sodium). It wasn’t quite what I wanted, but it tasted good enough. I could do this.

Now, it’s been a year and a half since that moment. Last weekend I made homemade pitas, Greek-style lamb kabobs and rice pilaf with less than 150mg of sodium content. My ejection fraction, the number that describes how strongly your heart is pumping, is just 15%, but I go to work every day, cook most of my own food myself, and live a relatively normal life. My lung function, while not normal, is good enough at rest — I am not drowning in my own fluids. No coughing, no shortness of breath, and I have the ability to walk fairly long distances (though days in the sun can wipe me out). Many people with better heart function than I have are on heart transplant lists and have LVADS installed. The only difference between them and me is diet — I am on an aggressively low sodium diet, and they are not.

I can’t describe how many patients I’ve met over the last year with classic heart failure symptoms who say they can’t do this. But the reality is, they choose not to. They can do this. CHF is a horrible disease, but unlike cancer, it’s something that you can fight — you can take action to help ensure that you don’t succumb to it. As I said, Dick Logue has lived for 10 years and still works full time, and I have lived over a year and also work full time. I’m not special — I’m just a normal person who adapted his diet. And despite what you might think, you can, too.

Over the next few weeks, I will describe how I adhere to a low sodium diet and still enjoy eating. I prepare food every night that I enjoy, and it contains very little sodium. This series is mainly for the purpose of sharing with my fellow patients at the Washington Hospital Center congestive heart failure clinc, but hopefully other patients will find this helpful. Much of what I’ve learned, I’ve learned from other people on the Web, and I will reference them as much as I can. Please keep in mind that I am not a doctor or dietician — you should always check with your doctor if you have any questions about my advice.

This is my personal blog, and I will admit that I write about a wide range of subjects, of which cardiomyopathy and CHF is one. I hope you aren’t turned off by the political beliefs espoused on this site — what we share as heart patients transcends political disagreements. I want to help you live, just as others have helped me live.

Remember, you can do this. You will have to change your life — there’s no question that it’s a difficult transition — but it’s one you can make. You can both eat well and survive. I promise you, this is something you can do.