January 24, 2013

(+++) LIVING HEARTILY


Dr. Suzanne Steinbaum’s Heart Book: Every Woman’s Guide to a Heart-Healthy Life. By Suzanne Steinbaum, D.O. Avery. $26.

      A whole-body and holistic approach to heart health directed specifically at women, Dr. Suzanne Steinbaum’s Heart Book offers an extended prescription for better cardiac health from the Director of Women and Heart Disease at Lenox Hill Hospital in New York City. Steinbaum views the cardiovascular system in the context of the overall body, which includes the mind, and is well aware of the psychosomatic elements involved in heart disease – “psychosomatic” not indicating “imaginary,” which is a popular misunderstanding of the word, but meaning “mind-body connected.”

      Convinced that many women’s heart problems indicate lives that have gone out of balance, resulting in symptoms ranging from chest pains, fatigue and panic attacks to vaguely described “heartsickness,” Steinbaum urges women to use their hearts to keep their cardiovascular systems healthy. Of course, the body uses the heart constantly in a purely physical sense, but Steinbaum goes beyond that. She wants women to adopt a diet that is good for the heart, yes, and to exercise regularly, but she also wants women to practice better stress management and focus on enhancing interpersonal relationships in ways that enhance heart health.  Her end-of-chapter summaries, which can easily be read and understood before looking at the chapters themselves, neatly encapsulate her recommendations. “Chronic stress is one of the biggest heart disease risks for women,” she points out in one summary (this is true for men, too). “I would like you to start your very own Heart Book, in which you will record the details of your lifestyle choices, like diet and exercise and sleep, as well as the story of your life,” she suggests at another point – the idea being to get more in touch with your total being, body and mind, to help pinpoint why you may not be feeling your best.  “It is more important to be fit than skinny,” she comments in the summary of another chapter, adding, “Remember that the next time you decide to starve yourself and skip the gym!”

      The plainspoken advice is actually nothing particularly new and is certainly not limited to women, but Steinbaum’s way of delivering information is upbeat, intelligent and well-informed, as one would expect (or at least hope) from an attending cardiologist.  She acknowledges that it is one thing for her or anyone to prescribe lifestyle changes, and another for people to accomplish them: “Compliance, or ‘sticking to it,’ is one of the most difficult issues to tackle when it comes to changing your lifestyle habits.”  But she keeps coming back to what she says (perhaps rather na├»vely) will make the difficulties easier: “getting to know yourself.”  For example, when it comes to exercise, she says that everyone has an “exercise style.” One person may be an “obsessor,” who needs “a routine that will keep you exercising after the initial thrill wears off” and must also “guard against overdoing it at first and injuring yourself.” Another person may be a “variety lover,” and “Variety Lovers get bored easily, so they absolutely need to mix things up if they are going to make exercise a regular part of their lives.”

      By presenting straightforward medical advice in an attractive verbal package, and returning again and again to the issue of stress – identifying it and learning to control it – Steinbaum gives women a series of road maps for improving their everyday lives and, in so doing, their cardiac health. Indeed, there may be a few too many of those maps – she has one for many elements of life. For example, she offers a guide to five “stress management types,” including “the deliberator,” “the quantifier” and “the pragmatist,” with suggestions on how to decide which one you are and what to do about your particular style. Taking all the self-tests Steinbaum offers – and taking the many medical ones that she also discusses, which are entirely ordinary and would be recommended by any competent modern cardiologist – requires considerable time and attention (worthwhile if you can manage your life and insurance accordingly).  Indeed, a few of the self-tests, such as “your pleasure style,” are genuinely innovative.

Steinbaum’s overall recommendation is that women “de-stress by taking your life back,” which is an excellent prescription but by no means as easy to do as she suggests. A few of her notions of what to do are downright quirky, such as singing a theme song to yourself – one that “expresses how you feel, or how you want to feel, during stressful situations.”  The song is supposed to provide “courage, motivation, and a better attitude,” and Steinbaum says this works for her. But she notes elsewhere that what works for one person does not necessarily work the same way, if at all, for someone else.  Still, it is hard to argue with her assertion that “health care is self-care” (one chapter title); and she certainly makes some intriguing points, sometimes almost as asides (as when she remarks that she can tell from heart monitors when a patient had sex, but sex does not increase heart rate as much as exercise and therefore “does not count as your cardio”).  At more than 370 pages, Dr. Suzanne Steinbaum’s Heart Book is lengthy, and it is information-packed to such an extent that readers cannot simply enjoy the chatty sections – some of the material here really requires close, careful reading (and rereading). The strictly medical material in the book is unexceptionable and unexceptional, but its equal emphasis on whole-person wellness is unusual and attractive, and its slightly odd elements actually make it more enjoyable to read (for instance, Steinbaum’s display of an echocardiogram includes a note that the heart shown is that of her physical therapist).  The book is sometimes an uneasy mixture of the medical/scientific and the chatty/informal, but readers who enjoy the eclectic style will find much here to enjoy and much to learn – and may even be inspired to take some good-for-their-heart actions that more-straightforward books would not lead them to try.

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