January 8, 2019: Flourish: Living a Full Life with Heart Failure

i am running into a new year
and the old years blow back
like a wind …
it will be hard to let go
of what i said to myself
about myself
when i was sixteen and
twenty-six and thirty-six…

(From:  The Collected Poems of Lucille Clifton 1965-2010, Young & Miller, Eds., 2012)

I recalled “I am running into a new year,” the first line and title of Lucille Clifton’s poem,  as 2019 began, although “running” is not an entirely accurate description of how I’ve begun this New Year.  If I take account the reality of aging, of living with heart failure, I have to be honest.   I am actually limping into a new year, thanks to arthritis in my right knee, and, like it or not, a slower pace of life that comes with being a heart failure patient.   Nevertheless, I’ve begun the year with every good intention to make it as happy and healthy as I possibly can.

I greeted January 1st with a practice I’ve had for nearly ten years, considering what I want my life to be about in this New Year and how that is manifested in word, deed and action.  I began several days ahead of first exploring and choosing a single word to frame my intentions and act as a road sign for the year ahead.   With all that has happened in 2018, health-related words were top of mind.

After several hours of deliberation — a necessary process for me to find a guiding word that resonates with what I intend or hope for it in multiple ways–I finally settled on “flourish,” which, according to the dictionary, means, “to thrive, achieve success and prosper.”  Its etymological roots can be traced back to the early Latin word, “flor,” meaning to flower, although the first known use of “flourish” in the English language didn’t appear until the 14th century.  Flourish seemed an apt choice for framing how I want to guide my life and  health in the coming year.  I typed it out and, as I always do, placed it in a small 2-inch frame to sit on my desk as my daily reminder.

Choosing a word was only the first part.  Now I had to consider how “flourish” was going to translate to action, especially since I’m living with heart failure–and at a time when my daily intake of medications continues to increase, and I now record my blood pressure, heart rate and weight on a daily basis, sending it to the cardiac center with the push of a button on my iphone.

I couldn’t help but think of all the cancer patients who’ve written and shared their experiences with me.  Cancer mobilizes them to fight–it’s an invader, errant cells multiplying and growing, and they hope for a cure.  Where the heart is concerned, it is different, and as some authors have described, “the ultimate arbiter of our lives.  When it calls time, the game is over…The heart, “plain and simple, is a pump.”  (From the introduction: The Sublime Engine:  A Biography of the Human Heart, by S. Amidon & T. Amidon, 2012).  The thing is, this pump of mine is weakened and, gradually, wearing down.  It’s not fighting I want to do where the heart’s concerned.  Rather, I feel protective about my ailing heart, a sense of needing to treat it tenderly and gently, hovering over it like a mother at the bedside of her ill child.   I wrote the obvious question across the page of my notebook:  So how do I flourish living with heart failure?

Shakespeare’s “Shall I compare thee to a summer’s day?” came to mind–  an irrational thought, or so it seemed, but as I addressed my heart, I wrote,   “Shall I compare thee to an old car?”  I recalled my high school boyfriend’s old, well used, Ford Model A–a true jalopy.  It couldn’t do much more than get him from home to school, or provide the transportation for a date in our small town, its ancient engine “putt-putt-putting,” as he drove.  There was never any danger of a speeding ticket, although its age often cast doubts in our minds if the old jalopy would make it up a hill.   Yet my friend loved that old car, keeping it clean and shiny with polish, and together with his father, tinkering frequently with the engine to keep it running.

I suppose it’s not unlike the way in which I think about my heart.  Coupled with the care of my cardiologist, the medications I take daily, and my own efforts, I’m intent on keeping my aging engine going for as long as I possibly can.  It’s not perfect by any means.  But I’m intent on flourishing, walking as often as I can around the neighborhood, running errands on foot, carrying my necessary purchases on my back as I walk home.  I never forget about my heart.  How could I when, walking from uphill from our apartment to St. Clair Avenue, I have to pause at a corner, watching the lights turn red, green then red again, to quiet the thudding in my chest.  A momentary fear surfaces:  “Good grief, am I going to pass out here?”  Invariably, I recall the day I actually did pass out ten years ago while walking my dog.  But then the light turns green, and I resume my walk,  reminding myself to keep a slower pace.  I’ve become a “putt-putt” shadow of the long-legged, brisk striding, younger person I once was, when my husband would always complain, “Slow down”– but that was before heart failure and arthritis.  I can’t let the necessity to walk a bit slower keep me from doing something good for the heart.   Walking is one way  I can flourish.

Like it or not, flourishing also requires coming to terms with my aging body.  To wit:  I try to get to the pool a couple of times a week, but I’m no longer an energetic lap-swimmer I once was.  I lack the lung capacity I once had.   Now I carry a bright turquoise “noodle” into the pool to help keep me buoyant as I move back and forth in the water, legs bicycling,  arms doing a modified breast stroke.  I present a comical picture,  but flourishing also involves not taking myself too seriously.  I’m no beach blanket beauty, just an aging woman, less toned than I once was, trying to fend off my embarrassment as I try to exercise.  As the Nike ads once proclaimed, “Just do it.”

I also follow Nike’s dictum every  Friday, when I attend a weekly dance class with other women of indeterminate ages.  We’re  called “The Vintage Dancers.”  I think you get the idea.  Despite my arthritic knee and stiffer joints, I still like to try, because I love to dance.  I don’t have any illusions now:  one glance in the mirror dispels the memory of that former self, sleek in lavender spandex, quick to learn new routines.  Oh, I still wear spandex, common now in athletic garb, but the gracefulness and agility I once prided myself on has all but vanished.  I try to do my best to follow along with the fast pace my instructor establishes, whether it’s salsa, Bollywood, hip hop, or an Israeli folk dance, but I am no longer “fleet of foot or, it appears, able to remember all those new steps as easily as I once could. I end up laughing more often than getting through a complete routine.  Yet now and then, everything clicks, and I do a full routine correctly.  Then without thinking, I’m likely to raise my fist in the air and shout, “Woo Hoo!”  Clumsy or not, I dance because it’s joyous, fun, and above all, I love to laugh.  Movement helps, but laughter, I believe, is a necessary part of flourishing.

As for a heart healthy diet, I’m pretty good about watching salt intake, eating more servings of fish and plenty of fruits and vegetables, but I also enjoy an evening out with my husband, family or good friends.  I put caloric intake aside on those evenings, enjoy a glass of wine with the food and conversation, and the company of people I like.  Friends and family are important to my ability to flourish.  I recall the work of physician Dean Ornish, whose work I followed many years before I ever became a heart failure patient.  Ornish, founder of the Preventive Medicine Research Institute in California and a Clinical Professor of Medicine at University of California, San Francisco,  is best known for  his advocacy of diet and lifestyle changes in treating and preventing heart disease.  But importantly, Ornish  included social support as an important aspect of treating and preventing heart disease.  “The need for connection and community…affect the quality of our lives” he said, “but they also affect our survival to a much larger degree than most people realize” (quoted in Heart: A History, p. 237, by Sandeep Jauhaur, 2018).

As I listed these activities, I realized there are others also important to my ability to flourish,  like engagement in intellectual and social activities I care about:   writing, leading expressive writing groups for cancer patients or offering a patient perspective in heart failure care initiatives.  Flourishing is part of taking advantage of all this city has to offer:  music, art, theatre, walking trails, and the vibrancy of a multi-cultural environment.

After I’d enumerated the activities in my life that are important to for me to flourish in life, I returned to my heart, that “pump” I referred to  at the beginning of this post.  It’s no ordinary pump or engine.  The heart fascinates me.  It is the only organ that represents the qualities that make us most human and has inspired a multitude of  metaphors throughout history.  It is truly an uncommon pump.  It’s not only amazing, it gives us life.  Flourishing then, despite and yet because I live with heart failure, includes so much more than my diet, exercise and medications.  Flourishing is also about love, laughter, friends and the ability to find joy and gratitude in every day I live and breathe.

A Writing Suggestion

.  Have you chosen a guiding word for your life this year?  If so, try to flesh out all the ways in which your word translates into actions and intentions for living as fully and actively as you can.

.  Don’t have a word?  Why not try choosing one that captures what’s important in your life for 2019.