From my Heart to Yours

On this date three years ago, my husband's heart stopped beating. He was in his 50s, seemingly healthy and robust, and most people were genuinely shocked at his death. I didn't wake up that March morning believing that my husband would die that day, but in a general sense I was less shocked than many others seemed to be. That was partly due to life experiences (my mother died when I was young, so I grew up understanding the unpredictability of death) and partly due to understanding some of his risk factors. 

I'm going to mark this anniversary by writing about heart disease and talking about some lesser known causes. At some point I'm going to talk about a risk factor or two that I wish Dan would have taken more seriously. I imagine that last sentence put some of you on edge. Believe me, I spent a lot of time debating whether or not to write this post, but I decided to do so for multiple reasons, including that I'd like to think that Dan would want me to. 

Heart disease is the leading cause of death in the United States. The Centers for Disease Control notes that it causes one out of every four American deaths. Risk factors listed by the CDC include high blood pressure, high cholesterol, smoking, diabetes, excess weight, poor diet, physical inactivity, and excessive alcohol use. I believe these are fairly well known by the general population. There are many other risk factors, however, that are less understood.

This is by no means an exhaustive list, but some of the lesser known contributors to heart disease include the following: 

Air pollution - Air pollution is a broad term, but in general, fine particulates in the air, such as from industrial and traffic fumes, are associated with higher rates of heart disease. The American Heart Association reports research showing increases in death and hospitalizations when there are higher rates of smog. ABC News reports on a study finding that being stuck in traffic more than triples the risk of having a heart attack. 

Non-stick chemicals - As I've noted many times, chemicals in our consumer products are generally not tested for safety, so the health effects often remain unknown. Some, however, have been linked to heart disease, including a family of chemicals used in products such as non-stick pans and stain resistant coatings. A 2012 study found that people who had the highest rates of the chemical PFOA in their blood were twice as likely to experience heart disease, heart attack, or stroke as those with the lowest levels. Because of the bad press, PFOA is being replaced by other similar chemicals, but many health experts warn that there is no reason to believe that the newer versions are any less problematic.

Chemicals found in food and beverage containers - A 2014 study in the International Journal of Environmental Research and Public Health concluded that the chemical BPA, found in many places, including plastic bottles and in the lining of food cans, was associated with heart disease in both acute and chronic low-dose exposure situations. As with PFOA, the bad press about BPA has led to some changes, but a 2016 study found it present in 67% of cans tested. 

Heavy metals - University Health News reports that researchers have implicated at least four heavy metals associated with clogging arteries: lead, mercury, cadmium, and arsenic.  

Mold and other toxins found in water damaged buildings - Water damaged buildings, or those with high indoor humidity levels, tend to be breeding grounds for a multitude of  organisms, including a wide variety of fungi and bacteria.  Exposure can lead to chronic inflammation, which can contribute to heart disease. A study in the Internet Journal of Toxicology found an association between exposure to molds in damp buildings and high cholesterol levels.

Sleep apnea - The American Heart Association notes that sleep apnea is associated with high blood pressure, arrhythmia, stroke, and heart failure. I'm almost certain that Dan had sleep apnea, and I wish I had been successful at convincing him to get tested.

Sugar consumption - This is the big one that I worried about for years. Dr. Mark Hyman's summary of the research notes that people with the highest sugar consumption have a 400% higher risk of experiencing a heart attack than those who consume the least. Sugar (in all its various forms) is not just a problem because of its "empty calories," adding to weight without contributing nutrition, but because it is inflammatory and dangerous in and of itself.  

Americans eat a lot of sugar, and the amount continues to climb. A Huffington Post article reports that the American Heart Association recommends that women cap their consumption at six teaspoons a day and men at nine, but that the average American consumes 30 teaspoons daily. There are a number of reasons for this. One is simply that American food manufacturers sweeten almost everything. I remember returning to the United States after living overseas and being astonished to find sugar in canned kidney beans. Dr. Hyman notes, "Most of us don’t know that a serving of tomato sauce has more sugar than a serving of Oreo cookies, or that fruit yogurt has more sugar than a Coke, or that most breakfast cereals — even those made with whole grain — are 75% sugar. That’s not breakfast, it’s dessert!"

Americans also eat a lot of sugar because we're addicted to it. I don't use that term lightly. Sugar affects the same reward centers of the brain that other drugs do, and produces tolerance in the same manner. People find themselves needing more and more of it to satisfy their sweet tooth and may experience withdrawal symptoms when they don't consume it at regular intervals. To quote Dr. Hyman again, " Recent and mounting scientific evidence clearly proves that sugar — and flour, which raises blood sugar even more than table sugar — is biologically addictive. In fact, it’s as much as eight times more addictive than cocaine."  A 2007 rodent study reported that 94% of the animals chose sugar (or an artificial sweetener) over cocaine when given the choice.  

Drug abuse is a serious and growing personal and societal problem that I don't want to trivialize in any way.  An Associated Press article reports that almost 13,000 people died of a heroin overdose in 2015 and prescription painkillers killed over 17,500 people.  A  2015 LA Times story reports another serious statistic: sugary drinks are linked to 25,000 deaths in the United States each year.  

It seems likely that many, if not most Americans are addicted to sugar to some degree. I believe I was, until my health forced me to radically change my diet. I believe Dan was. We talked about it some through the years, and he never quite denied it, but he never quite addressed it, either. About a year before he died, he developed a persistent itchy rash that doctors had trouble diagnosing. At some point I sent him an article which suggested giving up sugar for two weeks in the case of mystery skin ailments. Not long afterwards, he remarked to me that he had decided that he wouldn't cut sugar out completely, but that maybe he would try to cut down.

I remember that conversation clearly. Dan was itchy and miserable, but not fully willing, for a a brief two weeks, to trade sugar for the  possibility of relief. The basic definition of addiction is continuing to engage in a behavior despite negative consequences, and I remember feeling a wave of deep sadness and thinking, "This is a strong addiction. It could kill him."  I thought there was a good possibility that his heart would cause him major problems some day, but I didn't know how soon the day would come. I think my vague thought of what might happen was that he might have a heart attack in his 60s, and that, if we were lucky, he would live through it and then maybe get serious about changing his diet. 

Obviously, I don't know that sugar consumption had anything to do with Dan's sudden death. He had plenty of other risk factors, including genetic ones, and had a period of high work stress in the time period before he died, which could well have been the final straw. I'm also certainly not unaware that my own health limitations added a significant degree of stress to Dan's life. (On the flip side, I think my need to live a low-toxicity life was protective for him in some ways, as well.)  I can't point to sugar and say that I know it killed my husband, but the research is clear that it is, in fact, a killer.

I'm very sensitive to "blame the victim" messages and absolutely don't want this to come across that way. This isn't blaming, but warning. It's remembering the events of this day three years ago and deeply and sincerely wanting to spare other people a similar experience. Sometimes people take things more seriously when they know people who have been affected, which is my sole motivation for sharing personal stories.

As I was debating whether or not to write this post, I ran across Leviticus 5:1, which says  "If you are called to testify about something you have seen or that you know about, it is sinful to refuse to testify." Yes, it's Old Testament and no, it wasn't written about blog posts, but it convinced me. What I can offer the world these days is limited, but I can testify about things I have seen and know about.

I imagine I've made a lot of people mad by this point. To those who are mad because they loved Dan and are angry that I wrote some negative things about him, I'll simply say that I loved him, too, and miss him greatly. I've cried every day this month so far. I'll also remind you that I wrote a very different sort of post about him three years ago.

To those who are mad because in addition to harping about chemicals, I'm now harping about a very prevalent food choice which is a source of comfort and pleasure, I'll simply say that I get it. Those of us who became addicted to sugar were simply eating the standard American diet or found ourselves eating more sugar because we were avoiding fat and dietary cholesterol like the experts recommended. The sugar industry manipulated studies and public policy just like the chemical industry does today.  It's easy to understand how we ended up in this place, but now that we're here, it's time to accept that there are real consequences.

I write because I care about you. Whether I know you personally or not, you matter to me simply because you've taken the time to read this post. I know other people care about you, too, and we all want your heart to keep beating for a very long time.

Notes from a Webcast Watcher

My health has kept me from attending church for more than a decade and a half now. Over that time I unfortunately haven’t seen much progress in churches addressing toxicity issues. One way in which things have improved, however, is that a greater number of churches are now streaming their services, which, although it certainly isn’t a substitute for attending in person, is a great blessing for those of us who can’t access corporate worship services otherwise. There are enough churches webcasting on Sunday mornings these days that I thought it might be helpful, as someone who watches regularly, to give a bit of feedback on what I most appreciate.

The best place to begin this list is with a genuine expression of gratitude to all churches who’ve made the decision to stream their services and all the individuals who make it happen from week to week. It’s very much appreciated. Online sermon archives are helpful and good, but I personally find the ability to watch a live service exponentially more emotionally satisfying. I feel less excluded and more an actual part of the congregation. When I was able to watch the same church my family members attended, we shared a common experience, at least to a degree, and were able to discuss the service over lunch. Thank you for the effort, webcasting churches everywhere. That said, here are some suggestions for optimizing the experience.

1. Identify your audience. Who are you hoping to serve? Is the stream primarily for regular church members who are unable to attend now and then? Is it for people checking out your church before visiting in person? How about folks outside of your geographic location? Your answer to these questions will determine how you handle other issues.

2. If the stream is for people other than church members, make it as easy as possible for them to know that you webcast your services and when and how to access them. I personally haven’t found any sort of central database, at least for the geographical areas I’ve searched. It would be helpful for denominational and interfaith organizations to compile and post that information.

In my quest to digitally visit as many churches as possible in my new geographical area, I’ve spent much more time than anticipated simply trying to identify my options. A simple google search for churches in my city that stream their services yielded a handful of helpful results and a lot of unhelpful ones. I also had mixed results searching the Livestream and Ustream sites. There were many dead links, but one church provided their new streaming address, which was helpful. A surprising number of churches didn’t provide their name anywhere in the video description. Some gave initials, which was at least a clue. I know the search results were incomplete, because I’ve watched services from at least one church on Livestream that didn’t appear in the results list. I’m guessing the church didn’t include the city name in their description.

Searching YouTube's "live" page wasn't very successful, and if there's currently a way to search for churches that use Facebook Live to stream their services, I didn't discover it. I was also unable to search the sites of Streamspot, Sunday Streams, ChurchStreaming, or Churchvu.

All that said, since there doesn’t seem to be any sort of comprehensive database, I suggest you make the information about streaming very clear on your website and/or Facebook page. (I’ve been surprised at how many churches apparently still don’t have either one of those things, but I’m assuming that if they don’t, they aren’t streaming, either.)  If you don’t stream every service, clearly indicate which ones are going to be available. If you want to make things easier for online visitors outside your geographical area, it’s helpful to note what time zone you’re in. Sometimes a webcast works better in one browser than another, or doesn’t work well on a mobile device, which is also helpful for potential watchers to know.

3. Monitor the feed to make sure it works consistently and have someone available to address issues as they arise. Over my years of webcast watching, I’ve spent a lot of time trying to decide whether, if a stream has consistent problems, it’s better than nothing, or it’s better for that church just not to try at all. I’ve never quite made up my mind. What I do know is that my frustration level was often very, very high when trying to watch services from a church with ongoing webcast issues. I often felt like Charlie Brown. Charlie kept believing that Lucy would hold the football long enough for him to kick it, despite her habit of yanking it away. I kept believing that the webcast problems were fixed, but they kept recurring. During some of those years, I had a way to communicate during the service that there were problems, but most of the time I didn’t. For those of us who are mostly homebound, watching a church service from home feels a bit like watching through a window because the door to church is locked and we don’t have a key. When the webcast stops working, it’s as if the curtains on the window close. The frustration level is lower when we believe someone has noticed that the window is covered and is working to open the curtains again.

4. If there are ongoing problems, look for patterns. I’ve noticed some churches seem to consistently have problems streaming the music, but not the sermon, and the pattern is reversed for other churches. Perhaps it relates to bandwidth or interference as certain equipment is used. I’ve been trying to watch services from one particular church here in town and have found that there are almost always problems near the end of the sermon. I don’t know why that is, but it’s difficult for me to relax when I tune in because I’m always waiting for the moment when the feed will stop working.

5. Start streaming on time, or, better yet, a little bit before the service actually starts. When I tune in at the projected start time and nothing is happening, I never know whether the church no longer streams its services, there are technical problems that day, or they’re just getting started late. I don’t know whether to bail out and find another service to watch or to stick with the one I’m attempting to access for a while. To compound the problem, I’ve found that for some streaming programs, if I tune in and nothing is happening, the video stream won’t automatically start on my end when the church begins the webcast. It will still show no feed until I refresh the page. That’s a very unfortunate system, especially for watchers who have no way to know they need to keep refreshing if they want to know when the service has actually begun.

6. If you have any interest in reaching people other than your regular church members, don’t ask us to create an account and log in to simply watch a Sunday service. It’s an unnecessary barrier and just doesn’t feel very welcoming. This doesn’t appear to be a common situation, but I’ve encountered it.

7. Give people who are considering visiting your church as much information through your webcasts as possible. If you have both a traditional and a contemporary service, for example, consider streaming both. Even if you have multiple services that follow the same pattern, it’s helpful to stream them all. This gives viewers options for choosing what best fits their schedule, and provides other information as well. Hope springs eternal, and I haven’t given up hope of being able to attend church in person someday. I find it helpful when the camera pans out and I can see where I might be able to sit and have potentially clean air. I also notice what people wear. Sometimes people dress up more for one service than another, which often correlates with more perfume use, a health and barrier issue for me. Other viewers may be interested in things like how many children are in the service, or if the aisles are wide enough for easy wheelchair access.

8. Make it easier for people watching at home to sing along with the congregation by providing us with the song lyrics. The easiest way to do that is to simply point the camera at the projector screens in the sanctuary when lyrics are being projected. I’ve watched webcasts from churches who project lyrics over the shots of the praise team, which is a good option for churches with the capability. One church in town has consistently wonderful music that always touches me deeply, but the camera tends to pan from the worship leader to the choir to the praise team and only occasionally gives a shot of the projector screens. I can worship with the congregation when I happen to know the song, but am left simply watching when I don’t. I was spoiled for many years by a worship leader husband who gave me a copy of all the music that was going to be used in the service that day. It’s very odd for me, since his death, to find myself in the position of not knowing many of the songs being sung, but it’s safe to assume that most webcast watchers aren’t married to the worship pastor and are in a similar position. For multiple reasons, I've often thought it would be helpful for churches to post their bulletins or order of service on their websites.  This would be especially helpful for churches that don't provide song lyrics during the webcast, because if I know what songs are going to be sung, I can look up the lyrics online.

9. It’s nice to be acknowledged. I know one pastor (my brother-in-law actually) who walks up to the camera at the end of the service and talks directly to those of us watching, telling us he’s glad we were able to join the congregation that day. I love that. It’s a small gesture that means a lot.

Again, many thanks to all churches who stream their services. Those of us watching at home certainly don’t expect perfection, and we know this is relatively new technology that requires some learning and experimentation. My suggestions are simply meant to spur thought and point out some things you might not have considered. May your efforts bear much fruit for the kingdom of God.