The Low-salt, Low-fat Diet. Part 1

General instructions for following a low-salt diet. You should eat only foods low in sodium content. Use no table salt (sodium chloride) in food preparation or at the table. Neo-curtasal, Diasal, Lacasal, Co-Salt (sodium free substitutes) may be used to season foods while cooking or at the table. Do not use bicarbonate of soda (baking soda) either in cooking or as an antacid. Use distilled water.

Rest. Sleep and rest are important. With a return of normal health, the heart patient may be inclined to do more than he should. Avoidance of fatigue from work or social activity, however, is the wisest course. Most patients should get from eight to nine hours of sleep in these hectic times. Some people, it is true, seem to get by with only five or six hours of sleep. But they are exceptional people. Patients must also be guided by their own reaction to work and daily activities. If they find themselves feeling tired or "run down" during the day, they should take a little time out for a nap. A good time for such cat-naps is the middle of the day and just before the evening meal. I often advise businessmen patients of mine to take a half-hour to rest, either in their offices or clubs, once or twice during the day, while their secretaries or business associates "cover" for them. They find that being "out" a half hour once or twice a day causes no great inconvenience, occasions no comment from their clients and is most refreshing. Social activities must be pleasant, non-taxing, and of the kind that induce a cheerful and relaxed mood. The coronary patient has always to bear in mind that he is better off away from scenes of anxiety, tension, or conflict - at play as well as at work. The value of relaxation to the coronary case and development of keen interest and enjoyment in activities outside work is especially appreciated by the physician. Several years ago in Los Angeles, a number of my colleagues formed a "Coronary Club." To be eligible, you had to be a physician and you had to have suffered a coronary thrombosis. Club members have developed the highest skills in their hobbies. Some of the most widely enjoyed of these hobbies are oil paintings, chess, sculpting, and water-color painting. Several of the doctors have already won recognition and prizes during the annual "shows" that local and national medical societies give for painting and sculpture. Indeed, one of my colleagues finds that he can hardly wait to get away from his office in order to work on an oil painting of his daughter!

Should you exercise? The kind and amount of exercise you take assumes a more important role in your life following a heart attack. Some people are almost fanatical in their belief that physical exercise is the only way to maintain good health. They are the persons who insist upon the efficacy of such gadgets as treadmill machines, Indian clubs, bar bells, and a variety of exercising machines. They will assure you that your heart trouble was caused in the first place by lack of exercise. The only way to regain your health now is to "restore the vitality and muscle tone that can come only from exercise." Some years ago I treated Dr. B., a brilliant and well-known biochemist and bachelor. After he recovered from his coronary attack he tried to live the exemplary, perfect life, living at home alone with his mother. After one year of excellent physical health, a new symptom developed: severe and persistent headache. The following conversation took place in my office: "Doctor Morrison, this headache of mine is just about killing me. I feel as though a vise were squeezing and crushing my head." "Well, Dr. B., you know your heart and blood pressure as well as the rest of your 'physical exam' are now perfectly normal". "But, Dr. Morrison, why do I suffer from this infernal headache? I lead an ideal life. I watch my diet, I don't smoke, don't drink, retire every night at 10 p.m., never keep late hours, am home every night with mother, never go out, don't even bother with women. What can it be?" Looking him straight in the eye and with a grin, I said: "It's simple, Ben, your halo is just too tight".

There was a startled minute of surprise and silence. Then Dr. B. himself grinned and saw through this joke into his own overstriving for perfection, having forgotten that the body needs more than physical tending to - it needs diversion, recreation, mental relaxation. I prescribed a holiday, a large dose of fun, a deep draught of gaiety and diversion, to be followed by regular, frequent doses of the same "medicine." His headache, obviously from tension and accumulated anxiety, vanished quickly! Actually, the extent of your physical exertion in any activity is a matter that must be decided by your physician. He knows that patients vary widely in their capacity for exercise and their body's tolerance to physical exertion. He knows also that exercise is nothing more than a means of stimulating the body's metabolism, of changing the body's chemistry through its effect on both circulation and on improved elimination. At least one half of all patients who experience a coronary thrombosis make a complete recovery and are able to resume normal physical activities. Of the other 50 per cent of patients, about one quarter find they are definitely limited as to their physical exertion or work. The remaining 25 per cent are either retired from work and normal activities entirely, or assume a disabled status.

President Eisenhower is a good example of those who recover completely. Despite the complication of ileitis added to his initial trouble, he made a satisfactory comeback following a coronary thrombosis. Although he was placed on a prolonged program of anti-coagulants (drugs that prevent clotting in the blood), he continued to play golf occasionally; he exercised with care and moderation, and returned to his customary Presidential duties.