Wednesday, July 26, 2017

Coronary Artery Disease, Stents and Improving Maximum Heart Rate


Dale Matson

I previously wrote an article, which may serve as a useful introduction: http://sanjoaquinsoundings.blogspot.com/2017/03/cardiac-stents-dual-antiplatelet.html
I believe there is a lack of understanding in the scientific literature on the extent of the personal devastation brought about by a diagnosis of Coronary Artery Disease (CAD). This is especially true of those like myself who have led competitive and active lives. Much of our lifestyles and even identities are based on being active. The grief, anxiety and occasional depression are difficult to live with especially since there is little good guidance available that can cushion the devastating diagnosis with hope for the future. My following comments are as an individual lay person and I do not recommend anything I have done for anyone else without that person first consulting with their medical specialists. However, I have found my primary care physician to be invaluable as a consultant and for looking at the overall picture. He has also been encouraging.
Yes, there are good recommendations on diet and food, which can be more than fuel. Food can be medicine. I am not convinced by personal research that the usual protocol cocktail of statins, blood pressure medications, and blood thinners save or even prolong lives. For me, it always seems to come down to the fine line between living the most ‘risk free’ life and a quality life. Additionally some measures and medicines may actually endanger lives with bleeding and anemia.
The most important number to me is not my cholesterol LDL or other measures. It is my Safe Maximum Heart Rate. My Maximum heart rate of 110 was set by my cardiologist following my treadmill stress test, which indicated Ischemia even thought I reached the maximum predicted heart rate of 148 (I am 72 years old)
I wanted a definitive test and we decided on an angiogram, which resulted in having drug-eluting stents implanted. Within two weeks I had a severe bleed resulting from the combination of dual antiplatelet therapy (DAT) (Plavix and aspirin) and undiagnosed ulcers. The GI doctor was able to stop the bleeding with hemoglobin of 7 and with antacids was able to keep me from a reoccurrence. He did caution me that I could bleed again.
The long road back began with the anxiety of another possible bleed or a thrombosis in my stents caused by a clot if I stopped the DAT. This anxiety has been severe enough for me to have ‘as needed’ Xanax prescribed by my primary care physician. I believe it has kept me out of the emergency room more than once.
Three Variables I can control
1. Since the stents were inserted, I have lost 17 pounds. I now weigh less than when I completed Hawaii Ironman and the Western States 100 mile endurance run.
2. I continue to build my iron levels with an iron rich diet and iron supplements. My current hemoglobin is up to 12.8 but not optimal. I hope to raise my hemoglobin to about 16. This will allow better oxygen availability.
3.  I intend to incrementally increase the intensity and duration of my exercise to strengthen my heart. This includes cycling, swimming, walking, and weight training. I can do this because I have a “new” maximum heart rate of 120bpm to work with. The cautionary low heart rate guidelines I have been using have actually ‘detrained’ my heart. Much of my exercise will be in the Sierra Nevada Mountains so there will be additional acclimatization. All of this is done wearing a Suunto heart monitor and chest transmitter. I also keep careful records.
            I have places in the mountains I want to get to and photograph. Each place is progressively more difficult with the final destination requiring four days and three nights of backpacking. Of course this is all predicated on discipline, patience and knowing when to back off if necessary. My next scheduled appointment with my cardiologist is set for January of 2018. I don’t think of this as “heart rehabilitation”. I think of it as I have thought about it for the last 30 years, “Training”. I hope this makes sense to others out there like me.  

    

Monday, July 17, 2017

Is Fear A Part Of The Christian Life?

Fr. Dale Matson

“And I was with you in weakness and in fear and much trembling.” (1 Corinthians 2:3, ESV)
One of the things that happen for me with Scripture is finding new meaning in a familiar verse or in this case a word in a verse that I had never noticed. I think God is selective in what we see and understand as we read Scripture, gradually revealing Truth to us. This is consistent with Jesus statement in St. John’s Gospel, “I still have many things to say to you, but you cannot bear them now). When the Spirit of truth comes, he will guide you into all the truth, for he will not speak on his own authority, but whatever he hears he will speak, and he will declare to you the things that are to come ((John 16:12-12). In this case, I had never noticed the word “fear” St. Paul used in the verse from 1 Corinthians.
St. Paul is a hero of the faith for me. He suffered so much for the sake of the Gospel (2 Corinthians 11:24-28, ESV). In this passage he also refers to his anxiety for the churches. “And, apart from other things, there is the daily pressure on me of my anxiety for all the churches.”
Because of serious and chronic health problems, I have been more fearful and anxious this year. It is so easy to be preoccupied with the nature of my own problems that they become an idol of sorts.
How often do we think of St. Paul’s phrase, “And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.” (Philippians 4:7). How is this peace possible with such physical and emotional suffering?
Although Christians are comforted by faith with the hope that like their Lord Jesus, they too will be resurrected following their death, they generally are not comfortable with the prospect of their eventual death. Entertaining thoughts about death make us anxious and fearful no matter how familiar we are with Scriptures like, “Yes, we are of good courage, and we would rather be away from the body and at home with the Lord.” (2 Corinthians 5:8, ESV) and “in a moment, in the twinkling of an eye, at the last trumpet. For the trumpet will sound, and the dead will be raised imperishable, and we shall be changed (1 Corinthians 15:2). We also have the Old Testament story of Job as a witness. “And after my skin has been thus destroyed, yet in my flesh I shall see God.” (Job 19:26).
 But in the meantime, what are we to do? St. Paul states, “Therefore I take pleasure in infirmities, in reproaches, in necessities, in persecutions, in distresses for Christ's sake: for when I am weak, then am I strong.” (2 Corinthians 12:10).
Over the last year this has been the case for me. God the Holy Spirit has been the comforting voice in my day-to-day living. When we are strong, we depend on ourselves. When we are weak, we depend on the prayers of our brothers and sisters in Christ passages of assurance from Scripture and the calming voice of the Holy Spirit. “For God gave us a spirit not of fear but of power and love and self-control.” (2 Timothy 1:7). My weaknesses have become my spiritual ‘hearing aids”. God has always been there, I am just a better listener. I hope this offers some comfort to those who also suffer from anxiety and fear. Even St. Paul admitted to these problems.


Sunday, July 9, 2017

Transhumanism And The Christian


Fr. Dale Matson

"Transhumanism (abbreviated as H+ or h+) is an international and intellectual movement that aims to transform the human condition by developing and making widely available sophisticated technologies to greatly enhance human intellect and physiology."
https://en.wikipedia.org/wiki/Transhumanism

“Guilty! Guilty! My evil self is at that door, and I have no power to stop it!” Dr. Edward Morbius “The Forbidden Planet” 1956. https://www.youtube.com/watch?v=n0aO1sSILNw

Seven months ago my wife and I sat in the cardiologist’s office. He informed me after placing two stents in a coronary artery that I would not be a candidate for bypass surgery because the arteries to my heart were too small anyway. He said a transplant would help. We all knew that at age 72, my three score and ten years warranty had expired. I thought to myself, “I think I will ride it out with the original equipment.”

As stated in the series The Six Million Dollar Man, “We can rebuild him. We have the technology. We can make him better than he was. Better, stronger, faster”. I use hearing aids; have stents in my arteries and an intraocular lens following cataract surgery. I have no problem whatsoever with aftermarket parts.

Science Fiction is becoming science fact. On the surface it seems like advocates for Transhumanism want the same thing Christians want. We hope for eternal life with glorified bodies. “He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away.” (Revelation 21:4, ESV)

Transhumanists believe technology and science will help humans evolve into a new species. St. Paul said Christians were a new creation. “Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come” (2 Corinthians 5:17 ESV).

One transhumanist example would be the desire to couple computer technology with human biology to vastly increase human intellect and intercommunication. This is probably best demonstrated by the “Borg” in the Star Trek series. This would be “group think” at its worst. You don’t enlist. You are shanghaied.

In a sense, we are already wed to technology but have this technology outside of us with smart phones and less portable computers. I don’t think this has raised our intellectual capacity but it has allowed us more and fasters access to information and communication.

Can science and technology enhance our lives? Of course they can. Both the current Archbishop of Canterbury and former presiding bishop (a scientist) of TEC have stated that “human flourishing” should be a big part of church missiology. Human flourishing is a new gospel. My guess would be that both would advocate for most of the transhuman agenda.

The transhumanist agenda is not monolithic and in the extreme some hope to upload their consciousness to a mainframe computer, some hope to be cryogenically frozen at the moment of death in the hopes a cure will be available in the future. Others hope for genetic manipulation of a fetus to enhance inherent attributes before birth. I guess delaying for a year; your son’s kindergarten enrollment so he will be better in sports isn’t quite good enough.

Of course there are ethical concerns about whether we should use the technology once it is developed. More recently we have seen comic book heroes come to life who are genetically modified like Captain America. Will transhumans consider themselves super humans and the rest of us lesser humans? Will we become obsolete and therefore dispensable?

Whenever humans are considered subhuman, there will be those who will justify inhumane treatment even in the name of science. In addition to mass extermination, the experimentation with prisoners in the Nazi death camps is a prime example. Dr. Mengele, Dr. Morbius and the Krell had enormous intellects. However, no matter how much the intellect evolved, there remained a primitive evil that destroyed them and those around them.

What is the Christian position in all of this? We are to speak for those who cannot speak for themselves, especially the unborn. “For consider your calling, brothers: not many of you were wise according to worldly standards, not many were powerful, not many were of noble birth. But God chose what is foolish in the world to shame the wise; God chose what is weak in the world to shame the strong; God chose what is low and despised in the world, even things that are not, to bring to nothing things that are, so that no human being might boast in the presence of God.” (I Corinthians 1:26-29)

Maybe the antichrist is currently cryogenically frozen. Something to think about.



Saturday, July 1, 2017

Sin

Pentecost 4A 2017


Fr. Dale Matson

My homily is based on our Epistle Lesson from Romans.

“What shall we say then? Are we to continue in sin that grace may abound?  By no means! How can we who died to sin still live in it? Do you not know that all of us who have been baptized into Christ Jesus were baptized into his death? We were buried therefore with him by baptism into death, in order that, just as Christ was raised from the dead by the glory of the Father, we too might walk in newness of life.
For if we have been united with him in a death like his, we shall certainly be united with him in a resurrection like his.  We know that our old self was crucified with him in order that the body of sin might be brought to nothing, so that we would no longer be enslaved to sin.  For one who has died has been set free from sin.  Now if we have died with Christ, we believe that we will also live with him.  We know that Christ, being raised from the dead, will never die again; death no longer has dominion over him.  For the death he died he died to sin, once for all, but the life he lives he lives to God.  So you also must consider yourselves dead to sin and alive to God in Christ Jesus.” (Romans 6:1-11)
As a side note, our lesson is from our new Anglican Church North America lectionary readings. The 1979 Book of Common Prayer we formerly used leaves out verses one and two. This means that we now admit to more sin in the ACNA than we did before. 
In our reading, Paul uses the word sin seven times. To underscore this fact, verse 10a states “He [Christ]” died to sin once for all.” Let us also put this alongside Paul’s statement in 1st Timothy (1:15a) “The saying is trustworthy and deserving of full acceptance, that Christ Jesus came into the world to save sinners (ESV). It was the will of God the Father that Christ come into this world and die to save sinners. St. John states, “Whoever makes a practice of sinning is of the devil, for the devil has been sinning from the beginning. Adam and Eve were the first human sinners but the devil was the first sinner. The reason the Son of God appeared was to destroy the works of the devil” (1 John 3:8). And how did Christ destroy the works of the devil? He died for our sins. Christ’s death covers not only the sins we have and will commit. His death atones for original sin also. His death provided a path to reconciliation with God and it freed us from bondage to the devil.   
OK, so whatever became of sin? This is not exactly a new question for us in the 21st Century. Many psychiatrists, psychologists and sociologists have been asking this question for quite awhile. This just happens to be the title of Dr. Karl Menninger’s book, “Whatever Became of Sin” written in 1963. In his book the Psychiatrist wrote this. “Much behavior that would be classed as sinful had long since passed into the control of the law. What was considered criminal and treated so was understandably sinful. And now, increasingly, some crime was being viewed as symptomatic. Sins had become crimes and now crimes were becoming illnesses: in other words, the police and judges had taken over from the clergy, the doctors and psychologists were now taking over from the police and judges”
This reminds me of lyrics from the song “Officer Krupke” from the musical “West Side Story”. “Officer Krupke, you're really a square; this boy don't need a judge, he needs an analyst's care! It's just his neurosis that oughta be curbed. He's psychologically disturbed!”
Following Dr. Menninger’s book, Philip Rieff the sociologist and social critic wrote a book called, “The Triumph of the Therapeutic: Uses Of Faith After Freud”. (1966) As a sociologist, Rieff understood and reviewed how the culture of Christianity provided boundaries for human behavior. In his book he paraphrases St. Paul’s question, (1 Timothy 3:15) “Being saved, how should we conduct ourselves.” His answer, “Behave like your Savior.” (p. 12). His point was that when the cultural restraints are lifted, humans succumb to their uncivilized urges. The upcoming age was becoming the age of the autonomous, isolated individual, throwing off cultural restraints and pursuing pleasure rather than self control. Freud claimed that the rules of society were too strict and when those rules became internalized the individual was put in a state of war within him or herself. The individual became neurotic because a person’s conscience would punish them if they were to act on their urges. Sigmund Freud had given them the green light to misbehave by saying that their conscience like society was too strict. Keep in mind that Freud was also a cocaine addict for years. A more permissive society with relaxed standards of morality does not lead to less neurosis. Freud was wrong.

Philip Reiff laid the blame at the feet of those who led the institutions who did not attempt to hold back this new “unreligion” of Freud. In particular, he cited the preachers and priests in the pulpits who lacked faith and were too cowardly to advocate for renunciation. What is renunciation? Renunciation is self-denial, self-control and sacrifice for the sake of family and community. Renunciation resists sinful behavior. I think the title of the Isley Brothers song of 1969 pretty much summed up societies morals formed in the 1960s. "It's Your Thing, Do What You Wanna Do".
If one takes the ten commandments of Moses or the great commandment of Christ as a summation of all of the rules, what is it that enforces compliance? Why do we usually do the right thing? Most would say it is our conscience that is our personal policeman and judge. The conscience is the internal judge that uses guilt to punish individuals that do not live according to their own internal rules. Jesus would compare someone who does not live according to his own rules to a house divided against itself and a house divided against itself cannot stand. In reality, guilt is a painful blessing if it causes us to repent; if it causes us to say, “I am sorry for what I said, for what I’ve done. Please forgive me.”
The wish to express what Freud considered to be natural human desires was met with a scolding conscience. People hid these wishes from their conscience by pushing them down into their unconscious mind. These wishes came out in their dreams. Later, because of this constant inner war, the person developed mental and physical problems. It was the goal of psychoanalysis to get people to remember what they had intentionally forgotten. Intentional forgetting is called denial or repression. Neurotics were encouraged by their therapists to release the undesirable thoughts from the captivity of the unconscious mind much as Moses led the Israelites out of captivity in Egypt.  Like Adam and Eve attempting to hide from God, denial and repression are examples of a person hiding from his own conscience. The analyst or counselor is there to say to the individual, “It’s OK to have those thoughts. You are a good person. You are just being too hard on yourself.  You are suffering from false guilt. You are punishing yourself unnecessarily.” The reality is that boundaries/rules provide freedom. The most freeing thing God did for the Jews in the Old Testament was not providing for their escape from Egypt but providing them with the Law. The Law gave them rules to live by and a life with meaning and purpose. Make no mistake, the devil hates the Law and has hated the Law from the beginning because he is a sinner from the beginning. St. Paul talked about the end times in 2 Thessalonians 2:3, “Let no one deceive you in any way. For that day will not come, unless the rebellion comes first, and the man of lawlessness is revealed, the son of destruction.” This is probably a reference to the antichrist but to me, it is the devil himself who empowers and controls the antichrist. For most of our society not only is Christ no longer relevant, the Law God gave the Israelites and by extension, the Law God gave us also, us is gone. 
Here is where the priest should be taking a different path than other counselors. When it comes to the reality of sin, the Priest must not be “referring out”. The psychologist, psychiatrist or social worker as secular priests may claim that the individual suffers from false guilt but what about real guilt? They are enabling the individual to deny the reality of their guilt. They are providing a fig leaf and it doesn’t work any better for those they counsel than it did for Adam and Eve.  Unfortunately un-confessed sin and denied guilt eventually can give rise to physical problems and even “accidents”. In many cases self-destructive behavior is a form of self-punishment. Here is the reality of what I am saying. As Christians we have the Law placed inside us. If the Spirit leads us, we will not be in bondage to the Law but will love and honor the Law. The carnal Christian St. Paul describes in Romans 7 is not led by the Spirit and struggles in vain to honor the Law. Romans 7 could be summed by the 1977 hit song by Bobby Fuller, “I Fought The Law And The Law Won” Please see Romans Chapter 8.
It is not the job of a Priest to lower the conscience threshold in order to get rid of the conflict. We are here to diagnose the problem, which is sin, and prescribe the treatment, which is repentance and confession, and offer the prognosis, which is absolution and forgiveness.  What is needed is restoration to fellowship with God, our brothers and sisters through repentance confession and absolution. Unfortunately many clergy today have bought into the idea that people are basically good. If we are not in Christ, we are not “OK”.  Brothers and sisters, we are not born basically good. In Anglican and Orthodox Churches Baptism has included Exorcism; whether infant or adult. In the Roman Church we have the following: “During the Sacrament of Baptism, the Priest says two prayers of Exorcism”.
On those occasions where we experience real guilt there is only one healthy response. “If we confess our sins, He is faithful and righteous to forgive us our sins and to cleanse us from all unrighteousness.” (1 John 1:9). Guilt is a symptom of sin, with sin as the underlying illness. For us, there is the weekly confession of sin and there is the Sacrament of Reconciliation. We hear the following from the BCP, “When the penitent has confessed all serious sins troubling the conscience and has given evidence of true contrition, the priest gives such counsel and encouragement as are needed and pronounces absolution.” (p.446)
It has frequently been said that the couch of the psychoanalyst has replaced the confessional of the priest. The psychoanalyst has not replaced the priest because the psychoanalyst will not acknowledge the sin and guilt and cannot offer forgiveness on behalf of God. I know this from both personal and professional experience. I have more comfort, consolation and healing to offer as a priest who is a representative of Christ than as a psychologist.
 If you are troubled with guilt and anxiety because of unacknowledged sin, there is a course of action that is the only remedy. This remedy is not found on the couch of the psychoanalyst. It is found in the church. “Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working.” (James 5:16). Amen.