Mountain Top Reflection – Men’s Weekend 2011

So Jeremy (C) asked the question “What is most the most courageous thing I’ve done?”  We had climbed to the Cross on the mountain adjacent to Volmoed.  The climb alone brought tears to my eyes but I think the tears that followed came from the heart…..

It took a nano second to answer that question sitting on “My Rock” gazing over God’s magnificent creation, overlooking Hermanus and the bay. 

“To put my life and future solely in God’s hands”. 

You see I always believed my eternity and life was solely governed by my ego, personal drive and ambitions, to the extent of utter selfishness.  30 years ago at University I was an Ayn Rand fanatic. For those who do not know, she was born 1905 a Russian novelist and Philosopher. She is known for her two best-selling novels The Fountainhead and Atlas Shrugged and for developing a philosophical system she called Objectivism.

Ultimately the philosophy was the concept of man as a heroic being, with his own happiness as the moral purpose of his life, with productive achievement as his noblest activity, and reason as his only absolute. Rand advocated reason as the only means of acquiring knowledge and rejected all forms of faith and religion.  She was a determined atheist  and she valued reason above any other human attribute. 

Atlas Shrugged was published in 1957 (year of my birth). The theme of the novel outlines “the role of the mind in man’s existence and, as a corollary, the demonstration of a new moral philosophy: the morality of rational self-interest.”   You may be interested that after completing the novel of more than one thousand pages, Rand fell into a severe depression that may have been aggravated by her use of amphetamines and she died of lung cancer secondary to her lifelong heavy smoking.

Interestingly there is only one other book I have read more times since  – the Bible (3 times in 18 months).

When Thomas, one of Jesus’ disciples, heard from the others that Jesus had risen from the dead, he would not believe it. In fact, he flatly stated, “Unless I see the nail marks in his hands and put my finger where the nails were, and put my hand into his side, I will not believe it.” One week later, Jesus appeared to them again, with Thomas now present. Jesus said to Thomas, “Put your finger here; see my hands. Reach out your hand and put it into my side. Stop doubting and believe.” Thomas replied, “My Lord and my God!”

18 months ago I invited the Lord into my heart and life with the knowledge that Jesus told Thomas  “Because you have seen me, you have believed; blessed are those who have not seen and yet have believed”.

The late Carl Gustav Jung said, “The central neurosis of our time is emptiness.” All of us have a deep longing for our life to have meaning and depth. I am living proof Jesus offers us a more meaningful, purposeful, abundant life, which comes through a relationship with Him.

I now understand for the first time we are created in God’s image for relationship with Him. Being in that relationship is the only thing that will ultimately satisfy our souls. I have achieved some noble purposes in my first 50 years, but not the one I was ultimately designed for.  Not until I found the Lord this time last year.

Augustine summarised correctly with these words: “You [God] have made us for yourself and our hearts are restless until they find their rest in Thee.”

My relationship with God has quenched  my soul’s longing. Jesus Christ said, “I am the bread of life. He who comes to me will never go hungry, and he who believes in me will never be thirsty.”

What happened next is difficult to describe but I can only put it this way: I “met” God, after which I discovered real fulfilment. I felt inner peace and a wholeness I had never experienced before, as if an empty part of me deep down in my soul had been filled — a wholeness that has been a part of my life ever since that day.  “When I read and listen to  the words of Jesus, it seemed to me He was speaking to my heart, and he was saying, ‘I am the way to life. If you follow me and do what I say, your life will change’.

My life has changed. 

Isaiah 40:28

Do you not know?  Have you not heard? The LORD is the everlasting God,  the Creator of the ends of the earth. He will not grow tired or weary, and his understanding no one can fathom. He gives strength to the weary and increases the power of the weak. Even youths grow tired and weary, and young men stumble and fall; but those who hope in the LORD will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint.

Wow what a journey.  Lord keep me humble and desperate.

Matters of Health (Part 4a)

I plan to cover in great depth the prevention and management of cardiovascular disease over the next few Blogs.

This will be broken down onto “bite-sized” chunks as the data is extensive (to digest).

• Lifestyle choices with detail covering the process of physical conditioning (this Blog Matters of Health 4a)
• Lifestyle choices with nutrition
• Aggressive risk factor reduction with modern pharmacology
• Role of the Holy Spirit

The Compression of morbidity as we age:

The pandemic of overt clinical cardiovascular disease starts to manifest around mid-life but as you are now aware the pathology of the disease has started 2-3 decades earlier.  As a major chronic disease the burden to society is high and the quality of life deteriorates progressively.  Health care costs rise progressivley (yellow line below) until the end of life.  The whole idea of primordial prevention of cardiovascular disease is to compress the chronic morbidity (blue line below) into the last few months of life, rather than struggling with chronic disease for the last few decades or life.

This “compression of morbidity paradigm” not only provides far better functional and productive quality of life in the latter decades but actually allows us to reach our “biological clocks” rather than dying prematurely.  We don’t have clear data as to what the optimal biological clock is in us as genetics play are large component in our survival but according to Genesis:

Genesis 6:3

Then the LORD said, “My Spirit will not contend with humans forever, for they are mortal; their days will be a hundred and twenty years.”

Prevention of Chronic Disease:

Published in Science (2002; 296: 695-698) from the Centre of Research for Disease Prevention it has been projected that with balanced lifestyle intervention and modern pharmacotherapy we can pretty much eradicate vascular disease; many cancers and the epidemic of overweight/ obesity  related Type 2 Diabetes Mellitus.

Heart Rate and Survival:

In our lifetime we have approximately 8 000 000 000 heart beats per life.  Remarkably (but not surprisingly with God as our Creator) this parameter is constant across all human and animal life (including reptiles, mammals and birds).  There is a LINEAR inverse relationship to survival and resting heart rate (HR) per minute across ALL species.  Man is also reflected on this curve for those with slow HR at rest have higher life expectancy as an independent parameter for survival.

Resting heart rate is thus a very important contributor to heathy ageing in both heathy individuals and with those who have established cardiovascular disease.  In folk with heart failure or coronary disease the prognosis of patients with a resting HR > 80 bpm is considerably worse than those whose resting HR is < 70 bpm.

It has been calculated that by JUST reducing HR  from 70 bpm to 60 bpm in heathy individuals you potentially ADD 13.3 years to life expectancy!

Relative risk of Death verses Objective Physical Performance:

This is a very important graph as it demonstrates that your OBJECTIVE performance base is the most important “benchmark” of SURVIVAL.  Even if you think you are healthy if you can’t exercise to a workload of 5 METS then your prognosis is lousy.  In fact you have the SAME prognosis as a heathy individual with poor performance base to a person with advanced cardiovascular disease who also can’t exercise through 5 METS.

The reverse is true in that if you have cardiovascular disease and CAN exercise to high workload > 10 METS (through stage 3 of Bruce protocol on formal exercise stress testing on a treadmill) your prognosis is as good as a corresponding “healthy” person who can achieve te same workload.

In other words your OBJECTIVE physical performance is the most important determinant of survival and life expectancy.

Cardiovascular Conditioning with Exercise:

The purpose of daily conditioning exercise is to change our intrinsic balance of our AUTONOMIC NERVOUS SYSTEM in favour of the parasympathetic nervous system.  Individuals who are driven by and generally over express the SYMPATHETIC nervous system (the “fight-and flight” system) do not survive well and tend to “burn out’ with chronic disease.  These individuals are “adrenaline” junkies and self destruct.  By contrast the training up your parasympathetic nervous system with regular conditioning exercise slows the HR and lowers adrenaline (and other stress hormones) and lowers BP.

So What is Cardiovascular Conditioning (fitness)?

There are 4 components to fitness/ conditioning:

1. Aerobic Fitness
2. Muscular Fitness
3. Flexibility and core strength
4. Body Composition

A little more about visceral adiposity:

The adipose tissue (specifically visceral intra abdominal adipose tissue), once considered a simple energy warehouse, is now regarded as a complex organ not only contributing to the management of energy flux within the body but also interacting with the inflammatory system and the vascular wall.  Recent studies have underlined that there is intricate interplay among adipocytes, the sympathetic nervous system, and the renin-angiotensin system which participate in the obesity-associated dysmetabolic state. Thus, the adipose tissue is believed to play an important role in the development of both hypertension and other complications related to insulin resistance.  When adipocytes become enlarged, for unknown reasons, they secrete factors which attract inflammatory cells, called macrophages which in turn release toxic factors such as the interleukins responsible for damage to the liver and other organs including our arteries and promote the insulin resistance causing type 2 diabetes and accelerated atherosclerosis.  Today we have tests to assess our inflammatory load, generally thought to arise from our arteries.

Aggressive reduction of obesity and in particular the visceral component, has major implication in reducing the associated chronic conditions of obesity.

SUMMARY:

To physically condition ourselves, requires a dedicated sophisticated daily training programme.  Walking puppy round the block three times a week sadly does not suffice.  It is important to objectively measure your conditioning response to assess the benefit of your exercise programme as I meet many people who consider themselves fit but are actually not optimally conditioned (poorly developed parasympathetic nervous system).

Physical conditioning is THE most important benchmark of healthy ageing and contributes to considerably improved quality and quantity of life.

Your need on average to dedicate 1-2 hours per day to perform the process to optimise the 4 components of physical conditioning, bearing in mind you would NEVER just study God’s inspired word for 15 minutes a day.  Would you??

1 Corinthians 6:19

Do you not know that your bodies are temples of the Holy Spirit, who is in you, whom you have received from God? You are not your own; 20 you were bought at a price. Therefore honour God with your bodies.

Yours in exercise

Cardiologydoc

Spiritual Freedom

I was really touched by Jeremy’s Sunday sermon on “Spiritual Freedom” but realised this concept has quite profound consequences on how we have to behave.  We have been privileged to have been given “freedom of choice” but sadly historically we have got ourselves into bad trouble with this freedom and there seems to be a “fine line” between relative and absolute truth:

Genesis 1:15

The LORD God took the man and put him in the Garden of Eden to work it and take care of it. 16 And the LORD God commanded the man, “You are free to eat from any tree in the garden; 17 but you must not eat from the tree of the knowledge of good and evil, for when you eat from it you will certainly die.”

Somewhere along the line I guess we have to CHOOSE to use our “freedom” appropriately but where are the guidelines? Jeremy pointed us to the Book of Romans for the answers regarding “spiritual freedom” where the Disciple Paul inspired through God reminds us vividly on this topic:

Romans 1:16

“For I am not ashamed of the gospel, because it is the power of God that brings salvation to everyone who believes”.

Certainly there is no ambiguity of the consequences of not following the guidelines, as on the opposite side of the coin is God’s wrath against sinful humanity.  This pretty much ties in with my previous Blogs regarding the current health woes of mankind (see Health Matters 1-3).

Romans 1:18 

The wrath of God is being revealed from heaven against all the godlessness and wickedness of people.  17 For in the gospel the righteousness of God is revealed-a righteousness that is by faith from first to last, just as it is written: “The righteous will live by faith.”People, who suppress the truth by their wickedness, 19 since what may be known about God is plain to them, because God has made it plain to them. 20 For since the creation of the world God’s invisible qualities-his eternal power and divine nature-have been clearly seen, being understood from what has been made, so that people are without excuse.

28 Furthermore, just as they did not think it worthwhile to retain the knowledge of God, so God gave them over to a depraved mind, so that they do what ought not to be done. 29 They have become filled with every kind of wickedness, evil, greed and depravity. They are full of envy, murder, strife, deceit and malice. They are gossips, 30 slanderers, God-haters, insolent, arrogant and boastful; they invent ways of doing evil; they disobey their parents; 31 they have no understanding, no fidelity, no love, no mercy. 32 Although they know God’s righteous decree that those who do such things deserve death, they not only continue to do these very things but also approve of those who practice them.

The rewards of obedience to God are clear but as Jeremy indicated on Sunday, do we spend enough time and effort with those non-believers that they face real dangers……?

Romans 2:7

To those who by persistence in doing good seek glory, honour and immortality, he will give eternal life. 8 But for those who are self-seeking and who reject the truth and follow evil, there will be wrath and anger. 9 There will be trouble and distress for every human being who does evil.

In Romans 6:23  almost cerainly Paul is referring to “spiritual death” when he refers to:

For the wages of sin is death, but the gift of God is eternal life in Christ Jesus our Lord.

Romans 8

Life Through the Spirit

1 Therefore, there is now no condemnation for those who are in Christ Jesus, 2 because through Christ Jesus the law of the Spirit who gives life has set you free from the law of sin and death. 3 For what the law was powerless to do because it was weakened by the flesh, God did by sending his own Son in the likeness of sinful flesh to be a sin offering. And so he condemned sin in the flesh, 4 in order that the righteous requirement of the law might be fully met in us, who do not live according to the flesh but according to the Spirit.

5 Those who live according to the flesh have their minds set on what the flesh desires; but those who live in accordance with the Spirit have their minds set on what the Spirit desires. 6 The mind governed by the flesh is death, but the mind governed by the Spirit is life and peace. 7 The mind governed by the flesh is hostile to God; it does not submit to God’s law, nor can it do so. 8 Those who are in the realm of the flesh cannot please God.

Romans 15:13 summarises beautifully:

May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit.

Philip Yancey writes in his wonderful book “What’s So amazing about Grace”…

” the proof of spiritual maturity is not how pure you are but awareness of your impurity”.  “That very awareness opens the door to grace.”

Amen