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When heart patients sit across from Dr. Stephen Devries at his University of Illinois at Chicago office, they are usually in for a surprise.
"People test high for cholesterol and I mention that one option to get the cholesterol in check is to take medication," said Devries, medical director of the UIC Outpatient Heart Disease Prevention Center. "A person often looks uncomfortable and then says, `I don't want to take a drug.' "
At that point, Devries looks the patient right in the eyes. "OK," he says. "Let's try something else first."
The patients are typically relieved and surprised. Here is a doctor willing to work in their comfort zone rather than dictate treatment.
"It's wrong to move people into a treatment before they are ready," Devries said. "That's not a healing situation. So we will start with changes in diet and exercise and stress management, see how far that takes the patient."
In many cases, that's pretty far. Researchers are building a heart-healthy case for diets high in produce and grains, regular physical activity and less chaotic lifestyles. Devries' patients are building their own evidence.
"Cholesterol is far from the only indicator of heart health," he said, "but it is tangible evidence that a person is moving in the right direction. People can see results in a matter of weeks."
Although heart disease prevention is the focus of Devries' practice, he realized he didn't know enough about natural lifestyle therapies to properly guide his patients.
"I attended mainstream medical schools," said Devries, 46. "I didn't learn anything about nutrition."
Devries has addressed the shortcoming in effective fashion. He is participating in a continuing education program at the University of Arizona founded by integrative medicine pioneer and best-selling author Dr. Andrew Weil.
"It's helped me to see a wider range of options for people," including dietary supplements and relaxation techniques, said Devries. "No one therapy works for everybody, so it is valuable to be familiar with different approaches. Even if I eventually prescribe a medication, I tell patients it is only a half-dose. The other half comes from making lifestyle changes."
An important note: Heart disease prevention tends to be a long-term proposition, which makes lifestyle interventions safe to try. Any person diagnosed with heart irregularities is likely to require more urgent medical attention.
Devries' interest in integrative therapies grew as he listened to more and more patients discuss successful or failed attempts.
An October 2003 survey commissioned by the reputable supplement maker Enzymatic Therapy confirms Devries' position that "patients will be leading doctors to gentler solutions" to heart problems. Nearly two-thirds of the 1,156 U.S. adults surveyed said they ate a healthy diet to safeguard against heart troubles, while about half said they exercised regularly for similar purposes. Thirty-five percent take supplements to support heart health.
Devries often fields questions about the Atkins and South Beach diets. (Discussions intensified last week with the release of a medical examiner's report that Robert Atkins weighed 258 pounds when he died. His allies said much of that was fluid retention from a coma.)
"I talk with patients a lot more these days about carbohydrate limits and monitoring the glycemic index," which gauges how quickly foods metabolize in the body, said Devries.
But Devries also discusses the unsung strategy of heart disease prevention.
"I'm very interested in stress reduction as it relates to heart problems," he said. "It can make a huge difference in heart health and quality of life. I might recommend yoga, breathing exercises or biofeedback, depending on the patient."
Devries discovered biofeedback therapy through a patient who quit smoking in just one session. A biofeedback specialist typically wires a person to check such factors as pulse, finger temperature and muscle tension in the face and jaw. The idea is to demonstrate to people that stress shows up adversely in the body (fast heart rate, cold fingers, tense jaws). Then the biofeedback therapist or Devries himself can offer relaxation techniques.
Devries recommends a "relaxing breath" exercise to his patients for tense moments and before going to bed: Inhale for a count of four, hold the breath for seven beats, then exhale for an eight-count. Devries uses the technique.
"People are receptive to breathing exercises, and many of them find yoga to be a perfect complement to a hectic week," said Devries. "Patients get motivated when you tell them they might have to take medication, possibly for a lifetime."
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(Bob Condor writes for the Chicago Tribune. Write to him at: the Chicago Tribune, 435 N. Michigan Ave., Chicago, Ill. 60611.)
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(c) 2004, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.
