The Heart Attack

I am a 56 year old 6 foot 13 stone 12lbs male and 9 months ago I had just returned from my 2 mile run. This is an additional run to my weekly 6 mile run with the local running club. Things felt fine on the run, I even recall quickening up a bit on the final 600 yards. On entering my house however I felt a pain in the centre of my chest. It wasn’t a doubling up kind of pain, just an annoying, gnawing kind of ache. My first thought was that I had over exerted my lungs but when it did not subside after 45 minutes, despite trying various positions, I decided to ask my son to drive me down the infirmary to get it checked. I walked into the infirmary and was seen pretty quickly, they clearly take chest pains seriously. The first doctor thought it was skeletal and gave me a couple of pain killers but when neither of these worked I suspect they guessed it could be more serious. The next treatment was a spray under the tongue which dilates your arteries. This did the trick and the pain was completely gone after 10 minutes. In the meantime blood had been taken and was being checked for signs of a heart attack. I was way over the limit and this time it was not my driving licence that was at risk. As Eric Morecombe famously once said, its not until they tell you that you have had a heart attack that you really have a heart attack. I was transferred to a specialist hospital where I stayed for 4 days during which time an angiogram was performed. This involves injecting dye into your blood stream and then x raying your arteries to check the flow of the dye and hence the openness of the arteries. My main arteries were fine but a minor artery showed some signs of narrowing and the doctor suggested a stent was not mandatory but he would advise it. Now here is my first piece of advice. If the application of a stent or stents is precautionary rather than life essential then I would suggest you refuse them, although this is not always easy to do when you are lying on an op’ table with no phone a friend let alone an alternative Cardiologist. You will see why I suggest such action later in my blog entries, but bare with me for now.

You are out with your stent the very same day along with a bag full of drug goodies. Mine included Aspirin to thin the blood. A Statin to lower cholesterol and anti oxidate. A Platlet aggregate reducer to lower Platelet stickiness. A beta blocker to lower heart rate and finally a drug to reduce blood pressure. In my next post I will explain why I rejected all of these drugs in favour of a dietary approach to the problem and how the doctors penalised me for adopting such a course of action. I will also look at how woeful the NHS is at tackling route causes of disease whilst pouring millions of pounds into suppressing symptons on behalf of drug companies.

Quick footnote to this first entry. How would you recognise a heart attack and what should you do ?. The symptons can vary and some people complain of pains down the arms, neck or even chin. In my case it was a central pain. I think most people report that the pain is permanent, that is to say it does not ease with lying down or varying your position. What you need to do is sit down rather than lie down and whilst waiting for an ambulance or lift to the local hospital, get your arteries to dilate. The quickest natural way to do this stick some Cayenne Pepper under your tongue and/or drink a glass of water with a tea spoon of Cayenne Pepper in it. I would actually recommend the cayenne drink on a daily basis regardless. You will quickly get used to the heat after the first few experiences. Its probably wise to also immediately take a couple of baby aspirins. Hopefully you will need none of the above and I hope to explain in future entries how to improve your chances.

Out Of Hospital

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The first thing that struck me about leaving hospital is that I had had no screening for what caused the problem. Plenty of drugs to sort out the symptons but no advice on how to treat the root cause or causes. I had not even had any dietary advice which seemed strange although I now realise that this comes in a group session a month or two afterwards. You might think that a couple of month’s gap between getting dietary advice and heart attack is a bit much. I suggest this not because 2 months is likely to reek untold havoc on the endothelial wall of your arteries, but because it gives you time to research into what aspects of diet actually contribute to heart disease and then realse that at the group meeting a great deal of the dietary advice is wrong and out of date. I will cover this meeting later and how I thought the rest of the 40 strong group came close to lynching me.

After a month I decided to end all but two of my drugs which were playing havoc with my stomach. One thing you don’t welcome after a heart attack is heartburn as it takes a  while to distinguish between the two. I dropped the blood pressure tablet as before, during and after my hospital stay my blood pressure numbers were always OK and have continued to be around 120 over 80. I also dropped the heart rate controlling drug as once again my heart beat whilst resting is consistently around 60 to 65.. The final ejection and one which caused a great fall out with the doctors was my rejection of the Statin. There has been plenty of research evidence in which a Mediterranean diet has proved as effective as Statins in controlling inflamation and cholesterol levels and although Statins have been found to be useful in secondary prevention I decided that radical diet change with plenty of cholesterol checks to monitor my progress was my preferred way forward. I stayed with the platelet inhibitor for 6 months and aspirin for 9 months.

The doctors were not happy when I declared my intentions although this seemed at odds with the fact that after 9 months of post heart attack recovery, not one GP or Cardio has taken a single blood pressure reading, cholesterol reading, blood glucose reading or C Reactive Protein reading. This leads me on to the next problem I encountered with the post treatment. Not only were they not testing anything but when I requested tests myself at my GP, they seemed to be testing the wrong things. For example you can get your cholesterol tested with your GP and they will tell you your total Cholesterol, HDL and LDL readings but you have to request the more useful indicator CRP, which is a better indicator of oxidisation, the probable culprit with heart disease. It would also be useful to find out the composition of particle size with regard to LDL. The problem I had with this request is not that my Cardio could not offer it for free, I expected this and was willing to pay if he posted me in the right direction. What worried me more was that he did not know what I was talking about.

Based on my research the most probable culprit in my case was sugar. My 6 cups of tea per day each with a sugar in and my consumption of dessert’s, bread,pasta etc was probably causing my 2012 cholesterol LDL reading of 3.9. It now stands at 2.1 without the use of Statins. I should also point out that probably a big part in that LDL reduction is the fact that I take a daily Krill oil tablet. It was when I started taking Krill that my numbers fell further from 3.0 to 2.1, The important factors with Krill over fish oil seem to be the easier absorbtion of DHA and EPA and the presence of a powerful antioxidant in Astaxanthin. Its more easily absorbed than fish oil and I have far less gastric upset from taking it.

If you check out the role of fat in heart disease you will soon realise that it’s unlikely that fat plays any great role in promoting heart disease. The Inuit Eskimo tribe have a huge consumption of fat and yet heart disease is pretty much unheard of within the population. In fact heart disease has only really exploded within western societies in tandem with the industrialised production of grains and processed food. Whether you look at the Okinawa’s of Japan or rural Chinese populations or any other low heart disease groups, the absence of processed food and high sugar intake seems a fairly common denominator. My diet therefore centred around no sugar at all and the reduction of foods that produce sugar spikes in the blood, namely simple carb’s. These simple changes resulted my weight plummeting back to what it was when I was 25 years old, namely 11 stone 7 lbs, a full 2.5 stones below my pre heart attack weight despite me eating as much as I want and indeed can. I have never really eaten red meat and my consumption of white meat is low and now only free range. Modern meat production is based on feeding cattle and poultry on cheap grains which in turn pollute your system. Fish remains on the menu in particular oily fish such as salmon and mackerel which I luckily enjoy. Make sure you buy wild salmon however otherwise you are again buying battery fed fish.

In the next post I will discuss how my rejection of Statins caused my discharge from my hospital despite my protests and how I had to get my local MP involved to help tackle this blatant victimisation.

Do You Have a NICE Doctor

I have mentioned Cholesterol levels on more than one occasion so far and there is great debate amongst doctors and researchers, at least those not within the stranglehold of the drug companies, about the merits of cholesterol as a pure indicator or heart risk. I suspect it’s more a question of what condition your cholesterol is in as it courses around your arteries than how much there is. Oxidisation of LDL via inflammation is bad news for the endothelial wall of your arteries. A pro inflammatory diet is the root cause of Lipid oxidisation and boy do we in the western world have a pro inflammatory diet. Most people, me included, probably think that their diet is pretty good, after all I cannot recall the last time I ate in a fast food joint.  Once you start to drill down into the western diet you quickly realise that even the more diet conscious amongst us have been sleepwalking into premature illness and disease.

The culprits are sugar, grains and all processed foods. With sugar it is more than just cutting down the tea and coffee sugar, it’s the elevation of blood sugar levels from all high glycemic sources. Simply Google ‘Glycemic Index’ and start checking foods above and below the fifty mark. Foods such as potatoes are ubiquitous within the Britsih diet and I suggest you switch to sweet potatoes if you do not wish to give them up.

Grains are a little more surprising after all are we not inundated with eat grains advice from the nice guys at N.I.C.E. To give them the benefit of the doubt maybe they were talking about the grains that used to be available a hundred years or more ago. The modern, human altered form of grains have wreaked havoc on our health and if it wasn’t for the havoc such an announcement would have on powerful grain barons, more people would be aware of this and perhaps there position would be rearranged on the N.I.C.E food pyramid. By the way it’s kind of ironic don’t you think, that pyramids were something the Egyptians used to bury people in and we use them to represent our food recommendations. For a complete account of how grain production had been altered and its consequences for our health read a copy of the book ‘Against the Grain’.

Whenever I have entered a doctor’s office and asked him his opinion of some of the dietary research out there I hope and expect some informed input of both agreement and scepticism. What I did not expect was ignorance and lack of interest. One doctor defended his lack of knowledge by stating that he was not a nutritionist. I suspect by nutritionist he means the people who oversee the pro inflammatory food served up in hospitals or maybe the people who defend the fact that hospitals have Coke dispensing machines on the entrance to every ward in a hospital I recently visited. Yes I do mean defend, a doctor I spoke to suggested that having coke machines allowed the consumer to exercise his or her free will and to withdraw them would be an infringement on this right. Now if that doesn’t sound like self preserving career speak then I don’t know what does. Surely a hospital’s stance should be ‘you can do what the hell you want to your bodies out there but in here we will show you the light’. During my four days in hospital a trolley came round on a daily basis. It was full of chocolates, crisps and just about every imaginable food product that had put you there in the first place. This was battery faming of arterial plaque.

Getting back to my personal experiences with the NHS things were about to take a bitter twist. My first appointment with my cardio was ‘challenging’, his words not mine. A positive outcome however was that he thought a visit to the Lipid clinic to help answer some of my questions and to have an MRI stress test would be useful. I duly received letters of appointment for both with a week’s gap in between. At the first appointment I was warned by a junior doctor that when the head honcho came in, a doctor Madeira, he would not be too pleased to know that I was not on my Statins. Not too pleased was a bit of an understatement. He proceeded to bully me with extensive arguments about getting LDL cholesterol down to half of what it was before the attack. Funnily enough that is about what it is now. I responded with the dietary arguments which were once again brushed aside. I was already to call it a draw when I failed to see what would come next. Doctor Madeira made it clear that if I got back on the Statins I would be kept in the fold, if I did not then he would discharge me there and then from the clinic. This sounded unethical to me but nevertheless I was booted out. I had no intention of pursuing the matter further, the last thing you need is stress, but what happened next shocked me. The discharge took place on Thursday, my second appointment was the following Thursday. Two days later and only five days before the second appointment I received a letter stating that my MRI stress test had been cancelled by Doctor MCcann. Apparently this close occurrence of two rejections was pure coincidence and in no way related to each other. Even if this is true, their explanation that the written confirmation was issued by a booking clerk and it’s only after scrutinization by Doctor MCcann, five days before the appointment, that the final go ahead is confirmed. Now the words piss up and brewery, don’t really do this justice and that’s assuming that the first dismissal is not related to the second. I don’t want to bore you with the details of this ongoing debacle but I had to get my MP involved to help sort it out.

What does this all tell me about the doctors I have met so far? Well they are well meaning I am sure but my impression is that they operate in a narrow funnel of information flow. That information is controlled by medical research and agencies such as N.I.C.E who govern what doctors do and don’t do. Who controls the research, well you don’t have to be a brain surgeon to figure that out although if you were a brain surgeon you probably wouldn’t be able to figure it out or at least not to acknowledge it.

If you called in an electrician because your washing machine kept giving you an electric shock every time you turned it on, and he handed you a pair of rubber gloves and promptly left, would you be very happy?.

In my next post I will talk about my visit to a group therapy session where some of my suggestions nearly invoked secondary heart attacks amongst the audience.

It’s Sugar Stupid

Sugar finally appears to be getting the reputation it deserves, as one of the main causes of illness and disease. We are already seeing food producers scurrying to cover their sugar laden tracks. Our intake of sugar had escalated over the years and even more so in the last twenty when it was used to replace the loss of taste when fat was removed from so many food products. What part does it play in heart disease?, well diabetics have a much greater risk of heart disease and the blood sugar/insulin rush relationship to heart disease seems logical. My Achilles heel was certainly sugar in the form of desserts and simple carb’ based foods.

One question that often gets asked is ‘how about fruit?’. Fruit contains a natural sugar in the form of Fructose. Will fruit cause those dangerous sugar spikes within the blood stream and hence damage to the endothelial wall of our arteries ?. I had read one blogger state that after eating 15 bananas he found no great change in blood sugar levels. Finding this a little hard to believe I decided to try and find out for myself, especially as I have always been a big consumer of fruit.

Testing blood sugar levels is normally done in the morning after at least 12 hours of fasting. Normal levels of blood sugar at this time of day are reported to be 70 mg/dl to 100 mg/dl. Dr Houston author of ‘What Your Doctor May Not Tell You About Heart Disease” feels this range is too high and the upper limit should be 80 mg/dl.

Testing my levels at this time of day and then once again after eating 2 bananas, one apple and a strawberry seemed a sensible way to check the effect an average fruit salad would have on blood glucose levels. Fasting blood levels are not however the best test for potential diabetes or heart disease problems. A better test is to take your blood levels before a main meal and then one hour, two hours and three hours after the meal. The one hour reading should ideally be below 140 mg/dl whilst the three hour reading should have returned back to a baseline reading. This is not only a much better indicator of potential future illness but also allows you to test whether what you are eating is causing dangerously high sugar spikes.

My fasting blood readings on the day I tested was 76 mg/dl. After the fruit cocktail and half an hour wait my reading had jumped to 98 mg/dl. My next question was how would this compare with a non fruit, first morning meal?. I checked again the next day this time with a simple bowl of porridge oats, soya milk and half a chopped apple. My pre and post readings came out at 69 mg/dl and 91 mg/dl. This is a similar jump to the fruit breakfast and suggests that at least in my case, fruit is not a particularly high sugar spike. Having said that i do not think I would want to become a fruitarian as a friend of my yoga teacher has.

My results for the after meal test were quite pleasing and perhaps backs up the idea that what you eat has a great impact on blood readings. After a lunch of curried chicken, brown rice, broccoli and carrots I was hoping for a reading some were below 140 mg/dl but certainly expecting something above the fruit reading. My post meal reading came in at 92 mg/dl. The worrying brown rice clearly is a big improvement on white rice which is seen as a sugar spiking food.

There is an excellent account of blood sugar and how to interpret it at the following web blog.

http://chriskresser.com/when-your-normal-blood-sugar-isnt-normal-part-1

http://chriskresser.com/when-your-%E2%80%9Cnormal%E2%80%9D-blood-sugar-isn%E2%80%99t-normal-part-2

How to Prevent Diabetes and Heart Disease for $16

While I am suggesting Dr Kressler there is also this link which spells out the the things we really need to know about Cholesterol other than the simple figures given to you in a NHS blood test. Incidently I have asked 2 doctors and 2 Cardio’s about particle size LDL test’s and not one of them had a clue what I was talking about.

The Most Important Thing You Probably Don’t Know about Cholesterol

I would also suggest listening to this now well visited seminar on the ills of sugar.

http://www.youtube.com/watch?v=dBnniua6-oM

I would strongly suggest cutting out refined sugar and lowering your simple carb’s as a way of getting your blood sugar readings in some sort of healthy order. Big thanks by the way to the girls at my local Pharmacy here in Tavira Portugal for all their help.

Exercise Good or Bad ?

It is always more striking when you come across research results that endorse your own gut instincts, not that you should seek out such data as this can lead to a biased view of things. Before my heart attack I had, despite being a long term runner, football, tennis and general sports player, a gut feeling that excessive exercise was not particularly protective. I based this on what I thought was a premise too shaky to be a solid foundation for truth.  My feeling was that perhaps the heart was just like any other muscle. Exercise it too vigorously, especially as you get older, and maybe you run the risk of straining it. I know my calves are not what they used to be and can occasionally pull on a run. On the other hand sit around doing no exercise and the heart like any other muscle loses strength and performance. A simple analogy is that of a car. Thrash it and it will quickly give up on you. Leave it unused and it will equally pack in on you. Although I hate the word moderation except in the phrase’ moderation kills’, I have to admit that when it comes to exercise I wondered whether moderation was the key.

I was very interested therefore to discover some research that appeared to back up my feelings. A group of people had been tracked for a number of years after first being categorized into one of five categories. Category 1 was the complete couch potato. Number 2 was the type who did a small amount of walking, maybe half an hour a day but not much else. Category 3 were people who whilst not being regular exercise types did have a regular informal workout such as cycling to work or conducting say an hour’s walking per day. Group 4 were regular sports types, maybe two or more sessions per week. The final category 5 was for people who are very serious sports enthusiasts. Marathon runners, triathlon competitors and the like. When these five groups of people were rechecked after 10 years the worst performers in terms of medical incidents was category 1, the couch potatoes (no surprise there). The second worst however was the serious sports people in category 5. Coming out tops was category 3 followed by category 2.

It seems that light but regular exercise is all one needs to keep the engine ticking over and the no pain no gain merchants may be doing more harm than good. My exercise schedule now consists of Yoga twice a week. Walking at least an hour each day and light jogging twice a week. I have just bought a bike so some cycling will find its way in there as well but those eyeballs out running sessions I used to do are certainly a thing of the past.

There is an article here about some research finding similar to those above but with regard to runners http://www.webmd.com/fitness-exercise/news/20140401/too-much-running-tied-to-shorter-lifespan-studies-find

There is also an excellent talk here https://www.youtube.com/watch?v=Y6U728AZnV0

Finally a link here to an article by Dr Mercola on similar research

http://fitness.mercola.com/sites/fitness/archive/2015/05/01/right-dose-exercise-for-long-life.aspx?e_cid=20150501Z2_DNL_NB_art_1&utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20150501Z2_DNL_NB&et_cid=DM73599&et_rid=936116915

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Rehab Riot

About 3 months ago I attended a heart attack rehab meeting. there was about 40 people there and two speakers. I interjected with questions like

1. How can one find a UK test for LDL particle size (They had no idea that LDL had particle sizes)
2. Why is the T break we have just had in the canteen 70% full of heart unfriendly food
3. What do you think of the new Swedish guidelines (they had no idea what I was talking about)

These questions started to wrangle the audience a little, there was a feeling of shut up and listen to the experts. One woman who was with her husband shouted up to point 2, ‘You dont have to buy it, its your free choice as an individual’. The fact that the hospital endorse poor dietary choices by stocking them seemed lost on her.

However things went really off the rails and the audience turned on me big time when the inevitable food pyramid diagram went up. It was the usual out of date bollocks with lots of Carb’s advocated. There was pictures of potatoes and corn flakes amongst the heavily promoted carb’s. I put my hand up once again and stated that the diagram was wrong to which the roof went off the room as the audience hooted laughed and hollowed. One guy shouting ‘are you a doctor then ?’ to which I perhaps churlishly replied ‘No but then again thst means I am not tied or influenced by drug or food companies’, that really caused a furorer. I finished by saying ‘Look that diagram will have to be completely rewritten particularly with simple carb’s being relegated to the top (eat less) section, unlike Sweden, it may take another 5 years but it will happen’.

There was a feeling amongst many members of the audience that heart disease was hereditary and not really due to the diet we have been cajoled on to by food companies. This argument does not really stand up when there is plenty of evidence showing when heart healthy Japanese populations migrate to heart disastrous USA they develop heart disease as readily as your average coke guzzling, overweight American. Their magical genes offer little protection. Of course this has not stopped my local Cardio heading a gene based study attempting to drill down and perhaps find gene profiles that suggest high risk of heart disease. Call me cynical but this smacks of drug companies funding a project that if baring fruit will enable them to promote a gene heart busting drug at a much earlier age than they prescribe a statin. There is a whole lot of money to be made out of prescribing such a drug to 18 year old’s  as opposed to waiting for cholesterol levels to rise in mid age.

Asking the Right Questions

I mentioned before the importance of asking the right questions. At the moment the standard lipid tests available to you at your doctors are next to useless. If you do ask for one make sure you insist that they test your CRP (that’s C Reactive Protein) levels. This is one useful number, worth knowing, that they will do for free in a standard NHS test. It is a reasonable indicator of the level of inflamation within your body and it is inflamation of LDL particles that may well be one of the major contributors to heart disease.  The more accepted gold standard test today is a VAP test which carries out a wider range of tests and produces much more meaningful data than simply how many LDL or HDL particles you are carrying in your blood stream. Alarmingly when I have asked two GP’s and two Cardios about particle size and VAP tests, they had no idea what I was talking about.  In America it appears to be a standard available test.

Most people are under the false illusion that cholesterol is swimming around in our blood stream. this is not actually the case nor is the quantity of cholesterol the main issue here. There is a very good video explanation using a simple analogy here, I suggest you watch it and rethink what tests you really need

http://lifedoclifetime.com/tag/lpp-and-vap-cholesterol-test/

Remember LipoProteins are the cars on the freeway, cholesterol is the passengers in the cars. In the same way we want to encourage car sharing during our rush hour we also want to lower the number of Lipo carriers and stuff higher amounts of cholesterol into each carrier. This is what is meant by assessing LDL particle count and this measurement is much more meaningful than simply our simple UK available LDL numbers which is measuring cholesterol. The tests that give you this information are standard in the USA for about 100 dollars but unavailable here in the UK. The best approximation is to get a test that gives you your ApoB measurement. ApoB is a protein that is used to form LDL particles and hence can be an indicator of LDL particle number (cars on the road).

PS You can get a pretty full blood check including Apo B and A and Iron blood content which is quite important from Blue Horizon in the UK, link below

http://privatebloodtests.co.uk/epages/www_privatebloodtests_co_uk.sf/en_GB/?ObjectPath=/Shops/www_privatebloodtests_co_uk/Products/%22BHM6%20%2A%2A%281%20x%20grey%20for%20glucose%2C%201%20x%20purple%20for%20Haematology%2C%20process%20within%2024%20hours%2C1%20grey%2C%203%20x%20gold%20for%20chemistry%2C%20centrifuge%20well%20and%20deliver%20ASAP%29%2A%2A%22

 

 

Typical Day

I have been asked on more than one occasion what my diet is like, especially as I have been banging on about food and heart disease. The best way to sum it up would be with a typical days food and drink, here go’s Breakfast – Green Tea with Ginger, Glass of water with T spoon of Cayenne Pepper, Porridge with Chia seeds, red grapes and apple and either Hemp milk or Almond milk, one Krill oil tablet, one vit D3 /K2 tablet, one 1000mg vit C tab, one 500mg L-Lysine tablet, one 500mg L-Proline tablet and two Fruitflow tablets. One veg smoothie consisting of red grapes, one beetroot, glass of beetroot juice and a couple of handfuls of Kale Lunch – Usually a visit to the local Veggie cafe or Pret a Manger where I may have something like Pumpkin soup followed by a Salmon sushi Salad (no bread), more green tea and couple of pieces of dark chocolate minimum 70% cocoa Dinner – Wild Sockeye Salmon with sweet potato and fresh vegetables, Garlic tablet, Nattokinase tablet, fresh fruit and greek yoghhurt, maybe a glass of red wine or green tea Snacks – If I feel snacky I always have a box of Brazil nuts, Walnuts, Almonds and Pumpkin seeds to nibble on. I may also snack on Mackrel on toast using a gluten/grain free bread such as Genius (probably the only time I eat bread). The interesting thing is that with this dietary approach I never feel hungry or that I am restricting how much I am eating and yet my weight has dropped from 14 stone to 11 stone 5lbs and importantly remains constant. I am no expert on weight loss diets but it seems to me that what you eat is far more important than how much you eat. Traditional weight loss seems to centre around ‘keep eating the crap but count how much you eat’. This has been shown to be unsustainable in the long run even though it may give short term results. If there are any dieticians out there I would welcome their comments

Vitamin K2

A quick post to alert you of the importance of this little talked about vitamin and how it helps keep calcium out of your arteries and in your bones and teeth where it should be. It is particularly important to couple this with vitamin D3, especially in the winter months if you live in sun deprived areas.

This video interview covers things better than I could. Start adding Brie or Gouda cheese to your heart healthy diet.

http://articles.mercola.com/sites/articles/archive/2012/12/16/vitamin-k2.aspx

 

 

Taxi for Mr Lama

Got my blood test results back the other day but before I go over them some wise words from the Dali Lama when asked what surprised him about humanity.

“Man, because he sacrifices his health in order to make money. Then he sacrifices his money  to recuperate his health. And then he so anxious about the future he does not enjoy the present; the result being that he does not live in the present or the future; he lives as if he never going to die, and then dies having never really lived.”

Although not really connected I also love the story about the day the Dali Lama was visiting a function in a London hotel. A taxi arrived for him when it was time to leave and the taxi driver entered the large reception room and shouted,  “Taxi for Mr Lama!, Taxi for Mr Lama!”