[editor's note:  Many of you know Andrew and know of his recent health scare. I am going to let him speak about that directly but want to reinforce a message that he shares about knowing your body and knowing when it is time to go get help. He offers some great advice but only you and your doctor know what is best for you.]

 

The Monday after the MS150 was supposed to be the start of a normal work week.  As you’ll recall, the second day was cancelled due to extremely stormy weather which would have made the ride pure misery.  So, Sunday was a pleasant and relaxing day. It’s a good thing that it was…

The following day was an entirely different story.   I was awakened suddenly at 3am with severe chest cramping and tightness, upper back pain, felt light-headed and was having trouble breathing.  Needless to say I was concerned and took a couple of aspirin and waited for it to subside, which it didn’t. It wasn’t long before I made the call.  Living alone made my decision to dial 911 an easy one.  I hadn’t been in an ambulance since I was 4 years old and our family’s boat blew up in a harbor off of Lake Michigan. It was an unsettling and bumpy few miles.

Upon arriving at the ER and immediately being wheeled into one of their cubicles, I noticed the TV overhead.  You’ll remember that Monday morning as the day Osama Bin Laden was killed by our Navy Seals; I’ll have a different memory of that day.  The next several hours was filled with: X-rays, cat-scans, several blood tests, an echocardiogram, multiple EKGs, and a bevy of questions asked over and over again. The only test I wasn’t given was a stress test. (I told them that Saturday’s MS150 and 85 mile bicycle ride was the stress test…)   I apparently “passed” all the tests except for the second blood test looking for an enzyme that heart muscle produces when it has been damaged. It appeared that I had a myocardial infarction (heart attack); me, the one person I would least consider as a candidate for that affliction.  More blood tests; more confirmation of the prognosis.  Looked like I was to remain their guest for a few days; I kind of felt sorry for them as I had no desire to stay in their uncomfortable bed for any period of time. I didn’t have time for this…

I had an angioplasty done that same night and the cardiologist found one artery completely blocked and another about 80% closed. (The 100% blocked one is what caused the heart attack symptoms. It’s the body’s way of screaming for help. It did a good job of letting me know it was not happy.) There were also a couple of smaller vessels 50% and 30% obstructed. The 100% blocked one got a stent, the others will be treated by several drugs, none of which I am thrilled to be taking but don’t really have much a choice in the short term.  It was a very long day but ended on a good note. Most of the discomfort was gone other than the 10 lb. sandbag (not joking; they used an actual sandbag)  on my leg used to stabilize the recently closed incision in my carotid artery, where the cardiologist gained access to do the procedure.

What I thought would never happen to me, did.  Not the way I planned to start my week, nor was it on my “to do” list….ever.  I guess that’s what you call one of life’s “curve balls”.  That was one hell of a pitch and one that is going to keep me from harassing you for some time. How much time is still in question at this point.

 

I know many were shocked that I, your resident health nut, would have a heart attack.  I was also surprised, but was probably more disappointed than anything.  I knew something wasn’t right and that was based on my performance, or lack of, on the bike. As hard as I have worked I thought I should be a stronger rider and certainly should recover from my workouts much quicker.  I joked many times that I had an underpowered heart and weak legs, a bad combination for cycling.  Seems I was pretty prophetic on that one.   But more on my particular risk factors later.

 

What are the symptoms of a heart attack? How do you know if you’re having one?

My symptoms were right out of the textbook.  I had tightness of the chest that felt like Rosanne Barr was sitting on me, which is wrong on so many fronts.  My upper back between my shoulder blades was uncomfortably tight. There was tingling down both arms, I felt lightheaded and was experiencing shortness of breath.  I was fortunate that the symptoms were so convincing because I’m sure my stubbornness would have left me in much worse shape had I not acted quickly.  Others may not be so lucky. Don’t let your stubbornness put you at risk!

Pay particular attention to the following symptoms if you are; over 50 years of age, a smoker, have high blood pressure, high cholesterol (total cholesterol over 200) or have a family history of heart disease.

  1. Chest pain.  Feel Rosanne on your chest? How about a “squeezing” that lasts a few minutes or goes away and comes back again. Or chest “fullness”; do you just feel uncomfortable?  You’ll probably know as it will feel very “un-normal”.
  2. Shortness of breath.  Feel like you just rode or ran up a hill and you’re actually sitting on the couch watching Jeopardy?  Not a good sign.
  3. Dizziness or lightheadedness. This is not a normal feeling and similar to when you stand up too quickly.  This can happen to anyone, but combined with other symptoms should alarm you.
  4. Cold sweat.  This one is self explanatory and is never a pleasant feeling.
  5. Indigestion?  Kind of a vague description but I have heard of many who have nothing more than a feeling of improper food digestion and it’s actually something much worse.

Women are different. Okay, you knew that was the case and apparently their heart attack symptoms can be very different and confusing.  If you’re a woman, don’t think this doesn’t apply to you. Women are equally apt to have heart issues. In fact, it is one of the leading causes of death for American women and they are actually more apt to die from a heart attack than men.  They are also not likely to have typical symptoms.  As an example, chest pain was not the main symptom in 46% of women studied.  A woman’s main symptoms are as follows;

  1. Pain in the arm (usually the left arm), back, neck, abdomen and shoulder blades and the discomfort can wander.
  2. Jaw pain. It can begin in their chest, move up to the throat and feel like they’re being choked, and then settles in their jaw.  This symptom is sneaky though and sometimes sends women to the dentist instead of the ER.
  3. Nausea and vomiting; might feel more like the stomach flu than a heart attack.
  4. Overwhelming and unusual fatigue. This is much more common than you would think.  In this day and age, fatigue is all too common but shouldn’t be dismissed. (Be extra careful when out in the hot weather.)

Sharonne Hayes, M.D. of the Mayo Clinic said, “Women don’t call 911.”  Don’t be one of them. I worked with a lady that went to bed one night and never woke up. That’s the way to go, but Yvonne was only 50 (and very active, BTW).

For the athlete reading this, you’re probably used to pushing yourself. You and you alone know your body. You know what feels right and what doesn’t.  Don’t push yourself just to be trying to squeeze more out of your workout. Pay close attention to what your body is telling you. It seldom lies and usually lets you know when something is wrong.  If something doesn’t feel right, it’s okay to let someone around you know so you can get their opinion.  A false alarm and a trip to the ER is much more palatable than ignoring something that can kill you.  A large percentage of Americans will die from heart disease. If that happens to you when you’re 93, then you have lived a good life. If it happens when you’re 53, then you’ve left a lot of memories on the table.  As I mentioned earlier, your body will let you know that something is wrong. You just have to be listening.

 

 

 

 

Who’s at risk for heart disease?

Heart disease is really many different disorders including heart failure, hypertension, angina, etc, but for our purposes we’re concentrating on a heart attack. The risk factors are the same for most of them other than stroke.

  1. Age.  Your risk increases after you reach 50.
  2. Excess weight.  If you’re overweight, especially if it’s concentrated around the waist, you’re risk increases significantly.  Think of it this way; your heart wasn’t built to carry excess weight. Plus, the more fat you carry around your vital organs the chances of having a heart attack go up significantly.  There is a direct relationship to belly fat and heart disease (and diabetes for that matter).
  3. Type 2 Diabetes. Having diabetes can significantly contribute to heart disease. It can be a kiss of death if you get it and don’t manage it properly. The keys to avoiding diabetes, in most cases, are a healthy, low sugar diet, plenty of exercise and keeping your weight down. Over 20 million Americans have diabetes and many in our society will die as a result.
  4. Lack of physical activity. A sedentary lifestyle sets you up for a life of heart disease.  You already know most of the benefits of staying active and don’t need another lesson.  However, here’s another plus.  It’s called “collateral arteries”.  The human body is an amazing creation and is demonstrated in many different ways.  If you’re an endurance athlete and you’re heart arteries are blocked to the point that it’s not getting enough blood to power the oxygen through to your muscles and the rest of your body, your system may do something remarkable. If you’re lucky, it will build arteries around the blockage just as a bridge builder would do around a logjam in a river. Those are called collateral arteries and this wonderful anomaly may have saved my life.  A perk from endurance training.
  5. High blood pressure. High BP damages the arterial lining and increases the pressure your heart is under. This can be controlled by lifestyle changes. High BP is downright dangerous. You might not even know you have it especially if you’re one of those stubborn people that don’t visit any doctors on a regular basis.  Stress is a major contributor to high BP; get it under control before it puts you under.
  6. Stress. Do you have a high level of stress? If so, heart disease is not your only risk. Stress can kill you many different ways. Don’t ignore it.  Let’s add anger and depression to the mix. Research shows that none of these is good for your heart. Stress releases the hormone cortisol into your blood supply (supplied to fight the crisis your body thinks you’re under at that time). Cortisol causes irritation, which in turn causes inflammation. Inflammation in your blood vessels causes plaque buildup. Now you have a heart related problem.  Easier said than done but keep your cool.
  7. High cholesterol.  Cholesterol by itself is not really the indicator that most of the medical profession thinks it is. However, you still need to be aware of yours.  The LDL is the important number. You need to keep it under 100 to be safe unless you have had previous heart problems, then your doc will want it under 70.  This is another “lifestyle” issue that can be addressed by lifestyle/diet changes.  I have to believe that you can get it under control without the use of any statin drugs, but you have to be very diligent to have a fighting chance.  The statin drugs have many side effect that you should avoid if at all possible.
  8. Genetic disposition.  The great Mickey Mantle’s father and uncle both died of heart attacks before they turned 50 and poor Mick though he would too.  After passing that age he tried to drink himself to death but didn’t buy the farm for many years after 50.  Don’t give up if you have a family history but be aware of and use that knowledge to protect yourself through lifestyle modifications.
  9. Unhealthy diet. The only way you can ingest cholesterol is through animal and fish products, including dairy. Soy milk has no cholesterol. Cow’s milk does.  Chicken, hot dogs, cheese, butter, yogurt, filet mignon all contain cholesterol. You can eat fruits, vegetables, nuts, seeds, grains and most bread products all day long and unless they contain meat, they have zero cholesterol.  But, you have to eat smart and keep the weight down too. There are a lot of overweight vegetarians that are not consuming any cholesterol yet increase their chance of heart problems thought the excess weight. So diet has two factors; your intake of cholesterol and total caloric intake. BTW; you can get enough protein without consuming animal products. I don’t recommend becoming a vegetarian, but if it makes you feel better you’ll probably be better off for it. If you are a strict vegetarian you will need to supplement some B vitamins and other substances your body requires.  If you’re reading the food labels, pay attention to the cholesterol number. Under 200 mg. a day is preferred or less if you can. It’s easier to do than you think.

10. Here’s one you never thought of. The same bacterium found in periodontal disease is also found in the blood vessels of the heart. According to WebMD; “Researchers know there’s a synergic relationship between oral health and overall wellness. Gum disease is linked to a host of illnesses including; heart disease, diabetes, respiratory problems, osteoporosis and rheumatoid arthritis.”  “Researchers at the University of North Carolina School of Dentistry found that people with gum disease were twice as likely as others to die from a heart attack and 3x as likely to have a stroke.”  (I had a root canal done a couple of years ago that still seems infected; time to have it checked out. I don’t want infectious bacteria being constantly dumped into my blood supply and neither should you.)

What can you do to prevent a heart attack other than diet and exercise?  Those two by themselves might not be enough.

Like me, you work out and eat right. So what else can you do to minimize your risks of spending time getting poked and prodded?  The steps you can take to minimize your risk of having heart related issues are really fairly simple. I didn’t say easy…It takes a little work and probably some lifestyle adjustments to put you on the right path.

Medical Family Tree:  This is one of the most important steps you can take. You need to know your family history. You don’t really want to say “I don’t know” as they are wheeling you into the ER.  Giving them a heads up will make their job much easier and might save your life while keeping the number of invasive tests to a minimum. Plus this will give you a blueprint on how to live a healthier life.  Several blood relatives died prematurely from heart disease?  That might get your attention.  Want an even better reason?  You owe it to your children. Do the work, have your spouse do the same and give this information to your adult children. They might not thank you now, but I can guarantee you they will at some point in time especially when they get to be your age. Picture your kids being wheeled into an emergency room saying the same, “I don’t know” when asked about their family health history. Don’t put them through needless anxiety.

Get your Excel spreadsheet out and talk to your siblings, parents, blood aunts and uncles and maybe one step further out. Find out about your grandparents on both sides.  Tell the ones you can that this is important and hopefully you’ll get a complete picture of your family’s health history. This may take some time but is well worth the effort. Once it comes together, it will make sense.

I thought I knew my family medical history. As it turns out, I didn’t know squat. I found out, after the fact, that relatives on my Father’s side did indeed have heart issues. My Father had a valve replaced when he was 80; I wasn’t concerned but should have been.  Might seem silly, but it will get your attention.

I just googled “family medical tree”.  Here is one site that can help you, but there are others.

http://njaes.rutgers.edu/healthfinance/pdfs/family-medical-tree.pdf

Stay active.  Your heart is a muscle; no big surprise here. It needs to be worked just like all other muscles. Plus, working out changes your percentage of fat vs. muscle which is much more efficient and will benefit you in countless ways.  Bike, walk, run, lift, garden, paint the house; it doesn’t really matter. Do something that gets your heart rate elevated and repeat this several times a week for the rest of your life. Your life depends upon this regular movement. If you sit behind a desk all day, it’s important for you to get up and move while at work even if you’re active outside of the office. Recent research shows that those that are active all day decrease their risk of heart disease significantly. So, take many breaks and walk stairs, outside, around your building or just do what you have to in order to burn more calories during the workday.

Visit your doc.  You need numbers and the only place to get these numbers is from your doctor.  Blood pressure, cholesterol, PSA, blood markers, etc.  Most people trust the medical profession; for those of you that don’t, remember that our Western Medicine doctors are the best in the world at diagnosis. You may not trust the treatment they prescribe but you can’t get any better at assessing your overall health.

On the other hand, don’t have blind faith in their treatment protocol.  The medical profession has been derailed by the pharmaceutical industry and as a result drugs are the only answer given many times.  Remember this; lifestyle changes are much more effective than any drug.

Supplements.  There are many heart-friendly supplements that can help you avoid heart and other health related issues.

Fish Oil.  This is good for your brain, heart and all your cells. Experts can’t say enough about eating fish up to 3 times a week and/or supplementing with good quality fish oil high in DHA and EPA.  There is a product called Super DHA. Loading up on this will do you a lot of good.  I just read about Krill oil. Apparently the oil found in these little fish that many whales feed on is more readily absorbed than regular fish oil.  Both krill or fish oil and the super DHA product can help your health tremendously and do absolutely no harm.

CoQ10.  This is a co-enzyme used by the large muscles in your body and that’s exactly what your heart is. If you’re on statins, they deplete CoQ10 and it’s imperative to supplement it. Ubiquinol is the concentrated form that you want. It’s a little more expensive but well worth the cost. Let me repeat this; if you are on statins now, you need to supplement with Ubiquinol.  Every piece of advice I have seen says this same thing. All statins deplete the heart muscle of this important co-enzyme and you must add it back in.   Ask your doc; they know the relationship that exists here.

Vitamin D. If you get outside much in the warm weather, you don’t need to supplement it. Those living in the far northern areas such as Canada, Alaska, Northern Europe, Oklahoma, etc have specific ailments from a vitamin D deficiency, some life threatening.  (just kidding about OKC).  If you live in Texas, add this in the wintertime only unless you cover yourself up completely while outside.  Vitamin D is a co-enzyme used in countless processes in your entire body; the cardiovascular system is just one.

Plant Sterols. Many cholesterol lowering supplements have these. They are basically a plants version of cholesterol. When eaten, plant sterols compete for the cholesterol you ingest from other sources.  There are many cholesterol supplements that tout the benefit of plant sterols.  They are cheap and readily available. Take them before meals for best results. These are essential if you feel you have heart and cholesterol issues or to just be on the safe side.

Niacin.  I asked my cardiologist what I can do to lower my cholesterol and hopefully unblock my arteries and the first thing he told me was to take more niacin.  Check with your doc first though.  Therapeutic dosage is 2-3 grams a day and may cause flushing in your face but not much else.  Spread the dosage out through the day to minimize the flushing. This really works!

Soluble Fiber.  I almost forgot one of the most important tools for plaque management. You can supplement this and/or find it in the food you eat. As you know, there are two types of fiber; soluble and insoluble.  The difference is easy to understand. Soluble dissolves into your blood supply and literally scrubs the walls of your arteries, at least in theory. So, increasing your intake of soluble fiber is a wise choice. The insoluble type is important also, but the main benefit of it is to scrub your digestive system and help you maintain your weight easier. (There are countless benefits of fiber, but not for this discussion.)

As with most of the other supplements noted, you can google then to find more information. There are lists of foods containing soluble fiber and it will make your job of finding them much easier. For instance, oatmeal is a good choice and has been a part of my regime since this happened.  By far the highest concentration of soluble fiber is psyllium husks, the main ingredient in Metamucil; not my favorite product.  Sprouts grocery store carries it in bulk (so do many others) and you can sprinkle it in your oatmeal, cereal, salads, etc. It’s fairly tasteless and has a ton of soluble fiber, much more than you can get from any other source. This is an easy way to up your soluble fiber intake.

My update 30 days after being released from their jail.  (After talking about supplements, now is a good time to give an update since supplements were a huge part of my effort to lower my cholesterol.)  I was given all sorts of wonderful, side-effect causing drugs and was able to convince my doc to reduce the dosage of the worst culprits. I also upped my niacin to the therapeutic dosage and added the plant sterols. I cut out most of my beloved dairy products where I was getting a good deal of my protein from.  I had my normal physical done a little more than 30 days after the heart attack and my LDL already went down from 95 to 75; almost where they want it. My HDL, the good kind, went up to 71; 50 is great and the higher the better on this one.  My triglycerides were also 71, half of what is considered normal. You can make a difference, even if you’re a registered health nut!

Are there any tests you can take that will help you assess your cardiovascular health?

Up until my release from the hospital I thought that the angioplasty was the only way to discover that I had a cardiovascular problem and that is a very invasive and expensive procedure.  Our friend, Rudy has found a heart-specific business that offers four different and inexpensive tests that you might want to consider.  If you’re not in the Dallas area, I would assume that there are others in the larger metropolitan areas near you that might.  If you know what to look for, you can probably find something close by.

The Legacy Heart Center is offering four different tests in two different packages.  Here are the tests that they offer:

  1. CT Scan for Coronary Calcium Scoring.  This 10 minute CT scan will look at your heart and give you a score from 0 to 400+. Studies have shown that coronary calcium scores directly correlate with the risk of heart attack. It will show any  blockage in the heart arteries, the blood flow in the heart muscle and the pumping action of the heart.  This test, which has been taken by several of our club members, can give you a good idea of where you stand. Unbelievably, this test is being offered for only $49 by itself.  For the cost of dinner out, you can assess your risk of heart disease!  I wish I had known about this test earlier.
  2. Carotid Artery Sonogram.  This is the artery in your neck and they assess your risk of stroke as this is the main source of blood to your brain.  Not offered alone.
  3. Aorta Sonogram.  The aortic vessel is a large artery that feeds the lower part of your body and is located behind your lungs and other vital organs. It can burst, which although not common, can happen. If it does, you will die. You will bleed out before the ambulance shows up.  This is one of those proactive things you can do. If a weakness is shown, it can be corrected through surgery to strengthen it.  Also not offered alone.
  4. Ankle Brachial Index. This evaluates blood flow to your legs. This is another tool to assess your overall risk for cardiovascular disease.  Again, not offered alone.

They offer all four of these for $399. Still a great deal for such good potentially life-saving tests. . Check with your insurance carrier. They may cover this. In my opinion, all insurance carriers should cover these type of proactive tests, but probably don’t.  The Legacy Heart Center, on Preston Road in Plano can be reached at 469.326.3400. If you are a PBA member, tell them. They are a friend to us and might keep a couple of us on the road.  Here is their website:

http://www.legacyheartcenter.com/tests/ctscans.html

You’ve heard that saying, “Things usually happen for a reason” and the same holds true in your body; you just may not know what that reason is. In my case, diet and exercise wasn’t enough. Lack of good quality sleep hindered my cells from repairing the damage caused each and every day from the countless oxidizing attacks from normal living.  The stress I put myself through the last couple of years dumped artery-damaging cortisol into my system and then throw in some previously unknown extended family genetics and it isn’t such a big surprise anymore that Mr. Health Nut wasn’t so healthy.  Hopefully I can correct that. I suspect that I’m not the only one with “issues” that need addressing.  I hope this can be of assistance to you. Feel free to pass it on to others and best of luck.