Archives for June 2014

Generation XL – From MTV to Obesity

genxperspectives_nirvana-lrgrGeneration X, the MTV generation, my generation, the fattest generation ever! There is an alarming increase in obesity, diabetes, cardiovascular disease and heart attacks in Gen-Xer’s.  And from the looks of things, it’s only going to get worse for Millennials.  Now that I have completely bummed out two entire generations, let’s see what’s behind all of this unhealthiness.

Enter the Aussies

A study done by researchers at the University of Adelaide in Australia has confirmed that if current trends continue, Generation X will overtake Baby Boomers for poor health, including rates of obesity and diabetes. I wouldn’t dismiss this as an Australian problem. According to the American Heart Association, nearly 70% of American adults are either overweight or obese.

Hold on, I thought this was a heart blog, not an obesity blog.  It is, but being obese puts you at a higher risk for heart disease and high blood pressure. Guess what happens to people with heart disease and high blood pressure?  Their left arm starts to hurt.

The researchers found that Gen-X is more than twice as likely to be overweight or obese at 25-44 years of age, compared to Baby Boomers at the same age.  One of the coauthors of the study, Ms. Rhiannon Pilkington, suggests there is growing evidence the the trend is happening world wide.

So what is fueling the rise in obesity for Gen Xer’s when compared to Baby Boomers?  According to Ms. Pilkington, it’s because we sit on our ass and eat junk food.  Ok, she actually stated it this way:

Although the two groups in our study did not seem to have any difference in levels of physical activity, our lifestyles and food environments have changed dramatically over recent decades.

So both generations are equally active, what gives Ms. Pilkington?

Transport options and workplaces encourage sedentary behaviour, and food high in fat and sugar is often more readily available than a healthier alternative. This may account for why the younger generation is developing unhealthy weight levels at an earlier age.

See, I told you it’s because we sit on our ass and eat junk food.  If you haven’t seen it before, check out my series on cardiac recovery for tips on exercising and eating healthy.

All This Obesity is Stressing Me Out!

As a Gen-Xer, I am supposed to be indifferent about the Millennial generation (Gen-Y).  But it’s hard not to feel bad for them.  The Millennials may be the first generation to see rising rates of early-onset obesity related diseases such as high blood pressure, type-2 diabetes, and elevated cholesterol.  To put things in perspective, the number of young adults (18-29) who are obese has more than tripled in the last 40 years.

Millennials are overachievers.  In addition to being obese, they are completely stressed out.  Unfortunately, a lethal cardiac combo. According to a report by the American Psychological Association, with the exception of Millennials (those 18-33 years of age), all other age groups reported decreasing levels of stress.  So why are the Millennials so stressed?  Here is what the survey found:

  • 76 percent were stressed out about work;
  • 73 percent fretted over money;
  • 59 percent obsessed over relationships’
  • 56 percent were faced with intense family responsibilities;
  • 55 percent were freaked out over the current state of the economy.
  • Money for nothing and chicks for free sounded sensible when I was younger.

Don’t worry Gen-Y, in addition to offering tips for healthy eating and exercising, my series on cardiac recovery also offers tips on simplifying your life and relaxing.

Money for Nothing

Who knew that money for nothing and chicks for free would lead to obesity and heart attacks?  Both of our most recent generations are facing serious health issues.  It’s time we clean up our act.  Not only can we save our lives, but we can start providing a good example for the next generation, our children.


The University of Adelaide. Gen X Obesity a Major Problem for Healthcare, Workforce. The University of Adelaide News and Events. N.p., 27 Mar. 2014. Web. 22 June 2014.

Pilkington, Rhiannon, Anne W. Taylor, Graeme Hugo, and Gary Wittert. Are Baby Boomers Healthier than Generation X? A Profile of Australia’s Working Generations Using National Health Survey Data. PLOS One. University of Adelaide, 26 Mar. 2014. Web. 22 June 2014.

Pew Research Center. (2010). Millennials: A Portrait of Generation Next. Retrieved from

Watson, Elwood. “Millennial Stress College Years and Beyond.” Diverseeducation. N.p., 6 Mar. 2013. Web. 26 June 2014.

Leg Cramps from Hell, Is It Your Statin?


About a month ago, I started to experience some pretty significant cramping in my feet, legs, and hands.  The leg and feet cramps happen mostly at night and typically result in banshee screams and tears.  The pain is intense!  The hand cramps happen throughout the day, typically when I try to hold a pen or other small object.  Less frequent, but just as painful are the cramps I experience in my hips and even my back.

Could it be the Statin?

I contacted my doctor to see what could be done about the cramps.  He asked me to come in to give blood and recommended I stop taking my Lovastatin.  I told him I started getting steroid shots in my back around the same time as the cramping started.  I also stopped taking my multivitamin (based on his recommendation) around the same time.  He seemed focused on the Lovastatin as the culprit.

My appointment was on a Thursday and he thought I should know something as early as the following Monday.  I was still cramping on Monday, though not as badly.   I stayed off the Lovastatin another few days to see if things would improve.  Sure enough, a week later the cramping seemed to be reduced by about 80%.   Progress, but not perfection.

Yes, It Might be the Statin

In an article published by the Mayo Clinic, muscle pain and damage is the most common statin side effect.  As we all know, statins are designed to lower cholesterol.  They do this by telling your liver to stop producing as much of it.  There is a chance that the statins may also affect or lower the production of enzymes that are responsible for muscle growth. This may be the cause of muscle aches.  Could also be why I am not HUGE!

Ditch the Statin?

Hold on, don’t be stupid.  Although the cholesterol guidelines are constantly evolving one thing remains clear: cholesterol plaques clog your arteries and clogged arteries lead to strokes and heart attacks.  Satins are a proven method for reducing the production of cholesterol, thus reducing the clogging of arteries.  Lifestyle changes can be very effective also, but likely need to be combined with statin therapy for the greatest risk reduction benefits.

What To Do?

Ok, so I have to take this statin.  What can I do about these damn muscle cramps?  Mayo recommends a number of steps to consider (in consultation with your doctor), including:

  1. Take a break from the statin
  2. Switch to another statin drug
  3. Lower your dose

A number of sources also recommend supplementing with CoQ10.  CoQ10 occurs naturally in the body and helps muscles produce energy.  There is some belief supplementing with C0Q10 can counter the statins effect of reducing the enzymes responsible for muscle growth.  In theory, this could reduce muscle cramps.  More studies are needed, but at least there seems to be growing consensus regarding the benefits of CoQ10 for statin users.

An article on Livestrong recommends supplementing with vitamins E and D (in addition to C0Q10).  The article cites a couple of studies suggesting vitamin E and D have been effective in reducing statin myopathy (muscle cramps).  The studies seem far from conclusive and of course it is suggested you speak with your doctor before trying either.

Like I said, I am one week into the no statin experiment.  I will speak with my doctor in a few days to determine next steps and post them here.  In the meantime, let me know if you are on a statin and have experienced muscle fatigue or cramping.  If so, how did you deal with it?


“Statin Side Effects: Weigh the Benefits and Risks.” Statin Side Effects: Weigh the Benefits and Risks. Mayo Clinic, 24 Apr. 2013. Web. 19 June 2014.

Lundin, Deborah. “How Can I Avoid Leg Cramps When Taking Cholesterol Medicine?” LIVESTRONG.COM. LIVESTRONG.COM, 16 Aug. 2013. Web. 19 June 2014.

How to Stay Motivated After a Heart Attack

army motivation

Was I motivated to stay healthy after my heart attack?  Of course I was – for awhile.  I changed my diet, joined a gym, and started running.  Then, the same lack of self-control and discipline that fueled my first heart attack started to creep back into my life.  I began binging on junk food, became too busy to go to the gym and became too bored with running.  I was not spiraling out of control (yet), but I had lost the motivation to “move”, to be healthy.

Movement is a medicine for creating change in a person’s physical, emotional, and mental states.” – Carol Welch

What is Motivation?

In layman’s terms, it’s the desire to do something.  I want to be healthy, therefore I eat right and exercise.  It’s pretty simple on the surface, but there are many theories and models devoted to understanding motivation.  For our purposes, let’s focus on just two – intrinsic and extrinsic motivation.

Intrinsic Motivation

Intrinsic motivation comes from within and is based on the enjoyment of a task or a belief that it is the right thing to do.  For example, I really enjoy eating vegetables and running.   I also believe eating right and exercising is the right thing to do.  Based upon my enjoyment and beliefs associated with these tasks, I stay motivated to do them because they are a part of who I am.

If eating right and exercising were part of who I am, I would not have had a heart attack at 41.

Extrinsic Motivation

As the name implies, extrinsic motivation is based on external factors – primarily rewards or punishment.  Rewards are awesome, and punishment (or guilt) has fueled my personal development since childhood.

In the green vegetable/running example above, extrinsic motivators or rewards might be improved appearance and health.  The punishment for not eating right and exercising is another heart attack (or death).

Which is more Effective?

Based on my examples, you might say extrinsic motivation is superior.  However, research indicates that intrinsic motivation is more effective long-term.  So we focus on intrinsic motivation, right?  Not entirely.  As with anything in life, there needs to be a balance.

An article on HealthCentral discusses the need for a balanced approach.  Intrinsic motivators keep you going in the long run, but extrinsic motivators get you started and keep you moving in the short-term.  Check out the article for more detail.

Enough Psychobabble, How Do I Motivate Myself?

You form habits.  Early on, rewards are going to help.  Exercise and eating right improve physical appearance.  Who doesn’t want to look better?  But let’s face it, even if you had a heart attack at a “younger” age, you are still probably past your physical prime.  Looking good will only take you so far.

In order to stay motivated long-term, you need to make the mental shift.  You need to envision yourself as a healthy person.  Healthy people do healthy things.  Before you know it, you enjoy doing healthy things.  Congratulations, you are intrinsically motivated.

To put the plan into action, try the following:

  1. Set goals – Goals need to be measurable and obtainable.  I will lose 2 pounds a month.  Not I will have six pack abs.
  2. Schedule activities – I put my morning workouts on my Google calendar.  I also build exercise into activities I am already doing (riding my bike to work).
  3. Measure performance – Take before and after pictures.  They are very motivating!  There is also a lot of cool wearable technology out there to track fitness goals.
  4. Provide rewards – Recognize when you achieve goals.  If all goes as planned, you may need some new clothes.  Or, a Fitbit may be in order.
  5. Enjoy – Make sure you are doing something you enjoy.  Running sucks, try biking or swimming.

Most people can’t understand how surviving a heart attack isn’t motivation enough to be healthy.  I get that, but I also know how difficult it can be to break old habits and form new ones.  Start with a decision, take action, repeat.  If that doesn’t work, get the dude in the picture above to start yelling at you.


Nelson, Lisa. “Getting Heart Healthy: Motivation to Change Your Habits.” N.p., n.d. Web.

Photo credit: United States Marine Corps Official Page / Foter / Creative Commons Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0)

heartgeek Exposed!


I would like to start off by saying happy Father’s Day to all the dads out there.  I am going on a bike ride this morning and then relaxing with the kids all day.

I found out that I’m a pretty bad father. I make a lot of mistakes and I don’t know what I’m doing. But my kids love me. Go figure. —Louis C.K.

Now on to heartgeeky stuff.

My 15 Minutes

I was interviewed earlier this week by WTOP, a Washington, D.C. radio station.  The reporter was doing a story on the rising trend of heart attacks and heart disease in younger people.  She found my blog and reached out, saying “You are just the guy I am looking for”. As a result, couple of audio clips aired during the morning drive hours and an article appeared on the WTOP website.  Just like that, heartgeek is a exposed.  I am expecting a call from Oprah at any moment.

Many friends and co-workers were caught off guard when they heard my voice on the radio.  Up until  heartgeek, I maintained a very low profile on the internet and social media.  I wasn’t even on Facebook until this March!  Now here I was talking on the radio and laying out some extremely personal information on a blog.  If people hadn’t heard my story before, they certainly know it now!

A great benefit from this sudden exposure was finally connecting with other people who have gone through a similar experience to me.  People found the blog and then shared with me their cardiac stories.  I learned how others are successfully living with heart disease and also what has been a challenge.  This was the interaction I had hoped for when I started heartgeek!

It’s Not Just Me

One email I received that really stood out was from a guy who wrote and told me he read the blog and it scared the crap out of him.  I do enjoy scaring people, but my goal with heartgeek is to motivate.  Not surprisingly, I heard from a few people that motivation is a problem in cardiac recovery.  Having heart disease at a young age means staying on top of your health for a long, long time.  That in itself can crush motivation.

I received quite a few emails on the benefits of a vegan diet in both preventing and reversing heart disease.  I received recommendations to watch the “Forks and Knives” documentary, read Dr. Caldwell B. Esselstyn, Jr.’s book “How to Reverse & Prevent Heart Disease” (I have already purchased) and visit the Happy Herbivore blog.  Each of these sources describes how a plant-based diet can not only prevent heart disease, but also stop the progression and reverse heart disease.  Former President Bill Clinton follow’s Dr. Esselstyn’s program.

There were a couple of recommendations for Dr. Ornish’s Lifestyle Program.  This one looks interesting and is something I will spend time reading up on.  I also received a recommendation to read Mark Bittman’s book “Vegan Before 6”.  Mark is a food writer/author as well as a columnist for the New York Times.  In my house, we already rely on his “How to Cook Everything” cookbook and I like the fact that his approach provides the best of both worlds.

These are all great recommendations and I am sure to experiment with each of them.  I will also try P90X3 at the suggestion of one reader.  What sticks with me most from all the email I received is each writer’s desire and actions to live a happy and healthy life despite having heart disease.

Let’s Keep It Up

A community is starting to form, let’s keep it up.  I do a lot of research geared towards improving my health and I learned quite a few new things from this initial wave of interaction.  There are new diets, lifestyle changes, and exercise programs that I need to check out.  The only way to continue to learn is to share information.   Please join the email list, send emails, and most importantly, leave comments and engage with other readers.

Can I ask a favor?  Leave me a comment below regarding topics for future posts.  Based on the input I received so far, I am thinking we need one on motivation.  I would love to hear from you.

Finally, thank you for all the engagement over the past week.  It’s been great to interact with other heartgeeks!

The Head and the Heart

Its All In Your Head

When I had a heart attack at 41, a number of thoughts went through my head, and none of them were very good.  An inventory of my mental state post heart attack:  shock, panic, guilt, anger, denial, fatalistic acceptance.  Interestingly, that was also my pattern of thought about most life matters pre-heart attack.  Must be the Irish in me!

Let’s take a look at each one of my my mental reactions in a little more detail before diving into the connection between the head and the heart.


Holy crap, what just happened?  I didn’t remember going into cardiac arrest or having a heart attack.  In fact, I didn’t wake up for a couple of days.  As the fog cleared and I was informed of my condition, I really could not believe what had just happened to me.  With my family history and reckless lifestyle, I anticipated clutching my chest at some point in life – just not at such a young age.


I’m going to die!  I was hooked up to a bunch of machines and had tubes coming out of every orifice of my body.  They even made new orifices to stick tubes into!  They told me I needed open heart surgery.  What about my family?  I have a three year old and my wife is pregnant with our second child.  How am I going to pull through and support my family?   I still needed to work for another 25 years!  A million thoughts like this went through my mind.


What have I done?  Everyone around me offered tremendous love and support and I felt like I deserved none of it.  I put myself in this situation.  I knew my family history with heart disease.  Yet, I chose to smoke, drink like a fish, eat like crap, and sit on my ass.  Now I had put the future of my family in jeopardy.  Bad Paul.


Why me?  Early anger was mostly directed at myself.  Why did I make such stupid choices?  How could I be so reckless and irresponsible?  Not being a fan of self-directed anger, I moved on to directing my anger towards others.  Why are other people making healthy choices and living happy lives?  Yes, I was resentful of healthy and happy people (who isn’t?).

Denial/Fatalistic Acceptance

Carry on, nothing to see here.  Another trait I learned from my Irish parents. I am not sure why I am so obsessed with my Irish heritage right now.  Here is a great quote from a recent Lonely Planet guidebook that may explain it all:

The Irish – fatalistic and pessimistic to the core – will shrug their shoulders and just get on with their lives.

That’s me.  Strap on the blinders and go!

Fix the Head, Fix the Heart

There is a head-heart connection and for me it is the key to preventing my second heart attack.  I couldn’t fix my heart until I fixed my head!  So what was wrong with my head?  A pretty loaded question.  I found a New York Times article, “Why Smokers Still Smoke”, that offers an interesting theory.

the personality trait that distinguishes smokers from nonsmokers is their relative inability to delay satisfaction and respect long-term considerations (like their health). In other words: it’s their poor self-control.

Bingo! Not only did I lack poor self-control, I completely ignored any personal responsibility for my actions.  Here I was in my mid-forties, and I suddenly realized I was responsible for the rest of my life.  I was responsible for preventing my second heart attack!  Without this mental shift I truly believe I would be dead right now.

So how did I come to make this obvious but elusive mental shift?  By taking an honest inventory of my life.  Where had I been and where did I want to go?  This is not an easy exercise for someone like me who preferred to let life happen.  Once I discovered a morsel of self-control and realized I was responsible for my actions, I found doing the right thing became much easier.

Action Needs a Plan?

Say what?  Doing the right thing became easier when I finally started to set goals and make plans.  Remember the process of deciding where I wanted to go with my life?  In my compromised situation, it was pretty easy – I wanted to live.  Instead of putting on the blinders and seeing what life brought me, I needed to set a goal and make a plan.

My immediate goal was to get healthy.  But how do I make that happen, how do I translate a goal into a plan and then into action?  Keep it simple (stupid).  Here is what worked for me:

  1. Set a goal
  2. Make a plan
  3. Share the plan
  4. Execute

Exercise seemed like a good place to start if I wanted to get healthier.   I plotted out my exercise program on a calendar.  I shared my plan with my family and friends to make sure there was a built in method of accountability.  Then, I just did it.

Guess what, it worked!  Fixing my head may not fix my heart, but I have a feeling it will go a long way in preventing my second heart attack.

Check your head!


Eyal Ert and Eldad Yechiam. “Why Smokers Still Smoke.” New York Times, July 26, 2013. Accessed June 7, 2014.