How To Prevent Your Next Heart Attack

planning

During a bike ride last week I was listening to a Tim Ferris interview of Kevin Kelly, the co-founder of WIRED magazine.  Tim is a little smitten with Mr. Kelly, and rightly so.  In fact, he has declared that Kevin Kelly might be the real-life Most Interesting Man in The World.  Listen to the interview(s) and you might agree.

Mr. Impatient and Irreverent

Where am I going with this and how is it related to preventing a heart attack?  At about the 34 minute mark of Part 1, Tim asks Mr. Kelly for advice in regards to optimizing the rest of his life. Mr. Kelly offers some guidance for practically reinventing yourself.  It’s not going to happen over night, so don’t feel impatient.

The advice to not feel impatient struck a chord with me.  Prior to my own death, impatience defined my approach to life.  My attitude towards my own health is a good example.  I knew I needed to quit smoking, exercise, eat better, etc.  The task just seemed too large.  I was stressed out about my unhealthiness, but I lacked the patience to make a plan for change.  The ability to make slow and steady progress towards a goal was not in my DNA.  If it couldn’t happen over night, I would just accept my doomed fate and carry on!

Not a solid approach to managing ones life, but it defined me.  Not only was I impatient, I was irreverent about my life. It could be health, school, work, or even relationships. Big things intimidated me, so I just put my head down and waited to see what would happen.  Even after my heart attack, I didn’t feel changed. I was grateful, but I wasn’t making a plan for the rest of my life.

Back to Mr. Kelly.  About 15 years ago, he had a revelation.  He was going to live his life as if he only had six months left.  The complete story is detailed on a very early episode of This American Life.  He thought is would be a series of high risk flings.  Instead, he spent his time visiting family and taking a bicycle trip across the country.  Family time and a challenge filled with quiet discovery.

Bringing Back Planning

As the interview progresses, Mr. Kelly refers to his friend, Stuart Brand.  Mr. Brand is another interesting guy and is best known for his early role as the editor of the Whole Earth Catalog.  Honestly, I had never heard of Mr. Brand or his catalog.  What struck me was the discussion on making plans for your life in 5-year chunks or “projects”

The more time you spend contemplating what you should have done… you lose valuable time planning what you can and will do. – Lil Wayne

You see, Mr. Brand wants to make long-term thinking sexy again.  Did I mention that back in the 1960’s Mr. Brand was one of Ken Kesey’s original LSD fueled Merry Pranksters?  Anyhow, he might be on to something with the five-year plans.  Basically, he believes five years is about the amount of time it takes to identify and execute any meaningful project in your life.

So let’s see, I am an almost 50 year male who survived a cardiac arrest and heart attack and am now living with advanced cardiovascular disease.  How many projects do I have left?

I don’t think of this question in a morbid sense.  I have a second chance. This is my opportunity to plan and hopefully accomplish a few meaningful things with the rest of my life.

So what are my projects (I consider these goals)?  I have one overarching goal right now:  Start an online business.  Over the next week or so, I intend to write out a five-year plan to help me accomplish this goal.

I wanted to share my plan, but I need to learn patience and think through this.  More to come.

Share your five-year plans below.

Photo credit: stargardener / Foter / Creative Commons Attribution-NonCommercial-NoDerivs 2.0 Generic (CC BY-NC-ND 2.0)

Yes, Foot Pain Could Be a Blocked Artery

Blocked Iliac Artery

Like any good cardiac patient, I started exercising regularly after my heart attack.  I began with short walks and eventually built up to running 2-3 miles at a time.  Then my right leg died!

The death of my leg did not happen over night.  I noticed that my leg felt like it was “dragging” when I ran.  The same dragging or sense of weakness then developed when I was walking, particularly on stairs or inclines.   Eventually, I experienced extreme pain in the arch of my foot while running.
Due to the weakness in the leg, I decided I must have a muscular problem.

Dr. Moron

With my own moronic diagnosis in hand, I began an almost two year odyssey of visits to specialists:
  • Chiropractor – advice:  not sure what it is, but keep coming back ($$)
  • Physical Therapist – advice:  not sure what it is, but keep coming back ($$)
  • Acupuncturist – advice:  not sure what it is, but keep coming back ($$)
You get the idea.  I then mentioned the problem to my primary physician during a routine checkup.  He suggested a visit to the neurologist to see if a nerve was being pinched.
I scheduled a visit with the same neurologist that treated me post-cardiac arrest.  She was familiar with my background and suggested a vascular consult before we started messing with nerves and spinal cords.

Pictures Don’t Lie

A quick CT Scan (that’s an actual of my scan above) by the Interventional Radiologist found a 65% blockage in my iliac artery.  You can see the blockage on the left side of the image, right after the split from the aorta.  The iliac artery carries blood from the aorta down to the lower extremities.  A short-time later I had a stent placed in the artery and voila, blood started flowing again.
I learned a few important lesson from this experience:
  1. I am a moron and should stop self diagnosing
  2. I should also consult my primary care physician if something is wrong
  3. I have cardiovascular disease and that has to be factored into any physical issue I am experiencing
That final point is important.  Below is a list of signs & symptoms I found on livestrong.com related to poor blood circulation:
  1. Leg Pain While Walking
  2. Numbness and Weakness
  3. Coldness and Swelling
  4. Non-healing Sores
  5. Changes in Skin Color
  6. Weak Pulse in Legs
  7. Chest Pain (duh!)
  8. Erectile Dysfunction (doh!)
I am learning my lesson and bringing more issues to my doctor’s attention.  I am still getting cramping in my legs and feet.  My primary physician recommended a new statin and vitamin D supplement.  My cardiologist recommended a test for peripheral artery disease (PAD).  Luckily, there were no significant findings.  The point is, if you have a condition such as cardiovascular disease, don’t trivialize it’s impacts downstream.  Be a dork, or maybe even a geek and do some analysis of your own.  And, it should go without saying, talk to your doctor.

Why I Am Volunteering With Mended Hearts

mendedheartsWhen I was in the hospital recovering from bypass surgery, a volunteer from an organization called Mended Hearts paid a visit to my room.  This was seven years ago and I was a little pumped up on morphine, so I don’t remember the name of the person or even what we talked about.

I do remember that he gave me a pillow that I was to hold against my chest if I needed to cough or laugh.  Doing either of those activities after open-heart surgery can be quite painful.   I made good use of the pillow, but put the name of my visitor and the organization out of my mind up until recently.

I forgot Mended Hearts because I wanted to forget about Mended Hearts.  I was pretty sure I could handle cardiac recovery on my own.  Honestly, I was young and incredibly gifted with street smarts.  What could go wrong?  Besides, I didn’t need help from some old guy!

Time to Give Back

A few weeks ago, I contacted Mended Hearts to inquire about volunteering.  So what is Mended Hearts?  I have taken the following description from the their website:

Our support groups help people understand that there can be a rich, rewarding life after heart disease diagnosis. Members listen, share their experiences and volunteer to talk to other heart patients about what they may face including lifestyle changes, depression, recovery, and treatment.

Mended Hearts volunteers offer peer-to-peer support to patients, family members and caregivers via:

  • Hospital Visiting – In person visit from a Mended Hearts volunteer while you are recovering
  • Online Visiting – Email check in and provide materials electronically
  • Phone Visiting – Calling to provide a word of hope

Our mission is to “inspire hope in heart disease patients and their families.”

This past Saturday I met with one of the coordinators and attended my first Mended Hearts support group meeting.  It was good to be among “my people”.  Over the next several months, I will get a few training sessions before I am fully qualified to begin my volunteer duties.

A big reason I started this blog was to fill an information and support gap for “younger” cardiac patients.  My motivation for volunteering with Mended Hearts is to connect with this same demographic.  I think this is a great organization and I am excited to get started.

My Heart Attack Anniversary – 7 Years Later

Me at the Beach

I missed a very important anniversary last week.  July 1st marked 7 years since my cardiac arrest, heart attack and bypass. As the author of a heart attack blog, it’s a little odd that I missed my own anniversary.  On the other hand, I was at the beach enjoying time with my family.  Celebration enough.

Se7en

No, I won’t be writing about the seven deadly sins – maybe what led to my heart attack.  Instead,  a quick post to highlight the 7 things I am most grateful for on this lucky anniversary:

  1. Being alive
  2. Having a wonderful family
  3. Having great friends
  4. Having a healthy lifestyle
  5. Having the ability to relax
  6. Having a job that provides for my family and I
  7. Having the experience of death

I didn’t put a lot of thought into this list and number 7 may seem a little strange.  I am sure it will evolve and grow over time – at least to 8 by this time next year. That’s it for now – Paul

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.

References:

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 http://pewsocialtrends.org/files/2010/10/millennials-confident-connected-open-to-change.pdf

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?

cramps

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?

References:

“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.