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.

References:

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!

HG_WTOP

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.

Shock

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.

Panic

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.

Guilt

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.

Anger

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!

References:

Eyal Ert and Eldad Yechiam. “Why Smokers Still Smoke.” New York Times, July 26, 2013. Accessed June 7, 2014.  http://www.nytimes.com/2013/07/28/opinion/sunday/why-smokers-still-smoke.html?_r=0.

Why Get CPR Certified?

CPRBefore I answer that, let me ask a question.  How can a cardiac arrest survivor and self-proclaimed HeartGeek not know CPR or how to use an automated external defibrillator (AED)?  I go around preaching about heart health, gratitude and doing the right thing, yet I wasn’t equipped to help someone experiencing a cardiac emergency.

Time for HeartGeek to man up and get some CPR training!

Chain of Survival

First a little history.  I survived a cardiac arrest because of the quick actions of my wife and the early medical attention I received from EMTs and doctors.  In my case, a near flawless execution of what is known as the “chain of survival”.

The chain of survival significantly increases the chances of survival for someone who experiences a cardiac arrest, heart attack, or stroke.  The five links or steps in the chain are:

  1. Early recognition and call for help, such as dialing 9-1-1
  2. Early CPR
  3. Early defibrillation
  4. Effective advanced life support
  5. Integrated post-cardiac arrest care

Step one is a no brainer and is typically well  executed.  Step two is where things start to go awry.  Sadly, only about 30% of cardiac arrest victims get CPR from a bystander.  Think that could have something to do with less than 10% of out-of-hospital cardiac arrest victims surviving?

Paying it Forward

I signed up for a CPR/AED class provided through the American Red Cross.  My class was instructor led, lasted three hours, and provided a lot of hands-on practice.

After some brief overview information, we jumped right in to the hands-on part of the agenda.  There were only about a dozen people in my class and we were paired up into teams.  With our partners, we practiced assessing the scene and and preparing the victim to receive aid.

Now it was time to bring out the manikins (you don’t practice CPR on each other).  I had a good idea of what to do here, but going through the paces made me feel more confident that I could pull it off in a real-life situation.  There are three simple steps for CPR:

  1. Give 30 chest compression at 100 beats per minute (see Stayin Alive)
  2. Give two rescue breaths
  3. Repeat

We next moved to the part of training I was most interested in, use of the automated external defibrillator (AED).  If you are like me, use of the AED is the most frightening aspect of providing assistance.  Shocking a loved one or total stranger with a device you have never used before is intimidating.  Rest assured, it’s not as hard as it sounds.

It is necessary that you make sure the victim is not in water and make note of any body piercings (or any metal) or medical patches.  Fire up the AED and it will provide audible step-by-step instructions.  When placing the patches on the victim, avoid those piercings and medical patches if you found any.

The AED will analyze the heart rhythm and make a determination to proceed with a shock.  Next, clear the area, push the button, and the shock is delivered.  At this point, continue CPR until assistance arrives.

The class concluded with instructions for dealing with choking and head/spinal injuries.  I will let you learn more about those in class.

So Why Get CPR Training?

Because four out of five cardiac arrests happen at home.  The life you save will likely be someone you know and love.  Also, it’s easy and it’s the right thing to do!  And yes, I can save your life.

 

My Favorite Heart Health Gadget

AliveCorWhen I started heartgeek, I promised I would provide information and reviews of technology related to heart health.  In doing so, I found a way to justify my uncontrollable appetite for new phones, watches, fitness trackers, and miscellaneous gadgets.  The first piece of tech up for review is the AliveCor Heart Health Monitor.

What is This Thing?

The AliveCor heart monitor is a serious little piece of equipment that allows you to monitor your heart health in realtime by  providing a personal electrocardiogram (ECG) on your phone.  AliveCor sells the unit integrated into cases ( iPhone 5 or Samsung S4 only) or as a universal attachment plate that can be stuck on the back of any phone.  The universal attachment is a good thing for someone like me that changes phones every 6 months.

Why Use It?

I use it to satisfy my inner geek of course.  But  I also use it to monitor my heart health, particularly my arrhythmia or a-fib episodes.  I can fire up the app on my phone, put my fingertips on the device, and within 30 seconds have an ECG readout.  I am not a doctor, but I can pretty quickly identify a normal or abnormal reading.  So what if there is an abnormal reading?  We will get to that further down.

Is it Hard to Setup?

The setup is very simple.  I attached the AliveCor pod to the back of my phone in about 10 seconds.  It can also be attached to the back of a 3rd party case.  The pod is held securely by what I imagine is some type of 3M adhesive.  Be forewarned, it takes a bit of work to pry the pod off when you change phones.

Next, I downloaded the AliveCor app (free) from the Google Play Store.  Once the app was downloaded, I had to enter a bit of personal information.  AliveCor assures users that all of their personal data is kept safe in two places.  First, in the AliveCor app itself and second, on the AliveCor servers.

AliveCor states that their servers are secure and HIPAA and EU Data privacy compliant.  Fine by me.  If you have looked around this site, you know that I am not too concerned with privacy.

Is it Hard to Use?

Using the device is almost as easy as setup.   Fire up the app, put your fingers on the device, and your live ECG appears on the screen almost instantly.  After 30 seconds, the readout is final and is then stored on your phone and the AliveCor servers.

Now here is the really cool part.  You can print a PDF of the reading or send it directly to your doctor or anyone else who may be interested.  For a small fee, you can send your reading (via the app) for further analysis by a U.S. board certified cardiologist or cardiac technician.

The image below shows a reading I took earlier this year.  As you can see, the heart rate is very low.

Sinus Bradycardia 54

As I mentioned, I am not a doctor, but that reading didn’t seem good.  I decided to use the AliveCor ECG analysis service to get some more insight.  The two levels of reporting and pricing are shown below.  I believe I chose the $12.00 report for this reading.  Although turnaround time is quoted at 24 hours, the report came back in about 10 minutes.

Here a sample of the report I received back.  Honestly, not that informative.

Bradycardia Report

In their defense, AliveCor does have a Education feature in the app.  As shown below you can lookup just about any cardiac term your heart desires.

AliveCor Education

Should You Buy This Device?

If you have arrythmia, I highly recommend purchasing this device.  Although not cheap ($199), the AliveCor device is FDA approved and very good at what it does.  It is simple to use and can provide peace-of-mind anytime, anywhere.  If nothing else, it is a great way to entertain family and friends by letting them see where they measure up against a heart patient.

Heart Attack and Cardiac Recovery – Relax

Hammock_relaxLife is full of stress.  Before my cardiac arrest and heart attack, my primary two methods of stress reduction were smoking and drinking.  It was the perfect one-two punch.  Smoking, the constant jab, providing immediate stress relief. Drinking, the knockout punch for total relaxation.  My one-two punch served me fairly well for twenty-odd years, only to be derailed by a cardiac arrest.  I was no longer allowed in the ring!  Stick with me and I will show you how I am dealing with stress and even getting better sleep.

Before my event, I knew that my unhealthy lifestyle was not going to lead to a pleasant outcome.  After all, both my father and brother suffered heart attacks before 40.  So how did I deal with the stress of my gloomy cardiac fate?  See one-two punch above.  That’s right, more smoking and drinking!

And then BAM!  Cardiac arrest, heart attack, dead – the Triple Lindy!  As moronic as it sounds, I felt a sense of relief when I ended up in the hospital.  I could now get on with the rest of my life. However, the uncertainty regarding the rest of my life brought on new stress.  Will I fully recover, will I be well enough to support my family, will I be around to see my children grow up?  I have a great cardiologist and he put things into perspective for me.  I can’t remember the exact words, but he advised to put the trauma behind me and live my life as fully as possible.  I could worry about every ache, pain, or what if – or I could go enjoy life.

Do the Right Thing

I still needed to find a way to reduce stress and relax in general.  I considered aromatherapy, but found that just doing the right thing allows me to relax best.  So how does one do the right thing:

  • Act in a respectable and responsible way.  I’m trying. Acting respectable is a challenge.
  • Take ownership for my health and actions.  I do this most of the time.  Exercise has proved a solid replacement for smoking and drinking
  • Have some humility.  I’m trying.  It’s hard when you are the center of the universe.

Again, try and keep it simple.  Don’t be a jerk, do what you’re supposed to do, and get over yourself.

Sleep

Studies have shown the poor sleep can increase your risk of cardiovascular disease.  And, cardiovascular disease can decrease the quality of your sleep.  A vicious circle that I have been trying to solve for years.

You would think with all the simplification, healthy eating, and daily exercise, I would be stress free and sleeping like a baby.  Sadly, not true.  I have made progress with reducing stress, but I could use some improvement in the sleep department.  I can fall asleep, I just can’t stay asleep.  I average about six hours per night. If you remember back to Part 1 of this series, I introduced you to Leo Babauta and his Zen Habits site.   On his site, Leo provides a formula for sleeping like a baby:

  1. Exercise – I do this, not sure I can do much more here.
  2. Get up early – I do this, up between 5-6 everyday.
  3. Establish a bedtime ritual – Doing this, but not in the best way.  I read my books on an iPad.
  4. Keep the bedroom only for sleeping – No TV in the bedroom.  Just that damn iPad.
  5. Focus your attention – I need to do this.
  6. Change slowly – OK.

I like that Leo admits he is still not a great sleeper. I also take a magnesium supplement and have installed f.lux on my laptop to assist with sleep.  Magnesium plays a role in sleep regulation and calming down your brain at night.  I have noticed that I fall asleep faster and get more restful sleep since starting the magnesium supplement.  F.lux makes the color of your computer’s display adapt to the time of day, warm at night and like sunlight during the day.  I am not sure that it helps me sleep, but my eyes don’t get as strained at night.  I’ll keep it just for that.

That’s the plan.  Simplify your life, eat right, exercise, and relax.  You have a second chance at life.  Experiment, have some fun, and find what is going to keep you engaged and healthy.   Writing this series made me realize just how far I have come and how much I have changed.  I’d love to hear about how other have changed.  What’s your cardiac recovery plan and how’s it working?  Let me know in the comments below!

The full series of Zen and the Art of Cardiac Recovery Part 1Part 2Part 3, Part 4

Photo credit: Joe Shlabotnik / Foter / Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0)