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.

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)

Heart Attack and Cardiac Recovery – Get Off Your Ass

get_off_ass_2Dying isn’t hard, but it does provide a good lesson in humility. My cardiac rehab started with short walks on the high school track. I remember that first day I barely made it one lap. I was 41 years old and being lapped by speed walking retirees. I had to find a way to crush my competition! Stick with me, and I will show you the way.

I went for walks, either on the track or in the neighborhood, everyday. It’s amazing how quickly your body begins to gain strength and endurance. Within two months, I had progressed from 1 lap at the track to walking several miles at a time. I was eventually keeping pace with the retirees. At month three, I went back to work and the daily walks came to an end.

The daily walks ended, but I needed to find time to continue with an exercise routine.  In a rare moment of dedication, I decided to get up early a few days a week so I could continue my walks. Once I felt strong enough, and with the permission of my doctor, I graduated to light jogging on flat surfaces. Eventually, I built up to a four mile walk/run three to four times a week. Then, as usual, I lost interest.

In my next futile attempt at physical fitness, I joined a gym. I was going to get ripped! I even shelled out a bunch of money on a personal trainer. I didn’t like going to the gym and I didn’t like my trainer. I stuck with it for about a year, but I was miserable. I was paying good money for the inconvenience of traveling back and forth to gym to hang out with a bunch of lunkheads while getting no results. And it stunk. Gym experiment over.

Do Your Best, Forget the Rest

Back to the internet for more inspiration. Who did I run into, none other than Mr. Tony Horton. If you are not familiar with Tony Horton, he is the force behind the P90X series of home workouts. If you can make it past Tony’s cheesy infomercials, fabulous and perpetually dark hair, and bulging biceps, you will find a very effective program. Not only does it work, but in my opinion, is great for “younger” cardiac patients like myself.

P90X is what finally made me focus on diet AND exercise together. Instead of justifying my bad diet with more exercise, I finally saw the light. Diet and exercise needed to be worked together in order to achieve a healthy lifestyle and physical results. The basic P90X program:

  • Diet – The diet has three phases designed to burn fat and build muscle. I never followed it strictly but I hear it works.
  • Strength – A set of dumbbells or bands is required, but many of the routines incorporate a heavy dose of bodyweight strength training (push-up, pull-ups, etc.)
  • Fitness – There are a few cardio workouts and some pretty serious yoga mixed in throughout the program. The cardio is definitely intense and the Yoga will kick your ass.

I liked P90X so much I did it twice. I then went out and bought Insanity and P90X 2. If you can find a cardiologist that recommends Insanity, you should change doctors. I made it about halfway through and gave up. P90X2 is good for a change of pace, but I prefer the original. More recently, I have started Turbulence Training. I will describe that in a later post.

Modify, Modify, Modify

P90X is a commitment, at least an hour a day, six days a week for 90 days. I definitely needed the structure in the beginning. Today, I am doing a modified version of everything. By modified, I mean only the first half of each strength routine and no cardio. Here is what that looks like:

  • Monday – P90X workout & bike to work
  • Tuesday – Core workout or stretch & bike to work
  • Wednesday – P90X workout
  • Thursday – Core workout or stretch & bike to work
  • Friday – P90X workout

I usually leave the weekends unscheduled. If inspired, I may go for a run or bike ride, but that rarely happens.

Since I reduced the workouts, added the biking (15 miles round trip to work) AND started eating right, I have lost weight, put on muscle, improved my cardiovascular conditioning, and just feel better. I have read that 80% of conditioning is diet related. I finally believe that. Once I cut the bad carbs and sugar and focused on lean protein, vegetables, and healthy fats, everything just clicked.

What’s the point of all this? Find a program/system that works for you. If it’s not fun or convenient, you aren’t going to stick with it. Also, you don’t need to spend a ton of money or time. And of course, talk to your doctor before beginning any new exercise program.

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

Photo credit: The U.S. Army / Foter / Creative Commons Attribution 2.0 Generic (CC BY 2.0)

Heart Attack and Cardiac Recovery – Stop Eating Crap

pick your poisonAfter  bypass surgery, I was discharged with a green light to eat whatever I liked because I was extremely weak and anemic. I needed the calories, protein, fat, and iron found in the typical crappy American diet. It seemed rather enabling, but who was I to argue with the doctor. I did enjoy my fatty meals and desserts, but I also knew it couldn’t last forever; I had to stop eating crap! This post explains how I made that happen.

Like most cardiac patients, I believed my biggest concern should be reducing cholesterol. It makes sense to start here since most of us ended up on an operating table as a result of clogged arteries. It is also an easy place to start since most of us are on a statin such as Lipitor and get an immediate assist.

Although I truly believe in the benefits of statins and will likely remain on one for life, I also have a problem with them. They give a false sense of security. How many times have you finished a huge steak covered in cheese sauce and said “I guess I will have to double up on the Lipitor tonight”.  Adorable, aren’t you?

You Are What You Eat

If this is true, I was eating moron. I would estimate that I ate about 75% healthy and 25% crap for a number of years after my event. I could make myself eat pretty well at breakfast and lunch. Evenings and weekends were another story. If you have young kids like me, you end up serving and eating a lot of mac & cheese, pizza, and ice cream. And as proof that I am not the most responsible person, I began to eat worse once I started exercising. I figured I was working out, I could eat whatever I like, right?

In fact, the answer is no. The American Heart Association provides the following as a basic guideline for diet and cardiac health:

  • Don’t intake mass quantities of calories
  • Eat a variety of nutritious foods including vegetables, unrefined whole grains, lean proteins, and fish.
  • Avoid nutrient-poor food

Sounds sensible, and it is. But it also sounds extremely boring and like something my mother would tell me. I have a long history of ignoring the good advice of my mother.

The Pretty Pig

I needed to put some lipstick on this ugly pig called eating right. I stumbled upon Tim Ferris’ blog while looking for ways to get rich by working four hours per week. Although I haven’t pulled that off (yet), I did find a lot of very useful information regarding diet.

I was drawn to the experiments Tim describes that test the relationship between food and exercise and the impact on weight and muscle gain. I tried a couple of his experiments and learned some interesting lessons along the way. For example, gorging and heavy weight lifting in your mid-forties produces fat not muscle (I gained 10 lbs of neck fat). Fun experiment, but not quite so effective (or attractive).

With my added neck fat in tow, I decided to see what Tim had on weight loss as opposed to muscle gain. I tried the slow-carb diet. On the slow-carb diet, you basically don’t eat anything processed or white – sugar, flour, dairy. You do eat a lot of that same meals (over and over again) that contain a combination lean protein, vegetables, and beans. And the best part, you get a cheat day once a week to eat whatever you like.

I had pretty good luck combining this diet with a regular exercise routine. I lost a few pounds, gained a little muscle, and felt overall more healthy. It also helps that you don’t have to be great cook on the slow-carb diet. On the flip side, egg whites, chicken, broccoli, and black beans gets pretty boring after a month or two.

Cardio Caveman

I followed the basic guideline of the slow-carb diet for quite awhile. The only difference being that I eventually was up to about three cheat days a week. Knowing I needed to get back on track, I went in search of a new program to keep me engaged.

I found the Paleo diet. The basic concept here is to mimic the diet of our prehistoric forefathers. Somehow, we know that there was very little cardiovascular disease back in the paleolithic days. Therefore, reverting back to a caveman lifestyle will lead to improved cardiovascular health. Stepping back in time is not a big stretch for a hairy backed dimwit such as myself. It’s probably this same dimwittedness that led me to try the diet ranked dead last on The U.S. News & World Report best diets list.

With that bad news aside, I can tell you that I really enjoyed the Paleo diet. The concept of Paleo is to eat meat (a lot of it) fish, vegetables, eggs, and healthy fats. Do not eat grains, sugars, most dairy, or any processed foods. Basically, if you can kill it or dig it up, you can eat it. Did I mention you get to eat bacon?

The inclusion of significant amounts of meat and eggs in the Paleo diet will scare many cardiac patients off. Maybe rightly so. I set out with the goal of 30 days for Paleo. Partly because of my short attention span, but also because I know there are healthier options out there. What I found over the 30 days is the following:

  • I lost 9 pounds
  • I had more energy
  • I really enjoyed the meals
  • I was never hungry
  • My back got hairier

My Cardio Diet Top 10

As you can see, I like to try new things. That might be a polite way of saying I can’t stick with anything. Regardless, I am motivated to eat more healthy. My experiments keep me entertained and help me maintain focus. When I take the bits and pieces from cardiac eating guidelines and my various experiments, I am left with my Cardio Diet Top 10:

  1. Eat lots of vegetables
  2. Eat some fruit
  3. Eat lean meats
  4. Eat fish
  5. Eat eggs
  6. Limit dairy
  7. Eat the right carbs (complex)
  8. Eliminate/reduce sugar
  9. Eliminate/reduce grains
  10. Don’t listen to me (I’m not a doctor)

The top ten works for me and provides a lot of options and variety. Remember, I am not recommending you go out and eat a lot of bacon. I am only recommending that you find a way to eat healthy. For me, it’s my little experiments.

If you are looking for your own heart-healthy diet programs, a good resource is the best heart-healthy diets on The U.S. News & World Report. My next program will focus on the Mediterranean diet. The benefits seem well established and the menu seems like something the whole family can enjoy.

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

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

Heart Attack and Cardiac Recovery – Simplify Your Life

simplifyI thought about changing the title to “Cardiac Recovery Step 1 – More Porn” in order to get you to read this.  A few years ago, I would never have continued past the headline “Simplify your Life”.  Sounds like a load of new age nonsense.

That was before I died.

Now that I have a second chance at life (as may you), I am a little more open to new concepts.  Cardiac recovery begins with simplifying your life.  After all, you may have just lived through a major cardiac event – you don’t need more complexity in your life.  You need to simplify in order to recover, get healthy, and enjoy life.

It’s Simple, So It’s Easy, Right?

Wrong.  Simplifying is difficult; it means shedding bad habits and behaviors.  It means changing the way you live.  It means changing your values.  It means changing the way you think about the things you have and the things you want.  In addition to being an irresponsible man-child, I am also a gadget guy with a short attention span and I like things!  While I still accumulate my fair share of them, here is what I have given up over the past few years:

  • Smoking
  • Drinking alcohol
  • Drinking soda
  • Junk food (mostly)
  • Chocolate (somewhat)
  • Gym membership
  • Cable TV
  • Satellite radio

So why did give all this up?  Smoking and bad genes are what killed me in the first place.  Many people thought I should quit that habit.

Drinking wasn’t helping me out either.  If I drank, I wanted to smoke.  If I drank too much, my heart went into A-fib.  If I was hung over, I wanted to sit on the couch, watch, TV and eat bad food – while in A-fib (told you I was a mess).

There have been a few studies over the years that indicate diet may have a role in heart disease. I have mostly stopped drinking soda, eating junk food, eating handfuls of M&Ms, and chewing a pack of gum a day (did I mention I quit smoking).  As much as possible I eat whole foods and avoid sugar.

Quitting the last three on the list was all about simplification and came with the added benefit of saving money.  I spent more time driving to and from the gym than actually working out at the gym. Cable and satellite can be time sucking black holes of mindless babble.

What do I miss most?  Smoking and Howard Stern.

So what did I gain?  Making a commitment to simplify my life has provided me with more time to eat right, exercise, sleep, and focus on my overall well being.

It’s Simple, So It’s Quick, Right?

Wrong.  There is no quick fix here.  I did a lot of reading and experimenting with different methods to simplify and be more productive.   There are thousands of great books and blogs out there offering all kinds of advice.  A couple that I found helpful were Zen Habits by Leo Babauta and MyrkoThum by well, um,  Myrko Thum.

When I learned Leo Babauta  was previously an out of shape smoker like me, I knew I was in the right place.  Take some time and check out his site.  The site link provided above is to the Getting Started page.  It’s also useful to read his bio.  If I didn’t know better, I would say Leo’s list of changed habits belonged to a cardiac patient.   From quitting smoking, to exercising, eating healthy, and starting a new career.

I have to admit, I am actually not all that familiar with Myrko or his SYSTEM of personal development.  Myrko made MY list because of HIS list at the link above.  A very simple guide to simplification:

  1. Turn down the noise
  2. Clarify what you want and need
  3. Do less without losing anything
  4. Say “No” in Order to Say “Yes”
  5. Declutter
  6. Invite silence into your world

If that list makes you cringe, the site also offers a practical explanation of how to simplify your life in two steps:

“The first is to get clear and to focus on what is really important to you. This means to do more of what makes you truly happy, what you feel you have to do on this world. The second way is to remove as much distraction from your life as possible, so you actually can live in purpose and fulfillment”

For me, this meant getting rid of the unhealthy habits and distractions and focusing on what is important to me and the well being of my family.  Simple enough, right?

If you think you want to explore this topic more, check out the Alltop Lifehack page as a starting off point.  Here you will find everything from how to simplify and declutter to how to build a Bluetooth speaker and why you should own a survival bow & arrow – as if that is not obvious.

I am not following any specific program, list, or person in my path to simplification.  Nor have I quit my job or given away all of my possessions. I just take bits and pieces from all over the place, try a few out, and see what works for cardiac recovery.  When in doubt, I keep it simple.

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

Photo credit: Jon Ashcroft / Foter / Creative Commons Attribution 2.0 Generic (CC BY 2.0)