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 Does the Ocean Make Me Feel Better?

ocean

I am on vacation in the Outer Banks (NC) with a dozen or so members of the Maher clan.  Sitting here watching the sun rise and listening to the break of the ocean waves is not a bad way to start the day.  I like being near the ocean for a number of reasons: I like the sun, I like the water, and I like the salt air.  I exercise more, I relax more, and I just feel better.  Is it all in my head, or does being or living by the ocean actually have health benefits?  Let’s find out.

Bathing Hospitals

According to a study last year by epidemiologist Lora Fleming of the University of Exeter (England), the benefits are real.  An article highlighting her research points out that doctors have been prescribing visits to the shore or “bathing hospitals” since the 18th century.

It seems they were on to something.  The study goes on to provide examples of people relaxing, feeling better, and being more active.  The study used an interesting combination of census data, surveys and social experiments to arrive at their conclusions.  Bottom-line, being by the ocean makes people feel better.

The Elements

Sun

The sun get’s a bad rap these days.  The amount of sunscreen slathered on people makes a day at the shore look like a zombie beach party.  I am not saying burn your kids and yourself to a crisp.  I am sayIng exposure to the sun does not translate to immediate skin cancer.  In fact, there are a number of well documented benefits of sun exposure:

  • Helps promote healthy bones and teeth
  • Helps prevent some diseases, including heart disease
  • Helps reduce cramping due to prolonged use of statins

Drinking on the beach all day and passing out in the sun for several hours is not recommended.  A little exposure is all that is needed to feel the benefits of the sun.

Water

Salt water also seems to have medicinal properties.  I found an article on Boomer Living + that highlights the benefits of the minerals contained in the ocean’s water.  Benefits include help with:

  • Arthritis
  • Psoriasis
  • Skin diseases (rosaeca, eczems, etc.)
  • Depression

It seems that the iodine found in ocean water boosts thyroid function and even improves the immune system.  An important benefit for those of us with cardiovascular disease is improved blood circulations. So go ahead, enjoy a little salt.

Air

The article also cites the benefits of the ocean air.  The theory goes, as waves break on shores, ions are released into the atmosphere.  Rumor has it, these are negatively charged ions.  This is important to those of us addicted to computer screens since they produce positive ions (also known as free radicals).  The claimed benefits of increased negative ions are:

  • Enhanced immune system
  • Increased alertness
  • Improved concentration

I am not sure how much of this “research” I actually buy into.  I just know that I feel better when I am near the ocean.  It could be time for a permanent stay at the bathing hospital.

 

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

Is It Safe To Do a Triathlon After a Heart Attack?

tri picture

There is a reason you hear about people dropping dead during these events.  Heart attack or not, endurance events put a significant strain on the body, particularly the heart.  If you are going to train for and compete in one of these events, it’s important to understand your underlying cardiac condition and always consult your doctor.  It’s also important to be naked, play guitar and train with “friends”.

Silly Mamil

I am not the only middle-aged guy contemplating one of these events.  There are so many of us out there that we even have a nickname:  Mamils (middle aged men in lycra).  According to an article in Bloomberg, the average age of competitors in these event is on the rise.  The 40-60 year age bracket now holds 32 percent of the membership in USA Triathlon.

Sinking Mamils

study published by the Mayo Clinic found that the death rate for triathlons is about twice that of marathons because of the overall intensity, particularly during the swim event.  In a triathlon, the swim event is first.  Swimmers pumped full of adrenaline swim on top of each other as they position for the lead.  The panic, physical exertion, and lack of oxygen can be lethal.

The Bloomberg article mentioned above is an excellent resource and goes into much more detail on the risks.  I recommend reading this if you are contemplating one of these events.

Stupid Mamil

So why am I doing this?  Because I am a stupid!  Also, because I have two good friends to compete with, I need something new to keep me engaged, and I like the challenge.  I am already biking and running, what’s the harm of a little swim?  I outline my approach to exercise in a previous post if you are interested in reading more.

Trimamil

Trinewbie is great site full of training advice and programs geared towards first time competitors.  I actually completed one of these events back in my smoking days, prior to the heart attack.  That one was done with little training.  This time around, I will l somewhat follow the 10-week program on the Trinewbie site.

If you haven’t had a heart attack and are not exercising, hopefully my participation in this event has appropriately shamed you.  As always, check with your doctor before competing in one of these events.


References:

Khan, Natasha, and Shannon Pettypiece. “Men Over 40 Should Think Twice Before Running Triathlons.” Bloomberg. N.p., 21 June 2013. Web. 19 July 2014.

James H. O’Keefe et al. Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise. Mayo Clinic Proceedings, Volume 87, Issue 6 (June 2012) DOI: 10.1016/j.mayocp.2012.04.005

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

What is Your Child’s Risk of a Heart Attack?

obesity by age and year

Pretty high if you are a Gen-X or Y parent. My last post may have depressed you or even made you a little mad (I think I called you fat).  If so, this post is going to really piss you off.

It looks like Gen-X and Y are passing down the “sit on your ass and eat crap” gene to our kids – the “Net Generation”.  As a result, children today are experiencing high blood pressure, type-2 diabetes, and elevated cholesterol – previously adult conditions.  Unfortunately, the perfect storm for early-onset cardiovascular disease and heart attacks.

NetGen’s Fate

I am not trying to piss anyone off.  As a father, I am very concerned about the declining health of our NetGen children. The American Heart Association (AHA) found that nearly one third of today’s children are overweight or obese – one third!

Although the moniker “NetGen” sounds kind of cool, it does not conjure images of a very active lifestyle.  My kids are in the 6-11 age group in the chart above and my wife and I are in a constant battle to reduce their screen time and get them outside.

I don’t think we are alone in this battle.  This quote from former Surgeon General Richard Carmona puts it in perspective:

Because of the increasing rates of obesity, unhealthy eating habits and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents.

I am not sure if that quote is about Gen-X, Y, or the NetGen, but you get the point.

There is Hope

I provide a lot of information on this site about self-improvement.  Hopefully some of that has sunk in and is incorporated into your new healthy lifestyle. Why – because you have a generation to save!

One of the first things you can do for your children is make them aware of heart disease in their family history (if there is any).  My kids are already aware of the crappy hand Dad dealt them.  It’s hard to ignore the big zipper running down the middle of Daddy’s chest.

Smoking has already been established as evil with my children.  My wife and I also frequently speak with our kids about eating healthy and exercising.  Talking is great, but kids learn by watching.  So set a good example – eat your vegetables and exercise (I am assuming you no longer smoke at the dinner table).

Need more help getting your kids to eat their veggies?  Here is an outstanding post on the Fooducate blog that finally unlocks the mystery.  Guess which one of the following three strategies works best to get your kids to eat healthy foods?

  1. Eat it, it’s good for you
  2. Eat it, it’s tasty
  3. Eat it

You guessed it, number three.  We are parents, we can tell our kids what to do.  Eating healthy is not an option.   Now with that mystery finally solved, on to exercise.  Get up off the couch and get active with your kids.  Play with them!  Watching sports on TV with your kids does not count as active playtime.

Let’s Move

I am far from an expert in motivating children.  Just ask the kids and parents on the kindergartener soccer team I coached this year.   What a cluster….I mean challenge.  Fear not, there are a lot of great resources out there to help us parents.  Check out the First Lady’s Let’s Move initiative.

The physical and emotional health of an entire generation and the economic health and security of our nation is at stake. – Michelle Obama

The American Heart Association also has a program called Voices for Heathy Kids.  Both offer similar strategies for reversing the declining health of our children.  Eat healthy and get active!  It’s pretty simple, but definitely a challenge for today’s “over committed” families.

Time for the guilt.  Disregarding our own health is irresponsible enough.  We can’t encourage the same behavior in our children.  A healthy lifestyle is a family commitment.  Just start small, make it fun, and make it a habit.

References:

“Overweight in Children.”  The American Heart Association, 17 Mar. 2014. Web. 22 June 2014.

“Statistics Fact Sheet – Youth and Cardiovascular Diseases” Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Mussolino ME, Neumar RW, Nichol G, Pandey DK, Paynter NP, Reeves MJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;129:e28–e292.

Exercise After 40? It’s Not Too Late!

older_fitI didn’t have a heart attack at 41 from an over indulgence of healthy living in my 20’s and 30’s.   To put it another way, I smoked, drank, ate crappy food, and sat on my ass during my 20’s and 30’s.  By the time I hit 40, I figured the damage was done, no point in changing.

Wrong again!

A recent study found that starting exercise at 40 has the same heart benefits as starting exercise earlier in life.  One of the studies authors, Dr. David Matelot, says:

“Despite biological changes with age, the heart still seems – even at the age of 40 – amenable to modification by endurance training. Starting at the age of 40 does not seem to impair the cardiac benefits.

However, endurance training is also beneficial for bone density, for muscle mass, for oxidative stress. And these benefits are known to be greater if training was started early in life.”

So it’s not too late.  For more information on getting active later in life, check out this post: Heart Attack and Cardiac Recovery – Get Off Your Ass.

Photo credit: ritavida / 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)