National Wear Red Day® is Friday, Feb. 2, 2018

Heart disease is the №1 killer of women, causing 1 in 3 deaths each year. That’s approximately one woman every minute!

To spread awareness about heart disease in women, the American Heart Association invites you to wear red on Friday, Feb. 2 and share pictures on social media using the hashtag #WearRedDay

Learn more about women and heart disease on the Go Red For Women website.

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The Best Post Heart Attack Diet and How it Can Also Prevent a First Heart Attack

I can say with no uncertainty that the fastest way to get into an argument with a bunch of heart attack survivors is to discuss diet. Seriously, you’re better off discussing politics or religion. I think the reason for this is quite simple — nobody really knows the best way to eat to prevent heart disease, the number one cause of death in the world.

Well, that’s not entirely true. I don’t think anyone would argue that a truly healthy diet is mostly focused on fruits (providing you are not diabetic) and vegetables. And while we can argue about the merits of measuring glycemic load vs glycemic index, or whether juicing fruit removes too many of its healthy properties, fruit is healthy for most people and it is part of a balanced diet.

But that’s where the agreement ends and zealotry begins. For every diet “expert” on the Internet that claims fat will kill you there are an equal number who tell you fat is our friend. Should we eat meat? Just white meat? Just fish? And what about carbs? Simple or complex? Gluten or gluten-free? And just what the hell is a FODMAP?

For each style of eating there’s a diet out there that helps you meet these typically strict requirements. U.S. News and World Report recently published its 2018 ranking of diets, and they looked at no less than 40 popular diets. Some you’ve likely heard about, like the Mediterranean Diet, Weight Watchers, and the Zone Diet. Others sound flat out made up, such as the Nutritarian Diet, the Volumetrics Diet, and the Flexitarian Diet. And of course there are the “hot new trend” diets like the Whole30 Diet, the Engine 2 Diet, and the suddenly everywhere Keto Diet.

But back to my fellow heart attack survivors. I run a support group for heart attack survivors on Facebook and whenever diet comes up the same thing happens — everyone chimes in that their diet is best and if you don’t eat this way you’ll die. And they usually point to legitimate studies to support their view. And that’s the real problem. Many of these diets will improve your overall health, but in some cases the diets themselves contradict each other.

For example, one popular diet among the heart attack crowd is the Esselstyn Diet, which purports to prevent and reverse heart disease. Holy crap, shouldn’t we all be on this diet? Dr. Esselstyn argues that a plant-based, oil-free diet can not only prevent and stop the progression of heart disease, but also reverse its effects. On his diet, you’ll also need to eliminate nuts/nut butters and saturated fat, but you can increase whole grains. Hot dog buns yes, hot dogs no? And beware of the vegan police!

Then there’s the Keto diet, which argues you can have all the meat you want, plenty of high fat dairy, nuts and other fats but stay away from grains, fruits and sugar. Lamb chops yes, apples no?

Which diet is right? Can they both be right? Well, that’s a tough question. Both diets will undoubtedly lead to weight loss, but I’m interested in heart disease prevention. Which is it, bread or no bread? Fat or no fat? Apples or no apples? Trying to figure this out is enough to cause a heart attack!

For what it’s worth, U.S. News and World Report ranked the Keto Diet 35th out of 40 for best heart-healthy diet and dead last in overall diets, for the most part because it’s hard to follow and the data is not in yet on this relatively new diet (although it sounds an awful lot like the old Atkins Diet to me).

U.S. News selected the DASH Diet tops overall and for heart health. This diet focuses on lowering blood pressure, emphasizes fruits, veggies, whole grains, lean protein and low-fat dairy, and suggests you avoid foods high in saturated fat such as fatty meats, full-fat dairy foods and tropical oils, and sugar-sweetened beverages and sweets. Hmmm. This sounds familiar — eat your fruits and veggies and lay off the fat and sugar. A little lean protein and dairy is okay.

Here’s my take — as long as the jury is still out scientifically on “fad” diets like Keto or ultra-specific diets like Essylstyn and its little brother the Engine 2 Diet, I’m going to stick to the basics. I try to eat a Mediterranean Diet, which has been proven to lower the risk for heart disease. It’s also easy to stick to and gives you flexibility. And it aligns nicely with the mantra espoused by writer and journalist Michael Pollan, who famously wrote about his seven word diet: eat food, not too much, mostly plants.

Am I eating in the best way possible for my heart? I don’t know and I don’t think the medical community knows. But my post heart attack health speaks for itself. I had a recent angiogram that showed very little plaque buildup in my arteries and my blood work would make a healthy person jealous. Cholesterol is under 100. Triglycerides at 85.

I eat a diet rich in fruits and veggies, lean poultry, fish, healthy fats (think avocado and olive oil) and small amounts of whole grains. I avoid added sugar as much as possible. Wonder Bread no, Ezekiel Bread yes. It seems to be working for me. Is this a Mediterranean Diet, or the DASH Diet, or the Michael Pollan Diet, or the “Pegan” Diet?

Yes.

I Was the Last to Know I Was Having a Stroke

Last spring I had a stroke. It feels weird writing these words, because truth be told I haven’t really shared this with too many people. When I had a heart attack in 2011 I shouted the news from the virtual mountaintop that is social media, but for some reason I’ve kept the stroke news closer to the vest. I think maybe I’ve been reluctant to share the stroke story because I’m still in denial about it and frankly it scared me more than I’d like to admit. More than the heart attack. I’ll tell you why.

My stroke occurred more than five years post heart attack, and in those five years I’d been doing everything in my power to take good care of my cardiovascular system. I had been eating right, taking my medications, exercising regularly, and keeping my cholesterol in check. I’d been going to the cardiologist every six months and having all the appropriate tests — stress tests, echo-cardiograms, blood work. I was in as good a condition as any heart attack survivor could expect. I let my guard down. So the last thing I expected last April 30 was a stroke.

I was helping my parents move into a new apartment in Tucson when it happened, but I didn’t know anything was wrong. I was moving boxes and clothes between the rental truck and the apartment when apparently I began slurring my words. My niece said later she thought I was being silly. My mother said she thought I was making fun of someone. My brother-in-law, however, was the first to notice something was not right. He was handing me a box from the back of the truck and evidently he yelled for my wife to come quickly.

My wife took one look at me and called 9–1–1. I was telling her to relax and that I was fine while she was on the phone with the 9–1–1 operator telling her that I was slurring my word and that the entire left side of my face had fallen. I assured her I was fine. The look on her face was of pure terror. She told me to sit down and be quiet.

The paramedics arrived within minutes and I guess by then the symptoms had already gone away. I listened to my family tell them what had happened and I honestly thought they were nuts. I was fine. They took my blood pressure and asked a few more questions, then let me know they’d be taking me to the hospital to be safe. I then got my second ambulance ride in the past five years.

At the hospital they ran some more tests and surmised I’d had what’s called a transient ischemic attack, or TIA. Basically a TIA is a temporary blockage of blood flow to the brain. A TIA is like a stroke, producing similar symptoms, but it usually lasts only a few minutes and causes no permanent damage. Unfortunately, after a few more tests, including an MRI of my brain, the truth was I did indeed suffer a stroke. A small stroke, but a stroke nonetheless. Additionally, one of my carotid arteries was 100 percent blocked. And despite my insistence that I was fine and more than well enough to fly to London in two days for a long-planned European vacation, I would not be going home for a few days and I would not be seeing Big Ben anytime soon.

Without going into too much detail, the next several weeks included more tests, a visit to my cardiologist back home in Phoenix, a visit to a vascular surgeon to confirm the carotid artery blockage, a visit to an electrophysiologist to rule out that the stroke was caused by a clot as a result of atrial fibrillation (AFib), and a trip to the cath lab to see if I had any other new blocked arteries.

None of these doctors could fully explain why I’d had a stroke. The vascular surgeon thought the stroke was likely caused by a spontaneous dissection of my carotid artery, meaning the blockage was the result of a random tear in my artery. The electrical guy pretty much ruled out AFib. The cardiologist who did my cath said my heart and surrounding arteries were clear and it was unlikely that the stroke was caused by a clot emanating from my heart.

All of this was good news actually, because the biggest concern for me was that despite all the work I’d been doing to keep my arteries clear (i.e. diet, exercise, medications) I was still producing sticky artery-blocking plaque. I was terrified that all my hard work was to be for naught, and in fact that fact alone caused me to fall into a pretty serious funk in the weeks following the stroke. I was sure my body was a plaque-making machine and that I was doomed to die an early death. I’m not typically a doom and gloom guy, but I actually started looking into burial plans so in case I kicked the bucket my wife wouldn’t have to worry about the details. Morbid I know, but that’s where my head was. And by the way, when you reach a certain age it’s actually a good idea to discuss your death wishes with your loved one, but that’s a story for another blog post.

The last specialist I saw was a neurologist, and his assessment was that the vascular guy was probably right — I’d had a dissection. And a few weeks later when another MRI showed that my carotid artery was no longer fully blocked but in fact mostly open, we all agreed that I did indeed have a dissection. In layman’s terms, this means I had a stroke because for some unknown reason my carotid artery decided to tear and as a result a small clot traveled to my brain and cut off the blood supply long enough to cause slurred speech and face droop. Yep, it was a freak accident and probably had nothing to do with my heart disease history aside from the possibility that my carotid artery may have been a little weaker due to plaque build up. Basically, there was nothing I could have done to prevent it, but it wasn’t likely to ever happen again.

Boy did I feel…lucky? I’d cheated death for the second time in five years. Let’s hope the third time is not the charm.

So why share this now, after nine months? Well, this week many of the best medical minds in the world are gathering in Los Angeles for the International Stroke Conference, the world’s largest meeting dedicated to the science and treatment of cerebrovascular disease. Yet I bet you had no idea stroke is the fifth leading cause of death in America.

I don’t think many of us think about stroke, or even really know what a stroke is. There are various kinds of strokes with different causes, and you can learn a lot on the American Stroke Association website. But really what I’d like to get across is that 80 percent of strokes are preventable through diet and exercise as well as by keeping an eye on the warning signs like high blood pressure, elevated cholesterol, obesity, diabetes and more.

I’d also like to spread the word about the warning signs of stroke — the things my wife and family noticed about me that lead them to call 9–1–1. The warning signs of stroke are: face drooping, arm weakness, and speech difficulty. One or all of these symptoms means it’s time to call 9–1–1. Knowing these signs can save a life.