There’s No Such Thing as a ‘Mild’ Heart Attack

Boston Celtics President Dany Ainge, 60, suffered his second “mild” heart attack on May 1

This morning it was reported that Boston Celtics President Danny Ainge suffered a mild heart attack last night in Milwaukee and was treated and will return to Boston. Ainge had a similar “mild” heart attack in 2009. This comes just a few days following the news that R&B singer Peabo Bryson had a “mild” heart attack as well.

I’ve noticed reporting on heart attacks focuses on just two kinds — major and mild. Major usually means the victim didn’t survive or needed bypass surgery. Everything else seems to get the “mild” classification from the news media. I wonder if they do this because they don’t want to alarm people, or because they don’t feel the need to describe with any detail exactly what happened to the person? Either way it doesn’t help anyone, not the least of which the survivor, who may feel better that the doctors said he or she had a mild heart attack but it doesn’t change the fact that mild or not a heart attack of any kind is a signal that things are not okay with your cardiovascular system.

I think the term “mild” heart attack gives the survivor a false sense of security. Any heart attack is a major heart attack and needs to be treated as such. Popular culture plays a role in this disservice. I used to laugh at the Saturday Night Live skit where “da Bears” fans would have a heart attack and keep on eating as if it is a normal part of life.

I suspect this image isn’t that funny to Chris Farley’s family given he died at 33 from a combination of drugs and heart failure from atherosclerosis.

Peabo Bryson  is “stable” after he “suffered a mild heart attack” on Saturday morning. Yet he’s still in the hospital and is cancelling most of his scheduled May concerts. Doesn’t sound too mild to me.

What’s my point? Any heart attack is a serious medical condition that requires considerable medical attention and lifestyle changes. Myocardial infarction means you had a significant enough blockage in an artery to cause your heart to lower blood flow and perhaps even stop beating. Or it caused a clot to travel through your heart to block blood flow. Ain’t nothing mild about that.

Some suggest the amount of permanent damage to the heart helps to classify a heart attack as mild or major. But what amount of damage to the thing that keeps you alive should be considered mild? My heart is about 15 percent damaged. Did I have a mild heart attack? Hell no. I nearly died and ended up needing three stents.

I would argue that any damage is major. Which means news outlets or doctors trying to placate patients or family members by suggesting a heart attack is mild are minimizing the seriousness of the event. I suspect Danny Ainge, now having survived two heart attacks at just 60 years of age, isn’t going to take things lightly going forward. I suspect he’s going to change his diet, take new medications, increase exercise, get regular blood checks, reduce stress, and more. And that’s the right approach for anyone who has had a heart attack — mild, medium or major.

Snoring is Much More Than a Simple Nuisance

I ran across an article today with the hyperbolic headline “7 Warning Signs That You May Be at Risk of a Heart Attack.” I truly hate headlines like this because they almost always lead to nonscientific blather. This article, from Men’s Health, suggests you may want to be concerned if you are exhausted (who isn’t), have erectile dysfunction (if your blood vessels down there are damaged, there’s a good chance the ones near your heart could be damaged as well), you have leg or hip cramps (again, blood flow issues), you’re bloated (too many beers?), and a few other seemingly innocuous maladies. But one potential symptom caught my attention and should catch your attention too — snoring.

Look at this sexy guy sleeping sound with his CPAP machine!

Snoring may seem harmless, but it could mean you have sleep apnea and that could be a big problem. Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts and that can have major consequences for your heart health. In fact, obstructive sleep apnea increases the risk of heart failure by 140%, the risk of stroke by 60%, and the risk of coronary heart disease by 30%.

Let’s be honest, most of us snore once in a while or even all the time. The person who shares your bed has likely let you know you’re making noise with a late-night nudge or perhaps an occasional punch in the nose if it gets bad (kidding). You probably know if you snore, especially if you’ve ever woken yourself up from it. But you probably don’t know if you have sleep apnea unless you’ve been tested for it. A sleep apnea evaluation usually involves overnight monitoring at a sleep center although these days there are even some at-home sleep tests.

A few years prior to my heart attack my wife finally insisted I talk to my doctor about my snoring. Like a lot of people, I associated snoring with obesity and figured mine was just a minor case. But it had become so prevalent that oftentimes I’d wake up in the morning to find my wife sleeping on the sofa because I was keeping her up. I agreed to see my doctor about it, for her sake, but had I been paying more attention to the research I might have taken it a lot more seriously a lot earlier on.

There is a clear connection between sleep apnea and heart disease. Here’s a quote from an article on the American Heart Association’s website:

“The evidence is very strong for the relationship between sleep apnea and hypertension and cardiovascular disease generally, so people really need to know that.”

— Donna Arnett, Ph.D., chair and professor of epidemiology at the School of Public Health at the University of Alabama at Birmingham

A Google search for “sleep apnea and heart disease” brings up tons of articles and links to studies that show a clear connection. Unfortunately for me, while I discovered my sleep apnea before I had a heart attack I didn’t know it was a potential symptom of heart disease and therefore it didn’t raise any suspicions that would have caused me to get my heart checked out in time.

When I had my sleep study it turned out I had an apnea event (literally stopped breathing) about 80 times per hour. Think about that for a minute. That is more than once per minute. Of course that is going to cause strain on the heart!

Here’s some information on sleep apnea event occurrences. Normal is fewer than 5 breathing events per hour of sleep. Mild sleep apnea: 5 to 14.9 breathing events per hour of sleep. Moderate sleep apnea: 15 to 29.9 breathing events per hour of sleep. Severe sleep apnea: 30 or more breathing events per hour of sleep.

I was diagnosed with severe sleep apnea and nobody told me it could be associated with heart disease so I didn’t immediately go get checked out by a cardiologist. That seems like malpractice, but if I’ve learned anything over the past decade it’s that we have to be our own health advocates because doctors are overworked and under-educated in terms of knowing the latest science.

I ended up with a C-PAP machine, which applies mild air pressure on a continuous basis to keep the airways continuously open while I sleep. I have adapted well to it and use it religiously, every night. I hate having to use it, but using it means I no longer stop breathing 80 times an hour. I get a better night’s sleep and frankly, I feel safer using it. It’s a pain to travel with, but someday I’ll spring for a travel-sized machine as well.

So yes, snoring can be a symptom of heart disease or an impending heart attack. Now that you know this, you have no excuse for not talking to your doctor about your snoring. Trust me, it just might save your life.

Why I’m Doubling Down on Low Carb, Intermittent Fasting in 2019

I’m not much of a New Years resolution guy, but it’s hard not to think about the year ahead as the new year approaches. When it comes to my diet plans for 2019, I feel the need to echo the late George Herbert Walker Bush during the 1988 presidential campaign — stay the course.

All of my reading and research last year led to my full adoption of a low carbohydrate lifestyle, and nothing has changed that would lead me to rethink this approach. I’m not a doctor, but I’m fully confident that my cardiovascular health improved over the course of 2018. A year-end visit to my cardiologist confirmed my own analysis. In December I had an echocardiogram, a nuclear stress test, and a blood workup and all of these diagnostics returned very positive results.

The biggest danger for a heart attack survivor like me is to have a second cardiovascular event. In the first few years following my near fatal event, my heart performance was stable and improved a bit. My blood work was better, if not perfect, and all the other tests showed incremental improvement. Most importantly, my ejection fraction (my heart’s ability to pump blood out to my body) went up each year.

At the time of my heart attack, my ejection fraction (EF) was measured at around 30-35 percent. An EF of less than 40 percent may be evidence of heart failure or cardiomyopathy. For me, this was the scariest aspect of my event. It was also what has been driving me to make changes to my lifestyle.

Improving my EF has provided positive reinforcement for the things I’ve been doing to improve my cardiovascular health. I know that lifestyle led to my heart attack, and therefore lifestyle could keep me from having another one. This is why I’ve spent the past seven years exercising more, taking my prescribed medications, seeing my cardiologist regularly, and eating right.

Honestly, the only aspect of the above lifestyle changes that have provided any complications for me over the years since my heart attack has been eating right. I truly believe the medical establishment either doesn’t know or doesn’t want to suggest how to eat appropriately for cardiovascular health (I think they don’t want to provide advice because it is not so clear cut and if they are wrong they may be worried about liability). All the proof you need that the medical establishment doesn’t know the best way to eat is to Google diet advice — you’ll go down a rabbit hole from which you may never surface.

After my heart attack, my first cardiologist told me to avoid sodium because high blood pressure can lead to heart failure and/or cardiomyopathy. In that first year I avoided sodium like it was poison. Do you have any idea how hard it is to limit sodium intake to less than 1,500 mg a day?

But sodium didn’t cause my heart attack, so I spent a lot of time researching the latest medical advice on diet. I was really frustrated with what I found. I read about the China Study and Dr. Caldwell Esselstyn and thought perhaps meat was the cause of heart disease. I became a pescatarian, eliminating all meat except for fish. Then research started to point to the Mediterranean Diet as the best overall diet and that seemed reasonable so I went down that path. My blood work was better, but still not where I needed it to be.

I watched every movie about diet from Forks Over Knives to Fed Up to Fat, Sick and Nearly Dead and all I got was more frustrated and confused. But as time went on, I started to notice a trend — there was more and more information out there about the dangers of carbs and sugar. I really honed in on this trend, reading everything I could get my hands on. At the same time, I started working with a new primary care doctor who also believed that carbs and sugar were the real culprits of diseases like diabetes, metabolic syndrome, and heart disease.

I jumped in to the low carb movement under doctor care and with regular blood work checkups to assess how I was doing. And for me, the results have been compelling. My blood work is enviable by any standard, and my weight is in a good range. Best of all, my EF has continued to rise and last month was measured at between 60-65 percent — the best it has been since before my heart attack and within the normal range.

As of today, I have above average blood work and a normal EF. That’s all I could have asked for seven years post heart attack. I may cheat here and there (I do enjoy a beer now and again), and my sugars are not as low as I’d like them (that’s where the intermittent fasting is hopefully going to help), but basically, I am in great cardiovascular health. And I’m enjoying how I eat, which is to say I get to eat a wide range of foods including meat, eggs, and a little whole grain bread.

So here I am in January 2019 with probably the best cardiovascular health I’ve had since I was a teen. I attribute this to exercising more, taking my prescribed medications, seeing my cardiologist regularly, and eating right — that is to say, a low carb, low added sugar diet. I definitely need to exercise a bit more, but for the first time in a long time, I am confident I am eating healthy.

It’s the Sugar, Stupid

A juicy steak on the left and a 6-inch Veggie Delight from Subway on the right

Which meal is more heart healthy, the steak or the sandwich? If you believe the American government, and the media, and the vast majority of medical professionals, then it’s no contest. The veggie sandwich is a better choice for heart health because it contains no cholesterol or fat. The steak, on the other hand, has been vilified for decades because we’ve been told that eating foods that contain fat (especially saturated fat) raises the level of cholesterol in your blood and high levels of LDL cholesterol in your blood increases your risk of heart disease.

Signed. Sealed. Delivered. Yes? Not so fast.

What if I told you there has been a vast conspiracy to condemn fat in order to bury the evidence that the real enemy of heart health is sugar? Would you tell me I am crazy and to lose the tin foil hat? Are you willing to risk your life on it?

Lately some of my friends and family have been telling me I sound like Oliver Stone barking about the Kennedy assassination when it comes to sugar. They’d like me to turn down the volume a bit and stop being such a fun suck. Sugar is a vice, but it’s not the root of all dietary evil they say. Shut up and eat a cookie for crying out loud!

Okay, I admit I’ve been ranting a bit too much lately. But if you’d read what I’ve been reading you’d be disturbed as well. And if you’d had a heart attack at a young age like me and have been in a life and death struggle to figure out how to keep it from happening again you might be more open to alternative theories.

The fact is, there is mounting evidence that sugar is the root cause of heart disease. Rather than treat you to a series of quotes from various authors, doctors, and scientific studies I’ll simply list some resources for you to explore on your own at the end of this post. But suffice it to say, I’ve seen enough evidence to convince me that fat has gotten a raw deal and sugar has been artificially and immorally propped up by the sugar industry itself as a simple vice that is fine in moderation. Hell, at first it was literally endorsed as a health food.

I’ve been on a personal journey to protect my heart for nearly a decade now, and at every turn I run into more evidence that sugar (and processed carbohydrates) is the cause of heart disease. Despite the fact that the government still points the finger at fat and cholesterol. It’s frustrating to see how slow this ship is turning. But I believe it is indeed turning and that in the very near future the health powers that be will be forced to issue a gigantic mea culpa and set us all on the path to healthier hearts.

Over the holidays I finally read The Case Against Sugar by Gary Taubes. You don’t have to read it to learn what he uncovered about the dastardly deeds of the sugar industry — you can Google it and read any number of reviews and interviews with Taubes like this one in the New York Times. Here’s a highlight:

Sugar is not only the root cause of today’s diabetes and obesity epidemics (had these been infectious diseases, the Centers for Disease Control and Prevention would have long ago declared an emergency), but also, according to Taubes, is probably related to heart disease, hypertension, many common cancers and Alzheimer’s.

Taubes is a journalist and a well educated one at that. He has degrees from Harvard, Stanford, and Columbia. He has won numerous awards for his work, including the Science in Society Journalism Award of the National Association of Science Writers. He is legit. But he’s not alone in this fight for dietary truth. My explorations have led me to some amazing journalists and health professionals who have all reached the same conclusions about sugar. Like Dr. Stephen Sinatra. Dr. Mark Hyman. Dr. Zoe Harcombe. And Nina Teicholz, science journalist and author of The Big Fat Surprise.

I have also been experimenting with my own body. The fewer carbs and added sugars I eat, the better my blood work turns out. I recently had a nuclear stress test and an echocardiogram as part of my cardiovascular follow-up care, and my cardiologist said my heart is pumping at full power and all the images indicate my heart is healthy. My most recent blood work reported total cholesterol at 118, triglycerides at 120 and LDL at 55. These numbers are enviable for anyone regardless of heart history.

I believe my heart attack was caused by a single blocked artery that became blocked from years of a high carb, high added sugar diet that caused my triglycerides to skyrocket. My trigs were so high at one point (north of 700) that it skewed by total cholesterol numbers to the point that they couldn’t be accurately measured. Ironically, I was not eating an unhealthy diet according to the U.S. government. In fact, I was eating the recommended diet of low fat, high carbs. Journalists like Taubes and Teicholz have uncovered how and why the U.S. dietary guidelines went so astray, but in a nutshell, the reason is sugar. Much like how the tobacco industry lied and manipulated the science and policy of cigarettes, the sugar industry did the same. The evidence is clear.

Sugar is toxic. It screws with your endocrine system, forcing your body to produce too much insulin, which in turn causes you to become insulin resistant. Insulin resistance causes increased production of fat in the bloodstream which causes both obesity and plaque in your arteries. That’s my nonscientific explanation, but if you want to understand it in more detail you can read more on your own.

So back to that question at the top of this post. Which is healthier for the heart, the steak or the sandwich? Well, the 6-inch Veggie Delight from Subway has 41 grams of carbs and the steak has none. Carbs are sugar. Sugar equals heart disease.

If you want to live a heart-healthy life, don’t listen to the government. Listen to science.

Dying From Heart Disease is Pretty Much Optional

Punk rock legend Pete Shelley died on Thursday from an apparent heart attack at age 63, and once again my reaction was anger. Every time someone famous has a heart attack, I get in a fight with my inner voice. How did he not know he was at risk? Why didn’t he take care of himself? When are people going to start paying attention?

I know this might seem a touch disingenuous given I had a surprise heart attack when I was 45, but what I’ve learned about heart disease in the past seven years is enough to make me want to scream from the rooftops — you don’t have to go out this way! Heart disease is optional!

I’m not mad at these people, rather I’m mad at the situation. Nearly 18 million people die each year from cardiovascular disease (according to the World Health Organization) and 85 percent of those deaths are from heart attacks and strokes. 

Heart attacks and strokes are 80 percent preventable!

Yes, that’s right. The vast majority of these deaths can be attributed to preventable factors like obesity, poor physical activity, heavy drinking, eating unhealthy foods and not keeping your blood pressure and cholesterol under control. The CDC also found that about six in ten preventable heart deaths occur in people younger than 65 years old.

So why do people keep dropping dead from heart attacks? Do we not know how to prevent heart disease? Do we not care about getting heart disease? Are we too busy to worry about it? WTF people.

See, I get mad. It’s my issue, I know. Every time a famous person under…say…75, has a heart attack I am reminded of my own mistakes and my own mortality. I immediately go back to stage two of the five stages of grief. I’m serious. I get angry, then I get depressed (which is stage three).

Coach Mike Ditka had another heart attack recently. Alan Thicke. Garry Shandling. Carrie Fisher. Bill Paxton. It doesn’t make a difference who it is. Each time it happens I take it personally.

I wonder why I’ve become so passionate about heart disease prevention. Plenty of people have a health issue and keep to themselves. You don’t see Mike Ditka tweeting about heart disease. I think maybe there’s something in my personality that makes me want to stand up on a milk crate on the corner and preach the gospel of heart health. Is that a personality flaw or strength? I guess it depends on how obnoxious I am about it!

So, if you’re going to get anything valuable out of this post I probably ought to tell you how to prevent a heart attack so you don’t become one of the 14.4 million people who die each year from a preventable disease.

It’s pretty simple actually. I can tell you how to NOT have a heart attack in six words: Eat healthy. Move more. Don’t smoke.

Not smoking is the most obvious one. People who smoke are two to four times more likely to get heart disease. The risk is even greater for women who smoke and also take birth control pills. Seriously, don’t smoke.

Moving more is actually pretty easy as well. The American Heart Association recommends adults get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week. What does moderate-intensity aerobic exercise look like? 

  • brisk walking (at least 2.5 miles per hour)
  • water aerobics
  • dancing (ballroom or social)
  • gardening
  • tennis
  • biking slower than 10 miles per hour

Seriously, all you have to do is walk for 30 minutes, five days a week. Nobody is suggesting you have to run a marathon or swim 50 laps a day.

Lastly, eat healthy. Well, this one may be a little more complicated. Note that I said complicated, not difficult. Most experts suggest you simply eat a diet that focuses on a variety of fruits and vegetables, whole grains, low-fat dairy, skinless poultry and fish, etc. 

There are some that argue a “Mediterranean Diet” is best. Some argue you should be fully plant-based. Others argue keto is the healthiest way to eat. Paleo? Pegan? You can spend the rest of your life trying to figure out the “best” way to eat and never figure it out. So pick one of the above because in truth, all of them are healthy enough for the average person to avoid heart disease in combination with moving more and not smoking.

I have written about this extensively, and I’m convinced from my own health and indicators that it’s working. I eat a low carb, very low sugar, high healthy fat diet. I’m also doing a little intermittent fasting and I’m doing great by any standard. 

Want to know how you’re doing? I recommend you sign up for Life’s Simple 7 and take the survey. It’s free and you can go back again and again as your numbers change. It’s not perfect, but it’s an easy way to see how you’re doing.

Yes, heart disease is voluntary. I wish I knew that prior to Oct. 11, 2011 and that someone had shared these tips with me. Then again, had I not had a heart attack maybe I wouldn’t be on the Interwebs sharing these tips with you.

Christian Bale Reminds us That Heart Attacks Vary

I read an interesting article today about how actor Christian Bale effectively saved the life of Vice director Adam McKay. As part of the Oscar-winning actor’s preparation to play former Vice President Dick Cheney in the upcoming film Vice, Bale learned everything he could about heart attacks because the veep had more than his share. At one point during the filming of the movie, Bale explained to McKay that not all heart attacks present with pain across the chest or shooting pain down the left arm.

Not long afterward, McKay was at the gym when he felt queasy and had tingling in his arm. He initially didn’t think much about it, but then he remembered what Bale had said about heart attacks and he rushed to the hospital. He was, in fact, having a heart attack, and getting to the ER so quickly likely saved his life and certainly saved his heart from having too much damage.

Fred Sanford on TV’s Sanford and Son had a “heart attack” in nearly every episode.

This is a lesson I try to share as often as I can. Not all heart attacks present in the same way, and in fact heart attacks in women often present in very different ways. When we think of heart attacks, many of us have the image of Redd Foxx as junkyard owner Fred Sanford clutching his chest and looking to the sky declaring to his dead wife “I’m coming to meet you Elizabeth.” That’s how I envisioned it. At least, until I had one.

Heart attacks can present in many different ways. Here are just a few: Pain in the area between shoulder blades, arm, chest, jaw, left arm, or upper abdomen. Dizziness, fatigue, lightheadedness, clammy skin, cold sweat, or sweating. Heartburn, indigestion, nausea, or vomiting. Discomfort or tightness in the arm or neck. Anxiety, chest pressure, feeling of impending doom, palpitations, or shortness of breath. In women, symptoms often include jaw pain, back or shoulder pain, shortness of breath, or nausea/vomiting.

Many times there’s little drama involved in a heart attack. My heart attack presented with a radiating heat across my chest, a cold sweat, indigestion, and pain down both arms. I didn’t think I was having a heart attack, though looking back I should have. And because my symptoms only lasted for about 20 minutes, I figured whatever it was had ended and I was OK. Because of that, I didn’t seek treatment for two days and ultimately that caused permanent damage to my heart that otherwise could have been avoided. I could very easily have died while I avoided going to the hospital. My E.K.G. was so bad when I did go to my doctor two days later that she called 9-1-1 and I got a ride to the ER where 30 minutes later I was in the cath lab receiving three stents for a mostly blocked left anterior descending artery (LAD).

Heart attacks are also not always caused by blocked arteries, otherwise known as atherosclerosis. Heart attacks can also be caused by a spasm of a coronary artery, arrhythmias (abnormal heart rhythm), cardiomyopathy (enlarged heart), undetected heart defects, and even electrical shock. In other words, heart attacks are not monolithic in nature.

WebMD has a nice list of common heart attack symptoms, but even if you’re having one or more of these symptoms it can be confusing to know if you should get to the hospital. It’s easy for me to say this in hindsight, but when it comes to heart attack symptoms I suggest you don’t take any chances. What’s the worst case — you spend a few hours at the ER and go home feeling silly? It beats dying!

52 Things I’m Thankful for on My 52nd Birthday

52-highsOne thing about nearly dying is that it makes you appreciate life more. It may sound cliche, but there was a time not too long ago when I wasn’t sure I’d make it to 52. And even though it’s not a nice round number like 50 or 55, I still feel like celebrating simply waking up for another birthday. Happy 52nd birthday to me.

Even for those who did not have a near-death experience, the world sure seems to be coming apart at the seams. Things feel pretty dire. We have a lunatic in the White House. The world looks to Germany for moral authority. The climate is changing so rapidly that huge chunks of the polar caps are falling off and melting into the sea. The American wage gap is getting wider. Americans are getting wider. Kids keep getting gunned down at schools. The U.S. Men’s National Team didn’t make the World Cup!

Yet even still, perhaps because I have been consciously trying to pay less attention to politics and the news, I feel like I have a lot for which to be thankful (including knowing how not to end a sentence with a preposition).

I’m not really going to tick off 52 things I’m thankful for as I turn 52 (not because I can’t come up with 52, but because I don’t think you’d read through a list that long). I am, however, going to hit some high notes.

  • First and foremost, my heart is strong and while it will never be fully recovered it is pumping within the normal range (ejection fraction at 55). My arteries are clear. I recovered completely from the little stroke I had last year with no permanent deficiencies. Aside from a few normal age-related aches and pains, I’m in pretty good health given my history.
  • I have a loving wife/best friend who treats me like a king despite my often whiny personality. In a few months, we’ll be celebrating our 25th wedding anniversary.
  • We have raised a remarkable son who at 20 is wise beyond his years. He may still be trying to find himself, but he’ll never be lost.
  • I live in a wonderful town in a perfect townhouse in a great neighborhood.
  • For the first time in my life, I can truly say I love my job. I had a great year raising money for the American Heart Association and I am honored to be able to do this work for a living. Strange way to find a calling, but I’ll take it.
  • Despite some ups and down this year, my mom, dad, and sister are doing well (as well as can be expected given they all live in Tucson now).
  • We’re doing well enough financially to afford to travel more and are starting to tick off our bucket list one by one.
  • I have great friends both online and in real life.
  • The heart attack support network I founded on Facebook has grown from a handful of survivors in Phoenix to nearly 3,500 across the globe.
  • I serve my community as a board member of a great nonprofit that unites, strengthens and advances the state’s nonprofit sector.
  • The Suns have the first pick in the NBA Draft tonight and will finally land the “big man” they’ve always needed. The Padres are not winning, but they are on the right track with a great young core and some special players almost ready for the big leagues. The Cardinals drafted a QB of the future. No team I’ve ever rooted for has ever won a world championship — but that will change in the next few years. Go Cardinals. Go Padres. Go Suns.
  • I have found a new passion in soccer and have become a rabid fan. Seriously, I wake up early every weekend during the season to watch Arsenal play.

All this is to say that I’m living a great life. It’s nothing like the life I imagined I’d be living in my 50s, but it’s great nonetheless. And despite world events, my own life is really good. And I’m grateful. And I need to remind myself to share that fact more often, and certainly not just on my birthday.

I’m a heart attack and stroke survivor and I’m grateful for everything I have in this world.

Regrowing Damaged Organs no Longer Stuff of Science Fiction

timeismuscleI have only one regret from my heart attack experience in 2011, and that is that I waited two days from the onset of symptoms to seek treatment. Aside from the fact that I very likely could have died during those 48 hours, the time I waited very likely caused more damage to my heart than if I had gone to the hospital right away. In the heart attack business, time is muscle.

It’s a sobering experience to hear your cardiologist say that part of your heart is dead, but that’s exactly what happens to your heart when oxygen is cut off. In my case, I lost about 15 percent of my heart muscle in the area at the lower left ventricle known as the apex. Because of this dead muscle, I have what the doctor calls left ventricular hypokinesis. Basically, it means my heart doesn’t contract as much as most people’s hearts resulting in a lower ejection fraction.

This means my heart doesn’t pump out as much blood as a normal heart, which is no big deal until it gets too low (an ejection fraction of 50 percent or lower is considered reduced) and if it gets down below 40 or so it means you are in heart failure. At the time of my heart attack my ejection fraction was around 35-40, but today it’s in the 55-60 range which is at the low end of normal. Lucky me.

Every cardiologist I’ve seen, and everything I’ve read, says heart muscle damage is permanent. But as college football broadcaster Lee Corso says — not so fast my friends!

Medical science is progressing at a breakneck speed. Just think about coronary stents for example. It seems like they’ve been around forever, but the first one was inserted into a human in 1986 (just 32 years ago). If I had the very same heart attack in 1985 I’d be walking around with a 90 percent blocked left anterior (LAD) descending artery (also known as the widowmaker) instead of having three stents. Or more than likely I’d be dead.

Which brings me to that dead heart muscle. This week in the magazine Nature I read about a new procedure that will be done on three patients in Japan. Doctors at Osaka University will take thin sheets of tissue derived from cells and graft them onto diseased human hearts. The team expects that the tissue sheets can help to regenerate the organ’s muscle when it becomes damaged.

If this works as it has in lab animals, these doctors will in effect reverse thousands of years of medical orthodoxy. Time may be muscle, but science is more powerful than current knowledge.

This experiment is part of a field known as regenerative medicine. Rejuvenating or regrowing human tissue has limitless possibilities for medical science, and while the field is in its infancy it feels like every day we hear about a new breakthrough. Just a few years ago scientists grew a complete human bladder outside the body, and we’re not very far from the ability to grow more complex organs to use for transplantation. How long before scientists can grow a human heart that can be used to replace failing ones? The stuff of “science fiction” is no longer outside the realm of possibility.

I recently read Never Let Me Go by Nobel Prize winner Kazou Ishiguro. Spoiler alert: it’s about clones who are created to harvest replacement organs. But given the direction of real science, the dystopian world laid out by Ishiguro will not be needed!

This is a long way of stating that I am grateful for medical science. In fact, science is the closest thing I have to a religion. I put my faith in regenerative medicine, CRISPR, biotechnology, immunology, and everything else that involves the scientific method. My heroes are scientists, doctors, and inventors. They bring me peace of mind and hope for the future.

My heart damage is probably not severe enough to warrant stem cell therapy or regenerative cell sheets. But it’s nice to know if things get worse for me, or as science continues to progress, my heart could easily be fixed. Permanently.

I ♥ science!

You Are What You Eat

fatsickandnearlydeadLong before I suffered a heart attack I had been thinking a lot about food and its relationship to health. I had good reason to learn more about food as my cholesterol, triglycerides and blood sugar were elevated due to a combination of genetics, inconsistent activity levels and an undying love of pizza. So I started doing research on how to naturally lower these signs of impending crisis and each time the path led back to the same place — food.

Flash forward to last night and here I am again watching a documentary about food and health, this time at a special screening of Fat, Sick and Nearly Dead at a local restaurant called Pomegranate Cafe. And just like all the others, the premise involves eating fruits and veggies. Hmm. Maybe it’s true that 50 million Elvis fans can’t be wrong.

Here are just some of the films I’ve seen and books I’ve read over the past few years that preach the gospel of healthy eating:

I’m sure you can find tons more, but these are some of the popular ones. The thing is, so much research (both scientific and anecdotal) points to the plain fact that food can make us sick and conversely food can heal. You don’t have to believe it, or even care, but that doesn’t make it not true. What would it take for you to change the way you eat?

What of you had a heart attack? Would you change the way you eat, or would you continue the unhealthy lifestyle that made you susceptible to heart disease in the first place? It’s not an easy answer. In the months since my heart attack I have run into all types of survivors — those who don’t change because they either don’t care about living or they think it’s too hard to those, like me, who are willing to make a radical change in hopes of not only living longer but being healthy enough to enjoy that longevity. For me it’s a no brainer, but I understand the other side.

Changing my diet was really hard at first, and not just because I missed regularly having a couple of slices at NYPD Pizza. The hardest part has been eating at restaurants. I’ll tell you what’s not hard — eliminating most animal products. I have been mostly vegetarian for years (I continue to enjoy seafood) and truthfully I don’t miss the meat. Yes, every once in a while I dream about a Double Double, but it passes and those cravings happen less and less. I’m even thinking being vegan or raw wouldn’t be too hard since I’m almost there already. Limiting fat and cholesterol is simple, especially if you eat mostly vegetarian anyway.

Unfortunately for me, my heart was damaged by my heart attack and if I want to take care of it — permanently — I need to severely limit sodium. This has been the hardest thing for me, and not because I crave the taste. It’s hard because sodium is everywhere and often in places you least expect it. I won’t go into detail on why sodium is so bad for heart patients, but suffice it to say sodium makes you retain water and retaining water makes your heart pump harder. When your heart pumps harder, it will naturally enlarge and that would exacerbate my damage and inevitably lead to heart failure. How much sodium are we supposed to eat? The recommended daily allowance for a healthy person is 2500 mg. For someone like me, I need to stay under 1500 mg. I am currently eating between 1000-1500 mg per day. To give you an idea of what that means, a single teaspoon of table salt? There is around 2500 mg in a teaspoon of salt. A typical slice of pizza? 700 mg. How about a “healthy” meal at a “healthy” restaurant? A small Greek salad at Pita Jungle has 940 mg of sodium.

So you can see eating at restaurants is a challenge for me. But it’s worth the hassle given my condition. If you don’t have a heart condition, changing your diet is a breeze. But even keeping to the RDA is tough for a healthy person. A single portion of lasagna classico at Olive Garden contains 2830 mg of sodium. Holy salt lick Batman!

Why wouldn’t you change your diet? It’s so easy and the evidence is so clear. I know, you love a good steak. Enjoy, but why not consider making small steps in the right direction? Michael Pollen says it best. When asked how to dig through all the hype and misinformation he says, simply:

Eat food. Not too much. Mostly plants. 

In case you’re confused, by suggesting we “eat food” he’s basically saying to eliminate anything processed, chemical, manufactured, toxic, etc. Broccoli is food.  Methylchloroisothiazolinone is not.

A Bitter Pill to Swallow

pill_box_with_pillsOne result of my heart attack is that I now have a crapload of pills to take each day. There are two ways to look at this: on one hand, I am very lucky I live in a time when science has brought us so many amazing medicines, and on the other hand I am a little freaked out by how many foreign substances I am putting into my system each day. On top of that, during my recovery, I have done some reading and watched some documentaries that not only question the use of drugs but provide scientific evidence for natural ways to bring about the same positive results. What to do, what to do?

Here’s a little taste of what I swallow each day just for my heart:

  • Plavix — Keeps the platelets in your blood from clotting to prevent blood clots after a recent heart attack or stroke.
  • Carvedilol — Used to treat people whose hearts cannot pump blood well as a result of a heart attack. Carvedilol is a beta-blocker that works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.
  • Lipitor —  Used together with diet and exercise to reduce blood levels of low-density lipoprotein (LDL) cholesterol (”bad cholesterol”).
  • Altace —  Used to reduce the risk of heart attack and to improve survival in patients with heart failure after a heart attack. Altace is an angiotensin-converting enzyme (ACE) inhibitor that works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.
  • Aspirin —  Used to prevent heart attacks in people who have had a heart attack in the past or who have angina. Also used to reduce the risk of death in people who are experiencing or who have recently experienced a heart attack.
  • Warfarin — Used to prevent blood clots from forming or growing larger in your blood and blood vessels. Warfarin is also used to treat or prevent swelling and blood clot in a vein and it works by decreasing the clotting ability of the blood.

Last night I finished watching a documentary about Ray Kurzweil called Transcendent Man. Ray is the proponent of something called The Singularity, which he thinks will take place within the next 30 years. The Singularity is “a proposed advancement that will occur sometime in the 21st century when progress in genetics, nanotechnology, and robotics will result in the creation of a human-machine civilization.” Until this time, Ray is trying desperately to keep his biological body alive and as part of this process the man swallows more than 150 supplements per day. That seems like a lot of effort, but if you honestly thought it would extend your life wouldn’t you at least consider it? That’s sort of my conundrum with all the pills I’m taking. I definitely believe in science and my cardiologist is highly trained and has seen results with pharmaceutical treatment. I’d be stupid not to do what he says. I know there are some of you out there who think taking drugs is a scam and all the hype is just a way for big pharma to make money, but that’s easy to think until you are faced with a life or death situation. Mike Tyson used to say “everyone has a plan until they get hit.” That’s how I feel.

I will say this — I have made a pretty solid recovery in the seven months since my heart attack and I have to believe the reason for this is because I did the three things my cardiologist asked of me. I did cardiac rehab and continue to exercise regularly, I drastically lowered my intake of cholesterol, fat and sodium, and I’ve taken my meds. As much as it freaks me out to take all these drugs, it appears to have made an impact. Of course, if I follow this logic I will be on tons of drugs for the rest of my life. But at least I’ll have a rest of my life.