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!

The One Thing You Should Do Today if You’re at Risk for a Heart Attack

1_lp5iquleQM96kgSkir-iegAs a heart attack survivor, I’ve had the opportunity to speak to hundreds of people about my experience. Whether I’m sharing the story over dinner with friends or blogging about the day of my cardiac event, one particular question always seems to pop up: what can I do to make sure this doesn’t happen to me?

People have preconceived notions about who is at risk for a heart attack and unfortunately these assumptions are usually very wrong. Most of us think heart attacks only happen to overweight people, or sedentary people, or smokers. People look at me and see themselves and it freaks them out. True, I didn’t have any outwardly apparent risks for heart disease, but below the surface I was a ticking time bomb. My triglycerides were significantly elevated. My high-density lipoprotein (HDL or good cholesterol) was low. My blood sugar was borderline high. My family history was chock-full of heart disease. I had what is commonly known as Metabolic Syndrome or Syndrome X — a cluster of conditions that increase the risk of heart disease, stroke, and diabetes.

Metabolic syndrome occurs when a person has three or more of the following measurements:

  • Abdominal obesity (Waist circumference of greater than 40 inches in men, and greater than 35 inches in women)
  • Triglyceride level of 150 milligrams per deciliter of blood (mg/dL) or greater
  • HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women
  • Systolic blood pressure (top number) of 130 millimeters of mercury (mm Hg) or greater, or diastolic blood pressure (bottom number) of 85 mm Hg or greater
  • Fasting glucose of 100 mg/dL or greater

I had three of the above symptoms, all hidden below the surface. And I knew about it. And I tried to fix it on and off for years by adjusting my diet and exercising more. But I still had a heart attack at 45.

What could I have done to avoid having a heart attack?

When people ask me that question (and they always do), I say the same thing: if you have three or more of the signs of Metabolic Syndrome, or a family history of heart disease, and are over the age of 40 — go get a coronary artery calcium (CAC) scan.

Right now you’re probably thinking how come you’ve never heard of this test. Is this something new? It’s not new, and has been around since the early 90s, but for a long time it has been seen by many cardiologists as not reliable enough to recommend for their patients. But that is changing, as discussed in a newly published article by Harvard Health Publishing, and as evidenced by the growing number of hospitals and diagnostic labs that offer the test.

“CAC results can help identify a person’s possible risk for heart attack or stroke, even if that person doesn’t have the obvious risk factors or symptoms,” says Dr. Jorge Plutzky, director of preventive cardiology at Harvard-affiliated Brigham and Women’s Hospital. “It can be a way for some people to get the necessary treatment early and hopefully head off a serious cardiac event.”

If I’d had a CAC at a local hospital prior to having a heart attack on Oct. 15, 2011 it’s very likely the test would have shown that I had a severe blockage in my left anterior descending artery. Instead of having the heart attack that nearly killed me and permanently damaged my heart, the test results would have tipped off doctors that I was in danger and they could have gone in and stented the artery before the damage was done.

I’m not saying everyone should run out and get a CAC. But if you are at risk for heart disease it’s a valuable tool in the arsenal and it just might save your life. And while insurance companies aren’t yet sold on its value (and since when have insurance companies cared about your health), it’s a relatively inexpensive test and in most places you don’t even need a referral from a doctor. That’s right, you can use Google to find a test location near you, make an appointment, and plop down less than $100 for a 15 minute non-invasive test that might save your life.

That seems like a small price to pay for peace of mind.

Heart Attack? That Was So Six Months Ago

Today is the six-month anniversary of my heart attack. Milestones seem like a good time to reflect a little, so here are some random thoughts:

  • Thinking back to the early days of my recovery, it feels like I have traveled a “life marathon” since then. So much has happened, both physically and emotionally. Truth is the emotional has been more difficult.
  • Health wise I have made tremendous progress. Without getting too technical, my ejection fraction has gone from “about 30-35” in the days following my heart attack to “about 45” six months later. This measurement means my heart is working much more efficiently than it was at the time of my M.I. and is now pretty close to the normal range of “50-75.” My cholesterol is way down (much lower than yours I bet!) thanks to diet and medication. I have had no medical issues since my heart attack and in fact I’m probably stronger now than I was prior to the attack thanks to stronger blood flow through the three stents in my left anterior descending (LAD) artery. In other words, I feel great physically.
  • I am exercising without any issues 5-6 times per week.
  • The mental rehabilitation has been more complicated. Most days I feel great. Happy to be alive and feeling like I have the whole world in front of me. Some days I freak out that I had a heart attack and worry that I’m going to drop dead at any moment even though that is extremely unlikely. My cardiologist said he had a higher chance of having a heart than I do now. Still, it’s hard not to think about how close I came to death and how scary it would be to leave my family behind.
  • Some days I wake up feeling anxious even though there may be no apparent reason for the anxiety. It’s a nasty thing anxiety. If you’ve ever struggled with it you know it can manifest itself in physical ways including chest tightness, the inability to concentrate and even heart racing or palpitations. The anxiety comes less often now but it can strike at any time. If I seem short with you one day maybe I’m having one of those days. 😉
  • Some of my friends and co-workers seem to be worried that I have to avoid stress or I’m going to have another heart attack. To them I say thank you for your concern, but stress didn’t cause my heart attack and stress is not a big issue for me these days. Like everyone I have some days that are more stressful than others, but don’t baby me — I’m not going to drop dead from stress.
  • The biggest (and in some ways only significant) change in my life has been food. If you believe as I do that food can kill you and food can heal you then it seems like an obvious thing — eat well and you’ll be well. But it’s not that easy. There are three things I have to look out for — saturated fat, cholesterol and the biggest one, sodium. Lowering fat and cholesterol is really quite simple. I stay away from red meat and fatty foods. Simple. Sodium on the other hand is a bitch. Why is sodium so important? Well, sodium makes you retain water and that forces your heart to work harder and your blood pressure increases. You don’t want that, as a heart patient or as a normal person. It’s one of the biggest reasons why heart disease is the number one killer of men and women in America. The average American gets as much as 10 times the daily recommended allowance of 2,500 mg per day. As a heart patient, I’m supposed to keep my intake to around 1,200-1,500 mg per day. It’s not so much the added salt that troubles me (I don’t use any), but it’s the sodium in foods that you may not know about. Cooking at home makes things easier, but eating out is no fun. Do yourself a favor (and I won’t preach anymore) and check out the nutritional charts online for some of your favorite restaurants. It will scare the shit out of you. Before my heart attack one of my favorite places to eat was Rubios, where I’d typically have a shrimp burrito. The burrito has 2,200 mg of sodium, nearly double my daily allowance. Nowadays I still go to Rubios but I have the salmon or mahi mahi tacos on corn tortillas (190 mg of sodium per taco).
  • Eating out has become a social occasion for me rather than an eating event. For instance, tonight I am going to a concert with friends and we’re meeting beforehand for a meal. I checked out the online menu of the place we’re going and there’s really nothing I can eat, mostly because they don’t list their nutritional values on their site. I’m going to eat something at home beforehand and enjoy my time with my friends over a beer. This is, as my lovely wife likes to say, my new normal. I nearly lost my life because of food and I’m not about to give it a second chance to kill me. Most people who have heart attacks have more than one — I am never going to have another one because I am willing to sacrifice being a foodie for being alive. Yes, it’s a tough sacrifice, but I feel like I don’t have a choice. Not everyone who has suffered a heart attack makes this choice (some don’t even stop smoking), but I have too much to live for to let a little thing like food stop me from enjoying my life. I will miss you NYPD pizza and Rubios shrimp burritos…have fun killing someone else!
  • Lately I have thought about becoming a vegan. It is clear to me that a vegan diet is healthier for humans, and the research I’ve seen (including the film Forks Over Knives) makes a pretty compelling case. I was a pescaterian prior to my heart attack, meaning the only meat I ate was fish, but I ate a crap load of dairy and dairy is loaded with bad fat. From the way I’m eating now it’s not a stretch to get to veganism. Maybe if I make the decision it will take some of the stress away from worrying about meal preparation and eating out. It would certainly simplify it. I’m willing to listen to my vegan friends out there. Sell me.
  • I need a hobby. I love to read and watch films, but I need something more active. Any suggestions? Golf is fun but it’s expensive and it’s about to get hot in Phoenix. I’d love to go fishing if anyone out there enjoys it and wants to bring me along. I have a rod. Bowling maybe? At least it’s indoors which is a bonus here in Phoenix. I don’t really have an active hobby and frankly I’m a little bored in the evenings and on weekends. I certainly don’t want to work more!
  • I have been trying to be more active with my volunteering. I’ve always volunteered and done pro bono work, but these days it’s calling me. I’ve started to do some work with the Heart Association, helping them with PR and social media. I’m also looking into ways to be more involved with what my company has to offer in terms of corporate social responsibility. Apollo Group does a nice job in the community and I’ve already reached out to some folks in our external affairs department for ideas. I’m looking for something more in-depth than just doling out food or cleaning up trails — I’m thinking board level or committee chair. Send me your ideas. When I have been an active volunteer in the past it has come with many rewards.
  • I’m going to do more travelling with Leslie and Connor. I lost all of my vacation and sick time when I was on disability, so we haven’t done much travelling in the past six months. We did spend a wonderful weekend in Coronado at New Years and we’re planning something small for Memorial Day weekend. In July we’re going to go to Chicago to meet family and see some sites, and then after my vacation gets refreshed in August I think we’re going to plan something special for fall break. We’d also like to do something spectacular next summer — perhaps Europe. Having future things to look forward to makes life worth living.

Well, that’s about it for now. Consider this my therapy blog post! Six months post heart attack and frankly I think I’m doing great. People tell me I look great, which makes me wonder how I looked before October 15, 2011. I have lost about 20 pounds as a result of my healthy diet and I am exercising a ton so maybe I do look good! Oh, and methinks the goatee has outlived its usefulness so I think it’s coming off today to mark the anniversary. Hearing Josh Brolin make fun of goatees as “so 90s” last night on SNL was the clincher.

Thanks for reading.

The Heart of the Matter

leslieValentine’s Day is a silly made up Hallmark holiday designed to con men into buying flowers and candy, not to mention a corny greeting card inscribed with someone else’s sentiment. When you’ve been married for nearly 18 years, it’s hard to take Valentine’s Day too seriously. I can never figure out what to do for my wife on Valentine’s Day. She doesn’t eat candy and flowers seem so cliché. Jewelry is out of the question because she isn’t a big jewelry person and what she does wear belonged to her dead mother so how can I compete with that? This year I can’t even really take her out to dinner because I can’t eat much of anything on my post heart attack diet. I’ve been thinking about it for a few days now, and what I’ve decided to do this year is give her a gift from my heart — hell, it is my heart.

Dear Leslie,

Tomorrow is the four-month anniversary of my heart attack and I have made so much progress it is remarkable. But what is even more remarkable is how much you have been there for me. I always thought wedding vows were just a formality, but I have a new appreciation for “in sickness and in health.” It’s one thing to stand by your partner in tough times, but there are degrees of being there — not everyone is capable of giving as much as you have given to me over these past few months. From the moment Dr. Kerr called you from her office and told you I was headed to the emergency room you changed your entire life for me. Hell, you beat the ambulance to the ER and was waiting for me when I arrived! At that moment I put my faith in you to make decisions about my health because I knew after 17 years of marriage I could trust you more than anyone with life and death decisions. I never once felt scared because I knew you were there for me, which is why I seemed to be so cavalier about the whole experience. I was scared inside, but I also had a tremendous peace about things because I knew you were going to take care of me.

In the days and weeks that followed you took the bull by the horns and made my care your top priority. You didn’t just sit by my side, you owned this crisis and became an overnight expert on heart health. You researched all of my medicines and asked a million questions of my healthcare team, all so you’d know how best to take care of me. And then there was the food! I don’t think people understand how critical food is in the first six months post heart attack, but you do. Reading labels is only the start…but you went so far above and beyond the call of duty its astounding. I don’t think I had to cook a single meal in the first few weeks, and even today you make my eating life so much more amazing than it would have been had I been in charge. I don’t think there’s any doubt had I been alone on this journey I would be eating peanut butter and jelly sandwiches for every meal. In the past few months you have made — from scratch — a variety of meals fit for a heart-healthy king. Pizza. Lasagna. Sweet and Sour Chicken. Chili. Soups. Fish. Casseroles. Grilled cheese. Even hamburgers this week! All low fat and low sodium. This is no small task and I want you to know how much I appreciate it. And have I mentioned the bread. I had no idea that when you bought a bread machine I’d be eating every kind of low sodium bread under the sun. Rye. Pumpernickel. Wheat. Sourdough. Homemade bagels and buns! You are not normal and I am so damn lucky.

Not every wife would have come with me to all my doctors appointments, or reminded me to take my pills (and there are so many of them!). When I started cardiac rehab you came three days a week with me until I settled in and got comfortable. You are one of the only spouses who regularly attends the learning sessions so you can have even more knowledge to take care of me. But it’s so much more than my physical health that you’ve taken care of these past four months. You’ve managed to do all of this while still making me laugh, and going on walks with me, and taking me out to restaurants and parties and friends houses. You planned my first post heart attack “vacation” with an incredible weekend for all of us in Coronado over New Years and while it could have been so stressful it was instead a new beginning and it shed the light on our future together. We can travel and eat out and enjoy the life we were meant to share together. You even encouraged me to buy the expensive impractical car and you haven’t complained yet about my new (is it permanent?) facial hair!

It hasn’t always been easy. But I really haven’t had too many down periods since all of this shit hit the fan. On the rare occasions when I’ve felt overwhelmed, you’ve simply been there for me to talk to or to hug. You have been so strong through all of this, and though I know you’ve had your moments as well, they have been few and far between. You are such a strong person…I could only hope to be as strong as you someday.

Through sickness and in health. We have been together for 20 years and it hasn’t always been easy. Relationships are hard work, and there is a reason why most marriages don’t make it. But through it all, you have been there for me. This may have been the biggest crisis we’ve had as a couple, but there were plenty of smaller ones. The common theme though is that you always rise to the occasion. Whether it was Connor’s health issues or our ill-fated move to Georgia or my career fiascos, it never mattered to you — you simply did what comes natural to you and took charge. I think you are the most remarkable woman on the planet and I don’t know what I did to deserve you. You are the most beautiful, intelligent, funny, caring, sexy, amazing woman in the world and you’re my Valentine. And I’m your Valentine. I wouldn’t want to be with any other woman in the world…ever.

I love you and Happy Valentine’s Day.

Lenny

Three Months and Still Ticking

coronary_arteriesYesterday marked the 90-day anniversary of my heart attack which occurred on Oct. 15, 2011. I figured this is as good a time as any to give everyone an update on my condition, especially since I went to the cardiologist today. Here’s the latest:

  • I feel great. I am back to work full time, attending cardiac rehab twice per week, walking briskly 3-4 additional days per week, eating amazingly well (thanks in no small part to Leslie’s wonderful skills in the kitchen) and doing pretty well emotionally too.
  • At the time of my heart attack there were two main concerns — I developed a clot in the lower portion of my heart and there was muscle wall damage there as well. The good news from the cardiologist appointment today was that both of these have improved. The clot has shrunk considerably (the echocardiogram tech couldn’t even see it) and my heart function has improved as well.
  • Clots are common with heart attacks. The goal is to eliminate it, and to do that they put me on a series of drugs to thin my blood and lower my heart rate and blood pressure. The doc says another few months on the drugs and the clot should dissipate or be absorbed into the heart wall.
  • Heart function is measured by what is called an ejection fraction (EF). Basically it is the percentage of blood that’s pumped out of a filled ventricle with each heartbeat. A normal ejection fraction is anywhere from about 55 to 70. At the time of my heart attack the cardiologist estimated my EF to be around 35 and today it is closer to 45! An EF under 40 can be life threatening and may be a sign of heart failure, so the fact that mine went up so dramatically in just three months is a great sign. This improvement can be attributed to taking my meds, exercising and eating a low fat, low sodium diet.

So, what’s next? In mid-February I will be taking a stress test to see how my heart performs when my heart rate goes up. Since I have no other blockages and my stents have fixed the one I did have, I should be able to exercise vigorously going forward without any trouble and this test will show my doctor how my heart performs under duress. Even though I am exercising now with no trouble, my heart rate has remained low because of the drug therapy. I’d like to start increasing the intensity of my workouts so this will tell the doctor if that is ok. In March I have another appointment with my cardiologist to check my blood work (my cholesterol was around 70 in December…yes, 70, not 170!) and then a few weeks after that I’ll get another echo to see if the clot is gone and if my EF has gone up any more. I can have a very normal life with my EF at 45 but of course the closer to normal the better.

Physically I feel great. Psychologically I am doing good, but I still have bouts of anxiety although these are fewer and further between. The big mental part is wondering what the future holds and whether or not I will be able to do all the things I want to in life. Intellectually I know I will, but the anxiety can still get to me. It’s weird, but it hits at strange times like when I see a commercial on TV where someone is talking about retirement or when someone is working out really strenuously (damn you Gatorade!). I’m sure this will all get better over time, although I am seriously considering starting a local Meetup group for young heart attack victims to have some people to share stories with. It’s hard when all the patients in cardiac rehab are 20-30 years older than me! If you know anyone who might be interested in this kind of meetup group send them my way…

That’s it for now. Take care and thanks for listening!

To Infiniti…and Beyond!

What do you get when you take one 45-year-old man and add in a heart attack? A serious mid-life crisis! Surviving a heart attack last month really fucked with my concept of the future and now I truly understand what people mean when they say life is short. Shit, life can end in the blink of an eye. So why put off until tomorrow what you can do today?

For me, that means getting the car of my dreams. I have always wanted a convertible but old “practical” Len kept buying the Honda Accords and the Nissan Altimas. Hey, there’s nothing wrong with being practical and those cars served me well. But this life-altering event called for something really, really impractical! Why not, right? We have the Murano for long trips and hauling stuff around town, so today I got the flippin’ convertible!

Len Gutman would like to introduce the newest member of the family — the fully loaded 2011 Infiniti G37 convertible:

This is a car show image, but this is the car I leased today…black obsidian with wheat leather interior. Rear-wheel drive. V6. 330 horses. Retractable hard-top roof. Wicked sound system with Bose speakers built into the headrests. Navigation with real-time traffic. Heated and cooling seats.

I’m kinda diggin’ this whole Len 2.0 thing. You know you’re jealous! 😉

Are You a Heart Attack Waiting to Happen?

calciumThe most common question I’ve received so far from friends and relatives regarding my heart attack is how in the world did this happen to me? It’s true, on the surface I seem like the least likely person to have a heart attack. But the truth is, I was a ticking time bomb and had no idea. This much is true — I am thin, I run three miles three times per week, I do not eat meat with the exception of some fish, I have a relatively stress-free job and I see my doctor regularly. So why did I have a heart attack at 45?

I’m not sure we’ll ever fully know the answer to that question, but here are some other facts:

  • I have had high cholesterol and triglycerides  for more than a decade. I have been monitoring this, however, and have been on a baby aspirin and a statin (Lipitor) for many years and every six months I get my blood tested and my cholesterol numbers have been good. Last check my overall cholesterol was around 175.
  • I have a terrible family history of heart disease. My grandmother and grandfather on my dad’s side both died relatively young from heart related illness. My father had a heart attack in his early 60s, had both carotid arteries blocked and had quadruple bypass surgery. He has high blood pressure and diabetes.
  • I grew up in a household where both parents smoked and I ate a shitload of red meat and fatty foods well into my late 20s. I had a 80-90 percent blockage in one artery and it probably started long before I began to take care of myself.
  • What I’ve learned in the past few weeks is that with my family history I should have done more to keep my cholesterol down even lower.

So what could I have done differently? What can you do if you have concerns about your own heart health? The first step is to see your primary care physician and get a blood workup. After that, make an appointment to see a cardiologist to get a baseline of your heart health. They’ll do an EKG and maybe even a stress test. I saw a cardiologist about 8 years ago right after my dad had his bypass. I was 38 and the doctor told me to take a baby aspirin every day, stay active, eat right and come back and see him in five years. I did not, and looking back he may have done a stress test at that time and found the blockage before I had my heart attack.

But there’s a new test that is available now that anyone can take and it can determine your likelihood to have a heart attack well in advance and it is non-invasive. It’s called a Calcium Score Test and it’s a simple CT scan that can show whether or not you have any blockages. Had I had one of these tests they would have seen my blockage and been able to go in and clear it out before I had a heart attack and before any long-term damage was done to my heart. Wow.

The test is available at many places around the Valley. Because it’s new, it is not covered by most insurance companies (why does that not surprise me? ) but it’s really inexpensive. You can get the test for under $100 at Abrazo and Chandler Regional for example:

Get smart for your heart!

Len 2.0

I realize this is a cliché, but I have been thinking a lot about life these past few weeks and I sort of get the whole re-birth thing. I really do feel like I have a second chance at life and that has caused me to think about all of the things I always said I wanted to do but never got around to. I have also been thinking about past mistakes and regrets, and although I have made it a point not to dwell on the past, there are some things I’d like to go back and fix.

Yesterday, for example, I reconnected with an old friend that I lost touch with. I was thinking about all the great times we had in college and afterward and I realized I had no idea why we lost touch. All I knew is that I wanted to talk to him and find out what he’s been up to — and after a 20 minute phone call I felt great about rebuilding that relationship, hearing about his new family, and generally just knowing he was doing well. I’m not going to get all preachy during my recovery but if there’s someone important out there that you have lost touch with take the first step and give him or her a call.

My friend and co-worker Mike McClary and I both returned to the corporate world together last year after many years in solo practices and we agreed the second time around in the corporate world would be different because we were wiser, older and less concerned about all the usual corporate B.S. that made us hate corporate America in the past. We call this new attitude “Corporate 2.0” and for the most part we’ve managed to make it work. This has inspired me to call my post-heart attack life “Len 2.0”

Len 2.0 is more than just a philosophy though because I really did almost kick the bucket a few weeks ago! I remember after my mother-in-law passed away at an early age Leslie and I talked a lot about how she had done all the things expected of a wife and mother and when she was finally free from those responsibilities she always thought she’d be able to finally do all the things in life she wanted to do. She was young, had some money and had the desire…but it turns out she didn’t have the health and unfortunately she ran out of time. We always said we weren’t going to make the same mistake — we were going to do all the things we wanted to do while we had the chance. But it’s not so easy. Sure, we went to Hawaii a few times and I went back to school to get a master’s degree. But the truth is there are tons of things we want to do but haven’t gotten around to. That changes now.

I have actually created a bucket list. I don’t care how silly it seems — life is just too damn short. I’ve added a page to this blog to host the list and it’ll be a living list that gets updated as I think of more things I want to do. There’s not much there yet, but I assure you it will grow. Feel free to offer suggestions, but I can tell you now I’m not going to jump out of an airplane no matter what!

A Few Things That Make Life Worth Living

sunsetWe have a Thanksgiving tradition in our family that I’m sure many of you share — we go around the table before dinner and we each say what we are thankful for. It’s pretty corny I know, but we do it anyway and truth be told I never really put much thought into it. I suspect this year my entire family is going to look to me for some sort of sage advice now that I am a heart attack survivor (still seems weird to say that). But who the hell knows if any of us are going to still be here on Nov. 24 so I figure why not do it today (I have always been one of the world’s worst procrastinators but somehow now that seems like a bad way to go through life).

There’s a great scene in Woody Allen’s Manhattan where he talks into a tape recorder and lists the things that, to him, make life worth living.

There are certain things I guess that make it worthwhile. uh… Like what… okay… um… For me, uh… ooh… I would say… what, Groucho Marx, to name one thing… uh… um… and Willie Mays… and um… the 2nd movement of the Jupiter Symphony… and um… Louis Armstrong, recording of Potato Head Blues… um… Swedish movies, naturally… Sentimental Education by Flaubert… uh… Marlon Brando, Frank Sinatra… um… those incredible Apples and Pears by Cezanne… uh… the crabs at Sam Wo’s… uh… Tracy’s face…

In that spirit, here goes:

  • My wife Leslie Gutman and our son Connor Gutman
  • My family (especially my sister Jodi!)
  • Arizona sunrises
  • Tom Wolfe novels
  • Walking along the beach in Coronado
  • Every song ever recorded by Joe Jackson
  • A grande nonfat latte at Starbucks
  • A gorgeous pair of legs
  • Field of Dreams
  • Baseball
  • College basketball
  • Driving alone with the radio blaring and no particular place to go
  • An ice cold craft beer
  • Dexter
  • Conversations with friends
  • My iPhone
  • A Love Supreme by John Coltrane
  • Pedro Almódovar movies
  • Real Time with Bill Maher
  • Introducing Connor to new films, television shows and music
  • The Shipping News by Annie Proulx
  • Wasting an hour browsing for nothing in particular at a good bookstore
  • Dean KamenShai Agassi, and Elon Musk
  • Hearing One Shining Moment on the night of the NCAA basketball final
  • Chilling by a pool…any pool…with a novel and a beer
  • Seeing Connor’s excitement over the latest technology news
  • Quoting Seinfeld
  • Spotify
  • Teaching
  • My Barnes & Noble nook
  • Staying in touch with friends, new and old, on Facebook
  • ESPN SportsCenter
  • Honeycrisp apples

Well, that’s a start. What makes your life worth living?