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?

Workin’ Too Hard Can Give You a Heart Attackackackackackack

photo-on-10-25-11-at-8-23-pm-2It’s Tuesday, Oct. 25, 2011 and I am lucky to be alive. I don’t mean that in some symbolic sense, but rather in the real, honest-to-goodness medical sense. Let me say it again so there is no confusion — I am lucky to be alive.

Ten days ago I had a heart attack. I can’t tell you if it was a big heart attack or a little heart attack because my cardiologist said there is no such thing as a little heart attack. Let’s get the obvious stuff out of the way first. I am 45 year’s old, I jog about three miles, three days per week. I eat very little meat (some fish) and the occasional grass-fed burger. I do not have a stressful job (or life for that matter). I am relatively thin (prior to last Saturday I was 5–9, 158 pounds). Yet I had an 80–90 percent blockage in my left inter-ventricular artery.

Author Len Gutman in the hospital following a heart attack in 2011.

The fact is we cannot escape family history. My father had a heart attack, his father had a heart attack, and his father before him probably had a heart attack as well. After my father had his open-heart surgery about 8 years ago I went to the cardiologist for the first time and he told me to take a baby aspirin every day and come back to see him in five years (I did not). My cholesterol has been high for years, but I have been dutifully taking statins along with my aspirin and I figured with my lifestyle I was doing all the right things. Clearly I was not.

But this blog post is not about looking back, but rather it’s about looking toward the future. Thanks to the good folks at Medtronic I have three capable stents propping open my newly cleared artery and I’m taking a host of drugs to nudge my heart back into solid working order. My cardiologist says I can run a marathon one day (though I will not, thank you) and as long as I take my meds and eat right I should die of something other than a heart attack. I will follow his instructions to the tee and am fortunate to have a wonderful life partner for this journey who has already proven in these past few days that she is a more than capable low-fat, low-sodium chef!

But I have some fucking things to say!

  • First and foremost, I love my wife Leslie and my son Connor more than life itself. This too is not a symbolic statement — I mean it. I am no longer afraid to die, but rather my only fear is leaving my family too soon. I promise to take care of myself even more than I did in the past to ensure my family has the pleasure of having me around for all of life’s amazing events going forward.
  • Colors seem brighter to me now and food tastes better. This may be psychological or may be a result of the sinus surgery that may or may not have had a role to play in my condition. I don’t really care.
  • I am no longer going to find excuses (time, money, etc.) for not doing the things I want to do. We are planning a trip to Europe next summer and not only are these plans still on, you can bet we are not going to skimp on the hotel rooms. Expect to hear about my kayak trip someday soon. I imagine my 2005 Honda Accord is not going to be my primary form of transportation much longer. Life is just too damn short.
  • Aside from family, the most important thing in the world is friendship. I have nearly 600 “friends” on Facebook, and many of them have checked in on me over the past week. My close friends have called or come to see me. You can’t put a price on that. If you haven’t called or come to see me yet, please do. My “door” is ALWAYS open. I love you all and am lucky to have you in my life.
  • Despite my near death experience, I am sorry to report to my religious friends that the old adage that there are no atheists in foxholes is not true in my case. I believe even more now that life is random and that there is no god. I’m great with this and will continue to live a moral life because it’s the right thing to do.
  • If you are over 40, get yourself checked out by a cardiologist. I did so many right things, but because I did not follow up with my cardiologist I have permanent damage to my heart which would have been prevented had they found and corrected the blockage prior to my “event.” By the way, my “event” didn’t hurt. I had all the signs (radiating heat, pain down both arms, cold sweat, indigestion and anxiety). I worked through it, denied it was a heart attack, and waited two days to go see a doctor and only then because Leslie insisted. She saved my life, as did my primary care physician for calling 9–1–1 last Monday morning. The nurses at the hospital told me lots of men ignore the tell-tale signs of a heart attack so I am not alone, but my cardiologist said 50 percent of men who have a heart attack at my age die immediately or within six hours. I played Russian roulette and I will never forgive myself, but I am not going to dwell on it. Stay present my friends.

That’s it for now. I’m sure I’ll have lots more to say going forward. I will be taking about six weeks off work per doctor’s orders, and during this time I will eat right, go to cardiac rehab to strengthen my heart, catch up on reading and films (I still have 75 films on the AFI list to get through and no damn heart attack is going to keep me from this ridiculous quest). I expect after a little while I will be able to meet up with friends for lunch or coffee and I will cherish every moment of those meetings.

What I’m looking forward to today: sleeping next to my wife, watching Arrested Development on Netflix with Connor, reading the stack of magazines piled on my end table, resting, visiting with friends…and of course…being ALIVE.