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.

I Was the Last to Know I Was Having a Stroke

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.