Last year on Thanksgiving I hit my head while playing kick ball with my cousins (yeah, we’re not exactly the Kennedys). This led to me having an EKG and the discovery that sometime in the past that I had a heart attack, which led to changing my Crohn’s medication for fear it was effecting my heart function, which led to a bowel perforation and my current ostomy.
So what am I thankful this year? Just being alive and able to celebrate another Thanksgiving with loved ones!
Which may be as much as any of us should be thankful for.
Question: which do you think has less sodium, a medium order of McDonald’s French Fries or a small salad?
Answer: It depends. Are you going to put dressing on that salad? If so, the fries win. In fact, the fries win even if you go up to large size and small fries can win if you are looking at overall fats, too!
Surprised? Don’t be. Since discovering that I had a heart attack sometime in the past, I’ve been working harder than ever to get my diet in line. I was already doing pretty good in keeping my fats low and started cooking for myself and am getting a little more “Mediterranean” in my eating and food choices each week (more fish, more veggies, less sugar). So, I thought it was time to take the next step and reduce my sodium intake.
I now understand the trials and tribulations of people with high blood pressure. Sodium is in everything that is even slightly processed. Fast food, sit down restaurants, frozen food, soups, canned vegetables, frozen vegetables (but not always), baked goods, lunch meat, you name it and I bet it’s got more sodium than you would think.
Fat free means “added salt.” Pizzas should be called sodium pies. Surprisingly, things that taste salty, like potato chips, may have less sodium than a small can of spring peas.
According to the American Heart Association we should be eating no more than 2,300 mg of sodium per day, 1,500 if you have high blood pressure. But, the average American consumes more than 3,400 mg each day (more at the AHA website)! And I know from MyFitnessPal that I’m somewhere north of that figure on any given day. How much is 2,300 mg of sodium? About 1 teaspoon of salt per day.
Now in my case, I do not have high blood pressure and my heart attack does not appear to have been caused due to any dietary issues (arteries, with the exception of the one where the damage occurred are clear and “beautiful” according to my cardiologist). It’s likely, in fact, that the heart attack occurred due to my Crohn’s. And, I could choose to side with some of the research out there which suggests that if you don’t have high blood pressure sodium intake isn’t really an issue. However, with one big strike against me, I don’t think I should risk a second. So, I’m going to keep doing my best to get my diet in line and that means lowering my sodium intake.
Now should we talk about the amount of potassium in salt substitutes and the effect that has on someone taking ACE inhibitors?
While waiting for my brother-in-law to come pick me up and take me to the Emergency Room I just lost it. Why was this happening? Why couldn’t I cope with this? What have I done with my life? Is this really it? Is it over? Just a few of the many thoughts flying through my mind as I tried to digest the news I had gotten earlier in the week. My heart was damaged.
I had suffered a heart attack. I thought I was having another one now.
Now, interestingly enough, this wasn’t news to me. As I blogged earlier (Total Eclipse By My Heart) I knew that I had apparently suffered a heart attack some time in the past. The echo cardiogram had indicated reduced heart function. I had learned this more than a month earlier and seemed to be handling the news well. But, earlier in the week I had an appointment with a cardiologist. She recommended a heart catheterization to investigate further (for those who don’t know, this is a procedure where they actually insert a “tube” into your heart to find out what’s going on. I’ll spare the details, but there’s more info here). The test was less than a week away. But for some reason the news was really hitting home now.
As often happens with people in my situation, I became hyper aware of every little twitch, pulse, pang, twinge, tightness, tingle, etc. of my body and my chest in particular. And trust me, for a middle age man in his late fifties – there are a lot of them. Finally the feelings – some brought on by my medication – became too much and I thought my heart was failing. Add a feeling of impending doom (another warning sign of a heart attack by the way) and I just lost it. I called family who immediately rushed to respond (thank you) and then just blubbered like a baby. Something I hadn’t done since my father passed away four years ago. I miss my dad dearly, but I’m not anxious to see him again if you know what I mean.
Fast forward several hours to the University of Michigan Emergency room and I’m lying there talking with a wonderful head resident – who’s name I wish I had taken note of – and she’s advising me that there appears to be no immediate issue with my heart. In fact, if they didn’t know about my earlier diagnoses they would have thought I was in very good health, but that sounded like it has been a life changing event and maybe I needed to find someone to talk to about it.
She was right of course.
This news was, and still is, life changing. One week I’m hiking through the mountains of Colorado, hanging out with Olympians (more on that story here), feeling like a teenager who just discovered the gym, a little sore but full of energy, on most days, and enjoying a relatively active lifestyle. The next, I’m lying in an emergency room surrounded by people who are literally dying and thinking that I might be one of them.
One day I see myself as a strong, healthy “old man” who can bench more than most twenty somethings. The next day I see myself as a feeble old man who’s days are numbered and has one foot in the grave. I moved mentally from someone who was eager to tackle the next challenge and change the world to being someone afraid that there was no more to offer. No more opportunity, no more chances, it was time to sit down and wait for the end.
These emotions, thoughts and feelings are not unusual. According to the American Heart Association it takes anywhere from 2 to 6 months for a person who has experienced a “hard cardiac event” to come to grips with what has happened. My mood improves each day – occasional panic attacks aside. I’m sleeping through the nights now. But, I’m still “hyper aware” of each little pang and twinge.
And aware that my life has, and has to, change.
Diet – which I have always been trying to improve – is not literally a matter of life and death for me. And I still have trouble sticking to it! Do you know how much sodium is in like everything?
Roller coasters – a passion for me – are now something I probably should avoid (sadly, at first my cardiologist thought they’d be okay. But on re-thinking and researching a little more she decided that I probably shouldn’t open myself up to “potential exposure” of a different type of cardiac event).
Probably should find a travel buddy for long hikes in the woods. Which, to be fair, is always a good idea anyway.
No more heavy weight lifting. In or out of the gym.
And, I’m undergoing more tests. Do I really have asthma as one doctor once thought? I’m a heavy snorer (so I’ve been told), better check for sleep apnea. Maybe my Crohn’s treatment is part of the issue. Time to re-evaluate my medication.
But, I do have a new perspective on life. At some time or another we all must come face to face with our mortality. Once we do we have two choices: 1) give up and wait for the end or 2) embrace each day as a gift and work to make the world a better place than we found it. I’m choosing option 2.
Filters are off – or at least subdued – no more polite agreement on political and moral issues. I don’t need to be rude, but I’ll stand my ground more. I’ll smile more, I’ll say hello more, I’ll…well, you get the idea.
In the time honored tradition of setting resolutions (aka goals) for the New Year, I’ve reviewed my fitness goals from 2017 and made some adjustments for the new knowledge regarding my heart health (see my earlier post here regarding details if you’re curious). In the interest of keeping myself accountable, here they are:
1. Fast food no more than once a week. Obviously heart health is now, and probably should always have been, my number one concern. Crohn’s is second. Mediterranean is my mantra for the year and means less reliance on “convenience” and more self sufficient eating and disciplined meal prep. Both of my major health conditions – and probably others I’m not fully aware of – will benefit by putting an emphasis on vegetables and fish in my diet. I’ve already started to make the adjustments and am actually looking forward to a more varied diet.
2. Increase cardio. Back to 10,000 steps everyday – minimum. Even if it means walking around the living room at night. I know that 10,000 is just a number, but it is a sign that I’m moving through the day. Pending approval from my cardiologist, I’ll be spending more time on treadmills and bikes this winter and still looking forward to running the occasional 5K.
3. Goal bodyfat percentage of 15%. I can’t sugar coat it. I’m fat and not getting thinner. It doesn’t matter how much muscle I have if it’s hampered by just carrying my own extra bulk. 15% seems to be a good ideal for a man in his late fifties. I may never actually see my abs, but I plan to at least feel them!
4. Keep strength up – 250 for 10 reps on bench. Again, pending my cardiologists approval as it’s possible that heavy lifting might be off the table for me. Of course, if I’m strong enough 250 won’t seem like heavy lifting, will it?
5. Put size back on the bis. Hey, I have to have at least on vanity goal, right? With the lower bodyfat my historic goal of 18 inches may not be possible (maybe with a pump). But if I don’t lose size my arms might at least look like 18 inchers if they’re lean enough.
These are written down and in my wallet as a reminder to me everyday.
I hope you all have a happy, healthy, and productive 2018.
As I was thinking about the quickly approaching New Year and what new, or old, goals I could set I realized that I haven’t blogged in a while. Somehow, things no longer seem real unless I post them somewhere on social media (don’t pretend you don’t know what I’m talking about – there’s too many posts out there to suggest otherwise).
It’s actually been an eventful couple of months health-wise. Shortly after returning from my inspiring visit to the Olympic Training Center in Colorado Springs, Colorado (see my previous posts on Olympic Goals and Heart of a Champion) a pain in my shoulder that I had been ignoring too long started to get worse. So, I made a trip to the doctor’s office after Thanksgiving. After explaining my pain to her and describing a incident on Thanksgiving regarding a kick ball game with the family, my head, and a back stop support bar (ouch) she said, “you know, even though you are at a low heart attack risk maybe we should take an EKG just to check things out.” I thought for a minute and said, “sure, why not. What’s the harm?”
Well, the EKG came back with a concerning result. Though my heart rhythm was strong there was an abnormality. So a stress test was ordered then cancelled because that wouldn’t tell us anything we didn’t already know. Then an echocardiogram stress test was ordered. We didn’t ever get to the stress test because the cardiogram showed what we needed to find. I had “reduced heart function.” In short, sometime in the past 11 years (since my last EKG) I had a heart attack.
Now, I don’t know exactly when this heart attack occurred. It could have been over Thanksgiving this year when I felt crappy after my collision with the support bar. I think it’s more likely to have occurred in January 2017 when I had a significant Crohn’s attack and pain unlike anything I had ever had before. I likely falsely attributed my pain and cramps to dehydration caused by the severe diarrhea and vomiting I experienced. Plus, some of the warning signs of heart attack are the same as those I experience from Crohn’s and it is even possible that my Crohn’s directly hit my heart. Very rare – but still possible.
So, in short (I know, too late to be a short story), I’m seeing a cardiologist in January. Like, I presume, many others I am now taking a statin drug in the evening and a low dosage aspirin (approved by my gastroenterologist of course) in the morning. Along with my usual array of vitamins. Also, doing as much cardio as possible though I’m no longer pushing to failure, which I really wasn’t doing anyway. This is all the easy part.
The hard part is changing my diet again. Though I’ve always had low overall cholesterol my HDL/LDL ratios have been off for a long time. This combined with my high triglyceride level is a problem. So I’m watching what goes into my mouth closer. Need to lower the bad fats and raise the good fats. More fish and vegetables and less red meat and fried foods – the Mediterranean diet in popular parlance.
Italy is on the Mediterranean right? So I’m assuming unlimited pasta and sauces…what? Limit pasta? Really? Bummer.
At least I still have doughnuts.
What? Oh come on!
P.S. regarding the shoulder pain that sent me to the doctor’s office in the first place, I have a small muscle tear. No surgery – just exercise. That, I can handle!