Thursday, December 18, 2008

Women and Heart Disease

In my journey with coronary artery disease I have been made very aware of the sometime lethal discrepancies between the diagnostic protocols used to treat men as opposed to women. The sad reality is that many women just do not receive the same level of care that men normally receive. I have been privileged to become acquainted with the woman who wrote the book on women and heart disease, From the Heart: A Woman's Guide to Living Well with Heart Disease. Kathy recently wrote an op-ed for the Memphis newspaper, The Commercial Appeal. Click here to read the article, and if you know a woman who has been through bypass surgery or any heart related issue her book is a must read. 

Monday, December 8, 2008

Motivations for Heart Healthy Living

The beautiful red head in the picture is my daughter, Heather, standing next to her husband, Tim. In February of next year she is due to deliver ourfirst grandchild. They know she is carrying a little girl who will be named Savannah. Knowing that she is on the way is a real motivator to me to make good lifestyle choices.  I have found that the further I am removed from my surgery the more I need to be motivated to eat right and exercise. I have also found that my yet unborn granddaughter, Savannah, is proving to be a great incentive to live heart healthy. I want to be around to spoil her. I want to be around to hear her call me grandaddy, and I want to be around long enough for her to remember me for the rest of her life.  I am truly a blessed person with so much to live for. Having a loving supportive family, I am convinced, is on of the main reasons why I am doing so well today.  I love my family and appreciate so much what they have done to help see me through a really tough time. 

Monday, December 1, 2008

Food and the Holidays

Well I made it through Thanksgiving sort of. If a person is trying to eat heart healthy the holidays can be a killer. This seems especially true in the South where I live. In the South even spinach can be considered junk food. You see, in the South spinach must be "seasoned" correctly which usually involves the adding of about two tablespoons of bacon grease during the cooking process. In my path to recovery food has been a challenge. Right after surgery I was so afraid that I didn't want to eat period. I went for a full six month and had oatmeal for breakfast every day. At some point though I fell off the wagon. I remember well one day making sure that no one I knew was watching before I pulled into Wendy's for a double with french fries. I felt so guilty, but it tasted so good, and what was worse was that I didn't have a heart attach, not even a slight chest pain. What you eat can kill you but with a person with heart disease it's not like you have a food allergy. Nothing happens, in fact for me those bad foods, like deep fried catfish, taste just as good as they did before bypass surgery.  

As I have encountered people like me who have had serious issues with CAD I have seen three very different reactions to food. Some go radical and totally change everything about their diet. I have a friend who is a doctor that took this route. He also rides his bike to work every day. He has lost over 50 pounds and looks great. Others make some modifications to their diet, but find sticking to those lifestyle changes to be a constant challenge. Then there are many who just eat what they ate before they knew they had a problem. Some of these make a feeble effort to change their diet with the key being feeble.  From my own personal observation most people I have known who have had bypass surgery or angioplasty just don't eat right. 

The sad thing is that while genetics seems to play a real role in the development of heart disease so does diet. I have a strong family history of heart disease, but I also never met a fried food that I didn't love.  Eating the right kinds of food is a struggle for me, but I just cannot cease to struggle. 

Thursday, November 20, 2008

The Pressure for Normal

Not only am I a counselor. I am also a minister, and part of your job title is doing weddings. Several months before my bypass I had agreed to perform the wedding ceremony for two wonderful couples.  One of the young women had been a student of mine when I taught in a private high school. The other had been the maid of honor at my daughter's wedding. The only catch was that I was living in Knoxville and both weddings were to be in Memphis, and they were both on the same day. I got together with both couples and everything looked like it was going to work out when I found out that one wedding would be an afternoon affair and the other would be in the evening.  Then my near heart attack happened followed by the surgery all exactly one four weeks before the weddings.  My wife told me that she would call the two couples assuring me they would understand, which of course they would. I asked her not to call because I thought I could still do the weddings. She said I was crazy. I told her that I wanted to get back to normal as soon as possible. I still don't know why I put so much pressure on myself to "get back to normal." What happened in four weeks?  I went to Memphis and performed tow wedding ceremonies. I still remember how it felt to push yourself too far. I was so exhausted, but I did it, but instead of making me feel better it actually had the opposite effect. I became consumed with getting back to normal not knowing that there was a new normal out there that I couldn't find for looking for the old normal. I hope I haven't been too confusing, but I know now that deep down I was scared that I would be viewed as some kind of cripple if I didn't do all the things I did before.  There is the healing of the body, and there is a timetable for that. There is also a healing of the mind, and the timetable for that is often very different.

Tuesday, November 18, 2008

Depression and Heart Disease

I found the following statement and recommendations only reconfirm what I have seen in my own life and the lives of many others.

Heart patients should be screened, treated for depression
Heart patients should be screened for depression — a common condition that can profoundly affect both prognosis and quality of life — according to the American Heart Association’s first scientific statement on depression and coronary heart disease.The recommendations, which are endorsed by the American Psychiatric Association, include:early and repeated screening for depression in heart patients; the use of two questions to screen patients – if depression is suspected the remaining questions are asked (9 questions total);
coordinated follow-up for both heart disease and depressive symptoms in patients who have both. “The statement was prompted by the growing body of evidence that shows a link between depression in cardiac patients and a poorer long-term outlook,” said Erika Froelicher, R.N., M.A., M.P.H., Ph.D., a professor at the University of California San Francisco, School of Nursing and Medicine and co-chair of the writing group.Dale Briggs, who experienced depression after his heart valve surgery, said the statement is welcome news. “I think it’s long overdue. It is unfortunate that some patients aren’t warned of the possibility of some depression after surgery,” he said. Experts say depressed cardiac patients have at least twice the risk of second events in the one to two years after a heart attack. Furthermore, studies have shown that more severe depression is associated with earlier and more severe second cardiac events, Froelicher said.Co-authors include J. Thomas Bigger, Jr., M.D.; James A. Blumenthal, Ph.D., ABPP.; Nancy Frasure-Smith, Ph.D.; Peter G. Kaufmann, Ph.D.; Francois Lesperance, M.D.; Daniel B. Mark, M.D., M.P.H.; David S. Sheps, M.D., M.P.H.; and C. Barr Taylor, M.D. Individual author disclosures are included on the manuscript.

Thursday, November 13, 2008

Am I Depressed?

I want to say up front that I am not a doctor, but I still want to share my thoughts about depression.  Even though I have a master's degree in counseling I had some trouble seeing depression in myself.  I knew that I did not feel emotionally well after my bypass surgery, but it was easy to label that feeling as anything but clinical depression.  I never wanted to admit that I was depressed. It was OK to feel down in the dumps, but depression was for other people. I finally started to come to grips with my own depression when my wife started to make it clear to me that I just wasn't anything like my old self. My first thought was, "I guess you wouldn't feel like your old self if you had just had your chest cracked open." But she persisted, and I started to listen and then I started pulling out some of my books from graduate school. I also went on line and took a simple online screening test for depression. You can find a good one right here.  I filled one out and it was off the charts. I think that, as much as anything, made me go to the doctor.  Finally admitting that I was really depressed also got me talking and helped me take the first step down the road to recovery.

Saturday, November 8, 2008

Happy 50th Birthday to Me!

I guess I shouldn't wish myself a happy birthday, but after all that I have been through I am going to do it anyway. You see, I wasn't satisfied with quadruple bypass surgery. I have also had major neck surgery, shoulder surgery, and a right total knee replacement. My goal for my 50th year is a year without a surgery. I think that is a pretty modest goal. I will keep you posted. In all seriousness, I am so glad that I can look back on my many travails and laugh. Not because surgery is funny, but because laughing just feels good and I think it is really good for you too. I have a good friend who has fought breast cancer twice and she credits the ability to laugh in the face of the disease with her ability to beat it. I think she might have something.  Wow, I actually made it through my forties.

Thursday, November 6, 2008

Dealing With Your Own Mortality


On Saturday I turn 50. I think that is pretty cool considering what I have been though during the last few years. I have told you about my bypass surgery, but that was only one of several surgeries that I have faced since then. I now know I am going to die. Doesn't everyone. Not really. When I was a teenager I don't think I even had a concept of dying. I don't especially like the fact of someday dying, but there is not much that I can do about it. For me that was one of the toughest parts of going through my bypass surgery. For the first time in my life a doctor, in fact two,  told me that I almost died, and would have without the surgery. That kind of information kind of gets to you, at least it did me. I think part of my emotional recovery has been to learn to be at peace with the reality that I am getting older and my past is longer than my future. I think I have finally gotten to the point where I am much better at living in the present and finding the joy of a single day. In fact, today was an especially good day. I even took the time to take some pictures in my neighborhood of the beautiful fall foliage. Life is good.

Tuesday, November 4, 2008

Passion

I have always been interested in politics, and have kept up with every presidential election since I was a kid, which means Johnson and Goldwater. This election seems different to me, and I am not talking about the potential firsts like first African-American, or first female Vice-President. I am talking about level of passion. People are voting in record numbers. People are voicing their opinions. I just hope people will behave after it's over. Passion is a funny thing though. It is pretty easy to get, but is also equally easy to loose. It really doesn't matter what the passion is. Most people loose it. Now what in the would does this have to do with bypass surgery and heart disease? More than you think. When I was cracked open over three years ago I was told all the changes I would have to make to my lifestyle, like diet and exercise. In the beginning it was easy to make those changes. The passion was there, but eventually things settle down, and the pain and fear go away, and a feeling of normalcy returns. That is when passion is hard to maintain. The sad fact is that most people that I know who have had bypass surgery have long since abandoned their special diet and the exercise bike makes a great place to hang clothes. But I do know a few, just a few, who have held on to there passion to live different lives, and their passion has paid off.

Monday, October 27, 2008

My Sister Had a Heart Attack

My sister is a nurse at Methodist Hospital in Germantown, TN, a suburb of Memphis. She takes care of newborns and she is one fantastic nurse. Last week she was at the hospital doing some paperwork when she started experiencing some tightness in her chest. An observant doctor overheard her complaints and started asking a few questions. This doc had known my sister for over 20 years and also knew to take women's heart complaints seriously.  In a moment the doctor told my sister that she was on her way to the ER.  Judy resisted and then the doc told her that she had watched a 53 year old fellow physician drop dead of a heart attack in another hospital the previous week and she was in no mood to argue with Judy. That ended the discussion. The doctor probably saved my sister's life.  I can't tell you how many women with heart disease have told me their nightmares about struggling to get a correct diagnosis.  My 59 year old sister had one severe blockage. She missed out on the by-pass surgery that my brother and I both enjoyed. One stent and she was good to go.  Earl Corum, our father,  had by-pass surgery in 1979 at the age of 69, and now each one of his three children has had a major cardiac event. My prayer is that my sister will use this tough life experience to make some lifestyle changes. She knows she needs to, but we all know it's still tough to change life long habits. Having heart disease in your family is a bummer, but my brother, my sister, and myself have really gotten closer in the last few days. We are now officially fighting the same battle, and I think we are going to come out on top.

Tuesday, October 21, 2008

He Wore Five Out.

"He wore five of them things out." That was the response to my question. I was talking to a retired butcher about his family. In the course of the conversation he mentiontioned his brother and the two heart attacks he had had. The first one hit when he was in his forties, back in 1988. He had bypass surgery. Just a year or so later he had the second heart attack. I then asked my friend, "When did your brother die?" He answered back, "Why he's not dead. He's going strong." I then asked him how his brother was finally doing so well. That's when he said, "He wore five of them things out." I said five what. "Treadmills," he said. It seems his brother decided to get serious,I mean real serious, about exersize after the second heart attack. I told my wife the story and she had the nerve to ask me when I was going to get serious. Could exersize be that important?

Friday, October 10, 2008

Bless Others, Bless Yourself

In my three plus year journey to survive and thrive after bypass surgery I have found certain activities to be counter productive to better health. At the top of the list is isolation. I know all about extroverts and introverts, and even extroverts need some solitude, but even introverts need some contact with others. For myself I have found that there have been times when I would allow myself to become almost totally separated from the human race, and that seemed to be the time when I also allowed myself to throw my biggest pity party and begin to feel depressed. My isolation gave me the perfect opportunity to focus on all the negatives in my life, especially when it came to my health. On the other hand, when I have had meaningful interaction with others, especially in the area of service, that contact proved to be quiet therapeutic. I am often asked to visit patients who are about to undergo bypass surgery. Most people are so thankful to get a visit from a survivor, and I leave the room feeling needed and blessed that I could be of some encouragement to another person. You don't have to limit yourself to visiting people who are about to have surgery to gain this benefit. A few days ago I went with several other men from my church to start a tutoring/mentoring program at a local middle school. I was pared with a struggling sixth grader. This little fellow was not doing well in school, but was also facing a cruel world, especially for an eleven year old. His dad had just left the family and his mom was ill with some form of cancer. I could look in his eyes and see that he was carrying the weight of the world on his shoulders. We spent more time talking about how he was coping with life than we did with homework. For that hour all of my energy was focused on another human being and how I could help him. I can remember a time a few months after my surgery when the only person who got my undivided was myself.  I was self absorbed with how my heart disease had changed my life, and how I was almost certain to die a a young age.  It was all about me. Getting beyond that focus contributed greatly to my recovery. Every time that I am reminded that others are fighting their own battles and and need someone to offer genuine encouragement and am given the opportunity to reach out I am lifted up. The bottom line is that often the best way to help yourself is to help another. That sounds pretty simple, and it really is.

Tuesday, October 7, 2008

They Don't All Look Alike

On Monday I spent a good bit of my day having a Thallium Stress Test. While waiting my turn on the tredmill I spent some time talking to two other men waiting too. One looked like a heart attack waiting to happen. He was over-weight and looked out of shape, but the other guy looked like an athlete. I found out that he had been. Even played pro ball for the Vikings, mostly on the sideline, but still he made the team. That little encounter reminded me of something that I have noticed often. You can look great, but still have heart disease. I had lost 50 pounds not long before you bypass. I have seen marathon runners have heart attacks. Yes, if you are 100 pounds over-weight, smoke and drink too much you are probably going to have heart disease, but you might look like the picture of health and in reality be on the verge of problems. What both of these men did that was the right thing was they were getting checked out. Hey, why don't you get checked out?

Monday, September 29, 2008

The Bumps Along the Way

One thing that I have come to realize about heart disease is that it just doesn't go away. For the rest of my life I will have to manage this disease, and for the rest of my life there will be bumps along the way. Last week I encountered a bump. My pulse rate has gone up for some reason. I am scheduled for a treadmill next Monday to find out what is going on. To be honest I am a bit mad right now, but not depressed. I am mad because I just don't like the fact that I have heart disease, and this bump probably won't be the last one. I have learned not to be depressed though because I have learned to live with heart disease. Hey, we all have to live with something.

Monday, September 22, 2008

Talking Can Be Good

Tomorrow I am going to share my story with a graduate class in counseling. I have found that telling your story can be one of the most theraputic things a person can do. It's kind of like unpacking a suitcase. At first it can be difficult to tell someone that you got very depressed after surgery. I thought I would be much stronger, but I wasn't and that ok. I got through it, and I think my story can help others. Everyone has a story, and most of a time when they struggled, but got through it. Someone just might need to hear your story.

Saturday, July 12, 2008

Different Kinds of Pain

My mother is almost 90 years old and has never had surgery 0f any kind. I am 49 and have mine listed an an excell spread sheet. Last Monday I think I went through my most painful surgery yet, a full knee replacement.  Agony is a pretty good word to describe the first few days. I had been warned, but I had been through heart bypass and several others, and I thought I was ready, but boy did that hurt, but not all pain is physical.  

I think that all of us who have been through open heart surgery know that there is more to recovery than dealing with pain, and not all pain is physical.  I think this most current surgery has actually reminded me how much better I am on the inside. I have always told people that the worst thing about bypass surgery is not the physical pain, for me it was the emotional pain that proved to be the greater challenge.  I am hoping to post more often as I am off for a few weeks learning to use my new knee.

Wednesday, May 28, 2008

What Not to Eat!

I was reading a friend's blog and found a picture of something I doubt I should ever eat.

Tuesday, May 27, 2008

Food: An Everyday Challange

Yesterday was Memorial Day. In otherwords it was a day where food was a top priority. I remember a time when I gave absolutly no thought about what I ate except whether it was good or not. I don't know how much my diet played a role in my coranary artery disease, but knowing what I put into my mouth I have to believe it played a major role. The reality was that I loved fried food and all the other things people sometimes call "artery glue." After my surgery I had to face some major lifestyle changes and food was near the top of the list. About a year post-op I was talking to a cardiac nurse who claimed that the majority of people who had bypass surgery we back to their old ways of eating within two years.

With the help of a wonderfully supportive wife, everything about my diet changed, but after three years I still have a some challanges. First, days like yesterday are tough. We had a bunch of family over and we did have grilled chicken, but we also had fresh strawberry pie, and homemade lemon ice cream made with heavy whipping cream. I know it is ok to have some of the bad stuff, but on days like yesterday and the 4th of July the challange becomes moderation. By the way, that ice cream is out of this world. I face a second challange everytime I go out to eat. I just wish there were move healthy options for folks like me. When I look at the number of fast food places and resturants in general I am amazed that there is not even more heart disease. I am not interested in becoming the food police, but I do believe that the resturant industry could do better.

Tuesday, May 13, 2008

Three Years to the Day

My wife and I were watching some TV and she looked over at me and asked me if I knew what today was. I looked at he funny and told her it was Tuesday. She smiled and said,  "It's May the 13th. It's been exactly three years." I couldn't believe it. Not that three years had passed since my bypass, but that I didn't think about it one time today until she reminded me.  I remember when I thought about it all the time, but now things are different. I am back to a new normal. In a sense nothing will ever be the same, because as my wife also said, "You were given a second chance at life."  I know a lot of folks think that someone who survives bypass surgery wakes up from surgery with a realization of this second chance. I guess some do, but to be honest, it has taken me a while to get to that point. Today has been a good day. Three years down and a bunch more to go!

Wednesday, May 7, 2008

Back and Doing Well

My trip to Pepperdine exceeded all expectations. I feel great. I feel alive. I feel whole. I really wondered how my return to the place where it all seemed to have started would feel. For a long time after my bypass I spent a good deal of time wondering when I would have more problems. Every passing pain can feel like a heart attack. I no longer feel that way. I can laugh again. Three years ago my friends were joking about my constant complaining. This year we were laughing together about my past complaining. Recovery takes time. When my wife's uncle told me that I would feel like a new person, but it would take eighteen months, I didn't realize how right he was. I am a survivor.

Thursday, April 24, 2008

Signs Ignored

In a few hours I will be traveling to California to visit my my son, who is an officer in the Air Force, and attending a conference at Pepperdine University. I must admit that I have been experiencing some unexpected flashbacks. Three years ago I also went to Pepperdine. I didn't know it at the time, but I was trying my best to have a heart attack. I spent the whole time complaining to anyone who would listen. My friends were heartless. The actually joked about my complaining. I was having almost constant indigestion, or at least that's what I thought it was. I just assumed I was sick with some bug. I still wasn't thinking heart. If you have ever seen or been to Pepperdine you realize that it is literally built on the side of a mountain, and it is not unusual to walk up or down over 200 steps to go from one building to another. Before the end of the week I had stopped walking and started riding the shuttle bus. Again, my wonderful friends made jokes at my expense. I finally told them that when I died I would have these words inscribed on my tombstone: "See I told you I was sick." Even though I knew something was wrong, I laughed right along not having a clue that at the time I was just two weeks away from my life changing and life saving surgery. There I was walking up and down mountains with my "widow maker" over 90% blocked. I am lucky to be alive. I will explain in another post, but the realization of a genuine brush with death can often lead to depression instead of the happiness many would expect.  I am excited about the trip, and am indeed thankful that when I visit this time I will walk up the steps with a strong heart and a new outlook on life.

Monday, April 21, 2008

Heart Bypass: Three Years Later (Part 2)

I have talked to several bypass survivors who remember little about their time in ICU. For someone who forgets way more than he should I remember way more than I would like to about my time in ICU. I Clearly remember waking up and thinking that at least I was alive. I had tubes coming from holes that weren't there a few hours ago. I love the term the doctors used for my time in ICU. They called it "uneventful." I guess to the doctors my case was pretty uneventful. I came off the respirator right on schedule. They yanked the catheter out with no problem, at least for them. My skin was put back together with super glue. I am sure there is a more proper name for the stuff, but trust me. It was super glue. Thankfully, there was only a relatively small incision where they harvested the vein from my leg. The pain level was manageable. I have had kidney stones and those little things are off the pain meter. If kidney stones are a 10, and they are, then bypass surgery is about a seven. The word that always comes to mind when trying to describe the pain of bypass surgery is the word "sore."

My surgeon came in and assured me that everything went well, and he was right. I guess you could call my surgery "textbook." There were no complications. Those would come later, some much later. At that point I don't recall anyone even mentioning depression. For the moment I was just glad that I was breathing on my on.

Thursday, April 17, 2008

Heart Bypass: Three years later

I should have started this blog three years ago, but in retrospect I don't think I was really ready. I have been through so much and I have learned so much. Three years ago on this date I was less than a month from emergency heart bypass surgery. Three years ago I was feeling bad, but didn't really know why. I was living in Knoxville, TN, and knew something was wrong, but really never thought about my heart. I guess I should have. After all, both my older brother and late father had been through bypass surgery, but they were smokers. My brother was 52 at the time of his surgery, and my father was 69. I was only 46. I was just too young, or so I thought.

I will never forget Wednesday, May 11, 2005. I had just finished a meal at a restaurant with some work associates. I told the guys that I really didn't feel well and was going home. When I walked thru the door my wife looked from the computer and calmly let me know that she had diagnosed my problem and we would need to leave for the hospital. I didn't want to go, but she didn't express herself in the form of an option.

The hospital was close by and in the beginning I really wasn't that frightened. After all, it was my wife sending me to the hospital and not a doctor, but once there my wife's order started making a lot of sense. After the initial EKG there were obviously problems. Then off to get a heart cath. That would settle things once and for all. In the back of my mind I was convinced that after getting a couple of stints I would be as good as new. I'm not sure how long the heart cath had progressed until the cardiologist started breaking the bad news. I had too many arteries blocked and the blockages were in some bad places.

Before that Wednesday was over I knew my life was about to change forever. I now was scared. I was mad. I was basically full of just about every emotion. More than anything else the reality starting hitting me that on Friday May 13, 2005, I would undergo a surgery unlike anything I had faced before. There was no time to go home, just some time to think. A number of people came to lend support. I was glad to see most of them, but more than anything else I wanted to talk to someone who had been through what I was about experience. I had a great visit from the hospital chaplain, but when he left I kept wandering if he really had a clue. It wasn't his fault. It was just my state of mind at the time.

This is just the beginning of my story. My goal for this blog is pretty simple. I want to create a place where survivors can come to share their stories and concerns. I am not a doctor. I am a survivor, but I am also a counselor by training, and would love to put both my experiences and training out there to offer helpful support to others. I feel much better today, but there have been times in my recovery process when the depression was almost unbearable. I want to share my story to encourage others to do the same. I would love to hear from you about your experiences.

As I said, I am not a doctor, and I won't try to act like one. I am just a fellow survivor who is trying to make some lifestyle changes that will affect the length and quality of the rest of my life.