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. 

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. 

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. 

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.

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.

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.

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.