Heart Disease: Understanding and how to live with it!

We are so grateful to Bill’s brother, David, and his wife, Linda. They really helped us through our first week of the shocking revelation that Bill was at risk of a massive heart attack and heart disease, written about here, in case you missed it. Thankfully, they not only are medical professionals – have attended continuing education to stay on top of their fields – but they have also focused on heart disease since David has had a heart attack.

They figured out how to live with heart disease and we have watched their lifestyle from a distance since they live states away. We don’t usually see each other more than once a year. Normally, when a sibling has a heart attack, it raises your chances. But Bill felt he and his brother had such different lifestyles, he was not at risk. Guess he was proven wrong now!

We had to wait a week before we met with a new cardiologist, Jeffrey E. Askew, MD. He happens to be one of the cardiologists intimately familiar with the Heart Calcium Scan Score. In the meantime, they told us a few things he would suggest the next step would be: possibly a heart cauterization to actually look inside his arteries to see what is going on; and/or a stress test. But more than anything, adopting a heart healthy lifestyle will be the #1 suggestion.

That is exactly what we did. We began to educate ourselves on what we were putting into our bodies. Granted, we have more or less bragged that we eat healthy, we certainly are active with walking and hiking, and we really haven’t been sick much in our lifetimes. We were deluded….

There is a way which seems right to a man, But its end is the way of death. 

Proverbs 14:12

We heard a sermon this winter that helped us see our own delusion. We tend to overestimate how “good” we are (in whatever way: fitness, relationship with the Lord, relationship with others, our health, our weight….) and underestimate the reality! We replay that a lot to each other. We knew we were gradually gaining weight, but we thought it was part of the aging process.  We told ourselves, we were eating healthy and were exercising…we aren’t that old, we did eat a basically healthy diet – but we were ignorant about preservatives, additives and how many cookies and klondike “no sugar added” ice cream squares we were eating! That undid the nine miles we may have just hiked!!!

Our sister-in-law, Linda, was our best teacher about the additives, etc. in the foods we eat and then we began to do our own research. We were shocked at some of the ingredients we were consuming in the foods we eat. We began to look up each word we didn’t know what it was – and what a shock! We began to eliminate processed foods from our diet.

We began to research what we could about heart disease. Here are a few facts we began to realize and incorporate into our lives:

It’s important to note that one common heart health mistake is to believe that lowering cholesterol levels is the key factor in preventing cardiovascular disease. Actually, the body needs cholesterol to perform many of its functions, so the ultimate goal should be to maintain healthy cholesterol levels and to protect that cholesterol from oxidative stress.

You know it’s true for everyone: having a balance and variety of foods is key to a healthy, nutritious diet. Of course, fad diets come and go, and while some stick around longer than others because of dramatic, temporary results, they all lead to nutritional deficiencies of some type.

So how do you achieve a proper balance while maintaining a healthy weight? What’s important is to manage your ratio of carbohydrates, fats, and proteins. For adults, proteins should be between 10 and 35 percent of the diet, fats between 20 and 35 percent and carbohydrates between 45 and 65 percent. And in addition to helping you achieve your weight-loss goals, eating the correct ratio of foods may help you permanently change your eating habits, which can improve your long-term health.

Make sure your diet includes a wide variety of micronutrients as well. You’ll find a great deal of these in fresh, colorful vegetables and fruits. Make sure the majority of the food you eat is nutrient dense, as opposed to empty calories from processed food.
From USANA Health Sciences

We never thought about the ratios of the fats, proteins and carbs. That was the key point Linda made when she suggested we start tracking everything we eat in the Lose it! app. Since Bill doesn’t use a smart phone, I downloaded it and became his food coach, monitoring his every bite he ate! Then I downloaded the FoodEducate app to do the same for me, after all, I want him to succeed. To be honest, I needed to lose some weight and take care of my heart as well. So while his app showed us those percentages, my app also showed the “value” of the nutrition. So while we’ve basically had a high carb diet (I avoid bread and potatoes – but he ate regularly), we learned fast we needed to change! Within a few days of food tracking, we could see many carbs we now are eating are “good” carbs (mainly fresh fruit)….there is a lot to this nutrition thing! Here is a sampling of the Lose It! app:

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Bill began to see food as the “enemy” as we transitioned from a processed food diet, to one of more “whole” foods. In just one week, he lost four pounds! And that was really eliminating the junk food we didn’t really acknowledge we had in our lives. In time, he has balanced out his view of food and now knows food was created for our good! It’s just best in its more natural state!

“Don’t you see that nothing that enters a person from the outside can defile them? For it doesn’t go into their heart but into their stomach, and then out of the body.” (In saying this, Jesus declared all foods clean.) (Mark 7:18).

It is now Thursday, December 22, 2016. Yes, right before Christmas and we are ready to learn more about Bill’s condition. When Dr. Askew came in, he had a look, “Where is the patient?” He was not expecting a rather tall, relatively slim and healthy looking guy! We joked about it, but the reality of the facts, numbers and our concern were all he needed to start explaining where we were.

The first thing he told us was that Bill had metabolic syndrome! This was actually the good news! It explained why Bill had been unable to lose any weight this past year. We had both tried to no avail.  Let’s simplify it by copying from WebMD, with my notes in italics:

Metabolic syndrome is a health condition that everyone’s talking about. (Really? We never heard of it until Bill was diagnosed with it!)

Although it was only identified less than 20 years ago, metabolic syndrome is as widespread as pimples and the common cold. According to the American Heart Association, 47 million Americans have it. That’s almost a staggering one out of every six people. The syndrome runs in families and is more common among African-Americans, Hispanics, Asians, and Native Americans. (Bill is none of these, he’s of Irish descent.) The risks of developing metabolic syndrome increases as you age.

Indeed, metabolic syndrome seems to be a condition that many people have, but no one knows very much about. It’s also debated by the experts — not all doctors agree that metabolic syndrome should be viewed as a distinct condition….

Metabolic syndrome is not a disease in itself. Instead, it’s a group of risk factors — high blood pressure, high blood sugar, unhealthy cholesterol levels, and abdominal fat. (Later, the article says to be diagnosed with metabolic syndrome, you would have at least three of these risk factors – which is all Bill has.)

Obviously, having any one of these risk factors isn’t good. But when they’re combined, they set the stage for serious problems. These risk factors double your risk of blood vessel and heart disease, which can lead to heart attacks and strokes. They increase your risk of diabetes by five times.

The excellent brochure provided by Dr. Askew. Note this excerpt: “Primary care physicians, who are already experts at managing patients who have multiple medical conditions, have what it takes to reverse metabolic syndrome. Initial prevention and treatment tactics center on diet and exercise interventions.”

Dr. Askew was a great teacher. Since it was almost 4 months ago, I don’t recall exactly what he said. But Bill got it! What was so strange, is that Bill has had high triglycerides nearly ever since he has had his blood work monitored. In fact, the only concern any doctor had about Bill was his cholesterol. And Bill pushed back because it runs in the family as well as longevity.

What about triglycerides?

They are important to life and are the main form of fat – they are sometimes called “lipids” — in the body. When you think of fat developing and being stored in your hips or belly, you’re thinking of triglycerides.

They are the end product of digesting and breaking down fats in food. Some are made in the body from other energy sources, such as carbohydrates. When you’re between meals and need more energy, your body’s hormones release them so you tap those unused calories.

Bottom line is that Bill experienced the perfect storm, and there was no denying he has this syndrome. And now for the great news about it, and this was the doctor’s focus: “A good diet and exercise plan can lower triglyceride levels, improve cholesterol, and decrease the chance of heart disease.”

Dr. Askew then went into great detail about the heart function, arteries and how the calcium score revealed his risk factors. Here is what we learned in a nutshell, to better understand what Bill is facing, from Medicinenet:

Heart (cardiovascular) disease definition and facts

• Heart disease refers to various types of conditions that can affect heart function. These types include:
  • Coronary artery (atherosclerotic) heart disease that affects the arteries to the heart
  • Valvular heart disease that affects how the valves function to regulate blood flow in and out of the heart
  • Cardiomyopathy that affects how the heart muscle squeezes
  • Heart rhythm disturbances (arrhythmias) that affect the electrical conduction
  • Heart infections where the heart has structural problems that develop before birth
• Coronary artery disease is the most common type of heart disease in the US.
• Coronary arteries supply blood to the heart muscle and coronary artery disease occurs when there is a buildup of cholesterol plaque inside the artery walls. Over time, this buildup of plaque may partially block the artery and decrease blood flow through it.
• A heart attack occurs when a plaque ruptures and forms a clot in the artery causing a complete blockage. That part of the heart muscle that is denied blood supply starts to die.
• Classic signs and symptoms of coronary heart disease may include:
  • Chest pain (angina) – This pain may radiate or move to the arm, neck or back.
  • Shortness of breath
  • Sweating
  • Nausea

Now for more good news! Bill is probably in the early stages of coronary artery disease, but since he has none of the classic signs and symptoms, he is a great candidate to turn his prognosis around. While the doctor said Bill’s calcium score will never change, he can make positive changes to his health by a radical adjustment in his diet and exercise.

Dr. Askew recommended a Mediterranean type diet and suggested we look up the diet recommended by Caldwell B. Esselstyn, Jr., MD. He added, it is a radical diet but this is Bill’s best hope for a long healthy life. David did go on this diet and lost 50 pounds. He was transformed into a mean, lean, fighting machine! But there was a downside…so we’ll learn about it next post.

Dr. Askew did not feel he needed to do a heart cauterization (hallelujah!) but only needs a nuclear stress test at this time. Phew, we haven’t mentioned planned to leave Virginia for three months, to go to warmer climates for the winter. It looks like we can still leave in early January.

Dr. Askew was also very optimistic about Bill’s future. He didn’t think he needs to be on any heart medicine at this time, Not even a statin – although if Bill wanted to go forward with the one the other cardiologist prescribed, it was up to him.

We left feeling somewhat optimistic, but we learned an awful lot of new information. It was going to take time for it to make sense and for us to absorb it. We just need for Bill to take that one more test, which he felt we could get scheduled within the week. And we had to get a grip on the diet.

Next up, the radical dietary changes begin.