Bruce A. Smith
Part 2 in a series.
I’m in my eighth week of recovery from a heart attack experienced on February 26, 2012. Since then, I’ve explored the murky world of aftercare, finding great relief in the Good Samaritan cardiac rehabilitation clinic in South Hill.
Rehab is a lot like a gym where guys like me can slowly rebuild stamina and muscles, guiding the body’s recovery from the trauma of a stent placement or bypass surgery back to full health. Besides the treadmill machines and rowing devices, there are weekly educational classes and nutritional seminars that include tours of a local Safeway grocery store.
But one of the greatest benefits has been my exposure to advanced theories – and highly controversial to mainstream medicine – in reversing the effects of heart disease through a diet absent of any animal products and extremely low in fats and oils. Perhaps the leading proponents of this perspective is Dr. Caldwell Esselstyn, Jr. and Dr Colin Campbell, whose work is featured in the popular documentary “Forks Over Knives.”
In my next essay I’ll discuss Esselstyn and Campbell’s plant-based, cholesterol-free nutritional program in more detail.
Before then, I’d like to address another important element of the cardiac “underground” – those programs and ideas that helped fuel my desire to heal my heart, and which exist slightly off the radar screen of Good Sam’s standard rehabilitative care.
Chief among these is the Yale Heart Study, which I found posted on a dusty bulletin board. It’s based in the Yale University’s School of Nursing and administered by a Dr. Angelo Alonzo, Ph. D, who has been a life-long public health official specializing in medical sociology and cardiac care-seeking.
The purpose of the Yale Heart Study is to learn how Americans respond to the first signs of a heart attack and how quickly we get ourselves to a hospital. This information is of critical importance since one out of two Americans are currently expected to die of heart disease.
The truth is that most of us are confused and scared when things start to go wrong with our heart, and many of us drag our feet before we get help. Doc Alonzo helped me understand how fortunate I was to be alive, and that’s what I want to share with you now.
The statistics on heart attacks are alarming. 40% of guys like me don’t make it in time to the Emergency Room – that’s 3,000 guys a day, seven days a week. On average, most Americans take about four hours to get help, and time is not the friend of a troubled heart – and I took twelve hours.
Further, for many the symptoms of heart trouble are too varied or confusing for us to make decisive actions, or they run into a gamut of mental and emotional resistance that serve to help us get through the ordinary challenges of life but can kill us when the pain is signaling a plugged artery.
More disturbing, the above people who wait are the fortunate ones since for 25% of all heart attack suffers death is the first symptom.
Doc Alonzo is looking into all of these variables in his Yale Heart Study, a nationwide survey seeking answers from 2,300 heart attack patients on what happened to them – what the onset of symptoms were like – and what they did about them and how quickly.
My experience was classic, and I share it here to illustrate a general template for how many Americans, particularly men, react to their heart attack.
My onset of symptoms began the night before I went to the hospital. At midnight on Saturday Feb. 25 I went for a walk, which was part of my daily regimen of physical fitness. I needed to go for a walk because I was at risk for heart trouble since I was overweight, 62, and leading an increasing sedentary lifestyle as a journalist who sat perched in front of a computer screen most days.
At the end of my driveway I felt a pain exploding in my chest – like a grenade going off – and it spread into my arms. I stopped and leaned over. The pain did not dissipate.
Is this angina? I thought.
I had been researching the subject of angina and was scheduled to speak with a physician the next day for an article for the Mountain News.
Angina is caused by the reactions of muscle tissue to toxic buildup in the cells due to inadequate blood flow and oxygen exchange. As a result, chemical residues are not flushed out of the cells and they cause cramps and pain.
That was my rationalization, and it worked. Never for a second did I seriously consider that I was having a heart attack, nor did I ponder if I should call 9-1-1.
Since it was late, I went home and went to sleep. Fortunately, I woke up. When I did, I didn’t feel any symptoms, nor did I when I spent an hour in meditative focus, visualizing scrubbing out my arteries and veins with mind-as-matter techniques that I’ve learned in Ramtha’s School of Enlightenment in Yelm.
Afterwards, my friend Dave called and asked if I could take some pictures of him working in his garden, which I had promised to do once we had sunny weather. However, while getting dressed my pain came back – it was like fire crackers going off repeatedly in my chest, and now they were radiating up into my jaw and face.
Nevertheless, I continued dressing and went out into Dave’s nearby garden with my camera.
“I’m not feeling too good Dave,” I said. “I think I might be having an angina attack. Do you know anything about taking aspirin for heart stuff, like angina?”
I heard aspirin is good,” Dave replied. “Maybe you should take some.”
“I will, but let me take some pictures first.”
We headed out into the rows of kale and I took about a dozen pix. My pain got worse and I began to feel nauseous.
“Dave, I’m really feeling lousy. I gotta quit.”
I walked back to my home and sat down. I took some aspirin. The pain continued and was ringing in my cavities and my palms got sweaty.
This is getting serious, I thought. But not knowing what to do, I called Dave to ask him to come over and help me decide on a course of action – but his line was busy.
I called again, but it was still busy. The pain intensified.
I need help. I picked up the phone a third time and dialed 9-1-1.
The emergency dispatcher picked up on the first ring.
“9-1-1; may I help you?” she said, and thus began my journey to cardiac health.
The events of the next few hours are told elsewhere, but what I’ve described above is a classic response to a blocked coronary artery – and I had two. https://themountainnewswa.net/2012/03/18/a-love-letter-to-all-of-you-anatomy-of-a-heart-attack/#more-5097
To whit, symptoms of a heart attack are: Chest pains that radiate. Sweaty palms and other “clammy” responses. Nausea. These are major symptoms.
Other folks feel ill, like they are coming down with a cold or flu.
When my symptoms hit I was confused intellectually. I didn’t know exactly what a heart attack was supposed to feel like so I mis-diagnosed myself when I had symptoms on my walk.
Then I rationalized away the pain, thinking it was angina. It wasn’t; it was a heart attack.
Then, the next day, my routine and spiritual practices took prominence, and then the responsibility of promises and friendship over-rode the return of my chest pain and I went off to film Dave.
Later, when overwhelming pain forced me to go back home, it was only when I had even more pain that I found the courage to call 9-1-1 on my own.
Doc Alonzo told me that my actions are typical behaviors for single guys who live alone. We keep trying to tough-it-out and explain the pain away. If spouses and family are around, the call to 9-1-1 is made much sooner.
Alonzo said circumstances also play a major role in determining how quickly someone gets medical attention, since heart attacks can happen during work or in inconvenient places, such as commuting on public transportation, social gatherings and outdoor events, or are compounded by family obligations.
“People want to certain that they need medical care, and it takes a long time to clarify what is happening,” Alonzo said. “Often we need validation from someone else that something is wrong, such as a spouse.”
Alonzo acknowledges that the symptoms of a heart attack can be confusing, unknown or unfamiliar, which further delays decision making.
“Statistically, it is taking people about four hours to get to a hospital after the onset of symptoms,” said Alonzo, declaring that the best chance for recovery occurs when a patient can get to a hospital within an hour.
“We are seeing people getting to hospitals faster in the past year or two, and in many places the average is down to about two and a half hours,” Alonzo said.
Besides the psychological variables to getting to a hospital, the study is balanced geographically between urban, suburban and rural areas, and includes the dynamics of paramedical responses in small cities, which may still be far away from a hospital of significant size, such as Eatonville.
Alonzo also said that response times within the hospital setting are also improving, with shorter waits in the ER, faster EKGs and blood tests, and expedited runs to surgery – all borne out in my experience at Good Samaritan Hospital in Puyallup, WA.
In fact, Alonzo told me that the best place in the world to have a heart attack is in the Pacific Northwest, as our paramedics are the best trained and best equipped, and our emergency rooms and cardiac teams are the best prepared.
Also, myths need to be debunked – women get heart attacks, too – in fact, more women die of heart attacks than men.
If you would like to be part of the Yale Heart Study and you’ve had a heart attack within the past year, you can join the study – it’s online at www.heartstudy.yale.edu or contact Dr. Alonzo at firstname.lastname@example.org . It’s completely anonymous and takes about 30 to 60 minutes to complete depending on your care-seeking experiences. The survey can be done in total privacy online.
“Anonymity encourages truthfulness,” said Alonzo, who added that the outreach will continue for another six months or so, until about October 31, 2012.
“November 1, the analysis begins,” he said.
Dr. Alonzo is particularly interested in having African-Americans participate, as these folks have the highest mortality rates for heart attacks in the United States. Further, African-Americans have the greatest difficulty getting to a hospital, and they have the least amount of access to cardiac rehabilitation for their recovery.
“We want their experience to be represented,” said Dr. Alonzo, and yet only nineteen African-Americans have joined the study in the first six months of outreach, which includes direct contact with African-American ministers.
For its overall outreach, the Yale Heart Study has bought advertising space on Google, Facebook, Yahoo and Bing. They have also contacted health bloggers and the Yale Alumni Association, along with developing contacts with reporters at online news organizations, such as Susan O’Malley at the Huffington Post.
Dr Alonzo’s group has also developed action teams of students and volunteers who make direct contact with seniors, especially grandparents. Some 4-H members are earning a Yale community service award by helping their grandparents, parents and other relatives and friends who have had a heart attack participate in the Yale Heart Study.
In addition, the web sites for the Yale Heart Study carry many state-of-the-art messages about heart healthy diets and exercise practices. You can visit their two most visited sites for more information: http://www.facebook.com/YaleHeartStudy and http://yaleheartstudy.org/ .
Above, Dr. Angelo Alonzo, keeping a light heart. Picture, courtesy of Dr. Alonzo.
© 2012 Mountain News – WA