Update...

It's been a long time since I've written anything in here.  I have been busy with the new job and I'm learning lots.  Everything I learn, especially dealing with cardiology, has been fascinating.  I've learned more about not only coronary artery disease but all different types of heart problems.  Congestive heart failure, peripheral artery disease and carotid artery disease (a common precursor to stroke); the effects of hypertension and diabetes on the cardiovascular system; surgeries such as angioplasty and stent placement (PCI), CABG and AVR/MVR (aortic/mitral valve replacement); devices like VADs and ICDs, and pacemakers; reading EKG rhythms, identifying arrhythmias and knowing where the leads are placed and how they work; cardiac markers such as troponin I, CK-MB and myoglobin...etc.  That's really only a fraction of what I'm learning.

I still have (and probably always will have) a special interest in heart attack patients, and it is really fascinating putting the pieces of the puzzle together as to what happened with my dad.  Since it is becoming a while ago, I can be more detached from the emotional part of the experience, and use what I am learning up here on the heart floor to understand what happened on a more technical level.  A lot of things that didn't make sense five years ago make sense now.

I feel very deeply that I am supposed to utilize my experience and apply it to what I am doing.  Instead of becoming turned off by the "gross" parts of the job, I want to know even more.  One of my coworkers said that "we drop techs like crazy," and I can kind of understand that, but I feel capable.  For the first time in a long time, I am not doubting myself.  That makes me feel good, and it makes me feel good that I can take a traumatizing experience and use it to help better the lives of patients that have a chance.  It makes me feel good that I am finding more of myself.

I got it.

Got the job in the cardiovascular step-down unit, the one I really wanted.  Never have I felt so much passion for something in my life.

Thanks, Dad.  I know you helped me with that one.  I'm going to keep fighting for you.

Good news for dark chocolate lovers

Chocolate and Heart Health

Not bad.

I have to admit I'm a little stunned.  It wasn't nearly as bad as I had feared.  My total cholesterol was 207.  That's the lowest I've ever had it tested at.  I should be able to drop that just by diet and exercise.  I really don't know what I was expecting, but I was afraid it was going to be much worse than that.  That's borderline high.  If anything, my blood pressure was worse than my cholesterol, but I can bring it down, too.  Time is still on my side.

(For those of you thinking of course time is still on my side, because I'm only 26, put this into perspective: at age 26, my dad's [and grandfather's] life was already over halfway over.  That is why I stress that heart disease prevention should start as early as possible.)

Total: 207
HDL: 45 (good)
LDL: 144 (a little bit too high but manageable)
Triglycerides: 93 (really good, that's what surprised me the most)
BP: 132/96 (systolic number is a little high, diastolic is too high so I need to work on lowering that)

I'm not completely pleased, but this is going to be much easier to bring down than I thought. 

Cholesterol screen, take two.

I'm going to try this again in the morning.  I was going to have it done a few weeks ago, but I apparently decided to get sick with a stomach virus instead.  (They said fast for 12 hours, not 36!)  Anyway, I already know it won't be less than 200, which is desirable.  I am hoping for under 240.  It has been as high as 248.  Not good for someone who was 20 at the time.

Now for my periodic public service announcement:

The Methodist Wellmobile does frequent cholesterol screenings throughout the area that are free, and it doesn't take a lot of time to do.  You do need to fast for 12 hours before the test.  They give you your total cholesterol, HDL (the good cholesterol), LDL (the bad), triglycerides (fat that hangs out in the blood), and glucose.  It's a simple finger stick so no blood draws are necessary (good for those of you that get nauseated at the idea of a needle).  Your cholesterol levels are a good indicator of your risk for coronary heart disease and stroke, so knowing what yours are and taking the appropriate course of action to reduce high cholesterol, or maintain a normal level, is an important step toward maintaining a good quality of life.

I know, you've heard this all before...but it really can save your life.

If anyone is interested, here's the website with the screening schedule.  They also offer other screens for a fee.

Schedule and locations

Note: You do actually want your HDL (high density lipoprotein) levels to be high, since these seem to bind with and carry cholesterol away from the arteries and back to the liver, where it can be flushed from the body.¹  Physical activity can help boost your HDL, so there's a good excuse to get up off the couch (myself included).

So wish me luck.  Hopefully the numbers won't give me a heart attack.

¹  http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/Good-vs-Bad-Cholesterol_UCM_305561_Article.jsp

I MUST WALK THIS WEEK.

...that is all.

Motivation problems...

I have been a total sloth this week.  Not only have I been extremely lazy in the exercise department, I've been eating like crap again.  There's far too many foods in this house that are too tempting, and I have no control over what comes home...so I need more willpower than I currently have.  I have been feeling quite sluggish this week and I think it's a combination of staying up way too late (though partly that is because baby got off schedule and now sees fit to stay up until midnight...gonna have to nip that in the bud here soon), eating heavy, high calorie foods (my birthday was Monday and we ordered out, and it's been a snowball rolling downhill since), and not going out to walk because of the bitter wind and now cold.  The daylight is getting shorter and that is adding to it, I think. 

Part of me has been quite stubborn and defiant about eating healthy.  The truth is, I like foods that are terrible for you.  I know in my mind that they're terrible and I shouldn't eat them, and I feel a little bit angry that I shouldn't eat the foods that I like--even less than that of people who are at lower risk for heart disease.  I'm kind of angry that I keep losing all my crutches.  Somehow I'm just supposed to deal with emotions in healthy ways when other people are not required to.  For heaven's sake, I don't drink, I don't use drugs, I no longer smoke, and now I'm not supposed to eat anything that tastes good.  I know I need to continue making this lifestyle adjustment, but I have to drag along that inner child in me that keeps kicking and screaming, and not wanting to cooperate.

Once I get up and going, I'm usually fine.  It's actually getting up to do it.  I know that I always feel better after a long walk, so why can't I get my butt up and just do it?  I think part of it is the fact that not only do my kids get bored, I have a tendency to get bored, too.  Having the iPod helps, but not when I have two kids trying to get out of the stroller when we're still only halfway home, and it's not like I can let them walk in the street--they're way too young.  I'm going to try a few things suggested to me and see if that helps with their boredom. 

/end whining

Resolve.

As I stood in one of the waiting areas of St. Francis Heart Hospital, waiting for my interview to begin, I gazed out the window at the far west end of Methodist Medical Center.  It was the Pavilion wing that houses Methodist's Cardiovascular ICU.  I was gazing at the reason I was here in the first place.  It deepened my resolve.  Even though I was only trying to start out as a nursing assistant, my goal was to help these patients get better.  It also troubled my mind, "How can I convince people to take this seriously so they don't become this sick to begin with?"  There had to be something I could do.

Something.

The Good, The Bad, and The Ugly.

I have been neglecting writing this last week.  I could blame it on sick kids, being busy, or other things, but to be honest, I've just been in kind of a funk.  I really need to light a fire under my own butt and stay active. 

The Good: I did walk for two miles with the stroller again on Sunday.  The first walk wasn't timed, but I did one mile at a moderate pace.  The second walk was actually 0.85 miles (thanks, Google Pedometer) and I completed in 18 minutes alternating a fast pace and an easy walk.  I feel pretty confident that if I was walking alone, I could have done it a few minutes faster, but my kids weigh 63 lbs combined and that double stroller weighs at least 15 lbs.  It's not an easy push at a leisurely pace so power walking with that thing is more of a workout than you might think.  When I am done, I not only feel it in my legs, but in my arms and my abdomen as well.  I am also amazed at how much it affects my mood--I feared being tired and grouchy but instead I was quite relaxed and calm afterward.  I'm starting to understand the "runner's high".  I hope I can feel that same high someday.

On Sunday I weighed in at 173.1 again so I was happy.  177 had to have been skewed by some water weight by taking the steroids.  I am so glad to be done with those!  This morning I was able to tighten the belt yet another notch so I was happy about that, too.  Six holes in; I haven't seen that for a long time.  None of my pants fit well, so I may be searching some thrift stores soon.

The Bad:  I am having my cholesterol checked soon; HDL, LDL, triglycerides and everything.  I'm not looking forward to finding out what it is now.  My cholesterol has been as high as the 240's, which is bad for someone in her early twenties.  I haven't had it checked for a few years, and I'm long overdue.  I'm certain it's still over 200 and I need to bring it down, now.  If it's lower than 200 I will probably die of shock. 

The Ugly:  My diet.  It is atrocious.  Yeah, I have been losing weight, but I still eat a lot of "bad" food. 

I'm finding that I eat the worst after eating perfectly healthy all day.  Nothing tops off a healthy diet like a couple of cupcakes or a piece of chocolate cake, right?  Seriously, I need to learn better willpower.  I also think that if my diet during the day were more satisfying, maybe I wouldn't feel so inclined to binge on the junk at the end of the day.  Then it sits in my stomach all night and I don't feel hungry in the morning, which does not help my metabolism. 

Not only do I crave junk, but find myself eating mindlessly.  I had checked out a book called "Mindless Eating" some time ago; maybe I need to go find it again.  I don't remember the author but the book made a lot of sense. 

I need the strength to pull this off.  Exercising and eating less is helping, but putting the right things into my body is still of utmost importance.  I need to fill up on the fruits and vegetables, lean meats and whole grains...and put a padlock on the snack cabinet.  NO fast food, period.  And if I'm going to munch on something mindlessly, make it rice cakes...

Couch to 5K.

Okay, so I fall into the couch category at the moment.  Actually, that's not quite correct.  I happen to be hiding under the couch.  I remember many hellish P.E. fitness days where I failed to run the mile in 20 minutes.  I get a stitch in my side just thinking about running.  I'm one of the last people I ever imagined wanting to run.

I know at least a few people that have used this program, Couch to 5K.  It's a 9 week training program that is designed to have you running a full 5K at the end of it.  I don't think it's going to be 9 weeks for me, since I'm carrying around a lot more weight than I should be.  It might be next spring, as a matter of fact.  It's still progress, though, and better than doing nothing.  You never know, I just might surprise myself, and it might not take that long to get in shape.  My goal as of now is to actually run in the Race for the Cure in May.  I think that is a reasonable goal. 

For now, I think walking first might be a good thing before I start alternating walking and jogging.  I'm taking baby steps, but I don't want to get burned out in a week.

I weighed in this morning at 177.0 and almost flipped out, since I was at 173.something last week.  Then I remembered Prednisone.  I'm hoping I can write this week off since I've been taking that.  I took the last dose this morning, so maybe next week I can feel less like a water retaining sea cow. :-)

My story.

I've seen fire and I've seen rain

I've seen sunny days that I thought would never end

I've seen lonely times when I could not find a friend

But I always thought that I'd see you again...

--James Taylor, "Fire and Rain," 1970

I don't exactly know the mechanisms behind grief.  I don't pretend to understand it, and don't really know why there are some things that I have let go and some that I have not.  My understanding of anger is that it is a secondary emotion that stems from some injustice, and there is one chapter of my long life story that I have not moved on from that stage of the grieving process.  The only thing I can do now is to use that anger constructively and fight back.  It may very well be that is the only thing I hold over from that, and if that's the case, I am going to take it and run with it.  If I can help save at least one life it would make it all worth it.

Everyone has their story, and if you get nothing else out of this blog, please take this.  It can and DOES happen every day, and the saddest part of it is that this is highly preventable.  It could be happening to your grandparents, your parents, or even you...and it is sometimes silent right up until the end.  

On March 26, 1966, my paternal grandfather was on a hike with his Boy Scout troop when he collapsed, presumably from a massive heart attack, in the presence of his 11 year old son (my uncle).  That is about as much as I know about this particular incident, since it was rarely discussed by the time I was old enough to understand it.

He died at the age of 41.  I never knew him.

Fast forward 40 years.

In January of 2006 I was living with my father in his townhouse.  My parents had split in 1994 and after my high school graduation I moved in with him so I could attend a local community college.  After two and a half years of not knowing why I was still going, I took a full time position in the customer service department of the local newspaper, where I was already working part time.  Life was looking up; I had a new car, a “new” job, health insurance, and was looking forward to finding my own place later on that year.  

One nasty Friday night during that January, the snow was falling faster than the city could plow and salt the roads, and driving was treacherous.  We were on our way back from his longtime girlfriend’s house in separate cars and he followed me home, staying close behind in case something were to happen.  I remember one large SUV came flying up around us and it looked like he was going to cut in between our cars, so my dad sped up faster than he should have to keep the truck from cutting in.  I remember him saying afterward, “You can f--- with me, but you don’t f--- with my family.”  It was a quote I never forgot, spoken in his usual crass manner.  It still is significant to me today, possibly because this was the last time I ever saw him well.

The next day he came down with a bout of the stomach flu.  This was rare for him; I hardly ever saw him with even a cold.  I shook it off at the time, and by Monday he seemed to be feeling a little better.  We ate at the Golden Corral buffet there in town, but he still wasn’t eating his usual amount of food.  I found this to be a little odd but probably sensible for someone still recovering from a stomach bug.  He complained of continuous indigestion and was not comfortable in any position.  I didn’t know why at the time, but it bothered me.

By Thursday, however, it seemed to have taken a turn for the worse.  When I arrived home from work around 1:30 in the afternoon, he was home already.  I walked in the back door and he was nowhere to be found.  Worried, I went upstairs only to find him in bed, reading a novel.

His nausea had returned, and he told me he kept dozing off at his desk at work.  Something wasn’t sitting right with me about this, but I couldn’t put my finger on it at the time.  I went on to Bunco Night with some co-workers, but I couldn’t get my mind off my dad and his strange illness.  I believe he slept in the armchair that night.

On Friday night he still was feeling no better, and he asked me to take him to the emergency room.  I drove him in his car as he told me he was feeling too weak to drive.  Upon arrival at the emergency room, he told the registrar about his symptoms and that he thought he had the flu.  A flurry of doctors and nurses came through. Respirations, blood pressure, pulse, and pulse oximetry was taken, and though I don’t know the results (I do remember his O₂ levels being around 88-89%) the question afterward came, “Have you ever had an EKG?”

Most of the details of that night escape me now, but I remember the most important points.  Oxygen was started, EKG tests were done, blood tests were drawn, and finally around 10:00 P.M. one of the doctors came in.

“You had a heart attack.” 

As often as those words are spoken by doctors every day, they’ve become almost a staple in our society.  We all know that heart disease is the number one killer of adults in the United States.  That alone is saddening, but what saddens me more is how little this statistic is taken seriously by the general public.

The days afterward are very much a blur.  He was admitted to Methodist Medical Center’s Cardiovascular Intensive Care Unit (CVICU) and after he was settled in, I drove home so I could get some rest and come back the next morning.  My father was scheduled for an angiogram that morning and the results were grave: two coronary arteries were completely blocked, another was 95% blocked, and yet two others were severe enough to need coronary artery bypass grafts (or CABG).  

Anyone that is familiar enough with heart failure will understand what I mean when I say his ejection fraction was 25%; for anyone else, much of his heart muscle had already died.  At some point, someone said that the condition of his heart suggested that he had had other heart attacks in the past.  He was put on a balloon pump to help his heart keep blood pumping through his body, and in a nutshell was told that without CABG surgery he would probably die.  The surgery was scheduled for 7:30 the next morning.

I can’t even begin to explain what I was feeling.  Most of it was numbness.  This couldn’t be happening, this was my father, and he couldn’t die…this had to be a nightmare from which I would soon wake up.  It had to be.  We were too close for him to be taken away from me.  When I watched my father wheeled away to the OR I kept telling myself, It’s going to be fine…we’ll get through this just like we’ve gotten through everything else, we have to...it’s all we can do.  

Eight hours later, out of surgery and in recovery, the heart surgeon came out and spoke with my family, some of which had come from out of town and out of state.  I was floored when he told us that he had performed seven bypass grafts, not five.  I didn’t know it was possible for that many to be done…I’m not even sure what you would call it.  Septuple bypass surgery?  At that point I had heard of quadruple and assumed that that was the worst.  How little I knew.

He also told us that soon after anesthesia was administered he coded (truthfully his heart rate dropped to about 30 so it did not stop completely, I got that information from his medical records) and that he massaged the heart back to a normal pulse.  Everything seemed to go smoothly, although they did have difficulty weaning him from the heart-lung machine, which is what keeps blood moving through the body while the surgeon is operating on the stopped heart.  I remember him saying that if he was going to survive he absolutely had to stop smoking, and completely change his lifestyle.  Though he was in critical condition, the health care staff was “cautiously optimistic” about his prognosis.

That night I went in to see him.  It was one of the most horrible sights I had ever seen.  My father, who I had once perceived as invincible, lay there on a ventilator, heavily sedated, unresponsive.  Tubes and wires were poking out of him in every place imaginable.  The saddest change I noticed, and would continue to see in the coming days, were his hands…they were swollen at first, but as the swelling receded, his hands became those of an old man.  Not the strong hands that I had held so many times before…this really felt like the hands of some stranger.

The following days his condition did improve.  He went off the ventilator and was at least able to speak.  He sat up about a day and a half post-op, and gradually started to move around, little by little, with a walker.  One by one the tubes were removed and IVs were taken out.  Finally, eight days after his admission, he was moved to the cardiac step-down unit.

The night before he was discharged, I got sick with something and was running a fever, so I told him I wouldn’t be able to come see him that night.  Much to my chagrin at that time, he kept insisting, so I agreed to come up there for an hour or so, to keep him company.  I warned him that I was not feeling well, but he didn’t seem to care about that…he was insistent.  That was eight days after his surgery.  We sat and talked for a while, and finally I was looking so tired that he did tell me to go home.

He was able to stand on his own again, so he stood up and I went over and hugged him, being extremely careful of his sutures and his one remaining IV.  

“It feels so good to be able to hug you again,” I said to him.  He nodded his agreement and I gathered my things and went to leave.  He waved, in the way he always waved to me.  We had a thing where we always waved to each other using the “Live long and prosper” hand gesture.  I didn’t do that with anyone else, just him.  It was our thing.  

So I returned it, and stepped out of the room.  As I turned back to look, there he still stood, still with his hand up, fingers split down the middle.  I smiled and waved again, then walked away, leaving him standing there still waving.

That is my last memory of him…of him waving goodbye.  It was like he knew.  None of us knew, of course, but it was like he did know, nonetheless. That is how I’ll always remember him, as I have come to reject what I saw two days later.  If I could erase from my mind what I saw afterward, I would do it in a second.

It was Wednesday, February 8, 2006.  I was at work when my father’s girlfriend (we all worked for the same company) came to my desk in a panic, telling me we had to go, we had to go now.  I didn’t think.  I just reacted.  I remember a co-worker telling me, “Go.  Just go.  Don’t worry about all that, just get your stuff and go.”  I passed a desk where my father’s boss was standing, with an expression of shock on his face that I will never forget.  I don’t know exactly when I realized that my father had died.  I don’t remember who said it, I just remember it sinking in.

Another co-worker that I did not know drove his girlfriend and me to my grandmother’s house, where he had stayed overnight because I was still not feeling well and because he couldn’t take the steps anyway.  I felt so sick.  What I had been trying to convince myself couldn’t happen had happened.  My dad, who was undoubtedly one of the people I was closest to, was gone.  In two weeks he had gone from “having the stomach flu” to this.

I do not wish to go on after this point.  All I will say is that I got one last good-bye, one last wave that he was not able to return.

My father died at the age of 48.  My children, now 3 and 1, will never know him.

This is a story that I have been meaning to write for a few years now.  Now I feel certain that I’m doing it for the right reasons.  I’m not looking for sympathy; I’ve had four and a half years of that.  I’m doing this to help educate.  I wanted to share my experience because I do not take the statistics lightly.  I’ve seen them first hand.  As sad as this story may seem, it is not at all an uncommon one.  According to the American Heart Association: in 2006, the year that heart disease claimed my dad, over 425,000 people died from the very same thing.¹ 

Though there are uncontrollable risk factors such as age and family history, many of these deaths could have been prevented, including my father’s.  He was already high risk, being that he had a strong genetic predisposition to heart disease, but he also smoked close to a pack of cigarettes a day, ate most of his meals from restaurants and fast food, led a sedentary lifestyle, did not exercise, and did not see any doctor in the 10 years prior to his hospitalization.

So please…if you love your children, your grandchildren, and for heaven’s sake, yourself, please don’t take your life for granted.  The purpose of this blog is to help educate you as much as it is a crutch for me, if you are so willing to listen.  No other entry will have this degree of gravity, but I felt like I needed to share my main reason for this blog.

I still very much grieve that loss, and for years I have tried to figure out why I couldn’t let it go.  Now I don’t believe I was meant to let it go.  I plan to go on to nursing school and become a cardiac nurse, and I want to focus primarily on education and prevention of this very thing.  Life is precious and it doesn’t have to end this way.

Thank you for listening.  

My grandfather and father, around 1960.

¹ http://www.americanheart.org/presenter.jhtml?identifier=4591

Introductory post.

I should start off by saying that this blog is to help keep me on track with my weight loss, increasing exercise, and following a healthier lifestyle.  Anyone is welcome to read and offer support, suggestions, and constructive criticism, as I will probably screw up several times along the way (as a matter of fact, I'm currently munching on a brownie while typing this).  I need to change, though, both for my health and for the example that I'm setting for my children.  Having a child with type 1 diabetes puts him at risk for more complications than a completely healthy person would, so it's important to me that I set a good example early on.

Hopefully this blog will help keep me on track more than I have been lately.  I have a tendency to eat emotionally, and also out of boredom.  I really need a lot of willpower to stay away from those things.  I have found that I can still find taste in foods that are healthy, so maybe there's hope yet.  I do have a lot of junk-food cravings (such as McDonald's and brownies, for instance, so when McDonald's started offering their brownie bites, there went another couple inches on my butt!).  I love food itself, so I'll be doing some research into finding recipes that are both tasty and won't kill me.  My ultimate goal here is to tell McDonald's to piss off.

That being said, I'll try to make this as exciting and funny as possible for a potentially boring subject, for those that might be interested in reading along.  If not, oh well; if it keeps me on track, then it's fulfilling its purpose anyway.

Sweet dreams.