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Did you know that, worldwide, twenty-three people each minute have a heart attack? This adds up to about 12 million heart attacks a year. More than 1 million Americans will have a heart attack each year, and 14 million Americans now living have had aheart attack or angina.¹ In fact, if you live in an industrialized country, heart disease is either the number one killer there or a major cause of death.
Even when heart disease does not kill, it maims, so if you have had a heart attack, youmay well find yourself attending a cardiac rehabilitation program to help...
II The Participants’ Perspectives
January 17, 2000, began for me like any workday. I was up at 5:45 a.m., showered and had breakfast, was on the road by 7:50, and was in my office by 8:15.
I had booted up my laptop to check the weekend’s e-mails when I started to feel weird and queasy, though not nauseated. I also had an uncomfortable tingly sensation in my jaws and along the triceps in both arms. I realized something was wrong and decided to wait a few moments to see what would happen. And, in fact, after a couple of minutes the sensations eased off
3 Doing It My Way
On February 21, 2000, I woke up at 6:00 a.m. feeling pressure at the center of my chest. I assumed the pressure would go away, so I went ahead with my daily routine—shower, coffee—after which I got ready for work.
As I drove to the office, the feeling of pressure in my chest increased, and I became more and more uncomfortable. I decided I needed to have it checked out; even though I was only 47, I began to wonder if I was having a heart attack.
I turned around and drove to the emergency room of the...
4 It Takes a Team
August 20, 1988—a date I will not forget. On that day I joined a new team. I did not plan to become a participant, and I did not know at the time that the team would become a focus of my life. As I look back, I recognize that the team has had various members and that my own participation ranged from the initial passivity of being worked on in a hospital emergency room to a highly active role in understanding and managing my chronic cardiovascular disease. Many people have been part of my team since that fateful day; some...
5 Reversing Angina
The evening of August 12, 1994, is one I will never forget.
We were on vacation in our summer cabin, which overlooked a magnificent unpolluted lake in the East, very close to the Canadian border. On the previous day, my 83-year-old husband, George, (I was then 75) had mused out loud how wonderful it was that we were in excellent health. And we were looking forward to celebrating the birthdays, on the twelfth, of our granddaughter and daughter-in-law.
On August 12 our son was driving his Volvo, which at the time had the highest safety rating of any car. He...
6 Preventive Medicine Works
Most people do not associate heart attacks with African Americans. But I am an African American, and my elder brother died of a heart attack at age 47; I developed angina when I was 60.
In fact, African Americans have more heart attacks and strokes than Caucasians. High blood pressure is four times more common, and diabetes twice as common. One result is that heart attacks are more common in African American women than in Caucasian women, and tend to occur at an earlier age. For similar reasons, stroke and sudden death are more common in African Americans than in...
7 Modern Cardiology, Cardiac Surgery, and My Angina
Today is the day after my eighty-eighth birthday. I am celebrating, among other things, the fact that I am fit and healthy. How did this happen? Well, I think there are two reasons. First, my body has become a kind of showcase for the latest medical devices. Second, for the past twenty-five years I have belonged to a cardiac rehabilitation program.
Both my grandmothers lived into their eighties. One grandfather was killed in a railroad accident; the other died of “consumption” in his late fifties. My father lived into his nineties, my mother into her eighties. Heart trouble is not.
8 Success without Angioplasty or Surgery
After my heart attack many years ago, I soon found that no one was telling me what lifestyle changes Imight have to make to keep from having another. These days, most cardiologists and other health professionals readily offer such advice, but that was not the case for me—and if you are in a similar situation, perhaps my experience can serve as a guide.
My heart problems began in January 1984, at age 51. I awoke one night with crushing pain behind my breast bone, which radiated up into my neck and jaws and later spread to both elbows and.
9 Miracles Can Happen with the Two Ds
What my cardiologist and I were looking at recently was as close to a miracle as most of us are likely to get.
We were comparing two coronary angiograms. The first showed that the openings of two veins used by the heart surgeons to bypass my blocked coronary arteries had actually narrowed by 90 percent. The second, taken five years after the first, showed that those radically narrowed openings were normal.
A miracle? Only apparently. This dramatic change occurred because I believe in two Ds: the danger of cardiac Denial, which can kill you, and the beneficial effects of Discipline,.
10 Young People Do Not Get Heart Attacks (WRONG!)
Heart attacks are for old people . . . the chronologically challenged!! That is what I used to believe. So why did I get my first heart attack in 1966, when I was still a month away from my fortieth birthday? And why did my son get a massive, near-fatal heart attack at age 42? Why did my father die at age 60 of a heart attack, and why did my three brothers all die of heart problems? My mother too had heart disease. At age 51, she sought medical advice for a bruised leg and died suddenly of a.
11 Myth: You Are Lucky to Be a Woman
The idea that women do not get heart attacks is a myth. Women get as many heart attacks as men; they just get them a little later in life.
A second myth is that Asians rarely have heart attacks. I immigrated from an Asian country, where a number of close relatives had heart attacks despite the fact that they were on healthy Asian diets. Several relatives on my mother’s side have diabetes, and many have had heart attacks already, between the ages of 50 and 65—and some of my nieces and nephews have had heart attacks at even earlier.
12 Risk Factors from a Patient’s Perspective
My story is vitally important for two reasons.
The first is that I was massively at risk for a heart attack. I had seven of the risk factors: I have diabetes, I had a strong family history of heart attack, my blood pressure was high, I led a very sedentary life, I was overweight, I smoked heavily, and I am a type A person.
Second, I developed a blockage of the large artery in the neck that supplies the brain, leading, in my case, to amini stroke. (It is crucial to realize that heart attacks are due to rupture of.
III The Health Professionals’ Perspectives
13 The Complexities of Proper Nutrition
Nutrition—what you eat, and how what you eat becomesyou—is extraordinarily complex, and no one knows all the answers. What is clear is that no single diet works for everyone. Just as there are many components of good health, there are many different diets and each is appropriate for different people.
People with heart disease tend to ask similar questions about diet. Are there specific diets that are helpful to people with heart disease, including those with diabetes? Which diets will help to lose weight? What about the new medical foods, such as the Heartbar®? Are diets
14 Testing and Treatment
Coronary artery disease is the most common form of heart disease in the industrialized world, and it is what most people mean when they speak of “heart disease.”¹ Let us look at the anatomy of the heart, the symptoms of coronary artery disease, and the tests used to assess it, before discussing treatment.
The first component is the heart muscle, which performs the heart’s primary function—to pump oxygenated blood throughout the body.
The second component is the coronary arteries, which supply oxygen to the heart muscle. The heart, like any other muscle, requires a blood supply. Three major coronary.
15 An Introduction to Cardiac Rehabilitation Programs
Cardiac rehabilitation in the United States has undergone an incredibly rich and energizing thirty years. In the late 1960s you could count on the fingers of one hand the number of cardiac rehabilitation programs in this country. But Gary Fry, an especially enthusiastic and visionary cardiologist at the Palo Alto Medical Foundation in California, knew instinctively that there had to be something better than building more and more coronary care units for victims of heart attacks. His vision, his passion, was to keep people out of coronary care units, out of hospitals, and to keep them well.
16 Cardiac Rehabilitation in Action
If you had a heart attack in the United States in the 1950s, you would have had to stay in the hospital for six to eight weeks and not move out of your bed. During the next six months, you would have been allowed very little physical activity.
If you had a heart attack in the 1960s, you would have been much more fortunate, because it was then that the first programs were developed in the United States to promote appropriate exercise as part of your recovery.
If you had your heart attack in the 1990s, though, you would have.
