Friday, July 12, 2013

Better a hypochondriac than a dead hypochondriac: how not to let heart disease kill you

Ever since I was little, I’ve been certain I’d one day die of cancer.  Cheery, I know.

When you lose a parent at a young age, death is a part of your world; you don’t understand what it means, but you know it takes people away, and you know there are no do-overs. You also know that illness can happen to anyone, to everyone … and you simply should resign yourself to the fact that one day, it will be your turn.

And in my family, the disease of choice – well, clearly not of choice, but our reality nonetheless – was, and is, cancer. So when I was about 10, I convinced myself I would be diagnosed with it, and that it would kill me, so I’d better get things done fast.

And by “things,” I meant reading every book in the West Des Moines Public Library. I got as far as the letter “J” in the young-adult section, and then I stopped – not because I got sick, but because I discovered Skate West and boys, and focused on crossing another item off  my burgeoning bucket list: learning to skate backward.

And then came high school and college, and I continued to expect I’d die before I grew old.

Cancer finally struck when I was 35 – see, I told you so -- and I was pretty incredulous when it didn’t kill me. What it did do was enhance my certainty, though, that the disease would in fact be my undoing, because the next time, it would come back with a vengeance.

Imagine my surprise, then, 15 years later, when I was running up a hill and noticed not a tumor, but a pain in my chest. I took a deep breath, and the pain worsened. I walked, and it remained. I arrived home, and it was still there.  I called my doctor and she told me to come in for an EKG.

An EKG?  Excisions and biopsies, I knew. But cardiac stuff … that was foreign territory. I was thrown way off base, and was even more discombobulated when the EKG showed an abnormality. And then my doctor ordered a stress test, and I had no idea how to feel, except scared you-know-what-less.

But in retrospect, I shouldn’t have been that surprised. Although cancer is more high-profile because it often steals people in the prime of life – or even, all too often, childhood – heart disease is thought of as a condition that afflicts old people. And while it is prevalent in older populations, the statistics may surprise you.

According to the Centers for Disease Control and Prevention:
  • Heart disease is the leading cause of death in the United States. People of all ages and backgrounds can develop the condition. And generally, while it’s developing, a person feels fine.
  • High blood pressure (which I have), high LDL cholesterol (which I used to have), and smoking (which I dabbled in long ago) are key risk factors for heart disease. A staggering 50 percent of Americans have at least one of these three risk factors. (Lowering you blood pressure and cholesterol will reduce your risk of dying of heart disease.)
  • These additional factors put people at risk as well, though: diabetes, excess weight, poor diet, physical inactivity and excessive alcohol use. And who among us hasn’t been guilty of practicing a sedentary lifestyle and eating poorly?
  • In a recent survey, most respondents recognized chest pain as a symptom of a heart attack. But only 27 percent were aware of all major symptoms and knew to call 9-1-1 when someone was having a heart attack. Also, about 47 percent of sudden cardiac deaths occur outside a hospital, and this suggests many people with heart disease don't act on early warning signs.

A caveat here: It’s Friday, and I won’t know till Monday what’s going on, if anything, with my heart. But I want to make this point for the benefit of anyone who might be experiencing nagging symptoms:

By and large, the people closest to me are non-alarmists who tend not to react strongly to any medical situation that’s not a clear emergency. So I’ve been somewhat socialized into mentally downplaying any symptom out of fear I’ll be called a hypochondriac if I voice it.

That’s stupid and wrong. The last time I tried to talk myself into downplaying symptoms, I ended up in the ER with a gangrenous gallbladder.

Even if my chest pain turns out to have been unrelated to anything cardiac, I’m glad I've chosen to explore it.  As my doctor told me, “You don’t mess with chest pain – ever. Cemeteries are full of people who said, ‘It’s probably nothing.’”

The EKG wasn’t painful. The stress test wasn’t painful. And together, they’ll tell my doctor and me everything we need to know about what’s happening with my heart.

So: If you have concerns, please – make a call. Go to the ER. Do whatever you need to do. You know you're just going to worry; why not find out, once and for all, what's going on?

And if you’re not having symptoms, make sure you know how to recognize them when and if they appear. Again, according to the CDC, they are:

•Chest pain or discomfort
•Upper body pain or discomfort in the arms, back, neck, jaw or upper stomach
•Shortness of breath
•Nausea, lightheadedness or cold sweats

…and in women, the symptoms may present much more subtly.  

Go ahead; let them call you a hypochondriac. At least you won’t be a dead one.

Wednesday, July 3, 2013

Spelling champion AND athlete? It wasn't possible then, but maybe now.

Can you BELIEVE this girl wasn't an athlete?
I have never been an athlete. As a child, I took tennis lessons and was a disaster; in middle school, I tried my hand at softball and was worse. After my dad stopped by practice early one afternoon and saw me crying while trying to run a mile, he let me quit.

So the fact that I’m running now makes absolutely no sense. There’s nothing I understand about it; nothing except that this attempt may mark my last opportunity to try to not absolutely suck at something physical.

Growing up, I was the spelling champion who wanted instead to be good at kickball.  When we played at recess, I wasn’t chosen last, but I was darned close. I wasn’t bad at kicking the ball, but I couldn’t run fast enough to get on base. If I did happen, by some fluke, to get on, I was more concerned with not getting hit by the ball than I was with making it home.

I was also a larger girl, which didn’t help.  That’s funny to recall now, as I ended up topping out at 5’4” 1/2, but the weird thing was that I reached my full height – and a weight of 140 pounds -- in fifth grade. While the other girls were weighing a flat 90 soaking wet, I could have bench-pressed any boy in my class. So the combination of my awkwardness and my size didn’t exactly lend itself to agility.

The weird thing, though, was that I danced – ballet, tap, and “jazz,” as they called it in those days – and I wasn’t half bad. I was tall, but proportional and, strangely enough, muscular, and when it came to executing dance steps, I possessed none of the awkwardness that I displayed in any athletic endeavor.

(“You’re light on your feet for a big girl,” another dancer’s mom said to me once.  Uh, thanks?)

I also loved music and was able to somehow lose some of my inhibitions in the studio, although I really hated the full-length mirrors and did anything to avoid being in the front row so I didn’t have to see myself in them. I was an endomorph in a room of tiny, lean girls, and sometimes that wore on me. But if I avoided the mirrors and just danced, I didn’t hate my body quite so much.

That sentence really makes me sound more pathetic than I was; I grew up in a very affirming home and was praised for my talents. I really wasn’t full of self-loathing; I was a teenage girl who wanted to be something she wasn’t. That didn’t make me unique, or even particularly miserable.  It just was what it was.

But here I am at 50 – 50! – and I look down at my activity tracker and look in the mirror and wonder, could I be morphing into the woman that that girl so wanted to be?  Sure, I’m a whole lot older.  And a whole lot grayer.  But although I can’t call myself an athlete, I’m running.  And I don’t suck at it.

A few caveats – my goal is three miles, and I’m not there yet.  And I’m slower than slow.  But I get out there every morning, and I push and I struggle and I sweat.  And at the end of my run – in the interest of accuracy, my walk/run combo – I can’t wait to do it again. Not right away, but the next day.

How did this happen?  My daughter wanted an activity tracker, and I bought one for her. And when I saw how cool hers was, I bought one for myself. That was the beginning of the end of normalcy.

You see, I’m a bit competitive. After my surgeries, my physical therapist would get me to work harder by telling me another knee patient could bend his leg farther than I could. The result: I’d bend deeper and deeper until I “won.”  I didn’t find out till later that I’d been “winning” all along, but he had tapped into what made me tick and knew I couldn’t stand the thought of being bested.

When I run, I play head games with myself, using my friend Karen’s trick of pushing just one driveway farther, then the next driveway, then the next. Some days, it’s not easy, but doable; other days, my leg muscles are screaming. But each day, I inch closer to that as-yet-mythical three-mile mark, and I wonder if maybe I should have tried a little harder at kickball.

How many more times in my life will I have the opportunity to set this sort of goal?  At work, we talk about “stretch goals,” but in my arena, they’re not as readily tangible as this one. As I become able to run for longer distances, it’s as if I can feel muscles popping out where there had seemingly been none. I see the changes, and I feel strong.

I also feel … realistic. As my friend Gretchen wrote in response to a Facebook post about my running, “At your age, the goal is to not hurt yourself, and I’m not even kidding.”  I know I won’t be able to do this for long; half of each of my knees is a prosthetic, and one of my hip joints is on its way out.  And I’m by no means a natural runner; where others have lean muscle mass, I have still-jiggling masses of flesh.

But to be overly simplistic, it feels great to do something hard. And it’s affirming to be doing this as an old person; unlike in my angst-ridden middle-school days, the 50-year-old me could give a rat’s you-know-what how I look as I trudge alongside a busy street. 

As my Weight Watchers pals say, even as slow as I am, I’m still lapping everyone on the couch. I wish I could go back in time and tell the 13-year-old softball-wannabe me to stick with that mile run just a little longer, because eventually, I would have gotten there.  Sure, 37 years is a long time, but a finish line is a finish line.