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.

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