Sunday, June 16, 2013

Happy Father's Day and Please Take Care of Yourself


First, I want to wish a happy Father's Day to all those celebrating today.

Next, I want to wish a happy Father's Day to my husband, David, who is the father of my wonderful children.  David is the best of husbands and fathers, and I hope my children realize how fortunate they've been with their random act of birth to have lucked into a life with the kindest, most attentive, loving, and supportive of dads.

Finally, I want to dedicate this post to the legacy of my own father, Jerry, and to the memory of my brother, Ross.  As I mentioned in the post I put up recently where I had my father as a posthumous guest blogger on psychoanalysis, my father died of a heart attack at 40, and he departed this world before I was old enough to sustain memories of him, so I was left only with his wonderful legacy.  My father was among the 30% of people whose first heart attack is fatal. He didn't know he had heart disease and was out shoveling snow when he had chest pain.  He went to the hospital -- this was before the day's of CCU's and cardiac protocols-- was placed in a private room, and was later found on the floor,  presumably having died of either another heart attack or an arrhythmia. 

I last spoke to Ross on Mother's Day.  I had called him two weeks before and he was curt on the phone, "I'm cooking dinner, I'll call you over the weekend."  He didn't call that weekend and I was vaguely annoyed, but the next weekend, I got a warm message wishing me a happy Mother's Day and he mentioned that he had called me back the previous weekend, he just hadn't left a message.  He said I didn't need to call him back, but I wanted to speak to him, and I am so very glad I did call back.  I don't remember much of what we talked about, it was just the usual.  He mentioned he was giving talks in Vancouver and Sweden, and that his wife would be coming to Sweden with him -- their children were finally old enough that they could leave the youngest alone for an extended period of time -- and they would be taking their first trip to Europe together.  He sounded happy and all was good. 

When your father dies at 40, you worry.  Ross worried, I worry.  Ross was meticulous about life style issues, especially as he got older, and his cholesterol had once been high, there was transient concern about a slightly elevated blood pressure reading in his doctor's office.  He did not want to take medications, so he modified his diet, exercised daily, checked his blood pressure, weight, and heart rate daily. He had never smoked or abused any substances.  His numbers all normalized and his lipid profile was fine, because lifestyle changes can do that for you. He'd had a negative stress test years ago, and a normal cardiac echo not as long ago.  So in excellent health, at his high school weight, with the blood pressure of a teenager, my brother did his usual exercise then went to rest.  His wife assumed he was napping, but Ross had died.  He'd had asymptomatic coronary artery disease and hadn't known it.  We didn't live near each other, and I didn't see Ross regularly, but the last few week have been a real struggle for me, and I feel so sad for my brother who had so much to live for, and for his wonderful family who now have to recreate their lives without him.  I keep thinking that I feel so sad, but my poor sister-in-law, his wife and soul mate of 33 years, must be suffering terribly, yet somehow, she and my wonderful nieces seem to be holding up valiantly.  I am so proud of them.

So I want to use my post today to plug for a few things.

  • If you have a personal or family history of heart disease, don't assume that you're fine because you feel good and live a healthy lifestyle.  My brother lived significantly longer than our father -- no doubt because of his lifestyle efforts-- but perhaps a more aggressive search for coronary disease would have helped.  If you're at risk, genetics may trump all -- see a cardiologist even if your numbers are normal.  40% of sudden cardiac deaths occur in people with LDL-C's (bad cholesterol) in the normal (less than 130) range.
  •  We hear constantly -- in the media and from our doctors -- that lifestyle issues are a major factor in morbidity and mortality and this is likely true, however  there is an underlying harmful message here.  If you're sick and your lifestyle isn't perfect, it's your fault. And if you do everything right, you'll live a good long life.  Neither is necessarily true, but I believe the first message stops people from going to the doctor because who wants to be told that they're problems stem from their weight issue, their lack of exercise, from drinking too much, from eating the wrong things, from smoking, especially if you've tried to make changes and haven't been able to.  If you have lifestyle issues, try very hard to change, but if you can't, go to the doctor anyway.  Address your issues with medications, even if you can't make the necessary lifestyle changes -- you may live a longer and healthier life.  And while it's not in vogue to promote the pharmaceutical industry, the truth is that Americans are fatter than ever and live longer then they did back in the days of thinner people.  I believe this is from less smoking and from the benefit that medicines give people in dealing with blood pressure, heart disease, and diabetes.  If your doctor hassles you and you know you can't, or won't, change, remind your doctor that skinny people have high blood pressure and athletes die of heart attacks.  And if your doctor is not helpful, get a new doctor.
Happy Father's Day, please take care of yourself.



15 comments:

Anonymous said...

Powerful post, Dinah. Sending love from a relative. xoxo

Tigermom said...

Big hugs Dinah.

Sarebear said...

My father in law has had several heart attacks. He snores awful and has sleep apnea, but the sleep test people test him and tell him that but then say just lose weight it'll go away . . .uh, HELLO? Sleep apnea is hard on the heart . . . and he HAS lost weight, is pretty well that way for his age now. Still seems to have the apnea . .

So, a couple years ago my husband's snoring and night breathing seems to be apnea-ish, and bad. . . he was out of work for several YEARS, and only just barely got insurance last fall. So, he got a physical this spring (we had a cancer scare in there too, for quite a few months), and they sent a device home with him to test his sleep breathing/oxygenation or whatever. $450 test, to screen for if he needs the $3000 overnight sleep center at the hospital one.

He does, but our health insurance stopped later that month because his employer quit offering it to anyone below supervisor level less than six months after we got it, and the doc didn't get back to us with results on the sleep thing for 6 weeks. He DOES need the $3000 test. No insurance, and that is all of our savings.

Genetics mean alot, and sleep apnea is hard on the heart, and he's 42, ten years or less from his dad's first heart attack . . . our car is old and may need replaced and without that money we can't but you can't replace a person either.

Going to check out the financial aid poor people options the hospital has but I'm not sure he can get the test if we can't pay for it. Which means if he does have this (and i've heard and seen his breathing/chest catch and stop when everything closes up apnea wise) it's slowly doing harm to him.

There's some other reasons to be concerned cardiovascularly as well but I've said enough about his personal medical stuff . . . It's worrying. I'm thinking just pitch all the money at the test, and hopefully he doesn't have anything, but I don't know. His job isn't the most secure and one wants to have a little money for expenses if he loses his job.

It is his LIFE at stake, but since the harm happens slowly over time . . . it's not clear cut like a bleeding wound, but I guess with his dad's history it is clear enough. He's resistant to spending all our money though.

What can you do?

Dinah, I'm so sorry for the loss of your brother. Hugs and thoughts and prayers.

Dinah said...

Thank you, Tigermom and relative!

Sarebear, here's a link:

http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=684&pageaction=displayproduct

I don't know that much about sleep apnea. Sometimes when tests are intrusive or expensive, I ask, well what if we pretend the problem exists and treat it. I did this with the dog once-- the test to confirm Lyme disease cost $75 and the antibiotics to treat it cost $28, so the dog got a course of antibiotics for maybe having Lyme disease.

If your husband's father had heart disease at a young age, he may want to ask his doctor about cheap things like baby aspirin and statins (which now run $10 for 90 pills).

Tampa Mom said...

I know I need to see a dr. I've been thinking and worrying about it more and more lately, but I just can't bring myself to go. I am now the age my biological father was when he had his first two heart attacks (38). He did not live past age 50. By all outward observations, I have a far less healthy lifestyle than he did (I am significantly overweight). There is also a strong family history of heart disease on my mother's side of the family. I have had issues with my blood pressure since I was a teenager, but I haven't taken any BP medication for several years. I've had some experiences lately that have me convinced I have sleep apnea...jerking awake and having to catch my breath. But I also have PTSD and an extended trauma history (as well as being bipolar). There is absolutely no way I can go through a sleep study where I am being observed by strangers while sleeping. Absolutely not going to happen.

I do not have a primary care physician...other than my psychiatrist, which admittedly I don't see as regularly as I should, it's probably been at least five years since I've seen anything more than an occasional visit to an urgent care dr for a minor illness or injury. I do have insurance, I just can't seem to get over my anxieties and make myself take the step of finding a new dr and getting checked out. I have myself convinced that I know what kind of tests they would want to have done and I'm not willing/able to go through all of them so why bother going to the dr at all.

It does scare me, though. I am a single mother to an 8-year-old little girl. She needs me. This seems to be the one thing I can't or won't do for her.

Dinah said...

Dear Tampa Mom,

Please go see a doctor. Do it for your little girl, she deserves to have you around. Do it even if you aren't going to have a sleep study. If nothing else, getting medication to address your blood pressure may lengthen your life, prevent end organ damage, or prevent you from having a devastating stroke (in my opinion, there are things worse than death). As I tried to convey, there are things beyond lifestyle issues that can help.

There are no guarantees, but at least with Ross we knew he was seeing a doctor, actively addressing his issues, and there is no anger at him or regret.

Please get back to me. I will feel better if I know my post encouraged someone at high risk to address their health issues.

Judith Kastenberg said...

Some facilities will give you a lower rate for medical tests and fees if you ask. For example, I know patients in my area can get labs performed for lower then the sticker price if they ask.

Good luck.

Sunny CA said...

I am so sorry Dinah. What a heart rending story of the loss of both your dad and brother.

Today, my friend and I were talking about things in life we have control over versus those things, usually bad, that just happen and change our lives forever. The loss of your father and brother are the type of bad event we were talking about. All seems well, then through no fault or mis-action on your part.... bam!

I send a thousand "I am so sorry"'s to you and (((hugs))).

Anonymous said...

Dinah, my deepest sympathy for the loss of your brother.

Sarebear, please visit www.cpaptalk.com and mention your situation. There are extremely helpful folks on that board who might be able to point you in the right direction.

AA

jcat said...

Dinah, that was a beautiful post. I'm someone who checks all the wrong boxes on the lifestyle quiz - overweight, smokes a lot, drinks more than I should, eats badly, very little exercise, takes psych meds and the only doc I ever see is my psychiatrist.

I can't seem to make myself care enough about myself to do anything about the lifestyle, but what you said has made me think a bit, especially your comment about no anger at Ross or regret.

I'm lucky enough to still have both my parents, and a sister I adore - maybe for them, I can at least find a GP and get a general health check.

Sorry for your loss, but I'm glad that you at least had that last, good chat with your brother by phone.

Anonymous said...

Dinah, I'm late to the game but I would like to say how sorry I was/am to hear about your brother's death.

--I think [ergo] I am not a robot.

Anonymous said...

Tampa Mom, what about having a home sleep study? That is how I was diagnosed with sleep apnea. Not as accurate as a full scale study but I understand their accuracy has improved.

In light of your family history with heart disease, I would strongly urge you to look into this in light of the fact that having apnea can lead to heart problems and that you're having symptoms of it. Again, as I mentioned to Sarebare, cpaptalk.com is a great source of information as many members are very helpful.

AA

HIGurl said...

Dinah,

My condolences to you and your family on the loss of your brother. (hugs)

I want thank you for sharing a piece of your life with us - I hope this post will reach out to all your readers. It did, for me.

Like you, I worry (about CAD). My mother passed this past December 23rd, just twelve days shy of her would-be 63rd birthday and on the day of her 42nd wedding anniversary, of an arrhythmia (bradycardia). She was a diabetic, diagnosed in her teens and never took care of herself until recently (last 10 years). She was a hemodialysis (pre-peritoneal) patient and had triple-bypass about six years ago.

Like my mother, my only brother is following in her footsteps. He's five years older than I am and at the age of 35 (about 4 years ago) had a heart attack and quadruple-bypass surgery. I cringe at the fact that he has two very young children (19-months & 6-months) and does not take care of himself. He doesn't take his medications like he is supposed to - and he too, is diabetic (type 2) and has high cholesterol/blood pressure.

I honestly thought he was going to change his lifestyle after the surgery. He kept saying that he didn't want anyone to go through what he did, that he wouldn't endure another surgery. For a while, he didn't eat meat. But that was short-lived. Even seeing our mother suffer didn't phase him.

Like you, I worry. I'm like your brother - well, sort of. I don't smoke or drink alcohol. However, I'm a type 2 diabetic, also diagnosed in my teen years. Went from oral meds to insulin and back to oral meds. I don't have high cholesterol but because CAD runs in my family, I take Simvastatin. I try to take care of myself. I exercise almost daily. I stopped eating any meat (beef, pork, chicken and the like) since Lent began this year. I also take SAMe for mild depression. And even though I know the SAMe shouldn't cause me to have elevated homocysteine levels (especially since I don't eat animal foods), I worry enough to take Vitamin B Complex.

My total cholesterol 7 months ago was 133, so my Simvastain dosage was cut in half. Having too low of a number concerned me enough to bring it up to my doctor (and she agreed). This month was 167. It's up a little but like you said, you can't really help the genetics factor. Good numbers is just good numbers.

The main thing is that you take care of yourself to the best of your ability. Live life to your fullest. Embrace moments. Share moments. Just live life.

Dinah, thank you again for such a touching post...

Dinah said...

Thank you, everyone, for your kind sympathy wishes.

Hi Gurl, I'm sorry to hear your family has such awful health issues. Please don't be angry with your brother, it sounds like he's trying, lifestyle changes are difficult and people have powerful pulls towards things they should avoid, more so for some than for others, and the genetic issues sound powerful. At least he had the bypass and takes his medications.

Obviously, I don't like to blame people for their vices. I'm not perfect enough to sit in judgement of others. We all struggle to do our best, it's just so annoying when someone does it all right and they die young anyway, while there are those who eat cheeseburgers, chugging beer, and smoking away and still make it to their 80's.

HIGurl said...

Dinah,

I'm not angry with my brother. As selfish as it may sound, it really is his life and not mine. He's an adult, capable of making his own decisions. I do, however, worry for him and his children. He is family.

It only bothers me because he knows it's important to eat healthy, exercise, and take his medications - which is what he said he was going to follow yet does the exact opposite.

Stress eating. Excuses for not exercising. Forgetting to take his medications. Comparing my health (e.g., no HBP or HC) to his. More stress eating. That's my brother.

I know change isn't easy, no matter how easy or hard it may be. And I know that change can be an overnight thing or a never-there thing. Maybe if his wife was more supportive, she would try to eat healthy too.

I've tried to be a role model for him. Me not eating animal products has got him thinking again. The other day, he told me he was thinking about going back to a restaurant and ordering the same dish but without the chicken. I know he's still trying and I give him credit.

Our family physician keeps telling me that it must be a genetics-thing, for my brother (and father) to be like my mother. Stubborn. I always laugh and ask her where I came from because I'm not like them. But she knows, like you, lifestyle changes aren't easy and that everyone reacts differently.

I work with senior citizens and can see the frustration as you do. We have elderly clients in their 90s who eat terribly (and vise-versa). And we also have clients who look and eat healthy, who end up having a much shorter life. It is annoying, yes indeed. That's life, right?