About 700,000 of us will die of heart disease every year; most of which is preventable provided we become proactive patients.
But you do need to know that for most “heart patients”, dying does not come quickly, like a dart falling from the sky, fatally nailing you, as you clutch your chest, your friends desperately tapping 9-1-1 on their phones, with you stone-cold by time the ambulance arrives.
Quick and painless? You should be so lucky.
Let’s say you or your significant other is a typical ‘heart patient’. After pretty much paying half-assed attention to your doctor’s advice over the years, suddenly somewhere in your 40’s, 50’s or 60’s, you’re told you’ve had a small heart attack.
“Jeez? Me? A heart attack?”
You’re offered the hospital’s Cardiac Rehab Program. You sincerely mean to start (don’t feel bad, only 20% of eligible patients bother to show up).
Now slowly, but inevitably unless you become a seriously proactive heart patient, you will go into a decline ending with a statistically shortened lifespan. Note the “unless you become a seriously etc. etc.” Your symptoms will likely include chest pain with minimal activity, shortness of breath, chronic fatigue, palpitations (arrhythmias), which your doctors will try to treat with pills, then more pills. Maybe surgery, a wheelchair at home, applying for disability, and, if you manage to survive, moving into a long-term care facility. Most patients in long term care facilities have dementia, are stroke victims, or have chronic heart disease.
Finally, at a certain point, many realize they’re just going through the motions of life. Studies have shown about 40% of chronic heart disease patients suffer clinical depression, a number that to me seems low.
So let me make myself clear on this and then you can go back to your Cinnabon.
With COVID under (reasonable) control for the time being, and, if you read last week’s press releases, the actual number of cancer deaths are dropping in the U.S., the most likely first line item on your personal death certificate (you do realize you’ll have one, someday, don’t you?) will likely be related to your heart or your vascular system (arteries, like from a stroke).
Having practiced internal medicine with a subspecialty in geriatrics before switching careers into integrative medicine, I do know something about what I’ll be telling you.
Group A (Where I Want You)
You have been healthy well into your 90’s, hopefully your late 90’s. You’re on no meds but you continue to take your supplements. You’ve toned down your exercise program but certainly haven’t stopped it. You go to sleep one night and are found dead in bed the next morning unless some idiot medical resident tries to resuscitate you, but you’ll have made an advance directive, “Do Not F—k With Me”. This is a nice cardiac death. Wouldn’t mind it myself.
Having ignored your doctor’s pleas to stop smoking, lose weight, exercise, the most you’ll do is take the prescribed statin, and that erratically. Your coronary Angio shows several blockages; you’re scheduled for a quadruple bypass graft surgery. You’ve just signed an operative permit and read the word ‘death’, and your mouth has become very dry. You’re 63 years old and you swear you’ll stop smoking and even cut back on the Lou Malnati’s.
During the next few weeks we’ll talk about moving from Group B into Group A. This takes work.
Don’t expect ‘nice’.
David Edelberg, MD