What you donʼt
know CAN hurt you
Even though we all come from a variety of
backgrounds, locations and occupations, the one thing we have in
common is our passion for playing baseball.
Once we set foot out on the baseball diamond,
we will do anything to hold onto our youth. We will sprint down the
first base line, trying to stretch a single into a double with our
guts hanging over our belts, running on our surgically repaired
knees. We will dive to catch a fly or ground ball trying to make
that spectacular play while our not-quite-so-nimble muscles
painfully remind us of our attempt long after the play is over. Once
we are out there, we will do whatever it takes.
Our life experiences give us a wealth of
knowledge. But our intelligence goes right out the window when it
comes to our own health.
I would like to share my story with you and try
to educate you on a subject and hope that by reading this article,
you will learn a few things about cardiac awareness, your risks for
heart attack (or worse), and some tools that might save your life.
I have been an Emergency Room Physician for the
past 25 years. Nobody should be more aware of the warning signs than
me. I’m supposed to know better! But when it came to my own health,
my competitiveness and desire to hold onto my own youth made me as
dumb as a box of rocks.
I have been playing organized senior baseball
for approximately 18 years. I am not in the best of shape, but I am
also nowhere near the worst. I exercise, go to the gym, try to eat
right to stay in reasonably good shape.
In 1998, I had a routine Exercise Stress Test
and was found to have a blockage in an artery of my heart. I had a
stent put into this vessel (a stent is a device that keeps the
artery open and protects the circulation to the heart muscle).
This experience opened my eyes to the need to
continue to eat right, exercise and pay closer attention to my
health. A few years later, despite feeling good and having no
symptoms, I had another stress test and was surprised to learn I
needed another stent. After that, for the most part, I continued to
tried to do the right thing, to eat right and increase my exercise.
I know that as we get older, we have more difficulty staying in
shape, but staying on track was essential to me. However, despite
all attempts to maximize my own health, I felt that something was
wrong with me.
Recently, while playing baseball, I got so
short of breath from minimal exertion that I knew it was time to
shut it down and get properly checked out again. After I had myself
evaluated with another cardiac catheterization, it turned out that I
needed a quadruple bypass with over 90 percent blockage of four
major arteries to the muscle of my heart. This was a surprise since
less than one year prior to this exam I had a stress test with the
best results I had had in years.
Now the one thing that is important to repeat
is that I am an Emergency Room Physician. I am supposed to know
better and I didn’t. We are all out there trying to turn back the
clock, but we are not children and we need to be aware of some
simple facts.
Coronary Artery Disease is a major problem in
this country and around the world. It affects millions of people and
it can affect any one of us. You don’t have to be heavy and out of
shape to be at risk. And what every one of us out there should know
is that sometimes the first symptom of Acute Coronary Syndrome
(where the heart muscle is acutely robbed of oxygen) is Death!
You don’t always have to have chest pain,
shortness of breath or any other symptoms. Sometimes the symptoms
may be more subtle or vague. In my occupation, I have seen people
die in their twenties. In this day and age when we are forced to eat
junk food as we go to work, internalize much of our job and personal
stress, deal with supporting our families and paying our bills, if
we are not careful, some of us are at major risk.
Simply by being aware of a few important facts,
we can make it safe to play the game we love. I want to educate you
and make you aware of some key facts that you need to know to play
it safe. Here are some major risk factors for developing heart
disease and some of the things you can do to minimize your risk. The
more risk factors you have, the more risk you have. These risk
factors are cumulative.
Family History
This, in my opinion, is one of the most important risk factors.
If your mother, father, brothers, or sisters have heart disease, you
can have heart disease. If you are not in “good shape,” your risk is
probably greater. But you are not excluded from risk even if you
think you are fit. Like colon cancer, breast cancer, diabetes and
many other health conditions, if you have a family history of heart
disease you are at risk and you need to be properly evaluated.
Hypertension
Hypertension, or
high blood pressure, is extremely common in this country. It truly
is a silent killer, and you may have high blood pressure and not
even know it. Elevated blood pressure increases the workload of the
heart and slowly weakens the muscle. If you have high blood
pressure, while you exercise it can further elevate, putting you at
risk for a heart attack, stroke or worse. See your physician and
check your blood pressure. Make sure it is controlled with blood
pressure medications. Lower your salt intake. Managing your weight
and exercise properly.
Cholesterol and Triglycerides
Hyperlipidemia or elevated cholesterol and
triglycerides is another risk factor for the development of coronary
artery disease. If elevated and out of control, plaques can form and
slowly cause blockage of our arteries and rob our heart muscle of
its circulation. Some of us can control our cholesterol and
triglycerides with diet by eating less fatty foods, especially less
saturated fat. However, some of us need medication to control our
hyperlipidemia. Be aware of your cholesterol and triglycerides and
do your best to control them.
Smoking
Smoking is another risk factor for the
development of heart disease, not to mention emphysema, cancer and
other circulatory problems. There is not much to say about smoking,
you make the decision. If you want to minimize your health risks –
Stop!
Diabetes Mellitus
Some people have had the onset of diabetes as a
child and some people develop it later as an adult.
As we get older, some of us develop an impaired
ability to metabolize glucose and our own blood sugar elevates,
especially if we are overweight. This can lead to hardening of the
arteries and the development of heart disease. Some of us can
control our blood sugar with diet, some with oral medication and
some of us need insulin. Proper glucose of blood sugar monitoring is
essential for detection of diabetes and minimizing this risk factor.
Drugs
Although drugs are not considered a major risk
factor, if you are prone to coronary artery disease and you are
foolish enough to take them, you might as well step in front of an
oncoming train. The most dangerous are cocaine, methamphetamine and
other stimulants such as diet pills and even some over the counter
products. Supplements with Ephedra, some cold preparations with
antihistamines and decongestants can elevate your blood pressure and
heart rate and increase your risk of a heart attack. The advice here
is simple – stay away from these illegal drugs and use these over
the counter medications with extreme caution and only if your
physician says they are safe for your consumption.
Awareness and Prevention are Key
A proper physical examination is essential to
closely monitor the different risk factors that may contribute to
the development of heart disease. A physician who only checks your
blood pressure, pulse electrocardiogram, chest x-ray, and blood
(including cholesterol and blood sugar) may not be doing all that he
or she can do to insure that you are healthy to play.
Medications for blood pressure, cholesterol,
elevated blood sugar and blood thinners such as aspirin are commonly
used to control your cardiovascular risk. However, if you have
multiple risk factors, or if you think you may be symptomatic with
chest discomfort, shortness of breath or any unusual discomfort with
exertion, a thallium exercise stress test is essential. Not only is
it important that you exercise monitored on a treadmill, the
injection of thallium (a radioactive nuclear material) is vital, as
it can detect blockages of circulation to the heart. Many times I
did well and passed my treadmill test only to find out after I was
injected with the thallium that I had blocked arteries. A treadmill
exercise stress test is incomplete and can miss heart disease if the
radioactive thallium is not used.
If a thallium stress test is abnormal, a
cardiac catheterization is essential. This is done in a hospital
operating room. A small catheter is placed in an artery (usually in
the groin) and passed up to the heart where a special dye is
injected that allows physicians to visualize the cardiac circulation
to determine if there are any blockages. It is here that proper
treatment of arterial occlusions can be determined. The treatment
can be as easy as the placement of stents, a small device which
opens the artery and unblocks it. Multiple blockages may sometimes
require bypass surgery to repair the problem.
Well, the good news for me is that I am healing
nicely, back to work full time and starting to play baseball again.
And I just can’t wait to do the same stupid things I need to do to
feel young again. But it is important to realize that our lives are
precious, not just to us but to our families. Even though we may
feel young, it is essential to make sure we are healthy on the
inside.
Awareness and prevention are the keys. We must
take a proactive approach to maintain our health. There is truth to
the statement that “you are what you eat.” Eating foods high in
proteins, low in saturated fats and proper carbohydrates such as
whole grains and non processed sugars are essential. A proper and
safe exercise routine is also necessary.
These preventative measures plus proper
screening for a variety of illnesses, including those that put us at
risk for the development of heart disease, will allow us to go out
there, have fun and play it safe.
To contact Dr. Gershenbaum directly email him
at erdoc18@gmail.com
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