On the One Year Anniversary of my Heart Attack

So August 26th of this year marked the one year anniversary of my heart attack. I actually haven’t written a blog since the one I wrote about that day. That’s not as significant as it might sound – I have rough drafts for 3 different ones that I started but I’ve been busy with other things and haven’t devoted as much time to writing as I’d like (something I regret quite a bit). But for the anniversary of H-Day I thought it would be good to write an update on what has happened this past year. I don’t think a chronological narrative would make much sense, and besides, I don’t have that great a memory. So I’ll go with more of a stream of consciousness approach.

As you may know I am a high school math teacher. The heart attack happened exactly one week before the start of the 2014-2015 school year. Although many people couldn’t understand how or why I did it, I actually worked right from the first day of school. I certainly could have taken some more time to recover, but I didn’t feel I needed it that badly and the doctor said that if my job didn’t require heavy lifting and I felt okay there was no reason not to work. My reasoning for starting was that it was easier for everyone involved – students wouldn’t have to adjust to a new teacher twice, the school wouldn’t have to scramble to find someone to cover my classes and my colleagues wouldn’t have to worry about teaching more than their own course load. Now, almost a year later, I can say that the decision to start right away was neither good nor bad. If I had waited things would have been just as fine as if I had not. It’s funny how so many decisions in life seem important when they really are trivial. I took things easy at first and let my body tell me when I could ramp up, always erring on the side of caution. For example I took the elevator instead of the stairs for a couple of weeks, and kept my boardwork lower on the board (so as not to raise my right arm too high after the angio) for about a week.

One thing that I learned from my first follow-up with the cardiologist was that I have no “modifiable risk factors” for heart attack. Basically it’s good old genetics. I don’t drink or smoke. I have low cholesterol and low blood pressure. At the time of the heart attack I was overweight but by no means obese. I was keeping fit with heavy weights and regular though limited cardio. This was disturbing news – I mean it would be nice if I could just stop something I was doing and know I was preventing another heart attack, but as the cardiologist said, at least now I know. I had three partially and one fully blocked arteries, and except for one of the partials they were all stented. The one that was not stented is very small and doesn’t supply a large area, so that other arteries nearby can cover what it doesn’t manage. I am on a cholesterol medication that has been shown to prevent plaque buildup in arteries and even to slightly reduce existing plaque. I am hyper-aware of my heart so if anything does deteriorate I will be on it right away. In the meantime I decided to do everything I could do. As soon as I got the green light to resume exercising I began a cardio regimen of 45 minutes, 5 times per week. As of this moment, I have averaged exactly that. I say averaged because there were three weeks where I didn’t manage to get all 5 sessions in, but always compensated in succeeding weeks by adding sessions. Three different vacations didn’t keep me from my cardio. Some people tell me “Hey, you’re on vacation, give yourself a break.” My response is my heart doesn’t know I’m on vacation, there is no such thing as a break.

I also cleaned up my diet. Not that it was that terribly unclean to begin with. But I did eat a lot of red meat (3-4 times per week, sometimes more), and 2-3 times per week allowed myself cheat meals like KFC or Burger King, or just really decadent meals at restaurants. Now I eat only lean red meat, and only 1-2 times every month. I’d say over the past year I’ve probably had red meat about 15 times. My protein mainly comes from white meat chicken, fish, and some vegetarian sources like beans, quinoa, and nuts or nut butters. I eat very little fat, and almost no saturated fat. What fats I do eat come from the fish or chicken, or light salad dressing, which I use extremely sparingly. I don’t measure my food, but I never eat until I am stuffed. That’s also a change from before. For this entire year I have not felt stuffed even once. And I still eat a lot – probably 7-8 times each day. A lot of fruits, berries, vegetables and nuts fill out my diet.

So what the diet and cardio have done is resulted in fat loss. I spent my entire adult life struggling with fat loss – often successfully but not always. Each time the goal was fat loss. Now the goal is not that at all. The cardio and diet are to keep my heart healthy. The fat loss is a side effect, albeit a pleasant one. When I had the heart attack I weighed 225 lbs (down from an all time high of 245). Because I am a hobby bodybuilder that’s not as heavy as it sounds, but I was certainly carrying too much fat by an obvious margin. My weight this this morning was 189. I won’t lie and say that I’m ambivalent about that – I am overjoyed. But it wasn’t and isn’t the goal.

Speaking of exercise I also resumed lifting weights about 6 weeks after H-Day. This was with the doctor’s blessing. At first I kept things very light and let my body tell me when it was ok to go heavier, again always erring on the side of caution. I don’t remember the exact timeline but I’d say after about 3 months I was more or less back to pre-heart attack form. The weights and the fat loss are visually pleasing to me. Here are a few vanity photos of the impact this has had on my look.

IMG_0160 IMG_0683

IMG_0078  IMG_0159

I’d actually like to include a photo I took when I was 245 lbs but my computer is currently deciding I’m not allowed to look through old photos – thanks Windows 10.

The great news is that after the heart attack the cardiologist who saw me at the hospital said my heart was damaged (on a scale of 1 – 4 where 1 is the best, mine was a 2), but on my six-month follow up visit I had managed to return it to a level 1. The words of the cardiologist were “Except for the presence of the stents you have the heart of a healthy, athletic adult male with no sign of trauma.” And that, ladies and gentlemen, mattered profoundly more to me than how I look, although that is what people see.

Whenever you lose a lot of weight, or otherwise significantly change your look to something more aesthetic, people always want to know how you did it. The truth is I did it by having a heart attack. That flicked a switch in my mind that had never been flicked before. I no longer have a choice about eating well and exercising, which can read differently than I mean it. What I mean to say is that I know all to well what a struggle it is to have to make good decisions about healthy eating and exercise. To choose not to have a sundae and opt instead for the fruit salad. For me, now, the sundae is not a choice. Nobody is forcing me not to have it – it has been removed from the list of options by something outside my control. It’s actually pretty liberating. So my answer when people ask how I did it is to say “Well, step 1 is … you don’t want to do step 1.” Because Step 1 was have a heart attack. I didn’t decide to start looking better and then do something about it. I had a heart attack and this is how I am doing my best to prevent a repeat. I will say that I have had the odd dessert here and there. But each time I have done so it’s literally been a tiny forkful (as in just the tip of the fork) so I could taste it. The forkful concept would have seemed ridiculous to me a year ago. Now it is legitimately enough. I don’t have the forkful and then look longingly at the rest, wishing I could have more. The forkful does what I needed – it gives me the taste and that is enough. Once again this is not a choice I am making, or a philosophy I am forcing myself to embrace. It just is the way my brain works now – I didn’t deliberately activate it. If I did I would write a book about how. Another example is that there have been 4 times (no, I’m not counting I just remember them) when I have eaten one french fry at a meal. Because I wanted the taste.

Emotionally/psychologically it would be a lie to say I have not been affected. The day I had the heart attack one of the reasons I didn’t call an ambulance as soon as I should have is because I didn’t want to scare the kids. There’s no way around the fact that when your dad has a heart attack it’s scary. Same goes for my wife. The very last thing I want to do is scare them or have them worry. That said I am now hyper-aware of what is going on in my body, and especially my chest. And guess what? Chest pain happens, and it’s not generally a heart attack. Gas happens (especially because it is a side effect of some of the medication I am on). The pain can cause anxiety. Anxiety can cause chest pain. It’s a hilarity-filled ride. I can’t specifically recall how the heart attack itself felt – I just know it hurt but was not as intense as you’d think. I feel as though if it were happening again I would be sure. But I’m not sure if that’s true. So there are days when I find myself worrying. However with the cardio regimen I’m on I can always reassure myself that I wouldn’t be able to do 45 minutes of intense cardio without accompanying intense pain if I was actually having another heart attack.

On that note, when I started the cardio after the heart attack I was keeping my pulse rate in the 120’s, although my doctor did say I would be able to push it higher as I healed. As of today I usually use my elliptical machine (I have a gym in my basement although it has evolved since that blog about it), and the heart rate monitor I bought shows I’m keeping my heart rate in the 140-150 zone, which I made sure was ok with the cardiologist. Speaking of heart rate, I also take my blood pressure daily, and it stays in the 115/75 zone, with a resting heart rate of around 60 bpm.

One thing I have found recently (as in, the last 5 weeks or so) is that drawing is great therapy. It is extremely calming and does a great job of centering my thoughts. I highly recommend it. Another thing I’d have said if you’d asked me a year ago was that I can’t draw for beans. I never really believed I had any talent in that regard. But I have watched hours of YouTube tutorials and have been drawing every day. The therapeutic aspect can’t be overstated. It turns out when you practice something you also improve. Here is one of my earliest attempts at a portrait and one of my most recent ones. I’m no pro and may never be one, but the improvement is real and that’s only about a month. Therapeutic, fun, and inexpensive – I highly recommend it.

IMG_0442  IMG_1164

Wow. Ok this really has been stream of consciousness style. My writing is usually more organized than that. Ah well. This one wasn’t about writing, more about an anniversary summary. I admit I didn’t proofread that carefully either – forgive the errors. I am always happy to answer questions or offer assistance if I can. Leave me a comment and I will respond.

Thanks for reading,

Rich