Monday, February 8, 2010

Women and Heart Disease: The Heart of a Woman

Here it is: the final chapter - of the manuscript, not of life. Life keeps changing and I keep marveling at it. My little grandsons are the light of my life, beyond all expectations and my heart health continues to improve! I recently lost about fifteen pounds (a brain change!), which wasn't really necessary but is such fun... I never thought I'd be called "skinny", and in truth I'm not (middle-age spread anyone?), but I'm taking less medication and have more energy. The other news is that you can catch me on UTube doing a video for "Go Red for Women" and on a medical segment on CBS news with Dr. Holly Phillips which aired on February 4th. It's all enjoyable and I am so glad to have venues for my goal of educating health professionals and especially women, so we not only survive but we thrive. I'll probably write from time to time, but I sure would like to know my "audience", so please sign in and "talk" to me! I hope I've reached someone out there...

Adaptation: Skillful Thriving

By now you are well on your way to physical recovery and may be examining and perhaps reworking any lifestyle patterns which are not helpful. After all, what choice is there? You could not possibly stay in one place as you read on, exploring your own life each day. If this does not ring true, try re-reading the initial phase of this book - and the other wonderful reams of pertinent material out there. If you are really stuck, do not give in to feeling sorry for yourself and do not give up. You are inherently worthy of that further effort of exploration no matter how intractable you may find yourself! Besides, we all retreat, regress or have doubts from time to time, so be patient with yourself, but do not let yourself off the hook.
Adjusting to being a "heart patient" - and I freely admit to my continued discomfort with the term, still looking around me under the pretense that there must be another person in the room to whom that reference is being made - is far from simple and can be a lengthy process. I'm no Pollyanna and in fact am known for my realism, tinged with the optimism to which I have referred. Accommodating to an unwanted situation is a heavy burden, but failure to adapt is even more cumbersome. A modicum of fear may always co-exist with the prevailing feeling that you will live a long, productive, interesting life. I have reached a "this is it" point and know that whatever the damage or difficulty, there is ample solace in that the field of cardiology has more than ever to offer us if further treatment becomes necessary.
The challenges for women are unique: we must campaign for inclusion in more thorough, longitudinal studies. We must educate ourselves to avoid unnecessary incidents based on ignorance. We cannot allow ourselves to be ignored and need to take steps toward self-advocacy leading to prevention, by speaking up and insisting upon receiving the attention and medical care to which we are entitled. Perhaps we need to get political, going to bat for our inherent right to be taken seriously. We are dying of heart attacks at a terrifying rate and yet have not been properly informed. Gender differences in communication are widely studied, but how many women, their physicians, friends and family are aware of the crucial differences, literally in our hearts? We cannot afford to wait passively for this education to take hold: it is killing us at a rate of one in three, some of us at ages far too young to die. More women die of heart attacks than of the three other major causes of death combined. We must come forward to each other and to health care professionals – ladies, it is time to roar!
For me and many, many heart patients, the alterations in lifestyle due to having CAD are actually rather minimal in the scheme of things. I have conquered the issue of not exercising and know that I will maintain the level of fitness I have achieved, along with a decent weight based on reasonable eating habits. Mood stabilization and stress management are continuously challenging. Pill-taking, including vitamin supplementation, has become completely routine and self-education is ongoing and fascinating, particularly in the areas of complementary medicine and interventional cardiology. Since I have always been avidly interested in medicine and an advocate of involvement in one's own care, reading books and articles and tuning in to the latest thoughts and opinions in the field is, happily, natural to me. It is hardly necessary and you will not suffer if you do not mimic me in this area, but certainly be involved with physicians and others who are open-minded and up-to-date. Most of the time, I am attuned to my body without being either easily alarmed or out of touch. It takes most of us a long time to reach this point and none of us can honestly boast that we have reached that place of perfection where the pendulum is ever, let alone always, at the center. When I float too far from that midpoint, I either notice and correct myself or am willing to take note based on the recognition of those around me that I am out of balance. If your desire to maintain a realistic level of health is strong, it will be evidenced through your powers of adaptation. I hope you will take pride in your accomplishments; the tasks are remarkable, may be new in certain aspects and will bring you to a point to which few people aspire and even fewer achieve.
I have the sense that as my journey continues, I will learn more and hopefully better ways to manage my illness. Not a single day goes by that does not remind me that I am a heart patient. It may be a twinge; breathlessness when I take two steps at a time up a staircase because I have allowed myself to "forget"; or simply having to chase an errant pill that falls on the floor and rolls under a counter.
Every single day grants me the opportunity to appreciate that I am here to see my daughter blossom; to absorb and attempt to return the love of my family and friends; to nurture the determination I have developed to help me to thrive. The addition to my life of my three little grandsons is inexplicably extraordinary and has called upon strength and energy I never thought possible.
Not a single day passes that does not challenge me to become more, to use my strengths to help me build weaknesses into assets; to develop my ability to convey my odyssey to anyone who may derive value from it. I am actively involved in the “Go Red for Women” campaign and hope to deliver my messages of education for women and my mantra of thriving through the American Heart Association as well.
I know how fortunate I am to have survived the heart attacks themselves and that the intermittent symptoms, both physical and psychological, pale in light of the fact that I am still here, able to share my thoughts, ideas, dreams and, yes, nightmares with the people whose lives I touch and who enhance mine. Life can be stormy at times, challenging beyond my comfort zone, but I can generally figure out how to pick up the pieces, sometimes on my own, sometimes through friends, colleagues and family. I am staunch in following my medication regimen; careful, though not a purist in my eating habits; avidly active and, maybe most important and telling, as positive as humanly possible in my attitude about what it really means to live. I falter and I am more aware than I wish to be of the physical reactions that seem to haunt all of us living with coronary artery disease. Sometimes I feel overly dependent on the most valued and valuable people in my life, but they are consistent in their caring and comprehension of the ongoing saga. I know that they each have their own crew to spill over to if I lean too heavily on them or if I give them cause for immediate concern. Two years ago I was hospitalized overnight due to a new set of emergent symptoms that turned out to be based on small vessel disease - not life-threatening and easily treated, but frightening nonetheless. A follow-up angiogram actually demonstrated improvement (additional collaterals, probably my reward for knocking myself out in rehab!) With all my experience, all of my accumulated wisdom, I was so terrified that the "cath lab" team had me practically under general anesthesia to perform this relatively simple test! Anticipatory pain is not easily avoided and falls somewhere between warranted and absurd, closer to the latter in the end. The outcome served as a reference point for future tests, which have been necessary from time to time. I may never actually watch the procedure, as I have been told others do, but hopefully I will not be so filled with dread that anxiety overtakes rationality. I urge you not to be too hard on yourself should you be in a similar situation. I could not have predicted that I would have reacted so strongly, particularly given how many incidents I had weathered, but there I was, a virtual basket case! The good news outweighed the rest, but I have not had that that level of difficulty since. At this point I have nicknamed myself “Six-stent Sue”, proudly “wearing” them and doing quite well!

So there it is. This chronology hopefully has added to your knowledge base and will serve you well in your own journey toward not merely surviving, but thriving, day to day, often with small steps, usually in a forward direction. Humor, sheer determination, positivity, fine medical care and sufficient curiosity about the future will act as the balance on the other side of the seesaw as life continues.
Thriving is a skill seldom taught, that once acquired thoroughly enhances one's life. You will struggle to find your unique ways of achieving it. You will remind yourself that you are worth it and will take responsibility for seeking out and consistently utilizing the many resources that exist and will be there to assist you. You will revel in your small accomplishments and take note of the behaviors and attitudes that thwart you, consciously replacing them with more workable ones. You will be conscientious about following the advice of people who know you well, filtering their wisdom while increasing your own. You will accept and cope with the downturns, difficulties and scares, using those moments to drive you toward your ultimate goals. You have already survived, a wonderful feat that deserves momentous appreciation. You now have the incredible opportunity to use that survival as a stepping stone toward thriving, building and living a life defined by humor, delight, purpose and joy.

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