Dale Matson
I previously wrote an article, which may serve as a useful
introduction: http://sanjoaquinsoundings.blogspot.com/2017/03/cardiac-stents-dual-antiplatelet.html
I believe there is a lack of understanding in the scientific
literature on the extent of the personal devastation brought about by a diagnosis
of Coronary Artery Disease (CAD). This is especially true of those like myself
who have led competitive and active lives. Much of our lifestyles and even
identities are based on being active. The grief, anxiety and occasional
depression are difficult to live with especially since there is little good
guidance available that can cushion the devastating diagnosis with hope for the future. My following comments are as an individual
lay person and I do not recommend anything I have done for anyone else without
that person first consulting with their medical specialists. However, I have found
my primary care physician to be invaluable as a consultant and for looking at
the overall picture. He has also been encouraging.
Yes, there are good recommendations on diet and food, which
can be more than fuel. Food can be medicine. I am not convinced by personal
research that the usual protocol cocktail of statins, blood pressure
medications, and blood thinners save or even prolong lives. For me, it always
seems to come down to the fine line between living the most ‘risk free’ life
and a quality life. Additionally some measures and medicines may actually
endanger lives with bleeding and anemia.
The most important number to me is not my cholesterol LDL or
other measures. It is my Safe Maximum
Heart Rate. My Maximum heart rate of 110 was set by my cardiologist
following my treadmill stress test, which indicated Ischemia even thought I
reached the maximum predicted heart rate of 148 (I am 72 years old)
I wanted a definitive test and we decided on an angiogram,
which resulted in having drug-eluting stents implanted. Within two weeks I had
a severe bleed resulting from the combination of dual antiplatelet therapy
(DAT) (Plavix and aspirin) and undiagnosed ulcers. The GI doctor was able to
stop the bleeding with hemoglobin of 7 and with antacids was able to keep me
from a reoccurrence. He did caution me that I could bleed again.
The long road back began with the anxiety of another
possible bleed or a thrombosis in my stents caused by a clot if I stopped the DAT.
This anxiety has been severe enough for me to have ‘as needed’ Xanax prescribed
by my primary care physician. I believe it has kept me out of the emergency
room more than once.
Three Variables I can control
1. Since the stents were inserted, I
have lost 17 pounds. I now weigh less than when I completed Hawaii Ironman and
the Western States 100 mile endurance run.
2. I continue to build my iron
levels with an iron rich diet and iron supplements. My current hemoglobin is up
to 12.8 but not optimal. I hope to raise my hemoglobin to about 16. This will
allow better oxygen availability.
3.
I intend to incrementally increase the intensity and duration of my
exercise to strengthen my heart. This includes cycling, swimming, walking, and
weight training. I can do this because I have a “new” maximum heart rate of
120bpm to work with. The cautionary low heart rate guidelines I have been using
have actually ‘detrained’ my heart.
Much of my exercise will be in the Sierra Nevada Mountains so there will be
additional acclimatization. All of this is done wearing a Suunto heart monitor
and chest transmitter. I also keep careful records.
I
have places in the mountains I want to get to and photograph. Each place is
progressively more difficult with the final destination requiring four days and
three nights of backpacking. Of course this is all predicated on discipline,
patience and knowing when to back off if necessary. My next scheduled
appointment with my cardiologist is set for January of 2018. I don’t think of
this as “heart rehabilitation”. I think of it as I have thought about it for
the last 30 years, “Training”. I hope this makes sense to others out there like
me.
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