This is a report on the second part of a series on heart failure inspired by Dr. Richard N. Fogoros, M.D. on the website, About Heart Disease.
Recently, even when I was struck down by a heart attack and then heart failure in 1994; there was a tendency for some physicians and cardiologists to say “you have a touch of heart failure” and send them home with a time tested medication from a different time.
I was lucky. In spite of getting sick in Upstate New York in a rural area, my cardiologist did know to give me what was then a new “cocktail” of ACE inhibitors and beta blockers. I have been taking the cocktail (with a diuretic, statins and numerous nitrates) ever since.
Dr. Fogoros writes that a person with heart failure should:
“Insist” on a search for the “definitive underlying cause. That is good advice if it is not quite evident. In my case it came on the heels of a massive heart attack with (then) serious damage to the organ. So, yes, make sure you know what caused it but it will too often be (pardon the pun) painfully evident.
However, he also notes that “up to 30% of heart attacks are unrecognized as significant evens by patients at the time they occur”.
His next exhortation is to “insist” on being taught to watch your diet, exercise, weight and blood pressure. Some attacks can be prevented or controlled by watching for the tell tale signs of an impending attack.
“Insist” that you have any arrhythmias monitored and attempts made to control them. I can attest to the pain, the fear, and the debility that comes from them as it took some time to recognize mine, but I knew there were serious, new problems. At first they do not always appear at the time you are testing for them. When it is late; then they are unavoidable. A large percentage of death for people with cardiomyopathy (translation: a sick heart) come from ventricular arrythmias. These deaths can be sudden. So much so that the eupehemism-laden medical profession refers to “sudden death syndrome”. If you have it you want to know about it.
Find out about C.R.T. if you have serious heart failure. Breakthrough research is coming with increasing frequently in this advanced and digital successor to the “simple” pacemaker. I now have my second, a Guidant “bi-ventricular pacing device with an internal cardioversion defibrillator”. Which is to say that they planted a miniature computer in my chest and, with this one, connected three cables to the heart (two into the ventricals) through the veins. The machine synchronizes the action of the ventricals thereby strengthening the heart’s action. The studies do not show a longer life but they do show — and I can corroborate — a much higher level of functioning. Electrophysiological tests are run to determine if the heart muscle can still be shocked into movement. The machine also, since I am subject to sudden death syndrome; provides an instantly available defibrillator. Since I live in a primitive part of Mexico not long out of the jungle, this is an important attribute. The USA may be putting the new automatic defibrillators in Dunkin Donuts, malls, gas stations and everywhere else (which is a great idea!) but, here in Mexico the nearest one is probably from one to five hours away if anyone knows how to use it and no one has stolen the device.
Lastly he reminds us — and I echo that reminder for any and all infirmities — to watch papers, magazines and the internet for new research and treatment, new studies and medications. There is so much going on that a savvy patient will often know about it long before the doctor has waded through all the literature on his desktop — assuming you have one good enough to try.
He also mentions cardiac transplantation with these figures:
“Heart transplantation has progressed remarkably over the last 20 years. Today, almost 90% of heart transplant recipients survive for at least one year after transplant, and up to 75% survive for five years. Because of the scarcity of donors (only 2000 people a year receive heart transplants in the U.S.), this therapy is limited to the very sickest patients – those whose expected survival without transplantation is measured in months.”
Those figures and the thought of a circular saw going though my breastbone again have caused me to reject the idea of a transplant. There are few hearts, a lot of pain, and then a lifetime (which might be quite short) filled with AIDS like medications also fooling around with the immune system to keep the organ from being rejected.
Therefore, the moral of the story is this. Exercise, eat decent food in moderation, never even think of fried food or “convenience food” or the garbage doled out by the chain fast food joints, enjoy life, have sex but not too much to drink and, if all that fails; call 911 or get to a hospital as fast as possible. The is no embarrassment in saving your life.. If you make a mistake and go for heartburn, so be it. The next time might be the real thing. Or, to make it easier, just do what your mother always told you to do. Take care of yourself.