My friend, who I’ll call Empress in this story because she really is an Empress, is marking her two-month anniversary of Diagnosis Day.
In my friend’s case, the diagnosis is rheumatoid arthritis. R.A. is incurable, painful, debilitating and potentially fatal. Treatment plans vary according to the individual and healthcare provider. The disease, like many autoimmune illnesses, flares and then quiets like the hesitation between Fourth of July fireworks, making you wonder if each display is another burst of sparks or the blazing finale.
Anyone who has had a medical diagnosis of a nasty disease knows that this particular day will stand out among other days. For many, D-Day can offer a strange relief. Finally, there’s a name for all of the unexplained pain, dizziness or whatever bewildering symptoms. On my D-Day, my first thought was “Hey, maybe I’m not crazy after all.”
On my D-Day, my first thought was
“Hey, maybe I’m not crazy after all.”
I’d had two years of odd rashes on my face, legs and arms. My fingernails warped and rippled. I was always tired. My joints felt like balls of fire. My ribs and heart were sore. I was depressed yet caring for a 7-month-old son while pregnant with my daughter. When my physician called me at home one evening with the results of my most recent round of blood tests and told me that I definitely had systemic lupus erythematosus, I was almost delighted. Finally, a name! Finally, a reason! Finally, a treatment plan!
Photo credit: Albumarium/Chiara Cremaschi
The odd euphoria of D-Day ebbed quite a bit when I realized that remission was not around the corner and that the coming years would require that I change my expectations about certain facets of my life that I thought were part and parcel of who I am. Or was. Or will be.
Still, if I were to place SLE in one hand and my old self in the other, I would hold on to the Me with SLE. I used to let little things get to me but having this disease has forced me to see life from a different perspective. I don’t get ruffled easily. I avoid drama. I appreciate more. Sure, I miss out on some things due to pain, fatigue or my sensitivity to sunlight, but what I do have I hold more closely to my heart than I think I would have pre-SLE.
Empress is moving from the shock of D-Day through the grief of losing a part of yourself without really knowing what the part will be. Yes, there’s a reason for today’s blinding pain and the mental fogginess. The question really is all about tomorrow and the days after that.
Of course, no one knows from one day to the next what will be gained or lost. I would argue that for the most part, most people can live with the belief that tomorrow will be much like today in terms of physical and mental capacity.
For the person with a “Diagnosis” it’s virtually a certainty that each day will be uncertain. Sometimes, I see myself as an adventurer going into each day and night with hope and curiosity. Other times I’m grumpy and tired. We all build our own way of adjusting. I don’t know what the Empress will build for herself as an outcome of D-Day, but I’m hoping it will be a crystalline outgrowth: reflective, illuminating and precious.
Do you have a story about your D-Day that you’d like to share? Let me know in the comments below.
So, you’ve had a heart attack and you lived to tell about it. Great! Now what?
You were probably told about your medications and how important they are when you left the hospital. Yes, they are very important. Most of the medications are ones you’ll need to take for the rest of your life. Your doctor probably put you on an aspirin, a cholesterol medication called a statin, and likely one or two blood pressure medications. These blood pressure medications are not necessarily for your blood pressure; they’re good for remodeling your heart. Think of them as good medications for your heart health.
If you had a stent (a stent is what is used to open up a blockage in your coronary arteries), then you likely were put on a medication to help keep the stent open. You will need to be on this medication for at least one year (after a year, discuss with your doctor whether it is safe to stop it). You may recognize this medication by their brand names Plavix or Effient. These medications are important for your stent, and if you miss even one dose it could be catastrophic and your stent may close up (so don’t mess with this one). It is important that you do not stop any of your medications without consulting your doctor.
Your daily routine
Now that we have the medications taken care of, there are a couple other items on the agenda including diet and exercise. It’s time to eat healthy! Cut out the fast foods and most restaurant foods. Learn to eat foods with lower cholesterol, lower sodium and less processed foods. Go buy a cook book. Look into the DASH diet – it’s good for high cholesterol, weight loss, heart failure, high blood pressure and diabetes.
After you are discharged you were likely referred to cardiac rehab – GO! That’s important. Don’t sit on the couch and feel sorry for yourself. Get out there and exercise. Lose weight, but more importantly, enjoy your second chance at life!
A note to spouses of heart attack survivors: Don’t wait on your loved one hand and foot – that’s the worst thing you could do! Don’t enable. Instead help them work on exercising more and make sure they go to cardiac rehab.
Now, last but not least: smoking. Yep, we had to talk about it sooner or later. You HAVE TO STOP. Please discuss ways to stop with your doctor. No pills or hypnotic therapy will help if you don’t WANT to stop. Find the motivation and do it. I have helped many patients in my clinic stop smoking by exploring the reasons they smoke in the first place and helping them find substitutions for their behaviors.
Having a heart attack is scary. Surviving one means you have another chance at living. Change your life for the better and eat healthy foods, exercise and stop smoking. Make sure you’re around for your loved ones when they need you and work to prevent another cardiac event in your life.
We’re two months into the New Year, and you may have made a resolution to be healthier in 2015. Or maybe you are looking for ways to feel better. Maybe you’re tired of being tired and out of breath when you attempt simple tasks.
As a cardiologist who specializes in heart failure, I have many patients who come to my clinic with issues such as these. First, I evaluate them for heart disease. This may include laboratory tests, echocardiograms, or treadmill exercise tests. The results of these tests may lead to more invasive procedures such as angiograms or cardiothoracic surgery. Sometimes a serious cardiac or pulmonary condition is not diagnosed, yet the patients continue to have these progressive symptoms. In all cases, everyone gets the same message from me — Be Heart Smart.
To be heart smart, you have to take a serious look at what you are currently doing with your life. I focus on four areas: Sodium (salt), Calories, Smoking and Exercise. I find that all of these areas are equally hard for patients to gain control of.
Be Heart Smart
Stop. Smoking causes heart disease, pulmonary disease, and many cancers. However, you must want to stop before you can successfully quit. All the medications, classes and support groups won’t help unless you really want to stop smoking. My patients who have successfully quit have found something personal that motivated them to stop. I often ask them to name five reasons why they like to smoke, then we discuss ways they can achieve the same feeling they get from smoking with other activities.
Cut back. The first step is to educate yourself. Salt does not only come from the shaker; it is a major ingredient in all processed foods. Start reading labels and always remember salt = sodium.
Lowering your sodium intake can reduce your blood pressure, decrease water retention, and help with weight loss.
The average American consumes more than 4,000 milligrams of sodium each day.
The American Dietary Guideline recommends 2,300 mg per day.
I restrict some of my heart failure patients to less than 1,500 mg per day.
Foods high in salt:
Fast food anything
Seasoning mixes (steak, grill, etc.)
Of course, you should lose the saltshaker. I instruct many of my patients to avoid going out to restaurants until they know how to cook at home. Go back to the basics and explore a variety of herbs in your cooking: oregano, basil, rosemary, cilantro, chili powder, and many others. If you don’t know what to pick, just smell them in the grocery store; use your nose to choose. Tonight, pick three that you wouldn’t normally have used before and combine them in a chicken dish with a little olive oil and lots of your favorite fresh veggies.
Eat less. To lose weight you need to understand that it is not just a numbers game but also a metabolism game. Be honest with yourself with how much you are eating. Portion control is very important. There are many free phone-based apps now that can help you count your calories and show your progress. If you’re unsure where to start, try the DASH diet, supported by the American Heart Association. I like it because it is cheap and simple. It is not a fad diet. Rather it teaches you how to eat healthy for the rest of your life.
Exercise more. Yes, exercise does help you lose weight but only if you combine it with smart eating habits. Exercise in general is a way make you feel better and become stronger. As you age, your muscles can lose tone and strength, especially if you’ve lived a sedentary life-style. I advise my patients to “sweat” for 20 to 30 minutes a day. Choose an exercise or two you enjoy. For beginners, start out with a modest level of exertion and increase the intensity in 1-minute intervals during your exercise period – interval training.
The Key to Success
My patients who take being heart smart to heart feel better. Once on a routine, they are surprised how much more energy they have. Some have lost weight, a few have stopped smoking, and most have less shortness of breath. They admit it is not easy, but it is worth it. So talk to your doctor and get busy. Take control of your life. Be Heart Smart.