First, I want to wish a happy Father's Day to all those celebrating today.
Next, I want to wish a happy Father's Day to my husband, David, who is the father of my wonderful children. David is the best of husbands and fathers, and I hope my children realize how fortunate they've been with their random act of birth to have lucked into a life with the kindest, most attentive, loving, and supportive of dads.
Finally, I want to dedicate this post to the legacy of my own father, Jerry, and to the memory of my brother, Ross. As I mentioned in the post I put up recently where I had my father as a posthumous guest blogger on psychoanalysis, my father died of a heart attack at 40, and he departed this world before I was old enough to sustain memories of him, so I was left only with his wonderful legacy. My father was among the 30% of people whose first heart attack is fatal. He didn't know he had heart disease and was out shoveling snow when he had chest pain. He went to the hospital -- this was before the day's of CCU's and cardiac protocols-- was placed in a private room, and was later found on the floor, presumably having died of either another heart attack or an arrhythmia.
I last spoke to Ross on Mother's Day. I had called him two weeks before and he was curt on the phone, "I'm cooking dinner, I'll call you over the weekend." He didn't call that weekend and I was vaguely annoyed, but the next weekend, I got a warm message wishing me a happy Mother's Day and he mentioned that he had called me back the previous weekend, he just hadn't left a message. He said I didn't need to call him back, but I wanted to speak to him, and I am so very glad I did call back. I don't remember much of what we talked about, it was just the usual. He mentioned he was giving talks in Vancouver and Sweden, and that his wife would be coming to Sweden with him -- their children were finally old enough that they could leave the youngest alone for an extended period of time -- and they would be taking their first trip to Europe together. He sounded happy and all was good.
When your father dies at 40, you worry. Ross worried, I worry. Ross was meticulous about life style issues, especially as he got older, and his cholesterol had once been high, there was transient concern about a slightly elevated blood pressure reading in his doctor's office. He did not want to take medications, so he modified his diet, exercised daily, checked his blood pressure, weight, and heart rate daily. He had never smoked or abused any substances. His numbers all normalized and his lipid profile was fine, because lifestyle changes can do that for you. He'd had a negative stress test years ago, and a normal cardiac echo not as long ago. So in excellent health, at his high school weight, with the blood pressure of a teenager, my brother did his usual exercise then went to rest. His wife assumed he was napping, but Ross had died. He'd had asymptomatic coronary artery disease and hadn't known it. We didn't live near each other, and I didn't see Ross regularly, but the last few week have been a real struggle for me, and I feel so sad for my brother who had so much to live for, and for his wonderful family who now have to recreate their lives without him. I keep thinking that I feel so sad, but my poor sister-in-law, his wife and soul mate of 33 years, must be suffering terribly, yet somehow, she and my wonderful nieces seem to be holding up valiantly. I am so proud of them.
So I want to use my post today to plug for a few things.
- If you have a personal or family history of heart disease, don't assume that you're fine because you feel good and live a healthy lifestyle. My brother lived significantly longer than our father -- no doubt because of his lifestyle efforts-- but perhaps a more aggressive search for coronary disease would have helped. If you're at risk, genetics may trump all -- see a cardiologist even if your numbers are normal. 40% of sudden cardiac deaths occur in people with LDL-C's (bad cholesterol) in the normal (less than 130) range.
- We hear constantly -- in the media and from our doctors -- that lifestyle issues are a major factor in morbidity and mortality and this is likely true, however there is an underlying harmful message here. If you're sick and your lifestyle isn't perfect, it's your fault. And if you do everything right, you'll live a good long life. Neither is necessarily true, but I believe the first message stops people from going to the doctor because who wants to be told that they're problems stem from their weight issue, their lack of exercise, from drinking too much, from eating the wrong things, from smoking, especially if you've tried to make changes and haven't been able to. If you have lifestyle issues, try very hard to change, but if you can't, go to the doctor anyway. Address your issues with medications, even if you can't make the necessary lifestyle changes -- you may live a longer and healthier life. And while it's not in vogue to promote the pharmaceutical industry, the truth is that Americans are fatter than ever and live longer then they did back in the days of thinner people. I believe this is from less smoking and from the benefit that medicines give people in dealing with blood pressure, heart disease, and diabetes. If your doctor hassles you and you know you can't, or won't, change, remind your doctor that skinny people have high blood pressure and athletes die of heart attacks. And if your doctor is not helpful, get a new doctor.