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What she said next shocked me. She outlined the recommended diet to prevent heart failure. She told me, first off, that I needed to drastically restrict my salt intake because too much would cause fluid retention. (I will debunk that idea, and other nutrition fallacies, in chapters 10 and 11 and show how it might even be harmful to restrict sodium.) Then we moved on to diet. While the vegetables, f ruits, and lean meats on the list were acceptable because they are whole foods, my jaw dropped at the other foods recommended as “heart healthy.” They included canned fruit, fruit juices, instant breakfast, margarine, mayonnaise, tofu, breads and cereals, cornstarch, sherbet, sugar, jellies and jams, graham and animal crackers, and cookies and fig bars. I could not believe she was recommending a diet so high in processed foods, especially the processed grains, sugars, and vegetable oils. I knew, right then and there, that I would not be following the recommended diet. It looked, to me, like a one-way ticket right back into the hospital, and to chronic poor health.
From Hospital to Home: Critiquing the Care
That evening, my nurse told me I might be discharged in the morning. I was relieved. I couldn’t wait to get home and start my own carefully planned heart-healing routine. In the morning, I spoke again with one of the resident physicians and we had a good conversation about my situation. She still thought I should do everything they were telling me to do, like take all the medications, but she also acknowledged that it was obvious I was putting a lot of thought into my decisions.
Then I met a different attending physician for the first time. I told him I had been feeling better every day, and doing very well under the circumstances. He said that was great. Then he said he was not going to have a discussion with me about medication. He’d heard that I’d made up my mind, and he didn’t want to discuss it. I was discharged from the hospital later that morning.
A few days later I was reviewing my medical records, which I had requested be sent to me from the hospital. Aside from it being more information on my care than I had received from anyone in the hospital, one thing struck me as odd. My first night in the cardiac ICU, I had some chest pain, which I was told was normal after the heart attack and stent procedure. One of the nurses called in the resident physician who tried to troubleshoot it. She asked me a lot of questions, and I remember answering one with a lengthy explanation of the stress I had been under. Her response was to prescribe me a Xanax. Nowhere in the medical records did anyone report that conversation. Perhaps they didn’t think my stress was clinically relevant? In fact, there is a massive amount of evidence that chronic imbalance in our autonomic nervous system—essentially, our stress response—is a main contributor to heart disease and heart attacks, and that in many ways the diseases of modern society—including heart disease—are a direct result of the massive lifestyle changes humans have undergone in an evolutionarily short amount of time.
I’m not criticizing my care because I’m angry. I understand the strengths and weaknesses of modern medicine—I think most of us do—and I remain incredibly grateful to the people and the medical advances that saved my life. I describe all this to illustrate the dilemma we all must grapple with: that modern medicine has two very different faces. In my case, the production of synthetic insulin and the development of a stent procedure are modern medical miracles that saved my life. I will be forever in debt to those who made those discoveries and perfected those advancements, as well as to those who used them with such skill and care. The flip side is that modern medicine is incredibly lacking. It’s shockingly unenlightened about what actually fosters good health in humans, as well as about managing care following events such as the one I had in a way that will put a patient on the true road to recovery and back in the land of good health.
During my first night in the ICU, I had all but decided there was no way I could release this book. I was filled with self-doubt. But by the time I returned home, I had come to understand that many people have faced—or will face—the sorts of decisions and dilemmas I faced in the hospital. I believe the information in this book is critical for them, and no less relevant or correct because I had a heart attack. It is my hope that the information found in this book can ignite the open conversation about heart disease that is needed to inspire progress and change in our care and understanding of the heart. And while it’s true that I don’t have an MD and I’m not a cardiologist, and I’m cognizant that in our credential-driven world some will write me off entirely on that basis, my credentials are different—and I believe stronger. Aside from having a medical background, I’m a patient. And this is my health. There is not a person in the world for whom the stakes are higher than the patient. It’s not a person’s career on the line. It’s a person’s life on the line.
What It Takes to Understand Your Heart
That said, my goal in writing and publishing this book is not to be right, or to prove anyone else wrong, so much as it is to seek the truth, wherever it may lie. I know we can’t do that without open-minded, honest, and unbiased discourse. I was deeply disturbed in the hospital by the shutdown of conversation about alternative ideas and therapies. As soon as I started to question my doctors’ recommendations and approaches, I felt immediately branded as noncompliant and cast out of conversation—about my own care. All I really wanted was to have a discussion about my treatment options. I was taking the recommendations and my recovery seriously. I valued the doctors’ expertise and opinions and wanted as much information as possible. What in the world is going on with medical care that that’s so threatening? How did we get so far off course?
As soon as I was discharged f rom the hospital, I began a routine to restore the health of my heart. The rationale behind my approach is laid out in the pages of this book. I was told that if I didn’t restrict salt, eat the recommended diet, or take the aspirin, ACE inhibitor, beta-blocker, and statin, my heart would not fully recover. I did not follow these recommendations.
Instead, I sought the advice of a cardiologist who treats the whole person and who helped me decide what medications to take on a short-term basis, and what ones to avoid altogether. I started by taking two medications, the blood thinner and the ACE inhibitor, for a month, then just the blood thinner for the next six months. After six months, I stopped taking any prescription medications. I’ve also relied on a nutrient-dense diet and supplements like magnesium, taurine, L-arginine, and carnitine, and I have procured an infrared sauna and use it often. I make it a top priority to manage stress and expose my body to environments that help it be more resilient in the face of stress. This proved difficult at first because a new stress emerged following my heart attack: My confidence in my health was shaken. At times during my recovery, it felt almost as if my relationship with my heart was strained, like my heart had lost my trust and vice versa. As I healed, recovered, and slowly returned to normal activity, my emotional relationship with my heart recovered as well.
How’s it working out for me? So far so good. At my three-month follow-up, my echocardiogram report indicated that my interventricular septum (the middle part of the heart muscle that was damaged) had gone from “severely akinetic” to only “mildly hypokinetic.” This indicates that the signal conduction of that area of heart tissue was just shy of being normal. My left ventricular ejection fraction had improved from the 35–40 percent to 50–55 percent, the lower end of normal. There was no sign of anything suggesting heart failure.
All this said, I want to be clear. If you have heart disease or any symptoms of heart disease, you should be under the care of your physician or cardiologist. I hope that your doctor’s goal is to find the underlying causes of your disease and get you to the healthiest state possible as well as keep you off of medications, if practical. If this is not their goal, it may be time to find a new doctor. Many of the ideas presented in this book are very different from what you will find within the medical practice of cardiology, a field of medicine that is proving unsuccessful at preventing heart disease and fostering good heart health. Instead, this book presents information about the heart, what it is, why it is there, the ways it can malfunction, and how we can keep it healthy. It is my hope that being under the care of the correct doctor and being armed with the information in this book will empower people to take back control of their health, to prevent—and even reverse—heart disease.