You can be the Captain
I will draw the Chart
Sailing into destiny
Closer to the Heart.
– Neil Peart and Peter Talbot
In September 2018, I was hospitalized with acute pericarditis — inflammation of the pericardium with almost 500 cc of fluid surrounding my heart. As I lay in the Emergency Room, in the early hours of the morning, I experienced a cardiac tamponade: pressure from the fluid had caused my right ventricle to collapse. As my blood pressure plummeted, I felt a sudden flush, feeling like I would void and vomit, and pressed the call button. In seconds, I was surrounded by several members of the ER team. The ER doctor probed me, thinking he needed to do an emergency procedure, a pericardiocentesis, to drain the fluid. But the cardiologist on call recommended they stabilize me and perform a safer procedure, pericardial window surgery.
Later that morning, while the cardiologist discussed my case with a colleague, I saw my heart in technicolor on the HD screen. My heart was dancing all over the place like a fetus floating in amniotic fluid. I instantly understood why the pericardiocentesis was riskier than the scheduled surgery – it could have punctured my heart. Later, when I referred to My Dancing Heart, a resident told me that’s exactly what they call it.
I recovered from this episode, likely caused by an unidentified virus. But my stamina and fitness were terrible for a long time. Nevertheless, a year later, in December 2019, the cardiologist gave me his blessing and said I didn’t need him. My heart was in good condition, he said. It was a terrible, one-off event. If I ever needed him again, I could always call.
And then the pandemic hit. I cooked and ate more comfort food. Working at home on remote access, I sat more. Groceries were delivered, and gyms were closed. I walked less than ever before. Eventually, I bought my Peloton bike and started to exercise. But my stamina and strength did not improve until I was able to solve the problem of my weight.
I took sugar, processed foods, and refined carbohydrates out of my diet. I conditioned myself through at least 50-60 minutes a day of biking, walking, and light arm weight classes. It took months of dedication and experimentation to make these lifestyle changes. Although I implemented and committed to these changes one at a time, my weight dropped an average of 2 pounds a week.
I tracked every metric I could: calories in and out, macronutrients, micronutrients, water consumption, heart rate, oxygen saturation. Some might think this is too hard, too much work. Let me tell you, it really is not hard. What’s hard is lying in a hospital bed on oxygen, knowing you had a sudden brush with death. What’s hard is not being able to walk around the block because there is still fluid in your lungs. What’s hard is barely being able to climb one flight of stairs while your heartrate soars faster than 120 beats per minute. It’s hard to be sick.
Improving your health requires honest commitment, and even if there are challenges, even if it takes a little effort to monitor your progress, it’s the better path.
Your heart is the hardest working muscle in your body. Do not take it for granted. Know your risks and be proactive if you are in a risk category for any of these factors as listed in the attached Quest Diagnostics Cardio IQ brochure:
- Men older than 45 years of age and postmenopausal women)
- Individuals with a family history of premature onset of Coronary Vascular Disease (CVD)
- Unhealthy diet, excessive alcohol intake, smoking, and stress
- Low HDL-C (High-Density Lipoproteins/Conventional test)
- Established cardiovascular disease, hypertension, or dyslipidemia
- Metabolic syndrome
Metabolic syndrome and insulin resistance contribute to the inflammation at the root of cardiovascular disease (CVD). The following markers are universally used as reliable indicators of Metabolic Syndrome, as identified by Mark Sisson in his bestselling book, The Primal Blueprint:
- Elevated fasting blood glucose of 100 mg/dL or greater
- Blood pressure of 130/85 mm Hg or greater
- Waistline measurements of 40 inches or more for men and 35 inches or more for women*
- HDL of less than 40mg/dL for men and less than 50 mg/dL for women
- Triglycerides of 150 mg/dL or greater
Sisson writes that individuals “with three or more of these markers are said to have Metabolic Syndrome.”
The Cleveland Clinic and the Journal of the American Medical Association have reported that more than 40 percent of Americans in their 60s and 70s have Metabolic Syndrome. Furthermore, Dr. Jason Fung, author of The Obesity Code and The Diabetes Code, states that a 50 percent or greater ratio of waist circumference to height is a strong predictor of diabetes.
Insulin resistance is an important risk factor for atherosclerosis, as it increases oxidative stress and is a cause of inflammation, as described by Benjamin Bikman, PhD. on page 22 of his book, Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease – and How to Fight It: “First, insulin resistance increases blood pressure, increasing the likelihood of blood vessel damage. Next, it increases lipid deposition in blood vessel walls. Finally, insulin resistance increases inflammation, promoting the ongoing infiltration of the blood vessel with macrophages, which become increasingly laden with oxidized lipids, changing into foam cells. Altogether, these events, each spurred on separately by insulin resistance, culminate to form an atherosclerotic plaque. With all this in mind, it’s little surprise that insulin can directly promote foam cell formation in blood vessels.“
The science and the biochemistry in particular may seem daunting, but it is important to find out if you have markers of inflammation, insulin resistance and metabolic disease. According to Jonny Bowden, PhD. and Steven Sinatra, M.D., authors of The Great Cholesterol Myth (Revised and Expanded), insulin resistance is to heart disease what smoking is to lung cancer. To calculate your insulin resistance, you will need to have a Fasting Insulin test and a Fasting Glucose test. Input these numbers into an online HOMA-2 calculator. HOMA stands for Homeostatic Model of Insulin Resistance. Bowden and Sinatra state on page 139 of their book:
“If you have healthy insulin sensitivity, your HOMA number will be between .5 and 1.4. If it’s more than 1.9, you have early insulin resistance. Over 2.9 and it’s significant insulin resistance. In either case, it’s time to change your diet.”
Furthermore, Bowden and Sinatra advise us to dump the following from our diets: sugar, processed carbohydrates, trans fats, processed meats, and excessive Omega-6 fats. In addition to promoting the Mediterranean Diet, their “eat this” list includes: wild Alaskan Salmon, berries, cherries, grass-fed beef, vegetables, nuts, beans, dark chocolate (greater than 60 percent cocoa), turmeric, pomegranate juice, green tea, red wine, olive oil, and garlic.
To further understand the pieces of this puzzle, I have attached a copy of the Quest Diagnostics brochure, Cardio IQ – Advanced Cardiovascular Testing: Uncover Hidden Risk for Heart Attack and Stroke. This brochure was written for physicians, but there’s a good chance that your doctor may not be knowledgeable about the advanced tests for the markers of inflammation, and there are several which are indicative of cardiovascular risk. It’s up to each of us to advocate on behalf of ourselves for those tests that reveal our greatest risks. I strongly suggest you print a copy of the PDF, read it carefully, and bring it with you to your next doctor’s appointment.
Your heart depends on it.
♥ Susan L. Ward