Can't We Do Better at Prevention?
Saturday, August 04, 2018
What a whirlwind week.
Last Friday, early in the AM, my mom said she noticed my dad was clutching his chest and short of breath. She called the ambulance, but my dad insisted he was fine and to just drive him to the hospital.
Well, that was a mistake because he had a minor heart attack. We were extremely lucky that he didn't have a major event because he wouldn't have survived.
At first, I was really angry at traditional Western medicine. We are really great in the world at heart and cancer treatment, but really bad at prevention. We view it as an eventuality. Treat the symptoms, wait for the heart attack, then perform invasive measures.
Unfortunately for my dad, he was very lucky in some ways and very unlucky in others. He has 3 blocked veins in his arteries, a completely blocked carotid artery, and a partially blocked secondary carotid artery. The doctors felt he was too risky for bypass surgery, and gave him an option for a stent. Normally stents might be a routine and relatively safe, but in his case, they had to move past an artery that is 75% blocked in order to reach the one that was 99% blocked. They said that he was higher than average risk, but it was the only choice remaining. They would not do bypass, and he wasn't responding to medicine alone.
I am so grateful to the surgeons and nurses who operated on my dad. The procedure wasn't without risk given his other complications, and they did a miraculous job. I'm just struggling with why there were so many problems that seem to slip past screening. It's not like my dad hasn't been to the doctor recently. He goes a couple times a month for the past few decades.
I just brought him home today, and I went through his pantry and threw out a lot of unhealthy foods. Mostly stuff that is really high in sodium, high fructose corn syrup and processed crap. He said he is willing to make a change. I hope so. I really think this is a train that cannot stop at this point. We can throw more coal in and make it go faster, or we can try to slow it. But the train isn't stopping. We all want that to be as long as it can be. Through it all, my dad was just so determined. He wants to live. He's still sharp of mind, and as soon as his heart started getting blood flow again, it seemed to respond. Color returned to his face, and his blood pressure looked really good. As a muscle, his heart is so strong. It just his arteries that are failing him.
This type of damage doesn't occur within 6 month, or even a couple of years. This is decades. In some cases, damage can be reversed. But poor diet and lack of exercise will take its toll. The surgeon said she wasn't willing to perform the surgery because his lungs performed so badly, it wasn't an option. Exercise is what keeps your lungs strong, and he stopped walking even to the mailbox years ago. She said his overall risk of something going wrong on the operating table was 58%.
I can't stress enough that if you are well enough to change your habits and your health, you should do it now. No matter your age. Once you have a major problem, it is harder to reverse it, especially as you age. It's something we all realize sometimes at some point we're not invincible anymore. We don't rebound like we used to in 20s and 30s. Past 40, we will live with our consequences sooner and later.
I'm most worried about my dad's lack of motivation for exercise. The doctor has ordered cardiac rehab and 5 minutes of walking per day. He began giving excuses about how his back hurt, and I wasn't having it. I've known people with spinal cord injuries who wished they had the problems he has. I told him if his back hurt so badly he can't walk, then I'll get him a wheelchair. Otherwise, he can get up and walk. Sorry to be harsh, but I've always been more on the tough love side.
All of us have an expiration date. None of us know when. None of us can stop it. The best we can do is to extend it, and the worst is to shorten it. We cannot control genetics. We cannot change our expiration switch. We can control our lifestyles: nutrition and exercise. Those last two things determine our options. Traditional medicine is really great about medicating our symptoms, and critical care, but it is really bad about helping us avoid the train wrecks in the first place.
I saw my dad's cardiologist cycling into work one morning. I noticed his extremely lean, muscular calves. All of the cardiologists were very lean, despite working very long hours and demanding schedules. I guess if you work with sick hearts all day, every year, you figure out how to eat right and get enough exercise. With the situation, I didn't get my regular exercise, but I took the stairs instead of the elevator when visiting my dad everyday. My tracker said I climbed an average of 14 floors per day. I couldn't help but feel a little bit of pride that I could climb 14 floors a day, and my mountain bike rides were more challenging. There was a time when I couldn't climb one flight without feeling like I ran a marathon. I ate salads in my dad's room. I couldn't be a good example of how he should be eating if I was downing burgers and pizza in his cardiac ward just because it was convenient.
I just realized that being able to walk, having the choice to exercise in some way, and eating well, is all a gift. It is a choice we can make every day, every minute when we're healthy. Someday, we will not be healthy. Someday, we'll wonder, what could I have done better? Is this something I could have avoided?
Prevention is so hard because it's a gamble. If we could look in a crystal ball and know for certain, "If I don't do abc, then this event xyz won't happen in 40 years", I guarantee 99.999% of us would do it. It would be so easy. But it's not easy.
“It is easy to be wise after the event.”
― Arthur Conan Doyle, The Complete Sherlock Holmes
But can we be our own crystal balls and be wise before then? Can we not already tell what train wreck is coming? Isn't that why we all came here to begin with?