A Change Of Heart


February isn’t just about candy hearts. It’s American Heart Month, too. Did you know heart disease is the number-one killer of Americans? Fortunately, with certain lifestyle changes, it is also one of the most preventable diseases. Two local residents recently shared their personal heart attack stories with Ocala Style—and a local cardiologist weighed in on the importance of heart health—in the hopes of preventing it from happening to someone else.


 


An Unhealthy Balance
Sergeant David McClain


At 6-foot-2 and a fit 198 pounds from more than two decades of weight training, Sergeant David McClain did not look like a heart attack waiting to happen.


On November 3, 2010, the 13-year veteran deputy of the Marion County Sheriff’s Office woke up around 11am. McClain, a supervising road sergeant, had worked the previous night shift and had gotten off at 6am. After a breakfast of just coffee, he headed to his garage gym for his usual workout. But this was going to be anything but a usual workout.


“I started doing some arm curls,” says McClain, 52, who joined the U.S. Navy right out of high school. “And I got this tightness in my chest. It felt kind of like when you’re starting to get a chest cold.I even remember thinking the last thing I wanted was to get a cold.”


Then McClain started sweating—a lot, which he thought was particularly odd for such a comfortably cool fall day. He moved on to do some shoulder lifts and the sweating got worse. And he just wasn’t feeling right. Couldn’t put his finger on it, but he just wasn’t feeling like himself.


“I decided that maybe I hadn’t slept enough and just cut my workout short,” says McClain, an admitted Type A personality. “I thought maybe if I took a shower, I’d feel better.”


The shower didn’t make him feel any better. In fact, he was feeling worse by the minute. He walked into the living room and sat down heavily on an ottoman, wiping the sweat from his brow with both hands. And when his hands dropped to his sides, that’s when the tingling in his arms began.


“I was starting to think that something was really wrong and maybe I needed to get to the hospital,” recalls McClain. “I was alone at home since my wife, Leona, was at work. I looked at my truck keys on the table, but I could feel myself getting weaker. I decided it wouldn’t be a good idea to drive myself to the hospital.”


McClain dialed 911 and then called his wife.


In the ambulance on the way to Munroe Regional Medical Center, the paramedics hooked McClain up to the heart monitor. As soon as they got the first EKG reading, he was given a nitroglycerin tablet—then two more before they reached the emergency room.


Once in the ER, McClain got some surprising and disturbing news from Dr. Gregory von Mering, an interventional cardiologist with Munroe.


“The doctor told me I was having a heart attack,” says McClain, still with a bit of disbelief now months later. “He said I had a 100-percent blockage in my right coronary artery and he needed to go in right away. He handed me a clipboard with papers to sign and they wheeled me into the catheterization lab.”


Then, remarkably, 20 minutes later, it was all done. From the time McClain had arrived in the ER and had an angioplasty to place a coronary stent in his artery to clear the blockage and restore blood flow, only a mere 20 minutes had elapsed. Hospitals call it door-to-balloon (D2B) time. Munroe’s average D2B time is 48 minutes and the national average is 64 minutes.


McClain spent the night in the Cardiac Intensive Care Unit, moved into a private room the next day, and was discharged the following day. Those three days gave him a new perspective on life.


Despite the fact that both his parents had died from heart health issues, McClain had never shown any symptoms. His blood pressure was normal. His cholesterol numbers were low. He always aced his annual physical exams. But when McClain went for follow-up care following his heart attack to Dr. James London, the chinks in his armor became apparent.


Right off the top, McClain has a high-stress job and usually works night shifts, which both play havoc with his diet and sleep. While on duty prior to his heart attack, he ate little except for the odd-hour lunch at 1:30am. On his off days, he tended to overcompensate and eat plenty of his favorites, particularly fried foods, and drank lots of sweetened tea. A longtime snorer, McClain was diagnosed with sleep apnea prior to his heart attack and will likely always have to sleep with a face mask to regulate his oxygen flow. Medical research has linked poor sleep habits to heart disease, as well as high blood pressure, stroke, diabetes and obesity.


And, yes, McClain had worked out with weights during and after his 22-year Navy career. But what Dr. London pointed out was missing in his fitness routine was cardiovascular exercise like walking, jogging or bike riding. London explained that between his erratic eating pattern and one-sided fitness regiment, McClain’s body was always struggling for balance. Then on that November morning, it just couldn’t right itself, hence the heart attack.


“I knew my eating habits weren’t the best and I had always had poor sleeping habits because of the night-shift work,” admits McClain. “But I thought I was doing okay with my fitness because I had always worked out. I really didn’t realize how important cardiovascular exercise is for your heart.


A week after his heart attack, McClain began a 36-session rehab at Munroe’s LifeTime Wellness Center. He found new reason to like the treadmill, rowing machine and recumbent bike. The physical therapists urged him to change up his weight training, using lighter weights with more reps. At home, McClain added a treadmill and stationary bike to his garage gym, and he and Leona started taking long walks. Six weeks after his heart attack, McClain was cleared by Dr. London to return full duty to work.


“Now I eat breakfast and bring a bag of good snacks to work,” says McClain, who today weighs 190 pounds. “I usually pack fruit, nuts and raisins, and eat that during my shift. When we break for lunch at 1:30am, I try to make better choices than I used to about what I eat. No more fried foods and when I do have iced tea, it’s not sweetened with sugar.”


While still grappling with the idea that he had a heart attack, McClain knows he has to stay vigilant and not fall back into his old, not-heart-healthy ways. He wants to live a long, full life with Leona, his wife of 31 years. They have two sons and four grandchildren.


“Dr. London told me that I had to realize that for the rest of my life I’ll always be a heart patient,” says McClain, whose medication now includes a statin, beta-blocker, ACE inhibitor and a daily aspirin. “But on the other hand, I don’t want to live my life worrying about having another heart attack. So I’ve made the lifestyle changes that I needed to make and still live my life on my terms.”

Depths of Denial
Barbara Morrison


Despite a family history of heart disease, Barbara Morrison still didn’t think it would happen to her. But when her younger brother had a heart attack at 39, Morrison took notice. Always active and a regular walker, she tried eating healthier. But a smoker since she was 15, she continued her two-pack-a-day habit and still believed it wouldn’t happen to her. Then two years later, when she was 44, Morrison had a major heart attack and her days of denial were over.


“My husband, Jim, and I had been doing household chores all day,” recalls Morrison, a soft-spoken woman with clear, light-blue eyes. “I got really tired and decided I’d had enough. I went in, took a shower and went to bed early. I woke up about 11:30pm with pain and a cold sensation in my back between my shoulder blades.”


Morrison had suffered with heartburn for most her adult life, so she thought maybe this was just an odd case of indigestion. She got out of bed, took an Advil and waited to feel better. Two hours later, the pain and the cold tingling in her back were still there. Jim wasn’t back yet from a night out with some friends. She woke up her daughter Karen and had her drive her to the Munroe Regional Medical Center ER.


“Once they got me hooked up to the heart monitor, ran an EKG and checked my blood enzyme levels, they told me I had definitely had a heart attack,” says Morrison, who at the time was a physical rehab assistant. “And that I previously had had other heart attacks when I thought it was only heartburn. I was in shock.”


But the news only got worse for Morrison. Hours later, she was taken to the catheterization lab for what she thought would be an angioplasty. Instead, she was told she had three major blockages and coronary stents would not work for her. Morrison would have to undergo triple bypass surgery to restore the blood flow in her heart.


“I still couldn’t believe this was happening to me,” says Morrison. “My brother had a stent put in and he was good. But I hadn’t been that lucky.”


Following the major heart surgery, Morrison also developed acute respiratory distress syndrome, likely, she admits, another ill effect of her lifelong smoking habit. The latter complication extended her time in the cardiac intensive care unit to two weeks.


“I was very depressed,” says Morrison. “But one of the good things to come out of this was that I knew I had smoked my last cigarette.”


While still in the hospital, Morrison was referred to Dr. Srisha Rao, a cardiologist with the Cardiovascular Institute of Central Florida, for her follow-up care. Dr. Rao put Morrison on a medication regime of a statin, beta-blocker, ACE inhibitor and aspirin. For her post-op rehab, Morrison and her husband would walk every day, gradually extending the distance. Six weeks later, she returned to work.


Now 12 years after her heart attack, Morrison has thankfully not had another one. But she still struggles with health issues. Last June, she had to have carotid artery surgery and while recovering in the hospital was diagnosed with sleep apnea. She now sleeps with a device that provides her with a steady oxygen supply.


“Outside of my family history, I know that most of my health problems can be traced to all those years that I smoked,” she says. “People don’t realize how addictive and dangerous smoking is until it’s too late.”


Morrison tries to eat a healthy diet of fruits, vegetables and lean meats. She’s had to cut back on her favorites like pizza, bread and pasta, and says she “had to break up with cheese.” Morrison knows she needs to lose a few more pounds to be healthier, so she works out at Munroe’s LifeTime Wellness Center.


“I’ll do water aerobics and try to put in about 30 minutes on the treadmill,” says Morrison, now 56 and a secretary in Munroe’s ICU for the past eight years. “I know if I eat better and keep moving, I’ll be healthier.”


An avid reader, Morrison and her husband like to spend weekends in Cedar Key, where Jim enjoys fishing. When she isn’t working, Morrison spends as much time as she can with her two grandsons. At three and four years old, she says “they give me plenty of exercise and keep me laughing.”


Morrison, who definitely knows she’s lucky to be alive, has this parting advice when it comes to heart health.


“Pay attention and take your family health history seriously,” she says. “Don’t think it can’t happen to you. And most importantly, don’t smoke.”

Signs Of A Heart Attack


Chest Discomfort: Uncomfortable pressure, squeezing, fullness or pain usually in center of chest; can last more than a few minutes or can go away and then come back


Other Upper Body Discomfort: Includes pain or discomfort in one or both arms, the back, neck, jaw or stomach


Shortness Of Breath: Can occur with or without chest discomfort


Other Possible Signs: Breaking out in a cold sweat, nausea or lightheadedness


Women: In addition to chest discomfort, women are somewhat more likely than men to experience other common symptoms, particularly shortness of breath, nausea/vomiting and pain in jaw and back.


Most Important Thing To Do:
Call 911!


Source: American Heart Association

Love Your Heart


Aim for at least 30 minutes of physical activity every day. If you can’t do at least 30 minutes all at once, do 10-minute sessions throughout the day.


Eat a variety of vegetables and fruits.


Eat lean meats and poultry without the skin. Cook without added saturated or trans fats.


Eat fish high in omega-3 fatty acids: salmon, trout, herring, sardines.


Select fat-free, 1-percent or low-fat dairy products.


Read labels and cut back on foods containing partially hydrated vegetable oils.


Reduce consumption of beverages and foods with added sugars.


Choose and prepare foods with little or no added salt. Aim for less than 1,500 milligrams of sodium a day.


If you drink alcohol, drink in moderation: one drink per day for women, two drinks per day for men.


Keep an eye on the size of your portions at home and particularly when you eat out.


Don’t smoke and stay away from secondhand smoke.


Source: American Heart Association


 


Cholesterol


What is it?


Cholesterol is a fatty substance produced in the body by the liver from the animal foods we eat, like meats, poultry, fish and dairy products.


Why is it bad?


Cholesterol causes plaque to build up in our arteries, and that plaque blocks the blood flow to the heart. Lowering cholesterol slows the process of the clogging of the arteries. Everyone should check with their doctor about getting a fasting Lipid panel test.


Source: Dr. James London


 


Overcoming The Odds
Local cardiologist Dr. James London weighs in on heart disease prevention.


Here’s a statistic that will, well, make your heart skip a beat: Every 25 seconds, someone has a coronary event and every minute, someone dies from one.


The Centers for Disease Control and Prevention, the messenger of that sobering statistic, also lists heart disease as the leading cause of death in the United States. While heart disease has many guises, the one that usually—and with good reason—grabs people’s attention is a heart attack. It’s a hard-to-ignore reminder of our mortality.


Fortunately, there is some good news about heart disease prevention according to Ocala cardiologist Dr. James London.


“Outside of genetics, there are modifiable risk factors for heart disease that can be addressed with aggressive prevention,” says London. “Heart disease prevention can prolong and improve the quality of life.”


On London’s list of modifiable risk factors are high blood pressure, high cholesterol, smoking, diabetes and obesity.


“Proper diet and exercise can reduce high cholesterol, lower blood pressure and prevent Type 2 diabetes,” says London. “And to stop smoking is the most powerful intervention you can do. When you stop smoking, there is a 36-percent reduction in cardiovascular mortality and a 46-percent reduction in overall mortality.”


When it comes to diet, London recommends focusing on eating vegetables, fruits, lean meats in moderation as well as limiting portion sizes. He believes that exercise, a combination of aerobics and resistance weight training, is as important as diet.


“Try for 60 minutes of aerobic exercise like walking at least five days a week,” says London, who hosts a free Saturday morning Walk With A Doc program at Ocala Family Medical Center. “Resistance training is also important to increase muscle mass, which burns fat. Exercise is important because it burns calories, reduces weight and can lower bad cholesterol.”


London acknowledges that medications play a role, sometimes a lifesaving one, in treating heart disease, but he says, “The earlier you adopt a healthy way of life, the less likely you are to need medications to prevent a heart attack.”


 

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