Two doctors, half a dozen nurses, another Respiratory Therapist and myself were huddled around the patient’s bed. Unfortunately, despite our efforts, his condition was continuing to deteriorate. I stepped back from the bedside as the decision was made to palliate. There was nothing medically that could make him better – the team would now focus on keeping him comfortable.
We were in a four bed room, and the man in the bed across from our patient was staring with concern at the curtain separating them. He was visibly shaken. I stepped over to his bedside to see how he was doing.
“I’ve got to get out of here,” he told me and the two of us walked out into the hallway. “What’s wrong with him?” he asked.
“Heart failure.” I replied, and asked what had brought him into the hospital.
He explained that he had a small heart attack and was waiting to go to Victoria for angiography where they would insert a catheter into the arteries of his heart to look for blockages and open them up if necessary.
He was in his mid 40’s and looked reasonably fit. I asked him about his risk factors: “Do you smoke?”
He had never smoked, only occasionally drank alcohol, but had a genetic predisposition for heart disease. His father had his first heart attack at about the same age. He asked my opinion on the subject.
I believe genetics are a factor in health and disease, but in my experience there are usually other lifestyle conditions that contribute to the disease process. You are stuck with your genetics, but lifestyle can be changed. I congratulated him on not smoking and asked him what else might have contributed to his heart disease.
“I know I don’t exercise enough,” he admitted immediately. In fact, it had been many years without any regular pattern of exercise. His job was sedentary, but by the end of a long day, he still came home tired. As a single dad, by the time he took care of the household, there wasn’t much time left for anything else.
There was another risk factor, he continued. To save time, he had resorted to eating a lot of fast, processed food. He commented that even his son recognized this and requested the two of them start ‘cooking some vegetables’ once in a while.
“Do you think it makes a difference?” he asked, “I mean, if you have the genetics for a heart attack, isn’t it going to happen anyway?”
I explained that in my experience, it is rarely genetics alone that brings someone into the hospital. With the exception of advanced age, most of the disease I see in the hospital has a significant, preventable component. Cigarettes, alcohol, fast food and lack of exercise contribute to most of the disease I treat.
You can’t change your genetics, but you can optimize your health. I explained that the lifestyle he was living now was affecting his son’s health as well. His son was learning lifestyle patterns that would carry with him into adulthood. If something didn’t change, his son would certainly carry on the family legacy of heart disease.
The heart is a muscle, and like every muscle in your body, it needs regular exercise. Unlike the skeletal muscles which can benefit from only a few strengthening repetitions, the heart needs 20 to 40 minutes of continuous increased work for most benefit. A brisk walk is all you need – there is no need to destroy your knees running. If you are not challenged on the flat, find a big hill to climb. Walking up a hill is like putting more weight on the barbell and your heart will get stronger.
Nutrition is also very important. Fast, processed food has lots of energy to keep you going, but very little nutrition for the body to heal. I liken it to putting premium fuel in your car without ever filling the oil. You will go fast, but not far.
For food, less processed is the key: closer to the plant or animal provides the most nutrition. With bread and breakfast cereals, choose the highest fiber content to slow the absorption of the sugars into the blood. If you also try to locally source your food, you have the added benefit of fresh food, picked when ripe. The Farmer’s Markets are still open, and shopping there keeps your money in the local economy.
On the whole, North Americans eat too much meat; but, I believe a lot of the problems with beef come from the overcrowded feed lot conditions of stress, disease and antibiotics. Furthermore, cows evolved to eat grasses – when you force-fatten them with grain their bodies are not able to make healthy fatty acids. I do my best to buy local, grass-fed beef. I think he was happy to hear that he wouldn’t have to give up meat entirely.
We talked further. He had more questions, but like most people he already knew most of what he had to do. He pledged to make a shift in the way he lived his life, not only for his own health, but also for the health of his son.
Chris Semrick, B.Sc, RRT, CRE is a Registered Respiratory Therapist, Certified Respiratory Educator and a Smoking Cessation Counselor.