by Scott Zimmerman
Written in February 2000
It was Wednesday afternoon, February 23, 2000. I was walking across campus from my office to meet my wife Beverly at her car (she is also a professor at BYU), a distance of maybe 200 or 300 yards. A familiar pain hit me in the chest. This time, however, the pain was so severe that I had to stop three or four times during the walk for the pain to subside. I didn't know whether the pains were due to a lung infection, to my asthma, to indigestion, to a muscle cramp, or to a heart condition, although all these possibilities crossed my mind.
When I reached Beverly in the parking lot north of her office, she could see something was wrong. She could tell I was in pain and could see that my skin coloring was ashen. When the pain didn't subside immediately, she coaxed me into going to the emergency room at the Utah Valley Medical Center, even though that meant missing my daughter Melissa's parent-teacher meetings. At the hospital the medical staff gave me several tests, which were mostly negative. So they referred me to the hospital cardiac department for an EKG Stress (Treadmill) Test, which I took on the morning of Thursday, February 24. Before the test, and even while I walked on the treadmill at a slow speed, my heart gave a normal EKG, but by the time my heart rate got up to 100 beats per minute, the EKG became abnormal. The physician's assistant (PA) said that the abnormality was diagnostic of partial blockage in the coronary arteries. He then asked, "What are your plans for the rest of the day." I responded, "Whatever you say." The nurse and the PA liked that.
I was admitted to the hospital right then, and scheduled for cardiac catheterization and possible angioplasty to diagnose and open up my arteries. By about 1:00 p.m., the nurses had hooked me up to various monitors and wheeled me into the "cath room." They prepared my right groin with a local anesthetic (procaine) and gave me some sort of medication to sedate me. That's about the last thing I remember, even though I was conscious during the entire procedure. (The PA had told me the sedation medicine might erase my memory. It did. Totally. In fact, I asked Beverly three times what the cardiologist had done.)
Cardiac catheterization is the straightforward procedure of poking a long, hollow tube from the groin up through the body and into the heart. A dye is then injected into the blood stream. An X-ray camera provides a video (angiogram) of the flow of the blood and locates any blockages in the arteries. In my case, the cardiologist, Dr. Frischknecht (who does over ten of these procedures a day), found four coronary arteries with blockage.
The next procedure, officially called percutaneous transluminal coronary angioplasty (PTCA), involves poking a little balloon into the blocked regions of the coronary arteries and inflating the balloon to open up the blood vessel. To ensure that the vessels stay open, the cardiologist may insert a stent, an object made of (in my case) sterling silver that acts as a "culvert" inside the blood vessel. Actually, the stent is shaped sort of like a Chinese handcuff--the type that kids play with by connecting their two index fingers. The stent is placed around the angioplasty balloon, so that when the balloon is inflated, the stent expands, thus keeping the arterial passageways open. In my case, the cardiologist placed stents in three of the four partially blocked coronary arteries.
These procedures took a total of about one hour. Although I experienced some mild discomfort on occasion throughout the procedure, it was overall painless. I have had a relatively painless recovery so far.
I was relieved and deeply thankful that the physicians were able to diagnose and correct my problem so quickly. My biggest fear had been that they would have difficulty figuring out the source of my pains. I now know what my problem is, I know how to correct problem, and I'm making the necessary lifestyle changes to avoid the problem in the future. That's the good news.
The bad news is that I feel embarrassed about the whole situation. I knew I had a propensity toward heart disease, and so about 20 years ago, I got my weight down, I exercised regularly and copiously, I ate right (more or less), I lowered my blood pressure, and I lowered my cholesterol level.
But then in the early 1980s, I returned to my bad habits. I keep active but didn't exercise as much or as regularly. I ate anything and everything. My weight went back up . . . and beyond. My blood pressure got out of control. And my cholesterol levels skyrocketed. The result was totally predicable. Now I have atherosclerotic heart disease.
Fortunately, I love to exercise, and will now have a good excuse--and strong motivation--to go on the long mountain hikes and on the long runs that I love so much. Unfortunately, I also used to love fat-laden, cholesterol-filled food. That has changed. I now hate the stuff. I now love fruits, vegetables, salads, low-fat soups, whole-wheat grains, and other healthy foods. I pray for the self-discipline to stick with the new lifestyle. Very fortunately, my wife Beverly is joining me 100% on this diet, so we can support each other.
By the way, we’re starting out on a diet of 20 or less grams of fat per day. Maybe once my weight and my cholesterol get low enough, I can increase that to 30 grams fat per day. We’ll also eat fish three times a week.
Fortunately, I have been on some blood pressure medication for the past six months that really works. My BP has stabilized at 135/80, and I hope to get this even lower. I'm also temporarily on some blood-thinning medication, some anti-platelet medication, and some cholesterol-lowering medication. I'm also taking an aspirin a day, 500 mg of vitamin C morning and night, and 400 units of vitamin E morning and night. I’ll stay on the vitamin supplements and aspirin probably for the rest of my life, but I hope I can eliminate all the drugs once my weight is down and my exercise is up.
I can think of many lessons in this experience--lessons about the joy of life, the need for self-discipline, the problems of procrastination, the embarrassment of preaching one thing and doing another, thankfulness for being spared something worse than angina pectoris, and so forth--but I'll let each of you draw your own lessons. In fact, before I start preaching any lessons, I'll give myself time to make sure that I personally have taken these lessons to heart--and applied them to my own heart.
On the day of my angioplasty, I had the following blood lipid data [with the desired value indicated in brackets] and body weight:
Blood drawn Feb 24, 2000 [hospital]
Blood drawn May 8, 2001 [by my physician]
Since that time, I have completed three marathons: The St. George Marathon twice (once in 3:55:30 and once in 4:40) and the Ogden Marathon in 3:53:09. I have also complete one sprint triathlon (swim 350 yards, bike 12 miles, run 3.1 miles), an Olympic-length triathlon (swim 0.93 mile, bike 25 miles, run 6.2 miles), a half-ironman duathlon (bike 56 miles, run a half marathon), and a 184-mile bike race. I continue to run about 30 miles per week, swim 0.5 to 1.0 mile per week, and bike about 100 miles per week, although these numbers vary greatly over the course of several months. I also lift weights 2-3 days per week except during the heavy running, cycling, and triathlon race season. My current weight is still 170, down 65 pounds from when I had my angioplasty. I am one of the fortunate 5% of the people who lose weight and keep it off for two years or more.