Cardiac health and paranoia…

[SeaHorse81]

I've done some compelling reading lately--The China Study and How Not to Die--which have finally convinced me that the standard, meat-based Western diet is exposing all of us to unnecessary cardiac risk. We won't all succumb to it, but we all have arteries that could be healthier than they are.

Turns out that switching to a whole foods, plant-based diet will actually start to open those arteries back up. What you eat can add to the problem or actually start to fix it, depending on what you choose. You don't have to sit around wondering and worrying--you can actually do something that helps. You don't have to go full vegetarian or vegan, even. Just eat a lot less meat and a more plant-based diet and you can at least stop digging the hole deeper.

 

[Altamira]

You are not going to get a Cardiologist to do a angiogram on you unless he/she has some very strong reason to suspect blocked arteries that would likely show up in a nuclear stress test or chest CT Scan. An angiogram is a serious procedure, and it can kill you. If, during an angiogram, blocked arteries are found, the cardiologist will likely do an angioplasty and insert stents, all during the same procedure.

 

[Lorenzoid]

I discussed this very issue with my doctor when I had my annual physical last week. I explained that I'd be glad to pay out of pocket for a stress test, even a cardiac scan or whatever, if it would help me better judge my risk of heart attack. I explained that if I understood my risk more accurately, I could decide whether or not to put myself in places where, if I do have a heart attack, medical help can't reach me quickly. This is his reply to me (or rather, my interpretation of it, though the humorous bits are almost verbatim):

The only certain way to find a blockage is to cut the heart out and look at it. We can rule that one out. No test is completely accurate, and there are false positives and false negatives. Stress tests can tell some things, though they're not as accurate as scans. Stress tests are usually only indicated if a patient has symptoms or at least a family history of heart disease. If you feel perfectly fine when you do strenuous exercise, and you have no family history of heart disease, a stress test probably isn't going to reveal anything. So, what if you have a cardiac scan and it shows some blockage? Are you going to have an invasive procedure to have it addressed, potentially turning a non-issue into a serious issue? Are you going to stop diving? Some blockages will never cause symptoms. Lots of people have some degree of buildup in the arteries, so it's not like it's a black and white determination. For every Jim Fixx, there are many people who live active lives in blissful ignorance of a blockage that never causes any problem their entire life. The bottom line is that the most effective way for you to proceed is not to take tests but rather to build cardiac strength. If you come back in a year for your next physical and tell me you are running marathons or swimming olympic distances, then the fact that you are able to do that is the best evidence that you are at minimal risk of a heart attack.

 

[Steve_C]

If it's good enough for Wookie's wife, it's good enough for me..

Wellllllllll, not sure that I would go that far.

 

[Wookie]

I've done some compelling reading lately--The China Study and How Not to Die--which have finally convinced me that the standard, meat-based Western diet is exposing all of us to unnecessary cardiac risk. We won't all succumb to it, but we all have arteries that could be healthier than they are.

Turns out that switching to a whole foods, plant-based diet will actually start to open those arteries back up. What you eat can add to the problem or actually start to fix it, depending on what you choose. You don't have to sit around wondering and worrying--you can actually do something that helps. You don't have to go full vegetarian or vegan, even. Just eat a lot less meat and a more plant-based diet and you can at least stop digging the hole deeper.

Probably, but I didn't develop this fine specimen of manhood overnight. And, I'm going to die of something sometime. I'd far rather succumb to a massive MCI or stroke/aneurysm than lasting long enough to linger over a nice pancreatic or bone cancer. I think I'll go make a nice bacon and prime rib sammich. Or, in the immortal words of Billy Cristal, a nice MLT, where the mutton is nice and lean and the tomatoes are ripe....

 

[Duke Dive Medicine]

Sudden cardiac death in individuals with no cardiac history or risk factors is pretty rare but it does happen. Articles like this one strike fear in the hearts of all of us fifty-somethings, especially if we know people our age who have been through this. Still, the risk is comparatively low, and we can mitigate a lot of our risk factors, or not. Frank, just skip ahead and keep eating your sandwich ;-) We can also pay close attention to our bodies and not go into denial like the woman in the article did. She is fortunate to have lived to write her story.

You'll have a hard time convincing a practitioner to perform an angiogram on you if you have no symptoms and a normal stress test. You can pay to have one of those full-body scans done, which may or may not pick up an occlusion in a coronary artery. The best you can do is develop a plan with your primary care physician to mitigate your own personal risks, and enjoy every day.

Best regards,
DDM

 

[Stoo]

There's more to cardiac health than having a heart attack. My long term buddy has led a sedentary life for as long as I've known him... which is a long time. While my family has a history of heart issues (hypertensive here, and a brother who had two heard attacks by age 54 as well as a quadruple bypass, in spite of "looking" fit) my buddy's family does not. However, he is obese, and eats poorly.

Recently, he suffered a severe immersion pulmonary edema. A lesser diver may well have died, but he completed required deco (18 mins) and with the help of others on the boat, he was hauled out, and recovered successfully. We all learned after the fact that this was in fact the third time this had happened, although this was by far, the most serious episode.

To make a long story short, this led to a battery of tests including stress tests, an echo-cardiogram and even an angiogram (all for the price of parking Wookie, 'cause we are civilized up here in Canada). His diagnosis was a "weak" heart and he was told to lose 75 pounds and get exercising... Which I know he won't do. At my urging, he consulted with a respected diving Physician (who is also a friend) who basically told him it was time to stop diving. My buddy "negotiated" an approval to "sport dive"... 130', no deco. Whether this is wise or not, time will tell... He's 58, and loves diving as much as I do, so whether he's going to follow this advice is hard to say.

This situation has created a little "stress" in our group of diving friends. This guy is a long time friend and we don't want him to drop dead. Even more so, we don't want him to drop dead while we're diving with him. Apart from the paperwork involved, this would be unpleasant for all concerned.

One of my other friends talked to him last fall about dropping out of their Gunilda trip (260') and he opted to sit out of a high current dive with me in December, but the season is just getting going here now, so who knows what's going to happen.

We are all hoping that as much as well will miss diving with him, that he takes his Doc's advice and stops diving.

I don't profess to be be super fit, but I am not overweight, I exercise regularly (although at a much lower intensity than I did years ago) and so on, but the reality is that for those of us that are "getting on", we are at increased risk from all sorts of things including heart issues.

In Tobermory, we have lost three divers to health issues while they were diving over the past few years. One of them, just last summer, appeared to be in great health (given he was 70 or so) but none the less, he expired mid-dive, while on his deco stop. We heard the whole thing unfold on the VHF and it was very unpleasant for those directly involved. He was a good friend to many of my friends, and an acquaintance of mine.

So get off of your asses folks, and get in shape. If you aren't going to do it, then hang up your fins and take up bridge...

 

[Scott]

Turns out that switching to a whole foods, plant-based diet will actually start to open those arteries back up. What you eat can add to the problem or actually start to fix it, depending on what you choose. You don't have to sit around wondering and worrying--you can actually do something that helps. You don't have to go full vegetarian or vegan, even. Just eat a lot less meat and a more plant-based diet and you can at least stop digging the hole deeper.

This is the direction I chose to take about a year ago. I know I have one occlusion at about 50%. I'll take whatever steps I need to make sure it doesn't reach 51%.

 

[Rred]

I think the only "heart problem" known to be an issue for divers is a PFO. Basically, there's a spot in the heart where a hole (that we are all born with) hasn't fully closed, allowing some blood to circulate abnormally. This has been related to DCS problems, and either a very good echo cardiogram or other procedure can tell if you have a significant problem with this. I've heard an ECG with dye, or bubbles, or a more invasive procedure might be necessary as a gold standard, and also a simple ECG might be good enough. Dunno.

Diving itself is rated as a non-strenuous activity compared to most. The only "heart" stresses would come from trying to fight a current, haul a buddy, i.e. generally getting in over your head, the same way that people try to fight rip currents and drown--for no need.

It may be a feeling of guilt over years of neglect more than paranoia. You come to realize that either you have to change a lifestyle, or gamble on how close the nearest Cat1 ER is, and it turns out they are surprisingly far apart. You might want to call DAN and ask for a referral to a cardiologist who understands what "scuba" is, to get an informed opinion on your personal condition. Then decide whether it is or isn't something you feel is worth whatever risk. Typically, doctors have about as much reason to know what "scuba" is all about, as dogs have any reason to understand how elevators work.

 

[nolatom]

We could take a quiz:
https://www.johnhancockinsurance.com/life/life-expectancy-tool.aspx