Sunday, August 8, 2010

Getting Well

By Neal Lemery

I had work to do, I realized, as I lay in my hospital bed in the intensive cardiac care unit. I’d had a heart attack two days before, and I knew I was close to dying when I looked into the eyes of my long time doctor and good friend.

He’d driven me to the emergency room of the local hospital, after I spent a sleepless night with what I thought was back pain. I’m 57 and my dad had his first heart attack at age 59 and his last one a year later. Oh, I’d been trying to eat right, exercising, and taking my anti-cholesterol medication for quite a few years, but I knew the genetic clock was ticking quietly and steadily in the background of my life.

Last month, I’d had my annual physical, including blood work to check on my cholesterol. I passed with flying colors. I’d been exercising a bit, too, and eating pretty sensibly. Still, I felt kind of run down, sluggish. In the last few weeks, I felt pretty punky, just not myself. I blamed in on the winter blahs, and a mild cold. But, the last few days, I’d been short of breath, and then, the day of my heart attack, I thought all the pain was some strained back muscles. Boy, was I wrong!

Today, I was having heart surgery. They called it an angioplasty, but step one was running a wire up through my femoral artery into my heart and having a look inside. If I was lucky, my three blocked heart arteries would be reopened with metal mesh stents, the same technique that President Clinton had had a few weeks earlier.

Or, they’d cut open my chest and replace the blocked arteries with arteries in my leg, and hopefully I’d make it out of that process alive.

But all the amazing medical science I was experiencing here in one of the region’s finest and most advanced cardiac care hospitals wouldn’t really matter unless I did my part. It was either step up to the plate and swing my bat the best I could, or I could choose to wither away and probably die.

I’d seen my second choice about six years ago, when I watched my mother quickly fade away, deciding that she didn’t want to live, and certainly didn’t want to take the initiative to be in charge of her own life. She was 86, and could have lived another ten years or so, like her mother. But, instead, she found every reason not to exercise, or eat right, or involve herself in daily life so that she could be an active, thoughtful person, the person I had known as my mom for all of my life.

I’d seen a number of people come out of the hospital after a heart attack, and steadily slide downhill, becoming depressed and more frail, giving up on life. And, I’d seen others who had taken the bull by the horns and were healthy, energetic people, enjoying life and making a difference in the lives of others.

Even in intensive care, I was able to order my meals off a menu. And, I was amazed to see a cheeseburger and fries on the menu. Really? In the coronary care unit? My nurse shook her head when I mentioned this anomaly. But, she said, a lot of patients want that kind of food, even while they are waiting for their heart surgeries to repair their arteries, clogged with the cheeseburger and fries kind of diet.

I opted for the salads and the salmon, knowing that the least I could do before my own heart surgery was to give my body a little fish oil, and leave out the bad cholesterol. The doctors and the nurses were certainly doing their part here, and I could at least be a member of their team.

For many years, I’d known that the mind-body connection was essential to good health and good healing. My spirit needed to be engaged in this battle, and without my mental and spiritual commitment to recovering and healing, I was dramatically increasing the odds of me not coming out of surgery. Leaving my wife as a widow tomorrow was not a viable option.

And, I had stuff to do. A lot of stuff. I enjoy my job as a judge in my community, using that seat on the bench to do some good things for people, and stimulate a lot of healing for folks dealing with family crises, addictions, and violence. My work there was not done, and I have a few more years left there before I retire.

Equally important to me is the work I have to do in the rest of my life. I have poems to write, essays and probably a few books that aren’t down in print yet. And, those creations of my heart and soul need to see the light of day. It’s taken a lifetime for me to get to the point of having the experiences and the wisdom to say the things that I think I need to say to the world, before I leave here.

And, my guitar needs more work, and I have a lot of songs to sing and a lot of songs to write. And, the empty canvasses in my shop need to have me cover them in paint, too. My camera hasn’t taken all of my photos yet, either, and, of course, I have more trees to plant.

We had a trip planned to Alaska this summer, and I had promised one son I’d come to California to see his new house. My to do list was pretty long and had some exciting things on it. And, there were some items to add to the list, like fly fishing, and writing songs, and getting better playing my guitar.

So, it really boiled down to me that early morning, do I live or do I die? That really isn’t the heart surgeon’s call, though I had certainly relying on his expertise. I’d signed the consent form, giving him permission to roam around my heart with his wire, and do his amazing work to get my heart fixed up again.

But, I needed to negotiate my own consent form, giving myself permission to get on with life, to be an activist in healing my body, and becoming, once again, fully alive. Being the lawyer that I am, I started outlining the terms of my own informed consent form. Doing what the doctors ordered, exercising, eating right, and having the right mental attitude were the essential terms of this new contract. And, working on my “to do” list of my life was right up there, too.

And, I knew I wouldn’t keep up my end of the bargain unless I built in some rewards. I knew myself well enough that I needed the carrot at the end of the stick. Otherwise, I’d find the excuses not to do my work. And, the consequences of that breach of contract wouldn’t involve a lawsuit. It would result in a dramatic decline in my health, and, sooner than later, my death. I knew what it meant to me when my dad died at age 60, leaving me a 20 year old college student adrift in the world.

I didn’t want to do that to my sons. They are older, but the early death of a dad is a real blow to a young man’s sense of well being in this crazy world. And, I wouldn’t want to do that to my wife. She is in the full bloom of her retirement and we had too many things to do on our collective to do list.

The surgery went amazingly well, and I woke up feeling astonishingly great. So great that I first had thought I’d died. I felt the surge of oxygen in my body and my brain, and my heart was beating strong. It wasn’t all the “happy drugs” I’d had that morning, either. It was the proverbial new lease on life.

God and my good doctor and his wonderful surgery team had given me a new chance at life. I decided to accept their offer and get on with it.

As soon as my nurse would let me, I was out of bed and shuffling down the hall. OK, the first stroll was 50 feet long, and I was pooped. But, I rested up and after an hour, I took another stroll, making it a bit farther. A few hours later, I was making it to the end of the ward and back, and a nurse held up a sign promising a new pair of bed socks if I made another trip. I took her up on her offer and she laughed.

I learned all about my new drug regimen, and settled into the daily routine. Most of what I take are vitamins and aspirin. I learned that vitamins D and B6 are crucial to good heart health, as well as flaxseed oil.

My wife has helped me get back to the local Y, and I am now proudly doing 40 minutes a day on the treadmill, and lifting weights. I walk a lot, and have given up the lazy approach of using the elevator at work.

And, I’ve indulged myself. I bought myself a new iPod, and zealously load it up with my favorite music, using my workout time to enjoy my songs, and listen to podcasts of some great shows on NPR, the ones I’ve always wanted to listen to, but have used the excuse of not having the time. I’m not shy about buying new workout shoes when they start to wear out and go “flat”. And, I have new sweatpants and a nice pair of ear phones. The carrot and stick approach works for me. I know that, and I accept that. It is money well spent.

I keep a daily journal of my health. I weigh myself every morning, and take my blood pressure. I wear a pedometer, and I write down my workouts. I’ve lost a lot of weight, and that is an irregular line on a chart. I don’t lose weight steadily and sometimes, I hit a plateau. But, I am the tortoise in this race, and my slow and sure work has let me drop four inches on my waist, and I have had the pleasure of a spending spree on new clothes.

The hour of working up a sweat has become a sacred time for me. On my daily calendar, which can become chock full of projects and meetings, that hour is my first priority. Without my good health, I won’t be able to do anything else on the schedule, so it really is number one for me. And, it’s really my hour. I have my music or a good program on NPR, or simply have some peace and quiet while I work up a sweat and take care of my body. It is a spiritual time, a time of contemplation, and, strangely, a time of rest from the chaos and demands of the rest of the day.

No one can bug me during that hour. And, the headphones have a good way of deterring people from talking to me or asking me a question when I am on the treadmill or pumping some iron. It is really “me time”, and I treasure it. And, when I don’t keep that appointment, I feel sluggish and I am grumpy.

Sometimes, I take that hour and don’t go to the Y. Sometimes, I head out to the beach, or go for a walk in the country near my house, or walk around town during the lunch hour. Or, if I am at a conference, I take an hour to work out, settling myself into my routine of exercise, making sure I take care of myself. No one else will. This is my job. And, I certainly don’t want to be sued for breach of contract!

But, then there is food. Unlike a lot of the other addictive things one can fall into, but also can make the decision to completely avoid, I still have to eat, nearly every day. Well, three times a day for me. I love food. But, it’s more than love or even nutritional necessity for me.

As a kid, food was comfort and a way to escape some of the traumas and uncomfortableness of childhood angst and family dynamics. And, because one of the family rules is that you had to clean your plate, if I heaped my plate full of comfort food, I didn’t have to talk much, and I got more comfort. And, more comfort eating bought more silence from me, and when I needed more comfort, I ate more.

So, I was a fat kid. I thought I wasn’t any good at sports anyway, so being fat and withdrawn from other kids kicked the eating wheel into high gear, and I ate more, got fatter, and felt more miserable being fat and socially isolated. Thus, more food was needed.

I tried to break the cycle a bit in high school, and was pretty successful in college. Still, the twin demons of comfort and “clean your plate” sing a quiet medley in the background every time I sit down for a meal. It can be a catchy tune, and sometimes I realize I am humming it without really thinking.

But, now I have to think. The cardiologist told me to lose thirty pounds and be serious about it. Otherwise, the medications and the new stents wouldn’t really do much good, not in the long run.

I’ve tried a new tact now, not only chasing away the twin demons of comfort and “clean your plate” with my knife and fork, and practicing eating small portions. I’m no dummy and I’ve been reading a lot about nutrition these last few years.

There are other demons around, as well. The corporate food industry has dumped tons of high fructose corn syrup into much of the ordinary, everyday foodstuffs, like canned vegetables, ketchup, and a host of other foods you wouldn’t think needed sweetening. And, I know for myself, when I eat high fructose corn syrup, one bit, or one serving isn’t nearly enough. I want more. A lot more. And, I know that eating cycle all too well. I don’t need anything else in my life that makes me want to “clean my plate” and want more.

And, a lot of our food has a lot of added salt, which helps raise my blood pressure, and leaves me wanting more food and liquid. Not too surprisingly, the liquids you buy at the store, not only the pop, but soup and juice, also have high fructose corn syrup and added salt. We only need a quarter teaspoon a day. Most “servings” of prepared food has at least that much. But, salt makes us thirsty and makes us eat and drink more. Good for the corporate food industry, but not so good for my arteries!

MSG is another ugly food ingredient, which, at my current age, gives me a lot of itching and twitching, sometimes half way into the night, not to mention some nasty headaches. It has a lot of other names, too, including hydrolyzed yeast, gelatin, calcium caseinate, monosodium glutamate, hydrolyzed vegetable protein (HVP), textured protein, monopotassium glutamate, hydrolyzed plant protein (HPP), yeast extract, glutamate, autolyzed plant protein, yeast food or nutrient glutamic acid sodium, caseinate, autolyzed yeast, vegetable protein extract, senomyx (wheat extract labeled as artificial flavor). It doesn’t exist in nature, either, and if I buy fresh, wholesome food, I certainly don’t need this “flavor enhancer”.

So, I’ve tried a new mindset, and it seems to be working for me quite well. I am looking at food and the whole daily eating game as a form of spiritual communion. For me, food is now energy and sustenance, on all levels, from the Universe. It is akin to the vitamins and prescribed drugs from my doctor. Everything that goes into my mouth is limited to what is “prescribed”, what is to be viewed as spiritual sustenance and energy.

If it is grown in nature and has only healthy, organic, truly nutritional “stuff”, then I can eat it. If it’s highly processed, contains manufactured chemicals and is altered by the corporations, then it’s not medicine for me. It is poison.

I’ve become one of those shoppers who only shops around the edges of the grocery store. I avoid the processed food that occupies all of the middle aisles, including the canned food, the “salt” aisle, and the “sugar” aisle. Instead, I stalk the produce section, and take my pleasure in finding real taste with organic vegetables, whole grain bread and grains, and the more flavorful, raw items that are becoming popular.

I shop for taste, now, and real nutritional value. And, I eat that way now in restaurants, too. Even in the chain restaurants, I’ve learned to substitute the fresh fruit cup for the hash browns, and leave out the fried breakfast meats, or the heavy sauces and white flour products. I hunt out the healthy choices on the menu, and I’ve learned to advocate for my diet and my own nutritional needs.
I’ve cut way back on eating red meat, too. A lot of red meat has hormones and chemicals, and is grown on feedlots. And, the fat in those meats is literally deadly to me. Oh, I still have a steak once in a while, or a hamburger, but I limit myself to buffalo, or grass fed beef.

I feel good about all this, as I’m supporting healthy ranching practices, and I’m taking care of myself, too. And, like most Americans, I’ve been eating way too much meat anyway. Our ancestors ate very little meat, and either grew or gathered their meals from their gardens, the prairie, or the forests. Politically, I even feel I’m doing my part to fight global warming, and not supporting bad agricultural practices. For my analytical brain, it’s a good re-enforcer to this new attitude of mine.

Not that I don’t have a life or that I don’t indulge once in a while. A few days ago, I took myself on an adventure in the city, riding the light rail train and being a city boy. At the mall at the end of the track, I bought myself a double scoop of ice cream, enjoying the treat on a warm summer’s day, savoring being the boy inside of me on the way back on the train. The ice cream shop made a point of advertising the ice cream as organic. Oh, sure, there was sugar, but none of the high fructose corn syrup, and it was a treat for a special occasion.

I treat myself to a glass of red wine every evening, or a scotch and soda. A lot of the research says that is good for my heart, and well, I do enjoy a drink at the end of the day with my wife, talking about our days and having a life with the woman I love. Life needs wine and roses.

I really try to listen to my body now. If I have a craving, then I listen for what it is I want. And, then, being the good steward of my body, I feed my body what it needs. But, that doesn’t mean grease and sugar. Often, when I think I’m hungry, I’m really just thirsty. So, I drink some water, or get some tea or decaf coffee. If I’m still hungry, I’ll have a healthy snack, or listen to myself, to see if there is a nutritional craving that signals a nutritional need.

I surprise myself sometimes, not wanting to clean out the bread basket at a banquet, and even passing it along without taking a roll. I almost always turn down the desserts, as they really never taste as good as they look, and I know they are usually loaded with high fructose corn syrup and white flour. If I’m going to splurge, I save my tastes for things that are really good and wholesome. And, almost always, not giving in is always worthwhile, especially when the bathroom scale keeps showing lower numbers, and I get to buy skinnier clothes.

I still want something sweet at night, and I always replenish my stash of high cacao dark chocolate. Some stores hide it in the baking section and one store thinks it needs to be in the organic snack section. Whatever. I’m becoming a good scrounge in the grocery stores. A nibble of that often ends my cravings, and the cacao has a high level of anti-oxidants. And, for the sweetness in my life, I make a cup of wild sweet orange herbal tea, with a healthy teaspoon of honey. The tea, and the honey satisfy my craving for sweet, and the honey has some of the anti-oxidants that are good for me. Again, it is looking at what passes my lips as needing to be nutritious and caring for my body’s needs.

There are benefits at the gym, too, and I’ve been increasing my speed on the treadmill, and I feel myself feeling stronger and healthier. The stairs at work don’t steal my breath anymore, and I just feel a whole lot better. The last time I saw my cardiologist, he grinned at my story of success and said he didn’t want to see me until next year. If eating better and enjoying tastier food is what I need to be doing, then this whole diet regimen isn’t all that bad!

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