Lifestyle is Not the Only Factor in Coronary Issues!

"The basic question is this: Why should ANYTHING exist? NOTHING would be tidier."

Edward Abbey

Well, this past week was one of the most challenging of my 57 years on this planet. This winter, I've experienced the most intense asthma I've ever had, which has manifested itself in feeling uncharacteristically out-of-breath during hikes or in the early morning while still in bed. Simultaneously, my blood pressure has been much higher this winter, which is quite concerning to me, especially considering the fact that I meditate a lot and get lots of exercise. When I went to the doctor, he suggested it would be good to check out my heart, just in case the shortness of breath was somehow related to that. Consequently, I underwent a simple treadmill stress test ten days ago. Four days later the nurse called in the evening to say the results indicated something abnormal going on in my heart. She then told me: "If you have any chest pains tonight, be sure to go to the ER! The doctor will read the test in the morning."

As you might imagine, I got no sleep that night. The doctor called the next day and advised me to see a cardiologist. The stress test indicated that I had some kind of blockage in the heart - most likely a result of coronary artery disease. I realized that this was especially important for me to get checked out, since my Armenian immigrant grandfather died of a heart attack at age 61, and since all of his brothers died young as well. However, the possibility of a blockage was difficult to contemplate since several tests I'd had seven and twelve years ago indicated no evidence of this kind of diagnosis. It was also challenging to envision since I get lots of outdoor exercise, and have eaten a mostly vegan diet for the past year and a half.

In addition, I found it especially difficult to face such a possibility in the context of our current American culture, where any kind of heart disease is met with a modern reframe of the Puritan mindset which says: "This is YOUR fault because you didn't eat right. If you had eaten the correct foods, this would NOT have happened to you!" Adding to the stigma is the fact that I practice regularly - and teach - sitting meditation. It is generally assumed in our society that people who meditate have lower blood pressure and lower incidences of coronary heart disease. Apps such as "Headspace" - which regularly advertise the health benefits of meditation - and a perusal of meditation-oriented Instagram posts all confirm such an attitude, making it doubly difficult to admit to such a diagnosis.

In any case, I was told that I should avoid ANY strenuous exercise last week until we figured out what was going on. This generated a claustrophobic feeling in me because, as you know, I exercise in the Great Outdoors almost every day. The possibility of a block also caused me to contemplate the possibility of having to cut out my backcountry explorations - at least until some kind of stent or surgery could correct the situation - a scenario that was downright terrifying. After all, any degree of sanity I have comes in large part from my time spent in the natural world. In fact, it's been that way for at least three decades.

A visit to the cardiologist revealed that I needed a more accurate test, which I underwent the next day. It's called a Nuclear Treadmill Stress Test. Basically, they inject a radioactive substance into your bloodstream, and then take pictures of it as it enters your heart, both before and after exercise. The tests revealed that I have a small artery blockage on the back side of the heart, and that I am at intermediary risk for a heart attack. On Friday, the cardiologist informed me that the blockage was small enough that blood-pressure-lowering and cholesterol-reducing medications should help remedy the situation. He also recommended that I get even MORE exercise than I currently engage in, a prescription for which I am, as you might imagine, very grateful.
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Honestly, I think the shortness of breath issue really IS a consequence of the asthma, but I'm appreciative of the fact that I underwent the tests so I'm aware of the presence of the blockage, and so I have a greater possibility of staving off any further heart issues. What a crazy week it has been! But I enter the coming days with an increased gratefulness for the opportunity to continue re-creating in my beloved wilderness spaces, and for the enhanced health prospects which these occasions offer.

Photo: Fern Lake Burn, Rocky Mountain National Park, CO, February 15, 2016

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