Fighting Father Time
“Nobody gets out of this place alive.” I’m familiar with the line, I was just hoping to be the first exception. When you’re young, of course, none of this stuff bothers you….or probably even occurs to you. But when you hit thirty (at least in my case), mortality becomes at least a remote presence, stealthily moving closer. I hated becoming thirty, realizing one-third (yikes—maybe one-half) of my life had passed and the rest of it was racing along. After coming to grips with all that angst at thirty, however, I never let it bother me again. Now, at seventy, I’m stubbornly continuing on with most of my gym rituals but with one change. I seldom increase the weights anymore and I rarely increase the treadmill speed past 7 miles an hour. In the past, I might swing over a fence or jump down from a nominal height. Now, I think about potential broken bones, not that I’ve ever had one.
Before I was 55, I couldn’t gain a pound to save my life. At that age, I noticed my stomach was beginning to grow just a little. I had friends who had grown giant stomachs in very short periods of time (the ones with tiny asses were particularly repugnant) and I wasn’t going to let that happen. Siobhan bought me a 30-day gym membership at Lifetime Fitness, a gym/rehab facility owned by Marion County Regional Hospital.
“Try it for a month. If you don’t like it, quit,” she said. I’ve been going there three times a week ever since. I’ve outlasted twelve trainers, a couple dozen interns, three floor managers and countless other staff. When clients want to know how a machine works, they’re as likely to ask me as an intern. I have met people who have become friends and I have met people I would like to push down the stairs, it’s all a part of the game. I have woven Lifetime Fitness around my MWF schedule of doctor’s visits, car repairs, prescription pickups, post office visits and the like. And it’s a good thing I have, as you will discover in the next article.
What I’ve Learned
Esquire Magazine, the nation’s best monthly read, has a recurring feature called “What I’ve Learned,” which takes a prominent personality and gives him or her a page of the magazine to recite some of the more important lessons they have garnered in life so far. This is a great idea, but the problem is most of these people do not stick to the purpose of the page. In addition to the paltry few things they’ve learned, they elaborate various other likings which, while often interesting or entertaining, do not hew to the line of ‘What I’ve Learned.’ I will not falter in this regard in my collection of lessons which I will begin right now.
What I’ve Learned: (1) Exercise, Like Mighty Mouse, Will Save The Day
You can’t pick up a newspaper or magazine these days without seeing an article regarding some new, heretofore unknown benefit of exercise. It must drive the couch potatoes crazy. But the benefits of exercise are impossible to overstate. Exercise keeps my weight under 155 and my waist size 32. Exercise allowed me the endurance to climb Half-Dome in Yosemite National Park at age 65 (when I reached the top, nobody else was over 35). And exercise probably prevented me from being dead right now.
Four years ago, Siobhan and I were driving back from visiting friends at a farm in Fort McCoy, a ramshackle little town just east of Ocala. It was around noon. I had a slightly upset stomach and a minor ache in two small arcs just below the nipples on each side of my chest. I attributed the latter to overdoing my bench press a day earlier and figured it would disappear by next day. We went home, had lunch and fed the horses. The achiness remained modest but the stomach discomfort grew worse. I thought it was some variable of a gas problem, but Siobhan insisted we see my primary physician, James DeStephens, in Gainesville.
I had periods of improvement and regression, but the doctor thought it would be a good idea to have cardiac catheterization to see if anything was going on. My blood pressure and heart rate were a little high, but nothing scary. I thought I would get over it, but Siobhan wasn’t satisfied. The doctor offered to set up the cardiac cath, which, at this hour, required an overnight hospital stay, but I refused. All the warnings of heart attack I ever heard of—pain radiating down the arm, tightness in the chest, etc.—were not present. Riding back home across Payne’s Prairie, Siobhan read me the riot act and I finally agreed to have the procedure performed next morning at seven a.m.
I had a rough night, not sleeping much and clunking around the house, much sicker, but still able to take a shower while Siobhan fed the horses. By the time we reached the hospital, now 19 hours after the onset of the original symptoms, I was in Big Trouble. They put me in a wheelchair and I vomited—or tried to—continuously. They took me in ahead of the prior appointments. Dr. Daniel Van Roy, from Interventional Cardiologists in Gainesville, told Siobhan to stand by in case “decisions” had to be made.
“What decision?” Siobhan asked. “You’re the doctor—the decision is save him. I can’t just go to the corner and find another Bill.” He told her I could come out anywhere from halfway decent to oxygen-dependent to well, um….dead. Siobhan had a little over half an hour to ponder my fate. Eventually, an empty bed rolled by, which gave her a bad moment, then Dr. Van Roy.
“He’s pretty good,” Van Roy told her. "The heart attack was in the left anterior descending artery, about the worst possible place. We call this type of heart attack ‘The Widowmaker.’ Ten out of eleven people don’t survive it. We won’t know how much damage there is for awhile, but I did what you told me to. I put in a stent and saved him.” Siobhan smiled in gratitude.
I was supposed to be in ICU for a day, so I took it as a good sign when they moved me into a regular hospital room after several hours. When I was visited by Dr. Imperi, one of the partners at Interventional Cardiologists, I expressed my disappointment. All this religious exercise and I still get a heart attack.
“Without being in the kind of shape you are,” he said, “you’re dead now. Your heart wouldn’t tolerate a 19 hour siege. You’ve probably built up co-lateral circulation which allowed you to survive.” Dr. Imperi told me my arteries were “pristine” with the exception of the blood clot which secured itself in the worst possible location. Where did that blood clot come from? There’s a strong possibility it derived from an experimental drug I had been taking as part of a University of Tennessee study on prostate cancer. I had reached a pre-cancerous condition called P.I.N. at which time I decided that rather than just let cancer take its course, it might be a good idea to do something about it. The literature on the drug, which was already being used successfully against breast cancer, warned, among other horrors, that “blood clots can result.” So could everything else under the sun—you know how those things are. I dismissed the warnings and gave greater consideration to the more immediate problem. Obviously, Dr. Imperi took me off the drug and out of the program, putting prostate considerations on hiatus. I remained in the hospital three more days and went home.
Recovery
The last day of my hospital stay, I was visited by Mary, of Cardiac Rehab. She told me my doctors wanted me to start a recovery program “as soon as possible” after my release date. I showed up the next day.
“We didn’t exactly expect you this soon,” Mary said. Then she made me sit down and listen to the sad tale, filled with bad enzymes and the like, of how awful my heart attack was.
“Your Ejection Fraction, considering your activity level, was probably 55 or 60 before the heart attack. Now it’s 25.”
I learned that during each heartbeat cycle, the heart contracts and relaxes. When your heart contracts, it ejects blood from the two pumping chambers (ventricles). When your heart relaxes, the ventricles refill with blood. No matter how forceful the contraction, it doesn’t empty all of the blood out of a ventricle. The term ‘Ejection Fraction’ refers to the percentage of blood that’s pumped out of a filled ventricle with each heartbeat. Because the left ventricle is the heart’s main pumping chamber, Ejection Fraction is usually measured only in the left ventricle (LV). A normal LV Ejection Fraction is 55 to 70 percent.
Bottom line being, take the recovery slowly, said Mary. She called the doctor, who allowed me to walk on the treadmill a little bit. As the days passed, I was allowed to walk more aggressively and to begin on a rowing machine and a stationary bike, all the while monitored by an EKG machine which picked up signals from a very heavy machine on my belt which sent out a generous web of leads to every part of me. This went on for a month. Eventually, I graduated and was allowed to return to Lifetime Fitness, although with a reduced workload. I never experienced any discomfort and, as the months passed, I gradually returned to my old routine. A month later, it was time to return to Interventional Cardiologists to see how much damage had been done. Having had no difficulties, I was cautiously optimistic.
“You have almost no permanent heart damage,” Dr. Van Roy told us. “There is a slight scar at the apex of the heart, which should present no problems. The Ejection Fraction is 55.” Somehow, despite everything, I was back to normal. Handshakes all around. Drunken revelry well into the night. Well….maybe not.
After this incident, I am a lot more prepared to jump in the car at any provocation and go to the emergency room. Once, I went for a slight bout of vertigo, which I had never had before or since. Once, I went for a kidney stone. I am not so stubborn anymore. That’s one of the wonderful benefits almost dying will give to you.
What I’ve Learned is that exercise can save your life, literally. I once wrote an exercise-and-diet screed to my friend Pat Brown (before all this happened) back when my health program was burgeoning. I didn’t hear back from Pat for quite a while. Nobody likes an evangelist, so I calmed down and haven’t said much of anything since. But I’m still on the program. Not only would I like to continue living for a while, I’d like to do it on my own terms, without many limitations. I do not want to spend my declining days in a wheelchair in the company of the droolers on the front porch of the Bide-A-Wie Nursing Home. And I don’t want to visit you there, either.
