Before my last drink of alcohol, I carried 220 pounds on my 6’1” frame. None of it was muscle. Six months after my last cigarette, I was over 230 pounds. It was way better to be fat than it was to be smoking cigarettes and drinking a pint of alcohol a night, but I knew fat was’t good.

When I left the treatment center’s day program and began its evening program, I searched for a new doctor. My old one had about killed me with his cavalier attitude about the big red blood cells two years before my last drink. He was’t any better when I saw him after my last drink. I knew who I wanted – Dr. Farris Johnson, from the treatment center. He is smart, thorough, straightforward, and he is a recovering alcoholic. (I report the latter with his permission.) It turned out he was a very popular doctor. He wasn’t taking new patients, but the treatment center staff told me he might take on an alcoholic. He did.

After an initial consultation, Dr. Johnson said he wanted to see me again in three months. He arranged for me to have lab work done on my blood before the appointment. When I was back in his office, he looked at my lab results with furrowed brow. My glucose was high (118). My HDL (good cholesterol) was low (33). My triglycerides, at 423, were off the chart-- more than double the normal maximum value. With triglycerides results that high, LDL (bad cholesterol) could not be calculated. In short, I was in terrible shape and at great risk for heart disease and a host of other maladies.

Dr. Johnson told me those numbers and a waist size of 40 inches or greater were harbingers for a condition called metabolic syndrome. He told me to do some research on it. From his experience with me at the treatment center, he knew I’d soon be a metabolic syndrome expert. I didn’t have to do research to know that whatever metabolic syndrome was, it wasn’t good. I didn’t have to be told that I needed to lose weight and that I needed to exercise. Being an out of shape drunk does’t mean I’m stupid. The time had come to deal with the Snickers I had been using to substitute for cigarettes and the years of neglecting my body.

Dr. Johnson’s news was’t a total surprise. We had mirrors in our house. I had already done some research on exercise and I knew the device with the greatest success was the treadmill. I had learned that if I was to be serious about exercise, I needed to avoid cheap ones. Money was a problem. During my short time in sobriety, though, I’d learned that things work out somehow. I had faith there would be a way.

Heart Disease

I needed to find a good treadmill for the cheapest price and thought of Play It Again Sports, a store that sells used sporting goods. I left Dr. Johnson’s office and drove directly to the store. On the way, I figured out how to work the financial end. I owed the hospital that housed the treatment center a thousand dollars. My father had sent me a thousand dollars to help pay for treatment. The treatment center staff had told me I could work out an interest free payment plan with the hospital. I decided to use Dad’s thousand dollars to buy a treadmill and pay it off, in essence, by working out a payment plan with the hospital. Of course, I didn’t tell the hospital folks about my plan. I figured that they, being dedicated to advancing good health and all, would approve. I also figured there was no sense testing that theory. I needed the treadmill.

The treadmill went into my office space so I could watch TV as I used it. I followed the directions carefully, standing on the sidebars and turning it on. I set the speed to three miles per hour, the incline to zero, and pressed the start button. After grabbing onto the handgrips, I stepped on the moving mat and started walking. I lasted about ten minutes. When I stepped off the treadmill, the room twirled and I nearly fell down. It was truly a pathetic effort, but I’d gotten started. That’s what mattered.

When I researched metabolic syndrome, I discovered the set of symptoms making up metabolic syndrome were significant predictors of heart disease. The one thing I felt good about was the waist size. Having a waist size of 40 or more was one element of the syndrome. My pants were size 40. They were tight, but surely it would’t be too hard to get it below 40. Just to be sure, I measured my waist.

Yokes! My tape measure read 44 inches.

I examined the tape measure to see if it was defective. Maybe some numbers were missing. I reread the directions about how to measure the waist to be sure I was putting the tape in the right place — one inch below the navel. I tried again with the same result. What’s the deal? Why am I wearing size 40 pants with a waist measurement of 44? Marketing is my guess. We feel better about ourselves when our pant sizes are smaller, so manufacturers lie to us.

I had more to do than I thought.

A lot more.

The treadmill became a daily routine. The ten-minute stint stretched to fifty minutes within a couple of weeks and I was soon up to four miles an hour. I gave up food with sugar and watched my portions. I thought I was doing pretty good. Then three months later, around the first of June, I had just finished the fifteen-minute warm-up walk on the treadmill when I felt it. Something in my chest. Not a sharp pain. Hardly a pain at all, but something was’t right. All through my alcoholic drinking, I had indigestion and reflux problems. That improved when I quit drinking alcohol, and became much better after my last cigarette. However, I’d still have symptoms now and then. This thing I was feeling now seemed different.

I stepped on the side rails of the treadmill and the feeling went away. After stepping back on the treadmill and walking again, the feeling was back. Off and on several times brought the same results. My stomach did one of those little flips that seemed to happen so often. I’d read it a million times: Chest discomfort that last more than a few minutes and is exacerbated by exercise is bad.

Heart attack city.

How many times have I heard about somebody dying after complaining of similar symptoms and ignoring them? I did’t want to be one of those guys. I needed to go to the emergency room. My insurance company gives you a discount if you call their nurses before an emergency room visit. The nurse heard my symptoms and told me to call an ambulance. I told her I was two minutes from the hospital and could drive there quicker. She said to call an ambulance because the emergency room will see me right away if I arrive by ambulance.

I hung up and pondered. I certainly was’t doubled over in pain. I would feel stupid to call an ambulance. I just wanted to be safe rather than sorry. I drove to the hospital and arrived to a full house in the emergency room. As I wrote my information on the sign in card, I figured my symptoms would result in quick action. “Chest discomfort while exercising. Feels like pressure in my chest. Goes away with rest, reoccurs with exercise.” In other words, classic heart attack symptoms. I slid the card in the slot and wondered if I should bother walking all the way across the room to a seat. Surely, the nurse would call me as soon as she read the card.

The card sat there unread, so I found a seat figuring that my chances of avoiding sudden death would be better if I were sitting rather than standing. Time passed and several more people added cards to the box. Finally, the glass window slid open. A white sleeved arm emerged and retrieved the cards. Now, I thought, we'll have some action as soon as they read my card.

Nope.

I kept thinking about the nice nurse from the insurance company and her suggestion for me to call an ambulance. I waited a while longer. Nothing happened. OK, that’s enough. I headed for the door, cell phone in hand. My plan was to step outside, dial 911, and tell them I needed an ambulance. When the operator asked where I was, I would respond, “At St. Mary’s hospital just outside the emergency room.”

“Mr. Wyrick.” I heard my name and stopped short of the door. Finally, it was my turn. The initial consultation was fast. After my card was finally read, I became a priority was sent straightaway to an examining room. An attendant hooked me up to an EKG and drew blood. Then, it was waiting time again, only now they were monitoring me.

Dr. Agrawal came to see me. He’s the cardiologist I’d seen seven years before in similar circumstances and had seen again after my last drink when my heart rate was racing. He said my EKG and enzymes were normal. There was no indication I’d had a heart attack. However, given my symptoms paired with my thirty-year history of smoking cigarettes and drinking alcoholically, he was going to do a cardiac catheterization. He would run a camera into my heart to see if there were any blockages. He’d do it the next morning.

I stayed in the ER for observation for several hours before being admitted to the hospital in the middle of the night to wait for the procedure. Before sobriety, the waiting would have been horrible. The hours before the procedure would have been interminable and filled with anxiety and fear. I would be obsessing over the sedation and how that might react to the damaged liver I presumed I had from my drinking. Of course, I would lie when asked about my alcohol usage.
This time it was different. I had no anxiety. I used the tools I’d learned in the treatment center. For the past year, I had spent time each day practicing those strategies and that effort was bearing fruit now.

Cardiac Cath

Dr. Johnson came to my room before 6:00 a.m. He was clearly concerned, but not particularly about my heart. He had seen me in panic mode when I first entered the treatment center and seemed worried that I would revert in these circumstances. I’m not sure he trusted my reassurances that I was OK with the cath. I don’t blame him. I was a nut case when I arrived at the treatment center. My biggest concern about the cath was being sedated during the procedure. While drugs were never my problem, I’d been taught that cross addiction is a real concern of recovering alcoholics and addicts. Taking mind-altering substances of any sort could trigger my obsession to drink alcohol again, and I never, ever, ever wanted to drink alcohol again.

The treatment center staff had told us what to do when faced with the prospect of being given such drugs. First, if possible, avoid them. Many times, we’re given a prescription for narcotics just to make us more comfortable. Recovering alcoholics learn that it’s OK to feel uncomfortable from time to time. However, there are occasions when circumstances require pain relief medication. Having a tube pushed into my heart was one of those times. It was time to “frame up” my experience. That’s what the treatment center counselors called it. I talked to a counselor on the phone, then called another recovering alcoholic. I agreed to contact both again after the procedure so that I would be accountable during that vulnerable time. There are few things more dangerous than an alcoholic who is relying on himself to keep from drinking. Any pain medication going home would go to Pat with directions to hide them and to use them only if pain was truly an issue.

Enlarge

Shortly before noon, I underwent the procedure. Dr. Agrawal inserted a tube into an artery in my arm and manipulated it into my heart. I was feeling just fine from the medication I’d been given, and could see the television monitor showing my heart, and the instrument being inserted into it. It was all very interesting. What a delight to be sedated without worrying about my liver blowing up. Dr. Agrawal said the camera showed the left anterior descending artery (LAD) had a 60% blockage. That’s not enough to do stints, balloons, or bypasses, but he said I needed to continue to do all I could to be sure the blockage doesn’t worsen. He’d leave that part to Dr. Johnson.

After arriving home, and doing my own research on the Internet, I found out the LAD had another, more ominous name: the “widow maker.” It turns out that if the LAD becomes totally obstructed, death is instantaneous. OK, that is a big deal. Further research indicated that most heart attacks don’t occur from slowly growing blockages. More often, pieces of gunk, known as plaque, break away from the artery wall and is pushed along by the blood until they reach a narrowed point and block the artery. Or, the plaque splits and starts to bleed. The body, reacting to what it perceives to be a cut, begins coagulating the blood, creating a rapidly growing blockage that quickly blocks the artery. In either case, the blockage I had increases the odds of one of those things happening.

So, what to do? It appeared to me I had two choices. I could sit around feeling depressed about my bad luck (more accurately, poor life choices) and worrying about dying. Or, I could accept the reality of my circumstances, live life on life’s terms, and move on. Work harder on my weight, exercise harder, and deal with this thing.

With a lot of help, I had quit drinking alcohol. I had quit smoking cigarettes, too. It was god-awful, but I’d done it. As I walked out of the hospital, I made a commitment to get serious about finishing the job. Now, I needed to get my body in shape. I continued to exercise and switched to the Atkins. I had read that it was effective. But, mainly I decided on Atkins because I liked the idea of eating sausage and not worrying too much about calories. I always hated the idea of trying to count calories. I was losing a pound a month – seemed just fine to me.

That ended a year and a half later when I had a cardiac catheter back in my heart. Shortly after awakening on an October morning, I felt something bad in my chest. – a dull ache. It didn’t go away. I was a couple of miles out of town heading for work when I turned around and headed to the hospital. I didn’t want to be one of those guys who ignored the warning signs and keeled over dead. One of the gifts of sobriety was that I had quit obsessing about dying, but I still didn’t want to go down stupid.

Because of my known heart disease, along with my history of alcoholic drinking and thirty-one years of two-pack a day smoking, the cardiologist wanted another look into my heart. It turned out the blockage wasn’t worse. Maybe even better. I felt pretty good about that until I was back in Dr, Johnson’s office a few days later. The latest blood work showed my LDL cholesterol was 90. Under 100 was supposed to be good, so I was happy. Then, the doctor told me about the huge cholesterol study that had been done. Folks with known heart disease did better when the LDL was below 70. Nuts. Dr Johnson wanted to prescribe a statin – medicine designed to reduce cholesterol.

“I don’t want a statin,” I whined. I didn’t want to risk the side effects and I didn’t want to get on a medicine for life unless I absolutely had to. Plus, when you take statins, you had to have your liver checked every three months. After my two weeks of self-detox, I wasn’t interested at all in worrying about my liver again.

Dr. Johnson said, “Then you need to lose more weight.”

I’d gone from 230 to 211 in the last eighteen months. “How much?”

He shrugged. “What do you think?”

I pondered. I think he was wondering how far I was willing to go. I said, “One eighty-five?”

“OK, we’ll go for that.” He paused for a moment. “You know, this is for life.”

I nodded. “I’m not drinking alcohol for life. I’m not smoking cigarettes for life."

I knew I was embarking on a new regime that would be forever.

One day at a time.

I changed to the more traditional “heart healthy” diet of counting calories and eating whole grains, fruits, vegetables, and low or no fat. I also continued to run daily. A few weeks after starting the new regime, I began keeping a record of my weight each Friday. I took from October to May to get to my goal. Here’s the the log:

I had started at 230 pounds. I began keeping the record at 197 pounds on October 28, 2004. The end of the record was April 20, 2005 when I reached 163 pounds. Actually, I kept going until I got to 157. I wanted to get my waist below 35 inches. But, I grew tired of people asking my friends and family if I was dying. Age and genetics made my waist the last to go, so everything else – face, arms, legs – made me look like I wasn’t long to be with the living. I added some calories back into my diet and settled on 165 as my maintenance weight. That was in 2005. I’m writing this in July, 2009 and my Friday weight is still 165. While the weight’s stayed the same, my exercise has intensified. I now run five miles five days a week. I lift weights the other two days and run 2 ½ miles on those days. As I intensifed exercise, I added calories.

The results? I feel great! Losing weight has all sorts of advantages that had never occurred to me. I used to dread clipping my toenails. When I sat in a chair and tried to reach my toes, I had to grab the fat at my waist and rearrange it so it wouldn’t hurt. Breathing was a challenge while I was clipping. Now, I just bend right over without thought and breathe just fine. Really. There are lots and lots of things like that going on.

That’s not the big deal, though. Here’s the big deal: For three years my LDL has stayed in the sixties without medication, my HDL has risen to the upper fifties, and my triglycerides have stayed below 100. The latest heart disease marker is LDL type. Apparently, we have two kinds of LDL: fluffy and dense. Fluffy LDL doesn’t stick to your arteries. Dense LDL does. Dense LDL is bad. That’s why people with low LDL can still get heart disease and people with high levels of LDL can be disease free. It all depends on what percentage of the LDL you have is fluffy or dense. A few months ago, Dr. Johnson had my LDL type checked and the news was good. My dense LDL was measured at zero. Zilch. Nada. None.

Yes!