What You’ll Learn

What does a proactive cardiac patient look like? This individual exemplifies the self-advocate patient. Despite a heart condition and Type 1 diabetes since the age of 11, he has taken charge of his health with monitoring and lifestyle changes, losing 32 pounds in the process. His health journey has taught him the power of getting support in losing weight, that access to care means more than ability to see a doctor, how to ensure his doctors see his whole health status, the impact of lifestyle changes, and why men wait to seek help.

Interviewee: I’m 73 years old and have been married for 42 years and live in Houston, Texas. I have three grown children, six grandchildren. I like to hunt, fish, garden, read, cook, and right now my health is stable. My cardiac status is stable at this time. I like to walk, exercise every day and putter around in my garage and do some gardening and take care of my lawn.

VIVO: What’s the best experience you’ve ever had in healthcare? How did it make you feel?

Interviewee: It probably has to do with my left knee replacement I had in August of 2021. Much to my surprise, that went very well, the surgery and the required physical therapy afterwards. Of course you have to have good stable cardiac history to have that done, but that’s probably the best health event I can think of because it’s invasive. I went through the surgery well. I think it’s one of the best experiences I’ve ever had.

VIVO: What is the worst experiences you’ve had in healthcare?

Interviewee: The worst experience probably has to do with my diabetes. I have suffered numerous low blood sugars that were below 40. At that point, if you’re not rescued by someone, you can die. That was probably the worst healthcare experience I ever had. But things are much better now, much more stable.

VIVO: I’m glad to hear that. How did that make you feel, having those low dips?

Interviewee: It made me feel very threatened for my own safety, especially if I was asleep or alone, especially considering if I was driving. It’s a life experience that puts you on that tightrope of you could die, easily die. That was the worst health experience I ever had.

VIVO: Within the entire spectrum of healthcare, what is not being said that should be said?

Interviewee: I think it has to do with what we’re talking about today, and that is heart disease. It is rather silent. Thinking back to when I started to address my risk factors, that was what I thought was hidden, silent, needed more tests‚Äîblood work, EKGs‚Äîto discover what was going on with my heart and how we could start to stabilize it.

VIVO: What the risk factors that you personally experienced ? That you learned were risk factors or knew ahead of time?

Interviewee: Some of those I could feel. I have a stethoscope at home and I listened to my heart because I felt something wasn’t right. I couldn’t put my finger on it, but it was an irregular heartbeat. That was it in a nutshell. I went and bought an Omron Blood Pressure Cuff.

With the cuff, I took my blood pressure and noted the time and the date, blood pressure and pulse, and it was elevated, so I made an appointment with my cardiologist. I think at that time I was experiencing general life stress. My BMI was 31, which isn’t too bad, but it isn’t great. My blood pressure was up and I think I was overeating at that time and I was short of breath. If I exerted myself too much, I had some dizziness, but I never had chest pain. It was mainly the shortness of breath.

VIVO: When you started experiencing those symptoms, had you already been diagnosed with diabetes or did that come later?

Interviewee: No, I was diagnosed when I was 11 years old.

VIVO : Do you have a family history of cardiac disease or heart disease?

Interviewee: My maternal grandfather passed away of a sudden heart attack. My maternal grandmother had multiple strokes. My biological mother died at 95 and a half of natural causes, unfortunately in March of this year. My father passed away in a severe car accident. My brother had pancreatic cancer. But in answer to your question, no other family members had cardiac disease.

VIVO: Did you use alcohol in excess? Did you smoke? Anything of that nature?

Interviewee: Years and years ago, I don’t even keep track of that, but I did smoke at one time, about a pack a day, and then I quit. I was out in the garage one day and I went over to the ashtray and put the cigarette out and I said, “That’s it.” I don’t know why then, but I stopped. There was a time, when I was a young adult, I drank excessively, I stopped. I thought, what a waste of time. I’m not getting any benefit out of this. I quit drinking, I quit smoking, and now I’m working on how I could get my weight under better control by eating less.

VIVO: What heart disease were you diagnosed with and how do you manage it now?

Interviewee: The diagnosis is called persistent atrial fibrillation. In July of ’22, we did a cardioversion. Shortly after that we did an ablation. As a matter of fact, I’ve had two cardioversions, and right now my heart’s doing well according to both my cardiologists. I have a cardiologist and an electrophysiologist, and they say that I have what they call ectopic beats, but I’m not in full atrial fibrillation like I was.

VIVO: How much time passed between when you bought the blood pressure monitor and you said you felt the irregular heartbeats and then when you actually went to the doctor and received a diagnosis officially?

Interviewee: One to two months. Because I had the symptoms and I said, “I’m going to monitor it at home.” Instead of going to the doctor’s office to have one blood pressure done, I wanted to take it on a regular basis and show him what my readings were here at home, considering it was an accurate machine to do it on. That’s what I did.

I showed him that and I showed him a list of my medicine and I showed him my practitioners that I saw and their phone number, because the right hand has to know what the left hand’s doing. My general medical history. All my immunizations, I wanted to show him that my testosterone level was within normal limits. I showed him my summary of my prostate exam per my urologist. I also had a colonoscopy, and that was negative. I wanted to show him a clear picture, top to bottom of what was going on with me, whether it was stable or not.

VIVO: How did that feel to receive a diagnosis?

Interviewee: I felt rather nervous about it, frightened. I didn’t feel good about it. I felt preoccupied.

VIVO: Tell me more about that.

Interviewee: Kind of worried. I’m a worried person to begin with. He requested what they call an echocardiogram when I was at his visit. We went into the room where they do the echocardiogram and the technician started it and then he brought the doctor in and he looked at it and they’re both standing there looking at it and not saying anything. I’m like, what are they thinking? What are they seeing? That heightened my anxiety. He said, “You’re okay, but you’ve got heavy atherosclerosis.” I’m thinking the whole time, how in the world could that happen when I’m eating nutritionally sound? I don’t go around eating six Hershey bars a day, and now I’ve even cut out my carbohydrate load significantly.¬†

VIVO : You have, since the diagnosis, cut your carb load?

Interviewee: Yeah, significantly. I went so far as to implement, last year, what they call intermittent fasting. I lost 32 pounds. 16 hours fasting, eight hours eating lightly. It really helped. I didn’t announce it to anyone. Then I started to hear from friends and family, “Are you losing weight?” That was a thumbs up for me. I was trying to help myself out so that I wouldn’t have some sort of cardiovascular incident, no matter what age. Especially if you’re over 50 or 40.

VIVO: Did receiving this diagnosis change how you viewed yourself?

Interviewee: Yeah. I had a view of myself as not being at my best. Not my optimum, not of what I could do in terms of exercise or diet. I felt like if I had a little support. Unfortunately, I don’t know how to describe that, but I didn’t feel much support. I felt superficial support from my wife. But other than that, that was it. I guess what I wanted was a buddy, someone that had the same kind of thing and that had the same kind of goals to get better. Better meaning stable enough or doing enough via diet and exercise and medication and anything else, regular doctor visits. I don’t know what else to do.

VIVO: So to help you cope with it, you’re saying, more support from somebody who is in the same scenario as you would’ve helped?

Interviewee: At this point, I was going to, I hate to say this, but I was going to load up artificial intelligence with all my data and to see what it might say. It’s an idea. Because the doctor’s visit is 15 minutes. It’s like a foot race. You get in there and bam, bang, they listen to your blood pressure, do an EKG, look at your medicine. Boom, you’re out.

VIVO: In this idea of loading up AI with this, is your goal to learn more about what you can be doing or is it to get more consultation that you feel like you’re missing from a quick doctor’s visit?

Interviewee: Yes. I want to be an active participant. I want to be doing something that’s a reflection of my caring level for myself. If that means me doing a certain exercise for a certain amount of time every day, that’s fine. But I would like some research to back it up.

VIVO: That makes sense. You’re willing to make changes.

Interviewee: I don’t even know for sure if that kind of research goes on. Like, you tell me to walk, but walk how far, how long? And how often? I have to know specifics and then I’ll go to it and it might be about the same as what I’m doing currently.

VIVO: So somebody can give you goals and specifics you’re willing to make whatever lifestyle changes you need.

Interviewee: It has to be tailored to the unique individuals. That’s all.

VIVO : What are other ways you’re managing your heart disease right now? You’ve mentioned doctor’s visits, how frequently and how often do you have to take medications, anything of that nature?

Interviewee: I monitor, I take my blood pressure at home. It’s a blood pressure and a pulse. I also put every month my body weight. I always put down the information, my date of birth, for what it’s worth, and then I try to put down a list of my other physicians, like my endocrinologist, my primary care physician, so that if there’s anything that needs to be said between them, so be it. Because a lot of times you get the primary care physician would order something that might be contraindicated with what another practitioner orders, and there’s a whole software program for that. But I don’t even know if they implement that or not. That’s probably something extra I could do at home. I hope that answers your question.

VIVO: Yes sir, it does. And I’m curious, how would you say that your location, being in a more urban area, how has it impacted your entire health experience?

Interviewee: I’m within 12 miles of all of my practitioners. The accessibility is there, my pharmacy is close to home. I do have one medication I get from Canada, so the delivery, whether it be FedEx or Amazon, is adequate. The communication online is very good because they’ll go so far as to tell me when to expect it to the day and the time.

In answer to your question, everything is fine in terms of accessibility. Accessibility doesn’t mean seeing a practitioner. It can mean where I get my medicine, where I get my medical equipment. Whatever the doctor orders I can do, even if it’s a procedure. An EKG, a cardioversion, whatever, I’m in good access to that. Thankful for that.

VIVO: Would you say that heart disease has impacted you in any ways that are unique to your age or gender?

Interviewee: That’s a good question. I think I could answer it better if I knew who was in the same boat. But unique? I don’t think I’m that unique because I think it’s the leading… When you hear things like heart disease is the leading cause of death for men over the age of 50, that takes the uniqueness out. There’s nothing unique about it. It’s very common.

VIVO : Maybe what are some misconceptions about heart disease as a male then? 

Interviewee: I think the misconception is that men, in particular, maybe don’t want to know. I’m guessing here. I’m not saying it’s true, but I don’t think some men want… I think they have excuses not to look at it unless they get significantly symptomatic. That’s kind of what happened to me. I wasn’t even looking, and then something happens.¬†That’s the only unique thing is that we’re waiting for something to happen concretely. For me it was shortness of breath, I saw that I was overweight and my diet wasn’t great, and I had to adjust those risk factors in my life that were unique to me. I think that’s about it.

As I talk to my neighbors that are about my age, same things going on with them. Not exactly the same, but there’s some similarities there, that they have high blood pressure. I can go to two of my neighbors right across the street and they’ve got hypertension.

VIVO: So those symptoms are there, it’s a matter of what compels you to turn the symptoms into a doctor’s visit?

Interviewee: Yes, ma’am. That’s it in a nutshell.

VIVO: Do you have any future goals for yourself in terms of health and wellness?

Interviewee: Yes, the first thing is, I want to continue what I’m doing in terms of my diet. I think diet, we’ll call it calories. I want to get to the point where I can be comfortable in not eating so much, and especially carbohydrates. The more I read, the more I start to understand that carbohydrates, processed food, refined sugar is a big no when it comes to men or women with cardiovascular disease or without cardiovascular disease.

I think all people, all adults at any age, even young adults should start. It’s real interesting. I went to my granddaughter’s event at school she had, and the little kids, a couple of them were eating. I stared at them and I looked, both of them were choked, slapping in donuts. It was all refined sugar. It was all carbohydrates. I said to myself, that’s where it starts. It starts with the young kids. It doesn’t start when you’re 50 and have symptoms. It starts with those parents ate a certain way, and so they pass it on to their children. That’s what I think is most unique about heart disease. It starts when we’re very young. What’s quick? Here’s a little donut before you go to school.

But in terms of myself, I’m going to continue what I’m doing because it’s working. I’m going to be medication compliant, I’m going to be compliant seeing my clinicians. But the biggest thing is I’ve got to get my weight down to a level that looks like something that’s acceptable to the CDC.

VIVO: So you have that measurement as your goal weight?

Interviewee: Yeah. It’s around 180, 185. For my height, my gender, my age, I look at the CDC and I like to use that as a goal, a barometer of where I should try to get at. It’s amazing, this Christmas holiday, I go out and it’s watching what people and how much they’re eating, it is phenomenal. I’m thinking to myself the whole time, do we really need three meals a day? Do we really need to eat as much and what we’re eating?¬†

VIVO: Has what you’ve learned since gaining this heart disease caused you to question some of the things like three meals a day?

Interviewee: Yes, I started to question every aspect of my lifestyle. One thing I’ve learned now, especially at 73, is I got to move. Keep moving. Keep your balance, keep your strength. I visit people in nursing homes, hospitals, as part of my church responsibility, I cannot tell you the saddest story of people falling and fracturing. They’ve lost their flexibility, they’ve lost their strength, their balance. That’s what I want to work on and keep.

VIVO: With that in mind, would you tell me what advice you would give to someone who is newly diagnosed with heart disease, if they walked up to you right now and told you they’d been diagnosed?

Interviewee: Follow doctor’s orders. And honestly, ask yourself, are you looking at the main risk factors that are affecting you? And are you doing something about it? Not medication, but is there lifestyle factors that could help you? Like for instance, managing your own stress, eating in a way that’s nutritionally sound, at the same time lowering your risk factors. Are you getting blood work? Are you getting ECGs? Are you documenting your blood pressure? I would do a head to toe kind of thing I would tell them. Are you getting your colonoscopy, your prostate exam? Are you getting your PSA level looked at?

VIVO: Thank you so much. Could you clarify what age were you when you were diagnosed with this heart disease?

Interviewee: At least, I’d say 10 years ago. Might be longer. I would say 10, but at the same time, I’ll say 10 plus.

VIVO: Well, thank you so much for sharing your experience and your insights. I appreciate your time and I wish you all the best with your continued health journey.

Participant Profile

• Male heart disease patient with persistent atrial fibrillation
• 73 years old, residing in Houston, Texas
• Diagnosed with heart disease approximately 10+ years ago (around age 63)
• Also manages Type 1 diabetes (diagnosed at age 11)
• Active lifestyle includes walking, gardening, hunting, fishing, cooking
• Married for 42 years with three grown children and six grandchildren
• Lives in urban area with good healthcare accessibility
• Successfully implemented lifestyle changes including intermittent fasting (lost 32 pounds)
• Key challenges: maintaining weight loss, following specific exercise protocols, desire for peer support