What You’ll Learn

A 74-year-old resident of New York City with type 2 diabetes and heart disease unpacks the connections between love, loss, depression, socializing, exercise, and eating to find a path forward to better health.

Interviewee: I’m 74 years old and I retired in March 2020. My retirement party was on a Friday and New York shut down that next week. I retired to take care of my husband and he had throat cancer, and he passed away in August of ’21.¬†I live in New York City, Upper West Side. Been in this apartment since 1988.

I’ve had the same primary doctor. We both had him at least 15 to 20 years. When this came on board… The first thing that came on board was cardiomyopathy years ago, but they put me on a medication called metoprolol and explained to me what it is. And then every three or four years I would go in and update the study that they were doing on that. And I didn’t hear from them anymore for a while. And then a couple of years ago when I went in to do my physical, he was asking the questions about weight, because we’ve been working on obesity for a long time. I ain’t that obese, but I am…

So they ask you these questions about how far do you walk without getting out of breath? And so I was saying, “It’s because I’ve got to get this weight off. That’s what it’s from.” “Steps coming up the subway. Do you ever have to stop?” I said, “It comes and goes. Sometimes yes, sometimes no.” I said, “I’m old and this and that.” And he said, “I want you to see a cardiologist.” I can’t remember whether Dr. Patel ran a strip in his office, because it was a regular follow-up appointment, whether he ran a strip in his office or whether he just referred me over to my cardiologist. Her name is Betty, Betty Kim. All of my medical stuff is handled through my doctors and both use Mount Sinai Hospital here in New York. So I went to her and she did me a series of tests, and they called me back that night and said, “You need to call her immediately tomorrow.” And I’m thinking, “What?” Because I hadn’t changed any, I hadn’t passed out or had any of the symptoms.

VIVO: You weren’t anticipating this.

Interviewee: I just thought it was weight. And the next day she said, “No, we have to get you in right away. You have three clogged arteries.” Can you imagine?

VIVO: How did you feel when you heard that?

Interviewee: I was shocked because I just thought it was weight. I had no idea that the shortness of breath, when I run, the exertion was attributed to my heart. I just thought it was weight. You see heavy people always get… That’s what I thought.

VIVO: Did you know that weight could be a risk factor for heart disease or any other things could be?

Interviewee: I got the trifecta. They call it. High blood pressure, diabetes, and cholesterol. Some people here in New York, they say that’s the trifecta. If you’ve got those three, you’re high risk. Fortunately, there’s no STDs, no HIV. I guess because I met my husband in ’76, so monogamous since ’76. Anything before that was pre-HIV timing.

VIVO: What is the official diagnosis that you received?

Interviewee: Coronary artery disease.

VIVO: And how are you managing that? 

Interviewee: Medication and diet. So, in February, because she and I have been working well together… I’m sorry, I’m such a poor historian, but I know it’s been at least three years that I got these stents in. Where was I going with this? So I went in, I got the stents, and I’ve been with her all the time. And then she calls me in, this year, in February, and she says, “Since I’ve known you, you’ve been battling this weight addiction and your A1C. My A1C was constantly going up. They didn’t look at it too much the first year that my husband died because it’s not surprising that people use comfort foods. They’re just in grief. But then… So she called me and she says, “I want you to go on a medication because I see what a struggle it is for you to lose weight.”

Then, she said, “I want you to go on a medication that’ll do both weight and lower your A1C. And it’s been proven so far to be safe and effective.” I said, “What is it?” And she said, “Ozempic.” You know what I hear about Ozempic all over the place. You see people using it for the wrong reasons, all of that. But it’s worked well for me.

I went from 228 pounds, I’m 198 from 228, since February.

VIVO: Congratulations. How do you feel now?

Interviewee: I feel a lot better. The shortness of breath doesn’t occur.

VIVO: What other changes did you make after you received that diagnosis to your day-to-day lifestyle?

Interviewee: Start eating more baked foods instead of fried foods. Eating the fruits that I like. Bananas, blackberries, pears. Those are my three.

VIVO: How do you feel about your overall health at this point, knowing you’ve had some positive things happen recently?

Interviewee: I’m cautious only because it’s time for another MRI or PET scan, one of the two. And of course, I haven’t been doing exercise and diet perfectly. So when… I can’t remember, was it when the stents or before the stents, they had put me on… My primary, that put me on a walking routine, 20 blocks or 20 minutes three times a week.

VIVO: And do you keep up with that pretty well?

Interviewee: I’m doing a little part-time something with seniors, and believe it or not, it does that. But sometimes just to clear my conscience, I do it anyway, even though I escort seniors back and forth to doctor appointments in the neighborhood.

VIVO: Do you view yourself differently since you received this diagnosis?

Interviewee: Yes.

VIVO: How do you see yourself?

Interviewee: From the time I got my stents in, there’s been fear of a heart attack.

VIVO: Does that change in your perception of yourself?

Interviewee: It’s depressing and anxiety provoking at times, because if I do get tired, if I’m out and I happen to rush for the bus or something and get tired, the first thing that happens, not all the time… Let me tell you this. Everything is not all the time, most things are some of the time, most of the time, not all the time.

So that’s in the range that I am with the diet. Exercise is more, most… Both of them are most of the time. Because what I did was, since I liked those three, I pretty much substituted them as a snack as opposed to chips, ice cream, crunchables, snacks craving that goes from salty stuff to sweet stuff. And so, I start… You know what? Habit for something else. Whether they’re good or bad, it seems like if I get in the routine, I’ll stay in it for a while, just don’t break it. And that goes from unhealthy snacking to healthy snacking.

When I’m binge-watching TV or coming in at night. My husband and I were together for 45 years. I’m living in the same apartment we lived in. And I’m trying to learn how to live single in my 70s. We met back in my 20s.

VIVO: That’s a big lifestyle change. Who was your source of support then, as you were going through this diagnosis?

Interviewee: I have a couple of coworkers, we stay in touch with each other. And I have, of course, some neighbors because I’ve been here so long.

VIVO: Did they help you cope and build new routines for your life?

Interviewee: Yes. One of them. I started walking more, encouraged me to start that 20 thing that I’m telling you about, because she needed it. She needed to do some more exercise herself. So we would walk. And since she said it didn’t matter what pace it was, the walking, so sometimes… You know New York City, I live right off Broadway. So there’s plenty of stores and shops and stuff. But it would encompass the 20 blocks. And it would make it less of an exercise thing, and more is just the getting out thing.

Those are the kinds of supports. And the rest is conversational stuff, because most of the people my age are also either diet conscious or need to be diet conscious. Either going on one or coming off one, or I need to be on one. So we’d be checking in with each other and talking. And in the talking, we get, it’s no judgment, but just like… That’s what we do. So that’s my supports outside of my doctors.

VIVO: You’ve shared some of the changes you’ve made to your lifestyle. How would you describe your habits prior to receiving this diagnosis for your heart disease?

Interviewee: Between the weight and the A1C, my primary for quite a few years has been needing exercise. Wait a minute. Ask your question again. What did you say?

VIVO: Sure. What were some of your day-to-day habits and routines prior to this?

Interviewee: So I was conscious of the fact that I was eating and snacking wrong, but did nothing about it. You know that postponement, excuses, my birthday, all that kind of stuff. And then, I’m bad at years, but somewhere along the line I became pre-diabetic, maybe about 20 years ago maybe. And so it was something like proceed with caution kind of deal.

So we went through the nutritionist thing. Sweet girl. We had a great time, but I stopped going because I kept… Who likes to go to somebody when you keep failing?

And let’s see. So that’s an area that always made me feel bad about myself, and the A1C kept going up.

VIVO: You’ve talked some about LIVING in New York City. @hat role does being in an urban center like New York City play in all of this for you and your health journey?

Interviewee: It’s triggering.

VIVO: Tell me more.

Interviewee: I’m on the upper West side with a zillion restaurants and Starbucks, but the smell of the coffee on the street doesn’t bother me. So they love to have those fragrances coming out, and all these pretty pastries and stuff. So the role that it plays is that a lot of times it’s triggering, especially at… Of course, I’m in a different grief cycle now than I was three years ago, but still those times when I’m depressed, feeling sad or mourning the loss, it seems to me, especially the ones with the cookies and cakes and all of these little delicacies and stuff like that, they stand out more. But also with the foods, I’m a southern boy from Pensacola, Florida, born in 1950. And the only reason I say that is because the southern diet is crispy and greasy. That’s the code name. Everything is being fried and greasy. All of those foods that are self-fulfilling prophecies to end up with these kind of things are on display, if they’re not addressed.

VIVO: Absolutely.

Interviewee: But it’s hard to address them when your friends ain’t.

VIVO: That’s true. The social impact has been a vital part for you then?

Interviewee: Yes. And part of New York lifestyle is going out to eat. You go to a play, you go to a restaurant. When you go to church, afterwards you go somewhere to get a bite and sit. And the reason I said that about friends around is because I have friends that don’t have these problems. They’ll order what they order. And that is very tempting to me in terms of what I’m going to order. But I try to stay pretty much diet conscious now, only because I’m appreciating foods that before, especially vegetables and meat, I’ve been more conscious of that since the coronary artery disease.

VIVO: And I’m curious, do you think that this coronary artery disease has impacted you in any ways that are unique to your age or your gender?

Interviewee: It’s yes and no. And the reason I say that, as a kid, whenever mom or grandma are sitting with their friends, their conversations always include medical stuff and doctor appointments.

VIVO: Sure.

Interviewee: So seeing this and seeing them getting older and then seeing the results of having the trifecta, strokes, dying, this and that and the other.

VIVO: Can you think of the best experience you’ve had with the healthcare system? And specifically in that story, how it made you feel? Can you share a little bit about that with me?

Interviewee: I’m trying to think back to a point that it was even an issue that I started getting in my feelings about my weight, about diabetes. So when it started getting up, went from pre-diabetes to diabetes, the frustration began to build because I couldn’t diet. The majority of the time I was still eating foods that weren’t good for me. And going to a nutritionist, she was patient and working with me, but it’s like, “I don’t want to keep going and giving her bad news.” So depression started somewhere along the line. I’m trying to think, because that was a factor in my depression.

VIVO: The medical ailments were affecting…

Interviewee: Fighting and losing, fighting and losing, and coronary heart. And the fears, because I’ve had relatives that have been amputated because of their diabetes. I’ve had relatives who were overweight and had heart attacks and stuff. And so, it starts a cycle of not feeling good about myself. Knowing you’re doing something that you’re going to pay for later, that kind of stuff. My descriptions may be off.

VIVO: Are any positive moments that stand out to you within that journey that you’ve been on? Any good experiences?

Interviewee: It didn’t have to be perfect, but whenever I’m in reasonable conformity, yes.

VIVO: And reasonable conformity, meaning you’re having some success, you’re seeing progress?

Interviewee: Yes, when I would have some success. And after a while, the self-doubt came in because of the failures. But at first it was really, I had noticed enough that there was a pattern of an emotional connection to my weight and stuff, using food as a compensator or as an ease and comfort relief, whenever, if I had a fight with my husband, if someone died close to me, or somebody got a raise and we are celebrating retirement or celebrating whatever.

Those times I would eat. And then I would feel the guilt. Because I didn’t know how, it was difficult for me to… I don’t know the word for when you just eat enough. When you’re satisfied, satiation or whatever they call it. Just stop there. And there’s all that’s left on the plate. And somewhere between society, and I came up with down south, you eat everything, you don’t leave nothing on the plate.

So those things also had a part. And I think those were some of the precursors to the depression that came on board. It’s connected.

VIVO: What do you think the biggest misconception is for men related to heart disease?

Interviewee: Here we go. I know since I was an adult, I’m just trying to think when did all of this begin to make sense. I guess it began when the weight would come. This was before my weight, but when other relatives would die in the hospital and they say, “I keep telling you to watch your sugar. Watch your sugar.” Or when we would go out somewhere with aunt so-and-so-and-so and everybody’s saying, “Now, you know you got… You shouldn’t be eating.” “Yeah, but I’m going…” That began the concern because I was seeing what it was doing to them. And not on a real strict thing, but in my mind it was like, “Yeah, you need to tighten up some yourself.”

And I’ve never been an exercise person, which is… And the rhythm was diet and exercise. When I was a kid, I had asthma, chronic asthma. And at that time, I don’t know, because it was segregation. I don’t know whether white people had medication when they would have asthma attacks, but we would have to go out to the hospital and get in one of those lung chambers. So there was this heightened awareness about don’t let him run too much, swimming be careful, because you don’t want them to get an asthma attack. So it was a great justification for me not playing sports, which is the primary way of exercising, especially when you’re coming up as a kid.

So I was separated from the joys of the nutrition and exercise part, because of old ideas about my asthma. Even after it cleared up. It cleared up somewhere between puberty and 18 years old, somewhere up in there, it cleared up. But still that little voice in the back of the head, “Yeah, but you better be careful.” It’s funny how old thoughts can…

VIVO: What would you say the misconception is?

Interviewee: I blame everything on advertising and TV. But there’s this thought that if I do it this week, then the problem will be over. What do we call it? That there are quick fixes for this. That’s the miss. All you have to do is take Ozempic, or all you have to do is lay off of fried foods for a week and next week you’re going to be slim and trim.¬†

VIVO: And what do you believe the reality is? If that’s the misconception?¬†

Interviewee: And the reality is, these things take time. They take time. Rewarding myself because for the last two weeks I haven’t really overdosed with sweets or snacks or this and that and the other, is good, but I have to do a reality check that this is going to be a lifestyle change as opposed to quick fixes. This week I’m just going to eat salads, so that next week I’ll be okay when I do the finger stick, my blood sugars are going to be different. Short term, that’s the way I look at it and I have to process it.

VIVO: Is there other advice you would give to somebody if you met someone, if they’ve just been diagnosed with heart disease, what advice would you give them?

Interviewee: The first thing I would want to do is to gain their confidence. Not really confidence, like their secrets or something. Because it’s a sensitive issue. Your weight is about how you look and you already thinking about it every time you come out the shower. So if it was a friend or a neighbor and we happen to be chatting in the elevator or whatever, the first thing that I would tell them is that start looking at it first, and seeing what things that you like that are more healthy than the things that you dislike.

VIVO: So baby steps there.

Interviewee: Baby steps. And that there’s plenty of stuff, YouTube has so much, Google has so much that you don’t have to tell anybody, because, see, these are our secrets, we think, our struggles are our secrets.

VIVO: There’s a lot of wisdom to that. I’m curious, what are your future goals for your health?

Interviewee: To continue and I want to implement, I’m on the precipice of going to a gym.

VIVO: That’s awesome.

Interviewee: And it’s for a combination of things. I know it helps with my depression. When my mother died in ’07, I lived near Central Park. And at that time I was in a walking thing, of walking around the reservoir and stuff like that. And I know that it helped with the depression, and I also know that it helped in burning off calories. But again, there’s no quick fixes there. So just because you did it over the spring time, you know it’s about consistency. And I’m just coming to that awareness for whatever reason. And I think that the medication part of the spectrum, especially with the new med, has been the spark to make me consider it, because it’s free for me. Come on. It’s free for me. I don’t have to pay gym dues.

For the weight, but also for the depression. COVID, my husband’s death and retirement, because care taking had a lot to do with my eating too. It was a lot of ice cream, Jell-Os and stuff like that as a caretaker. So all of these things happened. And then when he died, my life went, boop, nothing to do. I’m retired, I’m sitting around, he’s gone.

VIVO: I can’t tell you how much I appreciate your insight. Thank you for giving me a picture of your life, and I wish you all the best with your health.

Participant Profile:

• Male heart disease patient diagnosed with coronary artery disease
• Lives in Upper West Side, New York City
• 74 years old, retired since March 2020
• Long-term management of multiple health conditions (cardiomyopathy, diabetes, high blood pressure, high cholesterol)
• Recently lost husband of 45 years in August 2021
• Treatment approach: medication management and lifestyle modifications
• Key challenges: weight management, emotional eating, adapting to living alone
• Notable progress: 30-pound weight loss on Ozempic since February
• Part-time work with seniors, providing escort services to medical appointments