James's Story: Managing the Unexpected
Like most men in their late 30s and early 40s, James Leaver is paying greater attention to his health these days. He bought a treadmill (and is using it), he swapped cookies for carrot sticks as his go-to late-night snack (most of the time), and is trying not to sweat the small stuff.
Most men implement lifestyle changes like these to help fend off an array of mid-life maladies, but for Leaver the reasons were much more immediate. Instead of trying to avoid illness, he was trying to recover from one. Last February, Leaver suffered a massive heart attack after a plaque ruptured in the main artery of his heart, completely blocking the vessel referred to by physicians as the widow-maker.
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At just 41 years old, Leaver is not the poster-child for heart disease. He is thin, youthful looking, and far more comfortable playing bass guitar in his band, The Low Czars, than riding a Lazy Boy in front of the television. What's more, he never had any of the physical warning signs of nascent heart disease—no chest pain, no chronic cough, no shortage of breath. He'd felt a little fatigued from time to time, but he figured that when you work all day and have two small kids at home, fatigue is not necessarily an indictor of something bigger.
"This thing hit me entirely out of the blue," Leaver says. "I am not the guy you would have identified as being the next in line for a massive heart attack."
Beneath his seemingly healthy appearance, though, were some hints that Leaver was headed toward ill-health. For one thing, his cholesterol numbers started creeping up a few years back, followed shortly by his blood pressure. But the most damning risk factor of all—the one that likely started him down this path—was a family history of heart disease.
"Family history is essentially your crystal ball," says Dr. Amish Raval, cardiologist at University of Wisconsin Hospital and Clinics. "You see your destiny and need to act accordingly to reverse course, because neglecting it could be deadly."
Leaver wasn't exactly neglecting his family history, but he wasn't paying enough attention to it either. He knew that his grandmother and uncle had both died of heart disease in their early to mid-50s and that his mother had been treated for severe blockage of her arteries with coronary stents. But he was too young to worry about all that, he remembers thinking. There was still plenty of time.
"I kept putting (lifestyle changes) off until next week, but then next week turned into next month, and next month turned into next year," recalls Leaver. "I think I probably knew deep down that I needed to step it up, but I just didn't have the motivation."
That procrastination caught up with James in February, when a relatively routine day ended with him being rushed via ambulance to the UW Hospital emergency room with the telltale warning signs of a heart attack: crushing chest pain, numbness in his arm and trouble breathing.
But even as the paramedics were giving him nitroglycerin tablets, Leaver still had a hard time believing things were as dire as his symptoms would suggest. Then, just as he was being transferred to the catheterization lab, Leaver had cardiac arrest and lost consciousness, waking up moments later to a nurse doing chest compressions and another readying the defibrillator paddles for another shock.
"Nothing puts things into perspective quite like a near-death experience," says Leaver. "You're 41 and thinking ‘what does this mean?' Am I 41 going on 80? Will I ever get to chase my kids around the room again or see them go to college? Your entire outlook on life is shaken."
Leaver was lucky. He received life-saving care by UW Hospital's cardiac team well within the "golden hour"—the ideal time in which a heart attack patient needs to be treated before the heart muscle starts to die. He credits his life to a fast-acting EMT service and exemplary care by the staff in the UW Hospital emergency room and cardiac catheterization lab.
"I am just astounded by the work that team did," says Leaver. "I never had so many people working so quickly over me in my life. If I could get them all together and buy them a drink I would. They saved my life."
All told, Leaver received an intra-aortic balloon pump for cardiogenic shock, a stent and nearly a week in the intensive care unit and on the general cardiology floor. Before being discharged, Leaver enrolled in the hospital's Cardiac Rehabilitation Program, where for the next few months he would learn to manage his heart disease during weekly meetings.
He worked with exercise physiologists and dieticians to bring down his high blood pressure and cholesterol numbers, learned how to exercise safely, to eat a heart-healthy diet, reduce stress, and get back to work safely.
"You kind of feel like a ticking time bomb when you leave the hospital, because you're not sure what is advisable," Leaver says. "But they (cardiac rehab staff) help you understand what you need to do and how you need to do it. You come out of there after a few sessions thinking ‘I can do this.' That's a huge confidence builder, not just physically but psychologically."
Six months after his heart attack, Leaver dropped 15 pounds, worked out regularly at home, further improved his diet, and doesn't let the little things at work get to him anymore. He says those changes, along with medication, are the reason why his heart function is now 100 percent normal—a remarkable recovery for someone so soon after a major heart attack.
"He's been totally committed to recovery and as a result is now the perfect success story," says Dr. Raval. "His story illustrates that no matter how busy you are, you must make lifestyle changes to improve your health. All men, not just those with a family history of heart disease, need to realize that just because they are relatively young and seemingly healthy, they are not immune to early onset heart disease."