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December, 2016

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Being Honest About Your Health

Many Americans are in denial. They refuse to acknowledge that they have a problem with their health, particularly their heart health. They have lost the idea about heart healthy living.

Denial isnt uncommon. It is quite the norm. Let me share with you a story about a patient who illustrates this denial.

A few months ago I saw a 50-year-old man who I have been taking care of with heart disease. About 3 years before our last visit Bob began having chest pain and rushed to the Emergency Room. Due to his typical symptoms they performed a cardiac catheterization, which revealed that all three of his coronary arteries were severely blocked.

Coronary Bypass surgery was performed for all three of his blocked arteries. He came to me about six weeks after his bypass surgery. He was a big believer in holistic medicine and wanted to take care of his heart disease with as few medications as possible.

I said to him, “Preventing heart disease isnt that easy. Being safe without medications is difficult.”

“I know,” he said, “But I want to try it without medications.”

“OK, lets take stock of your lifestyle habits,” I said. “Your serum cholesterol is 260mg/dl and your bad cholesterol is 170mg/dl. This is way too high. The bad cholesterol needs to be down around 50-70mg/dl.”

Luckily he didnt smoke or have high blood pressure. His family history was positive with his dad having a heart attack at the age of forty-five.

We both looked at his belly. It was huge. He stood five feet seven, and weighed about two hundred thirty pounds. All of his excessive baggage was carried in his protruding belly. Honestly, he looked eight months pregnant.

His belly hung over his belt a good four inches.

“I work out all the time,” he said. “And honestly, I dont eat that much.”

Staring at his belly, I had a hard time believing him. He gave me a run down of what he ate and on the surface it seemed pretty good.

So I asked him to give me a detailed dietary list. I asked him to write down everything he ate over the next four weeks. I gave him some literature on the Mediterranean Diet and made plans to see him back in a month.

On his return visit, a month later, his weight was unchanged. He still appeared very pregnant. Looking at his dietary report, it revealed what I had suspected.

He was in denial. He believed that he was eating a healthy heart diet, but it wasnt really true. His dietary history confirmed that he was consuming about 3500 calories a day, with a high percentage of saturated fat- ice cream, cheese, beef, and pork. Eating the excessive calories and wrong types of food explained his big belly and his heart disease.

I explained to him that for his size his caloric intake would have to be much lower, perhaps 1500-2000 calories a day for him to loss his belly. “Preventing heart disease,” I said, “will require that you dramatically alter your food choices.”

I gave him some detailed recommendations. Over the next three years, I saw him every 6-9 months. Nothing changed really. Each visit we would talk about his diet, the types and amounts of foods that he needed to be consuming. Every visit he would say to me, “I just cant believe I cant get this belly off. I dont eat much of anything.”

Periodically, I would go through his food list. Ice cream and a big steak was still a twice-weekly item on his list.

After his last visit, I began to wonder, “Why is it so difficult for people to be honest about their health?” This man was an intelligent business owner. I had explained over and over, that something was amiss in his body, something from his lifestyle that was causing his heart arteries to be blocked by cholesterol deposits.

Is it easy to change our lifestyles? No, it isnt. But we cant even start the process unless we are honest with ourselves about what we are doing.

Bob refused to acknowledge that he had a problem- that his eating was out of control.

Six months after our last visit, Bob was stricken with severe chest pain. Now however, he was having a heart attack. Two of his bypass grafts were closed and his heart muscle was damaged.

I saw him in the hospital, distraught, and credulous.

“I dont know how this has happened to me,” he said. “I exercise and I dont eat that badly.”

I glanced at his belly, still eight months big from ice cream and steak. I could only shake my head.

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