I Never Talked About My Heart Attack, and Someone Almost Died
You're busy. Seriously busy. Constantly driving forward and pushing ahead. And why not? Hard work lays the foundation for success.
But still, sometimes we all just need to stop. Not to smell the roses, but to think about what really matters to us and to the people we care about.
And to realize that truly caring means not just being thoughtful but acting on those thoughts--both to help others and, sometimes, just to take better care of yourself.
A few years ago I got tired of being old and out of shape. Creaky knees ruled out jogging so I decided to start riding a bicycle to improve my fitness.
The first time I rode I was exhausted just from doing a five-mile loop around my neighborhood. (We live at the highest point in town so the last half-mile is at a 9% grade. Making it home felt like hot death.)
It was hard to stick with it. Had to force myself. Didn't have to force myself to hate riding, though. That was easy.
Then one day I was out on my bike and realized I was actually having fun. Hills that had seemed like mountains now didn't even seem like hills. And even when I pushed fairly hard my heart rate no longer spiraled out of control. I actually started looking forward to riding.
So, as I often do, I decided to take a good thing way too far.
If you've read any of my articles you know my theories about how to accomplish goals are somewhat unconventional. In a moment of hubris or weakness or lunacy--take your pick--I decided to prove those theories were right. Assuming the bigger the goal the more right I would prove to be, I made my first mistake: I got advice from Jeremiah Bishop.
Jeremiah is a world-class mountain biker racer who lives in my town. He's won the Pan American Games, the U.S. mountain bike championships, is a twelve-time member of the national team... Jeremiah is to mountain bike racing what an NBA All-Star is to basketball.
I told him I was looking for an almost impossible (at least for me) challenge. I wanted it to be physical and involve a bicycle and needed ideas.
Unfortunately he had one: Ride his inaugural Alpine Loop Gran Fondo. At face value not so bad. A 95-mile ride is long but manageable; many recreational riders manage century rides.
Except his event is savage. It climbs one mountain into West Virginia, goes over two more mountains--one road paved, the other dirt--with a final climb up the dirt fire access road that summits Reddish Knob, the highest point between here and the Adirondacks.
As Jeremiah says, "Think of it like running a marathon... as long as that marathon includes going over a mountain."
So why did I want to do it? For the same reason you take on huge challenges: because of the words "now" and "then."
Think about something you really wanted to try but for whatever reasons never did. Think about where you would be now if you had actually started doing it then.
When you do the work, then pales in comparison to now: family, business... every aspect of your life. When you don't do the work, now is just like then--except you also have to live with regret over what might have been.
That's why people like you are driven to succeed: You like to "win," but even more you hate to lose.
Of course when you first start trying to do something hard, now is often a terrible place. When I started riding a bike, now meant riding like an asthmatic hippo. With time, though, now became transformed. Now meant riding with more speed, power, and confidence. Work at something--work at anything--and in time now is amazing compared to then.
Even though all the time and effort you put into achieving now can have its downsides.
So Jeremiah coached me (which was like having Kobe Bryant as my personal basketball coach) and I trained. A lot.
That fall I managed to finish the gran fondo in a decent time. It was both my worst and my best day on a bike--a seeming contradiction but, to anyone who has completed endurance events, one that makes perfect sense.
Going into the following year I decided going too far had not been far enough. (Sound familiar?) So I planned to head to France that July to ride the Etape du Tour.
The Etape is an event where amateur cyclists ride the same route as a Tour de France mountain stage from that year. It's extremely popular since the organizers close the roads, spectators line the route, and "only" about 8,000 cyclists (thousands more try to enter) get to ride an actual Tour stage.
That year the route included climbing three mountains in the Alps, the last cresting at La Toussuire. (It's safe to assume that whenever a ride ends atop a famous French ski resort that ride will suck.)
But I had lots of help lined up. Kevin Livingston, a six-time Tour rider and founder of a cycling training center, agreed to coach me. I booked a package through Trek Travel, the premier cycling vacation company in the world, to take care of accommodations, food, bikes, ride support... everything.
I had the best backing I could ask for. All I needed to do was put in the work.
One Sunday near the end of that April I decided to ride over the mountain to Charlottesville. Our daughter had a soccer game there so it was a nice excuse to leave early, put in a one-mountain, sixty-mile ride, watch her game, then pack up the bike and go home in the truck.
About ten miles into the ride my left pectoral muscle felt stiff. The feeling was strange, kind of like a pulled muscle but oddly different. So I twisted and stretched as I rode and after a few miles the pain went away. Cool.
On the other side of the mountain my chest started to feel tight again; I assumed I was just stiff from curling into an aerodynamic tuck on the steep descent.
Then my left arm started to hurt: first my bicep, then my forearm, then my hand. I couldn't shake off the pain. I stopped, drank some water, and tried to stretch but by then my entire chest hurt. Finally I called my wife--at that point she and our daughter were on the way over--to tell her I didn't feel great and ask her to pick me up on her way by.
Then my right arm also started to hurt. A lot. Everything in my upper body hurt. I felt sick. And faint.
I tried to think it through. Was I having a stroke? Couldn't be that; strokes only affect one side of the body, right?
Was I having gas pains? I had eaten a decent breakfast, but why would heartburn make my arms hurt?
Then I wondered if my long-sleeve Under Armour shirt was too tight. (That little theory proves a lack of blood flow will definitely impair judgment; back then my scrawny arms couldn't have filled out the tightest of shirtsleeves.)
In my mind, the only real possibility was the gel I ate at the top of the mountain. Maybe I was having an allergic reaction?
In the meantime the pain got bad enough I had to sit slumped on the roadside with my back against the guardrail. Most of the cars passing whizzed on by, but twice parents of players on the team stopped to ask if I was okay. I smiled and waved and said I was fine, that I was just waiting for my wife to pick me up... the last thing I wanted was to crawl into another person's car because I wasn't feeling well.
How wimpy would that be? After all, whatever I was feeling was momentary. It would pass.
I didn't know what it was... but I knew it couldn't be serious.
When my wife arrived I crawled into the back seat of the truck and started describing what I was feeling. Two sentences into it she cut me off. "You're having a heart attack," she said.
"Bull--," I said. "No way. Whatever this is will go away."
But after a few minutes of tossing and whimpering and crying--my arms and hands felt like they were going to explode--I agreed it kind of, possibly, maybe made sense to go to the hospital, where I learned that if your wife whips out her best steely-eyed look and declares, "Chest pains," to the triage nurse you can instantly bypass the black hole of the waiting room and in seconds have eight medical professionals scurrying around your bed.
But I still didn't think I was having a heart attack. I clung to my allergic reaction theory, even showing nurses the wrapper so they would know what I had ingested.
Stupid? Yeah. In denial? Oh yeah.
After she read the EKG strip my wife whispered, "It really is your heart..." but I was still thinking, "No way. Not me."
Um, yes. Me.
While I watched the procedure on the monitors above, the cardiac surgeon inserted a catheter in my wrist, slid it up to my heart, injected dye, said, "Uh-huh," and placed two stents. Then he injected more dye, and this time I saw blood flow to the bottom chamber of my heart.
It turns out my left anterior descending (LAD) artery had been completely blocked. (A nurse later said their nickname for that kind of heart attack is the "widow maker," displaying a lack of emotional intelligence that proves while there is a time and a place for everything, it is always possible to find neither.)
Yet I had trouble saying the words "heart attack" for days afterwards. Heart attack? Moi? No way.
In denial? Yes way.
I was 6'1", 155 pounds (can you say "cycling skinny"?), didn't smoke, didn't drink, ate healthy, had a resting heart rate below 50, normal blood pressure, cholesterol 120... toss me in a random pool of a thousand people and I would have been one of the last picked to win a "Who Is Most Likely to Suffer from Heart Disease?" game. So what happened?
It's possible a thin layer of plaque broke loose from an arterial wall and tumbled merrily along until it got stuck. That's just a theory, though. As my cardiologist said, "You might have to accept the fact we may never know what caused your heart attack."
Bummer. Not knowing why something happened makes it really hard to make sure something doesn't happen again. It's also a bummer since for years I had done everything right--diet, weight, exercise, etc--yet I still had a heart attack. That wasn't supposed to happen to me.
But it did.
It probably was a thin layer of plaque... but in retrospect I also feel sure stress had something to do with it.
Not that I ever felt stressed... and not that I ever said I felt stressed. (Heaven forbid.)
No, I was just busy: ghostwriting, launching a speaking career, writing my own stuff, doing some consulting, training for the Etape, trying to be a decent husband and raise a family... I was just busy.
Isn't that what people who want to be successful do? They stay busy.
But I do remember a bunch of sleepless nights. I worried about doing good work. I worried about bombing onstage. I worried about whether anyone would like what I wrote under my name. Like most entrepreneurs, even when I was flooded with projects I also worried about where my next projects would come from.
In short, I worried. When you have lots of balls in the air and you want all those balls to turn out great, you worry--sometimes a little, sometimes a lot. But I didn't think of it as stress because it was just business as usual.
Does all this sound familiar to you?
Of course it does.
Heart disease is the leading cause of death for men and women in the U.S. Every year over 700,000 Americans have a heart attack and half of those are fatal. You probably know someone that recently had a heart attack--and you definitely know someone who displays a number of risk factors for heart disease.
Fortunately all the things that made me less likely to have a heart attack also helped me weather my cardiac storm. I never lost consciousness, was never short of breath, and suffered less damage to my heart than might have been expected (although I do have some degree of permanent damage.) Less than a week later I feel normal.
So I moved on. I didn't think about it. I didn't talk about it.
And even though I have a fairly big audience, I didn't write about it.
Then last week I heard that someone I know almost died from a heart attack.
Like me, the first sign of his heart attack was denial. He tried to ignore the pain, hoping it would just go away. Unlike me he doesn't have an anesthetist wife (I married way over my head.) prone to taking charge, so he waited a few days before finally deciding to go to the hospital.
Where heart attacks are concerned time is critical. The longer you wait to get treatment the more damage your heart may suffer. I made it to the hospital in less than an hour and even then a lack of blood flow to certain areas of my heart caused permanent damage. In his case that damage was much more severe, partly because he's significantly overweight, partly because his heart wasn't nearly as efficient as mine... but mostly because he waited way too long to get help.
Him? He came very close to dying.
Me? I wish I had written about my heart attack before today. I wish I had served as an example that anyone--even someone relatively fit--can have a heart attack. I wish I had served as a cautionary tale. I wish I had served as an example of how improving your health now, by losing weight, gaining fitness, and improving your cholesterol might just help you avoid a heart attack or heart disease--and, if you do have a heart problem, might just help mitigate the damage and possibly even save your life.
And I wish I had written about how I feel sure that stress did contribute, even if in some small way.
Maybe, at the very least, my friend would have thought, "I'm having chest pains... and if that scrawny little jerk can have a heart attack, maybe that is happening to me. I better get this checked out now."
And maybe things would have turned out better for him.
But I didn't.
The best investments you can make to improve your life are not entrepreneurial or professional. The best investment you can make is to improve your health--professional success is meaningless if you're not around to enjoy it. And the best thing you can do for the people who love and depend on you is to do your best to make sure you can always be here for them.
Maybe you need to lose a little weight. Or improve your cardiovascular fitness, even if just a little. Or find ways to reduce some of the stress in your life.
That doesn't mean you can't keep your pedal pushed firmly to the metal as you drive full-throttle towards success... but it does mean you may want to change how you approach achieving all of your goals, even if just by tiny degrees.
And it definitely means you should reach out to the people you care about and encourage them to make a few small changes to their lives: Don't you always want them to be there for the people they love... and, even though it sounds selfish, to be there for you?
I wish I had made a few changes to my life, especially where dealing with stress was concerned. I know my friend, as he thinks about what his life will be like from now on, wishes he had made a few changes that would have improved his health and reduced his level of stress.
Most of all, I wish I had shared what happened to me. I might have made made a difference in his life. I might possibly have made a difference in the lives of a few other people.
As I sincerely hope I just made some small difference in yours.