A Weighty Matter

Some not so wonderful news to report: Children with Congenital Heart Disease (CHD) are more and more overweight.

That’s not good. While Cardiac Kids may be slow to add weight when they are young, most of us “catch up” later. We may be a little bit thin, but our weight is acceptable. But this study contends that once we catch up, we keep going! The reasons are many and varied, and usually just as applicable to Heart-Healthy kids: video games, fast food… you’ve heard all this before, I am sure.

But CHDers need to keep their weight under control. (…says the Funky Heart, who could stand to lose a few more pounds himself.) Every extra pound we carry means that our hearts have to work harder to pump blood through our body. That may not be a problem for the average kid, but our hearts are already bruised and beaten up; they have been cut apart and stitched back together again.  We need to make it as easy on them as possible.

So how much should you weigh? The research article cited above mentions the Body Mass Index (BMI) as one of its comparison tools.  The BMI is OK for use as a comparison, but don’t use it as your source for your proper weight. Ask your Cardiologist for advice about a good weight range to stay in. Many people contend that the formula used to calculate your BMI number is flawed. You have to wonder if they may not be on to something, since according to their BMI numbers, former President George W. Bush is a fatso and actor Tom Cruise (five foot, seven inches tall; 160 pounds) is plump.

So find out what your healthy weight range is, and do what you can to keep it there. Be sure to discuss any exercise plan with your doctor first – overdoing it and damaging your heart while you are trying to take care of yourself defeats the entire purpose, after all. Go outside and play; don’t think about exercising, just go have fun. Take a walk through the neighborhood, at your own pace. Get FitDeck Exercise Playing Cards. FitDeck Junior is great for Cardiac Kids, providing that their Cardiologist gives their approval. It’s all fun and games… but they are really exercising! (Shhhh! Don’t tell ’em the secret!)

I often remind my readers that CHDers are living longer and better lives as modern medicine develops new ways to overcome our Heart Defect. But it doesn’t “just happen”, we have to contribute to our own well-being.

Defect or Disease?

Do you have a Congenital Heart Defect, or Congenital Heart Disease?

Most people I know use the two phrases interchangeably – even my hero, Dr. Helen Taussig. She preferred to use the phrase Congenital malformations but even she fell into the Heart Disease/Heart Defect trap occasionally.

On paper it is an easy choice: a defect is a design flaw, while a disease is an illness. My heart has several design flaws (a missing valve, holes in the wall) so obviously, I have a heart defect. But my heart defect causes several heart diseases – if my heart wasn’t defective, I wouldn’t have to worry about Congestive Heart Failure, Cyanosis, or Atrial Flutter. So really, both terms fit the situation.

I may say “Congenital Heart Disease” but others only hear “Heart Disease.” That’s not so bad, since it is usually applied to the health problems that affect the heart as you age. Even though there is a misunderstanding, at least the discussion involves the heart. I can use that as a starting point. But the phrase “Heart Disease” is becoming a code for “unhealthy living.”

Heart Disease? Son, you need to step away from the cheeseburger. After all, if you didn’t open wide and literally shovel the food down your throat, you wouldn’t be having these problems. And don’t give me that look, no one held a gun to your head and forced you to have that second helping!

I have been sitting in the Cardiologist’s waiting room and been asked “So what are you in for?” (In the same tone of voice used to ask Prisoner #6298965 what he is in for!) When I replied that I had a heart defect, I was told in no uncertain terms that I should have been more careful! Her husband had the exact same problem and she had thrown the salt shaker away, cut out the cholesterol, and didn’t fry any foods at all! Knowing better than to argue, I nodded and just kept saying “Yes, Ma’m… Yes Ma’m!” I also wondered if her poor husband actually enjoyed eating cardboard boxes at every meal.

It seems to be a grim comment on our society that it is assumed if you have an illness, you’re automatically at fault. When I volunteered at the museum, my boss was participating in a county fair parade when he suffered a heart attack and fell off of his horse. During his recovery period we occasionally heard comments about how he was going to have to lose weight, watch what he ate, and other advice. These people didn’t know that he usually tipped the scales at 165!

This “It’s your own fault!” attitude has also led to almost making “obesity” a crime. The problem is, today’s definition of an “obese” person would have been quite acceptable in the past. Look at any of the paintings by the great masters: since most of the subjects were at least partially nude, it is easy to tell that they carry a few extra pounds. But what was recognized as healthy and attractive back then is seen as repulsive today.

And it is not because we have gotten smarter or more health conscious or “nutritionally aware.” The Body Mass Index (BMI) charts were accurate in the 1950’s… but humanity has grown taller and heavier, distorting the results. According to a BMI chart, all of the members of the 1996 USA Women’s Curling Team is obese. Actor Tom Cruise – all 5 foot 7 inches, 160 pounds of him – is considered just barely “overweight”. (A BMI of 25 is considered overweight, Cruise’s BMI is 25.1)

Young people today, especially young ladies, are held to an impossibly high standard. Anything less than perfection is unacceptable, and open to ridicule.

Bad things just happen

Here’s a news article that has been floating around the Internet for a few days: Overweight mothers linked to heart defects. Apparently if you are above your recommended weight when you get pregnant, your chances of having a child with a Congenital Heart Defect (CHD) increase tremendously.

Here’s my take on the article: %&^*@#!

Let’s look at some facts:

First, the researchers used the Body Mass Index (BMI) charts to determine if the women being studied was overweight, moderately obese, or severely obese. Right off the bat, we have a problem: The BMI is badly outdated. It was originally developed over 100 years ago, and the chart classifies Brad Pitt as being overweight. We can debate all day how good of an actor Mr. Pitt is (I’m not impressed) but just look at the guy – he’s NOT overweight!

Next, you need to look at the statistics not as stand alone numbers, but in context of what we already know about heart defects. An 18% increase in the chances of having a child with CHD if you are obese; or a 30% chance if you are severely obese. Good Heavens, you’re almost guaranteeing your child will be sick!

Are you?

We know that 1 child in 125 live births will be born with a heart defect, on average. Change 1/125 into a decimal figure, and your child has a 0.008% chance of being born with a CHD.

If we increase the chances of CHD occurence by 18%, the number jumps to 0.00944%…or 1.18 chances in 125. And if you increase it by 30%, CHD chances leap to 0.0104%. That’s 1.3 chances in 125.

When we – Americans are bad about doing this – start to search for a cause of something, it can turn into not only a search for a cause, but for a place to put the blame. Because we can’t accept that sometimes, bad things just happen. And look! Heavier women have more babies with heart defects! That must be the cause, or one of them! We’ve found it! And we can fix it!

But this world is full of women who abused their bodies in a hundred different ways, and had completely normal children. And it is also full of women like my mom, who did everything the doctor told her to do and still I was born with a heart defect. A lot of researchers think that environment plays a large part in the occurrence of Congenital Heart Defects; at the same time, there is a lot of evidence that genetics play a large role, also. So it’s probably a little of both, and who knows what else might contribute to CHD. Radiation? Possibly, I live 20 miles from a nuclear plant. But that plant wasn’t there when I was born.

Until we know more about what causes a heart defect, we just have to accept that sometimes bad things just happen.