Walking shoes, Liquid Plum’r, and Cholesterol

There was a pretty big announcement at the American Heart Association’s Scientific Sessions 2010 meetings last week: the new drug Anacetrapib is very good at raising “Good” cholesterol (HDL) while at the same time lowering “Bad” cholesterol (LDL) with very little side effects!

Why is this important? (Part 1): Here’s a good way to remember the difference: HDL is Happy Cholesterol and LDL is Lousy Cholesterol. Lousy Cholesterol gunks up your blood vessels and causes blockages. Blocked arteries are official, certified BAD THINGS. Happy Cholesterol, on the other hand, eats Lousy Cholesterol and then drops it off in the liver, where it is processed out of the body.

Why is this important? (Part 2): Drugs don’t always work like you think they will. A few years ago there was a big clinical trial for a new drug that would also raise your HDL while lowering your LDL. Suddenly the trial was cancelled… a significant percentage of the trial participants suffered from high blood pressure and/or heart attacks. Some of them actually died.

Ouch.

So there was a lot of excitement when anacetrapib came through the clinical trial with acceptable results. Dr. John M. has a good post on the new drug, including how it is more like Liquid Plum’r. Or maybe Pac-Man.

We’re still a long way from this drug going to market, the next step is another clinical trial involving 30,000 people. But in a few years it will be available – and someone will promote it as “an alternative to exercise.”

In the words of the great philosopher, Mr. Bruce Hornsby, “…don’t you believe them.” A pill can not replace exercise, no matter how much LDL it gets rid of. Your heart and lungs are muscles – If you push them just a little past their optimal range of use on a regular basis, they’ll get stronger. If you don’t – if you sit on the couch and take your pill – they’ll slowly wear out. It’s a rule of life; you can’t stop it. We all age, but some of us do what we can to slow it down.

The new drug won’t be cheap. New drugs never are, there is too much Research and Development funding sunk into it. No one knows what the price will be yet, so let’s make a guess. The new anticoagulation drug Dabigatran will probably cost about $240 per month. That’s not taking into account any insurance plan you may use, but if you walked up to the pharmacy counter with your prescription and paid cash.

Using this as our estimate, a one year supply of Dabigatran would cost $2,800 per year. You can figure that Anacetrapib’s price will probably be somewhere in that range.

But one pair of good walking shoes will cost you $85. Shoot, let’s splurge a bit and get one of the more expensive brands. That will cost us $130. If we just use them for our high intensity walks, they’ll last a while. If we use them as our everyday shoes, we may need a new pair in a year. Cost of drug: $2,800 per year. Cost of shoes: possibly $260 per year, more likely to be less.

Exercise is cheaper than drugs – and a lot more fun!

Casual Fan

Certainly you’ve heard the big news – the University of South Carolina beat the number 1 football team in the nation,  the University of Alabama. Boy, it was something to see! I would have loved to have been there, but I am a “casual fan”.

Now I consider myself a pretty loyal Gamecock supporter, but 1) I am not a Student; 2) I don’t give a ton of money to the Gamecock Club; so the athletics department considers me a Casual Fan. And like most venues, the Casual Fan doesn’t qualify for Premium Seating Options (a fancy way of saying “Good seats”).  Sit in the student section? Nope! Take the elevator to the skyboxes or sit close to the field? Surely you jest. Casual fans get the leftovers. But there are 80,000 seats in Williams Brice Stadium – lots of leftovers! And even with my heart defect I am mobile, so I don’t sit in the Handicapped section. Someone else may need that space.

You still have to think ahead, because with 80,000 people trying to get to the same place, not everyone can park close. Usually the closer you can park, the more money you contributed. So a guy like me might as well plan to leave early, because I can’t get there five minutes before game time. Sprinting to my seat just doesn’t work for me – especially if I have a seat in the  upper deck. The advantage to getting there early, of course, is that you get to take your time, look around, and if you are lucky, bump into a friend who invites you over to a tailgate party!

But then you have to hike the steps to your seat – and not at your own pace anymore. Steps and I do not get along well, I need to take it slow and easy and rest occasionally. That’s really hard to do with a group of fans behind you, all anxious to get to their seats. (Yeah, I’m the slowpoke that’s holding up progress!) And if my seat is high enough, I ain’t coming down until the game is over. No concession stand trip, because the fan who walks down must walk back up. Once is enough for me!

I’ve sat in some high seats at times. A friend and I went to an Atlanta Braves baseball game in the early 1990’s. That was before my stroke and I could handle steps better back then, and we had very high seats. The game announcer told us that Steve Avery was the Braves’ pitcher that night, but we weren’t sure – this little guy about half an inch tall walked out to the mound! He was a very good pitcher, but we couldn’t tell you if it was actually Steve Avery or not.

I had two sets of tickets to an opening round baseball game at the 1996 Olympics – one pair was low on the field, the others were very high. I kept the low seats and gave the higher seats to a friend and her boyfriend. Since we never saw each other at the game, I called her later and asked if they had made it.

“We were there! It was great, thank you again!”

Where were you two sitting? I asked.

“We were in the very top row! I think we were two rows above Jesus!” (Which team was He pulling for? I thought, but didn’t ask.)

Weather can also be a factor. It can get cold in South Carolina – and I’m cold natured. When I get cold, I can’t feel my fingers and toes. Then I can feel them again – they hurt! And until I get warm, I can’t move them without pain. My dad and I were able to go the 1981 South Carolina – Clemson game, when Clemson finished with 12 wins and no losses. The game was miserable (Clemson ran us off the field) and the weather was miserable  – highs in the 40’s with a stiff breeze blowing.  Not pleasant at all! Still haven’t figured out what I was doing there.

So when you add the walking distance, the steps, the weather, and my heart defect, I usually just don’t go to ball games. But I still have the best seat in the house…

…right in front of the TV!

Left foot, right foot….

I go walking,  after midnight... – Walking after Midnight,  Patsy Cline (1957)

Actually I walking early this morning, before the temperature went up. After my fall and the Gout, I’ve walked very little for the past month and my body isn’t used to it. I’ve not walked in so long that my dog barked at me! One bark… almost as if she barked and then thought  “I didn’t recognize you! Oh man, don’t take this personally, OK?”

I didn’t walk much at all before I was exhausted – I’m going to have to go alllllllll the way back to the very beginning of my walking plan. The first time my Cardiologist told me to get out and walk, I planned to circle the driveway for 15 minutes.

I barely lasted seven minutes before I felt like my lungs were going to explode. But I was back at it the next day, and slowly built up my stamina. It’s the only way I know how to do it.

So…. see ya on the walking trail tomorrow!

On the Trail

Steve be hurtin’.

I keep a chart of my walking, and right now it’s pretty embarrassing – I walked three days in September. That’s it. First we had a couple of days when the weather just was too nasty to get outside, then my grandmother fell. Hitting her head put her in the hospital for a week before she passed away, and then my hernia acted up.

And I know what did it, too. We stood in the receiving line before my grandmother’s funeral for three hours – and I think that is what triggered it. My niece was brave enough to go to the viewing but not the funeral, so when she was ready to go, my brother gave me a wave and made the “telephone” sign with his hand. I nodded and walked her outside to call home for someone to come and get her, and I swear that I couldn’t move my feet for a few steps, I had been standing that long!

And the hernia just didn’t get mad at me, it was in a full blown rage – it has hurt every day from September 10 until yesterday! Walk? I was glad to be able to hobble to the bathroom at times!

But yesterday it didn’t hurt – what’s wrong down there? – and today it has been well behaved also. So today, gingerly, I got outside and walked. My watch said that I walked 15 minutes and my pedometer records that I walked 1,637 steps. That’s about half a mile. Not much.

But I sure feel it. I’m “wore out”, as we say here in the South, because all of my stamina has trickled away during my month of inactivity.Today was my first day back, and it really took it out of me.

But if you want to stay healthy, you have to stay active. This is especially true when you have a Congenital Heart Defect (CHD), so I did a little bit of walking today. I had a feeling the rest of the day was going to be spent nursing little aches and pains, but I was out there anyway. Because for a while there my world was limited almost exclusively to either my bed or the couch, and that was not very appealing at all. And when I did go somewhere, it wasn’t very long before I was out of gas and just couldn’t go any further. I’m still not 100% certain what I’m supposed to do with my life, but holding down a couch probably isn’t it.

So I’ll be back out there again tomorrow, and I’ll probably be hurtin’ again tomorrow evening. But walking is a major part of my exercise routine, and I do what I do to defeat the evil that lives within me.

Don’t just survive, THRIVE!

Live your life.

That’s probably the best three words of advice I can give you. You (or your child) has a Congenital Heart Defect. Certainly there will be times that care has to be taken, adjustments have to be made. With a bad heart, you must take care of yourself first. Don’t volunteer to be on the “tote and load crew” and don’t let anyone volunteer you for something that you aren’t capable of doing. Sometimes you have to use a little trickery; when I worked at the museum I’d always volunteer for a job “if someone will help me.” When I got tired, I’d say “Hey, you look a bit tired, let’s take a quick break so you can catch your breath!” (Sneaky, huh?)

You have a Heart Defect, but the defect does not have you. Never give up and never give in. Exercise will build your stamina and allow you to do more later. Don’t have an exercise program? Talk to your doctor. Personally, I walk. Start at 15 minutes a day and walk until you are used to walking that 15 minutes. The next day, walk 20 minutes. Increase your time every few days – you’ll feel pretty tough those first few days, but after a while, you’ll feel your extra stamina kicking in when you need it. (Don’t take medical advice from me, since I’m not a doctor. This is what works FOR ME. Ask your doctor’s advice!)

Get involved. Find a good Congenital Heart Defect support group and participate. Share your story – who cares if you stumble and stutter at first? The more times you tell it, the more comfortable you will be. Be there for others when they are going through a rough time. Stand duty in a hospital with a family that needs your support. Volunteer to stay while they get lunch or some much needed rest. Support one another in person and online.

Teach by example. Wear a CHD Survivor T-Shirt. Participate in fundraisers. Get a customized license plate like one of my blogger friends has: HRT MOM. My friend Rachel has it right: “I’m a heart warrior!” I LOVE THAT PHRASE! I think that from now on, I’ll refer to adults with a Congenital Heart Defect as Heart Warriors. We fight battles that you can’t even begin to imagine!

Encourage research. Write your Representative at all levels of government. Make sure CHD issues become a priority. And hope for the day when all Cardiac Kids, Heart Moms and Heart Dads, and Heart Warriors can say, “There will be no more like us.”