I do not smoke. I am not diabetic. Among family and friends, my low tolerance for alcohol is a subject of ridicule. For the past 25 years, I have been a faithful visitor to the gym three times a week, on average, observing a tedious but beneficial regimen of cardio and weightlifting routines. In the steamy heat of a Toronto summer, I could manage 90 minutes of singles tennis without fear of collapse. (I played badly, but I played.)
Like many men my age, I carried a few extra pounds at the midriff, but no one would have called me overweight. My diet, while not exactly a nutritional paradigm, was reasonably health-conscious. And if my cholesterol and triglyceride levels were slightly elevated on occasion, they did not alarm my family doctor. Nor did my blood pressure, which tended to fall on the low side. At 65, my reliance on daily pharmaceuticals began and ended with vitamin D.
At least on paper, then, I was not an obvious candidate for triple cardiac bypass surgery.
So much for paper.
I am one of many. Too many. In Canada, someone dies from heart disease or stroke – the two are inextricably linked – every seven minutes.
That’s more than eight deaths an hour, about 200 a day, 70,000 a year. Heart and stroke constitute the leading cause of hospital stays in Canada (almost 17 per cent) and represent a staggering drain on the economy – almost $21-billion a year in physician services, hospital costs, lost wages and decreased productivity. Globally, cardiovascular disease claims 17 million lives a year.
Of course, heart disease used to be an even greater scourge. Over the past 70 years, the cardiovascular death rate in Canada has dropped by more than 75 per cent – more than half of that decline in the past decade. Cancer has surpassed it as the nation’s biggest killer.
But the reprieve may be short-lived. Doctors speak ominously of diabetes as an impending epidemic. Already it is almost four times as common as all cancers combined, and more than half of patients with type 2 diabetes – the product of obesity and a diet of highly processed, sugar-infused foods – will probably die of cardiovascular disease.
Cardiac bypass and angioplasty, the procedure that clears less severely blocked blood vessels, have become so commonplace that there is a tendency to take them almost for granted. But anyone who looks at the looming diabetic tidal wave and sees surgery as a quick and easy fix had better think again – or talk to me.
Even my dreams tried to issue a warning
One day last November while walking to work, I became aware of unusual pain in my pectoral regions. My instinct was to dismiss them, surely the result of upper-body exercise. The pain persisted, however – I’d walk 100 yards and it would solicit my attention – and seemed to spread to my upper back, between the shoulder blades.
I’m a trained hypochondriac and tend to leap from mild pain to it-must-be-cancer in no time. But even so, I never felt short of breath, and the discomfort seemed to abate as soon as I sat down at the office. I was not particularly concerned.
In retrospect, there may have been other signs of trouble: a brief but acute pain (9 on a scale of 10) in one of my thumbs, a searing ache in my right shoulder that would frequently wake me at night, and, occasionally, whole-body chills, which left me trembling beneath heavy blankets.
Even my dreams, it seemed, were trying to issue a warning. One night, I dreamed that a menacing black Labrador came charging toward me and fixed its jaws firmly around the fingers of my right hand. Significantly, perhaps, the dog did not bite. The dream ended with my fingers lodged in its maw, as if awaiting judgment.
By mid-December, with chest and back pains continuing, I had made a self-diagnosis: angina pectoris, the classic symptom of coronary artery disease. Still, I did nothing until, one Thursday morning, just before Toronto Western Hospital’s holiday shutdown, I mentioned my problem to Dr. Herbert Ho Ping Kong, whom I was seeing on a non-medical matter. The legendary internist promptly rose from his chair, walked down the hall and returned a few minutes later to tell me I’d be seeing a cardiologist, John Janevski, at 8 the following morning.