
My Life After a Heart Attack at 38 - onuralp
https://www.nytimes.com/2019/01/19/opinion/sunday/heart-attack-young-men.html
======
Waterluvian
Before kids nothing scared me. Not because I felt invincible but because I
felt like uncalled code. If I were culled, there'd be sad family but everyone
would move on. Nobody depended on me.

But now I have kids and they need me in a way I've never felt from anyone
before. It's F@#$_ing terrifying because of just how vulnerable I realise I
am.

~~~
mikegerwitz
I'm a father of 7- and 5-year-olds, and I constantly think of this.

I have some anxiety issues and frequently have mild panic attacks, which can
have symptoms similar to heart attacks. I have vasovagal responses triggered
by odd and benign things. I also have bad muscle tension in my neck and upper
back, which can extend around into my chest. And to top it all off, because I
have children, I am often sleep deprived and drink too much caffeine. Heart-
related issues are on my mind so frequently that I've almost convinced myself
that I'm going to die of a heart attack one day, despite me being in good
health.

I spend a lot of time worrying, so if I could share my advice with others: if
you are worried, just see a doctor. It's not worth being wrong. One day I had
symptoms of a heart attack for hours and went to an urgent care facility and
got an EKG and x-ray of my heart. They found nothing, and attributed it to
musculoskeletal pain. Considering I've been worrying about my heart for many
years prior, those tests gave me a strong sense of relief and allowed me to
focus on learning how to control my anxiety without getting into a feedback
loop (anxiety -> heart attack symptoms -> more anxiety from worry). I can now
calm myself down pretty quickly.

This may seem obvious, but getting extra sleep and cutting out caffeine helps
immensely with all of the above symptoms. Easier said than done as a parent
whose kids don't even sleep through the night. :)

~~~
pplante
I have been experiencing these same symptoms. I started seeing a therapist
again, which is starting to help me control and understand the trigger sources
for my anxiety. Thank you for sharing such a personal thing, it helps me know
I'm not alone in letting my brain trick me.

------
agumonkey
> The practitioner there did an electrocardiogram and said the left side of my
> heart was slightly enlarged, but my discomfort was probably just gas. Don’t
> worry, I was told: “Your heart’s not just going to stop. You’re not going to
> drop dead tomorrow.” But that’s what almost happened.

This is worrying. The habits of doctors can kill. They're not cautious enough.
My grand mother was misdiagnosed (not coronary but cardiovascular). My aunt
was misdiagnosed and sent home. I had clear cardiovascular issues but got
laughed at by half the people I talked to.

Non invasive diagnosis is one the few places where I do want tech to get one
or two more decimals of precision.

~~~
DoreenMichele
Historically, doctors were some of the most educated people in town and you
and your entire family saw the same doctor for many years. They had a lot of
context for what was going on in your life.

Now, people move around more, are less likely to see the same physician for
years on end, are less likely to see the same physician as their relatives who
may live elsewhere, etc.

I don't know how to fix it, but I think these changes are a very big part of
the problem. I don't care how brilliant and dedicated you are, having less
overall context is going to undermine your ability to draw accurate
conclusions about what's really going on.

~~~
nradov
Perhaps so, but do we have any evidence that the frequency of diagnostic
errors has increased?

~~~
DoreenMichele
No clue and it's entirely possible diagnostics have improved in some ways, in
part due to improvements in testing and in part due to patients being better
educated.

But I'm old-ish and I remember when it was pretty normal for Mom to show up
with all three kids and a couple of their cousins and get them all treated at
the same time. In contrast, in recent years, I routinely hear that people in
the family pass the same crud around repeatedly because they get treated as
individuals and it leads to recurrent or chronic issues. I've also dealt
enough with chronic health stuff that I'm quite confident that when doctors
decide "This is your normal. Just get used to it." it becomes self-fulfilling
prophecy.

From what I gather, obesity and chronic health issues are vastly more common
than they used to be. To my mind, that's probably evidence that something has
gone very wrong with our health mental models/practices overall and the change
in how we interact with physicians is probably just one grain of sand in a
beach of changes. (However, it will also be confounded by medical advances
leading to people malingering when, historically, they would have simply died.
We often can't cure them, but we can keep them alive longer than we used to.)

But I'm sure that's a case of "Other people won't necessarily see what I see
and if they don't, there will be no winning them over." (shrug)

~~~
Fomite
"From what I gather, obesity and chronic health issues are vastly more common
than they used to be."

Obesity, perhaps, but chronic health issues? Not really - and a tremendous
number of those went untreated. A huge number of people in the past lived with
perpetual pain and disabilities.

~~~
DoreenMichele
Historically, we didn't have the resources to "carry" a lot of disabled
people. You had to pull your own weight in some way.

Because I'm disabled and the internet is a thing, I'm very aware of the
existence of people on disability, on multiple meds and not doing much with
their lives. Historically, we simply didn't have the resources to support such
people.

I'm thinking of those folks -- not simply people living with pain and
limitations, but people who historically would have simply died because if it
was going to kill you to keep on keeping on, then you were going to die
because disability payments, etc, simply did not exist like they do today.

------
fipar
I had one at 40, just six months ago, and waited over 12 hours to go to the
doctor for the same reason as the author (didn’t want to mess with the things
my wife and kids had to do that day). I even drove my daughter to school while
having the attack, which is both scary and stupid when you really think about
it. Of course, denial had a lot to do too. Even though I woke up at 4 from the
pain, I spent all day thinking it must have been something else. The only
point of my comment is that if this ever happens to you, don’t delay going to
the doctor. I guess my behavior that day is an example of normalcy bias? I
don’t know...

~~~
shanehoban
A good rule of thumb, and something I learned while at medical school is that
if something wakes you or interferes with your sleep; especially a headache,
but would be applicable for anything else such as a cough, or pain somewhere
in general; it would be in your best interest to go see a doctor about it.

------
starik36
I had similar experience. Had a quintuple bypass at 36. Lots of emotions and
reevaluations of things. Will I see my kids grow up - things like that. I had
to relearn walking.

But it also served as a good kick in the behind in terms of taking charge of
my life. It motivated me to stop eating like a pig. To get rid of toxic people
that were causing me stress. To start exercising and leading a healthy life.
In a weird way, the bypass was a blessing in disguise.

~~~
math
reminded me of this: [https://sivers.org/horses](https://sivers.org/horses)

------
oredbored
I'll just leave this here
[https://www.ncbi.nlm.nih.gov/pubmed/25198208](https://www.ncbi.nlm.nih.gov/pubmed/25198208)

~~~
koboll
>Of the 198 patients with CVD, 177 (89%) were adherent. Major cardiac events
judged to be recurrent disease totaled one stroke in the adherent
cardiovascular participants—a recurrent event rate of .6%, significantly less
than reported by other studies of plant-based nutrition therapy. Thirteen of
21 (62%) nonadherent participants experienced adverse events.

So... heart disease can be attributed almost _entirely_ to eating meat? That
result seems too good to be true.

~~~
BadassFractal
How do we explain the vegans and the vegetarians who still get plenty of heart
disease? If veganism were a silver bullet, I'd be the first one to jump on
that bandwagon, today.

~~~
gnulinux
Because studies like this are sheer bullshit. There is no one "plant-based
diet". Eating fat heavy (avacado, nuts, seeds, coconut, acai berry, olives
etc...) and carb heavy (rice, fruits) diets and whether you eat few protein
rich plant sourced (basically only beans) will have very different
macronutrient, micronutrient profile and will have very different effect on
human body. Same goes for animal-based diets. Moreover, people who were able
to adhere to this study might have just been more disciplined and healthier.
This study does not control other important risk factors such as alcohol,
regular exercise etc. I find it very hard to believe we can really derive any
useful information from "we forced people to eat plants".

As a meat-eater I think the most stupid strawmen vegans hit me with is the
belief that I only eat meat. I think very few people advocate "only eating
meat" (e.g. recent 0carb hype, which I think is clearly pseudoscience). You
can still eat plants but supplement your diet with meat to get more protein
and healthy fats. You can still get 75% of your calories from plants but still
eat meat. Also, there will be a huge difference between highly processed meat
(bacon, salami etc) and unprocessed, grass-fed meat. Studies like this simply
ignore all these factors.

------
tjpnz
Any advice from doctors here on what to do if you believe you're experiencing
a heart attack?

~~~
bihnkim
I've heard a 911 dispatcher say take aspirin if you can

~~~
a_f
And when you do it is important to chew it, which helps increase the speed in
which it works.

------
known
[https://en.wikipedia.org/wiki/Fear,_uncertainty_and_doubt](https://en.wikipedia.org/wiki/Fear,_uncertainty_and_doubt)
about children leads to Stress. And stress leads to
[https://en.m.wikipedia.org/wiki/Takotsubo_cardiomyopathy](https://en.m.wikipedia.org/wiki/Takotsubo_cardiomyopathy)
which in turn leads to [https://www.nhs.uk/conditions/coronary-heart-
disease/](https://www.nhs.uk/conditions/coronary-heart-disease/)

------
aprdm
I feel like in technology we talk so much about metrics, observability, having
lots of logs and application metrics for _all_ of your infrastructure.

Yet, we don't seem to have anything similar for the human body. How many lives
can be saved every year by having a system that grabs some data from your body
and has some thresholds for warnings? Something doctors could simply hook into
(pull based) or something you could give to a doctor (push based). Some
"critical warnings" could call an ambulance straight away.

Do we need more IoT embedded systems to hook to the cloud? Is it a problem
with regulation? Physics / biology deterministic measurement?

~~~
throwaway5752
There are multiple companies working on this.

------
bobowzki
I've noticed a lot of health anxiety in this thread. I'd like to recommend
"Overcoming Health Anxiety" by Davis Veale and Rob Willson, for anyone who
feels they worry excessively about their health.

------
tarr11
Similar thread from 2014 (lots of comments)

[https://news.ycombinator.com/item?id=8550315](https://news.ycombinator.com/item?id=8550315)

------
mindfulplay
Are there any evidence-based efforts to monitor, diagnose these at an age
where it was previously thought to be too early to have an heart attack?
(Calcium score? CT scan?)

Most other diseases that killed vast populations at this age have been
resolved or worked around, so looks like we are looking at one of the last
remaining killer dieases.. would love to strap on Apple Android whatever
devices if it will help diagnose or monitor such patterns.

~~~
carbocation
You can get a sense of the age range from this article:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487339/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487339/)

MI (heart attack) can happen at almost any age, but it is rare for it to occur
before ~60. "Early-onset" MI is < 50 for men or <60 for women.

38 is extremely young. I know only a couple of folks that young who have had
an MI, and I work at a quaternary referral hospital as a cardiology fellow.

~~~
roboforce
> 38 is extremely young.

My Dad, his brother, and his father all had heart attacks in their late 30's
and early 40's. I'm in my early 40's and very concerned.

Should someone with a family history like mine be more aggressive with
testing? My family doctor does not think so.

Are there even tests today (like the "CT angiogram") that could detect (and
prevent) a person with extreme family history from a 1st heart attack?

~~~
carbocation
If you have access to a preventive cardiology clinic, it'd be worth getting a
second opinion.

------
known
We need to develop a type of x-ray machine that can instantly identify blocks
in arteries
[https://www.nhs.uk/conditions/angina/treatment/](https://www.nhs.uk/conditions/angina/treatment/)

------
sidcool
The important question is how can one regular cardio vascular health?

------
rblion
My uncle who named me passed at 39 of a heart attack. This resonates.

