Falling Back

Photo by Oedipushinx.

Before his heart attack there were warning signs. He ignored them. He was having the season of his career, setting personal bests, and in contention for his field’s overall title. Nearing the end of the cycling race that finally forced his heart over the edge, Scott prepared to push to the front. He suddenly lost power, the pack moved away. “What the hell just happened?” he thought. Time slowed,the people around him began to fade into the background. “Scott, are you all right?” they shouted as he crossed the finish line alone. He could barely hear them. A sense of dread began to build. “The buzzards were circling” he says, “I was overcome by an urgent need to call my wife.” The quick action of friends and the fortunate presence of an onsite cardiologist saved his life.

Scott Kasin, an elite master’s level cyclist, joins a surprisingly large group of athletes who, despite their lack of apparent risk factors, have experienced a myocardial infarction (MI) or heart attack. “Just because you’re an athlete and your heart it strong, does not mean you are immune” he says, in a demeanor framed two year later, with lingering disbelief that he is a heart attack survivor. “I did everything in my power to avoid the truth that I had had a heart attack”.

Talking to this educated, superbly fit, 43 year old, it is easy to see how everyone, including himself were fooled into believing he was safe. Words like lean and ripped perfectly describe his well trained physique. Many millions of Americans will have similar experiences. Half a million of them will die. Cardiovascular disease related conditions carry a price tag of $500 billion dollars annually. One in three Americans has it, more than breast cancer and lung cancer combined. More funding goes to fighting and researching cancer than heart disease despite its’ standing at the top of the people-killing podium for both men and women. Someone dies from heart disease in the United States every 38 seconds.

Grimmer still is the fact that half of those who die will not have any of the risk factors that we commonly associate with the disease. “There is a lot of conflicting information out there. A lot of guidelines that are currently used for diagnosis and treatment are outdated.” He insists that there are better options with greater life saving potential. His frustration is evident as he recounts his own missed opportunities to prevent an experience that has left a portion of his heart muscle scarred and lifeless.

“It fucking hurt!” he says, grimacing as he recalls how the attack felt. “It was like no pain anyone should ever feel.” Knowing the warning signs is the key to getting immediate medical treatment to prevent long term damage. Pain, discomfort or pressures, outside of your normal sensations, in the arms, neck, back, jaw or chest are major symptoms. Scott is adamant that people understand that the chest is not just the area of the “pledge of allegiance” but the entire area from your collar bone to the base of your ribs. “I thought I had indigestion and was clutching my stomach”, he explains, “I now realize I was actually clutching my chest”. Nausea, headache, loss of energy or performance in a previously easy activity and a sense of impending doom, one that Scott vividly remembers, are all warning signs that should alert you to see a doctor immediately.

Scott is concerned that when men get their blood test results back from their doctors, they aren’t paying attention. It is his and other expert opinions, that the greatest risk factor for developing the disease is a low level of HDL (high density lipoproteins) or good fats in the overall lipid profile. HDL levels below 40 are considered high risk for developing the disease. This is the one area that Scott did not address in his own profile, and the one he feels led to his attack. Keeping LDL (low density lipoproteins) or the bad fat below 100 is important to balance out the equation for reduced risk. It is widely accepted that blood tests that assess cholesterol levels should occur every 5 years in men over 35.

There are other lesser known variables that increase risk. Family history nearly doubles the risk of developing heart disease. Scott also learned through genetic testing that he is a carrier of something known as the KIF6 gene, which has been shown to correlate with a 55% increased risk of developing this disease. Not typically part of the routine risk profiling, this simple test, involves swabbing the inside of the cheek and sending the resultant tissue sample to a lab.

He remains concerned that the best available care is withheld because it is expensive, and insurance companies opt for the lower cost, less accurate technology. Scott has worked closely with physician groups from Berkeley Heart Lab in California and the Weatherhead PET Imaging Center at the University of Texas Medical School at Houston, two organizations that offer the most complete and accurate risk assessment available. One type of testing that they do, boasting 98% accuracy, is a PET scan. The PET scan (Positron Emission Technology), according to the Weatherhead website offers “the most advanced and accurate non-invasive technology for visualizing blood flow in the heart muscle...” Their onsite laboratories use a variety of advanced blood screening tools to determine individuals who possess the greatest degree of risk for heart disease and who would be good candidates for the PET scan.

Responding to the fear of another heart attack, in part to empower and educate himself, Scott established the nonprofit organization MIaware. Working with Optimal Care Providers, “heart crusaders” he calls them, cardiovascular physicians and specialists, Scott’s mission is to educate and inform the public about the reality of heart disease. He encourages everyone to be their own advocate- to seek out the best and most proactive doctors they can find. Despite everything he has been through over the last two years and what he continues to live with every day, Scott declares his heart attack year as “… the best year of my life. I took a year out of my life, focusing on nothing but my family and getting well. I pay attention now, to every test and every number so I won’t be ignorant again.”

To learn more about Scott and his organization MIaware please visit www.MIaware.org.