Heart BrokenReema Sukumaran
This post is about Sanj’s heart being broken. He is a very private person, unlike me, so this post of his thoughts is something special. It is something many men who have had a broken heart experience and yet suffer quietly not realizing they aren’t alone. It is a long piece, but definitely worth the read and sharing.
So you think heart attack and you think ooh that’s bad.
Most Indian/Sri Lankan immigrants from the early 70s would not be considered to be extremely health conscious. Really in the 70s most of society had not caught on to the healthy living lifestyles that we currently have great exposure to. Arriving in North America in 1970 as a five year old our family was definitely in that category. We ate primarily South Indian and Sri Lankan food at first, which has lots of oil involved. (The incidence of cardiovascular disease is statistically higher in India than most other counties as is the age of onset.) Later on we moved to a community that was primarily Ukrainian and of course Ukrainian food, which was delicious also was not the healthiest. Our Friday night treat was KFC as it was the only fast food in town. You get the picture. Sure we had an active life as kids in a rural community but we were not allowed to play organized sports. I don’t regret the piano lessons but I do wish I could have played more sports.
I remember watching Jack Lalanne on his workout show but working out was not something I knew much about. I was always a skinny child and wanted to be strong. My dad was ahead of his time as he took up morning exercising when I was quite young. I remember he bought one of those Joe Weider workout kits that had those spring based exercise gadgets. I would go upstairs in our garage ad try doing these exercises that promised I would no longer be a 90 lb. weakling getting sand kicked in my face. If only I weighed 90lbs I would have been happy. My dad had polio as a child and was deformed through a burn accident but that didn’t stop him from waking me up at some ungodly hour to do yoga and go for a morning run, both which I did without ever waking up. We also were put in swimming lessons from an early age.
The point is that exercise and healthy living was something that became a part of my life early on even though my diet was not all that healthy at the time. In high school I discovered the weight room and in university expanded my workout to swimming five days a week, running, and weight training. As I grew older I began to understand more about nutrition and became conscious of what I was eating. At about age 50, my very in shape daily exercising father had a heart attack. Dad had stents put in but years later required a quadruple bypass. I was not my father; I was eating right, playing sports, going to the gym and was in great shape. I could bulk up when I wanted to and lean down at will. Cardio conditioning became a big part of my life. In the summer I would get up as early as the sun would come up to do my quickie 20km bike sprint and then go to the gym. I became somewhat of a fitness fanatic. My routine for most of my life was a 5:30 arrival at the YMCA for my morning workout before work. I was stronger than I might ever have imagined in those Jack La Lanne, Joe Weider days. When my second child was 5 we started him training Jujitsu with some mixed martial arts as well. After a year I looked into my future and worried that this little boy would one day be a big boy and would be able to whoop me so I started training as well. We are both still training as he turns 23. I played hockey regularly, softball, golfed, snowboarded with the boys and was generally a very physically active individual. Having six boys gives you no choice but to be active. As I got older things started to change.
I was soon going to be 50 and over the years I had transitioned to a workout that was more cardio based and less power focused but I wanted to say that I still had “it” at 50 and was able to do so. Turning 40 didn’t bother me but turning 50 seemed like a significant age. As they say it was downhill from there. Soon after this I tore my meniscus in my right knee and while I had no pain I could no longer do some of the things I wanted to. I found myself struggling more and more with my cardio and I was beginning to gain weight that I could not take off the same way I could before. I mean I was 50! Things were bound to change. I would still go to the gym but I couldn’t do what I had been doing. I started getting discouraged at this darn, stupid aging process that I didn’t feel I could stop no matter how hard I worked. The fatigue led to weight gain and a diminishing image of myself. I was loosing control. It seemed ridiculous to voice to anyone around me that I was struggling with these things. I felt like this must be what all people go through as they age. I would still go through phases of digging a little deeper and willing myself to overcome. I would get on the treadmill and do wind sprints till I thought I would throw up pushing my heart rate up till I wondered if it would explode. The reality was that I could no longer sustain the effort. I was finding myself worn out and tired fighting to do what used to be easy. I was not depressed yet but I was discouraged. Soon it began.
My wife and I were in church one weekend and we were sitting up in the balcony waiting for the service to start that I was playing the piano for. I had my iPad with me that had my music on it and so I started doodling on one of the apps. It was some kind of silly picture and my wife Reema took a picture of me doing this. Reema posted the picture on Facebook with some caption about her strange husband. Later on in the day we were driving in the car when I saw a comment added to the other innocuous comments. This was someone who thought it ok to point out that I was looking like I had gained some weight around my midsection but not in those words. I was livid but mostly hurt and dejected. I have never felt it appropriate to comment on another’s weight or size or appearance. My second son along with his brothers saw this and went off. I love my boys. One of the sayings in our family has always been “brothers stick together”. Apparently these awesome kids also stuck with their father. In the end the boys learned the lesson that adults can be thoughtless and insensitive.
I guess because I had always been in good shape or even skinny, people noticed that I had gained weight and many seemed to have no problem pointing it out. At
Yes I am a type A and couldn’t avoid continuing to work hard at work and as well as in other areas of life. I may have taken a little longer to accomplish a task but I would get it done. One day I had done some significant weeding of the gardens that surround the house and had made large piles of weeds that were drying out. I went in the house to take a break when I was done. Later in the evening I remembered the weed pile and dragged myself outside to move the pile off the lawn and into an area out of the way where it could decompose. I went outside and grabbed a pitchfork, scooped up the weeds and threw them in the field a few meters away. I put the pitchfork away and came into the house completely out of breath. I was so discouraged because I believed this was just another indication of what poor shape I was in and how my weight was affecting me. I didn’t tell anyone but it did drop me a littler deeper into that well of self-loathing.
My wife is always worrying about me and while I had a doctor it was rare that I was able to see him. A number of years ago he had put me on a pill for cholesterol as a preventative measure given my family history. I didn’t often take that pill. My doctor did things in a very different way. In actuality I never even met him but rather just the nurse practitioner who I don’t believe ever touched me in any of the appointments or examinations but rather had her back to me the whole time working from her computer making decisions from diagnostic algorithms rather than connecting with me, the patient and understanding what I was telling her. I was not happy with this approach. The biggest issue was that I had to call the day I wanted an appointment and I would be given a time sometime in the day. I just couldn’t do this because I too had patients to see and this didn’t work. In the province in which I live you can’t just go find another doctor. We have a shortage and a doctor can’t take you until you quit your doctor and go on a waiting list.
One of our close friends works as a nurse/receptionist at a doctor’s office and my wife found out that there was a new doctor in town so she asked if he might take me. Somehow he said yes and I was scheduled for a meet and greet kind of appointment so that he could get a sense about his patient and review medical history. My appointment fell only a few days after I had my incident with the weeds. On intake my friend put on the blood pressure cuff, which automatically took multiple readings. I wasn’t paying attention but I might have noticed a strange look on her face when she came to take the cuff off and record the data. In the course of my conversation with my new physician going over my case history I mentioned that I was finding myself out of breath. In my head I thought it might have been a lung issue, which also worried me. I will forever be grateful for this doctor’s ability to listen and assess.
I was booked for a stress test. I took the first test and went back to the doctor who thought it prudent to book me a second stress test and maybe refer me to a cardiologist. I obviously knew that the concern was my heart. I was 52 I ate well, I exercised, how could this be. Sure my dad had a heart attack at my age but I wasn’t my dad. Or was I? Before my second stress test he gave me a prescription for nitro just incase I needed it. I was at the golf club that I belong to on the driving range working on my game. I found myself taking a few swings and then being really out of breath. It was getting worse. I tried the nitro for the first time. For those of you that have never experienced this it was a massive head rush. My head was tingling and I had an instant headache but I was no longer out of breath. It was at this moment that I knew I was having severe angina and that this was definitely my heart. I didn’t use that spray again till I was lying in bed one evening and I couldn’t breathe.
For Fathers day my wife had set up a day of fly-fishing lessons for me out of town. I was going to go to Toronto the evening before, go the U2 concert at the baseball stadium, stay over night and go fly fishing the next day. On the way to the concert Reema called to tell me that I couldn’t go fly fishing because the river was running too high. I was disappointed but also relieved because I didn’t know how I would be able to do it. Things had become so bad that I would stress about finding a parking space close enough to my pharmacy be able to make the slow walk in, get my refill, rest and get back to the car. My kids knew I couldn’t even carry anything without having issues so when I was playing somewhere that I needed my music equipment they would carry it in and out for me. At the ballpark I found underground parking by the elevator, which I could manage. When I got to ground level I realized that my entrance was on the side of the building which was up a fairly long set of stairs. I made my way slowly to the stairs and stood at the bottom looking up. How was it that the guy who not so long ago would do his morning mile swim or ride 20km sprints every morning and 60 km rides most weekends could be looking at these stairs as a challenge that might be harder than that. It felt like I was looking up at Everest. Anyone that could have seen me would have observed a man taking one slow step at a time holding onto the handrail while others rushed past. I got half way up and just couldn’t do it. I desperately reached into my pocket and grabbed my Nitro. As much as it hurt my head and gave me a headache it allowed me to make it into the stadium for the concert. While going back was a challenge it was downhill. I would even have to walk slowly in the office as I saw patients.
Finally the day came when I was to meet my Cardiologist. My Cardiologists was new in town but turned out to be a terrific human being and great doctor. They had me do another stress test and took my blood pressure and examined me. The verdict was that I definitely had issues with my heart and that I would likely require stents but they wouldn’t know for sure till they got me in for an angiogram. I knew that this was the likely scenario and was resigned to this possibility. I agreed that this would be best and asked when they would schedule the appointment. I had to get back to work to see the rest of my patients for the day. Without giving too much away she informed me that this would need to be done today and that there was a spot available. What I found out later was that I was actively having a heart attack in the office and that they were moving me to the front of the line for the angiogram.
I got into the hospital and prepped for the procedure. It tuned out that the head nurse was a friend, which reduced my stress, and it also turned out that the physician that was doing the procedure was the head of the Catheter lab at Toronto General a world-renowned hospital for cardiac care. He was covering for a Cardiologist that was on vacation. As it turned out this was providential since the 95% blockage was in a spot that where the route of the probe was tortuous. If they couldn’t get the stent in they would have to transport me to Toronto for a bypass. Did I say I own my own business and couldn’t afford to miss work for an extended time? In the end, although the procedure took twice as long
I was given a slew of medications that I was to take and was informed that some of them I would have to take for the rest of my life. I was feeling better now but still not myself. After a few weeks I was starting to feel down the beta blocker that was lowering my heart rate was also having other negative effects that I had not imagined. I felt like an old man. I was embarrassed and feeling down. My wife told me to talk to my doctor which I had a hard time doing but eventually did. He changed me to another medication that he hoped would be better. What had life come to? I was supposed to start exercising again in order to be rehabilitated. I tried going to the gym and found that the stupid beta-blockers kept my heart rate low and I couldn’t do my cardio, as I was accustomed.
I started noticing other things as well. As I said I am type A but beyond my usual worrying I found myself feeling anxious and agitated. As I drove to work, as I would run through the details of what I thought the day would bring. If I was leading a praise team at church or playing for another team I found myself planning with detail like I never had before and then stressing about every tiny thing. I was extremely agitated and anxious. I could almost feel my body vibrating. My wife again told me to talk to my doctor. Before I went to the doctor I knew what was going on in my head. I knew that this heart attack was out of my control. I knew that I had felt powerless. I understood that no matter how I lived my life those genetics were still an issue. In
My life quickly became one of inactivity, as I couldn’t make myself go to the gym. I would pack my gym bag at night and wake up at precisely 4:45 every morning as was my habit but couldn’t get myself out of bed. I was wide-awake but I felt like I was made of lead. I would lie awake till I had to get ready for work. There were times where I would try to go to the gym and drive over, park my car and sit there without going in. I couldn’t do it. I was struggling. I restarted Jiu Jitsu after a couple of months after the doctors cleared me. My Sensei is one of the kindest people I know and he knew I was struggling physically. I was winded so easily. I would have to stop every few mins and rest just to get through the lesson. I was doing more resting than training and I was frustrated with myself. I was slipping.
Because of my inactivity I started gaining weight again. I work with a lot of patients that are older and many I have known for a couple of decades. There are those in life that seem to say whatever comes into their minds. Perhaps it’s because I practice audiology connecting to patients on their level but it soon turned out that each and every day someone would make a comment about my weight. I can’t tell you how hurtful that was. The irony was that some of these people were very obese but were commenting about me. I felt like I couldn’t say anything to them in my professional capacity but I would try to avoid them the next time they came in. Some people even trying to be kind and compassionate knowing I had a heart attack would talk about my weight even as expressing their concern for my well being. I started wearing baggy sweaters and clothes to hide in. It was endless. Just about every day someone would say something to me. I didn’t want to interact with my patients for fear of what they might say. I didn’t want to visit family of friends that may make a comment. I made excuses to avoid reunions and social events that I would have otherwise loved to go to. I didn’t want to go near a scale; I didn’t want to look at myself in the mirror and would purposely avert my glance. My poor wife knew that she had to only post pictures of me from the chest up because I was embarrassed.
Somehow I had missed being called to Cardiac rehab at the hospital and when they recognized the error I was enrolled. I would go once a week before work. I was demoralized as I walked in and saw the room filled with primarily elderly heart patients. Now I was one of them. I didn’t need to be taught but I did have a physical therapist that oversaw my program. I was supposed to train several times a week with certain targets. I was going along just going through the motions making little to no progress when the PT gave me a kick in the pants and for awhile that worked until it didn’t. After rehab ended I fell back into my old ways. I had fears that I wasn’t even fully aware of. If I did take part in any physical activity I always held back for fear of what might happen. I was fearful of elevating my heart rate beyond a certain point.
I would go on Facebook and get furious at those who self promoted their healthy lifestyles. People that would post pictures of their healthy choices in meals and would have lots of advice to hand out to everyone else were getting under my skin. None of this motivated me instead I just fell a little deeper into the pit of depression.
I am not sure what snapped me out of my funk of two years but I think it was actually my boys. I knew they were worried about me. This was not the father they knew. I was the one that introduced them to the gym and now I couldn’t get myself to go. The boys I knew were worried about what might happen to me. This broke my heart, as even my youngest child would subtly express his fears for me. I was tired of not being the me that I knew. I was tired of not being the dad that my children knew. I am not the same today as I was post-heart attack I am indeed forever changed. I write this piece not because I am now in the best shape of my life because that is not the case; I write it now because I am finally in a place mentally that I can talk about the struggles. I started back to the gym at the end of April 2019, never taking my hoodie off even as I sweat probably for the first month. I started doing my cardio even though I was walking shamefully slowly on the treadmill. In humility, I would lift weights that were previously feather-light that now challenged me. Currently, I have stuck to my specific diet and have made consistent gains in the gym. I am finding my strength again and feeling healthier for the first time in several years. I have lost weight but have ways to still go. People around me haven’t changed and for many their insensitivity continues even as they congratulate me on my weight loss expressing their previous impressions about my physical appearance. Even those positive expressions still bother me because they also point out their previous view. It is not the physical change though that has allowed me to write this story ,it is the mental strengthening that allows me to share honestly.
I have spoken in these years to other men that have also suffered heart attacks, some young and some old and as I shared my honest feelings and experience I found that they had gone through similar struggles. The recovery from heart disease was the easy part; it has been the mental recovery that was an unforeseen challenge. I wish I knew earlier what I know now. I write this article in the hopes that others that go through these challenges before and after a heart attack will know that they are not alone and that their challenges are nor exclusive to them. I hope others will see that they need support and can’t do this alone. I was fortunate to have a spouse that picked me up constantly and a physician who spent countless hours really listening to me and working with me to find solutions. Yes heart disease came with a mental illness challenge that I didn’t expect. While there is still much more that happened in this particular time period, I wanted to bring to light some of the broader themes of heart attack and recovery. I took the time to document these events because I don’t believe I am alone in this reality. I actually know I am not given that others have shared with me similar experiences. Please feel free to share my experience with those you might know that are struggling with admitting to the symptoms of heart disease or have suffered from a heart attack. Hopefully this is useful to their family members that are having a hard time understanding what is going on with them. Above all if you are struggling talk to someone as you navigate these unchartered waters in your life.