AN EMOTIONALLY NORMAL HEART ATTACK

By RICHARD D. TENNEY MD

When writing his self-help book in 1993, little did cardiologist Richard Tenney know, that again in 2019 he would reemphasize the same messages he previously championed. Since then, a lot has happened to him, and luckily he followed his own advice. Clearly he had risk factors that affected his cardiovascular disease, but he is still alive and pr

• Language: English
• Publisher: TOPLINK PUBLISHING, LLC
• Release date: Jun 24, 2019
• ISBN: 9781733133029

RICHARD D. TENNEY MD

Richard D. Tenney MD He is a cardiologist who lives in Bozeman Montana, where he enjoys fi shing, reading, traveling, training horses, and walking his dog.

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An

Emotionally

Normal Heart Attack

Richard D. Tenney MD

Copyright © 2019 by Richard D. Tenney MD.

Paperback:    978-1-7331330-1-2

eBook:            978-1-7331330-2-9

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any electronic or mechanical means, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law.

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Contents

The Setting

Preface

Chapter One: Not Just Another Day (My Wife Eileen’s Account)

Chapter Two: Denial

Chapter Three: Letting Go

Chapter Four: Modify and Smell the Roses

Chapter Five: Physician Stress

Chapter Six: Overload

Chapter Seven: Is There A Gender Gap?

Chapter Eight: Empathy

Chapter Nine: CCU and Depression

Chapter Ten: It’s Ok To Mourn Your Own Death - For A While

Chapter Eleven: Catheterization Results

Chapter Twelve: Full Circle

Chapter Thirteen: You’re Normal

Chapter Fourteen: Ego Infarction

Chapter Fifteen: Diet

Chapter Sixteen: Exercise

Chapter Seventeen: Heart Attack Aspects - Some Good, Some Bad

Chapter Eighteen: Backward Steps

Chapter Nineteen: Guidance From Somewhere

Chapter Twenty: Deja Vu All Over Again

Chapter Twenty One: Recommendations

Appendix One: Selected Reading List

Appendix Two: List of Illustrations

Appendix Three: Glossary

Appendix Four: Bibliography

To My Heart Attack,

For Without It,

I Wouldn’t Be Alive

This book defines normality:

Just what is An Emotionally Normal Heart Attack?

How do I thank:

A partner, who has more talent than I, but has stood by my side through thick and thin in an unadulterated quest for my goals and aspirations, rather than her own: Mother Earth, who provides the fresh blue sky, the autumn reds, the chlorophyll greens and woods to walk in on a snowy evening: Children, who have grown up simply, developing their own understanding and compassion for life: A dog, Britty Spaniel who swims across the frigid waters of the Yellowstone River, with her hind end swept downstream, to be at my side while I fish; the same old friend, eventually crippled by arthritis, who licks my hand as I finally must put her to sleep: My own career, my life’s work that has demanded growth and transformation, that has drained and rewarded me for twenty years?

How do I thank my own profession as a cardiologist, and the medicines I have administered to keep people alive? And those that kept me alive?

The Setting

I have been accustomed to saying that myocardial infarction is the medical term for heart attack, and that angina pectoris is the medical term for chest pain originating from the heart. But from the first moment of that humbling day, I described my plight as, I had a heart attack. even to my doctor acquaintances. A heart attack is caused by a thrombus or blood clot forming in one or both of the two coronary arteries that provides the blood supply and oxygen to the heart. As long as there is an adequate blood supply through the coronary arteries, the heart receives enough oxygen and no symptoms are produced. However, when the arteries are narrowed or stenosed, the blood supply to the heart is decreased and chest pain caused by a lack of oxygen occurs. If the arteries are totally obstructed, a heart attack occurs. Fortunately, if thrombolytic drugs that dissolve the blood clot, are given early enough in the development of a heart attack, the heart attack can be prevented.

However, even after a person receives thrombolytic drugs, there often remains a residual narrowing of the coronary artery. By reason of this residual narrowing, the blood supply is inadequate and a coronary artery angioplasty is required. The angioplasty dilates the narrowed coronary artery by means of a balloon catheter that has been passed into the narrowed portion of the coronary artery. The balloon is then dilated to increase the size of the narrowing and permit more blood flow. If the angioplasty is successful, adequate blood is supplied to the heart. If it fails, the patient may require coronary artery bypass surgery. The purpose of bypass surgery is the same as the angioplasty: to provide a sufficient quantity of blood to the heart. During bypass surgery, a vein is removed from the patient’s leg and is placed between the aorta and the narrowed portion of the coronary artery, thus again supplying needed blood to the heart.

One sunny day in October 1993, while climbing a fairly steep slope in the California foothills near my home, I experienced chest pain, subsequently had a heart attack, received a thrombolytic drug, followed by a coronary artery angioplasty, and embarked upon the enlightening and challenging process of a successful recovery.

Preface

Generally, I opt not to read personal experience literature. I don’t know why. Probably, like everybody else, I am too wrapped up in everyday life to bother with it. Ironically, I now have my own personal experience, and fortunately, by the grace of God and modern medicine, I survived to tell about it. This is my story.

I am a 54-year-old cardiologist who suffered from angina pectoris, acute myocardial infarction and subsequently had a two-vessel coronary artery angioplasty. I was not the first cardiologist to experience this, nor will I be the last. However, my heart attack provided a message that changed my life for the better.

Prior to the heart attack, I was well aware of the usual causes for a heart attack: hypertension, improper diet, sedentary life style, increased blood cholesterol, family history of cardiovascular disease and atherosclerosis. I spent years talking to my patients about these factors. I pointed out that if any of these factors applied to them, there was an increased risk for cardiovascular disease and heart attack. I somewhat took my own advice, trying to reduce my risk factors, but I was not very serious about it. For some reason, I felt protected, a feeling and miscomprehension that is shared by many people. However, I was serious enough to feel victimized when I had a heart attack. Consequently, I agonized many hours when it occurred trying to decide why I would have it. I felt that there must be some additional reason for my heart attack. After doing some investigation, I became aware that improper diet, misguided exercise, excessive stress, and abnormal self-destructive behavior were also contributors. It became apparent that I had not considered these aspects to be very important to my overall health. However, after my heart attack, I realized I had to change and quickly began to practice behavior modification, mainly through stress reduction, self healing efforts, changes in my exercise program, and improvements in my diet. In doing so, hopefully I prolonged my life.

The lack of attention to my health, especially my bizarre and harmful emotional behavior, had a tremendous influence in producing my heart attack. It was apparent that I was my own worst enemy. This came as a shock. I realized I had to make a diligent effort to change both my personal and professional lifestyles if I was to avoid a second heart attack.

My research also led me to the older, but often omitted, phase of medical science dealing with how the mind can influence healing. For many years, scholars from different cultures have used these self-healing techniques to help patients heal themselves. During my rehabilitation, I too used these techniques to heal myself, and when I returned to practice to help my patients.

What did I learn from this heart attack? I became aware of how and why I responded as I did before my heart attack and with this knowledge, I can help my patients in their similar time of need. I learned that denial of the heart attack and transient depression are normal, the desire to sign out of the hospital and flee from the illness is normal, and the reluctance to return to work is also normal. I learned that there are proper ways to exercise, eat, and relax and that such a lifestyle can be enjoyable as well as beneficial. I learned that exercise need not be something to loath and be excessively rigorous, rather, it is just another tool for improving physical and mental health. I learned that a low-fat diet can be appealing, while decreasing one’s cholesterol, and can in fact lessen the chance of a second heart attack. I learned how to avoid foods with high fat, salt, and cholesterol by closely reading food labels.

I learned why, as a physician, I sometimes avoid the long and involved, but necessary discussions that occur when a patient’s death is near. Mostly, I realized that everything occurs for a reason, even my heart attack.

My heart attack helped me to understand my spiritual needs and taught me to approach death with less trepidation. I learned how inappropriate, misplaced, and harmful my need for material possessions had become. I learned to enjoy the present. The future would be here too soon. I now understood that my life could be prolonged and improved through lifestyle changes. It hurt to realize that I had made my life and my family’s life more difficult and miserable than necessary, and I vowed to change it.

My heart attack and my relationship with my doctor heightened my awareness of honest communication between the patient and physician, a relationship that usually needs improvement. Fortunately, changes have been made in medical school curriculum that produce competent and increasingly humanistic physicians. It is my feeling that because of this change in curriculum, physicians are becoming more aware of their patients as individuals rather than as just patients.

Prior to my heart attack, I was subjected to a lot of stress. It was apparent that I never gave myself the opportunity to decrease my stress load or calmly deal with stressful situations. Rather, I constantly put myself in a position to produce more stress, not less. My inability to deal with stress was witnessed by my family and colleagues, but not by me. They could see it fester in me, but I was not aware of it until it was too late. I ignored the battlefield that stress produced, and this attitude contributed to my heart attack. Once I learned how incredibly destructive stress can be, behavior modification became the necessary solution--an easy choice when I realized that the way I was dealing with stress was killing me.

Unfortunately, not all individuals are aware of, nor do they