HEART Insight:
doi: 10.1097/01.HEARTI.0000443044.61553.a6
Features: Cover Story

Live to Dance

Childers, Linda

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Heart attack survivor Ellen Abramson encourages women to be heart smart

Six years ago, 51-year-old Ellen Abramson of St. Louis was the picture of health. Working for a national weight loss company, the busy mom of three prided herself on eating healthy and working out on a regular basis. So when she began experiencing puzzling symptoms such as regular heartburn and crushing fatigue, she knew something wasn't right.

“Instead of going to a general practitioner for a physical, I went to a walk-in clinic and told the doctor I was tired and having constant heartburn,” Ellen says. “He handed me some over-the-counter antacid medication and told me I was getting older and needed to slow down.”

Yet even after taking the antacids, Ellen continued to feel worse. She couldn't maintain her usual exercise regimen, and when she looked in the mirror, she noticed her skin had taken on a gray pallor.

“I had been doing aerobic activity six days a week for an hour each day,” Ellen says. “Then it got to the point where I couldn't be on the elliptical machine for more than a minute without feeling exhausted.”

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Small changes make a big difference

While heart disease is the number one health threat for women, it's also preventable 80 percent of the time.

“No matter what your age, adopting a healthy lifestyle can dramatically decrease your risk of developing heart disease,” says Steven Masley, M.D., F.A.A.F.P, C.N.S., of St. Petersburg, Fla., a physician and nutritionist, health researcher, speaker, author and trained chef. In his new book, The 30-Day Heart Tune-Up: A Breakthrough Medical Plan to Prevent and Reverse Heart Disease (Center Street, 2014), Masley shows readers how they can make simple heart-healthy changes to prevent heart disease and strokes, and how to reverse cardiovascular disease.

“I encourage people to look beyond their cholesterol levels and consider their fitness, fiber and nutrient intake, body fat, blood pressure and inflammation levels,” says Masley, a Fellow with the American Heart Association's council on Lifestyle & Cardiometabolic Health.

The AHA recommends a daily intake of 25 to 30 grams of fiber, but Masley says most people only get a third of that, despite the fact that fiber can help with weight loss and studies have shown high-fiber foods are associated with a lower risk of heart disease.

Masley cites certain foods that are not only high in fiber but also possess extraordinary nutritional properties such as oatmeal, which is an excellent source of protein, magnesium and potassium. Tomatoes are also high in fiber and potassium, beta-carotene and B vitamins, and are linked to reduced cardiovascular disease risk.

“I recommend people eat more lean proteins and fiber-rich foods including beans, vegetables, apples and nuts and less saturated fat, [which is] found in many baked goods and fried foods,” Masley says. “In addition, try to get three servings per week of cold-water fish like salmon, mackerel, tuna and sardines that contain high amounts of heart-healthy omega-3 fatty acids.”

“Making positive lifestyle changes can lead to a decreased risk of heart disease,” says Masley, who calls prediabetes the leading cause of heart disease today. An estimated 87 million Americans have prediabetes, a condition where blood sugar levels are higher than normal but not high enough to be classified as full-blown diabetes.

Key signs of prediabetes include high blood pressure, high levels of triglycerides, low levels of “good” high-density lipoprotein (HDL) cholesterol and high levels of blood sugar. While prediabetes can be a stepping stone to type 2 diabetes and heart disease, people who lose 7 percent of their body weight and exercise for at least 30 minutes, five days a week, can reduce their risk of developing diabetes and heart disease.

“If you've been sedentary, get your doctor's OK to start an exercise program,” Masley says. “Then work out at least once with a fitness professional to determine how to raise your heart rate, preferably to 70 to 80 percent of your maximum rate, and keeping it in this range for at least 30 minutes, five days a week.”

In addition to diet and exercise, Masley says it's important to incorporate relaxation into your day in order to combat heart disease.

“Getting at least seven hours of sleep each night and adding activities such as prayer or meditation that promote calm and relaxation are important,” he says. “Having a regular relaxation routine can help you combat unmanaged stress, which can have an adverse effect on your health.”

After months of feeling lethargic and experiencing heartburn and shortness of breath, Ellen woke on April 27, 2008, feeling better than she had in quite some time. She worked in the garden, jogged on the treadmill and then, seemingly out of nowhere, she began experiencing chest pain and sweating profusely.

“I called my husband and daughter who were in another part of our house,” Ellen says. “I thought I was having a heart attack and yet I didn't want to believe it. I decided to take a shower before going to the emergency room, but when I got in the shower I noticed my feet were purple.”

Ellen suddenly had a vivid memory of her paternal grandfather who died of cardiac arrest in her father's car on his way to the hospital. Sensing something was terribly wrong, Ellen decided to forgo the shower and instead had her husband take her directly to the hospital.

Once inside the emergency room, a nurse took Ellen's pulse and then did an electrocardiogram, or EKG. Ellen watched as her hands turned purple and she heard the doctor tell her she was having a heart attack.

Ellen remembers little of what happened next. She knew she was fighting for her life and that her heart stopped beating and the medical team had to resuscitate her. She was told she was taken for a cardiac catheterization, where doctors did an angioplasty and inserted a stent, a drug coated device, in the coronary arteries, to open a blockage in her arteries. As she was wheeled to the intensive care unit, Ellen remembers the shock and tears she saw in her family's eyes and felt bad she had put them through such an ordeal.

“Having my husband and children confronted with my near death was devastating to them,” Ellen says. “As women we are caretakers, and we get busy doing everything for everyone else, but we need to take care of ourselves too so we can be there for the people who love us.”

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The day she began cardiac rehab was also the day that Ellen decided to use her story to educate other women about heart disease.

“I realized I had the gift of speaking and I wanted women to know that if I could have a heart attack, they could too,” Ellen says. “Women tend to fear breast cancer, yet heart disease is the number-one killer of women.”

The first thing Ellen emphasizes when speaking to women about heart disease is the importance of knowing their key numbers for heart health including cholesterol, blood pressure and blood glucose levels. It's advice she wishes she had taken herself.

“I never went to a doctor regularly, partly out of fear,” Ellen admits. “And even though I had a family history of heart disease, I mistakenly thought it only affected men.”

Although her grandfather had died from heart disease and her own father underwent quadruple bypass surgery at the age of 49, Ellen never considered she might be at risk.

“I remember my brothers being told that heart disease had a genetic component, but it was never an issue that was addressed with me,” she says.

While Ellen never missed a mammogram, she didn't know her cholesterol or blood pressure levels. After her heart attack, she learned her total cholesterol was 200, a number her doctor said was too high for someone with a family history of heart disease. Ellen also learned that smoking was a major risk factor for heart disease, especially when combined with other risk factors.

“I had been a closet smoker for years,” Ellen admits. “I started smoking at 16 and even though I had cut back over the years and had quit six months before my heart attack, I never fully realized the health implications of smoking and heart disease.”

A healthy eater before her heart attack, Ellen also made changes to her diet after finishing cardiac rehab.

“I learned how to cook heart-healthy meals years ago after my dad's bypass surgery, but after my heart attack, I cut out most of the processed foods I had been eating,” she says. “I used to buy things like spray butter, mistakenly thinking it was healthier, but I learned that imitation foods like that are just highly processed fake versions of the real thing.” For more tips on how to stay healthy, read our online-only bonus article, “Take a stand against heart disease in women,” at heartinsight.com.

To share her story with a wide audience, in 2012 Ellen wrote a book about her illness and recovery called Live to Dance, which she dedicates to “…the One who allowed me to dance at my daughter's wedding and to celebrate each and every day of my life!” You can read more about Ellen and her book at livetodancebook.com.

Today at age 56, Ellen remains grateful for the little things in life. She says her memory recall has been more challenging since her heart attack, but she is determined to live every day to the fullest. She has resumed her exercise regimen and enjoys activities including swimming and jogging to music, and spending time with her twin grandchildren—a boy and girl born in 2012.

“My doctors say the fact that I was so physically active before my heart attack helped with my recovery,” Ellen says. “I have great doctors and I see them regularly now because I'm doing everything I can to live the healthiest life possible.”

While Ellen says she always appreciated life, having a heart attack gave her a renewed appreciation for her health, her family and the little things in life that many of us take for granted.

“I have learned that what your loved ones really want for their birthdays, graduations and weddings is to spend time with you,” Ellen says. “The greatest gift you can give to yourself and your family is the gift of good health.”

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Treat yourself or a woman you love this Valentine's Day

With Valentine's Day on February 14, Tracy L. Stevens, M.D., a cardiologist at St. Luke's Health System in Kansas City, Mo., and a national spokesperson for the American Heart Association, suggests celebrating by giving yourself or a loved one a gift basket containing the following items:

* A home blood pressure monitor. “This can help make an early diagnosis of high blood pressure in family members and also help track your treatment if you've already been diagnosed with high blood pressure,” Stevens says. “Keep a blood pressure log and take it with you to your next doctor's appointment.”

* A tape measure. “It's crucial to know your waist circumference,” Stevens says. Waist circumference should be no more than 40 inches for men and no more than 35 inches for women. (Recommendations are lower for people of Asian descent: 37–39 inches for men and 31–35 inches for women.)

* A pedometer. “Track your steps during the day and try to work up to 10,000 steps a day,” Stevens says.

© 2014 by the American Heart Association