Taking Control of Your Heart Health
Originally published in January, 2011.
When Palos Heights Deputy Chief Bill Czajkowski walked into the Emergency Room at Palos Community Hospital in February 2009, he was the picture of health. Even doctors thought so, but looks can be deceiving.
“While I was running that day, I felt a pressure in my chest. It was just a sensation, like someone was pushing a finger against my chest. I had no other symptoms.”
At age 45, Bill is what some might consider a health nut. He doesn’t smoke, he doesn’t drink coffee, and he rarely consumes alcohol. He eats a healthy diet that has included a turkey sandwich for lunch nearly every day for the past 25 years, and as an avid runner, Bill is extremely active and in great physical shape. He has participated in numerous 5Ks, 8Ks and even half marathons, and in 2004 at the age of 40, he accomplished one his life-long goals – he ran the 26.2-mile Chicago Marathon. Bill also is a certified fitness specialist as well as the Palos Heights Police Department's fitness coordinator, and each year, he volunteers time with the Special Olympics.
On the day Bill walked into the ER at Palos, he had just been promoted to the position of deputy chief, in charge of the 30-person patrol division of the PHPD. Bill felt great about the promotion, and in general, he just felt great. So why was he in the ER?
“While I was running that day, I felt a pressure in my chest,” Bill says. “It was just a sensation, like someone was pushing a finger against my chest. I had no other symptoms.” Bill thought perhaps he was over-reacting by coming to Palos, but he just didn’t feel right and this wasn’t the first time. What Bill was about to learn was that he had a 95 percent blockage in one of the main arteries of his heart. Bill was, quite literally, a heart attack waiting to happen.
That’s why you should never ignore even the mildest symptoms, nor should you ignore the steps you can take to protect your heart.
Cardiovascular disease occurs in one of two ways, says Palos Interventional Cardiologist Stephen Wiet, M.D. One is literal, whereby the heart or blood vessels are damaged because of an illness or inherent problem. “The other is a disease of inflammation that is caused by an inability of the white blood cells to metabolize the excess amounts of cholesterol we ingest.”
The process is complicated by the fact that there are different subtypes of both good and bad cholesterol, Dr. Wiet explains. What makes HDL good is that it actually removes cholesterol from blood vessel walls, much like a garbage truck hauls away waste. However, there are several HDL subtypes, ranging in size from a dump truck, which remove large amounts of cholesterol, to ones the size of a Matchbox toy, which remove very small amounts.
The same holds true for bad LDL cholesterol, which damages arteries by weakening vessel walls. LDL subtypes range from the beach-ball variety, which bounces right off arterial walls and barely injures the vessel, to the denser bullet type, which can penetrate deep and does a great deal of damage.
Bill’s HDL and LDL subtypes proved to be a crippling combination. “Bill has an inefficient HDL – the Matchbox toy type – and a dense bullet-shaped LDL subtype,” says Dr. Wiet. “Despite the fact that his cholesterol levels looked reasonable, they weren’t. His family history of cardiovascular disease coupled with a high-stress job led to a blockage that needed surgery.”
The combination of Bill’s inefficient HDL and LDL subtypes created an arterial blockage that had caused symptoms before. Bill first noticed the pressure in his chest a year earlier on one of his daily jogs. The sensation came on at five miles. He immediately talked to his doctor and got it checked out, but a stress test and calcium score at the time revealed nothing.
Fast forward to February 2009, and he began to feel the pressure in his chest just three miles into his run and it was more intense. Because of a more recent negative stress test coupled with the worsening chest pain, Palos ER physicians sent Bill for an angiogram, a procedure that actually looks inside the blood vessels of the heart. That’s when doctors discovered that his left anterior descending (LAD) artery was almost completely occluded – a blockage so lethal that it’s earned the nickname the widow maker. Bill required immediate surgery.
Following Your Heart
Bill feels extremely fortunate that his blockage was diagnosed before a more serious cardiac event could occur, but he wasn’t feeling that way when he came out of surgery. “I was 44, and I was hooked up to a respirator,” he says. “I have a physical every year, and I’ve never had any health issues. I eat healthy. I’m very active. My wife is active, and our kids are active. I felt so good; it was just shocking.”
Dr. Wiet was just as surprised. “Bill was doing everything right,” he says. “I remember it vividly. He was the picture of health. No one ever expected to find a problem.” However, Bill’s father had a heart attack at age 55, and that family history combined with the stress of Bill’s job was enough to cause problems.
After surgery, Dr. Wiet started Bill on a medication regime that has significantly raised his good HDL subtype and lowered his overall LDL. As a result, Bill’s HDL has gone from 34 to 45, and his LDL, from 132 to 36. His overall cholesterol was 209. Now it’s 99.
“Theoretically, Bill now has a negative cholesterol risk factor,” explains Dr. Wiet. “He has more trucks taking cholesterol out of his arteries than he has bullets shooting it in.” Advances in heart disease prevention and diagnosis also are helping to save lives. Cardiologists can now test for inflammatory markers that designate an increased risk of heart disease. And cholesterol screenings to differentiate between the HDL and LDL subtypes can then be provided for patients at high risk.
On the Road to Recovery
At Palos Community Hospital, innovation in emergency cardiac care ensure that heart attack patients who come into the ER can receive life-saving cardiac catheterization to open blocked vessels within 90 minutes of arrival. Faster treatment translates into less heart damage and more saved lives.
But prevention is still key. “It’s so important for people to understand that heart disease is treatable and you can take steps to minimize your risk,” Dr. Wiet says. “You may never know that it’s making a difference, but it’s like investing in an IRA. A healthy lifestyle helps you bank health so you can live longer and have a better quality of life as you age. Medications alone can’t do that.”
Following surgery, Bill completed Palos Community Hospital’s Cardiac Rehabilitation program, and then slowly resumed all of his activities, including running. He started by taking small steps, first to the mailbox at the end of his driveway, then to the mailbox next door and on to the one after that. He returned to work after four weeks and was up to walking six miles a day when he enlisted Palos Heights Police Chief Larry Yott and fellow Deputy Chief Dave Delaney to start training with him to run a 5K.
Six months after surgery, Bill completed the American Cancer Society’s Lung Run at Montrose Harbor, and last May, he ran the 13-mile Palos Bank Half Marathon. In addition to eating a healthy diet, not smoking, watching his weight and staying active, Bill also has taken steps to reduce his stress.
“Stress isn’t quantifiable because every person handles it differently,” says Dr. Wiet. “So we’re also doing a lot more screening for stress and depression because of their association with heart disease. But people need to remember that all of the bad news in the world cannot stop you from making good choices.
“Put down the cigarette, eat the right foods and exercise. It’s always a good day when you’re not spending it in the hospital.”