I called the hospital in Florida where she was in the emergency room with a cheerful nurse who asked if I'd like to wish her well? I told him, no, I want to tell her it's her own fault for eating all that butter. (It was the bread and jam, not the cheese and butter, but I didn't know that then..so yes, I said 'butter' like it was a bad word). I was just trying to make them laugh. She did but he didn't. On the phone with me she kept saying, in earnest wonder and disbelief, "They said I'm having a heart attack. I don't think I'm having a heart attack." To the nurse: " Are you sure? I really don't think I'm having a heart attack." She didn't feel great, which my sister could see, so it was lucky she went to the hospital that day even while protesting in her usual optimistic denial mode.
Her name is Anne but it should have been Pollyanna, if anyone remembers that kid. My mother even promised me one time she wouldn't "die suddenly." Being the cynical daughter of my somewhat logical (cynical) father, this irrational sincerity drove me crazy at times. I protested: "Mother, you can't promise me that, everyone dies 'suddenly,' no one knows when that will happen." "Oh, but sweetie," she smiled, "I won't do that, I promise."
Of course, she ended up with a stent...and then another one...and a statin. The cardiology machine of standard medical advice. Lipitor. Although many deny it, including the cardiologists who now want me to take the same drug or one like it, she reacted to Lipitor in the worst way, developing muscle weakness and pain, and eventually was diagnosed by muscle biopsy with polymyositis. Or rather, the statin gave her this overwhelming nightmare of a disease. My next younger sister is an MD, and a fellowship-trained and experienced drug researcher. She was also completely convinced Lipitor caused the polymyositis, the treatment for which helped to kill our mother.
In addition, there were a few more unfortunate confounding facts. My dad, a pathologist, had experienced, self-diagnosed and survived the removal of a lemon-sized benign brain tumor, an acoustic neuroma, in the 1960's, but it had left his balance permanently damaged. The surgeon also had to cut his 7th nerve to remove it. This meant one side of his face and neck was both numb and unresponsive, but he was otherwise ok after a long convalescence, which I remember vividly from high school.
Before anyone knew what my mother actually had that prevented her from being able to move, transfer, and walk, my dad broke a hip trying to help her out of bed. He was 84. Due to his other limitations from the earlier brain surgery, like having his airway compromised from the severed 7th nerve, (this is another story that should be heard) he did not survive his hip replacement recovery and died in the hospital shortly after leaving the ICU (of the pneumonia his compromised status would not enable him to fight). My mother had been admitted at the same time, so they had shared a hospital room where she waited on testing results. Fortunately she was moved to another facility and did not have to wake up to find him lifeless on the bed beside hers. As she was wheeled from the ICU down the hall, where he had been moved after his surgery, nearly the last time she saw him, she insisted on stopping at the ICU nurses station and implored them to take good care of him..."he's my friend and my lover" she told them. Although she drew on her truth and dignity in that moment, I do recall thinking they had written her off as ageist young (40-something) women do, who have yet to give thought to the completeness of an older being, what it will feel like when their own youth has left for all the world to see, especially from the diminished height of a wheelchair among the upright. You could see the patronizing smiles writing her off as an "adorable" little old lady...even as I understand that no one wants to face your own old age before it is forced upon you.
Oh, yes, they thought it was utterly charming that my mother was still a sexual being, but the petite size, the softly wrinkled face, the faded nature of her beauty, allowed them to "other" her, and not appreciate the completeness of her love and understanding, just like we sometimes "other" those different from us by race or culture. Don't call someone older than you by 50 years "cute." Just don't.
My mom was in no position to grieve, as she was placed on high doses of prednisone to combat her now devastating neurologic condition, and entered a nursing home, where she lit up the halls with her kindness to her caregivers and fellow inmates, in spite of her new widowhood after more than 60 years of marriage. This, although at it's worst, she could not sit up, roll over, or hold a fork to feed herself. I recall a conversation with her as she sat naked in a shower stall, waiting for the attendant to complete her bath. She was sympathetic to her caregivers and appreciated the work they did, especially the ones who managed to be gentle. I admit I marveled at her astonishing beauty and at the same time her profound dignity, her soft lovely breasts, still beautiful but heavily veined legs, her sweet knowing feminine smile. With tremendous weight gain (which she also accepted with incredible grace) from the high dose steroid, she was able to walk again with a walker, after maybe a couple of months, and actually returned to her home. However, she repeatedly ignored instructions and would often fall when alone, and wait to be found. She also repeatedly sent her caregivers away as she believed she would be "just fine." Once when I came to visit, and helped her to bed the first evening, she promised me she would not get up until I came to her in the morning. She got up anyway, as soon as I left the room, fell to the floor and could not move nor call to me at the other end of the house, where I unpacked my bags and fell asleep. I found her on a tile floor, uncovered all night, in the morning, bruised, but not broken. The prednisone left her even more vulnerable to another heart attack, which came and killed her apparently peacefully on Christmas night 2008 at the relatively young age of 80. In a sense she kept her promise to me not to "die suddenly." She had asked for a glass of water before she went to sleep that night. I was told it was in her hand at her side upright in her bed, not a drop spilled on the bedcovers, when she was found lifeless in the morning.
What I didn't know then that I do know now makes me wonder if she got the care she should have, and could have had. If I had known, or my siblings had known, about EECP and the possibility of angiogenesis, today I wonder if she could have been with us longer. Knowing it was available, covered by medicare at that time, and never mentioned or offered to her or us, both saddens and angers me now. I will tell you about it, in the hopes your mother, or someone you love as dearly as I loved mine, will fare better, or maybe have more time and a better time, to live and to love you. A mother's love is quite uniquely a wonder of nature.
Below are just some of the people I've read and listened to about what we know and what we don't know about our number one killer, heart disease, and so much terribly wrong advice we've all been given about preventing it, and other diseases, or avoiding it for as long as possible:
Joseph Kraft, Ivor Cummins, Nina Teicholz, Dave Feldman, Peter Attia, Eric Westman, Jason Fung, Rhonda Patrick, Nadir Ali, Ted Naiman, Andreas Eenfeldt, Gary Taubes, Stephen Phinney, Jeff Volek, Christopher Gardner, so many brilliant minds moving forward, unafraid to intellectually challenge themselves and mainstream medicine. Like our other old infrastructure, it's broken. Let's fix it. No need for vitriol, let's just all fall in love with proof.