HEALTH RISK

So it's finally happened to me. My health insurance company has refused.

I've always considered myself and my family blessed to have good insurance. We've had our share of medical emergencies and long-term issues and with a little hard work and a lot of time on hold, we've gotten good coverage through the years.

So this is my first outright rejection. They don't want to pay for Crestor anymore, because my cholesterol no longer needs to be reduced more than 40 percent. So precisely because it worked -- dropping my LDL from 180 to 58 -- I no longer need it. Sure, that makes perfect sense.

They'll reconsider if I "try and fail" the generic brands, so lucky me, I get to start testing new medications and dealing with new reactions, interactions, and side effects. I'm especially looking forward to the muscle pain I hear comes with Lipitor; despite the mega-dose of Crestor I was on, I had managed to escape that. Muscle pain + marathon training = good times.

And then there's the anxiety of new drugs. I don't especially love that I'm on 14 pills a day, but at least I'm used to them all and I know what they do to me. Spending the next year trying and failing sounds like a new roller coaster ride of emotions and stress.

The most frustrating thing about this is that it seems that insurance would rather pay for another heart attack than keep refilling Crestor for the next 50 years (I'm optimistic, even when mad). They must have fed my data into their algorithms and concluded I was a low risk and therefore worth the extra cash in hand today. They feel comfortable with the risk; too bad I don't.

I know that this is a minor setback and that for millions of others, denied coverage is a much, much bigger issue -- one of life and death, not of anxiety and inconvenience. It happens. To many.

It shouldn't.

MYTH BUSTING

My new Road ID for running. In case I'm miles from home, alone,
it would be good for EMTs to know I've had a heart attack.

This post is inspired by a helpful American Heart Association article "Top 10 Myths About Cardiovascular Disease," which warns of the dangers of making false assumptions about your risk for heart disease.

I'm not the only one who made false assumptions about my heart; it took ER doctors and even cardiologists hours to believe I was really having a heart attack. But now I know the real truth and I want you to do the same.

Here are some of the myths the article describes and my own take on busting them. Read up, take your heart seriously, and pass it on.

I'm too young for heart disease.
Ha. I think we know how false this one is. I was 37 when I had my heart attack, and over the course of my eight weeks in rehab I saw at least two survivors much younger than me. In fact, 62% of people living with heart disease are under age 65.

I'll know I'm having a heart attack because I'll have chest pain.
Again, ha. No chest pain whatsoever. Sharp, stabbing back pain, yes. Arms, hands, and even palms aching to the point of tears, yes. Cold sweat, yes. Chest pain, not a bit. Especially for women, the symptoms of a heart attack can be as subtle as nausea. If something doesn't feel right, get checked. Don't assume it's heartburn, headache, muscle strain, or any of the zillions of excuses women make for their symptoms.

Genetics are destiny. Since heart disease runs in my family, there's nothing I can do about it anyway.
I fell victim to this one a little bit. I knew I had high cholesterol but so did most people in my family and they hadn't had heart attacks. I was off-and-on medication but it didn't really improve that much. I was off-and-on my low-fat diet, figuring all the exercise I was getting balanced that out.

Well, it didn't. With family history of high cholesterol my only risk factor, I had a heart attack anyway.

But here's the thing. After my heart attack, aggressive medication, diet management, rehab, and continuous exercise have brought my cholesterol way down, from a "bad" level of 180 to 58, and total from 230 to 106.

There is something you can do about it. So do it.

I don't need to start worrying about heart health until middle age.
Again, do I need to remind you that I was 37? (I guess that might be middle age - yikes!) Maybe it is, but if I'd been paying attention before that (I knew about my cholesterol levels in my early 20s), I might have avoided my trips to the cath lab and cardiac rehab.

The American Heart Association recommends you start getting your cholesterol checked at age 20 and to start even earlier if your family has a history of heart disease. Children with a family history can have high cholesterol levels, putting them at increased risk for developing heart disease as adults. My brother tested in the 300s when he was 13; I had my older son checked at age 10. So far, so good.

I should avoid exercise after having a heart attack.
Really? Someone actually thinks this? It might be hard. It might be scary. But if you want to live, get out there. I loved cardiac rehab and I recommend a formal, supervised re-entry into exercise. I felt so much safer, stronger, and more confident, and the structure it provided kept me accountable. Make sure your doctor approves and then get moving. I'm running a marathon this fall, but really, I'm running for my life.

The American Heart Association recommends at least two and a half hours of moderate intensity physical activity each week. There are 168 hours in a week; can you spare 22 minutes a day?

These are just half of the top 10 myths. Check out the AHA article for more!

LAUGHTER IS THE BEST MEDICINE

I really love this series of videos by the American Heart Association. They are designed to teach and encourage "hands-only CPR" and raise awareness about the importance of treating heart attack victims as fast as possible.

Thank you to comedians Ken Jeong and Jennifer Coolidge for lending their talent and visibility to heart disease!

Enjoy!

SURVIVOR IN TRAINING

It's on.

I've been stress-tested, blood-tested, and pressure-tested. I've been examined, reviewed, and notated. Poked, prodded, and medicated.

And all the tests and medical professionals have come to the same conclusion: There's nothing really wrong with you, except for that heart attack thing. So yes, go ahead and train for that marathon. Go ahead and live your life.

Oh, I will, and oh, it's on.

It isn't quite that simple, of course, but that's the (ahem) heart of the matter. There are a few rules to follow now that I'm a survivor. But I like it that way.

My first post-heart attack stress test was last November, and I passed it with ease. The test showed perfect heart function and no scarring, and while there is blockage in other arteries (that may either build up slowly or rupture spontaneously someday), it wasn't restricting blood flow. Dr. Murad, my cardiologist, said then: "It's like [the heart attack] didn't happen. But you know it did, and I know it did. We were there."

I was given the green light to resume vigorous exercise (which my trainers have taken extremely literally), and told I could probably try a marathon again. "But let's check again in May."

So last week we checked again. And by checked, I mean I had nuclear isotopes injected into an IV and then a 3D scan of my heart done in a kind of MRI machine. Then I ran on a treadmill at an ever-increasing incline while wired to an EKG machine and having my blood pressure taken every minute. When you are about to collapse -- like you really can't go another step -- you cry uncle and then they shoot you full of isotopes again and you have to keep going for one more minute. When you are done, it's back in the MRI machine to see what your heart is doing under  . . . well, stress.

Again I passed this one with ease, if being injected with stuff that comes in a locked, lead box is easy. My heart shows "excellent exercise tolerance" and "completely normal blood flow." And after obtaining sign offs on my training plan from Dr. Murad ("In my opinion, you can train for your marathon"), my trainers ("I'm gonna want to see your training plan. Are you resting enough?"), my old friends in cardiac rehab ("Cut back on the mileage in the later weeks; it is better to under-train than over-train. And take some vitamin D."), my primary doctor ("Do I think it is okay, yes. Do I think it is wise, no."), and even my ob/gyn (though that was just scheduling coincidence), I'm allowed to train for the Twin Cities Marathon.

But . . .

I'd better actually do the training. Because if they suspect I am not fully prepared, or that I'm pushing through something or forcing or sagging and lagging like I was last summer when I was training while getting ever sicker, they are going to pull the plug on their approval, like my trainer just did for the half marathon I was going to do June 2. (Having missed two long runs she doesn't think I can make up the training and just powering through is not allowed.)

Here are my rules:

• I'm not to over-train.
• I'm required to stop if something feels wrong, not just assume I must be some kind of wimp and keep going.
• I can't run if it is too hot.
• No anti-inflammatories. (That's Advil. Marathon training with no Advil.)

Basically, don't mess around, because you did have a heart attack, whether you feel sick or not. To quote Dr. Murad: "As we discussed, listen to your body, know your limits, and train within yourself. Be safe."

And really, this is the best thing they could have done for me or said to me. Because I do better with training when the rules are clear, the consequences are obvious, and someone's looking over my shoulder. I can't skip a work out because if I do I might ending up missing the whole thing. And I really don't want to miss it again. This year, I've got something to prove.

It's so on.