Driver Lifestyles

Listen To Your Heart

According to the American Heart Association heart disease, stroke and other cardiovascular diseases afflict nearly 62 million Americans and kill nearly one million men and women of all ages each year. And, with the cost to the country estimated at $352 billion for 2003, cardiovascular diseases impose a heavier economic burden than any other disease.

According to the Feds, last year highway accidents killed "only" 41,000 people. Most fender-benders are caused by 1) mechanical failure 2) a momentary lapse in concentration or 3) an impatient or drunken four-wheeler. Since our equipment is well maintained, and our skill levels high, today's freight haulers cause comparatively few accidents. If we exercised half as much diligence at the dinner table, we'd live longer, more active lives.

You are what you eat. Your grandmother passed this folksy wisdom down to her child, who passed it along to you, and you preach it to your own kids. But who can resist a thick, greasy pork chop with all the trimmings? Well, I can, but then I'm excessively fond of peach cobbler. I'm not getting any younger, either (few of us are).  People start dropping dead of coronary diseases in their thirties, so it's high time we all started taking better care of ourselves. To do so, we need knowledge.

Understanding heart disease

At the cellular level, life is basically a controlled "burn." Therefore oxygen, the volatile substance that fuels all fires, is essential to all life. When deprived of this gas, living tissue begins to die almost immediately. Heart cells, being biologically the most active, have the greatest need. A heart attack--a myocardial infarction in doctor-speak--is the irreversible death of a portion of the heart muscle. This occurs when the organ's oxygen supply is severely reduced due to excessive blood loss or cardiopulmonary disease.

Heart disease comes in many varieties. Congenital defects in coronary arteries or the heart muscle itself may go unnoticed for decades. Over the course of a lifetime veins and arteries, which are tiny to begin with, become clogged with insoluble fats, which raises blood pressure, which in turn causes a host of other problems.

Angina

A heart attack isn't a cause: it's a result. About half of all deaths from heart disease occur unexpectedly. But the other 750,000 victims receive ample warning. Many of these people are punched in the chest periodically by angina pectoris. The severity of this chest pain varies considerably from person to person. Some people hardly notice an angina attack; it sends others to the nearest hospital. The latter are the lucky ones, because angina is a symptom of myocardial ischemia.

Ischemia, and the resulting chest pain, strikes a person when blood circulation to his or her heart is enough for normal needs but insufficient to fuel strenuous exercise or physical responses to stressful situations. Running to escape a downpour, for example, might cause an angina attack while a sedate six-mile walk might not. Exertion usually brings it on, but some people experience angina even when they're curled up with a good book.

Cardiologist David Walker of South Carolina advises angina pectoris sufferers to undergo a thorough physical examination. "Angina isn't always a precursor to a heart attack," he says. "Don't panic if you feel a tightness, a fluttering sensation, or a momentary sharp pain in your chest. All three are important danger signs, however. So to err on the side of life, if you ever experience either of these symptoms, schedule a visit with a specialist at the earliest opportunity."

how is angina treated?

Once diagnosed, angina pectoris can be treated with medicines that either increase the heart muscle's blood supply or lessen its demand for oxygen. Nitroglycerin and other coronary vasodilator drugs cause blood vessels to relax, which enlarges the passageway somewhat, allowing more oxygen and other nutrients to reach the heart. Alternatively, drugs that reduce blood pressure can be prescribed, thereby reducing the heart's workload and need for oxygen. A third type of drug, those that lower the heart rate, achieve a similar result.

Invasive techniques may also be used. One method is balloon angioplasty. In this procedure, a balloon at the end of a flexible tube called a catheter is inserted into a partially blocked artery and inflated, hopefully expanding the blood vessel permanently. The success rate for angioplasty is about 91%, but if the blockage is severe, or the cardiologist thinks the artery's walls are weak, he'll opt for coronary bypass surgery.

SIGNPOSTS ON THE ROAD TO A HEART ATTACK

Symptoms of an impending heart attack include:

Pain or pressure in the center of the chest (my brother-in-law said it's like being squeezed by a bear)

Pain radiating down the left arm, in the shoulder or even the jaw

Sudden, profuse sweating for no apparent reason

Nausea

Weakness in the limbs or lower back

Shortness of breath

Dizziness

Rapid pulse

Silent Ischemia

Ischemia is the medical term for poor circulation. Three to four million Americans have ischemic episodes without feeling the slightest discomfort. But pain is Man's Best Friend, for it tells us when something's wrong with our bodies. People who experience silent ischemia may have a massive heart attack with no warning. If your doctor suspects silent ischemia, he may ask you to undergo a grueling exercise stress test. Or, if he can get you to park your rig in one place long enough (24 hours), he may strap you to a recording device called a Holter monitor.

abnormal heartbeat

Arrhythmia is "that fluttery feeling." It also may manifest itself as a "skipped beat." Most of us have experienced what we perceive to be irregular heartbeats. Whether they're a result of our imaginations or true arrhythmia must be determined by a specialist. If the abnormal heart rhythm lasts for a few seconds only, and occurs rarely, it's probably harmless. But prolonged episodes--episodes lasting minutes, or even hours--may result in what is called sudden cardiac death.

Sudden cardiac arrest is just that: one minute the victim is talking and smiling; a moment later, he collapses, and you can't find a pulse. Cardiac arrest is reversible if it's treated within a few minutes. So please, do yourself, your family, and your fellow motorists a favor: enroll in a certified CPR course.

While arrhythmia can sometimes be diagnosed by an electrocardiogram (paying the bill will take longer than the test), often more sophisticated equipment is required. Such as a Holter monitor, which records a patient's every heartbeat for a single 24-hour period, or an Event Monitor, which contains a continuous recording loop.

high blood pressure

High blood pressure—hypertension-- is perhaps the most common and the least understood ailment known to man. Millions of Americans have been diagnosed with the disease; millions more have it and don't know it. Who is susceptible to hypertension? Practically everybody. Yes, skinny people can become hypertensive, also. But gaining a great deal of weight in a short time will raise your blood pressure into the stratosphere (and losing weight will lower it).

Turn on a faucet and watch the water flow smoothly into the drain. Now partially block the faucet opening, watch what happens. As this kindergarten experiment demonstrates, as the size of the pipe is decreased, you get a corresponding increase in pressure. In that regard, your body's veinous system is exactly like household plumbing. Large coronary arteries might be able to handle the increased blood pressure, but one of the millions of microscopic capillaries in the brain may not. The result? Either a stroke or an aneurysm--neither is to be desired. If you have been diagnosed as hypertensive, and placed on medication, you must take it religiously, probably for the remainder of your life. I'll return to this subject later; it's that important.

preventing heart disease

Heart disease is the number one cause of death in America. It kills more people yearly than all other illnesses combined. You may be one of the millions already diagnosed as having coronary arterial blockage. If not, chances are you're developing it as we speak.

The risk factors associated with heart disease are of two varieties: those over which you have no control, such as your age, your sex, and your family history, and those you can minimize or even eliminate. You can guess what these are, can't you? Let's discuss them one at a time.

smoking

Smokers' risk of heart attack is more than twice that of nonsmokers. In fact, cigarette smoking is the biggest risk factor. Evidence indicates that for nonsmokers, chronic exposure to environmental tobacco smoke (second-hand smoke) increases their susceptibility to heart disease. The risk of death due to heart disease is increased by about 30 percent among those who live with a smoker. Smoking is also the biggest risk factor for peripheral vascular disease (narrowing of blood vessels carrying blood to leg and arm muscles). Actually, this condition, which can lead to gangrenous limbs (which require amputation), is almost exclusively confined to smokers.

When people stop smoking, regardless of how long or how much they've smoked, their risk of heart disease rapidly declines. Ten years after quitting, the risk of death from heart disease is almost the same as for people who never smoked.

It's important to stop smoking before the signs of heart disease appear, so if you do smoke, be it pipe, cigarettes or cigars, QUIT NOW. If you simply must imbibe, switch to either snuff or chewing tobacco. True, these two products may cause you to develop a cancer of the mouth or throat, and, yes, tobacco juice is ooey, gooey and smelly. But, hey, the stuff won't clog your breathing passages with mucous. If you make the switch, those who must move within your orbit will thank you (or should); your insurance company will thank you (with reduced rates); and your lungs will praise you (with every breath). Seriously, when you quit smoking, you will lower your susceptibility to heart attack by as much as 60%.

diet (your eating habits)

First, another definition. In the eyes of God and the medical profession, not all fats are equal. HDL or high density lipoprotein is considered to be a good fat because it helps the body eliminate other kinds of cholesterol and fatty acids. When it meets less dense fats, it absorbs the oily substances and carries it to the liver, where both are metabolized. It also helps your muscles oxidize triglycerides for energy.

Based on large population studies, blood cholesterol concentrations below 200 mg/dl (milligrams per deciliter) in middle-aged adults seem to indicate a relatively low risk of coronary heart disease. A level of 240 mg/dl and over approximately doubles the risk.

Blood cholesterol and triglyceride levels should be measured at least once every five years in healthy adults. People with cholesterol levels greater than 200 mg/dl should take measures to get it under control.

Exercise increases a human's HDL levels {HDL = the good fat}. Alcohol in moderation (and I stress the word "moderation") is also known to elevate HDL. While it's good that we are becoming more aware of our cholesterol levels, many physicians now believe that a person's HDL level is an equally important consideration when evaluating blood lipids (fatty materials).

At home

The next time you're home for a few days, check out your pantry. Does it contain an abundance of high-cholesterol, high-calorie foods? Of course it does. If you live, you have to eat, and if you eat, during the next ten years you'll consume enough fuel to light the homes of a small community for a day. Besides, all foods, even those that taste like boiled cardboard (tofu, etc.), are fattening when doused with butter, mayonnaise or ketchup. You can still serve meatloaf, fried potatoes and homemade lasagna occasionally, even while you're trying to lose weight. Because it's not what you serve, it's how it's prepared, and how much of it you eat. The next time you go grocery shopping, check the labels before you buy. All else being nearly equal, when shopping for any packaged food item, choose the brand that contains less fat and less salt.

dining out

For most drivers, eating out isn't the splurge it is for our stay-at-home families. For us, dining out equates to survival. We do have some choice in the matter, however. Even fast-food joints serve salads nowadays, and the menus of most NATSO truckstops offer several tasty, low-fat, low-cal alternatives to greasy burgers.

You don't need to enroll in a course on nutrition. You just need to start applying the knowledge you already have. Pay more attention to what— and how much— you eat, and you can lessen your chance of being stricken with heart disease by several more percentage points.

obesity

According to the AMA, people who are more than 30 % over their ideal body weight are more likely to develop heart disease and stroke even if they have no other risk factors. Allow me to shrink the size of this blanket. Weightlifters and other athletes may be far heavier than their so-called "ideal" weight. Muscle tissue isn't excess baggage: it works for its living. A pound of muscle tissue consumes a minimum of 2.5 calories every hour of its existence, even when it's resting. So you need more muscle tissue, not less. What you don't need or want is adipose tissue. Empty fat cells are like oil drums sitting on a dock, waiting to be filled. They don't excrete, they don't eat, and they don't help you drive from Maine to Sacramento.

For every pound of fat you gain, your body must construct a mile of new "highway," and every centimeter of those capillaries must be supplied with oxygenated blood and other nutrients. Consequently, excess adipose tissue strains the body's resources. The yucky matter clings like glue to arterial walls, narrowing the passages, thereby raising blood pressure.

The average middle-aged adult male has a bodyfat percentage of 21%; his female counterpart is about 38% fat. In other words, if you're a man and you weigh 200 pounds, you're carting around a 42-pound spare tire. No wonder you get tired so easily, huh?

Some of you may remember that in previous columns I have stated that all diets are counter-productive. I stand by that statement. Richard Simmons and I mean two different things when we advise someone to go on a diet. You didn't gain 40 pounds of blubber overnight. You have to lose it the same way: one calorie at a time. So do not fill your saddlebags with canned tofu, Mr., Mrs. or Ms. Truck Driver (unless you like the stuff). If you wish to lose weight, simply leave a few bites on your plate at every meal (your Mama won't scold you, I promise).

physical inactivity

Driver, I'm reading your mail. I know what you're thinking: you work hard for a living; you already get all the exercise a body can stand. I realize, believe me, that the average freight hauler can work the average factory-worker into an early grave. Nevertheless, I insist that you need more exercise.

The human body is highly adaptive. A brickmason can lay brick all day and half the night without raising a sweat, but put him behind the wheel of a car, he's utterly, completely exhausted in two hours. Secretaries, truck drivers, dockworkers, politicians... we've all adapted to our chosen way of life. Kids run and climb and roll in the grass. We adults do no more than we have to. Therefore, to ensure that each one of our body's 650+ muscles is kept in tip-top condition (in case we need them one day), we need to engage in a full-body exercise program on a consistent basis.

Kinda hard to get to a gym when you drive a truck for a living, huh? Thousands of drivers do manage to get a little exercise, though. So can you do it.

Summation

Heart disease is a killer, no doubt about that. Because our jobs can be highly stressful and our workdays long, we are at risk. Additionally, far too many of us smoke two-three packs of cigarettes a day, and most of us are overweight. We don't need to change our line of work to lessen our susceptibility to heart attack and stroke, however.  We just need to change our habits.