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Wednesday, 17 October 2012

In real life doctors get sick too

heart attack, warning signs, hear disease prevention, newport beach doctor
Just days after being named among the top four percent of doctors, Dr. James Weiss of Private Physicians Medical Associates, suffered a mild heart attack, despite having no risk factors. After his experience as a patient and a physician, we wanted to share his experience.

On Wednesday, Sept. 19, I received an email informing me that US News and World Report named me as one of America’s top doctors. On Sunday, Sept. 23, I had a mild heart attack and on Sept. 26, 2012, I turned 58 years old. That week will likely prove to be the most pivotal week of my entire life to say the least – from success to illness to a new take on life.

Having a heart attack, or in medical parlance, acute coronary syndrome, should not have happened to me, for the most part I had no risk factors and I have been tested yearly. My blood pressure and cholesterol levels are normal, I do not smoke, have diabetes or a family history of heart attacks. Acknowledging that my male gender is a risk factor, but I exercise four to five times each week, eat healthy and I am in a stable, happy marriage with a great home life. I even meditate every day.

Then how did this happen?

After I dropped off my son on Sept. 23, I went to fill my car with gas. I noticed some chest discomfort while walking from the car to the pump. It was like nothing I had ever felt before and it is impossible to describe the sensation. When I wasn’t moving, I had no pain. I finished pumping the gas, got in my car and pulled it away from the pump so I could assess the situation. I reviewed my symptoms, which included the chest pain that went to my left shoulder, upper arm and left jaw. I was sweaty and had a little nausea, but no shortness of breath. The following is the conversation I had with myself:

“Wow, is this feeling in my chest real? Could this be cardiac pain? No, it is just some chest wall pain, go home and take some Advil. Yeah, but with the left arm and jaw pain this could be significant. Remember what they taught in medical school, when patients complain about jaw pain? When that symptom comes with chest pain it is almost always associated with the heart, so take that complaint very seriously. This can’t be happening to me – I don’t have any risk factors. I’m too young for a heart attack, oh wait, I’m 57, a perfect age.”

I then realized two things: I was trying to talk myself out of doing the safe thing and if any of my patients had called me and described these symptoms, I would, without hesitation, tell them to go to the nearest emergency room. Even though my symptoms seemed to subside, I took my own advice and headed to the closest emergency room, Hoag Hospital in Newport Beach.

Although some may question that decision, I was not convinced I had a serious problem since I was already feeling better. I drove slowly in the right lane, knowing I could pull off the road at any time and was not a danger to others. I also knew that I could be at the emergency room quicker than if I had called the paramedics because in the time it would take them to get to me and load me in the ambulance, I could already be receiving care. The medical recommendation, however, is always to have someone else drive you.

I pulled my car up to the emergency room, handed my keys to the valet, walked slowly to the woman at the check-in desk said, “Hi, I am a doctor on staff here and I’m having chest pain.”

The staff then went into overdrive. They quickly hooked me up to an electrocardiography (EKG) machine. I could see the diagnostic changes quicker than the computer had and pointed them out to the nurse, “Ah, look at lead 3.” Before I knew it I was in the catheterization laboratory. I had 100% blockage of one coronary artery. Fortunately the cardiologist was able to open the artery completely and restore blood flow. I stayed one night in the Coronary Care Unit, one night on the telemetry ward and then was discharged home Sept. 25.

I have much to be grateful for. I made the right decision to get myself to the emergency room as soon as possible. At all times my vital signs were stable and there was never any lack of blood flow to my brain. I had access to the best medical care available and was treated by very competent, caring individuals who all put my needs above their own. My loving family, my medical partner and office staff and my close friends have provided the support I need to need to recover and my cardiac function remains normal. Doctors have determined the blockage was caused by a build-up of plaque in my arteries and it is still unclear what caused the blockage to burst.* Clearly it could have been worse.

I honestly don’t know what I could have done differently to avoid this. There are things in life that are simply out of our control. I know there are lessons here, the most obvious one being to enjoy each and every day because life is a gift not to be taken lightly.

I intend to enjoy each and every day I am blessed to walk on this earth and will work hard to stay one of America’s top doctors, with a renewed commitment toward sharing techniques for and delivering preventative medicine to my patients.

Heart disease is the leading cause of death in the United States (CDC). Please understand your risk, how to prevent it and most importantly, do not ignore the warning signs.

* In the U.S., by the time we reach adulthood, we can safely assume that most of us have plaque in our arteries. An autopsy study done during the Vietnam War showed most of the young men who had been killed, in their twenties, had plaque. This process, which develops slowly, is the body’s way to heal damage to the inside of the arteries. Think of it as the body putting a bandage on an injury. The injury may be caused by any number of insults, including high blood pressure, the inflammation caused by pre-diabetes and diabetes, smoking, lack of exercise and elevated bad cholesterol. If the cholesterol in the plaque comes in contact with the blood it will rapidly cause the blood to clot so it is important for the plaque to remain stable so the “cap” does not rupture. When a rupture of the plaque cap occurs, the cholesterol mixture comes in contact with the blood, causing the blood to clot and blocking any further blood flow in that artery. When this occurs in the heart, we call it a heart attack and if in the brain; a stroke. If the blood flow is not restored quickly, the cells that can no longer receive their blood die and permanent damage is caused. Certain people are more susceptible to this process due to their genetics that is why family history is so important because it provides an insight into one’s genes. Of course the human body is quite complex. People have been having heart attacks long before the advent of the western lifestyle that has made heart disease so common. There must be processes at play that we do not understand that make certain people more susceptible even when they do “the right things.” What made my plaque unstable and led to my heart attack? While I will never know for certain, I believe that there were factors at play beyond our current level of understanding. This has served not only as food for thought for me but will form the basis of my further research into this topic.