This article incorrectly said that avocados are high in LDL, or "bad" cholesterol. Avocados contain no LDL but are rich in monounsaturated fat, which is considered more healthful than saturated fat.
Doc, I've Seen the Light
Wednesday, June 13, 2007
As I was having a heart attack on March 30, my past flashed before me. I saw a freezer filled with hollandaise sauce, the leftovers of research for a February article in the Food section in which I wrote:
"I can see the e-mails already. The fat! The eggs! But the fact is, hollandaise is worthy of an occasional guilt-free indulgence." To that I can now add: Unless a doctor has just told you that one of your arteries is so blocked you need an emergency procedure.
The countdown to this "episode" had started a few days earlier, when I stepped on the scale at my March 27 checkup.
"Whoa!" exclaimed Theo Hodge, my doctor. "183!" he announced, visibly aghast. Not a good sign.
"Muscle weighs more than fat," I offered feebly.
"Not in this case," he countered. "You're 5 foot 7, 48 years old, and your total cholesterol is 284. You need to go on Lipitor." Then he delivered what was, for someone who eats and cooks for a living, the coup de grace: "And you have to drastically change your diet."
According to the National Cholesterol Education Program guidelines, total cholesterol should be below 200; LDL (the "bad" cholesterol) below 100; HDL (the "good" cholesterol) above 40; and triglycerides below 150. The numbers Hodge rattled off to me were largely not good (284, 168, 55 and 300, respectively), but what they represented was not exactly sinking in. My cholesterol had always been under control, so I considered myself immune to danger. I spouted the virtues of moderation over deprivation and pooh-poohed martinets who ranted against fat.
When I left the doctor's office, my thoughts turned to the steak-and-cheese taste test I had just conducted purely for my own edification. Perhaps I had been overdoing things a tad. Still, I managed to summon sufficient denial skills to rationalize a trip to Deli City for a Reuben.
And I smoked a cigarette on the way.
The next day, I showed up in the emergency room of George Washington University Hospital complaining of indigestion and pain down my left arm. Soon I was in the good hands of the chairman of GW's Division of Cardiology, Richard Katz, who also serves on the board of the Larry King Cardiac Foundation. He looked at my chart and concluded, "We'll just skip the stress test we scheduled for tomorrow and go right to the catheterization."
Blood tests and EKGs had revealed elevated levels of the enzymes that act as chemical markers for heart muscle damage.
Jonathan Reiner performed the procedure. Using ultrasound from inside the artery, he discovered a 95 percent narrowing in the mid-vessel of the LAD (lower anterior descending artery). During a 45-minute procedure, he removed the occlusion and installed a drug-coated stent to prop the artery open. "You were very lucky you came in when you did," he said. "Consider it a wake-up call."