How To Care For Yourself After A Heart Attack. The Low-salt, Low-fat Diet. Part 3

When may you return to work? When the coronary patient's heart has healed and its function has returned to normal (as determined by his doctor), he is usually allowed to return to his customary activities as soon as is practical. Of course, it is wise to do this gradually, rather than to plunge into a job where he left off. Even if it means only part-time activity at first, most people derive a great satisfaction and a lift to their morale when they can return to some useful routine of life. If the patient was engaged in very strenuous physical labor or factory work which he really did not enjoy, but which he was forced to do to earn a living, he is usually better off to find a lighter kind of work, provided it does not involve the frustrations of a long apprenticeship. There are many ways of reevaluating the kind of work a man or woman has been doing. Many of my patients were engaged in occupations that were a continued source of irritation, causing a state of alarm. Their coronary attack may even have been partly due to the unbearable and prolonged tension. For such patients I always recommend a different occupation or way of life. Then the question arises, "How can I find the right work for myself?" The American Heart Association has developed splendid programs in most of the large cities, aimed at rehabilitation of heart patients. An important part of these programs is helping the patients find the right kind of job. Some centers have also created 'heart kitchens," where housewives who have suffered heart attacks are taught many labor saving devices. Here women learn for the first time that housekeeping need not be a drudgery. The Association also sponsors vocational rehabilitation services which analyze each patient's skill, educational background, physical condition, and so on, to produce a profile of his job qualifications. Often it turns out that the average person possesses hidden talent or unsuspected skills that may open up entirely new vistas that might have remained closed to him all of his life, if he had not suffered a heart attack.

Develop a constructive, optimistic attitude toward life. The case of W. K., a brilliant and successful lawyer, is a perfect example of the vital necessity for the right attitude and philosophy of life. W., who was 52, certainly had a frightening family history. He was the only one of four brothers still alive. His three brothers had all died of heart attacks. Clearly, W. was a familial or hereditary candidate for coronary thrombosis, particularly since his blood cholesterol level was abnormally high. But Bill was a cynic, a disappointed father, and an unhappy man. By nature a pessimist, he believed that it was his fate to die of a coronary thrombosis. He proceeded to help fate along - as had the rest of his former family. No amount of pleading by a devoted and concerned wife, no amount of urging by his doctor, could induce W. to change his philosophy and his living habits. Bill insisted on eating everything, the richer and fatter the better. He drank to excess, smoked heavily and took as little rest as possible. In short order the ax fell. Bill had his coronary thrombosis and joined the rest of his family - 48 hours after his attack. On the other hand, Charles, an optimist and, of all things, an airplane pilot, was confronted with the same problem. He also had lost 3 brothers from coronaries, but Charles believed in helping to direct his own fate in a positive way. At the age of 37, he had the most vital of reasons, other than himself, for remaining in good health. The lives of thousands of passengers were in his hands. Characteristically enough, Charles also had an abnormally high blood cholesterol level. But being of a practical turn of mind, he set to work immediately in following a strict low-fat diet with dietary and vitamin supplements outlined in Chapter 5. His blood tests rapidly became absolutely perfect in every way. He felt and looked marvelous. Today, 10 years after the original examination, he is the perfect physical specimen.

What a sharp contrast in attitude and philosophy of living between Bill and Charles. What a striking contrast that meant perfect health in one case and death in the other! An equally dramatic instance of the importance of a constructive and optimistic attitude toward life and health is the case of John, a railroad engineer, 55 years of age. John piloted a crack transcontinental express for many years. He had become a little overweight and first suffered from mild anginal chest pains. He feared to bring this to the attention of the railroad doctors, for he was certain that he would lose his job. On examining him, I found that he already had coronary artery disease, was overweight, and had a high blood cholesterol level. Our engineer was also a man of constructive action. He put himself on a rigorous low-fat diet, he reduced his weight to the ideal one, and in two months became completely free of all pains. And in his own words, 'he never felt better in his life." He said his own engine had become tired of hauling "excess freight on the line" and "since disconnecting" (to quote his own terrible puns) "the fat in his freight had given him a fright." Now, after eight years of continual work, he has still a sense of well-being. He is in excellent health. His blood tests, his electrocardiograms, and his physical examinations are all perfectly normal for a man of his age. This then is an inspiring example of how a man can help direct his own fate and those of the countless others entrusted to his care. Your chances for long life are excellent. If you have had a coronary thrombosis, a key point to remember is this: your chances are excellent for many years of useful, productive living, provided you follow your doctor's advice. If you will reduce your weight to a normal figure and stay on the low-fat diet and nutritional health program described in this book, you can live just as long as the average overweight man or woman who does not follow the rules of good health given in these pages! The age at which you have an attack is not the important factor in your recovery. One patient of mine, for example, a business man in whom I am particularly interested, had his first heart attack at the age of 63. It was a severe coronary thrombosis.

Neither his family nor, to speak frankly, his former physicians expected him to live very long after the attack. But I recommended the diet and the health rules that I have included here. He took them seriously, and followed them faithfully. He is now 82 years of age, and so active in the conduct of his business that his 44-year old son, who is physically able and in good health, cannot keep up with his father's drive and vitality. A widower, he married a woman many years his junior, and they lead a normal, active, happy life together. They are constantly off on business trips, attend dances (he learned to dance when he was past 70), and take trips abroad. But it is important to bear in mind that this patient has wisely kept his weight to normal; he remains on a low-fat diet, avoids fatigue, naps often during the day, does not smoke or drink, worships regularly, and fallows the Golden Rule in both his business and private life. His outlook on life is vibrant, positive, constructive. No doubt many physicians in America could relate similar cases in their own practice. In short, you can be victorious over modern man's most deadly opponent if you play the game according to the rules. Here, in summary, are the 10 most important:

1. Hit that waistline hard! Keep your weight normal. Follow Chapter 6 on "Calling all Calories." Your belt in the front should not make you deserve a 'belt in the back'!
2. Follow religiously the low-fat diet and nutritional way of living. In this way you will "add years to your life and life to your years."
3. Consult your doctor for advice and check-ups regularly (just as you would your dentist) at least once a year. Certainly do so more often whenever there are specific questions or problems, "An ounce of prevention"
4. Be sure to get your complete quota of sleep and rest. The average adult needs eight to nine hours a night. The night owl is often a scarecrow in the morning. Whenever you can, steal a cat-nap or rest as often as possible through the day. You recharge your 'battery' this way.
5. Find out from your doctor how much exercise and physical exertion is safe for you. Then abide faithfully by his in structions. Perhaps your heart has completely recovered and you can do anything within reason. Perhaps you have to be moderate in physical activities. Your physician is the best judge of this.
6. You are best off to stop smoking cigarettes. Ideally you are better off not to smoke at all! If you can't give up the weed, try a pipe, or at least cut down to a few cigarettes.

7. As for alcoholic beverages, follow the Greek advice, "all things in moderation." Moderate and controlled drinking is a good relaxant. Remember, "what's one man's meat, may be another's poison." Some people don't tolerate alcohol well. To some it may have serious effects, especially when taken in excess.
8. Be sure that your "plumbing" system is working in the famous American way: your bowels must function normally. Avoid constipation, as directed.
9. Try to avoid extreme altitudes or extremes of temperature. If you have a choice, try to live in a temperate or equable climate.
10. Whenever possible, try to arrange your work and living so that they may give you a maximum of gratification and a minimum of grief. If you can, try to enjoy a hobby that will give you relaxation and mental refreshment. Develop a wholesome, cheerful outlook and philosophy of life.