Taking Steps to Not Follow in Her Father's
To hear Portia Rindos tell it, she wasn’t doing much of anything right — eating unhealthy food, living with a lot of stress, being sedentary. At some level, she knew that was taking her down a path going nowhere good — she is a nurse, after all. And she certainly had the genes for heart disease: she was part of a large New York Italian family. Her father died at age 58 of, she suspects, sudden cardiac death. “It wasn’t something that we knew he had,” she said. “He just went to work one day and didn’t return. His brother had his first heart attack in his 40s.”
She remembers most events involving the family were food centered. “Both my parents were overweight,” she said. “And years ago, people didn’t pay much attention, and high-calorie, fatty foods, are common in the Italian culture.” So that is how she fed herself and her family — husband Richard and daughters Kaitlyn and Nicole, now in their 20s and married.
Although Portia started out as a hospital nurse, always on her feet and burning calories, for the past 20 years, Portia, who is 62, has worked a more sedentary job in pharmaceutical research at a large academic institution. Always overweight, like her parents, she gained even more after a hysterectomy and menopause.
Portia’s cardiac journey began at work, which as it turns out, was a good thing. “In October 2008, I was leaving a meeting, when my eyes rolled back in my head and the person I was with had to hold me up. My boss at the time was a doctor, and she grabbed me, pulled me into a room and called an ambulance,” she said. Portia insisted that she was fine, but her boss was equally insistent that she go to the emergency room and get checked out. She even called ahead to Dr. Stacey Rosen and told her that she was coming over with one of her nurses because she had almost fainted in the office.
At the hospital, an EKG showed that Portia had significant heart block with a heart rate of 35. “A cardiologist came in and said, ‘You’re not going anywhere,’” she remembered. A pacemaker was inserted the next day, and she became Rosen’s patient. Close monitoring over several months showed that she had high blood pressure and high cholesterol. She also had prediabetes. She now takes medication for all three.
“Dr. Rosen took my entire history, including my family history on both sides,” she said. The doctor paid particularly close attention to her father’s branch of her family tree and sent her for an echocardiogram and a nuclear stress test. As a result of these tests, her doctors performed a cardiac catheterization, which discovered two blockages that required immediate coronary intervention in the form of two stents.
“You know, up until the day I went to the hospital, I thought I was just fine, but after they implanted those stents, I realized I was going to have to get very aggressive or else my outcome was not going to be good for me or my family. I didn’t want that to happen to them. I was 54, quickly approaching the age my father was when he passed. I was ready to take advantage of the things that I know now that he didn’t know then. I realized I hadn’t gotten there overnight, my lifestyle was a big contributor and it occurred over a long period of time,” she said. She also realized it wasn’t going to be fixed overnight.
Dr. Jennifer Mieres
Portia’s story is one of many that inspired Dr. Rosen and her colleague Jennifer Mieres, both cardiology professors at Zucker School of Medicine and Hofstra University, to write Heart Smart for Women. The book explains heart disease from a women’s perspective and highlights many of the risk factors that lead to heart disease. Back in 2008, Dr. Rosen worked with Portia to develop a plan to address her multiple risk factors. This plan eventually became the program outlined in Heart Smart for Women.
Heart Smart for Women offers a program of six steps to focus on how to improve your heart health. One of the first steps to take is reorienting yourself in your kitchen and stocking it with heart-healthy choices. “This first step in the journey to heart-smart living is so important because it encourages us to make a fresh start,” Mieres said. “Cleaning out the pantry and the refrigerator to eliminate all foods high in sugar or saturated and trans fats ensures that all of the unhealthy default choices — chips, crackers, cookies — are not an option.”
This focus had real resonance with Portia because she knew that the high-saturated fat, high-calorie diet she had inherited from her parents had to change. “Changing your diet is hard,” she said. “It’s a struggle every day, and I think it’s going to be like this for the rest of my life, because your diet is an everyday choice. It’s not something you change once, and you’re done and move forward.” She shops differently now, making sure to have healthy choices available, which include more vegetables and fruit.
Rosen understands the difficulty of this change and offered this tip: “Shop the perimeter of the grocery store, that is where the fresh fruits and vegetables are typically found,” she said. “In the rest of the store, get in the habit of checking labels and focusing on healthy choices that are better options for optimal heart health.”
Of course, after the kitchen re-org and restock, there is the all-important step of putting it into practice and actually eating better. “There is no doubt about it, what we eat impacts our health,” Mieres said. “Better food choices can significantly improve your blood pressure, cholesterol and diabetes, and reduce your risk of heart attack and stroke.”
Portia made some major changes in her eating habits. “I had to find the balance that works best for me,” she said. The AHA recommends eating an overall healthy dietary pattern that emphasizes a variety of fruits and vegetables; whole grains; low-fat dairy products; skinless poultry and fish; nuts and legumes; and non-tropical oils. Limit saturated fat, trans fat, sodium, red meat, as well as sweets and sugar-sweetened beverages. One of the diets that fits this pattern is the DASH (Dietary Approaches to Stop Hypertension) eating plan. Most healthy eating patterns can be adapted based on calorie requirements and personal and cultural food preferences.
Here’s a couple of tips from Rosen on how to incorporate better eating: “Institute ‘meatless Mondays’ to help cut down on saturated fats and boost your intake of plant-based foods that are rich in antioxidants and fiber.
When eating out, peruse the restaurant’s menu online, so that you have made your healthy food selections before you get to the restaurant.”
Of course, heart health is more than just eating right — it requires becoming physically active. “Aerobic exercise, strength training and adding movement to your day are equally important in affecting heart health,” Mieres said. “No matter what your current activity level is, develop a plan to gradually increase it. Exercise benefits our heart, our brain and our joints.”
Portia attends a Go Red for Women event with Dr. Stacey Rosen
Portia took stock of her activity level: “I realized I was basically walking out the front door of my house, getting into my car, which was 20 feet away, then parking in the garage at work, walking into the building and sitting at my desk all day,” she said.
She began to take control of her activity. She had the support of a neighbor who walked with her most days and helped her create the habit. Then she showed her commitment and bought a treadmill, which she uses for 45 minutes almost every day. “I used to think ‘I have a house, I have a family, I’m active, I do plenty of things,’” she said. “But obviously, whatever was happening once I got home wasn’t enough. Truth is, I look forward to it because this is for me, for my benefit. It has become routine and I enjoy it.” In the years since she started this routine she’s lost 60 pounds and her cholesterol, blood pressure and A1C are all normal.
The doctors recognize that if a person has been sedentary for years, becoming physically active again can be daunting. Rosen pointed out, “This is not an all or nothing proposition! Any movement or activity that we add to our daily routine is beneficial.”
The doctors know the importance of support. “Partnerships are powerful,” Mieres said. “It is easier to stay on track when you have a partner. Make sure you have a physician you like and trust because that partnership is crucial in your quest to stay healthy.”
Although Portia sees Rosen much less often these days, she still depends on their partnership to make her lifestyle changes permanent. She understands that her health was not fixed by two stents and some better food choices. She has also enrolled her husband’s support in that endeavor — he makes sure she gets her daily walks in.
Portia and her husband, Richard
Rosen suggests women take maximum advantage of their annual visit to their doctor. “Just as you prepare for a meeting with your lawyer or accountant, come prepared with questions, a list of symptoms or concerns that you would like to address with your doctor,” she said. “That way, you will leave with clear cut answers and a better understanding of what you need to do for the best results.”
“Of course, making these heart-healthy changes permanent is the goal, but that journey is not necessarily linear,” Mieres said. “As you put together your heart-healthy lifestyle, be sure to take some time to review successes and evaluate where there are opportunities for improvement.”
“A good way to do that, to track challenges and successes, is to keep a journal,” Rosen said. “This allows you to see how far you have come and provides a framework for appreciating the new, healthier you.”
Portia’s new routine is one she can live with. “These are the permanent steps I have to live by if I want to prevent my heart disease from worsening and live as long as possible. At first it was difficult, but I learned it’s not good for me to stray from my new normal routine. Planning is a big part of my life now. I still have at least 25-30 years to go. When you see your numbers coming down at your checkups, that is a huge reward and makes these sacrifices and changes worth it.”
EDITOR’S NOTE: Heart Smart for Women offers detailed information on easy steps you can take for better heart health. Available online at Amazon and Barnes and Noble.
This information is provided as a resource to our readers. The tips, products or resources listed or linked to have not been reviewed or endorsed by the American Heart Association.