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October 08, 2004

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Publication Date: Friday, October 08, 2004

Healing a hurting heart Healing a hurting heart (October 08, 2004)

Heart attack almost sneaks up on local woman

By Diana Reynolds Roome

In a way, Darlene Joy was lucky to be in pain.

At first, it hurt just between her shoulder blades, and Joy thought she must have pulled a muscle while sawing or sanding the koa wood she uses to build ukeleles for her family-owned company, Island Joys. She asked her husband Vini to massage her back, but the pain kept coming back.

At home in Sunnyvale one day in December 2003, Joy was working on some instruments when a tremendous pressure in her chest forced her to sit down. The pain quickly traveled down her left arm and she knew something was seriously amiss.

An EKG and blood work taken at the Camino Medical Group Urgent Care Clinic in Sunnyvale revealed nothing alarming, so the doctor sent Joy home suspecting digestive problems and suggesting she make an appointment to see her doctor next day.

Joy passed a rough night on the sofa, and finally got to sleep at around 5 a.m., rising in time to get her two sons, Kanaloa, 9, and Lokahi, 7, ready for school.

At the clinic, an examination still turned up nothing serious, until after another EKG and a chest X-ray when the doctor came back and told Joy to go straight to the emergency room. Before she left in an ambulance, she was given nitroglycerin -- a fast-acting drug to stimulate the heart.

Joy spent that night at El Camino Hospital, and the next day an angiogram revealed blockages of 75 percent and 97 percent in two critical arteries leading to the heart. Acute coronary syndrome like this means that a heart attack could be imminent, and there was no time to lose. Using tiny instruments guided through an incision in the groin area, surgeons inserted stents into the arteries to keep them open so that blood could flow freely again.

Risks other than older age

Heart disease in women is often not diagnosed until it's advanced. For the past two decades, more women than men have died of coronary disease, and it is now far and away the leading cause of death in women, according to the American Heart Association.

Yet symptoms in women tend to be less obvious and often show up as shortness of breath, dizziness, lightheadedness, or stomach pain, nausea and vomiting.

Though Joy's symptoms were typical, at 46, she did not seem a typical candidate for heart attack.

"She looks healthy, young and vivacious," said Dr. Jane Lombard, who is now her cardiologist. "But these days we're seeing coronary disease younger and younger -- even as young as 20."

Joy also has diabetes, which is a risk factor, and carries a little more weight than she would like. A year and a half ago, her mother, who lives in Hawaii and is also diabetic, underwent a triple-heart-bypass operation.

"I'm following in my mom's footsteps," said Joy regretfully, "though I'd rather not share those genes."

Soon after her own operation, Joy carried on taking care of her family and going to work. But she was shocked and scared by her experience.

"If I hadn't come in, I would have had a heart attack," said Joy, who still has bothersome symptoms. For example, even a regular task like folding clothes can cause pains in her arms and chest, and once when she tried to carry a watermelon, she had to yell for her husband to take it before the strain made her drop it.

But though her heart disease isn't cured, there are many ways she can help herself grow stronger.

Reducing the risks

"Women can do so much to regain health and stay healthy if they eat right, stop smoking and exercise regularly," said Lombard.

Joy stopped smoking 15 years ago, after she met Vini and he told her he "couldn't handle kissing a pack of cigarettes." Luckily, her husband and kids also enjoy healthy foods -- even spinach, for example. But Hawaiians, she pointed out, have lots of gatherings, and that means eating high-carb treats like rice, Spam and shredded pork, with too much fat, sugar and salt.

In terms of exercise, Joy is nervous about making any major moves. Though she has a treadmill in her basement, she doesn't use it much for fear of straining her heart. The pain in her legs, mainly from diabetes, is severe at times.

"You get to a point where you don't do what you're supposed to. I'd like to lose 50 pounds, but I get really tired and don't have the energy," said Joy.

Starting slowly with five or 10 minutes of regular exercise often leads to more, said Lombard, who is a marathon runner.

For anyone at risk, there are safe and supportive exercise programs, such as those offered by the Cardiac Therapy programs at El Camino Hospital (some in conjunction with the YMCA) or the Cardiac Therapy Foundation in Palo Alto. These offer heart-strengthening exercise supervised by trained cardiac staff, as well as friendly camaraderie.

Some fitness studios offer extra support for those having a hard time starting an exercise program or beginning again after an unsuccessful experience.

"Thirty minutes of activity a day makes a huge difference in cardiac health," said Ed Hamilton, general manager of Fit from the Core in Mountain View, who is certified in pre- and post-operative heart training. "We want to help people to get ready for living and to get back to their passion. If you can get here even twice a week, you can change your life."

Darlene Joy is more than ready to change her life for the better.

"I have to learn to live with this and try to improve," she said, ""If I don't change, I'm not going to live much longer. But I have two young children who want to do things. You have to think of your loved ones."

E-mail Diana Reynolds Roome at [email protected]

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