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Close to My Heart
By Elizabeth Hamilton-Guarino
Edited by Liz Foley
Contributions by my mom, Carolyn Hamilton

Thank you to Dr. Rick Guarino for all you do. My own heart has stopped, burned, ached, broken, ripped, torn, felt, beat, loved, but I thank my lucky stars that to date it has never attacked. In fact, I've led a life of not paying too much attention to my own heart health until these past 11 years of my life (from age 30-41) and particularly the last 6 years, when my dad had strokes as the result of diabetes and heart issues.
Like I said, my dad, at age 60, suffered one stroke. It was due to undiagnosed atrial fibulation, better understood as an irregular heartbeat.  

My dad had suffered three heart attacks that he had never complained about, nor reported to a doctor. Atrial fibulation is a leading cause of clots that head to the brain and cause strokes.

My mom, Carolyn Hamilton says, "Dad was given too much Coumadin which caused his stroke site to bleed, leading to three brain surgeries. A fourth surgery re-attached his cranium to his skull. The brain surgery had caused his brain to swell. They removed part of his cranium and attached him to a 'brain drain', which is a tube holding the excess brain fluid while monitoring the brain pressure. We watched it by the hour to make certain it didn’t go over 22. He was kept in an extremely cold room, on a bed of ice, for the first several days of his coma. He would not awaken from his coma. Doctor Rick Guarino discovered a chemical by reading his labs and had his meds changed. He began to come to."

He was in therapy at the University of Minnesota, where the goal is to get you off the trach, and the removal of the feeding tube. The goal is to sit up for 30 seconds. From there, he was transferred to Sister Kenny at Abbott. They were wonderful.

When we went to Abbott, we were so used to seeing Dad lying down that it felt weird to see him even sitting up in a wheel chair. We remember the therapist at Sister Kenny who told us that Dad would walk out of there. We thought it could never happen.

My mom says, "After months of rehab he did walk out. He had worked so hard and so diligently that he overcame most of the hurdles. They had said he would never be able to do those things again. He could swallow, speak, understand us, and remember the family and its history, and how much he loved me. People had informed me that I may get him back, but that he would never remember me or his children and grandkids. I think it is important to tell the part of this story, where everyone told us that he was brain dead. The neurologist wrangled with me daily to shut off his machines. We knew he was still in there."

Mom continues, "I think one of the most unbelievable parts of this story is that I had you there.  You, who almost never left my side throughout this ordeal, I think it is a real tribute to your husband that he just stepped in and took care of your four children while you were with us, and supported us through the financial ordeal that it caused. I will never forget it."  

And let me tell you, seeing my father (coolest dad in the world), sick in the hospital like that was heart-wrenching. Knowing that his heart had thrown a clot which had led to a stroke, which led to more and brain surgeries and one very long coma, was devastating. This led to months in rehab centers, and night after night of seeing him with what I call the "Darth Vader" machine - “The Vent“. I still have the worst nightmares from that sound.

It appears everyone you know has a story of someone – somewhere, connected to them who have been affected by heart disease, and it appears the problems are getting worse, not better.  

So I brought in the ultimate expert on the situation, and the man who helped save my dad’s life: Dr. Rick Guarino (aka my husband’s cousin).  Dr. Guarino is now in charge of Medical Affairs, SVP, Chief Medical Officer at Nash General Hospital in North Carolina, in addition to being a Board Certified neurologist. He has led a lifetime of helping people with strokes, and has collaborated with the heart folks as well as Dr. Denise Guiffrida, of Houston, Texas, to answer the following questions:  

Is there anything we can do to prevent a heart attack and or stroke?  

Yes, mainly treat all risk factors with advice from your primary care doctor. High blood pressure is the most important thing to pay attention to, but diabetes, smoking, high cholesterol, and obesity - all are risks. If the doc says take medicine, take it. Next, learn the signs of stroke, and if they occur, seek medical attention immediately. Also, don’t forget to exercise, after consulting with the doc.

What are the signs in women of a stroke/heart attack?  

The signs of stroke depend on where in the brain circulation a clot lodges.  Numbness, weakness, slurred speech, loss of vision are most common and are the same for all patients. In women specifically, a heart attack is more often associated with less common symptoms of pain in the jaw or, in fact, silent.  

Are heart attacks and stroke mostly fatal?  

No, most are not fatal, and often there are warning symptoms before a major event.  

Does butter really clog arteries?  

Diet can influence cholesterol and triglyceride levels and so, yes, in some people more than others, butter can lead to higher cholesterol levels, which can lead to clogging of the arteries.  

Is there any truth to the impact of birth control pills, smoking and so forth; or what other habits make you more likely to have heart issues?  

Yes, Birth Control Pills, especially in conjunction with smoking, are known to be associated with an increased risk of clot formation and, hence, heart attack and stroke. Bad habits, like certain drugs and too much alcohol, can also increase the risk profile.  

What can you do to check up on your health? Do you have to have a stress test each year?  

A physical exam with blood tests and a risk profile or wellness check is the best thing. Diet and exercise as recommended by your doc, especially if there is a family history, is the way to reduce the risk of stroke and heart attack. A stress test is indicated in certain people, but unless there are serious risks, I do not think it is necessary every year.  

What is blood pressure, and what is considered normal, low, high, etc.?  

Good question and it seems to be a moving target. In my prime, 140 mm Hg on the top, or systolic; and 90 on the bottom, or diastolic, was considered the upper limit of normal. The systolic pressure is the peak pressure on the arteries when the heart pumps the blood out and the diastolic is the residual pressure in between heart beats. Low blood pressure depends on if there are symptoms of weakness and lightheadedness. A neurologist will worry if the blood pressure runs 40 points above a patient’s known normal range.  

Are people to blame for their own heart attacks because of their bad health habits, such as poor eating, smoking, etc.?  

Oooh, tough question.  We can’t help the genes we are born with that might put us at risk, but we can try to control the risk factors mentioned above. Then there is our response to stress, which is always there, but can be worked on in a constructive way.

Thank You,
Dr. Rosario Guarino
Nash General Hospital, Neurology, Chief Medical Officer

In memory of Robbin Barr and her parents Barbara Jahns and Robert Jahns.

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Member Comments

    • 0 votes vote up vote up

      Joy Pachowicz wrote Feb 18, 2011
    • Elizabeth

      Wow: What a very intense article. I enjoyed reading the article and followed you through your paragraphs of pain to the happiness of seeing your father restored.

      I really never realized all the causes of strokes or heart attacks.

      I do believe that there are some heart problems in our family.  

      I do know that diabetes is in the family. I Have not yet gotten it.

      I am so happy that I read your article through and was able to rejoice with you over the rehabilitation of your father.

      I hope he continues to do well?

      Have a nice day:


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