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Don’t Learn This Too Late: 5 Things Top Heart Surgeon Says You Must Avoid to Live Longer

By Stitcher

In this episode of The Mel Robbins Podcast, cardiac surgeon Dr. Jeremy London draws from his own experience with heart disease to discuss heart health. He shares how his personal health scare—which led to an emergency stent placement—changed his perspective on patient care and his own life priorities.

The discussion covers the various ways heart problems can present themselves, with particular attention to the differences between men's and women's symptoms. Dr. London explains the role of lifestyle factors in heart health, including diet, exercise, and sleep, while addressing common medical interventions for heart blockages. He emphasizes that while procedures like stents and bypass surgery are effective, they don't address the root causes of heart disease, making ongoing lifestyle changes essential for long-term heart health.

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Don’t Learn This Too Late: 5 Things Top Heart Surgeon Says You Must Avoid to Live Longer

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Don’t Learn This Too Late: 5 Things Top Heart Surgeon Says You Must Avoid to Live Longer

1-Page Summary

Experiences With Heart Health and Impact on Perspective

Dr. Jeremy London, a cardiac surgeon, shares his personal experience with heart disease that transformed both his life perspective and his approach to patient care. Despite being a heart surgeon, he initially ignored his own symptoms of chest pain, attributing them to reflux. After experiencing severe chest pain while hunting and climbing stairs, he finally sought medical attention, resulting in emergency stent placement. This experience led him to prioritize relationships, family, and health, while making him more attuned to his patients' heart health concerns.

Recognizing Warning Signs and Symptoms of Heart Problems

Dr. London emphasizes that heart problems can manifest in unexpected ways. While discussing with Mel Robbins, he explains that symptoms occurring during physical activity and relieving with rest are particularly concerning. These can include non-traditional signs like upset stomach, jaw pain, elbow pain, or shortness of breath. He notes that more serious symptoms, such as persistent rest-related discomfort or escalating pain, require immediate emergency attention.

Role of Lifestyle Factors in Heart Health

Dr. London advocates for a comprehensive approach to heart health, emphasizing the importance of whole foods and minimal processing. He recommends shopping primarily on the store's perimeter, aiming for 80% whole foods in one's diet. He warns against excess sugar, alcohol, and nicotine consumption, noting their detrimental effects on heart health. While diet and exercise are crucial, Dr. London acknowledges that sleep is an often-overlooked but essential factor in maintaining heart health.

Differences in Heart Disease in Men vs. Women

According to London, women often experience "atypical" heart disease symptoms that can be easily misdiagnosed. He explains that women's heart disease can affect both large and small blood vessels, making diagnosis more complicated. Additionally, he notes that post-menopausal women face increased heart disease risk due to decreased estrogen levels, which previously provided protective anti-inflammatory effects.

Medical Interventions and Procedures to Address Heart Blockages

Dr. London describes various medical interventions for heart blockages, including stents and bypass surgery. While these procedures effectively restore blood flow and prevent heart attacks, he emphasizes that they don't address the underlying cause of arterial hardening. He stresses that even after medical interventions, ongoing lifestyle changes remain crucial for maintaining heart health.

1-Page Summary

Additional Materials

Counterarguments

  • While Dr. London's personal experience is valuable, it is anecdotal and may not reflect the experiences or best practices for all individuals facing heart disease.
  • The emphasis on recognizing non-traditional symptoms is important, but it should not detract from educating about the classic symptoms of heart disease, which are more commonly experienced.
  • Lifestyle factors are indeed crucial for heart health, but genetic predispositions can also play a significant role, which might not be as easily mitigated by lifestyle changes alone.
  • The recommendation to shop on the store's perimeter and consume 80% whole foods might not be practical or affordable for everyone, considering socioeconomic factors and food deserts.
  • The advice against excess sugar, alcohol, and nicotine is sound, but it's important to recognize that moderation and harm reduction strategies can also be effective for some individuals.
  • While sleep is essential for heart health, the complexity of sleep disorders and their relationship with heart disease might require more nuanced approaches than simply prioritizing sleep quantity.
  • The differences in heart disease symptoms between men and women are well-documented, but there is a risk of overemphasizing "atypical" symptoms in women to the point where "typical" symptoms might be overlooked.
  • The increased risk of heart disease in post-menopausal women is a concern, but hormone replacement therapy as a potential intervention is a complex issue with its own risks and benefits that are not addressed.
  • Medical interventions like stents and bypass surgery are critical, but the text does not discuss the potential risks and complications associated with these procedures.
  • The statement that interventions do not address the underlying cause of arterial hardening is somewhat misleading, as certain procedures and medications can indeed slow the progression of atherosclerosis and manage its underlying causes.
  • The call for ongoing lifestyle changes post-intervention is important, but the text does not acknowledge the challenges and support required for individuals to make and maintain these changes.

Actionables

  • You can create a symptom diary to track any unusual physical sensations, especially during exercise or rest, to identify patterns that may warrant a doctor's visit. Note down the time, duration, and intensity of symptoms like chest pain, jaw pain, or shortness of breath, and whether they improve with rest. This record can be invaluable during medical consultations.
  • Start a "heart-healthy swap" challenge with friends or family where you replace one processed food item with a whole food alternative each week. For example, swap out sugary cereal for oatmeal topped with fresh fruit, or replace a bag of chips with homemade kale chips. Sharing your experiences can make the process more enjoyable and sustainable.
  • Organize a monthly "sleep-in Saturday" where you focus on improving your sleep hygiene without the pressure of work or early commitments. Use this day to experiment with different sleep strategies like blackout curtains, a cooler room temperature, or a no-screens policy an hour before bed. Tracking your sleep quality and energy levels can help you find the best practices for your routine.

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Don’t Learn This Too Late: 5 Things Top Heart Surgeon Says You Must Avoid to Live Longer

Experiences With Heart Health and Impact on Perspective

Jeremy London, a cardiac surgeon, had a brush with heart disease that changed his perspective on life and his approach to patient care.

Dr. London Ignoring Heart Attack Symptoms and Emergency Stent

Cardiac Surgeon Dr. London Ignored His Own Chest Pain Due to Denial

While in a cabin an hour from town, Dr. Jeremy London experienced what he initially thought was reflux. His wife was concerned by his appearance, but London dismissed it, attributing his symptoms to exertion and the cold temperature. The relief he felt when sitting down led him to realize the potential for coronary disease.

He admits being embarrassed by his behavior, as he ignored the signs of a heart issue despite being a heart surgeon and knowing the symptoms. Dr. London highlights his feeling of denial and how that played a role in his delay to seek medical attention.

Emergency Stent Placement

Dr. London experienced crushing chest pain while hunting with his son, decided it was reflux, and did not seek medical help at the time. It wasn't until the following morning when he felt chest pain after climbing stairs that he informed his wife and went to the hospital. This decision led to an emergency situation where he required a stent to open a blocked artery. Dr. London revealed how his wife called him out for his selfishness in not telling her about the chest pain the night before, emphasizing the critical nature of family and health.

Dr. London's Changed Perspective After His Heart Scare

Prioritized Relationships, Family, and Health Over Other Matters

After waking up from the stent procedure, Dr. London felt a complete shift in his perspective. He rea ...

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Experiences With Heart Health and Impact on Perspective

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Actionables

  • You can create a "symptom diary" app that allows users to track any unusual physical sensations or pains they experience, with reminders to review patterns and consider medical consultation if certain symptoms persist or escalate. This app would encourage users to take note of their body's signals and could include educational resources about common symptoms that shouldn't be ignored.
  • Develop a "Family First" planner that integrates health check-ups, exercise routines, and meal planning with family events and milestones, helping users to balance self-care with family time. This planner could be a physical product or a digital app, and it would serve as a daily reminder to prioritize health and relationships, with prompts for scheduling regular medical appointments and setting aside time for relaxation and family activities.
  • Launch a community initiative called "Heart-t ...

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Don’t Learn This Too Late: 5 Things Top Heart Surgeon Says You Must Avoid to Live Longer

Recognizing Warning Signs and Symptoms of Heart Problems

Mel Robbins and Dr. Jeremy London discuss the various signs and symptoms that can indicate heart problems, emphasizing the significance of recognizing these early indicators for prompt medical attention.

Symptoms on Exertion Relieved by Rest Are a Red Flag

Dr. London shares personal experiences and professional knowledge on the subject, stressing that predictable symptoms during physical activity warrant medical investigation.

Unrelated Symptoms Like Elbow Pain or Reflux

Symptoms of heart problems are often thought of as pain in the heart or arm, but Dr. London, having personally experienced heart issues, identifies that heart problems can manifest as different types of discomfort. He had a burning sensation in his chest that felt wrong in his stomach while walking his dogs in cold weather, experiencing relief upon resting. These exertion-related symptoms that are alleviated by rest are important warning signs to heed.

Signs: Leg Swelling, Resting Shortness of Breath

Indications the Heart May Not Pump Effectively

Dr. London also talks about his experience of chest pain upon exertion, like when hunting and loading game, and while climbing stairs, noting that the pain dissipated with rest. He warns that these exertional symptoms, relieved by rest, can point to heart blockage. More serious symptoms include persistent rest-related discomfort or escalating pain, which necessitates an immediate call to emergency services as they indicate the heart muscle is not getting adequate blood flow even at rest.

Initially mistaking his chest pain for reflux, Dr. London asserts that cardiac angina can present in non-traditional ways, including upset stomach, jaw pain, elbow pain, shortness of breath, or easy fatigability. One case, for example, involved a woman who experienced elbow pain with repeated activity, which was later diagnosed as coronary angina.

Shortness of ...

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Recognizing Warning Signs and Symptoms of Heart Problems

Additional Materials

Actionables

  • You can create a symptom diary to track patterns of discomfort and their triggers, noting times when symptoms like shortness of breath or unusual pain occur, especially during different levels of activity. This diary can be a simple notebook or a digital document where you record the date, time, type of symptom, activity you were engaged in, and how long it took for the symptom to subside. This information can be invaluable when discussing your health with a medical professional.
  • Start a low-impact exercise routine, such as walking or swimming, to monitor your body's response to physical activity. Begin with short, manageable sessions and gradually increase the duration and intensity while paying close attention to how your body feels during and after exercise. If you notice any unusual symptoms like those mentioned, such as leg swelling or unusual fatigue, it's a signal to consult with a healthcare provider.
  • Use a smartwatch o ...

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Don’t Learn This Too Late: 5 Things Top Heart Surgeon Says You Must Avoid to Live Longer

Role of Lifestyle Factors in Heart Health

In the realm of heart health, lifestyle choices play a crucial role. Dr. Jeremy London and Jeremy London underscore the importance of diet, exercise, sleep, and the avoidance of harmful substances in maintaining a healthy heart.

Importance of a Whole Foods, Minimally Processed Diet

Jeremy London starts his day focused on a balanced diet—he consumes a protein-heavy breakfast, usually consisting of eggs and fruit, and incorporates a colorful variety of greens and proteins for lunch. His dinner is light, with an emphasis on protein and vegetables. Dr. London believes a grocery cart should reflect a balance of proteins, fats, and carbohydrates and that a grocery list is essential to avoid impulse buys and ensure dietary balance.

Dr. London recommends shopping primarily on the perimeter of the store where whole and single-ingredient foods are located, such as in the produce and meat departments. He advocates for a diet comprising 80% whole foods, recommending label reading to avoid processed foods with hidden preservatives, colorings, and sugars.

Avoiding Excess Sugar, Alcohol, and Nicotine Are Crucial

Dr. London lists smoking as one of the top habits to avoid due to its damage to every organ and its association with heart disease and lung cancer. Excess sugar intake is another concern, as it is fundamental to glucose metabolism and should be limited. Further, the aim should be to avoid processed or ultra-processed foods that are designed to be overconsumed, leading to inflammation and damage to blood vessel walls.

Jeremy London also warns against the toxic effects of alcohol—even antioxidant-containing red wine—stating that the risks of alcohol outweigh its benefits. He endorses using a food journal to monitor consumption, pointing out that it can reveal areas for improvement such as the intake of empty calories or soft drinks. Even non-food substances like alcohol-containing mouthwash can impact the gut microbiome and heart health, showing how what we ...

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Role of Lifestyle Factors in Heart Health

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Counterarguments

  • While a diet comprising 80% whole foods is beneficial, some individuals may thrive on different balances of macronutrients or may have specific dietary needs that require more processed options, such as fortified foods or medical dietary replacements.
  • The recommendation to shop primarily on the perimeter of the store may not be practical or affordable for everyone, as whole foods can be more expensive than processed foods, and not all communities have equal access to fresh produce and meats.
  • The advice to avoid alcohol entirely may not consider the potential benefits of moderate consumption for some individuals, as some research suggests that moderate alcohol intake, particularly red wine, may have cardiovascular benefits.
  • The emphasis on avoiding all processed foods might not acknowledge the convenience and potential nutritional value of some minimally processed foods, which can be part of a healthy diet.
  • The suggestion to use a food journal is helpful, but it may not be suitable for everyone, as it can be time-consuming and may lead to an unhealthy focus on food for some i ...

Actionables

  • You can create a "heart-healthy swap" chart to visually remind yourself to choose better food options. For example, next to your fridge, hang a chart that lists common processed foods you might reach for and their whole food alternatives, like swapping out potato chips for a handful of nuts or making zucchini noodles instead of regular pasta.
  • Develop a "no temptation" grocery list template that only includes items from the perimeter of the store and whole foods. Use this template every time you shop to streamline the process and resist the urge to buy processed items. You might include sections like "Fresh Produce," "Proteins," and "Dairy," and leave out areas of the store known for processed foods.
  • Initia ...

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Don’t Learn This Too Late: 5 Things Top Heart Surgeon Says You Must Avoid to Live Longer

Differences in Heart Disease in Men vs. Women

Jeremy London sheds light on the unique aspects of heart disease in women, highlighting the significant physiological differences from men and the implications for diagnosis and treatment.

Women Experience "Atypical" Symptoms That Are Less Recognized

London stresses that women's heart disease symptoms are not always the same as those typically seen in men. He cautions that symptoms in women sometimes masquerade as other conditions, which may not be taken as seriously, leading to misdiagnoses or delays in identifying heart issues. He specifically points out that blockages can occur not only in women's larger blood vessels, as is common in men, but in smaller ones as well—further complicating diagnosis and treatment.

Hormonal Changes Around Menopause Increase Heart Disease Risk

Addressing hormonal influences, London states that estrogen's anti-inflammatory effects are protective against heart disease prior to menopause, helping to maintain favorable ch ...

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Differences in Heart Disease in Men vs. Women

Additional Materials

Actionables

  • Create a personalized symptom journal to track heart health, noting any atypical signs that could be heart-related. By keeping a detailed record of symptoms, you can provide healthcare professionals with specific information that may help in the early detection of heart disease. For example, jot down instances of unusual fatigue, shortness of breath, or any discomfort that doesn't fit the typical heart attack narrative.
  • Develop a heart health plan with your doctor that considers gender-specific risk factors. This plan should include regular screenings and tests that are sensitive to women's heart disease symptoms, such as stress tests that detect blockages in smaller vessels. You might also discuss the potential benefits and risks of estrogen replacement therapy as you approach menopause.
  • Advocate for your health by preparin ...

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Don’t Learn This Too Late: 5 Things Top Heart Surgeon Says You Must Avoid to Live Longer

Medical Interventions and Procedures to Address Heart Blockages

When dealing with heart blockages, various medical interventions and procedures are crucial to restoring proper blood flow to the heart and preventing potentially fatal events such as heart attacks.

Stents Open Blocked Arteries to Restore Blood Flow

The placement of stents is a common procedure to address blocked arteries. A stent acts like a small scaffolding that is placed over a balloon and expands within the artery to hold it open in a specific spot to reinforce it. For instance, a woman with elbow pain underwent such a procedure which revealed a significant blockage in the artery at the front of her heart. The cardiologist moved to place a stent in this artery, which treated her coronary angina successfully.

Dr. London describes a life-threatening scenario known as the "Widowmaker" blockage, located in the left anterior descending artery. This artery plays a critical role as it controls the large pumping chamber of the heart. Blockages can begin with soft plaque that may rupture, causing an immediate and dire interruption of blood flow. Stenting here can relieve symptoms and prevent severe heart conditions.

Relief and Heart Attack Prevention

Stenting procedures like the one Dr. London described are valuable for immediate relief from symptoms and the prevention of heart attacks. During his own diagnostic study, a 99% blockage was discovered in the artery on the back of his heart. A wire was used to cross this affected artery and place a stent, successfully re-opening the artery and restoring blood flow.

Bypass Surgery Reroutes Blood Flow Around Blocked Arteries

Addresses Immediate Issues but Doesn't Treat Underlying Disease

Bypass surgery is another intervention that is used to treat or prevent significant heart attacks by creating an alternative pathway for blood flow around blockages in heart arteries. The surgery changes the patient's quality of life by alleviating exertional symptoms. However, the procedure does not address the underlying disease—hardening and narrowing of the arteries—indicating that further action is necessary for long-term health.

Importance ...

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Medical Interventions and Procedures to Address Heart Blockages

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Clarifications

  • A stent is a small mesh tube used to prop open narrowed or weakened arteries. During a stent procedure, a balloon catheter is inserted to the blocked area, inflated to expand the stent, and then the balloon is deflated and removed, leaving the stent in place to support the artery walls. Stents help improve blood flow by keeping the artery open and preventing it from collapsing. They are commonly used in treating blockages in the heart's arteries to restore proper blood flow and reduce symptoms like chest pain.
  • Coronary angina is chest pain or discomfort that occurs when the heart muscle doesn't receive enough oxygen-rich blood. The "Widowmaker" blockage is a term used to describe a severe blockage in the left anterior descending artery, a critical blood vessel that supplies a large part of the heart muscle. The left anterior descending artery is one of the main coronary arteries responsible for providing blood to the front part of the heart.
  • A stenting procedure involves placing a small metal or mesh tube (stent) in a blocked artery to keep it open and restore blood flow to the heart. Bypass surgery creates a new pathway for blood to flow around a blocked artery by using a blood vessel from another part of the body or a synthetic tube. Both procedures aim to improve blood flow to the heart muscle and reduce symptoms of heart disease.
  • Hardening and narrowing of arteries, also known as atherosclerosis, is a condition where fatty deposits, cholesterol, and other substances build up on the inner walls of arteries, leading to the thickening and hardening of these blood vessels. This process can restrict blood flow and oxygen delivery to vital organs, including the heart, increasing the risk of heart attacks and strokes. Atherosclerosis is a progressive condition that can develop ...

Actionables

  • You can track your daily habits to identify areas for lifestyle improvement, focusing on heart health. Use a simple habit-tracking app or a physical journal to log your daily activities, diet, and exercise. This will help you see patterns and make incremental changes, like increasing your vegetable intake or adding a 10-minute walk to your routine.
  • Create a "heart-healthy swap" challenge for yourself each month, where you replace one less healthy habit with a better one. For example, if you usually have a sugary snack in the afternoon, switch it out for a piece of fruit or a handful of nuts. Document the swap and how it makes you feel, encouraging gradual and sustainable lifestyle changes.
  • Partner with a friend or family member to set mutua ...

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