Saturday, April 20, 2024

CONTROL VS. BALANCE:

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Dr. Dawn Scantlebury

Shelby Gooding was a very particular young lady. She woke up every morning at 4:45 in order to get to an hour-long gym class and be back home by 6:30 a.m. Breakfast was always fruit and whole grain cereal or oats, with herbal tea. She was at work by 8 a.m., with the reputation of being the most punctual employee in her office, never late, and never absent. At lunch, she ate her home-prepared salad and fish or chicken, followed by a 15-minute walk around the park near her workplace.

She always left work at 5:00 p.m. daily. Her dinner was another salad, or another vegetable-based meal. After this, she prepared for the next day, did 15 minutes of meditation and was in bed by 9 p.m. On Saturday mornings, Shelby arrived at church precisely ten minutes before the service started and left just after. Her time for the rest of the weekend was occupied with housework and home improvement projects and she spent more time in the gym.

Shelby’s father had died from heart disease in his 40s and her mother never seemed to get her life back together after his death, moving from one low-paying job to the next, from one low-income housing facility to another. Shelby’s teenage years had felt like a roller coaster, financial, medical, or emotional crises abounding.

As an adult, therefore, Shelby was determined to exert as much control over her life as possible. She would eat sensibly and exercise to avoid her father’s fate. She studied hard at school and in college so that she could command a good job, with a good salary. To ensure job security, she would be the most diligent employee ever. At 39 years of age, Shelby had succeeded in her quest for control.

Then came COVID-19. The curfews descended, the gyms closed, and Shelby started working from home. She had difficulty obtaining the ingredients for her mostly plant-based diet. She stopped exercising and gained weight. Her routine disappeared. She felt as though her controlled life had shattered.

Shelby started to experience palpitations. Sometimes she felt her heart skip a beat, or sometimes felt it start to race for no good reason or felt a quick flutter in the chest. She experienced tightness in her chest, mostly at night. She became very scared that she was developing her father’s heart issues.

She saw her primary care doctor, who referred her to a cardiologist. Her heart rhythm monitor showed normal rhythm during symptoms, although she reported that her symptoms were minimal on the day of the test. Shelby continued to have chest tightness yet further tests showed that her heart structure and function were normal. A stress test was negative, meaning that she was likely not about to have a heart attack at age 40 like her father did. She was congratulated and encouraged to resume her healthy lifestyle.

Shelby’s symptoms persisted and even worsened.

She saw another cardiologist for a second opinion. The cardiologist reviewed all her previous test results.

Since her palpitations had gotten worse, a repeat heart rhythm monitor was obtained.

It showed that her heart rate sped up during symptoms, but the rhythm remained a normal rhythm. Shelby tried to insist that all the other testing be repeated but the cardiologist declined.

She had a suspicion about what was going on with Shelby.

“Shelby, what do you do in your free time? Do you have good friends with whom you spend time? Do you spend time with family?” Shelby pondered her answer. She had made friends in school and college, certainly. She tried to remember the last time she called one. She could not! When last had she visited her mother? Their relationship was slightly strained as Shelby was impatient with her mother’s chaos. What did she do in her free time now that she was working from home? She spent a lot of time watching the news channels.

In fact, her chest tightness often came on at night when she was watching the news.

As she spoke to the doctor, and as she explored her life, she realised that in her quest for control, she had not made time for a social life, for a social network. She had no close friends with whom to discuss the upheaval in the world, or to take her mind off her fear of getting COVID-19.

Following the doctor’s visit, Shelby picked up her phone and called her mother. She usually called her for five minutes on Sunday afternoon, but this was a Tuesday! Her mother was immediately concerned. “Shelby, is something wrong?” “No”, she assured her mother, “I just called to chat”. Her mother was surprised but leapt at the opportunity. The conversation was a little awkward initially, but they soon were comfortably chatting about people they knew and the state of the world.

Heartened by this conversation, Shelby called her best friend from college later that evening. She even forgot to turn on the news!

Her palpitations got better. She started to recognise them as anxiety over her loss of routine plus the scenes on the television. After the lockdown ended and she was back at work, she resumed her usual routine, but with some changes. She now made time to call or visit friends and family. Her social network was expanding. She even found time to learn to play tennis. She laughed more. She had a glass of wine on occasion. And, horrors! She had a serving of macaroni pie at her last family visit. It was delicious! At her last visit with her doctor, she reported that all her symptoms had resolved.

Shelby Gooding was still a very particular young lady, a diligent worker, with a healthy lifestyle, but her controlled life was now a balanced life.

This is ‘Go Red’ month where our focus here at the Heart and Stroke Foundation of Barbados is raising awareness of heart disease in women and by extension, the whole family. The Go Red movement is not only about raising awareness, though. It is also about making a commitment to our heart health. Like Shelby, let us make a commitment to leading a healthy lifestyle, physically, yes, but also emotionally and spiritually. Let us work towards balance.

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