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Test's Squiggles Alert Dieter, Give New Motivation

February 22, 1990|JAN HOFMANN | Jan Hofmann is a regular contributor to Orange County Life.

Since he started a new diet and exercise program last November, Kae Ewing's biggest problem has been motivation. He wanted to lose weight and get in shape, but there just didn't seem to be room in his busy schedule for regular exercise sessions.

As a result, the 55-year-old Newport Beach stockbroker, who agreed to let Health & Fitness follow his progress, has been frustrated because there hasn't been as much progress as he had hoped.

In the first two months of the program, he lost 14 pounds, and in the third month he dropped aonly a single pound.

Since then, the numbers have been moving again--but in the wrong direction.

Even though he's been sticking religiously to the low fat, high complex-carbohydrate diet recommended by his fitness consultant, Ewing has started gaining again and now weighs in at about 250, up from a low in January of 243. The 6-foot, 3 1/2-inch Lido Island resident's original goal, on the advice of fitness consultant Joe Dillon of Irvine's Body Accounting, was 203 pounds.

Instead of exercising five or six times a week, as Dillon recommends, Ewing has managed only one or two sessions a week.

But last week, Ewing may have found the motivation he needs, in the form of some electronic squiggles so slight even the doctor didn't notice them at first glance.

The squiggles showed up on an electrocardiogram taken while Ewing walked, then jogged on a treadmill at the UC Irvine Executive Health Program. Although Ewing had no symptoms or history of heart problems or any other chronic ailments, Dillon recommended that he undergo a health screening just to be sure.

It's something he suggests for all his clients, Dillon says, "But it's especially important for somebody like Kae, who has been sedentary for a long time, who's a male over 40 and who is significantly overweight."

As we are reminded every February during National Heart Month, heart and circulatory diseases are the nation's top killers, accounting for nearly 50% of all deaths. The UCI program also screens for other problems such as diabetes, cancer and their precursors.

But wouldn't Ewing have noticed something--pain, shortness of breath, high blood pressure--if he had a serious problem?

Not necessarily, says Dr. James Lindberg, medical director of the UCI program. "In 40% of cases, the first symptom of heart disease is sudden death," he says.

Unlike some busy executives who never find the time for a checkup, Ewing had undergone treadmill tests before, always with normal results. But this time, the tracings of his heartbeat showed slight changes as he exercised, changes that Lindberg says "might indicate there's some coronary artery disease." The coronary arteries supply oxygenated blood to the heart muscle, and when they become blocked, heart attacks can occur.

"It's nothing definite, but it does warrant further investigation," Lindberg says. He glanced at the electrocardiogram tracings immediately after the test, but "the changes were so slight I didn't even notice them at first," he says.

The treadmill test was part of the UCI program's comprehensive evaluation of current health, which includes an individualized battery of tests based on a person's age, sex and condition. In addition to the usual medical examinations such as blood tests, thyroid tests, urinalysis, blood pressure checks, the Executive Health Program also takes into account such factors as stress level on and off the job and even whether the person wears a seat belt regularly in the car.

After the results from all the tests are in, Lindberg will sit down with Ewing for a one-hour review of the findings and prepare a thick, bound personal health profile for him, spelling out Ewing's chances of dying of a heart attack, various forms of cancer or a motor vehicle accident within the next decade or so. The profile will also include a specific prescription for exercise, based on Ewing's current condition and capacity.

But Lindberg isn't waiting for the numbers to come back from the lab.

Immediately after he looked at the electrocardiogram printout and saw the irregularities, he made arrangements to send Ewing to UCI Medical Center in Orange for further tests. The first step, he says, will be another, more sophisticated treadmill test, and if that confirms Lindberg's findings, the next step would be an angiogram, in which doctors at UCI would inject dye into Ewing's coronary arteries while a special X-ray machine displays and records the results.

If there is a blockage in one or more of Ewing's coronary arteries, doctors may be able to remove it without major surgery by using a technique such as balloon angioplasty, in which a tiny balloon is inserted in the artery and then inflated to flatten out the blockage.

Of course, there's a chance that those suspicious squiggles amount to nothing more than a false alarm. Lindberg says there's roughly a 20% chance that the results are a false positive and Ewing has no coronary artery disease.

No matter what the doctors ultimately conclude, Ewing says the preliminary results have made a difference already. "When Dr. Lindberg called and told me, it was like when you hit the jackpot on a pinball machine, you know, how all the lights flash and the bells go off? And I thought, 'Maybe that's why I should lose weight.' Whether they find something this time or not, this brings it home that being overweight has to be a health hazard. Maybe this is what I needed to get me motivated."

In a couple of weeks, we'll check back with Ewing and find out what the other test results showed.

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