Cardiovascular disease -- the No. 1 killer in the United States -- faces a formidable foe on the Kenai Peninsula. Celebrating American Heart Month, survivors of heart disease, medical professionals and the peninsula's youth take stock of the battle being waged and victories being claimed.
Bonnie Smith's knowledge of heart disease came the hard way.
"I was in the middle of a meeting and I just started feeling really sort of strange," said Smith, 68, of her Dec. 13, 1995, heart attack. "I excused myself, someone followed me out of the room, and someone else called 911."
Once stabilized at Central Peninsula General Hospital, Smith was transported to Providence Medical Center in Anchorage, where bypass surgery was performed five days later.
"I can't say enough about how good the hospital was and the emergency room people," she said of her treatment by CPGH staff and Soldotna internist John P. Bramante. "The doctor in Anchorage said had I not had the care I got, the (Anchorage) doctors could not have performed the surgery. They said that care saved my life."
A few years later, Smith helped save longtime friend Jack Brown, 53, of Nikiski.
"I was playing in a softball game and I couldn't breathe," said Brown, who serves on the Kenai Peninsula Borough Assembly. "I thought it was a problem with my lungs or maybe a touch of pneumonia."
Later that summer, he had a similar experience. When Smith suggested Brown's problems were heart-related and advised that he seek medical attention, Brown got angry.
"I was in total denial," Brown said. "But she's like my mother, so I listened to her and went and had it checked."
After being diagnosed with heart disease, Brown elected to treat his condition with diet and exercise. But in December 1999, after Soldotna internist William J. Kelley ordered more tests, Brown received sobering news from doctors at Virginia Mason Hospital in Seattle, Wash.
"You're like a walking time bomb," Brown said they told him. "They said that somewhere around 30 to 40 percent of the people in my situation would have dropped dead on the spot. The majority of the remaining percentage would have irreversible (heart) damage. 'You're not dead and you don't have irreversible damage. We have one word for you: fortunate.'"
Before undergoing bypass surgery, Brown called his friend.
"I'll never forget it because he asked, 'Will it hurt?'" Smith said. "And I said, 'No, not really.' After surgery, he said, 'Bonnie lied. It does hurt.'"
Brown praised the care he received on the peninsula.
"I think the world of Dr. Kelley," Brown said. "He didn't leave any options for me. He said, 'You've got to do this, Jack.'"
Smith keeps close tabs on her friend.
"To this day, I check on (Brown) every day," she said. "Did I save his life? I think at that time, it did. I certainly am pleased that he followed advice and is doing well."
Smith and Brown have family histories with cardiovascular disease. Smith's father had bypass surgery, and Brown's father and grandfather both died of heart attacks. Kelley listed a family history of heart disease as one of several risk factors people need to be aware of. Others include smoking, high blood pressure, diabetes and high cholesterol.
"Have your blood pressure checked, have your cholesterol checked, stop smoking or, better yet, don't start," Kelley said. "The big thing is to know the risk factors and pay attention to them."
Although the peninsula lacks a cardiologist, two from the Alaska Heart Institute in Anchorage hold a clinic at Central Peninsula General Hospital's emergency room one day a week, according to Kelley. Initial diagnostic studies, however, can be done by local doctors, he said.
"If the results are suspicious or indicate significant problems, we refer patients to a cardiologist because more invasive testing is usually required, and that's usually done in Anchorage," Kelley said, adding that peninsula doctors have a good working relationship with Anchorage cardiologists.
"We have access 20 minutes away by helicopter if needed," Kelley said. "From a doctor's and a patient's perspective, quality of care can be pretty high even though we can't do it in house, so to speak."
The Soldotna doctor said symptoms aren't always like those on television.
"There's often not a crushing pain. It can be kind of vague or a mild discomfort that goes away. The symptoms can be not too dramatic. People don't recognize them and they wonder if it really is that bad."
Helping hold the line against cardiovascular disease are students at 14 peninsula schools, according to Jason Miller, American Heart Association regional director in Anchorage. Last year, the students helped raise more than $350,000.
Instructor Steve Gillaspie said ninth graders at Nikiski Middle-Senior High School researched and presented information on heart health to grades seven and eight, involving more than 300 students. A "hoops for heart" tournament organized by the students raised an estimated $1,200.
Other peninsula schools participating with AHA include Aurora Borealis Charter School, Hope Elementary, Kalifornsky Beach Elementary, Mountain View Elementary, Nanwalek School, Nikiski Elementary, Kenai Middle School, Ninilchik School, Redoubt Elementary, Seward Elementary, Tustumena Elementary, Homer Middle School and McNeil Canyon Elementary.
"If we educate them at a young age, we hope they will be a little more health aware in the future and as a result have a lower risk of heart disease," he said.
Miller said instructors who take a lead in teaching heart health "don't do it because it's a fun fund-raiser. It's a community service they're providing, not just for Alaskans, but nationwide. They're lifesavers."
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