“VR,” 65 Years Old

Excerpted and condensed from “Screaming to Be Heard,” pgs. 426 – 430, by Elizabeth Lee Vliet, M.D. Evans and Company, Inc., 1995

Medical Condition: Hypertension

“I’m the third girl in a family of four girls. My sisters and my mother had serious medical problems (mostly cardiovascular) while they were alive and they’ve died too soon. I enjoy life, I want to be physically and mentally active. I don’t want to be sickly or to die young. This is the reason for my story.

“In 1984 I was fifty-four years old, a widow for a year, and the mother of four adult children. I was enjoying my work with young people, my family and friends, and life in general; however, I sensed something was wrong with my physical condition. I had been disgnosed as having essential hypertension when I was twenty-nine years old. Over the years, physicians have prescribed a variety of medications which usually kept my blood pressure below the 150/90 threshold. I was taking four different medicines for five or six years and my blood pressure was staying within limits. But I knew something was wrong.

“My body just didn’t feel like me. Everything was taking more effort than it usually did. I felt more like I had to push myself to swim and play golf, my two favorite sports. I would go to aerobic class and really be working out well and never could get my heart rate into the target range. Very frustrating for someone who likes to follow directions and achieve my goals!

“When I mentioned this to friends, they made the usual comments, ‘Remember you’re older now, VR!’ I knew too many active excuses. I went to my doctor whom I’d been going to for seven years. I told him how I felt and suggested that I needed a reevaluation with an up-to-date cardiac stress test (remembering my sisters and their heart problems, it seemed like a reasonable request to me) and then a review of my medications. He looked over my record and said “No, there is no sign that you need a cardiac stress test. Your blood pressure is well-controlled and you seem fine to me.” I believe he thought this was true, but I think he was also influenced by the fact that I was on an HMO insurance plan and this would add to his medical expenses. He had indicated there would be problems justifying the cardiac stress test.

“At this point I did some serious soul searching. I felt something was wrong with me physically. I knew I couldn’t prove it, but I wasn’t going to let a doctor keep me from getting a correct diagnosis! I thought about my mother and sisters: Mother started having heart attacks in her fifties, had two operations on her carotid arteries in her sixties, had strokes in her seventies and eighties, and died in a nursing home at eighty-five out-of-touch with reality. My sister Rae, who was seven years older than I, started having heart attacks in her forties. At forty-eight she had a severely damaged heart, was bedridden, and died at fifty-one. My older sister Anne, who is ten years older than I, started having heart attacks in her fifties, and at sixty-four had a quadruple bypass. She is now very limited in her activities because of her poor health. My younger sister Mary died at age thirty-two of leukemia, so I don’t know what her cardiovascular condition might have been. With this kind of family history, I knew I needed help immediately.

“At the library I picked up a brochure on Preventive Medicine by Dr. Lee Vliet. Could this be the doctor I needed to see? Just walking into her office was a healthy experience: relaxing music was playing, the colors of everything were soothing, the art work was thought-provoking and creative; Dr. Vliet and her staff were obviously interested, caring people. I shared my story with Dr. Vliet. She asked many questions and then ordered a cardiopulmonary exercise test plus some labwork. I had never had such a comprehensive stress test. It was stopped suddenly because condition rapidly declined. The test report stated that I was heavily overmedicated, my heart was blocked so much by the beta-blocker that it couldn’t get to a higher heart rate even though I had already passed the aerobic threshold! The cardiologist’s report said I was in danger of sudden death if I participated in physical activities. And here I had been pushing myself in aerobic classes three times a week. I was flabbergasted with this news. I knew my body had been trying to tell me something, I just didn’t realize how serious it was. Needless to say, Dr. Vliet urged me not to go on my planned wilderness hiking trip, but to take time to get my medication changed and my body in better shape. After the abnormal results, my primary care physician then said, ‘Oh, well, I guess this did need to be done. I’ll send the prescription to the insurance company.’

“I believe Dr. Vliet saved my life. She listened to my concerns and accepted the possible validity of them. She ordered the tests that would give her the factual information she needed to confirm or deny my subjective feelings about my body. Dr. Vliet did a complete reevaluation, and with her colleague, provided me with a new regimen of preventative medicine and appropriate medications.

“Now, eleven years later, I follow the basic tenets of preventative medicine: low-fat foods, regular physical activity, relaxation techniques, caring relationships, and periodical medical checkups with required medications. I have lost weight, yes, but more importantly I have gained good health. My blood pressure is controlled; exercise four times a week. I take only two medications now, instead of five, and I am off the beta-blocker. I work full-time in a high-pressure job I love, I go jet-skiing and swimming with my grandchildren, and have just taken up scuba diving. Good living for a sixty-five-year-old woman! And my younger friends now say, ‘Gosh, VR, I hope I can be like you when I’m your age.’ And my doctor keeps thinking I’m fifty-five instead of sixty-five!”