Weighing the Options

By Jennifer Hulon

The need to pay better attention to your overall health may become even more important closer to retirement. The best way to stay well is to live a balanced lifestyle through exercise, diet, not smoking and maintaining a healthy weight.

Greg Podell of Carolina Forest decided it was time to adopt a life-changing lifestyle. His years of corporate travel and dining out nightly had led to unhealthy eating habits and increased weight.

In 2019, he contacted his friend and golf partner, Dr. John Karl with McLeod Primary Care Carolina Forest.

At Greg’s first appointment, Dr. Karl performed his Medicare annual wellness visit exam. Dr. Karl focused on Greg’s family history, current weight and other important risk factors. Together they developed a personalized plan to monitor Greg’s numbers and a schedule of preventive health screenings that could potentially indicate diseases before signs and symptoms were even present.

The Medicare preventive screening is a plan designed to help prevent disease and disability based on current health and risk factors.

Due to Greg’s family history of poor heart health, Dr. Karl was focused on Greg’s cardiac screening. After consideration of Greg’s bloodwork, sleep apnea, high blood pressure, high cholesterol and current weight, Dr. Karl ordered a Cardiac Calcium Scoring screening.

A Cardiac Calcium Scoring screening is performed using a multi-slice CT (Computed Tomography) scan that can measure the amount of hard, calcified plaque in the coronary arteries. A higher coronary calcium score suggests an increased risk of significant narrowing in the coronary arteries.

This Cardiac Calcium Scoring screening is not covered under the preventive Medicare screening program but is a critical test that can pinpoint a potential coronary issue.

The day after Greg’s screening, Dr. Karl immediately contacted him with the results, which were critically elevated. Dr. Karl referred Greg to Cardiologist Dr. Nicholas Jebaily with McLeod Cardiology Associates.

Dr. Jebaily met with Greg and discussed the results of both his Medicare preventive screening and Cardiac Calcium Scoring screening. Greg also underwent a cardiac stress test and echocardiogram during the visit.

An echocardiogram uses ultrasound waves to diagnose and monitor heart disease. A stress test shows how the heart performs during physical activity.

Dr. Jebaily explained to Greg that his body was stressed by his heart issues and recommended losing weight to improve his heart condition. That was the moment Greg chose to change his life. He left Dr. Jebaily’s office motivated to begin living a healthier lifestyle.

“Greg has a family history of heart disease, which is out of his control,” said Dr. Jebaily. “I advised him to adopt a healthier diet and incorporate exercise into his daily life. This would not eliminate his heart disease, but could lessen the stress on his heart.”

Within 10 months Greg lost more than 85 pounds and his body mass index (BMI) decreased from 45.64 to 32.08. Greg was making healthy strides, improving his overall health.

In January 2022, Greg got into his car and reached back for his seatbelt strap. He felt a sudden sharpness in his shoulder and chest. He recalled a conversation with Dr. Jebaily where he told Greg if he ever experienced a feeling like indigestion for more than ten minutes, to go immediately to the Emergency Department. As he drove, the pain continued but Greg still questioned if it was indeed indigestion or something heart- related.

In the middle of the night, he could not sleep due to the increasing pain. He woke his wife Betty and asked her to take him to the Emergency Department, as the chest pain persisted. An EKG test confirmed Greg had experienced a heart attack. Greg was transported to McLeod Health Seacoast for further testing and treatment by a cardiologist.

He was directly admitted and assessed by McLeod Cardiologist Dr. Amit Pande. Dr. Pande ordered an echocardiogram and EKG to monitor Greg’s heart. He was not actively having a heart attack, but the tests showed he had experienced one recently.

Dr. Pande explained that Greg needed a heart catheterization and depending on the findings, could require invasive procedures. Considering the possibility of Greg needing more advanced care, Dr. Pande recommended that Greg be transferred to McLeod Regional Medical Center.

Upon Greg’s arrival, McLeod Cardiologist Dr. Fred Krainin with McLeod Cardiology Associates performed a heart catheterization. Only a small area of Greg’s heart was affected by the heart attack. No further procedures were needed.

Greg was discharged and sent home with Cardiac Rehabilitation orders to begin in the next two weeks. Cardiac Rehab offers medically supervised therapy while monitoring the heart.

This program benefits the patient by strengthening the heart. At Greg’s follow-up appointment after the incident, Dr. Jebaily explained how incredibly lucky Greg was to have such a small amount of his heart impacted.

“If Greg had this heart attack before he made such healthy improvements, the outcome may not have been the same,” said Dr. Jebaily. “Family history plays such a significant role in heart health, but his lifestyle change improved his body’s responsiveness.”

“By coming in for his annual wellness visit and undergoing preventive screenings like the Cardiac Calcium Scoring screening, we were able to identify Greg’s heart condition along with his concerning family history,” said Dr. Karl.

Today, Greg can more fully enjoy his favorite pastime – golf – walking and swinging better than ever before. He feels confident as a result of his new approach to a healthy life.

“Utilize your primary care physician and the tests available to you. Take control of your health,” advises Greg.