I’m writing about my experience over the last year trying to get healthy; somewhat as a public journal, partly because people ask how I lost weight, and possibly to offer some encouragement. I don’t have a proofreader or an editor, so forgive the errors and disorganization.

I had a heart attack in March of 2018, after which I made huge lifestyle changes. I wasn’t especially excited about longevity then, and my diet reflected my disinterest in life. It’s been a bit more than a year, and I’m now healthier than I’ve been in a very long time. The problem that brought me to the hospital was an occluded left anterior descending artery — what they call a “widow-maker infarction.” A stent was inserted that afternoon.

Blood Work

My lipids and glucose were out of control. I was taking no medications prior to the heart attack. When tested in the hospital (possibly for the first time ever) I had a HbA1c above 13, which is typical for untreated type 2 diabetes. I was put on all sorts of medications for cholesterol and instructed on injecting insulin before each meal. Over the last year, I’ve had several blood draws and lab reports. My values are now within normal ranges across the board, however given my risk group, I need to bring my LDL even lower. The collection of medications I’m on today is pretty modest, and I haven’t needed insulin in months. Focusing on improving the out of range values was effective for me.

Exercise

I had been sedentary for years, except for the occasional short walk. I bought an Apple Watch a couple days after getting out of the hospital. The default goals during setup for me were 30 minutes of exercise and 600 calories of activity. After a few weeks of meeting those goals (or “activity rings”), I increased them when prompted. I’m now at 1 hour/1000 calories. There are some days I don’t hit those numbers, but I nearly always make it. Sometimes, I walk around the neighborhood late at night to finish off the rings. The gamification of closing those rings really works.

I started walking/jogging with a friend. She encouraged me to sign up for the Pasadena Half Marathon, which seemed crazy, to be honest. But I did it in 2 hrs 15 min; not too bad.

I started riding my road bike again. I do about 150 miles a week. I rejoined my old cycling club, and I go on group rides with them most weekends. I was ride leader for the first time last weekend. I’m signed up for several century rides this year.

Cooking For Myself

It’s very difficult to keep track of nutrition when eating out. I started preparing my own meals, with my diet goals in mind: fewer than 50 g of carbs per meal, no more than 2000 calories a day, a modest amount of salt and saturated fats. I use the MyFitnessPal app to track all my food. It’s not as tedious as it sounds, and being able to keep track eliminates a lot of guesswork and rationalization.

Vices

My cardiologist was pretty vicious about my nicotine use. I had quit several times over the last 30 years, but this time I was highly motivated. I haven’t cheated once. Although I wasn’t instructed to quit alcohol completely, I hardly ever drink now. I miss both. A lot. But giving them up has made an enormous difference.

Data Tracking

The Apple Health App in iOS is fantastic. I track my blood sugar (nearly) every day. My numbers are pretty great lately — typically below 90 in the morning. My last HbA1c was 5.6. I use the Accu-Chek Aviva Plus, which is fine, but I would prefer a device that pushed results into the Health App directly. Manually entering the results is five seconds every day that I’ll never get back.

I bought an internet-connected scale (Withings/Nokia Body+) that I step on every day. It’s a pretty good product for pumping data into the Health App and shows a line chart of recent weigh-ins on its little screen. It also measures body fat and water percentage measurements, but the accuracy of those are highly questionable.

I use an Omron 10 blood pressure device to see how I’m doing every few days. With my changes in diet and exercise, I was able to stop taking medication for high blood pressure. It’s now typically 115/70, which my doctors find acceptable.

For most of my cycling, I use Strava to keep track of my performance. I also use the Workouts app on my Apple Watch for comparison. I use an iOS app called Progress for my body measurements so I can see how many inches of fat I’ve lost. The improvements are frustratingly slow, but I try to focus on the trend lines.

Sleep

For a variety of reasons, I wasn’t sleeping regularly or very well. I used massive amounts of caffeine to keep me moving. These days, I try to get a solid 7 hours every night and hit the pillow at a reasonable hour. I’m actually sort of a morning person when rested. I still love my coffee and have a few cups a day, but I don’t use it as a sleep replacement now.

Carbs

Everybody loves to hate on carbs these days. Especially my endocrinologist! [pause for laughter]

I’m pretty selective today about which carbs I eat, and I get instant feedback by testing my blood sugar. I’ll still have things like pasta and rice, but in tiny portions. Instead, I try to stuff as many vegetables into my face as I can. That’s what any reasonable dietician would suggest, of course, but I’ve gotten good at actually doing it. This is another reason I mostly prepare my own food at home; it can be a real challenge to get good veggies when eating out.

I just consider total carbs. There are a lot of ways that can be broken up, but I don’t think it’s important or helpful to look at fructose/glucose ratios or glycemic index or net carbs. More kale, less cake.

Walk Everywhere

I’m pretty fortunate to live in a walkable neighborhood with a few stores nearby. I listen to a whole bunch of podcasts, and I’ll pop in my AirPods and take a walk a couple times a day. I walk to the grocery store, the gym, and the coffee shop — anywhere I can. Sometimes I’ll just walk around the block while I’m thinking about work stuff. I used to think all those “gotta get my steps in” people were just nuts, and now I’m a nut too.

You probably already knew all of this, but maybe you found something helpful. I hope so. I’m still aggressively trying to get healthier. Just considering weight for a moment, I was at 280 lbs in the hospital, now I’m 215 lbs, and my goal is 190 lbs. Of course, there’s more to being healthy than weighing less, but it’s a darn good data point. I will think about my other goals and write them down. Suggestions? One thing I’m considering is a benefit ride. Maybe a 500 mile fundraiser?