For a healthy New Year, doctor and patient preach the value of dialogue
The hints, however slight, hadn’t gone unnoticed.
Most of his adult life, Solana Beach resident Thomas Bassett had done his best to live a healthy and active lifestyle. But in the summer and fall of last year, there were suddenly times he would find himself feeling short of breath. Sometimes it came walking up a flight of stairs. Sometimes it was strolling up hills on the golf course. Or how during his workouts on the exercise bike, it had gotten too hard to get his heart rate up to where he was accustomed.
He wasn’t in any pain, and nothing in his family history gave him cause for concern. Maybe, he thought, it was just what comes with being 72 years old.
But ever conscientious, he mentioned it to Dr. Christen Benke during his next checkup at Scripps Clinic Del Mar. Knowing his background and lifestyle during their eight years together as doctor and patient, the complaint smacked of something serious.
“He’s healthy in every other way and he likes to exercise, but as a male of a certain age, he’s at a higher risk,” Benke said. “So when he said that he wasn’t able to exercise like he was used to and just felt different, I knew something might be wrong.”
She ordered a treadmill stress test at Scripps La Jolla. When those results came back problematic, the cardiologists took over. Dr. Todd Hitchcock at Scripps Clinic Carmel Valley ran an angiogram to pump dye into his heart and see where blood was flowing — and where it wasn’t.
Blockages were rampant. The next day, doctors implanted five stints to re-open the obstructed passages.
The culprit: cholesterol — was confounding because Bassett had been keeping close tabs on that ever since his cholesterol and blood pressure spiked after he turned 40. Medications had brought that under control, and for 30 years he ate healthy and stayed active. Always a stickler for yearly checkups, his blood tests never strayed outside the normal ranges.
Therein lies one of the biggest impediments to finding people on the verge of suffering something serious, Benke said.
With renewed resolve to live healthier lifestyles on so many people’s minds this time of year, Scripps is sharing Bassett’s story as a reminder that something as simple as mentioning a minor detail during a routine checkup can have a life-changing — or even life-saving — impact.
“It’s the Mr. Bassetts that we’re trying to catch. You can have lovely-looking cholesterol on paper but those tests can be a false sense of security,” she said. “We don’t know how to find the Mr. Bassetts unless they tell us when they feel a little short of breath or something is feeling different.”
Benke has seen it time and again during her decade at Scripps Del Mar: too many people, as they age, don’t want to consider that they’ve become vulnerable to age-related maladies, many of which can be found with simple, inexpensive tests.
“Take diabetes, for example. I wish diabetes hurt more. Most people don’t know they have it until it’s way too late,” she said. “Don’t wait until you have a symptom. Many things — whether it’s cholesterol or cancer or diabetes, even some infections — don’t have symptoms.”
Another common pitfall: too many people think changes in diet and exercise can erase a lifetime of bad habits.
“I see people all the time who used and abused their bodies in their youth. That can do lasting damage,” Benke said. “You can quit smoking, you can start doing yoga and go vegan, but it may be that some of this plaque and some of this narrowing already started way back when.”
When he thinks back on his past, Bassett’s thoughts land on the countless afternoons he and his father spent tending to the family’s citrus grove, working shirtless in the Southern California sun.
In that, patient and doctor share common ground: both of their fathers died of melanoma.
“What killed my dad is 90 percent curable these days,” he said.
That’s why Bassett never skimps on the sunblock for those rounds of golf and checks in with his dermatologist every six months.
But Benke stresses that even with his consistent checkups, Bassett may have gone on blissfully unaware of his blockages had he not spoken up about his shortness of breath. The lesson, Benke said, isn’t that everyone needs to have an annual physical. Rather, it’s about patients and doctors establishing a dialogue that gets both sides on the same page.
“We don’t know what would have happened,” Benke said. “Maybe nothing. He may have just gone on living and been just fine. Maybe he would have started to have some chest pains and we would have gone into action. Or maybe he would have had a heart attack.”
Bassett’s day-to-day hasn’t changed much in the year since his procedure. He’s on Plavix and aspirin to minimize clotting, and his stents are laden with meds to increase their efficacy. He’ll be on that regimen for another year, and he’s determined to maintain his healthy habits, knowing now how important it is to listen to his body and make that part of his dialogue with his doctors at Scripps.
“I’m a believer in preventative care. It’s a lot better to treat things early in the cycle than it is when you have a heart attack,” Bassett said. “It’s easier to prevent than it is to fix.”