Surgeon Marc Wallack was seven minutes into his run through Central Park in 2002 when he felt chest pain that he attributed to stress and indigestion. It happened again the next day, and again on a subsequent run. Finally, unable to ignore the telltale warning sign of heart problems, Wallack went to see a cardiologist and was told that all four of his coronary arteries were more than 95 percent blocked. He needed immediate open-heart surgery—a quadruple bypass—which he sailed through successfully from a physical standpoint, but psychologically left him feeling broken. "I woke up from the surgery and wasn't the same person," recalls Wallack, who is vice chair of the department of surgery at New York Medical College. His fears overwhelmed him. "I worried I was never going to operate again, pay my mortgage, support my family; every time I ate I could visualize the plaque going back on my arteries."
And he fantasized about dying, a hallmark of depression, which afflicts one in five patients after heart surgery and one in three heart attack survivors. Wallack knew other colleagues in the same boat; one had to quit his medical practice as a result. And Wallack knew that his depression, if left untreated, would dramatically increase his likelihood of more heart complications. So he and his wife, Fox News anchor Jamie Colby, devised an 8-step comeback plan and detailed it in their recently released book Back to Life After a Heart Crisis. "It was about helping to bring him back amongst the living," says Colby. For Wallack, that meant training for another marathon, which he managed to complete two years after his surgery; for Colby, it meant getting her husband through doctor's appointments, navigating him through career changes, and convincing him to see a therapist. Anyone who has been through heart surgery, Colby says, can benefit from trying the following:
Step 1: Take one night at a time. Most bypass surgery patients experience sleep problems initially, according to surveys, with many finding that the problems become chronic. "I'd close my eyes at night and worry that my heart wasn't going to continue to beat," recalls Wallack. What helped? His wife's reassuring words. "One night we were lying in bed and I had my head on his chest listening to his heart beat," says Colby. "I said, Marc, your heart is so loud, it's beating stronger than I've ever heard it before; I think that helped him." Regular visits to a psychiatrist and prescription sleeping pills (which he now only takes occasionally) also brought better sleep for the first few months. In addition, Wallack used a night-light and slept with the shades open to avoid total darkness, which he associated with death. And he initially took mid-morning naps since his fears didn't plague him during daylight hours as they did at night.
Step 2: Face the pain head-on—both the physical and the emotional. While Wallack took strong painkillers in the days following his surgery, he credits his wife for helping him avoid a potential addiction; she made him stop taking the pills after eight days once his physical pain had subsided. The pills, he writes, "made me high and lifted my severe postoperative depression" but were not safe in the long-term. Instead, he started seeing a therapist and was prescribed antidepressants. His therapist helped him realize that he was actually experiencing post-traumatic stress disorder, common in war veterans and rape victims, but also in those who have been through life-threatening medical experiences. Through counseling, Wallack learned to use his heart attack fears as a way to motivate himself to get healthy through cardiac rehabilitation, stress management, and dietary changes. Colby helped boost her husband's spirits by renting uplifting action movies like Rocky and Rambo and screening gifts and cards sent by well-meaning but sometimes misguided loved ones. One card that she initially hid from him had a depressing message saying: "So sorry you went through this; someday you'll recover."
Step 3: Get out, even if only to the supermarket. It took three weeks for Wallack to leave his New York City apartment after his surgery, and when he finally did he was mistaken for his wife's elderly father because he looked so frail and sickly. Still, he writes, after getting back from that outing, he had confidence to go on another. He recommends preparing by first visualizing the experience and reminding yourself that those first social interactions are bound to be a challenge.
Step 4: Plan for doctor's appointments. Each doctor's visit filled Wallack with fear that he would fail his cardiac stress test or have a scan that would detect new blockages. But after emerging from several without problems, the appointments became easier to bear. He also learned to call his cardiologist whenever he was concerned about a medical issue like his heart beating too rapidly after climbing a flight of stairs. And to keep Wallack's spirits up, Colby accompanied him to his initial appointments and privately asked the doctor to make at least one positive comment during every visit.
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