Four Stents and One Happy Software Developer


Big luck, preparation, vigilance, and science met on December 7, 2015, when  my husband, Jon had stents put in each of his four coronary arteries, as they were each blocked. Two were 90% blocked, the other two 99% blocked. This life-saving procedure was done in less than two hours. And it was done through a artery in his arm while he was awake but medicated.


Freakin’ amazing high-tech science…and fantabulous on the ball doctors. Wow!


One of Jon’s cardiologist made it very clear to me, when she praised me for my vigilance, that getting Jon properly diagnosed and pushing for this exact procedure saved his life. Her exact words, “Without this procedure Jon would have had a heart attack. He was a walking-ticking-time bomb.”


After this dramatic statement, unbeknownst to me and everyone else, I went into shock.


It was weeks later that I was able to appreciate that Jon and our family came out of this victorious.


Victorious because instead of Jon having a massive heart attack, and who-knows-what, Zack and Daniella (our kids, 11 and 29, respectively) got to celebrate Christmas with their father.


Before I tell you our story, I need to tell you that my medical knowledge is limited to high school science, the education our cardiologist gave me in his office–I’m relieved there wasn’t a written exam–and articles I read on-line. That’s it. I am sharing our experience as I remember it. Hopefully, I’m not over-romanticizing it with revisionist history, you’ll have to be the judge of that. If giving up a little of our privacy, putting this story out there, increases awareness then it’s worth it to Jon and me.


Arriving to Jon’s diagnosis required that we recognize three red flags that recently showed up in the regular course of our lives, and some tests, that led us to the diagnosis. In retrospect the red flags are clear. I’m listing them here because they were much more subtle in the moment, and it scares me to think we could have missed them, as they were so easy to “explain” and minimize away. Hopefully by pointing them out to you, and how easily we could have missed them, it might one day cause question in someone’s life, and save it. Just like it did for Jon.


Other people’s symptoms vary. What I’m trying to point out is how subtle heart disease symptoms can be and how easily these nuances can be missed, and how important it is to get proper medical care and diagnosis.


The three red flags we noticed happened over the span of about a week. The first red flag was when Jon and I decided to make our exercise target five miles. I thought we could help make up for some added celebratory calories by adding two miles to our workout. We did five miles effortlessly. When we stopped we both agreed we could have done a few more miles. Only this time after we were done my face was red, and Jon’s wasn’t. He looked slightly ashen. We had plenty of (wrong) explanations. Change in diet, added exercise, perhaps? Then Jon seemed back to normal after his shower and some lunch.


The following day we noticed the next flag, after a hard Yoga/Pilates work out. We took a selfie before and after. Jon did not look good after. He called the Kaiser help line. It was determined he was ok. Maybe it was too hard of a class? Maybe not enough to eat before the class? But my antennae were up.


The third was days after, when Jon and our son, Zack, were helping me set up for Christmas. Jon felt awful, wiped out. Jon is not a couch potato. He exercises regularly and he does a lot of projects around the house. He also does a lot of stair work at the track. His feeling like this after going up and down the ladder a whole bunch was inconsistent. He contacted his primary care doctor and Jon got in immediately.


After a failed EKG and a bad stress test result, it was determined Jon would have a cardiac procedure to see if there was blockage to his arteries. Jon was reluctant, I pushed heavily for this procedure, and I came across as a very pushy dominating wife–what’s new–and I didn’t care what anyone was thinking of me. It was suggested we do more tets but I was worried we’d get a misdiagnosis. This angio-plasti needed to get done. Period.


I’d like to tell you that it was a total surprise to me that Jon would ever need this procedure. After all, his blood pressure and his LDL cholesterol levels are in COMPLETELY NORMAL ranges, and always have been. Although Jon indulges in a few treats from time to time (fruit pies, fruit pies, fruit pies…and he loves a great steak), Jon’s been a health food nut since he was born in Berkeley, California to a mom that only let him eat sugar once a year, on Halloween. He’s rarely eaten processed food. He was never one to eat from a drive thru. He eats green leafy salads and/or vegetables at every meal, including breakfast. He doesn’t drink alcohol. He’s never smoked. He exercises regularly. I could easily say Jon eats 90% amazing.


However, Jon’s family has a medical history of heart disease–so, I knew what to watch out for.


Four years ago we changed up our game. We made our diet a top priority and exercise became second to breathing. We walked away from toxic situations and crazy people; you know, the ones that like to involve people in social underhanded warfare. Toxic situations and crazy people create environments that introvert you and keep you from seeing the real world. They distort and create mis-estimations of situations, and they create stress.


As a result of the changes we made, we’ve never been happier and more distraction-free. I really believe, and I can’t emphasize this enough, that if we hadn’t made all the changes we had made, when we did, then we would have been too absorbed in others’ drama to see the tiny red flags we needed to clearly see in order to keep Jon from having a massive heart attack. Even having the history of exercising together, gave us a base to know how we react to exercise so that we were able to recognize when post-workout reactions were out of the ordinary.


Now, let me be clear when Jon and I changed up our diet, the levels of change were as different as we are. Jon and I are not made of the same food groups. I love sugar and flour (I love whiskey and Scotch). Jon doesn’t. The immense dietary changes I’ve had to make have been different than Jon’s. But his diet has been is much improved these past four years, because I’ve upgraded so many of the things we eat, and even when we do indulge it’s still with better choices and with better ingredients–and more limitations. As an example, salad dressings are often made with avocado oil. Some of our cookies are made with almond butter, coconut sugar, and no flour. This isn’t all the time, we eat regular cookies from to time and other prepared salad dressings but our diet is vastly different than it was four years ago. And even when we do indulge, it’s about 1/2 a portion of anything we did before.


The day of the stents installation, Jon spent the night at the hospital, though they were willing to send him home the same day. Jon got settled into his hospital room, and out came his laptop and he got on his cell phone and called the office since it was still a workday. And I freaked out! Yep.


I was instructed by the cardiologist to wait a few days but they wanted Jon back out at the track doing a couple miles. She expected Jon out there doing his previous level of exercise within a week! We complied. And we haven’t had any problems. His rosy color is slowly coming back, and the ashen color is fading.


Five days after the cardiac procedure, Jon attended a holiday party with me. Minutes after we arrived, Jon made a new friend and I heard all the software developer geek talk I’m familiar with. For the first time ever, it sounded kind of sweet to me and it made smile.


We recently had a follow up visit to the cardiologist. I asked all sorts of questions about Jon’s health and prognosis. The cardiologist told us that Jon is no longer a cardiac patient. He has no physical restrictions or limitations. I was instructed to have him dance all night New Year’s Eve.


There are a few dietary restrictions–his dear steaks and pies are going to be fewer and further in between, but he will still have them. They’ll just be more special now. He made his famous rib roast for Christmas, though this year we froze the left overs before it got out of hand.


Because Jon has great cholesterol and blood pressure, his doctor pointed out that Jon was doing his part all along to fight the good fight, and pointed out that Jon’s genetic make-up of heart disease is luckily something modern medicine could deal with in this situation.


Don’t be surprised if you see Jon lose a bit of weight in the next year. I’m currently figuring out our plan.


I’ve also noticed Jon has a bit more energy than he did some months back. At my birthday dinner in November he seemed tired and quiet. Then, post-stents, at Christmas he was energetic, cheery and involved. Jon didn’t want to miss one single Holiday celebration this year. He made it to all we could fit in our schedule and he had a great time at all of them.


The cardiologist recently praised us for the deliberate choices we’d made in our lifestyle, Jon’s lack of medical history for his entire fifty-nine years of life, his blood work, his blood pressure.


When we left the cardiologist’s office I realized that this was the first time since the December 7th cardiac procedure that I was no longer in a state of shock. And I began to finally appreciate that because of everything we had done years before, and weeks prior, and because of freakin’ amazing modern medicine, and fabulous doctors, we were for this one situation in our life, absolutely victorious.


Absolutely victorious!


I want to give a shout out to our tribe of family and friends. Having real intelligent friends, who give unconditional love and support has allowed us to have the environment to fight real fights, not fake ones. I think fighting and and overcoming heart disease is a real battle we can all agree needs to be fought well. And, when you have to go into these sorts of real battles your close circle of friends can’t be stupid, toxic or crazy.


I think we also have a new lease on life and our priorities are going to get an even greater upgrade. One thing we both want is more face time and fun activities with our friends and family.


We don’t normally travel for the New Year. But this year feels kind of gifted, so we’re off to be with some of the dearest, most loving people in our life to celebrate all that we have and all the wonderful that is to come. And doctor’s orders are that Jon dance all night long.


Happy New Year, dear friends! May you have love and health, and keep them both!.


How My Primary Care Physician Helped Me Lose Over 150 Pounds

Grateful for the Doctor that Helped Me Change My Life,
Dr. James Kastelman

(Note: In October of this year I wrote the following as part of my gratitude thread on Facebook. Through my story, I wanted to tell my friends and family how vital it is to have a medical doctor oversee a weight loss transformation, and some of the things a doctor could and should be doing to help us change our lives; and what’s sometimes needed by our medical support teams to wake us the heck up and pop us out of our denial for whatever medical conditions we need to deal with.

Dr. Kastelman just saw a family member and ordered some life saving tests–I am not exaggerating about this. I will write more about this in the next few days. In the meantime, if you didn’t read this on FB, here it is. If you or anyone you love are going to be working on a diet and exercise plan, I can’t stress enough how important it is to get a competent primary care physician to examine you, do all the necessary blood work, tests, exams, to have all the necessary conversations, get all your questions asked and answered, and then for you to follow their instructions. Please note that I said ‘competent primary care physician’. You may have to do some extra research, like I did, in order to find one that fits that standard.)

Five years ago I selected my primary care physician after research through the Kaiser network. I needed more than a doctor to do maintenance doctor visits. I needed one that could supervise me into a healthy weight, as I needed to lose a dramatic amount of weight–without creating greater harm in the process.

For many reasons, I determined Dr. Kastelman was most qualified to help me. He had a strong interest in fitness and nutrition as part of the complete approach to overall health.

Unfortunately, at the time, Dr. Kastelman was filled to capacity with patients. I don’t know how I did it but I sweet talked him into taking a meeting me. I told Dr. K about my desire to get healthy, to lose a lot of weight and that I wanted to get fit through exercise.

With my great intentions and my winning personality, how could he not take me on as his patient? He accepted me. He seemed like one of the smartest, kindest, warmest doctors I’d ever met. Well, until I managed to piss him off.

That’s when Dr. Kastelman woke me up, and changed my life!

I had been Dr. Kastelman’s patient for about six months when I had to see him about a rash. My bestie had been in the hospital with cancer fighting for her life and I couldn’t be at the hospital with any type of contagious rash, or illness. I had been caring for her, cooking for her out of town visitors and taking care of her family. Every night, after leaving the hospital, I managed to unwind with friends and family with an alcoholic beverage (or two), a comforting meal and home made dessert.

By the time I saw Dr. Kastelman for this rash, I was up about ten pounds in weight from when he accepted me as his patient. He didn’t seem that interested in my rash–though he ruled it out as non-contagious–or my excuses. One look at him and I knew the excuses coming out of my mouth for my weight gain were futile. He told me the direction I was going in was destructive and not what he and I had agreed to. He made it perfectly clear he was not happy with me and exactly why.

For the first time in my adult life, I left my clinic visit jolted out of my denial and disconnected existence. Dr. Kastelman’s words and tone impinged upon me for days and weeks. I couldn’t shake them off. I was used to people getting mad at me for the lamest things. This was one of the few times in my life when someone was mad at me for all the right reasons, and I knew it. I didn’t realize then just how much I was affected by his attitude and his refusal to accept my “reasons”. This quick little visit to see Dr. K made such a difference in my life.

I knew I had the option to switch doctors if I wanted–I quick little email, and viola! I didn’t bother to entertain that idea, I knew it was a cop out.

I sucked it up and began to look at my life, my behaviors, and even the people I surrounded myself with.

My bestie died. With the loss of my friend, I probably could have gained another ten pounds but it was not an option for me, to see Dr. K with anything other than being with the program and showing some weight loss. I made sure the next time he saw me I weighed less than when he initially took me on as a patient. After that, I went on to lose and lose and lose.

Dr. Kastelman made sure we did all the blood work necessary to monitor my wellness and he ensured I stayed well. He guided me on staying with a nutritional diet and away from crazy fad diets. He got me to cut back on refined carbs and drastically cut down on sugar–probably the greatest impact on my weight loss. Most importantly, he kept me from becoming a diabetic. Other than the few pounds I oscillate in, I’ve managed to keep all my weight loss progress.

Since the beginning, Dr. Kastelman and I have discussed my exercise plans. He’s advised me on how to approach exercise, how to listen to my body, and what to look for. In the past five years I’ve walked, ran, rowed, done TRX, lifted weights, yoga classes, etc., and I’ve never had an injury. Not one.

I’ve fallen in love with exercise and I crave it.

In spite of being booked with patients, Dr. K has been quick to answer emails, return calls, and been very willing to take an appointment with me anytime I’ve needed it.

About a year ago in a visit, I reminded Dr. Kastelman of the time he got mad at me, and how much it meant to me. He looked up our conversation in his computer notes and smiled. He asked if he should apologize.

Um, no!

I’m in the best health of my entire adult life, and that has contributed to my overall happiness and sense of well-being. I think that speaks best to what Dr. Kastelman has meant to me.

I am eternally grateful for this smart, lovely, caring doctor that also knows when to call bull shit.

Forever grateful,
~Maricela Perry

Choose Your Hard



“Dieting and physical exercise are hard. Being fat and out-of-shape is hard. Choose your hard.”

My motto these past few years. Anytime I’ve wanted to give in, I would remind myself to choose my hard.

Which ‘hard’ is always a personal choice.

If I don’t feel ‘on plan’ about some aspect of my life, my mood when I go to bed is anywhere between slightly annoyed to majorly mad at myself, depending on the size of the self-imposed delays to my project. I don’t experience procrastination well–not that I don’t procrastinate–and I suck at making excuses for not following through. The Hubs will confirm that I’m not fun to live with when I’m disappointed, especially with myself. I’ve come to realize it takes more energy to NOT DO projects as I intend them, due to all the internal turmoil, than it takes to just do them and gain a feeling of personal satisfaction and pride.

When I’ve excused my way out of doing a workout, or gone ‘off-plan’ on my nutrition, I’ve experienced regret. It’s just how I am when I set goals and don’t live up to them. And I don’t think it’s a bad thing. Regret and owning up to things is how we process our actions so that we can appreciate better choices. I had to learn to experience regret and then let it go–a pivotal point for moving forward and creating improvement.

I find that once I get back ‘on plan’ that after a few days of eating well and doing my workouts, I go to bed happy with myself. Maybe all the yummy endorphins and nutrition make me feel satiated and at peace with myself. Or maybe it’s the personal respect of keeping my own promises.

There hasn’t been one single workout I’ve regretted. Not one.

There hasn’t been a time when I’ve made a nutritional meal choice that I’ve regretted.

I’ve just never had a nice piece of wild salmon with a great salad, and then thought to myself, “That sucked. Why did I eat that?” Or left the track and thought, “Why did I run three miles today? What a waste of my time?!”

Never happened. Not once.

There’s a saying in the fitness world, “The only workout you regret is the one you didn’t do.”