Dave Baker: Racing to Win Back His Heart and Life
BY Gretchen Nash
For Dave Baker time is precious. But then again keeping time means everything to an athlete who’s trained for and raced in triathlons for more than 20 years. Baker is an icon of physical fitness and clean living; his 207-pound compact frame broad grin and positive attitude make him seem larger than life. That’s a good thing since he’s in the business of saving lives. He is the Ocean Rescue director firefighter and E.M.T. for the town of Wrightsville Beach. And for a man of such strength and endurance he is also a man with a big heart — just not a healthy heart. In May 2007 at age 49 Baker was faced with a challenge that he could not win alone. While participating in the Surf and Turf Spring Triathlon in Surf City North Carolina he was so overcome by fatigue and tightness in his chest that for the first time in his life he did not finish the race. “I thought I was over-trained ” says Baker. “And I thought ‘I’m probably going to get sick. No need to push it anymore.’” Three days later at the beginning of the new training season for Ocean Rescue Baker ran the usual seven miles with his lifeguards. Afterward when he simply could not recover he consulted his family doctor. The routine test results looked good but he decided to check in with a cardiologist just to be sure. Two and a half weeks after the triathlon Baker visited cardiologist Dr. Tim Winslow and had an EKG which showed extensive recent myocardial infarction — heart muscle tissue death due to acute deprivation of circulating blood. Next Baker received an echocardiogram or ultrasound. The cause of his fatigue was shockingly apparent on the screen. “And that is probably one of the visuals that sticks with me ” Baker says “seeing your heart working except this one area. Everything else is squishing and then that’s just nothing.” He squeezes his large fist as if pumping blood and then his hand remains clenched immobile. Even though Baker was asymptomatic when he arrived at the cardiologist’s office he did have typical symptoms of a heart attack according to Dr. Winslow. “Most patients with heart attacks have a discomfort that consists of a tightness heaviness or pressure in their chest that is often uncomfortable but frequently not painful. As such many people assume the symptoms are due to indigestion and do not seek medical attention. The media often does the public a disservice by portraying people with heart attacks as clutching their chest with severe discomfort when in fact the symptoms are frequently much more insidious.” And despite Baker’s level of fitness he still had risk factors for heart disease. He had a low-to-normal HDL (good cholesterol) level especially for someone with an active lifestyle; he was overweight at 248 lbs.; and he had a family history of heart disease says Winslow. Baker was on a New Hanover Regional Medical Center (NHRMC) surgery table by 3:30 p.m. An angiogram showed that the proximal left anterior descending artery — often referred to as the “widow maker” — was 100 percent blocked. When the artery is completely blocked it leads to a massive heart attack which often results in death. “To screen people who are concerned about their risk for heart disease who have or don’t have known risk factors and who are asymptomatic I would generally recommend a fasting lipid profile to analyze cholesterol levels (HDL and LDL as well as triglycerides) and would suggest a C-reactive protein level (a blood test that checks an inflammatory biomarker that has been shown to correlate with increasing cardiac risk when elevated). For more sophisticated screening I would add a coronary calcium score obtained by ultrafast CT or a CT angiogram. Unfortunately most insurance plans will not pay for CT studies. We are in the process at NHRMC of adding a coronary calcium screening program for which we will charge a modest cash fee to encourage wider use of screening exams. Prevention remains the cornerstone for treating heart disease and everyone should strive for an ideal body weight a low fat diet and regular physical activity.” His heart also suffered extensive damage consistent with a very large heart attack explains Dr. Winslow. Winslow’s partner Dr. Bill Buchanan reopened the artery with an angioplasty and inserted a stent to help keep the artery open. In 10 days Baker was back at work on limited duty. For the next four months he was a regular at NHRMC’s cardiac rehabilitation program where a team of nutritionists and exercise physiologists helped him to adjust his physical medical and nutritional habits to living a life with a permanently damaged heart. “Those individuals are the unsung heroes ” says Baker. “I’ve gone back and gotten just teary-eyed. I still do just talking about it.” He was advised that while his quality of life and exercise regimen were uncertain the current goal was to get him beyond just walking from the car to the mall. Without faltering Baker said to the group “Well I want to be able to run a 5K.” Looking back “They didn’t know what they were getting when they got me ” he says. At rehab he worked out while hooked up to a heart monitor. At first Baker could only walk 200 feet before losing his breath. When he surpassed the car-to-mall goal he worked toward and ran a 5K. Finally on his last day at rehab he set a new goal. “All right ” he declared to the rehab team. “I’m running a 10K and I’m running it in under an hour. Just watch the monitor.” He ran it in 58.40 minutes and still has the computer printout at home to prove it. After rehab he was allowed to work out on his own without a heart monitor but he was given strict orders to never go over 75-percent effort in his training or racing. He followed the new parameters given to him by the rehab team: He adopted the new rules of eating trained correctly took his heart medication and stepped back to appreciate the big picture. “You look at grains of sand differently the way the waves break what the wind does ” he says gazing out over the ocean. “You appreciate days. You appreciate moments. And it is just a great feeling.” On May 17 2008 about a year after his heart surgery Baker competed in a half-Iron Man distance triathlon. This time he only suffered cramping in his quads and a serious cut across his big toe and he finished the race. Two weeks later Baker found himself in the same Surf City Surf and Turf Spring Triathlon he almost lost his life to a year before. He admits that starting the race was emotionally difficult for him. But once he broke the barriers of doubt and fear he says the race was a “true affirmation of life.” Baker finished the race this time and came in second place. “And to finish second is just icing on the cake ” he says. “Why Dave is able to live a normal active life at this point when others with his condition have limiting symptoms is unexplainable but likely related to his pre-MI (myocardial infarction) fitness level determination and extraordinarily positive attitude ” says Winslow. He and Buchanan are both active and participate in triathlons as well. “A regimen of appropriate medical therapy is also very important. Dave is definitely a ‘glass is half full’ guy in his perspective and I truly believe that has a lot to do with his recovery.”
Dr. Tim Winslow with Coastal Cardiology Associates in Wilmington: