Adjusting to a 'new normal' during the holidays after a heart attack, stroke

On the first Christmas after she suffered a major stroke, Chris Richards was determined to craft her traditional family celebration at their home in Laramie, Wyoming, rising at 5 a.m. for a day of baking, cooking and wrapping presents.

"I was trying to prove I could still do it all myself," Chris said.

"Everyone was trying to help, but pretty soon she was shooing everybody out of the kitchen," said Loren, her husband. "We weren't doing it the way she would be doing it."

That night Chris wound up in the emergency room, exhausted, suffering chest pain and fearful she was having a heart attack.

She wasn't, but the Richards family learned a lesson that everyone with cardiac or stroke issues should heed during the holidays: "You can still have your traditions, but things are going to change," said her daughter, Brittany Board. "There's going to be a new normal."

That's the message that Melissa Carry, M.D., emphasizes this time of year. Carry, a cardiologist at the Baylor Jack and Jane Hamilton Heart and Vascular Hospital in Dallas, said many of her patients have already made lifestyle changes to protect their health, but need a reminder when the holidays come around.

"I tell them when you start thinking about what you're going to do for the holidays, it's not about being perfect," she said. "You have to try to tone it down."

That means limiting stress by not overbooking too many holiday events, Carry said. It means not comparing yourself to Martha Stewart when you prepare your holiday home. And perhaps most of all, it means thinking twice, and maybe a third time, at the dinner table and the bar.

Disregarding the advice invites many health consequences.

Carry said the body responds to stress by producing adrenaline, a hormone that increases strength and awareness to help deal with a crisis. But too much adrenaline over an extended period causes problems ranging from anxiety to headaches to heart disease.

"As adrenaline levels go up, blood pressure goes up," she said. "Then you add a bunch of fatty food on top of it and your arteries become unstable. You can have a heart attack. This is our busiest time of the year because people don't handle the stress of the holidays well."

Alcohol, meanwhile, "is actually a toxin to the heart," Carry said. "You can drink too much and go into atrial fibrillation (an irregular heartbeat that increases the risk for stroke). We call it 'holiday heart syndrome' and we see it a lot around Christmas."

Carry has always told her patients not to overeat or drink to excess during the holiday season, and to work in some exercise to relieve stress. In these hyper-partisan times, she has another recommendation to bring to the dinner table.

"I'm going to start telling them, here are some safe topics to talk about," she joked. "No politics, no religion. Let's not get upset."

But the responsibility doesn't just rest with people who have health issues. Carry said family, friends and caregivers need to pay attention as well.

"Someone who's had a stroke or a heart attack that weakened their heart or impaired their abilities may try to do what they did in the past, and they're frustrated because they're not able to," she said. "I have to remind them, 'You've already done this for 40 years. It's time for somebody else to step up and do it.'"

The Richards family said they tried that first year after Chris's stroke, but gave in too easily. They haven't made the same mistake since.

"Before the stroke we'd sit on the couch and ask if she needed something and she'd say, 'No I have it,'" Brittany said. "Now we don't ask. We all pitch in a lot more. You have to stay aware as a caregiver, making sure they don't overdo it."

The result, she said, is a better Christmas.

"It's made us closer," Brittany said. "We're able to step back and say we're having another holiday together and that's what matters. In 2014 (when Chris suffered the stroke), we weren't sure if we ever would."

Loren agrees, with one wry addendum. "Everybody pitches in," he said. "But we still do it her way."