On Valentine's Day 2005 I nearly died from a 'widowmaker' heart attack--I was 57 but have lived to see another 20 years and counting

This may be the most important thing I'll ever tell you: Take care of your ticker. Low-risk PCa isn't likely to kill you. But heart disease most likely has a target on your back and mine.

By Howard Wolinsky

Twenty years ago today, at age 57, I should have died from a widowmaker heart attack.

I had been an exerciser for 30+ years. I followed a heart-healthy diet. My cholesterol and weight were good. But even though I had done everything right, I nearly died.

The survival rate for a widowmaker heart attack is around 12% when it occurs outside of a hospital. Mine happened at home on Valentine’s Day, 2005.

I have lived to see another day. In fact, more than 7,305 days. And counting.

My diagnosis with low-risk prostate cancer came five years later.

Most guys freak out if they get a prostate cancer diagnosis, even with a lame Gleason 6. The Big C in any form can be a killjoy, if not and out-and-out killer.

But I’m telling you, if you’re looking over your shoulder at threats to your life, watch out for heart disease.

Heart disease is the No. 1 killer in the U.S. for men and women. The main cause is heart attacks. About 360,000 American men die from heart disease annually.

The number of men who die from prostate cancer annually is about 36,000, mainly in men with advanced disease. Gleason 6/Grade Group 1 PCa virtually never spreads or kills. (Still: Never save never.)

We fuss about low-grade prostate cancer but we need to take care of our tickers. A heart-healthy diet and heart-healthy exercise offers a bonus: It help slow progression of prostate cancer.

I am re-running an article I wrote about my MI experience for the Chicago Sun-Times. The original article saved lives and got me involved for the first time in personal health journalism. I got phone calls from women who remembered my message and experience and brought their husbands to the hospital ER STAT when they recognized what was going on.

I hope reprinting this column for The Active Surveillor community can help save some men with PCa from dying from heart disease. I hope we’ll die from “natural causes.”

I know several men who have heart disease, prostate cancer, and type 2 diabetes—all inflammatory diseases. Get motivated and try to reduce risks for that trifecta.

March 28, 2005

Reporter's brush with death holds lessons for life
Healthful behavior, misleading symptoms mask heart attack

By Howard Wolinsky

My obituary should have run on Valentine's Day.

It would have gone something like this: "Howard Wolinsky, 57, a
veteran Sun-Times staffer, among the first reporters to cover the
AIDS crisis and the emergence of the Internet, died Sunday from a
heart attack."

Things could have turned out that way. But thanks to some good
luck, and the fact that I was in good health overall, my time
wasn't up. As Blue Grass singer Ralph Stanley put it, death "spared
me over till another year."

"Do you know how lucky you were?" asked Dr. A. Tom Petropulos, a
good-hearted cardiologist at Christ Hospital in Oak Lawn.

He explained that a blood clot in my left anterior descending
artery, one of the three major arteries that feed the heart, had
nearly choked off blood flow. "They call it the widow maker," said
Petropulos, emphasizing how close my call was.

It was a heart attack that shouldn't have happened. I had done
everything in my control to prevent a heart attack.

My diet is as bland, and cardiac correct, as oatmeal and ground
flax with soy -- not cow's -- milk and blueberries. I eat all of
those servings of vegetables and fruits each day that you've been
hearing about. I eat salmon twice a week and no red meat. I have
never smoked.

Warning clouds

My weight is where it should be. My blood pressure is low. My
cholesterol is fine, too, thanks to cholesterol-cutting medicine
and regular exercise. A heart doctor told me back in November that
heart attacks were unheard of in people whose "bad" -- low density
lipoprotein -- is as low as mine.

The picture I've just painted is bright. But there were some
warning clouds.

Genes can trump good intentions and actions. My father had a
massive heart attack around the time of his retirement. He died
from congestive heart failure just before his 80th birthday.

Last September, I had a "virtual cardiac angiogram," a
controversial new test from Greenberg Radiology in Highland Park.

I had suggested to my family doctor that I undergo one of those
widely advertised cardiac scans. She said it wasn't worth the
trouble because I'd have to pay for it out-of-pocket and my
treatment wouldn't be any different.

I got a second opinion from Dr. Brent Greenberg, a pioneering
radiologist I have known for 20 years, back when I covered health
care for the Sun-Times. He invited me to be among the guinea pigs
to help calibrate his new system.

The test showed a "soft plaque," a rogue capsule of cholesterol and
other fatty compounds. This capsule had the potential to break up
and form blood clots that can block blood vessels and trigger heart
attacks.

Greenberg urged me to have my physician refer me for an exercise
stress test. I had one in November that yielded confusing results.

I had some electrical irregularities on the traditional stress
test, but my heart looked normal on a sophisticated scan.

What to do? The cardiologist said it wasn't worth the risk of
undergoing an invasive angiogram. He told me after my heart attack
that an angiogram wasn't in order because I had no symptoms.

On his advice, I started taking aspirin. But in mid-January, I
underwent a colonoscopy to look for polyps. This was a real concern
for me since my mother was killed by a combo of colon and breast cancer.

As part of the preparation for that test, I stopped taking aspirin.
And I didn't resume taking it after the test. Aspirin just wasn't a
habit yet. This turned out to be a big mistake.

On Feb. 13, I started to have some unusual symptoms. I had a sharp
but transitory pain in my head after riding my exercise bike for 10
minutes. I stopped. I felt my head. I had a slight fever. I
realized that despite having had a flu shot last fall, I apparently
had the flu.

Later that day, my head hurt again.

Aspirin a life-saver

Then I had tightness in my chest. It was brief. It didn't hurt a
lot. I thought it might have been from coughing.

Then my right arm felt tight in the elbow, and a pain shot down my
arm. It only lasted a couple minutes.

I knew that a pain in the left arm is a sign for a heart attack. It
turns out that one in the right arm also is a symptom.

I took an aspirin as an insurance policy. At worst, I thought it
might help bring down the fever.

"That was smart. That's standard treatment when paramedics treat a
patient with chest pain," a cardiologist in the hospital told me
days later. He said the aspirin probably saved my life by
preventing the artery from being completely blocked.

Meanwhile, I still thought I had the flu. I stayed home for two
days and then returned to work. I again had a mild chest pain while
walking to the Sun-Times building.

The next day, I went to see my family doctor. I knew I'd get in
quickly when I reported chest pain. But the doctor was distracted
by the headache. She thought I might be having a stroke and sent me
to the ER.

Once CT results ruled out a stroke, the emergency room physician
ordered some blood tests. My level of CPK, an enzyme used to
diagnose heart attack, was completely normal. But a newer test for
troponin, another enzyme released when there is heart, brain or
kidney damage, was slightly elevated, a sign of a mild heart
attack.

Next, an angiogram showed a 90 percent blockage in two blood
vessels. I had two stents implanted to open vessels.

The cause of my heart attack remains unknown. That soft plaque
might have broken up. Another possibility is that my immune system,
switched on by the flu, threw a blood clot. I'll never know.

Training pays off

Now, weeks later, I am back to work full-time.

One of our columnists asked me: "Having second thoughts about the
health kick?"

I knew what he meant. Here, I did just about everything I could
right and still had a heart attack. Maybe I should have enjoyed
some cheeseburgers.

But I have no regrets. Although I had considered myself in training
to prevent a heart attack, it turns out my training paid off in
helping to minimize one.

Colleagues and health professionals alike have suggested that I
write about my experience. It might help to know that heart attacks
come with many different symptoms, including pain in either arm,
the chest, the back, the jaw, the armpit. Sometimes, what seems
like indigestion may be a heart attack.

The point is it's worth checking out any unusual symptom.

Petropulos, the philosopher/cardiologist, told me: "You either must
have done some good in your life, sir, or you're going to."

If this article persuades a reader or two to check out a symptom,
quit smoking, improve their diet or take an aspirin a day, that
could be my "good thing."

POSTSCRIPT: Sad to report that Dr. Petropulos, one of the top cardiologists in Chicago area, died at age 69 nine years after we met. He had posted my article on the front door to his office. Read his obit here. He died from ALS. I think Dr. P. would have appreciated my efforts to spare men from aggressive prostate treatment and also to help them reduce their risks of dying from heart disease.

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For women only: Team up with the Wolinskys against prostate cancer

By Howard Wolinsky

As many webinars and support meetings as I have done on Active Surveillance for low-risk prostate cancer, I have never done one with my wife, Judi.

That’s changing on Tuesday, February 18, 2025 at 8:00 PM Eastern during the ONLINE WOMEN’S SUPPORT GROUP for Fans for the Cure.

Judi and I have been invited to speak to the group.

We want to invite women with spouses/partners/support givers who have prostate cancer, especially those partners on Active Surveillance for lower-risk prostate cancers. Register here: https://fansforthecure.org/online-womens-support-group-registration/

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Don’t miss the upcoming ASPI webinar on Gleason 3+4=7 and AS

By Howard Wolinsky

Kevin Ginsburg, MD, urologic oncologist at the Karmanos Cancer Institute/Wayne State University in Detroit, will be presenting a webinar for Active Surveillance Patients International (ASPI) entitled “Is favorable intermediate-risk PCa the future of AS?"

The program will be held from —12-1:30 pm Eastern, Saturday, Feb. 22. Celebrate President George Washington’s birthday with ASPI.

To register, go to: https://aspatients.org/event/is-favorable-intermediate-risk-pca-the-future-of-as/

Ginsburg is J. Edson Pontes, M.D., Distinguished Endowed Chair in Men's Health at Wayne State and co-director of the MUSIC prostate program.

(Dr. Kevin Ginsburg, co-director of the very successful MUSIC program in Michigan.)

MUSIC (Michigan Urological Surgery Improvement Collaborative) has been one of the most successful U.S. programs for Active Surveillance. Over 90% of patients with low-risk prostate cancer in its program go on AS vs. 60% nationally. Likewise, MUSIC has been successful in offering AS to patients with favorable intermediate-risk prostate cancer at a rate of about 45% compared with 20% nationally.

In 2023, ASPI presented MUSIC with its first ASPI AS ADVOCACY AWARD for its advances in researching and promoting Active Surveillance for lower-risk patients in place of aggressive treatments.

Check out my new Substack newsletter Prostate Cores, abstracts on research on PCa, biopsies, BPH, prostatitis.