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After a heart attack, Kevin Smith shared a touching message about life and gratitude.

'Don't silence the Bob yet.'

In the early morning hours of Feb. 26, filmmaker Kevin Smith tweeted a photo from his hospital bed. Apparently, he'd had a "massive" heart attack.

After the first of two scheduled comedy sets at Glendale, California's Alex Theatre, Smith could tell something was wrong. On Facebook, he wrote that he felt nauseous. "I threw up a little but it didn't seem to help," he wrote. "Then I started sweating buckets and my chest felt heavy."

He didn't know it at the time, but he was having a heart attack. After making his way to a nearby hospital, he learned that he had a 100% blockage of his left anterior descending (LAD) artery. Had he not gotten medical attention when he did, he could have died.

He continued his post by reflecting on life, death, what he appreciated and what he'd miss out on if his time came:

"[E]ven as they cut into my groin to slip a stent into the lethal Widow-Maker, I was filled with a sense of calm. I’ve had a great life: loved by parents who raised me to become the individual I am. I’ve had a weird, wonderful career in all sorts of media, amazing friends, the best wife in the world and an incredible daughter who made me a Dad. But as I stared into the infinite, I realized I was relatively content. ... But generally speaking, I was okay with the end, if this was gonna be it. I’ve gotten to do so many cool things and I’ve had so many adventures — how could I be shitty about finally paying the tab. ... I faced my greatest fear tonight... and it wasn’t as bad as I’ve always imagined it’d be. I don’t want my life to end but if it ends, I can’t complain. It was such a gift."

Friends and well-wishers offered thoughts, support, and gratitude.

"Clerks" star Brian O'Halloran said, "Don't silence the Bob yet," a nod to Smith's character, Silent Bob.

TV personality Chris Hardwick and actor Josh Gad offered well wishes and a speedy recovery.

Rosie O'Donnell, having experienced the same kind of blockage five years ago, offered solidarity with Smith.

Heart attacks aren't always big, obvious, dramatic events. As was the case in Smith's situation, they can be sneaky. That's why it's important to spot the warning signs.

The Centers for Disease Control and Prevention lists five things to keep an eye out for when it comes to heart attacks:

  • Pain or discomfort in the jaw, neck, or back.
  • Feeling weak, light-headed or faint.
  • Chest pain or discomfort.
  • Pain or discomfort in arms or shoulder.
  • Shortness of breath.

Other possible symptoms include indigestion, heartburn, nausea and vomiting, and extreme fatigue. Women are a bit more likely to notice and experience shortness of breath, nausea, and back/jaw pain. The CDC recommends calling 911 if you notice those symptoms in yourself or someone else around you and says that medical professionals will be best suited to assess the situation through tests.

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Her chronic illness helped her understand just how important preventive care is.

True
Cigna 2017

When Terran Lamp was just three weeks old, she was admitted to the University of Virginia newborn special care unit.

There, doctors discovered that, along with some other health issues, Lamp had been born with two holes in her heart — which would have huge implications throughout her life and inform how she thought about her health and preventive care.

Image by Ted Catanazaro courtesy of Terran Lamp, used with permission.

She stayed in the hospital for three months after the diagnosis. By age 4, she had already had two open heart surgeries, gone into complete heart block, and received an implanted pacemaker.

Just as she was learning to live her life managing one serious illness, she was diagnosed at age 10 with a benign dermoid brain tumor — and then, more recently, with breast cancer.

But while Lamp has had way more than her fair share of hardships, today she does her best to stay as healthy as she can by taking control of her health.

As a child, Lamp says, the constant worrying about her health taught her a valuable lesson about living with a chronic condition (a lesson that can help us all).

It taught her that if she still wanted to do things, like run and travel, she would have to take control of her health and not let being sick completely define her. "I can't not have it, but I can not be restricted by it," she says. "Heart disease doesn't have me. I have heart disease."

So she joined the state champion track team, she went to a college some distance away from her mom, and later, she travelled to Germany and California. Claiming this little bit of independence helped her feel like she was in control of her health and her life.

But to do this meant learning a lot about preventive care.

"I'm at the doctor probably every three months," she says, but these doctors are not just specialists to treat her heart and her cancer.

She also sees a general practitioner for an annual check-up, who helps her monitor her four health numbers: blood pressure (too low, in her case, could signify a problem with her pacemaker), cholesterol, body mass index (BMI), and blood sugar levels.

She also tries to stay active in order to stay healthy.

Image courtesy of Terran Lamp, used with permission.

She works out at the gym four to five times a week and runs half-marathons. "I can't always run [the entire way]," she says. "But I complete them. I'm a finisher, even if I end up walking for most of it. That way, I feel like I've done something."

And now, Lamp is working to help other women stay healthy too.

She got involved with the National Coalition for Women with Heart Disease and became a WomenHeart Champion. She wants to help educate other women about the importance of preventive care and motivate other women with heart disease to keep thriving despite their diagnosis by sharing her story and what she does to try to stay healthy.

"I know what it is like, first and foremost, to be a patient," she says. "That's why I do so much for WomenHeart. That's why I tell my story ... and that's why I encourage women to go out and get checked for heart disease, so it does not go unnoticed."

As a WomenHeart Champion, she can meet other women with heart disease, offer advice and help pass along important information so that no one overlooks a possible symptom.

For example, she says, she recently met a flight attendant through her work as a WomenHeart Champion who volunteered that she was a little worried about her health. "She said, I'm a little concerned because about 25,000 feet, the left side of my face goes numb," Lamp remembers, "and she was all nonchalant about it." But immediately, Lamp felt compelled to push her to see a doctor to figure out what was causing this numbness.

To Lamp, the peer-to-peer advocacy is a very powerful tool because it allows women to look out for each other.

"We have got to make sure that we are paying attention [to our health] and we have to make sure that we are passing along that attention and that awareness," she adds.

That way, she says, maybe we can help more people take control of their health before they ever get sick in the first place.

Learn more about how to take control of your health at Cigna.com/TakeControl.

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A doctor cuts through the conflicting science on cholesterol.

True
Cigna 2017

It’s easy to feel like there’s too much to keep track of when it comes to staying healthy.

Calories, fat, pounds, carbs, miles, steps — it's easy to get overwhelmed with conflicting science and false health fads. So the more complicated things, like cholesterol, often get overlooked.

Cholesterol plays a surprisingly large part in your overall health, and knowing and managing your cholesterol level (plus your other three health numbers — blood glucose, blood pressure, and body mass index) can help prevent health problems down the line. We chatted with Dr. Christina Stasiuk, senior medical director at Cigna, to learn more.

Image via iStock.

Here are 13 interesting facts about the role cholesterol plays in your body's health.

1. Cholesterol was first discovered in 1784, so scientists and doctors have been studying it for a long time.

There are two major sub-types of cholesterol: good (high-density lipoprotein, or HDL) and bad (low-density lipoprotein, or LDL, and triglycerides). Bad cholesterol is a fatty substance that can stick to the linings of your arteries and veins, whereas good cholesterol acts as a sort of broom that helps scrub away those LDL buildups in your body.

Image via iStock.

2. Your weight isn’t an indicator of your cholesterol level or overall health.

“There are thin people who are at higher risk of heart disease than people who may be overweight but who exercise, don’t smoke, and have normal blood pressure,” says Stasiuk. The only way to know your cholesterol levels for sure is through a blood test.

3. Your body makes all the cholesterol it needs on its own.

The body makes both good and bad cholesterol, as they’re both needed to help perform a lot of the body's necessary functions. It's only when we consume too much LDL and triglycerides that it becomes “bad” by forming harmful buildup in our veins and arteries.

4. Clogged arteries look like they’re coated in butter.

If your body doesn’t have enough good cholesterol to scrub away sticky buildups, your arteries become clogged with yellow plaque-like fat. If you could slice open a clogged artery and look inside, it would look like it was filled with a thick layer of frozen butter. Uh ... yum?

5. You could end up with high cholesterol regardless of your healthy habits — thanks, genetics!

“Familial hypercholesterolemia” is a genetic condition that causes naturally high levels of bad cholesterol. A heart-healthy lifestyle can help, but people with a predisposition for high cholesterol usually also need medication.

Lots of other genetic factors affect heart health too, so the only way to know for sure that your heart is healthy is to consult your doctor.

Image via iStock.

6. Your body can generate good cholesterol with regular exercise.

According to Stasiuk, there are really no foods or drugs that significantly increase good cholesterol levels. Regular exercise, however, can help the body create the good cholesterol it needs.

7. When it comes to eats, the richest foods are usually the worst for you.

"Bad cholesterol is typically animal-source cholesterol," says Stasiuk. "The solid stuff — the bacon fat, the fat around a steak. You're better off having liquid fats, like olive or canola oil or the oily fats you get in fish." Solid fats are the ones most likely to "stick," while liquid fats can be cleaned out of the body more easily.

Image via iStock.

8. Look out for the cholesterol double-whammy: the trans fatty acid.

Two things to look for on nutrition labels are saturated fat and trans fats, both of which raise your LDL levels. But trans fats also lower your HDL, pulling double-duty against your cholesterol health. And both saturated fat and trans fats show up in manufactured foods you might not expect because they help lengthen shelf life. "Think about it this way," says Stasiuk. "The amount of time that food lasts on the shelf is how long those lipids will be in your body." Ack!

9. One surprising source of high cholesterol? Coffee.

Don’t worry. Only when it’s unfiltered, like in Turkish or French press coffee, does your morning joe contain a harmful substance called cafestol, which raises bad cholesterol. If you drink drip coffee, you’re good to go. The filter catches cafestol before it hits your cup.

Photo by Jen/Flickr.

10. Certain foods can help pull bad cholesterol out of the bloodstream and send it out of the body (and it’s not just Cheerios).

Salmon, oatmeal, berries, avocados, beans, nuts, and spinach are all power workers when it comes to scrubbing and flushing out all those sticky cholesterol particles.

11. Women are at a generally lower risk for bad cholesterol levels and heart disease than men — that is, until menopause.

Estrogen helps balance good and bad cholesterol levels in women's bodies. Once menopause occurs and estrogen levels drop, women's cholesterol levels and risk of heart disease rise.

Image via iStock.

12. Cholesterol also plays a big role in keeping your brain healthy. In fact, about 25% of the cholesterol in your body is stored in your brain.

Cholesterol is a structural component of myelin, which is the protective substance that covers the nerve fibers in your brain. Strong myelin sheaths help the brain function, facilitating things like memory and quick thinking.

13. Laughter might be good for your heart.

Research suggests that laughter can trigger a variety of heart healthy reactions in the body. It decreases stress hormones, reduces artery inflammation, and increases good cholesterol. So if you can’t fit in a workout today, make sure you get in a laugh!

The most important part of maintaining good cholesterol health is to be aware of it and, where you can, make lifestyle choices that support it.

It's not about counting milligrams or calculating intake levels — it's about making lifestyle choices that benefit you and your body. "It all comes back to this: go, know, and take control," says Stasiuk. Get your blood tested during annual checkups with your doctor and take the time to make sure you understand your results. Then make small, progressive steps toward better heart health. Nothing drastic and no special secrets — just little changes toward treating your body right!

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She went a whole day not knowing she was having a heart attack. And she's not alone.

True
Cigna 2017

Beatriz Martinez was exercising at the gym one day when she suddenly felt unusually breathless and a little dizzy and got a pain in her stomach.

She stopped and took a minute to breathe, which made her feel a little better. But the pain was still there. Maybe she had pushed herself too hard and pulled a muscle?

"I thought it was the exercises, a muscle ache," says Beatriz. So, she decided to call it quits for the day and drove home.

Beatriz Martinez in her home in Miami. Image via Beatriz Martinez, used with permission.

She made lunch, washed her hair, and went about the whole day like everything was normal — even though the dull ache in her stomach never really went away. That evening, she and her husband even went to a party. But at that point, the pain had gotten worse, and by the time they went home, she was vomiting and the pain had spread to her chest.

They went straight to the emergency room.

At the hospital, they ran some tests — and Beatriz was told she was having a heart attack.

One of the most important arteries in her heart, the left anterior descending (LAD), was completely blocked. "That I'm alive, it's like a miracle," she says.

She had a stent put in and she was in recovery at the hospital for six days before she was able to go home again.

Beatriz's story is not uncommon.

Heart disease is actually one of the most common causes of death for women in the United States. But in some cases, it can be prevented — which is why preventive health care is so important.

Image via iStock.

"What creates problems for people are the things that they don't know and therefore can't change," says Dr. Nicholas Gettas, a family doctor who is now a medical officer at Cigna.

With health issues, such as heart disease, it is the cumulative effect over time of risk factors, such as high blood pressure, high cholesterol, or diabetes, that can cause a problem — like a heart attack. That’s why it is important to be informed about your four health numbers: blood pressure, cholesterol, blood sugar, and body mass index (BMI).

Image via iStock.

Even if you eat well and exercise, it's still worth getting checked. "You might see a person who is thin, who exercises, whose diet appears to be great ... [but] there is some genetic issue that means that their cholesterol is still high," says Gettas. In fact, he adds, he had a patient with a similar experience.

"The earlier you identify, the earlier you can moderate and modify the issue and the more likely you are to get a better long-term result," he says.

According to the Centers of Disease Control and Prevention (CDC), if everyone got their recommended preventive care, we could probably save 100,000 lives in America every year.

Beatriz's experience taught her a lot about the importance of keeping an eye on her health.

Even at the hospital, when everyone was rushing around to treat her, Beatriz says she couldn't help but think they were overreacting because she still didn't think it was that serious.

"I never thought that I had anything wrong with my heart," Beatriz says. She had always thought of herself as healthy: She was active, she exercised regularly, and she wasn't overweight.

Image via iStock.

She was also unaware of something very important: The symptoms of a heart attack are often very different for women than they are for men.

Most of the heart attack indicators we hear about are actually what happens when men have a heart attack — such as the left arm going numb or the obvious severe chest pain. In women, heart attack symptoms can be more subtle, as Beatriz experienced:

  • The pain isn't always in the chest. It can be in the neck, jaw, upper back, or stomach region.
  • Sometimes it just feels like a bad case of indigestion.
  • Other times it just causes shortness of breath — which is sometimes mistaken as a panic attack — or dizziness.
  • It can also cause nausea and vomiting.

This means women are more likely to ignore their pain or downplay the symptoms, causing a dangerous delay in treatment that can be deadly. In fact, according to the Mayo Clinic, women often show up in emergency roomsafter heart damage has already occurred.

Image via iStock.

But there are some warning signs — Beatriz just didn’t know to look for them.

"Before I had the heart attack, I felt breathless a lot and had pain in my jaw, but I didn’t pay attention to that because I didn’t know that was symptoms of your heart," she says. There was also a history of heart disease in her family, she adds, "but I never thought I was going to have it in my life. I never thought it would happen to me."

Beatriz wants other women to know the risk factors for heart disease before a health incident makes them all too aware of it.

She has gotten involved with the National Coalition for Women with Heart Disease and has become a WomenHeart Champion. She wants to spread awareness about heart health and the symptoms of heart disease to women across the United States. And she wants to encourage them to take control of their health before they ever get sick.

Image via Beatriz Martinez, used with permission.

It has been almost five years since Beatriz had her heart attack, and she says she's come a long way in terms of taking control of her health.

She started on medication and a special diet immediately after the heart attack. And now, not only does she go to the gym, but she also does aerobics three times a week, and she works with a personal trainer three hours a week. With the help of her doctor, she also keeps close tabs on her four health numbers. And now that Martinez has taken control, her health has never been better.

"I went to my cardiologist [recently] and he said that now, my cholesterol numbers are excellent, my blood sugar is excellent — my numbers are excellent," she says.

Beatriz says that the one thing her heart attack taught her was that she can’t become complacent about her health. "You can die if you don't take care of yourself," she says.

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