Heart failure. It was not the diagnosis that Reverend Adam Leeper, a 55-year-old hospice chaplain in Chambersburg, PA, says he expected in any way.
The triathlete had competed in swim meets in high school and even trained for the 1984 Olympics—and since then, Leeper had been doing laps, bicycling, or running most days of the week. Regular checkups showed his health to be good, and his heart seemingly strong.
Through the years, he occasionally experienced chest pain and shortness of breath, but blood tests and other examinations never found anything amiss. His pulse was steady and low, as would be expected in a trained athlete, and EKG (electrocardiogram) readings, which measure the heart’s electrical activity, weren’t unusual in any way. His performance on exercise stress tests (to see how his heart handled exertion) was better than men half his age.
“I thought it was just aging,” Leeper says.
A New Test Exposes the Truth
Then, after a particularly intense bout of symptoms in 2010, Leeper’s doctor said it was probably best that they get actual images of his heart to be sure everything was OK. He climbed the steps to the second floor of the local cardiologist office—no need to take the elevator—to get the echocardiogram done.
The images the sonogram captured were startling but clear: Despite looking and feeling pretty good, his heart was in bad shape. He had cardiomyopathy, a disease of the heart muscle, which led to heart failure. "We don't know what caused it in me,” he says. “Maybe it's congenital, or maybe I had an infection."
Basically, his heart no longer pumped enough blood out to his body so it could function normally. His ejection fraction—a measure of the percentage of blood exiting the heart with each contraction—was 25, which is very low; a normal range is between 55 and 75. “When it gets under 20,” Leeper says, “the doctors start to consider heart transplantation.”
“Two Sides of the Coin”
Reflecting on the years he felt occasionally sluggish and out of sorts, Leeper says he thinks his endurance training both hid his problems—and helped him continue feeling pretty well.
“I think there are two sides of the coin,” he says. “Because it masked some things, the heart failure took longer to diagnose, but it also allowed me to function better. And I think I got used to being in oxygen debt. [Heart failure means your tissues don’t get the oxygen and nutrients they need.] You get tired, but you still just do stuff.”
Since the diagnosis, he also developed a blood clot in his leg. It got so painful at one point that he could hardly stand on the leg. When his cardiologist heard about this development, he told Leeper to go straight to the emergency room; a clot can travel to other parts of the body with potentially deadly consequences.
Leeper was admitted to the hospital in November 2018 and was treated for the clot, which did eventually travel to his lungs, causing what’s known as a pulmonary embolism. Leeper suspects the long hours he spent sitting in the car for work were partly to blame. He’s now on a blood thinner to prevent new clots from forming.
Lessons in Living Well
“When I first heard I [had heart failure] I was upset about it,” he says. “But so many good things can come out of it.” The illness has informed his work counseling and giving spiritual support to terminally ill people and their families–many of whom are dying of the same condition he has.
“Probably three out of five days of the work week, I am with people on hospice who have a diagnosis of heart failure,” he says. “And I count having it myself as a blessing because it helps me understand a little bit more.”
One example Leeper shares: If a person is entering the active dying process and not eating or drinking, loved ones often insist the patient receives IV fluids. But once a person’s body has shut down, he says, they can’t process it. “I can say, ‘This is how the person will feel when they fill up with fluid.’” He knows because he’s experienced the swelling (known as edema) that often comes with heart failure himself.
He says other things he’s certain have helped him do well despite his illness include the way he eats (he follows the plant-based Engine 3 Diet), continuing consistent exercise, and most important for him, his faith. Ulimately, it's about taking personal responsibility.
“Your health is up to you,” he says. “Listen to what your doctors tell you. Don’t just keep doing what you’re doing and expect them to prescribe more medicine, or to have some device, or some surgical procedure that counteracts what you’re doing. The doctor is responsible for giving me correct advice. Our job is to follow it.”