Brian Horner has survived avalanches, sinking boats, climbing accidents and sea lion attacks. He’s gone on search and rescue missions in Greenland and Costa Rica. He has been climbing on Denali multiple times. He has taught a myriad of rescue, survival and wilderness medical training programs over the last 36 years.

“I did all that and made it through all of that,” Horner said. “But do you know what almost killed me? Mayonnaise.”

For two years Horner had been noticing some symptoms of a heart problem that would eventually require major surgery: he began experiencing shortness of breath; the back of his tongue hurt; he’d get tired mowing the lawn and sweeping. Still, he maintained that it wasn’t anything to worry about — he was active and physically fit.

“Even as a medical practitioner myself, I kept ignoring it and disbelieving it, because I’m very energetic and in my line of work I tell people ‘just push through this, will is everything’,” Horner said.

Finally, the 62-year-old went to a cardiologist and was told he needed five — it would eventually become six — coronary artery bypass grafts, a procedure that removes veins and arteries from other areas of the body to be used to create new pathways for blood to reach the heart. Suddenly something he told himself was nothing had become a very big deal.

Recognize something is wrong

Horner’s story isn’t a unique one, at least his hesitancy to seek medical help isn’t.

Dr. Kent Stephens, the surgeon who worked on Horner, said often people will realize that there has been a change in their body, but ignore it. Sometimes they chalk it up to getting older. Other times they will rationalize that they are not any more out of breath than their friends are. Frequently, would-be patients try to conceal the issue from themselves — if they don’t pay attention to the problem, it’s like it’s not there.

“There is this misconception in America that people sometimes believe that it is only possible to have a cardiac problem if they are in a high risk category, like if they are a smoker or if they are diabetic,” Dr. Stephens said. “But people without any of those risk factors can still get cardiac problems that require the attention of a cardiologist or cardiac surgeon and it’s not anything to blame themselves for, it’s just the way Mother Nature works.”

Even the people who appear incredibly healthy on the outside, like Horner, need to listen to their body, said Dr. Stephens, and take note of changes, even minor ones. It’s not always a dramatic announcement, like a seizure, that indicates there is an issue. Often it’s smaller signals that hint at a larger medical problem.

“Those indicators are the things that allow you to get an item brought to attention before it reaches the point that it might not be so fixable anymore,” Dr. Stephens said.

One of the most common signs of underlying heart problems, Dr. Stephens said, is somewhat counter-intuitive: shortness of breath.

“People think the problem is their lungs, but the single most prevalent complaint that people have when they start getting on the track of having a cardiac diagnosis revealed is shortness of breath,” Dr. Stephens said. “So if you’ve been walking up the same flight of stairs for 10 years and never had a problem, but then all of the sudden over the last six months you’re huffing and puffing after that one flight of stairs, that is a sign that something has changed and needs attention.”

Other common symptoms medical professionals look for as early detectors of heart problems are chest pain and swelling in the legs. The latter is caused by a battle between gravity and the heart operating at low efficiency — gravity pulls fluids down to the legs and the fatigued heart can’t lift it back up. According to the American Heart Association, heart-health screening tests, including blood pressure, cholesterol, body mass index and blood sugar, as well as analysis of physical activity and diet, can also help medical professionals determine if someone is at higher risk of developing heart issues.

Helping hands

Horner is lucky. By his own account, he probably shouldn’t have survived the number of incidents leading up to what would become his second major heart surgery — Horner had his first brush with heart issues in 2007; He had recently helped with a rescue mission on Denali and had a heart attack in the middle of the night caused by a major blockage in his lower descending artery, a type of cardiac arrest known as a “Widowmaker” because of its often fatal nature

He credits his team at Alaska Regional Hospital, including Dr. Stephens, for the successful surgery and the nurses who chatted with him all night to help him through postoperative pain. Noting, while he’s only a relatively short time removed from his second surgery — a procedure done in February 2021 — he’s already back climbing for work.

Although he would have preferred to meet his team in other circumstances, within a couple months of being released, Horner sent everyone who had helped treat him, from the medical assistants to cardiac rehab specialists and surgeons, a thank you letter and a gift card to a local restaurant. In the note, he wrote: “Coming from a very active lifestyle as a rescue training instructor, I was devastated by the immediate loss of my ability to take care of myself and be forced to rely on your staff … Through it all, I was supported by caring professionals that demonstrated a dedication to patient care that goes well beyond normal expectations.”

This story was produced by the sponsored content department of the Anchorage Daily News in collaboration with the Sponsor. The ADN newsroom was not involved in its production.