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A HOW-TO MANUAL FOR HEART REPAIR

Robert E. Kowalski says he had to do something "to save my own life," so he wrote a book.

In doing so he not only restored his health, he also became one of America's best-selling self-help authors.

The book that did it is The 8-Week Cholesterol Cure, published in 1987. By then Kowalski had had a heart attack and two bypass surgeries. His newest book, 8 Steps to a Healthy Heart (Warner; $21.95), is a mix of his personal experiences coupled with medical expertise.

Although Kowalski had made a rapid recovery after each medical setback, he always knew that the next attack could be his last. He admittedly was running scared.

"Every time I felt a twinge in the left arm, or a pressure in the jaw, or wave of indigestion, I thought I was having another heart attack .

.

. It's difficult to live, much less enjoy life that way," said Kowalski, 49, in a recent interview during a promotional tour for his new book. "I spent six years living the life of a cardiac cripple."

So Kowalski decided to remove the sword of Damocles from his life. "The first thing I had to do was to get my cholesterol under control," he said.

The low-fat diets his doctors gave him did little to lower his count. So Kowalski, who had been a science writer for 25 years, and has two degrees in science journalism from Iowa State University, started researching. What he ended up with was a dietary plan based largely on oat bran and niacin. It worked for him so he decided to share his findings with others.

He did so in a book entitled The 8-Week Cholesterol Cure, published by Harper and Row. Before Kowalski wrote his book not too many Americans knew the dangers of the waxy, fatty substance known as cholesterol. What he learned is that some cholesterol is essential to life but problems arise when too much builds up and blocks the arteries, leading to stroke, heart disease and other life-threatening problems.

Cholesterols counts are expressed in milligrams per deciliter. In 1987, new federal standards were established, coupled with a warning that desirable cholesterol levels should not exceed 200 mg./dl.

Kowalski's book was an instant hit: It was on the New York Times best-seller list for 115 weeks (between 1987 and 1989) and sold more than 2-million copies. Americans started loading up on oat bran and checking their cholesterol count.

The book was also published in nine foreign language editions, recorded on video and audio cassettes, made into a computer program to help readers measure their progress, the subject of a quarterly newsletter and expanded in a follow-up volume entitled Cholesterol and Children. The subtitle of Kowalski's new eight-step book is The Complete Guide to Heart Disease Prevention and Recovery from Heart Attack and Bypass Surgery.

"The attitude of the book is returning people's spirit to what it was before they had a heart attack or heart surgery," he said.

In his eight steps, Kowalski deals with the depression and anxiety that generally accompany heart disease. He recommends getting back in the swing of life as quickly as possible, which includes resuming normal sexual activities; discusses options for cardiac rehabilitation, cholesterol and hypertension control; and looks at the medications heart patients take.

Kowalski thinks the psychological aspects of heart disease have been "tremendously underrated." After his second surgery, which he calls his "re-do," Kowalski said he reluctantly agreed to his doctor's prescribed course of cardiac rehabilitation. After finishing the formal rehab period, Kowalski signed up for an unmonitored program at the hospital. He said he doesn't know exactly when he came to the realization that "if he felt this good now, just a short time after surgery, how good could I feel if I really worked at it?"

The exercise and the dietary changes worked. Now, according to Kowalski, his most recent angiogram showed his coronary arteries to be free of blockage.

The research that led to his first book found that cereal fibers, particularly oat bran, and niacin, which is a B vitamin, both helped purge the body of cholesterol. Experimenting on himself, he said he worked out a low-fat regime featuring three oat bran muffins and a maximum of three grams of niacin daily.

In Kowalski's case, it worked. He reduced his cholesterol 115 points in eight weeks. To confirm his results, he enlisted the aid of his own physician, Dr. Albert A. Kattus, director of cardiac rehabilitation at Santa Monica Hospital Medical Center. Kattus recruited 25 volunteers, including two physicians, with high cholesterol levels and found that all of them benefited from the program.

Kowalski is quick to caution that no one should follow his example without consulting his physician, because an excess of niacin can produce side effects like gastric upset and even heart arrhythmia.

And he has his detractors. A $6-million lawsuit was filed against Kowalski and Harper and Row in 1988 in U.S. District Court in Cleveland. Retiree Maurice Fishman, who lives in Florida, is the leading plaintiff in the case and alleges that he suffered "serious bodily injuries and emotional distress" as a result of taking high doses of the vitamin niacin that were recommended in the book. The case is awaiting trial. According to Cleveland lawyer Willard E. Bartel: "Fishman and 17 other plaintiffs in the five-count suit became ill as a result of following Kowalski's advice."

In his new book, Kowalski cautions readers that he is writing from research and experience and that they should consider the book "a bridge between patient and doctor."

While it is too early to tell if the new book will make the best-seller list, Kowalski has been pleased at the favorable response from the medical community. One of the country's leading heart specialists, Dr. Dean Ornish, who is president of the Preventive Medicine Research Institute in San Francisco, sees Kowalski's work as "showing the way to turn the crisis of heart disease into an opportunity for transformation."

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