Exploring Cardiac Health in Firefighting: The Brenda Superko Interview

In this episode of the All Clear Podcast, host Travis is joined by Brenda Superko of Select Well, who shares her journey from cardiac nursing to advocating for firefighter health. Brenda discusses the genesis of her dedication to heart disease prevention in firefighters, sparked by a 9/11 encounter, and the critical importance of identifying and mitigating heart disease risks among firefighters. They dive into the specifics of Select Well’s advanced metabolic panels, the significance of genetic predispositions, and practical steps firefighters can take to improve their overall wellness. This episode also offers personal insights from Travis and highlights the role of comprehensive physicals and continuous health monitoring in ensuring the longevity and well-being of firefighters.

00:00 Introduction and Special Guest Announcement

00:38 Brenda's Background and Journey

01:39 Firefighter Wellness and Heart Disease Prevention

06:35 Challenges and Trends in Firefighter Health

13:39 Genetics and Cardiac Health

18:37 Prevention and Testing

23:49 Conclusion and Contact Information

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Transcript

 Boy have I got a special guest. I've been trying for a long time to get on here. I've got Brenda Erco. How are you doing today, Brenda? 

Hey, Travis. I'm good. Thanks for having me. It has been a long time. Hey, it's a 

privilege. It's a privilege. So I've been trying to get you on the podcast for what, about two years now?

I probably it is been a minute. It has been a minute. But I think I should probably tell people a little bit about you. Okay. Brenda, you work with Select which is a company that has a very keen interest in the wellness of firefighters. So that's all I'm gonna say. Why don't you tell us about you, your experience, your background, and how you got to where you are now.

Okay. You got more than a minute, I hope. 

Oh, absolutely. 

First of all, Travis, I think the most important thing is I'm a nurse. I like to say I am a mature nurse. I've been around for a few years and my passion was in cardiac. That's how it started and that's how I met my husband and I.

We attended medical conferences, fell in love. The rest is history. He's the nerdy part of me and I'm the I'm the kind of down to basics, but I was a coronary care ICU nurse for many years. Went into private practice, started these things called prevention clinics. There's not a lot I haven't done in the cardiac realm of nursing.

However, Robert and I were attending a medical conference back on nine 11. And that's where the firefighter story began. I don't have to tell you about that day, but for us, I think what the impact that we came away with was we saw obviously, frantic, scared, terrified, people escaping a war zone.

And then we saw organized, prepared. What appeared to be fearless people preparing to walk into that building and okay. We we solved that. We went back to Atlanta to our everyday profession cardiology and research and. A couple of weeks after nine 11, we heard chief rollator from Gwinnett County Firefighters talking on the 11 o'clock news about the incidents of heart disease and firefighters, and frankly, how he was sick of going to funerals and somebody had just retired early, getting to time to enjoy their life, and, but they didn't have a heart attack.

So that caught our attention. Long story short. Robert reached out to the chief. We ended up writing a grant theme of funded the Heart Disease Prevention Study in Firefighters. So that was a little bit over a minute ago. We have been advocating for firefighter heart disease prevention since then. I went to work for Select about three or four years ago because they're a lab company.

They're our, the parent company of what I do is a lab in North Carolina, Greensboro, North Carolina, and they gave Robert and I the opportunity to create a lab panel that we knew I helped to identify a firefighter who was vulnerable for a heart attack, who was more at risk. It's not that firefighters have any more.

Metabolic or inherited risk than let's say your next door neighbor. It's the mechanics of what firefighters do combined with the metabolics that you may or may not have that makes you more vulnerable, and we believe both of us do that. Heart attacks don't have to happen. You don't have to have a sudden heart attack.

You could find out you have, you're at risk or you have heart disease. You could get checked out and get on the right track. And so that's where we are. Select well gave us the opportunity. We ran with it. And great people like Vaughn McAfee, who, Melissa, we've got sales reps across the US that, among other things, promote the Firefighter program.

I can speak personally, I know the department that I work for professionally. We utilize select I think we might've been one of the first ones in the state to start using it. And the heart is truly cutting edge in my opinion, in my layman's opinion about it. Because I know that you guys not only can test for markers, cholesterol all that fun stuff, but you can also talk to me about what the problems are.

And I've had the privilege of sitting down with you and going over my numbers more than once and it helps me understand what I need to do. But I guess one of the big things, people talk about wellness in the fire service, people always talk about, oh, firefighters are healthy. They work out every day.

Yes they may, but that's what every third day for a lot of places. But it's about consistency. I know a lot of times diet is garbage for firefighters. So is the workouts. They may go and do the wrong thing and firefighters, I'll be honest, that weigh 2, 3, 400 pounds. I'm not joking, and I wonder how can you do your job.

So with all that being seen, Brenda what are some of the trends that you see that might be causing issues with firefighters, particularly with like their cardiac health and such? 

Travis, if I could start even before their cardiac health. I think one of the trends, and one of the things I've learned about firefighters after talking one-on-one to firefighters about their labs and their heart health, too many of you don't have a dang doctor.

Honestly as you get older, I'll tell you that the older firefighter has a primary care. Some more times than not, the married firefighter has a doctor because his wife makes him get one. That's a trend that I see that scares me. And I tell firefighters all the time, you go get these physicals, these your physicals that the fire department has, you do that doc is not following you.

Your doc is checking a box. Not saying those aren't. Worthwhile and beneficial, but I want, the trend is you should have your own doctor looking after you. Second of all, I see basically three types of firefighters, and I saw on I saw this topic listed on the agenda for your, that upcoming sapphire meeting.

I think it was three types of fire firefighters. It was the recliner, the shiner. What was the other? There was some of it but I was like, that's right, because there's, they're the guys that I get on the phone to the Zoom call with to review their labs, and they've listened to Homan, they've listened to all these healthy podcasts.

They're reading up on it. They know their stuff and they ask questions. Good question. Then I talk to the firefighter who's not really even interested, and then the firefighter that I. Probably enjoy and can help the most is that guy that's in the middle that wants to know more. He doesn't think he already knows everything and he wants to do something different.

And so I think there's, so when you put those categories then there's, there are, obesity is a problem in the fire community, no doubt about it. I'd say about a third of the firefighters. That I've seen and talked to over the country are obese and used to I will say it's a little worse in the southeast.

I'll give you the fried chicken and the sweet tea. That does not help. But it's a trend and 30 is 30 A BMI 30 considered obese. I've seen 40, and now it's like getting to where 30 is normal and it's not healthy. 

It's very interesting when I talk to firefighters, not just where I work, around the state.

It's interesting to see the wide range of interest and help you have some that are, they're in the gym every day. They watch what they eat. Then you've got some that are a little over the top. They will whatever, supplements new, whatever, new diet. Keto carnivore, it, all these different things come out and some of the people care way too much to the point that it's detrimental.

Then you have those that don't care to the point that it's detrimental and I've talked to guys that don't even know where to start and I think when you get that. That understanding of where you are in your career. How old are you? Are you old like me, or are you a young guy that's only been doing it for a year or two?

That kind of helps you get the square point. Now I know. Or get square with the point. I know in my personal case, and I don't mind talking about it a little bit, I know that as soon as I got the understanding of what I was facing my sugar was high, my stress was high, everything was bad. The scared straight program that you guys gave me, not in a bad way caused me, I've lost about 20 pounds because of it.

Hey, 

I'm eating better. I still, my cholesterol's still a little bit of a concern working on that, but I saw the need to make the change and you guys gave me the confidence to make the change and, I'm still working at it. And I think that's something that is underutilized a lot of times.

People look at their NFPA physical as, oh man, I just gotta go, see how strong I am, see how long I can plank. They don't think about the other part of how the blood work and the testing and the prevention phase of it is just as important if not important with the condition that you're actually, 

and Travis, one thing that I wanna point out is you see these overweight, unhealthy firefighters, maybe the guys that are eating the jump.

Not working out. And then you see your fit guys doesn't always match up metabolically. I would like to say that you, it's that easy to say, yeah, you're overweight, you're outta shape, you're at risk for a heart attack. But you'd be surprised at the fit people that think they're, they may be doing everything right, but they're still at risk.

That's called genetics and. That's a big part of the story that we weave in when we talk to firefighters, and that's what our test help identify. It's not, yeah there's a connection between LDL, cholesterol insulin resistance, elevated blood sugar, what you eat, your BMI, are those all risk factors?

Absolutely. But don't kid yourself, that's what got me started was when I was in Atlanta. I was a CCU nurse in the coronary care unit on 4th of July, and I kid you not time. I was 25 years old, so I thought 40 was over the hill. I saw a 40-year-old lean runner have a massive I, and he was, when he brought into the unit, I just.

I've never gotten that image out of my mind. 'cause he was lean, he was young. I thought he was old, but he really was young. And come to find out, he survived his mi it's all it for him, it was all genetics and he thought he could beat it by running. And the fact of the matter, he probably beat having an earlier MI and he probably beat death from his first MI because he was in shape.

But you wouldn't have looked at him and thought he had problems. 

So if we are genetically predisposed for cardiac issues whether it be, diabetes, I know if you go to the doctor, they ask, Hey, are, do you have a family history of if we have that and we are in the fire service, are we condemned to suffer?

Or is there a way that we can, if not fix it, at least work with it. 

First of all, if you have a family history, it's a 50 50 crapshoot. 'cause you get one gene from mom, one gene from dad. If you get a bad gene from mom and a bad gene from dad, you're you got it. But if mom gave you a good gene and dad gave you a good gene, you might have beat that bullet.

Robert and I used to run a family heart disease clinic and we did. Phenotypes and genotypes. Genotypes is, when I look at your DNA phenotypes is when I look at your LDL and we took all that information and let's say dad was in the CCU and had a heart attack. We looked at his kids, his adult kids. I like to stress out.

I don't like to do small children, not they're important, but not my deal, but. It's interesting to see when you look at three si, three siblings from the exact same parents and dad had a heart attack, you're gonna find most likely one of those that looks just like their dad and that's the person that you start putting the preventative efforts on earlier and that you're not doomed, but you're sure as heck the one that better not.

Start using tobacco. Watch your blood pressure, watch your weight. That's what I see in the fire service too is some denial. The use of tobacco is, I was shocked. They don't smoke, they don't light a match to their face and light a cigarette, but they use zen patches. They use tobacco products.

Yep. 

And tobacco products are bad for your heart. Another thing they do, which I'm still working through with the carnivore diet. You know that fat is not the bad evil guy, but being on a high saturated fat 24 7, you're bathing your arteries in it. I'll have a good steak myself. I'm not opposed to red meat, but I'm opposed to that firefighter that eats bacon, sausage, hamburger meat every day.

He's doing it to keep his weight down and to look good, but he's a mess metabolically inside. 

So when you get a negative metabolic panel back, apart from the genetics, how long does it typically take to turn the ship around, so to speak, to get it moving in the right direction? Is it something that can be done in six months or is it something that might take five years?

I like to, I like the three to six month window. I really just, if you haven't gotten on the train by three months and you're making progress, then you've gotta start right then and there. But that six month window, that's a good time to be able to see, did the lifestyle make my numbers get better? Did that walking every day, or lifting weights or swimming, did me switching from all those trans fats.

A lot of people don't even, that's something when we talk to firefighters, they don't know the difference between a trans fat and a saturated fat. They don't know the difference. They think all red, all meat is, maybe they think that's equally bad. A lot of firefighters eat venison.

That's a very low fat meat. So I think six months to get your diet on track and then if. And even if it is genetics, Travis, there's things you can do. We talk about LP little a lot. That's one of the things we test for. And if you've got that, yeah that's a significant risk factor.

But it doesn't mean you're doomed. You need to talk to your doctor. You need to be followed. And maybe you're the person that needs to take a baby aspirin every day, 'cause it makes your blood clot quicker. Makes your blood stickier and a baby aspirin can change that. I don't think you're doomed, but you've got to practice.

And if you fall off that horse, like we say, you can always get back on it. Nobody, there are people that are, go crazy like you said, the most of us live in a world of moderation. 

That there, at least we try to, but, I know somebody if they've never had the physical that Select Wall provides along with your other partners.

It is very in depth. In fact, I count I may be wrong, but I think I counted eight vials of blood that were pulled from me last time we did it. Our physical with y'all. I'm not trying to scare anybody, but when you pull that's a big number at the end of the day, compared to some of the other draws that I've had.

But the value of the information I personally got from that was huge. I can't even begin to talk about the value of it. But when you do the prevention, the blood work and the panel, I'm gonna take a minute and talk about the other things that go with that. For example Truman we've had him on the podcast before with the ultrasound.

He was able to look at my heart. C, the physical structure of the heart, was there anything wrong with it, with the valves and things like that. How important is it to have the blood panel, the metabolic panel, in addition to additional tests to help identify other potential problems? 

That's a great question, Hannah.

I wanna back up a little bit because when you're doing just my heart, our heart panel select that's three tubes of blood. I think what you're referring to is when Health Fit Clinic and Dr. McCarthy, they came on site to do your NFPAs and I can't recall if your department did the PFAS or if y'all were doing the interferon, hepatitis.

We do all those tests. We're a lab, so we can do all that. So yeah, that can be a lot of blood to draw. If you're just doing the heart health it's three three tubes of blood. Megan, let me just say a word about, you mentioned Truman and we met Truman through Dr. McCarthy. Robert and I have known Megan McCarthy for 15, 20 years.

Robert and I gave a lecture out in Phoenix right after we did the FEMA study, and she was a nurse in the audience and we talked about firefighters and she lit up like a light bulb and said, this is what I wanna do. She now works for er. In Phoenix where they have a spectacular center for firefighters.

So anyway that's Megan. And she does a physical, unlike most of your NFA providers she teaches other nurse practitioners how to do a physical like that. They actually listen to your heart. Isn't that amazing? Yeah. 

I have a buddy of mine who's a doctor. He says, if they don't lay hands on you, it's not a real physical.

I, I agree. So back to your question about the other test. There is a test that I really like at Truman's test. When Truman looks at your heart, he also, if he's doing the cardiovascular ultrasound, he's also looking at your carotids. He also looks at your femoral artery. Cardiovascular disease is not limited to your heart.

If I see plaque or Truman picks up plaque in your carotids or your femoral, guess what? You've got disease. He can't see the plaque in the coronary arteries. But a test that I do that a lot of fire departments do utilize is the coronary heart scan. And my team of nurses that talk to firefighters all over the country and review their tests with them, we quickly get a feel for if they wanna know more, if they're the kind of person that's gonna go to the doctor, we will tell them they need to go to the doctor.

Sometimes we suggest, why don't you ask your doctor, would I be a candidate for a heart scan? I like to have those. My test, if somebody's got a lot of red alerts and a heart, a calcium scan test or Truman's test looking at your carotids, it gives me a picture book, if you will, that you've got, this is this.

This is the story I'm telling, but here's the picture. 

And that is very true. Those follow up tests that you guys recommend, they really do have true value. And like I said, I've done the calcium score myself, came back great. And it took one more thing off my plate to not worry about. And so the other thing that's unique with you guys and what you do is the fact that there's consistency.

I know that if I get tested this year. If I get tested again next year, you're able to compare those numbers to each other and see if it's getting better, if it's getting worse, if there's something else coming along. So there's a lot of value in the work that you guys are doing and I'll be honest I am very excited.

We are the North Carolina Firefighter Cancer Alliance, but we also realize heart and cancer are the two number one killers of firefighters right now. That those are our biggest enemies right now. And we're excited to be working with you guys on all this. In fact, I'll, we'll give a sneak peek, I think in August.

If you're gonna be in at the Safer Conference in Raleigh, North Carolina. You'll get a chance to hear Dr. Perko. You'll get to see Brenda and a bunch of these other names we're mentioning. So yeah come by. If you're a chief that's listening and you're not sure what to do for the physical program for your.

For your department I can recommend some people you need to talk to. And Vaughn McAfee, who Dodges cameras and microphones at all cost. He he's the one you need to talk to. I remember meeting him at Midwinter Chiefs and he was talking about what you guys did, and I was like, yeah, okay.

It's another company just trying to, get to know. But then he kept showing up and every time he would talk, he would say, have you looked at this? Did you know about this test and the value that it has? And now we truly understand that, you may focus on cancer, but if your heart's not good, if your head's not in it, if you're not taking care of yourself across the board, you can't fight whatever your issue is.

And so overall wellness is something that I think that you guys are really promoting. I know cardiac is your sweet spot. But you guys really do help us look at our diets, look at our exercise, and make sure we're looking in the right direction. But if there is a firefighter that's wondering where to start what are some simple things they can do to start getting on the path to to weld, so to speak?

First of all, diet's important, but so is movement. I'll ask you, I'll, I'm gonna throw back a question to you. Okay. On this why I, there are some firefighters that don't wanna know anything, they would rather not know. I see that too often. I think that I'm a curious person about health.

I'm a nurse, so I, that's a fit. But I run across some firefighters who don't wanna know if they're ld, if they're LDLs, the bad cholesterol I'm talking about. If that's 160, that's a bad number. 

Yeah, 

but they don't care. Some firefighters don't care. Some public people don't care either, so I can't say that, but I don't know.

I just feel like firefighters have seen heart attacks. They've seen. They seen that wife standing over her husband that just had a massive MI and heard her say he didn't have heart disease, and guess what? Yay did. 

So I can probably answer that with two individuals that I've talked to. I'm not gonna mention their names, but over my years of doing this, I talked to a young firefighter one time and this was back during the time of Covid, and I know there's a lot of.

Things about vaccinations and all that. And, we were talking about just, health in general during that time when everybody was so focused on, am I gonna get it? Am I, can I get it? Before we knew anything and his whole thing was, oh, I die. I don't care if I get something and I die.

That's just, money for my family. So he had that, whatever attitude about it. And then I've talked to old crusty firefighters that are grumpy and their whole thing is, I go, I fix stuff. I do my job, I go home. And they really don't want to be thinking about mortality outside of their time on the truck, if that makes any sense whatsoever.

And I, so I've seen those two different extremes with it and I think a lot of firefighters probably fall somewhere in between. But you have some that are. That, they just don't care because they don't wanna see it anymore. And then there's some that you know they have fake bravado.

They act like they don't care, they just don't know what else. Deep down 

inside they do. I think the most important thing, and I hope this is what your takeaway has been from talking to my team, is that even if you only talk to us once, you're gonna learn something, you're gonna learn.

What an LDL cholesterol is, you're gonna learn that there's different types of LDL and the smaller and the more dense the LDL is, the more easily it gets inside your blood vessel wall. And that is stimulated by gaining body fat. Lose body fat, reduce your small dense LDL, lower your risk. Your LDL. Your LDL number might be good, but what's that small, dense ld?

What's that dangerous LDL. All this stuff goes back 50 years and it's very academic. It's very scientifically proven. But what I like to do and I've found a great team of nurses that love it just as much as I do. We like to weave that story and tell you that story, and hopefully when you do gain five pounds or 10 pounds, you think about that and you say, God, that's 10 pounds.

That's making my LDL more dangerous. So I think that fire, everybody needs to understand this stuff. Firefighters, who doesn't love firefighters. I love firefighters. I have worked with every, I've worked with professional athletes, I've worked with executives, I've worked with the general public. I've done it all.

Firefighters are worth my time and effort 'cause they're damn good people. 99% of the time that I've met. And I feel like the mechanics of being a firefighter. So maybe we'll do another podcast. I wanna talk about the mechanics of being a firefighter and how that affects the metabolics. What's inside of you?

What lights that ignites that fire. What you're doing as a firefighter that your next door neighbor and his job's not doing, you two could have the exact same heart risk panel. Why are you on an average? The, an average male has his first MI at age 62. Average firefighter has his first MI at age 49, so why is that?

That could be another podcast. 

You know what I've been sitting here making notes as we're going along. I have a very long list of things, and if you're willing to come back, we're, I am willing to come back and learn stuff 

now that I'm over this hurdle of how this all works. And I don't usually talk on Zoom with earphones, so this is fun.

I'm getting into it. 

Alright, so I'm gonna ask all our listeners to do me a favor. If you can go leave a comment on YouTube or our Instagram and let Brenda know that she is fine at podcasting and there's nothing to be scared of. 

Thanks 

Brenda, thank you so much for your time talking with us today.

So if anybody wants to learn more about select if they want to reach out to you guys what's the easiest way to find you guys? 

Wow. I would, you know what? I don't think our website's the easiest way to find us. How about if I just say be seco@selectwell.com. 

Okay. Very good. And we'll put that in the show notes and we'll put a link to select I, 

I don't mind responding and passing on emails, so give me a shout over email and I'll help direct you.

I know you will. You've got a big heart. You help firefighters all the time. Everybody that works with you is awesome. And like I said, I met you guys through Vaughn McAfee that we will get on the show eventually. He you guys are great and you do find work and it we're not sponsored by select I'm just telling you from my personal experience, what really is the truth that NFPA physicals and all of this screening doesn't have to feel like it's painful.

Learn something, take something away from it. And Brenda, thank you again for taking time to talk with us and we're gonna have you back real soon. That's Travis. This say here on all clear lights are fire within.

 That's a wrap for this episode of All Clear Firefighter Wellness, your host and producer, Travis McGaha. Thanks you for tuning in. Remember the views and opinions shared by our guests may not always reflect those of the host or the team, but we're all here to spark important conversations for Firefighter Health and Wellness.

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Thanks for listening. Stay safe out there and we'll catch you next time on All Clear Firefighter Wellness.