Feature Article: January 2019 – In Memoriam: Dr. John Crisler

“Dr. Crisler was a key Member of the Conference Planning Committee and was preparing two lectures for the April 2019 Conference at the time of his death,” said Greg Fillmore, AMMG Conference Director. “His depth of knowledge and clinical experience were vital in helping AMMG formulate our educational curriculum. He was always willing to help me with any question and readily offered to  approach a colleague to speak if he felt they would be a great speaker. He brought all this to the planning table in addition to delivering superb lectures of his own. Most of all he was a true gentleman to everyone, myself included, and I sincerely appreciate his professional attitude. I think I speak for the rest of the Planning Committee when I say that we are shocked at his untimely death and will miss him greatly.”

“Dr. Crisler was a thought leader in age management medicine,” said Dr. Edwin Lee, a member of the Planning Committee. “He opened my eyes through his talk at AMMG of using testosterone with an an insulin syringe. I just assumed that testosterone was too viscous to draw it up through an insulin syringe. I think he might have been the first doctor to use it subcutaneous. On a personal note, I enjoyed giving John a swimming lesson.  We had a lot of laughter. He realized that swimming like any sport has to do with proper technique. I will miss his entertaining lectures and his dynamic personality.”

Dr. Rob Kominiarek, another Planning Committee member, said, “John was an instrumental pioneer in the advancement of Men’s Health and Wellness at a time when it was not so fashionable to do so. He led the charge with a compelling case and conviction for the importance of testosterone in achieving and maintaining health in men. John made it clear to the entire world that healthy aging for men was intimately tied to the optimization of testosterone and that this messenger would help men who were suffering from visceral fat gain, energy loss, insomnia, muscle loss, anxiety, depression, decreased sexual function, lack of libido, poor exercise recovery, insulin resistance and more. He championed the idea that testosterone optimization along with nutrition, exercise, quality sleep and stress management would alter men’s health and their health span.”  

Dr. Kominiarek added, “On a more personal note, John was a ‘man’s man.’ He was a man of his word and a friend to all who knew him. John deeply cared about his profession and his patients, and many would state that he truly cared and listened to their tribulations. He was not only their doctor but their friend. John was a mentor, a true professional and a personal friend. We spent many hours over the years engrossed in deep, passionate conversation about the exciting direction of age management medicine and the field of interventional endocrinology and the responsibility that we all hold in ensuring that the truth of our field of endeavor not only continue to advance, but that its light shine brightly for all to hold evident. We all owe John a deep gratitude, for he is one of many that have helped to pave the way in understanding the critical role hormones play in our daily lives. I know that I can speak for many that John’s smile, laugh, and camaraderie will be sorely missed not only in the lecture halls of AMMG but in our personal lives as well.”

Another Planning Committee member, Dr. Mark L. Gordon, said, “I will remember John as the only person to stay at my house that got attacked by my daughter’s cat. We soothed the injury with a nice 21-year-old scotch and talked about life, love, and hormones. He had a deep respect for the human condition and the need to keep the body going and the spirits elevated in light of challenges. I will miss my friend.”

Dr. Crisler’s office staff posted the following message:
“Our friend Dr. John Crisler died unexpectedly on Wednesday. Although Dr. Crisler had a history of heart disease, he was an active athlete and bodybuilder, and lived life to its fullest. He had a soft spot for little dogs that he rescued. We all benefitted from the power of his gentle spirit and generous nature, and are devastated by the loss. His office staff requests contributions in his name be made either to the American Heart Association or to the pet rescue shelter of your choice.”

In addition, a long-time associate posted this illuminating memorial:
“Dr. John Crisler was my friend. Then he became a client. My firm built his website and handled social media communications, but he was always a friend first.
He was one of the most soft-spoken, gentle men I have ever known, and he loved to adopt little tiny dogs that nobody else wanted. He loved humanity, he loved healing, and he trusted everyone. As a young man, he watched helplessly as his fiancé was taken by cancer, then decided to become a doctor himself.  He spent 15 years championing the cause of men broken by steroid abuse. He was a pioneer in the field of testosterone replacement therapy, and endured slings and arrows from the medical community until studies proved him correct in 2017.
Years ago, he suffered a setback that was to shape the remainder of his life. Challenges stemming from an embezzlement of his practice and theft of his identity dogged him, complicating each step forward. Despite this, John, ever the optimist, rebuilt from scratch, all the while spreading his medical knowledge freely to other doctors.
He survived a heart attack two years ago, bounced back, and naturally used the experience in his training of other doctors. The private stress stemming from the embezzlement remained however, and endless paperwork stole away his time with the patients he loved. Sometime during the night of January 15, 2019, his big, kind and generous heart stopped beating, and we lost him forever.
He leaves behind his parents, two sisters, his beloved life partner, Arline, and friends too numerous to count. In lieu of flowers, the family requests contributions in John’s name be made to the American Heart Association or The Humane Society, Lansing, Michigan chapter.”

Finally, perhaps the best representation of Dr. Crisler’s spirit and determination is one he wrote himself. Here, in its entirety, is the compelling account he posted on the first anniversary of his heart attack.

I’m still here.
One year ago today, I had the heart attack that could have easily ended my life. Complete right coronary artery occlusion for nearly an hour and a half. I was on a treadmill, running 1.1 miles at a 10:00/mile pace, TWENTY EIGHT HOURS LATER.
There are lessons in this for us all.
I’d just gotten home from the gym that morning. Did a full-on Nautilus leg workout which, for those of you familiar with this type of training, is extremely intense. The day before, I swam ¼ mile, without chest pain or any negative symptoms. What happened next was a complete surprise.
Fifteen minutes after leaving the gym, I picked up the phone to call my first patient. Suddenly, a sharp discomfort—like an ice pick—between my shoulder blades. Heart attacks (heart problems in general) are usually associated with “pressure” pain. This was different. I got on my foam roller, and did get a few crunches in the vertebrae between my shoulder blades. Osteopathic physicians will understand why this was. But then a total body discomfort (it never felt like pain, more like how your legs feel when you really want to stop running), and some nausea, came on. As I rolled over on the carpet, I knew this was something more serious.
Grabbing a wastebasket, I unlocked the front door, laid down on my back in the foyer, and called my best friend. Then came that awkward moment when you see the back of your hand is sweaty, and you realize you really are having a heart attack. I hung up, and he called 911 for me. Lots of things go through your mind as you are lying on the floor, wondering if these are your last moments in this reality.
NOW would be the time to chew up a couple aspirin. But I was afraid of going down in the bathroom, and slowing them finding me.
It felt like my head was building up with pressure. The same with my legs. I began taking in the deepest breaths I could, and then forcibly crunching my chest and abs down, a couple times a second. Don’t know why—it just felt right. The pressure feeling in my legs and head decreased. When I stopped, it got worse. Then I figured it out: right side myocardial infarction.
Time for an anatomy/physiology lesson. The right side of the heart—which draws the blood in from the body, and pushes it up to the lungs–was failing. Because it sits right on the spine, that’s why I had back discomfort between my shoulder blades (the left side of the heart—which pumps blood out to the rest of your body—actually faces the front). That is how your body interprets it. So creating a large negative pressure in my chest cavity, and alternating with a positive pressure in my abdomen, was actually helping pull the blood from my upper and lower extremities, into my right heart. The left side was still pumping just fine—it just needed blood.
At this point I went right out and laid down on the front porch. In retrospect, I wish I’d spread out in the driveway. Or out in the street. LOL. I put my feet on the upper step, and raised my head with my hands, to help drain blood to my right heart. If I passed out, my head would then drop, and increase blood flow to my brain. This is survival stuff of the first order.
The sweetest sound I have ever heard was that ambulance. Strangely, it’s a pleasant sound ever since. They didn’t even need to extend the gurney, or get it up/down the stairs. I hopped right on, and began barking orders: “Oxygen, aspirin, morphine, twin big bore IV’s, and prep the Cath Lab!” That ambulance crew saved my life.
However, while in the ambulance, the Paramedics were trying to get me to stop doing the accentuated breathing, as it risked “wearing you out”. But I was maintaining a 99% 02 saturation, on only a nasal cannula, with complete right side failure, so I continued. My Cardiologist told me I was actually in what is called complete heart block upon arrival at the ER.
Yes, it’s true: when you are dying of a heart attack, you do not care they are cutting all your clothes off, right out in the open.
The morphine and Versid (an “amnesic” pain killer) combination make things kinda fuzzy, but I do remember feeling that catheter snaking its way from my wrist (the radial access—as opposed to the usual groin cut-down—is why I was up and running the next day), through my shoulder, and into my heart. And I promise, NOTHING will EVER feel as good as when that big clot breaks loose, and blood once again gets to half your heart, for the first time in an hour and a half. The warmth is indescribably wonderful…but I hope you never have to feel it!
The next thing I knew, we were coming off a huge elevator, with lots of equipment and medical staff around me, on our way to the CICI (Cardiac Intensive Care Unit). As the drugs wore off, I felt better and better. Good enough to get on FaceBook, and start broadcasting the experience. Friends came by to visit.
Yes, hospitals do look different from the other side. But Nurses are wonderful no matter what your situation.
Around eight o’clock that night, my Cardiologist finally got to me. He’s an old friend; we graduated medical school together. He told me they had put a stent in, and that he had gone all through my heart, and the rest of my pipes were pretty clean. He estimated my Ejection Fraction (how much of the blood in the large left ventricle gets pushed out each beat) at greater than 60% (not bad for a weightlifter my age) and…get this….they could find no Wall Motion Irregularities. That means my heart was functioning perfectly fine.
We guessed at the time the heart attack started; he told me once it starts, the clot grows, and blocks the coronary artery, quickly. They knew when the clot got busted. He just shook his head—reporting he had no idea why, given the length of time my right heart went without blood, there was no damage.
Then I shared with him what I had done. He said he had never heard of such a thing. You know what they say about the relationship between Necessity and Invention….
Well, my next question involved why—if I was in such good shape—I was still in the hospital. The Cardiologist replied it’s not unusual to have electrophysiology problems after the muscle of the heart is starved for oxygen for a long time. And man, was he right.
The Cardiologist is a serious Tri-athlete, so we mostly caught up on old times, and talked training. He said he’d be back in the morning to discharge me.
Later that night, as I was typing on FaceBook, it felt like a horse kicked me in the chest. Alarms went off. I looked up at the monitor, and quickly recognized (coming to me through the mist—hadn’t read an EKG in fifteen years) I was in V-Tach…a fatal cardiac arrhythmia. I could hear staff running down the hallway.
I held my breath, and bore down as hard as I could, twice. It’s called a Valsalva Maneuver. Like bearing down for a bowel movement (without anything coming in, or going out LOL). Remember that. The chest discomfort stopped. As the staff came through the doorway into my room, I was sitting there, smiling, pointing up at the monitor. Normal sinus rhythm. Enough excitement for one day!
I tried not to be a pest—there are REALLY sick patients up on that floor. So with an “acuity” (number of patients a Nurse has to cover) of only two, when the nightshift Nurse came on, she came down to introduce herself, saying everyone wanted to see the “muscle doctor who’d cheated death” that day. I got lots of yummy snacks.
Around ten the next morning, the Cardiologist came down, with a Resident in tow. I was glad to take the baby aspirin, and anticoagulant, because of the stent. But I refused the statin (toxic). And the beta blocker, which is used to prevent “remodeling” after an MI (Myocardial Infarction, or heart attack). Without getting too technical, my pulse was back down to its usual low rate, so unnecessary. Besides, beta blockers have so many negative side effects, we have a joke in medicine that we prescribe them for patients we don’t like. LOL
I called a buddy, who came to pick me up. Went home, changed clothes, and off to the gym.
The only thing different about the picture you see here, and one which could have been taken a couple days earlier, is the bandage on my right wrist. That is where they inserted the catheter.
But this was not as much a daredevil feat as one might think. The stent was in place; it wasn’t going anywhere. I knew my heart was in good shape, and felt fine. So my walk on the treadmill broke out into a run. No angina (chest pain), dyspnea (shortness of breath)….but lots of diaphoresis (sweating).
Why did I have the heart attack? Given my fitness, diet, and supplement regimens, the Cardiologist said he thought it was from stress. And, no, I did not go off my TRT. You see, understanding the relationship between testosterone and cardiovascular health is part of what I do for a living. It’s also called “walking the walk”.
No doubt being a physician helped me exercise basically a new form of CPR, on the spot. I’d paid attention during my college Physiology classes. And plus—as we say in the Airborne, when your main parachute fails–I knew I had the rest of my life to figure it out. LOL
The REAL difference, though, was that I was in such great aerobic shape, from doing all those 5K races, to generate what became the hardest workout of my life. The hard chest and abdominal contractions I was doing lasted about 45 minutes, until arriving at the ER. Lest anyone doubt their will: when Death is on your heels, you WILL run.
I guess March 23, 2016 was a bad day at work for the Grim Reaper.