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Giving up pancetta and canned vegetables was bad enough. It was harder to cut out garlic salt. Mike Brusa worried his Italian dishes would lose their signature flavor, but he had promised his daughter he’d cook healthier to help her get well.

“This condition of hers kind of shook me awake and said, ‘You better change or you’re going to lose her,’” said the 71-year-old retired businessman from Fort Worth, Texas. “Corrections had to be made, and by God … I was going to make those changes.”

He’s talking about youngest daughter, Karyn Brusa. Nearly three years ago, the 42-year-old flight attendant was diagnosed with heart failure caused by a viral infection that damaged her heart. Suddenly, taking care of her health became a family affair.

“It was a life change for everyone,” said Karyn of her new dietary routines and medical care. “But it was also a wake-up call for everyone.”

Perhaps for her father most of all because he accompanied Karyn to her doctor’s appointments in the early stages of her disease. He was with her when a doctor told her she’d need an implantable cardioverter defibrillator to help prevent cardiac arrest, and he was with her in the hospital the day she got the device.

Karyn Brusa (back row, left) with her sister and her parents at the 50th wedding anniversary of a family member.

Karyn Brusa (back row, left) with her sister, Katie Campbell, and her parents, Mike and Nancy Brusa. (Photo courtesy of Karyn Brusa)

The two have been close since she was young, but her health scare brought the father and daughter closer. And food has been at the center of a journey that began when Karyn was first hospitalized in August 2014.

A persistent cough she’d had for about a year worsened. She couldn’t walk the short distance from her bedroom to the kitchen, and washing her hair wore her out. One day at work, she was so exhausted from walking to a plane that she threw up.

Soon she’d be hospitalized twice and diagnosed with heart failure. By December of that year, doctors had implanted the ICD to shock her heart should it ever start beating erratically. She took a year off from work to recover.

Transplant cardiologist Mark H. Drazner, M.D., said he could tell Mike and Karyn had a strong father-daughter bond the first time he met them.

“I think even during that first hospitalization, I remember just kind of a very jovial atmosphere, and part of that was created by the obvious warmth between the two of them,” said Drazner, medical director of the heart failure, heart transplant and ventricular assist device programs at UT Southwestern Medical Center in Dallas. “My sense was they had each other’s back.”

Family support is vital for a patient’s successful recovery, he said, especially considering the necessary lifestyle changes. Drazner said it is critical for heart failure patients like Karyn to dramatically cut back on their salt intake during the first year of recovery.

Karyn, who was already eating a healthy diet before her diagnosis, learned from nutritionists how to cook low-sodium dishes and how to interpret the nutrition labels on canned foods. She shared that information with her Italian-American family so they could make changes, too.

Karyn Brusa and her dad, Mike Brusa, at a Texas Rangers game. (Photo by Karyn Brusa)

Karyn Brusa and her dad, Mike Brusa, at a Texas Rangers game. (Photo by Karyn Brusa)

But her father was stubborn. It took her a while to get him to stop using garlic salt and processed meats and canned vegetables packed with sodium.

“I’m like, ‘Dad, you need to listen to this because you suck at this.’ He didn’t understand the serving size,” Karyn said.

“He finally came home one day — he goes, ‘They’re really trying to kill us.’”

Mike agrees it hasn’t been easy for him to change the way he makes his spaghetti gravy, pizza and meatballs. The recipes were passed down to him by his father, and Mike worried he wasn’t keeping his family’s culinary traditions alive.

But the Brusas have new culinary traditions now. Fresh vegetables such as broccoli, corn on the cob and green beans are now staples in Mike’s kitchen.

Karyn lives down the street from her father and mother, Nancy, who is also a flight attendant. She often has dinner with them when she’s in town and always makes time to go to a Texas Rangers game with her dad.

Even though she’s doing better, Karyn occasionally reminds her dad not to go back to how he used to cook. She tells him, “I’m not cured, so let’s keep it up there, Brusa!”

When Mike does fall off the cooking wagon, he always gets back on. He does it for his daughter. “I want her to live to a ripe old age,” he said.