Health First Nurse Practitioner Joy Cruz is Lifesaver: ‘Joy Found the Problem—I Owe Her My Life’

Cruz detected a troubling sound in Fred Gynan's carotid artery called a bruit

A nurse’s quick thinking, a 54-year bond with his wife, and timely medical care have Fred and Rita Gynan back to living their best lives together.     

BREVARD COUNTY, FLORIDA — This past February, typically recognized as American Heart Month, holds a special meaning for Fred Gynan and his wife, Rita. It is a time of celebration and reflection, marking their enduring love story and Fred’s life-saving health journey.

This year, they celebrated 53 years of marriage on Feb. 12—a milestone in a journey that began 54 years ago with simple dates and shared dreams.

But just as February symbolizes love and commitment, it also serves as a stark reminder of how fragile life can be. Trouble struck Fred without warning. “I woke up in the middle of the night on a Saturday with back pain that wouldn’t go away,” he recalled.

“It felt like a deep pressure between my shoulder blades, which kept getting worse, then finally subsided a bit.” Rita acted quickly and called 911. Paramedics advised Fred to seek further assessment, so the Gynans went to Health First Palm Bay Hospital, where doctors admitted him and confirmed he had a heart attack.

Fred spent four days in the hospital, where he received two stents to keep his artery open and blood flowing properly. After completing cardiac rehab through Health First, doctors gave him the all-clear.

Despite feeling healthy, Fred was always cautious about his heart due to a strong family history of heart disease. “It’s hereditary—my father, grandfather, and great grandfather and my uncle all had heart issues,” he explained.

“I started asking the doctor to check my heart annually over a decade ago and attended regular screenings and other various Health First Health Plans events.” Still, his heart attack came without classic warning signs—no chest pain, no shortness of breath.

Post-surgery, Fred embraced significant lifestyle adjustments, starting with his diet. Although he believed his habits were healthy, he began reassessing his meals. He cut portions in half, prioritized lean proteins like fish, and added more vegetables to his plate. He reduced red meat and limited indulgences, feeling more energized and in control of his well-being.

These changes and consistent exercise led Fred to lose 35 pounds. The Gynans participate in Health First’s Silver Wellness program three times a week, wear their fitness tracker, which the Silver Wellness program provides at no cost, and go on regular walks together.

Nine months later, during a comprehensive health assessment, another threat emerged. Health First Medical Group Nurse Practitioner Maria “Joy” Cruz, of 30 years, detected a troubling sound in his carotid artery called a bruit, or as Cruz likes to explain it, a “whooshing.”

Cruz referred him to Dr. Kamil Ceiply for further testing, which revealed a high-grade stenosis—meaning his artery was over 90% blocked. In fact, it was a heartbeat away from a stroke.

The urgent call soon came to the Gynans.

“They asked, ‘How fast can you get here?’” Rita recalled. Two days later, Dr. Roger Moccia, a Vascular Surgery physician at Health First Palm Bay Hospital, cleared the artery.

His heart was beating even better—not only for his health but for his wife, who stood by his side every step of the way. She received regular text updates from the operating room, easing her mind as Fred progressed through surgery.

“With a high-grade stenosis, you can wait a few weeks or even a month, but not beyond that,” emphasized Moccia.

According to Moccia, Fred received the same prompt care as every other patient: “We accommodate based on the possible outcome.”

Preventative measures are crucial because once the condition occurs and becomes that severe, there is no way to correct except to have the build-up surgically removed.

Known risk factors include high blood pressure, diabetes, genetics, smoking, a Western diet and being male. While a healthy lifestyle can reduce the risk, genetics can still play a significant role in the development of carotid artery disease.

After treatment, the risk of recurrence is about 5%. However, Moccia has seen nearly 0% recurrence when using a specialized patch technique. Carotid artery buildup is mostly found in males between the ages of 60 and 70, with plaque accumulation taking anywhere from 20 to 40 years to develop.

Fred and Rita also credit Silver Wellness (previously Silver Sneakers), a Medicare benefit, for helping them stay active and informed. They are very good,” said Fred, also accrediting the program for always having the information you need.

The Gynans enjoy events such as movie outings, trips to the zoo, and other activities offered through the Health First Medicare Advantage plan, which help stimulate both their mental and physical well-being.

As Health First Medicare Advantage members, the Gynans praised their comprehensive care. “They’re more than insurance,” Fred said. “They provide information, events, and support.”

As for Cruz, she credits God. “It was God guiding me and telling me what to do, and it makes me feel that I was able to help someone.

“Rita said I gave Fred more years with her husband,” said Cruz, reflecting on her recent visit with the Gynans, who stopped by the Medical Group to thank her and give her a big hug.

“Joy found the problem—I owe her my life,” said Fred.

Fred’s story stands as a testament to the power of attentive care, diligent screenings, and the life-changing impact of listening to the right people at the right time—one heartbeat at a time.

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