Tuesday, March 31, 2015

How My Heart Attack Saved My Life

There are strange days that can change everything. February 6, 2015, was that sort of day for me. I became a Medicare patient as of February 1. As they say, timing is everything and location is everything else. Both played major roles in the events that followed. This blog is based on notes I wrote in hospital, Feb 6-8. On February 5, I underwent my “Welcome to Medicare Fitness Examination .” I had been plagued by chest pains for over a year and a half. I was given a stress test to rule out my heart. Was in treatment for acid reflux disease and, recently, an ulcer. The reflux condition allegedly was giving me the heartburn I was experiencing. I was taking Nexium, watching my diet, and otherwise behaving relatively normally, but the episodes of heartburn continued. The dose was doubled. When I came in for a follow-up to get a new prescription for the Nexium, my care provider decided that this was too long a stretch, that the pain should have gone away. A blood test revealed I had an ulcer, and I underwent treatment for that with a course of antibiotics. The day I finished that course, I went in for the Medicare check-up. The night before the exam, I had a severe episode. It passed, and I attributed it to the chili I had for dinner. Except for the ulcer (under treatment), my right hip(arthritis), and poor eyesight (cataracts), she gave me a clean bill of health. The blood work revealed nothing alarming: my kidneys were in great shape, my liver normal, my cholesterol levels where they should be or better, my heart sound. She even ran an EKG that revealed nothing past or present, though she did wonder at my fixation with my heart. Given my family history and my anxiety, she was most pleased to once again rule out heart problems. It was a nice Friday. I worked at my job as janitor at Joe Blogz from four am until seven. Once home, Di and I had breakfast, watched the first twenty minutes of The Today Show to find out what didn’t happen in the world, and then attacked the backed-up DVR. MSMBC’s golden quartet – O’Donnell, Matthews, Hayes and Maddow – gave us better coverage with that liberal slant we both love so much. Then we watched Elementary and Backstrom. It was after twelve when Joop, our friend, called to tell us that the Chesapeake Bay crabs he had ordered had arrived, would we please come get it so Di could prepare it for Tuesday? After Backstrom, I got up, intending to go potty, get my shoes, and drive over to Joop’s to collect the crab. It was exactly one p.m. I went to the kitchen to bus a plate on my way, and to check the outside temperature to see what outer garment I might require. It was a balmy 51 degrees, downright hot for Montana standards in early February. Then the earthquake hit inside my chest. For want of a better metaphor, someone had placed a heavy box about the size of a small priority mail package inside my chest and then set it on fire. In the flames, my heart muscle began to constrict, to cramp, and pain radiated down my left arm from the elbow to my fingers and my right shoulder. I could breathe, but in desperate gasps because I could not get on top of the pain. It was like nothing I had experienced before. Still, I thought I could ride it out. I had gotten through fairly severe episodes before, and was able to control them through a change of position and controlled breathing. This one got away from me at the start as if I were a jockey thrown off his thoroughbred but with one foot still caught in the stirrups. Over the next five minutes I struggled to the bathroom, still in severe pain. When I finished I collapsed to the floor seeking the cool of the linoleum. I hollered for Diane, who came running. By now perhaps five minutes had passed and the pain was just as intense, and I began to feel like giving up – please let it end. It’s hard to judge time when you’re in pain. Di called 9-1-1. Even though we live in rural Montana, we have a fantastic Emergency Medical Technician unit just a few minutes away, just down the road. By now, ten minutes had passed. the pain now ebbed and crested like waves on a surfer’s paradise. But it did not stop. The EMT’s got there quickly. In all, fifteen minutes passed by the clock between the initial attack and the moment one EMT gave me nitroglycerine while assessing me. It took two nitro tablets, but then the pain was gone, completely gone. I was never so grateful in all my life. And the pain has not come back. Then the ambulance ride, more assessing, admission into the cardiac ward, tubes and drugs and blood draws and monitoring, and now I sit at 4 am, jotting all this down. Hard to believe 24 hours ago I was clocking in to work. More later: think I’ll catch some sleep. Angio tomorrow. It may as well be Anzio. I’m not being glib here. There is a real chance that the pain I have been dealing with for the past eighteen months will be vanquished from my body in the next eight hours. It turns out that esophageal issues and cardiac issues often mimic each other. What we thought was one thing, turned out to be the other. I had stress tests and EKG’s to rule out heart issues, but the issue hid. In my case the Lateral Anterior Descending artery, the LAD, was 95% blocked. They call that artery the widow maker because you essentially have to be in the middle of a crisis for it to reveal itself. Stress tests and EKGs and enzyme levels in blood tests tell nothing; in fact, the only difference between my blood work for the Medicare exam and after the attack was a spike in the cardiac enzyme troponin. I look healthy. I shovel snow and don’t get short of breath. I carry reasonably heavy loads. I can walk for miles and miles. I have maintained a reasonable weight for several years. My veins and arteries are virtual hoses by virtue of the fact that, as a mail man, I walked for a living. I am proof of, perhaps a poster boy for, the fact that this could happen to anyone. The angioplasty revealed that most of my vasculature is reasonably healthy for a man of 65. The one blocked artery required a substantially long stent to repair, but repaired it is. I am on a pill regimen designed to keep my blood pressure and heart rate low, as well as to allow my body to finish the repair without forming clots or attacking the foreign material. I began cardiac rehabilitation two weeks after the attack, along with my son’s father-in-law Frank. Frank had triple bypass in December. More than half my fellow patients in rehab have had open heart surgery. I was lucky. Now I can say I am healthy, except for the heart attack. And that issue was resolved. In a sense, I have won the lottery for a second time in my life (the first time is a completely different story). No cash but great value. If I had not had the heart attack when and where I did, I would still be suffering the same symptoms and probably, some even stranger night, I would have died. My heart attack literally saved my life.

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