My Heart Attack
by Submitted anonymously
I had pamphlets on the warning signs, but when that big squeeze crept up my chest like an alien life, angina never crossed my mind. Especially being a svelte 5' frame at 104 lbs, 57 yrs old, I wasn't exactly a profile of a person about to have a heart attack. The diagnosis of my heart condition became a life altering reality that shocked my world and changed the way I live.
The year 2005 was a particularly difficult time for me. The strain of running a practice sometimes left me with frequent bouts of insomnia and anxieties. Rather than seek advice and sleep medication from my doctor, I increased my vitamin regime, added green tea to my already no-red meat diet, and stayed the course with weekly tennis and yoga class.
By summer 2005, I was feeling so worn out that even climbing a half flight of stairs left me breathless. When I exercised more, I could not build any endurance. Catching my breath to slow down my rapid heartbeat took minutes instead of seconds. By fall 2005, I developed a discomfort in my upper chest area just below my collarbone and beneath my sternum. It felt like a gentle push that lasted a few seconds. These occasional bouts of discomfort developed to daily occurrences whenever I exerted myself. By Thanksgiving, a simple task like carrying groceries up 13 steps left me so breathless and exhausted that I started to rationalize that my asthma was acting up. Day by day, my chest pressure grew with more intensity. My blood pressure was elevated from last year. I had low energy and lacked appetite. I was losing weight. The chest pressure felt like something was pushing or squeezing my upper chest, lasting a few seconds to 1/2 minute. It wasn't painful and it wasn't constant. The discomfort was enough that I was pretty baffled.
In early December, I was very busy with moving my office, which meant a lot of packing, organizing, and heavy lifting. By then, the chest pressures became a daily occurrence, but they didn't seem to bother me. Then, three days before Christmas I had a fitful and sleepless night. I felt like hell and was late to work. My partner encouraged me to see my doctor. When I called the Kaiser advice nurse, I was told to go immediately to the emergency department. Considering that I wasn't in pain, I really thought this was a little extreme.
Kaiser Emergency December 22, 2005
I decided to get myself checked out so I drove to the Kaiser Oakland Emergency. When I explained my chest pressure symptoms to the triage nurse, I was seen a doctor immediately even before a crowded room of patients. After three hours of wearing an EKG monitor, lying on a gurney, I showed no symptoms. When I got up to walk around, that tight feeling returned and finally triggered the monitor. It was then, that I heard the doctor say 'angina attack'. At that point I really didn't know what an angina is or its implications. I only learned that it was enough to admit me to the hospital, three days before Christmas.
Tests and more tests...
After four days at Kaiser Hospital, I was poked many times, medicated with anti-platelets and confined to complete bed rest. Initially, I declined to undergo a cardiac-catheterization; an invasive procedure to view my heart using tubes, catheters, dyes and x-rays. I insisted that they check my thyroid as the culprit. My thyroid levels were high, but the cardiologists weren't about to let me go. So less invasive tests were ordered which included an echogram, more x-rays, and nuclear stress tests. It was my failed stress test that confirmed my lack of oxygen to my heart. Absolutely stunned, I was finally convinced that I needed the cardiac-catheterization tests.
It was on day six, December 28th, when I was transferred by ambulance to Alta Bates Summit Hospital for my cardiac-catheterization. I signed several forms-no time for the fine print. I was wheeled into the steel trussed room that housed a large equipment with giant overhead monitors. Jazz music was playing in the background while the doctors and technicians were getting their garbs and masks ready. I was drugged to a semi-conscious state, which made the entire hour procedure feel timeless. When the doctors finished, I started to regain full consciousness. Suddenly, I felt an even deeper pressure, a heavier weight on my chest. I heard a female voice instructing me to open my mouth. She placed a nitroglycerin pill under my tongue. I heard a faint voice in the distant, "she's having a heart attack."
The Surgery Team
The tiny white nitroglycerin was like a magic pill. I found instant relief as the pill dilated my arteries so that I could breathe easier. I was taken to a private room in the intensive care unit. I was alone with my book until a team of white jacket doctors paid me a visit. The chief thoracic surgeon introduced himself and proceeded to inform me that I had a heart attack in the Cardiac Lab, that they identified four artery blockages that were over 50% and that I needed open heart surgery immediately for a triple by-pass, a rerouting of my blood circulation in my heart. The doctor continued talking, but I heard nothing more because I started to cry. I was emotionally overwhelmed by the bad news. The young woman doctor in the group saw my reaction and quickly dismissed the group, leaving me with my attending nurse. Sometime that day, my daughter and my close friend consulted with my doctors. Some conclusion was made that my surgery could take place in five days to allow time for my anti-coagulant, Plaviv, to pass out of my system. It was also a measure to minimize potential bleeding during surgery. The young woman returned to explain the surgery procedure. Although I learned that I had a mild heart attack with minimal to no damage to my heart muscle walls, I was very fearful and anxious. I explained that I did not want my heart stopped during surgery. The notion of 'shock paddles' was more than I could handle. What if my heart doesn't start up again? She suggested that my by-pass procedure might be achieved by the 'beating heart ' method thereby avoiding the need to stop my heart. The next few anxious days involved getting my durable power of attorney signed and notarized. I was given an instructional video, which was rather benign. My attending nurse gave me the 'no panic' instruction in anticipation of a breathing tube down my throat during and post surgery.
The night before surgery, I was given a special disinfectant bath and a sleeping pill. I was awakened at 5:45 am and taken to the surgery unit. I barely heard my daughter's words of encouragement as the sedatives began to take hold. The last thing I saw were the three large translucent disks above my head in the cold surgery room. I was told the surgery lasted over five hours, that I had excessive bleeding, and that the heart lung machine was used as a precautionary measure. That meant a machine did the breathing for me and circulated my blood while my heart was stopped for surgery. And no, I did not see a white light. So bring on the shock paddles....
I woke up in the Cardiac Intensive Care Unit to familiar voices, my daughter, her father and my best friend. The next few days were the hardest part of the recovery. I was so weak and in some real pain, but at least I knew I had survived. The breathing tube was removed within hours. I was nauseated, thirsty, and sleepy. Post surgery procedure included sitting up in a chair within 24 hours-that was an ugly moment. I think I was moved after two days to the Cardiac patient room to continue my recovery. During the next nine days on pain medications, I had my stitches and drain lines removed-that process really hurt! I worked with my Physical Therapist to relearn walking, sitting up, and all the basics to begin caring for myself. I was told that my three by-pass grafts came from leg veins and a mammary artery. That explained the nasty scars I found, not to mention the 7-1/2" zipper down the middle of my upper chest. By this time, I weighed 91 pounds and looked like an ashen colored ghost. Finally, after my blood pressure was stabilized, I was discharged after twenty-one days -- eight days post surgery. I was given my meds, a heavy-duty schedule for follow-up appointments.
Recovery at home
In the weeks ahead, I had underestimated the difficulty of home recovery. I struggled climbing those damn stairs and felt physically challenged especially moving in and out of the car to doctor appointments I missed my daughter's help when she left for her new job in LA. I wasn't allowed to drive for seven weeks so I learned to accept help from the dearest of friends and my cousins-- only a handful of family and friends learned of my heart episode because I didn't want people to think I was going to become an invalid. I am forever grateful to them for being there- C.W., L.B, W.B, M.H., B.H., J.C, K.G., A.J., G.W, B.T, L.G., C.H.
Two months after surgery, I joined the Kaiser Multifit class for cardiac patients. I learned how to optimize my recovery. My atherosclerosis is a chronic condition that involves understanding my risk factors, making lifestyle changes and taking medications. I wanted to do everything I can to avoid another episode, because studies have shown one-third of recovered heart patients become repeaters and need a second heart procedure. I feel a world of difference from my pre-surgery days. I can breathe deeply. I can walk a mile.
Understanding your heart
We should all be aware of the early warning signs for heart attacks and strokes. Often the symptoms for women are different, woman-to-woman, and women to men. Some women feel only mild angina attacks before a major attack happens. Sometimes the symptoms in women are misdiagnosed because women's arteries are smaller than men. The statistical data reveals heart failure among women nearly matches the men. I was lucky-I unknowingly described my 'classic angina attacks' to the attending emergency doctors. Even after a three-hour wait in the emergency department without any visible symptoms, the doctors did not send me home. I received very good care at Kaiser and Alta Bates Summit hospitals from the numerous doctors, technicians, and nurses. I am most grateful to my surgeon and for saving my life.
I was very saddened to hear that Nan Croley died last March. I will miss my talks with her at the OWA retreat. I remembered that she retired early to bed during the last retreat instead of joining the belly dancing festivities. I, too, chose to watch everyone because I was too tired. I now realize that she could have gone to the doctor long before her heart gave out. Indeed, heart by-pass surgery is a frightening prospect for anyone who needs it, but the success rate is nearly 90%. Those are pretty good odds.
The American Heart Association website has a wealth of information on heart attacks and strokes. You can evaluate your own risk factors and your own health level. You can decide for yourself what lifestyle choices you need and learn more about healthy nutrition and daily exercise. I think everyone should do him or herself a favor and read the material, because the knowledge can improve your odds for longevity.
I know it's difficult for me to explain what it's like to have that close call unless you've experienced one yourself. Life is sweeter now and I am very glad to be among the living.
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