Wednesday, December 03, 2014
My Heart Attack
I wanted to share more on my heart attack from two weeks ago. Maybe there is a lesson in here that will help you.
I’m leaving a lot out. Just accept that I was once very athletic, that I’ve had some health setbacks that have led to less exercise and more weight gain. Also, I was adopted in the Chicago area and thus do not know my family history. I have to assume my gene pool is probably best represented by these fine gentlemen:
During the heart attack I was angry, confused and embarrassed.
I was angry the moment I realized it was a heart attack. I never thought of death, and I never felt any fear. Funny as it may sound, my mindset for those 95 minutes was very similar to Lt. Dan on the ship mast during the storm.
The initial anger came from the fact that I’m under 50 and in relatively good health. The subsequent anger, and embarrassment, has come from the realization that my health is not as good as I first assumed. Genetics played a major part, but any additional blame falls squarely on me.
I was confused. I am diligent with my meds and spent the past two years with my doctor tweeking the doses of my blood pressure and statin drugs. My numbers looked great. Further, I have taken a baby aspirin every day for the past two decades. I even paid out of pocket several years ago for a CAT scan to check my heart for blockages and received a clean bill of health. Although my cardiologist suggests otherwise, I cannot recall having any symptoms prior to the attack. In the six months prior, I was eating better and was more active. Obviously the damage had already been done.
0:00 Pain started when I stepped out of the shower
2min: Full pain. Tried to find a comfortable position. Tried to determine cause. Did my Lt Dan impression. I came up with four possible reasons for the pain and started narrowing them down.
4min: Full pain. Called the better half and told her to come home. Still not sure what the cause was, but a heart attack was the worst case scenario and I decided to get dressed and go unlock the front door just in case.
19min: Full pain. Dressed. Front door unlocked. (Yes, it took ALL 15 minutes to get dressed and make it to the front door.) 90% sure it is a heart attack. I call a neighbor who is an RN and off duty and asked her to come over. By the time I hung up with her, I was sure it was a heart attack.
23min: Full pain. Call 911. I hear the siren less than a minute into the call. RN helps answer all the medics' questions as they prep me for the ride.
65min: Full pain. Rolled into ER.
80min: Full pain. Rolled into catheter lab. Blood clot removed. Stent installed.
95min: Zero pain. Rolled into ICU.
I required two full days to sleep off that 95 minute experience.
Someone once told me a heart attack feels like an elephant stepping on your chest. That is a bingo.
The reasons I did not immediately identify it as a heart attack: 1) there was no pain or other sensation in my left arm, 2) did I mention I’m under 50? and 3) there were other recent activities and events that could have led to muscle cramping and/or nerve pain.
It was at the 23min mark when I looked up and saw the elephant.
The CAT scan checks for calcium deposits, not plaque. It is simple, cheap and fast. It is a good test, but NOT the assumed foolproof peace-of-mind procedure. The proper way to check for blockages is with angiography - an involved procedure that is expensive and can take a full day. The angiography may be hard to arrange for someone without symptoms. Some still use a stress test and this too is a useful procedure to check for blockages. My advice: ask your doctor, but do NOT settle for the CAT scan as I did.
My attack was triggered by the combination of a blood clot and a partial (70%) plaque blockage in one artery. I had a pain level of ten going into the catheter lab off the ER. The doctor first removed the blood clot and asked about my pain. Four. A minute later he placed a stent in the area of the blockage and expanded the diameter from 30% to full. Pain level: zero. First question: I take a baby aspirin every day, so why the clot? First assumption: The clot was floating around and became stuck in the blockage. Wrong. I now understand the plaque can crack or be disturbed, causing a rough surface. Blood cells attach to that rough surface and a clot forms. Once the clot became big enough, blood flow was reduced to the point the heart muscle reacted.
A funny note: When speaking with friends and family, I was shocked at how many carry baby aspirin in their car in fear of an attack. These are people who have never had a heart attack. I took one about 10 minutes prior to my attack, and the medics gave me three more on the way to the ER. I had never heard of this before, but now I too have some baby aspirin in my car.
Every heart attack causes damage to the heart muscle. There are two factors in my favor: 1) the degree of blockage and 2) duration.
I did not have a full blockage. Circulation was limited, but there was no time when that part of my heart muscle did not have blood flow.
I heard two timelines from the several doctors I spoke with. Less than two hours is ideal and can lead to nearly no damage. Less than six hours is ideal to limit the worst kind of permanent damage. They told me there are patients, with similar symptoms as mine, who wait a day or two before coming in. They suffer permanent damage that includes scar tissue and huge health issues from that day forward.
I’m headed to a cardiac rehab program for two months of supervised cardio. I can’t wait. I’ll do a stress test next year to get a good benchmark.
My cardiologist says the biggest worry for a man my age is that, from the anger and embarrassment, I make radical changes to my diet and exercise to the point that I become frustrated and give up. He advises minor and steady improvements, and to avoid processed meats. He advises becoming more active with minor activities like walking the dogs or raking the leaves.
The science of the heart is understood. Most of the drugs are now generic. One can have heart disease but, with diligence, live a full life.
I had a 70% blockage two weeks ago. Now I have none. I feel great.
The rumors of my demise have been greatly exaggerated. I renew my pledge to seek commies out and mock them for a good laugh. It is what He wants me to do.
Thanks for the advice and comments in the comments section! Wayne - I read your comment an hour ago and I'm still laughing. Thanks Comrade, and be well!
UPDATED 12.6 Noon:
Found at Imgur. This about sums it up.