Sunday, October 4, 2015

RECOVERY....After a Heart Attack

Big Hair Don't Care....I have a new attitude

Summary Paragraph...for those who don't want to read the entire post :)

Sometimes it takes me a minute to title my story, but not today.  August 27 at age 50 and in what I would call great health; I suffered a heart attack. It took me over 2 weeks to even say the words heart attack. I was in total denial. I called it everything in my mind but heart attack. I would tell people I had a cardiac event or cling to the diagnosis "Broken Heart Syndrome" which is indeed a cardiac condition that the cardiologist initially mentioned to me during my cardiac catheterization. In all my 25 years of nursing I never heard of the condition Broken Heart Syndrome ,but it indeed exists although it is relatively rare seen in 2-5% of people that go through a cardiac cath. This is a heart condition that occurs immediately after incredible stress such as the death of a relative or some life altering event. The body releases a huge amount of a stress hormone called norepinephrine and this injures the heart. This condition can be fatal. But what was odd about this condition as it relates to my situation is that during my attack I was not under any major stress at the time of my chest pain. Now chronic stress...yes, but acute My final diagnosis was Acute Non Q-Wave Myocardio Infarction. In layman words...Heart Attack.

My story...

I had worked a full day without incident. I did not find my workday stressful at all. I did not eat lunch during work (which is not unusual at times) so by time I got off I was starving so I decided to stop at Panera Bread and get me a few cinnamon bagels to chomp on while driving home. Of course I went through the drive through and as I looked at the menu I saw Tortellini Alfredo. That sounded delicious so I ordered my 2 bagels to devour on the way home (which takes me about 70 minutes-construction crap) and then the tortellini to eat when I got home. So I ate the 2 bagels kinda fast cuz I was hungry and I eat fast normally. The bagels sat in my stomach like 2 rocks. Agh... Got home, changed into my pj's and washed my face prior to relaxing with my hubby to watch Youtube videos. Around 8pm I microwaved my Tortellini and preceded to smash it, even though I was not hungry at that point. I ate the majority of the dish and gave the last couple of bites to hubby. Immediately after that, I started to have UNBELIEVABLE CHEST PAIN that felt like an elephant sitting on my chest. It was so bad that my immediate instinct was to get dressed and head straight to the hospital. (I had that feeling of impending doom that so many people I have cared for in the past described) Bob was watching tv and did not even noticed that I had changed clothes at first but then he he figured it out and could tell something was wrong. He asked what was wrong and I sat down and told him I was having severe chest pain. My dog Polo immediately got off the bed and went to where I was sitting and started pawing me in concern. (That should have been the second sign..aside from the impending doom feeling, to get my butt to the ER).  As I sat, I told myself that if my pain does not get better we will go to the ER. I was trying to attribute the pain to the bagels and tortellini sitting in my stomach like a rock. I usually don't eat meals like that, so in my mind I was thinking I had MASSIVE INDIGESTION, so I bargained with myself and decided to wait and see if the pain would subside with time. 😐😐😐

After about 30 minutes the pain did get substantially better going from a 10+/10 to a 4/10 pain level on a scale of 0-10. So I felt good with that, went to the medicine cabinet to see if we had any antacids hanging around. We did not have any antacids and I did not feel like going to Krogers to get some, so I took some Milk of Magnesia to get that nasty, pain causing, food out of my body. I hoped that within 5-6 hours the MOM would do it's magic and rid my body of the foul food. I managed to fall asleep on the couch and awoke around 2am with my stomach gurgling with the chest pain still there at a 4/10. I tried to poop without success. Now I was really miserable...chest pain AND a rumbling stomach. I decided to drink some water and I went back to bed. 

I awoke around 5:30 am and made some coffee. The chest pain was still there. I  did eventually have a small poop which pissed me off since my stomach still felt full. I took a shower, put on my makeup and was out the door by 7:30am. I stopped at Krogers to get some TUMS to get rid of this nagging indigestion.  I bought a couple packs of the Tums Chewables and then also the soft chewables. Prior to leaving the parking lot I chewed 2 of the soft tums and about 4 of the small chewable tablets. I drove away waiting for the medicine to work. I became a bit concerned when 15 minutes within taking the medicine the chest pain was still there bigger than day. So as I drove, I started to really concentrate on the type of pain I was having and I started making plans of where I can stop along the way to Flower Hospital (my place of work) in the event that my pain got worse. I also started having morbid thoughts of dying  and thinking about all my family. At one point, I felt a peace if I did die. I had raised all my kids and had a good life, so I was cool with it. I made it to work and instead of going to the ER, I went to my office and fired up my email as usual. I started to work through some of the issues that needed immediate attention. At one point I had to walk a good distance to take care of an issue and as usual, I climbed the 3 flights of stairs to get where I needed to go. After climbing the stairs my pain went from a 4 to a 7. At that point I walked back down the stairs straight to the ER. I minimized my symptoms and told the registration desk that I was having CP but it was probably just indigestion...and then I joked with the staff:  I don't want to be that stupid nurse that sat on a MI (Myocardial Infarction) so I need some peace of mind.

They took me back quickly and immediately got an EKG prior to even taking my vitals. I kept my clothes on just lifting my top and pants for the technician to do the EKG. After it was done, I asked to briefly look at it since cardiac used to be my main squeeze in nursing and was relieved to see a fairly normal EKG with some non specific changes, but basically a normal EKG. My chest pain at that point was at about a 2/10. So, with peace of mind I started working on things on my laptop from my bed. The nurse eventually came back after about 20 minutes and took my vital signs. I was floored when my blood pressure was 148/98. NEVER IN MY LIFE have I had high blood pressure, it is ALWAYS low. The nurse minimized the high BP and said she would take it again in about 5 minutes. "You are probably just a bit anxious being here." But I was not anxious at all....until that moment, lol.

My blood pressure started to slowly come down as I waited for lab test results. Then the doctor came in and told me the bad news. He said, it was not indigestion Annette. It is your heart. My cardiac enzymes were elevated which typically means a heart attack (Myocardial Infarction). I could not believe it and in that moment my quiet bed became a very active place as the team came together to try to save my heart muscle. I had more EKG's which were getting worse and an echocardiogram. The echo showed that my heart was pumping adequate amounts of blood to my body. The ER doc said that he was uncomfortable keeping at Flower Hospital (which kinda freaked me out since it is a big Tertiary Care Hospital) and he wanted to have me transferred to the mother ship...Toledo Hospital.  I called my husband, mother, and texted my kids at that point. Agh... 

The ER doc called the cardiologist who came in immediately to see me. I knew the cardiologist and most of all the people caring for me since I work there. He smiled at me and said, hey Annette, you wanna take a trip with me? I knew what he meant and I said, sure.... He said the mobile ICU crew are on their way and I will follow you there. At that point, I smiled and acted stoic and he left. My mom was at my bedside at that point, but Bob was out of town as he is a trucker. I smiled and said, this sucks and mom smiled back. I continued to be the silly strong nurse joking with the other nurses as I waited for the crew arrive. When the squad arrived, all of a sudden reality set in again and my eyes started to water. I was scared. My cardiologist said everyone is waiting me at the cath lab and that he will see me in a few. All my friends said bye and I gave permission to them to follow my progress.

I got to the cath lab and everyone was indeed expecting me. I was in the lab within minutes of arriving. While I was having my cath, Dr Yazji was perplexed and surprised to see that all my arteries were squeaky clean. He was anticipating a clot in one of my main arteries. At that point he explained that I had a condition called Broken Heart Syndrome. He also told me my that my arteries were abnormally small in that area of the heart I was having issues....something I was born with I guess. So with the exception of the small arteries, I had a GREAT report and he said I should have a complete recovery in a few weeks. The plan was to keep me over night then I could go home the next morning.

The following day, I got up at 5am, put my makeup on and got dressed assuming I was out of there since my cardiac enzymes were getting better and all was well through the night. Then at 10 am, I started to experience chest pain again. I tried to minimize it, but I did not want to be stupid. I was on the monitor so I could see that for the most part my rhythm was the same, but I did notice some changes. The nurse came in and took my BP and it was 148/98...agh and she called for an EKG which showed some changes. At that point I had 2 nurses at my bedside and it was on.... they gave me nitro under the tongue. I still had pain and so they gave me another NTG and my pain went from 4 to 0 almost immediately. Shortly after that I became severely nauseated and they called the hospital cardiologist to get something for the nausea and he said no, I will be right there. He ordered another echo cardiogram and  then came in to see me. I was disappointed to see it was not Dr. Yazji who did my was his partner. The first thing he said to me was "I got bad news" and went on to tell me that my coronary artery (LAC Left Coronary Artery) was so small that they can't even do surgery on it if ever needed. He went on to say that they don't even have instruments small enough to do surgery and that he could not stent it if I ever needed it. Damn....he was so brutally honest and it pissed me off. My cardiac enzymes spiked back up as well. He went on to say, now I am treating you as a full blown Myocardial Infarction. He said that my arteries are "spasming" which is blocking blood flow. So he was going to start a couple drips, put me on heavy hitter cardiac meds, and watch me for a few more days. He also put me on ativan to limit anxiety so my body won't release stress hormones and further injure my heart. Agh... (I later found out after much questioning that my small artery was not the entire artery itself, but where it branches off at the tip of my heart. The vessel above that was ok).

Thankfully the rest of my stay was non eventful and I was released home Sunday evening at 6pm. I went home with 7 heart medications including a major blood thinner. I was glad to leave and start my recovery.


Doc told me not to lift anything greater than 5 pounds....very sad indeed! Also, no cardio that will increase my heart rate over 100...that sucks! I need to let my heart rest., what I did was go to Dicks and bought a higher end heart rate monitor that people use for exercise and I used that to get my baseline heart rate and to used it as a monitor  my heart rate when I exercised (walking the track). For the first 4 weeks I was good keeping my heart rate around 100. The past 2 weeks, I upped my pace a bit and let my heart ride around 110 as long as I have no chest pain or shortness of breath. So I walk a minimum of 2 miles a day...and often more than that.

I eliminated wheat from my diet 90% of the time. (I have been on this diet for over 2 weeks) Wheat is very inflammatory to our organs and so I eliminated wheat/gluten from my diet with spectacular results. Just doing that, I dropped 9 pounds in 2 weeks, my skin is glowing...with no hormonal breakouts, my bowel health has improved dramatically, and my energy levels have increased. I will have to do an entire blog post about this diet change. I don't believe in extreme changes, so I allow some wheat here and there. I also eliminated all processed foods. I am eating pretty much all organic whole foods with grass fed meats.  I am looking into dairy...keeping it or eliminating it. Right now I am keeping it in my diet but am eating raw organic cheeses instead of pasteurized cheeses for bowel health. Again, the diet strategy requires it's own post.

I have started seeing a relaxation coach to help me with my Type A tendencies and help me relax internally as well as externally. People that truly know me know I am high strung, always in a hurry, want it right the first time, an extreme procrastinator that loves doing things at the last minute and barely making deadlines...but I always make my deadline (stressfully). That has to change as my vessels react to stress hormones by constricting!!! I noticed this immediately when I returned to work after 3 weeks off. As I started going through all my emails and the tons of to do list things I had to take care of, I immediately started getting chest pain. Agh... But I have some new relaxation tools in my arsenal to help me and some good old NTG medication. I have had to take NTG twice since my heart attack and both were during work. So I am working really hard on not stressing and taking things one at a time at work and not letting the job kill me. I am getting better at it. It is not the job causing the chest pain, it is me stressing when I don't need to stress. I can no longer procrastinate to deadlines as that causes stress. I am getting there. I am also looking into Yoga and Tai Chi in the future. When I can start training and exercising again this will help a lot too with my stress.

I am experiencing the grieving process with this heart attack, mostly because of my ego. I was proud to be what I thought was the epitome of health. I probably was a bit arrogantly proud. I boasted about being 50 years old with the health of a 30 year old. Ha....boy set back was a seriously humbling event. I think my ego needed it. So, I went through the denial phase for a good 2-3 weeks. I am still working through the anger phase. I can't help but get angry as I am walking that dinky track at the YMCA with that stupid clicker to keep track of the million of laps I have to do in order to do 2 miles watching all the people nonchalantly head to the weight room. Or walking in Krogers and looking at all the people buying crap and they don't have a heart attack.....yet. Yup, I still get a bit angry. But I am moving into the acceptance phase of grieving, hence the ability to blog and talk about my heart attack. I am truly aware that I am BLESSED and things could have been WAY WORSE!!!! I just spoke to a friend and FB buddy who I just found out had a heart attack as well when he saw my post. We messaged back and forth and he said a thing that had a profound effect on me. He stated,  "I would not trade a thing for the journey. This is where you get to see what you're really made of. " Thanks Dave G....I needed that. (((HUGS))) coach for a couple of years and a long time friend, has been a true help indeed in keeping my head in the right place regarding taking things slowly with training. (((HUGS)))

I kept my hospitalization and details of my illness very private, just sharing it with my hubby, mom, brother, sister, and kids. That pissed all my other family members and close friends off. I won't do that again....that's for sure. Hopefully there will not be a do over. To be honest, I just hate worrying people and when I am stressed I don't want to be surrounded by people visiting or calling. I am just that way...have to let things sink in first. Maybe that is selfish....but that is the way I am...a loner. I don't like attention that way. Now, if people want to swoon over me in regards to makeup and stuff like that, that is My mom was my rock and so were my kids. My brother and sister called me every day and I was happy with that. My in-laws and ex's knew about the heart attack as well due to the hubby and kids telling them and they were very supportive too. My ex husband, his brother and sister checked in on me by phone frequently and that was much appreciated.

1. Eliminate all medications except aspirin ASAP
2. Super duper clean diet 90% of time
3. Relaxation techniques to keep stress down
Me Relax...I need all your prayers to help me with this

I see my cardiologist October 13th and we will have the medication discussion. I want off!!!! A lot of the medications I am on I feel is not necessary since my arteries are clean and I feel I can heal safely through dietary changes!!!! I have done my research and I want OFF THE MEDICATIONS!!!!

I am hoping that when he see's me on the 13th he will notice that I have dropped 10 pounds (almost there) and I mean business. I want him to trust me to make the NATURAL changes to prevent further cardiac events.  

Cardiac rehab....I think I can do it myself now!!!!! Also I am doing my research to see when I can safely start doing weight training again. I have read a few studies where people started heavier weight training pretty early after a heart attack. I will have this discussion with my cardiologist pending that my echocardiogram and EKG are basically back to normal. I will not even bring up the conversation if there are not improvements on both these tests.

I am walking alot...and taking the stairs for 1-2 flights. I cannot do more than that without raising my heart rate to the 120's.

So that's my story. Next blog post will be about my AMAZING diet changes. If you read through this entire long blog post...thank you...cuz it was long.

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