Another Anniversary - 16

Sunday morning, January 3, 2010. The day started as most of my days in that time. I woke up, I had coffee, read the news, and had a light breakfast, it was Grape Nuts. [1]

It was the week between Christmas and New Years, and I was off work (shut down).

After my breakfast, I did what I often did and headed to the gym for an hour on the elliptical trainer. What I often did when I wasn't working. When I was in the office, I would lace up my trainers and do an hour of jogging.

Anyhow, at the gym, I felt off. I couldn't get into a groove, and strangely, my heart rate just wouldn't get to a cardio zone. I completed the hour, and for the first time ever, I skipped the 5 minute cool-down. It was about 7:30AM.

I head home, and jump into the shower, and BAM, it hits me. Pain shooting down my arms, and it felt like Dom DeLouise was standing on my chest.

I stumble out of the shower, and walk down the hall to my wife's "office" where she was reading her news, and I told her I needed her to take me to the hospital.

Naturally, she freaked the fuck out, dialed 911, and got the EMT team in (took about 5 minutes. They hooked me up to their junior EKG machine and took my vitals, and declared to my wife that since I was at the gym, I probably pulled a muscle and that it was nothing.

They said they didn't think I needed to go to the hospital. She "disagreed", and told them to haul me away. They relented, but they didn't think it was serious enough to run their sirens.

Meanwhile, my chest felt like a 1964 Chrystler Town & Country wagon was parked on my ribcage:

The EMT team rolled me into the ER, I got wheeled back, and they hooked the better EKG on, and they diagnosed it properly, that I was having a heart attack, and that I was going to be wheeled into the catheter lab STAT.

My wife hadn't arrived yet, but I was sure she would be there shortly, and I got weepy. What was goign through my mind was not the usual, trite "life flashing before my eyes", but the thoughts that I wouldn't see my dogs again.

The shit you prioritize, right?

Anyhow, off to the lab, they ask me some questions, and I remember to tell them that I have a shellfish allergy, important because they shoot you full of iodine! They hit me with a huge bolus of benadryl, so for the actual procedure I was out cold. Apparently, I had a complete blockage of the descending node of the right coronary artery, they fed a catheter to it, hit it with a blast of an anticoagulant, and then dropped in a stent (a Boston Scientific Taxus drug eluting stent, I kept that card in my wallet for a decade) and off to recovery.

Note: for angioplasty, they want the patient awake, but because of all the benadryl they hit me with, I was out like a light.

My wife appeared when I came out of it in recovery. I was in ICU, as, well fuck, I had a motherfucking heart attack, or as they politely put it, a "myocaridal infardction" or MI. I was weak as a kitten. I could barely move my head. I was hooked up to an 8 lead EKG telemetry box, and I had ICU nurses checking on me often.

One thing that I noticed (but didn't learn why until MUCH later) is that they would feel for my pulse in my ankle.[2] I thought it was wierd, but who the fuck was I to question it.

Anyhow, I looked like death warmed over. My wife was there and it was clear that she had been crying. (That is not a surprise, she is a "crier")

I was on intravenous blood thinners, I was tired, and I was hungry (and to be quite frank, since my "shower" didn't happen, I was a wee bit "ripe". Nasty.)

My wife had arranged our dog sitters to pick up our dogs, two rescued greyhounds, because she didn't know what was what. That was a good thing.

In total, I was in the hospital 3 nights, and I had to call my boss and tell him that no, I wouldn't be flying to those important meetings in Bellevue, Washington on Monday. Naturally, he was fully supportive.

Afternoon on the second day, I was encouraged to get out of the bed and (slowly) walk around. In fact, I was ORDERED to, but to not overdo it. One of the things they do before letting you leave is to track your vitals (remember the telemetry module) for light activity (I will not call it "exercise") looking for any trouble signs.

Noon on Tuesday, they proclaimed that I was fit to be released, with a parcel of literature, a long list of "Thou shall's and Thou shan't's", some dietary advice (high fiber, low protein, and long term adjustments), an appointment in 2 weeks time for something called an "echo cardiogram", and a doctors note to not go to work until they release me.

I was ecstatic to see my buddies. Garrett and Oliver.

The recovery

I literally didn't do shit for the first two weeks. I played X-box, I futzed around on the computer, I read, I ate, I pooped, I slept. I slept a lot.

At two weeks, the crucial check happened, I was visiting my new specialist, a "Cardiologist" and the first task was a full echocardiogram.

On with the myriad of electrodes, and this time some of that sonograph goo as they look at the heart in motion.

For this one, they didn't add the "stress" to the front (that is where you are on a treadmill to get your heart rate up before the measurements, and it sucks).

Apparently, both the tech and the doctor (my cardiologist was manning the cath lab that faithful morning) were astounded. Their hushed conversation caused me to ask what were they seeing.

The response was that had they not been there, had not performed the angio, they would have sworn that the heart muscle was in perfect shape.

In other words, I was lucky. I wasn't going to have permanent function degradation.

The danger of a heart attack is that the blood flow is blocked to the heart, and the muscle dies. My wife did the exactly right thing, she dialed for the ambulance, and also have the ambulance haul my in, because that gets you wheeled past the masses in the ER. Even though the EMT's misdiagnosed the event, that likely not only saved my life, but prevented me from long term reduced life quality.

Anyhow, I was released to work, and to start the 12 weeks of rehab.

The aftermath

I won't go into the details of the rehab, it was a weekly ordeal with goals, and increasing levels of activity to monitor the heart (I hated having that sensor pad adhesive all over my torso), but by the end, I was jogging on the treadmill to get the full range of exertion, something that was freaking out the other denizens who were 15 - 30 years older than me.

I was 44 years old when the event happened. I thought that was "young" so I did some research, and no, that isn't young to have a heart attack, it is just that a lot of people that age (or younger) assume it can't be a heart attack, and ignore the symptoms, and they expire.

For a full year, we had been planning to hike down to the bottom of the Grand Canyon (we lived in Tucson, AZ at the time), and I was super bummed that I would have to skip it. I asked my cardiologist and he said that if my rehab was going well, and I did a full stress echo-cardiogram, he would clear me.

I did it, I passed, and 8 weeks to the day (Sunday, March 6, 2010) we set out from the south rim down the South Kaibab trail to the floor. It was snowy at the top, so we needed boot crimps, but at the bottom it was near 80F. Taking my boots off and soaking my feet in the ice cold Colorado River was the best. The second best was a $6.00 can of Tecate at the Phantom Ranch. I had two.

3 days later, we hiked out the Bright Angel trail, and when we got to the top, I shouted to the gods!

Lessons:

If you have symptoms, don't dawdle. Time is muscle. And women have different symptoms (for instance, instead of shooting pains in the arms, it often manifests as an "achy" jaw) so familiarize yourself.

Call 911 (or whatever your emergency system is). Time is muscle, and the ambulance will get you past the ER waiting room.

Don't blame yourself. Get help, and listen to the experts. In my case, as I was working with my exercise physiologist (the rehab) and we were listing the risk factors, the fact that not one of my mother's side of the family made it past their early 60's was a strong indicator that it was mostly a genetic risk factor. That and as a product manager, I am a fuckin' stress junkie working myself into manias.

Anticoagulants suck ass. I was on plavix for 8 years because of the stent, to preven restenosis, and even a minor nick will bleed for fucking ever. Years later, I was hiking at Sabino Canyon, and on the way back I slipped and fell on a rock and gashed my forehead. When I got back to the car, it looked like I had tangled with an axe murderer.

Trump taking 325mg of aspirin a day (as reported in the WSJ) is just fucking dumb. I take 81mg, and no other thinners. 325 daily (and I would bet that he takes more than one) is a recipe for ulcers and internal bleeding. If asprin came up today for approval, there is no way it would be approved for OTC usage.

Live life. You never know when you will draw your last breath. Behave like it.

If you want to peruse the photos from that trek to the Phantom Ranch, chek them out on my Lightroom account.

1 - little did I know that it would be 30 hours until my next food. I might have had a bit more to eat...

2 - Apparently, they check at the ankle because if you are having issues with your peripheral arteries, the pulse in the ankle will be weak or missing, and that gived them a lot of clues. My cardiologist to this day still checks it.