Checking In

Shortly before I began my cardiac rehab program I told my cardiologist that I planned to run in a 10K race this spring.

“You might have to wait another year for that,” he gently replied.

Nothing doing. I was determined to be a model cardiac rehab patient and get myself back in shape quickly, as long as it was within the bounds of the nurse directed program.

Okay, I wasn’t exactly a model patient. I skipped most of the “education” sessions. I attended a few but soon I grew uncomfortable sitting in a small crowded room watching a videotape for thirty minutes. I am much too restless for that regime.

On the other hand, as far as the exercise portion of the program was concerned, I was focused like an athlete training for a big game. The nurses soon caught on to my determination and they supported and encouraged me as long as I kept within their prescribed limits.

The result was that at the end of the 36 sessions I was ready to get back to my old exercise regimen and I was even more determined to participate in the race that was now about two and a half months away.

To make a long story short, I completed the 10K race in just under an hour. I was elated to say the least.

I was also thankful. I truly believe that the nurses in the cardiac rehab program were instrumental in making that happen. To thank them I bought a large box of Godiva chocolates and stuck my marked up race bid in the bag with them and dropped back by Howard County General Hospital to deliver them. It was a small but heartfelt gesture.

Finding My Voice

When I started this blog back in October I thought I had a clear idea of what I wanted it to be.

I am now rethinking that clarity.

After an initial burst of posts about my own cardiac event and subsequent posts about other guy’s heart attack stories I began to run out of steam. To anyone who has been following this blog that is pretty obvious. My last post was almost a month ago when I graduated from cardiac rehab.

In a way that was a turning point for me. Once I had completed the rehabilitation I actually felt like my old self again. I am back running at a pace that is pretty darn close to my pre heart attack pace and I am seriously considering entering a 10K race this April.

That is not to say that I feel like I am cured. I realize that this would be pure folly. You don’t “cure” heart disease; you simply learn how to live with it.

I am learning how to live with it. I am much more cognizant of what I eat and drink and I no longer consider exercise to be an optional activity. I am growing comfortable with these changes too. Oh sure, I still miss the buzz of three cups of black, caffeine infused coffee. Decaf just doesn’t give me the same thrill. On the other hand, I really don’t miss fried food and I have found that I enjoy eating heart healthy. It actually makes me feel better!

Don’t get me wrong though. I am still no saint. I still enjoy drinking more than a couple glasses of wine and I have no intention of giving up steak. It is just that now I savor those indulgences a bit more. If I am going to have some wine it is going to be GOOD wine. The same goes for steak. If I am going to have a steak is going to be USDA Prime.

The bottom line is that I have adjusted to my new life with heart disease. I understand that there is a very real possibility that, no matter what preventive measures I take, I will have another heart attack at some point in my life. I have simply decided to accept my fate and get on with life.

So what about this blog then?

I have been told that depression is pretty common amongst people who have had a heart attack. A buddy of mine recently told me that depression is more prevalent in heart attack survivors than in cancer survivors.

Fortunately that has not been the case with me. I have a rather enlightened view of my new heart reality. I like poking fun at myself and being a little irreverent at times. Perhaps that is my own personal coping mechanism. Perhaps that is something that may help others in dealing with their own reality of life with heart disease.
So I guess I’ll continue here, sharing things I find that may be of interest about life with heart disease. In my mind this is kind of like a heart attack club but you don’t necessarily have to have had one to join.

Graduation Day

I completed my cardiac rehabilitation classes today. The nurses said I graduated.

Three days a week for the past three months I have dutifully trekked to Howard County General Hospital to rehabilitate my cardiac. I am proud to say that my cardiac is fully rehabilitated.

I’m glad to be done.

It wasn’t the exercise that bothered me. I have come to accept that my lot in life is to make exercise part of my regular regime at least five days a week. It was the other stuff I grew to dislike like strapping on the remote EKG monitor. Each time, after the class was finished, I’d defoliate my chest just a little more as I tore off those sticky EKG pads off my chest. My chest hair now resembles a rogue timbering operation.

I also hated having my blood pressure taken while I ran on the treadmill.

I’m going back to my old gym now. I haven’t worked out there since the treadmill incident. I’m looking forward to returning to that routine.

I will miss the people though. The nurses, Susan, Allyson, Beth, Ann, Cindy, Diana and Tricia (I probably missed a name or two) were terrific. Their humor and compassion made the inconveniences more than tolerable.

I’ll also miss my cardiac classmates. I met lots of great people over the three months. Some I posted about already, others I just met today, like Ed. Ed had a quintuple bypass. He was on vacation in Calgary when he came up short of breath.

“I really didn’t have any chest pains,” he told me.

I told him I didn’t either. Ed told me that he had actually been feeling fatigued for about a month before that fateful day in Calgary. “When I told that to my wife I thought she was going to kill me.”

If the heart disease don’t get ya, the angry spouse surely will!

When he got home and went to hospital he was admitted immediately. They told him he had two arteries that were 90% blocked and three that were 60% blocked.

Ed was just starting his cardiac rehab run. I told him that I clearly recall my first sessions. I felt like the new kid in school.

I’ll miss the women in my class too. They have made me think that perhaps I should start a new label entitled “Heart attack gals.” They have some pretty incredible stories too.

Still, I am glad to be finished. In my exit review with Beth she told me that I remain at high risk for another heart attack due to things I have no control over; my age and my family history. I guess it’s possible I could end up for some post grad cardiac rehab sometime down the road.

For now though I feel pretty good so I’ll just be happy with that.

The ICU

“We are going to take you upstairs to the ICU now.”

It was about 6:00 am on Sunday morning. I had been in stall numero uno in the emergency room for about six hours.

I’m thinking “ICU! That’s where really sick people go!”

At this point I’m still thinking that I’m not really that sick. Yeah, I now knew I had a heart attack but hey, I’m still joking around. I mean I didn’t expect that they were going to pat me on the head and send me home but I didn’t think I was a candidate for the Intensive Care Unit.

On the other hand, the ICU is the place to be if you are sick, sort of. The best part is that if you want anything outside of a cheeseburger and fries, you get it. Got a headache? They won’t just offer you an aspirin, they’ll offer you morphine. You need a nurse, push a button and they arrive in a flash.

Then again it isn’t the most comfortable place to be either. I mean just how comfortable can you get with an automatic blood pressure machine on one arm which squeezes your arm every fifteen minutes, three IV lines in your arms and an oxygen tube stuck in your nostrils. Surprisingly, I was able to sleep with all this going on though I imagine the morphine probably helped that somewhat.

The biggest impediment to sound sleep was the wave machine, at least that’s what I called it. The ICU bed had this anti bed sore mechanism that called to mind a waterbed with a built in wave machine.

“Can you turn off the wave machine?”

I seemed to be able to come to terms with all the other stuff that was going on but that was just too much.

One of the ICU angels kindly granted this request.

I spent most of the day Sunday watching football and dozing in and out of sleep. My team, the Baltimore Ravens got creamed by the Cleveland Browns. That coupled with the constant mild headache I was getting from the nitro drip didn’t exactly help my mood. Still, at least there was football to watch. I counted myself fortunate that this didn’t happen on weekday when my viewing choices would be more limited. Though I consider myself to be a reader I didn’t feel much like reading.

I didn’t know it at the time but in less than two days I’d be patched up and back home. Amazing.

Some Choice

“We are going to move you to either Adventist Hospital or Johns Hopkins to have a cardiac catheterization procedure.”

David Jackson, my cardiologist, had stopped by the ICU on Sunday to check up on me. I told him I was impressed that he showed up on a Sunday. He was even wearing a tie.

“It’s up to you as to where you’d prefer to go.”

I chose Hopkins. The only reason I chose Hopkins was that, having grown up in Baltimore, I always been told that Johns Hopkins was one of the best hospitals in the world. I also believed that they were particularly renowned for their work with heart patients.

I really didn’t know anything about Adventist Hospital.

Some choice, eh?

I mean, here I am, lying in a bed in the ICU unit and being asked to pick a place to have a pretty serious medical procedure performed and I don’t have so much as a brochure to look at. For all I know Adventist Hospital may actually kick Hopkins ass when it comes to this procedure. How about a sales pitch somebody?

Think about it, this procedure probably costs somewhere around 10 grand (I say somewhere because I have had a difficult time getting a handle on the exact costs…more about that in later post) and no one is pitching me on features and benefits. Maybe it is just my background in sales but I’m thinking that this is a big purchase and all I have to go on is what my cardiologist recommends.

Not that this recommendation doesn’t mean anything I just think there should be more. I think that for the money, there should be more of a sales job. Something like “Adventist Hospital has not lost a patient in a cardiac catheterization procedure for the last six months.”

Or, “This week Johns Hopkins is offering an upgraded hospital room for every cardiac catheterization plus a visit by a Ravens cheerleader.”

The heart attack guy could really help these guys with their marketing.

Sleepless

“I can’t sleep.”

“Whah?”

I had nudged Denise awake. It was around midnight. She had been sleeping. I had been tossing and turning in bed since 6 pm.

I should note here that under normal circumstances I can fall asleep fairly easily. I lay my head on a pillow, I go to sleep. These were not normal circumstances. I had reached the conclusion that something was very wrong me. I uttered the words I thought I’d never hear myself say.

“I think I should go to hospital.”

Every thing you read about a heart attack tells you that the very next thing you should do after coming to a realization such as this is to dial 911. That’s not what I did. No, I came up with a brilliant idea. “I’ll drive over and you stay here with Morgan until her mother gets here.”

I have no doubt that in some heart disease pamphlet or brochure or poster there is an example of somebody taking this very same course of action. It will always be found under a heading like “Bad Example” or “What Not To Do.”

It’s kind of like the drunk who insists he can drive home. Fortunately for me Denise wasn’t having any of that. The end result was a compromise between me not wanting to make a big deal in the middle of the night in the neighborhood and me not driving.

Morgan’s mom showed up shortly and Denise drove me to the hospital. Once I was in the car the wisdom of this course of action became very apparent. I didn’t feel real good.

As we pulled up to the emergency room doors, Denise leans over and looks at me, “It’ll be a lot easier if we tell them we’re married.”

“Works for me.”

I now consider September 30th as our wedding day. We honeymooned in the ICU.

Red Wine

“I probably didn’t need that last glass of wine last night.”

“You probably didn’t need that last bottle!”

Denise and I were lying in bed. It was Saturday morning and I felt like crap. The previous evening our friends Alan and Patty had dropped by. We drank a few bottles of wine. At least Patty and I did. Alan later reported that Patty wasn’t feeling that great either.

I had to recover. That evening we had plans to go to a party thrown by our friends Paul and Cindy Skalny. We had been looking forward to it.

“Maybe you should stay in bed for awhile.” That sounded like a good idea to me. Denise was giving me a free pass on our regular Saturday routine. She said she would also keep my daughter occupied. Morgan is nine years old. She spends every Saturday with her dad. I had promised to take her to Clark’s Elioak Farm later that afternoon. Denise didn’t think that was such a great idea.

“When are we going to the petting zoo?” Morgan had come up to our bedroom. It was then about three o’clock in the afternoon. Typical of a dad, I am somewhat of a pushover for my daughter.

“I’ll get up now and we can go.” I still wasn’t feeling that great but I convinced myself I felt a little better. I was beginning to suspect that perhaps this was more than a red wine hangover I was dealing with. We went to the petting zoo and she had a great time. I felt tired but otherwise okay. Still, I took it slow and avoided any running around. Before long we were back home and it was time to shower up and get ready to go to the party.

Around six o’clock I was all dressed and ready to go. The babysitter was at the house and Denise had put together a little dinner for Morgan. I went back upstairs to get a sports coat. No sooner than I walked into our bedroom I started feeling a little nauseous. I sat down on the sofa in our bedroom. I felt real clammy. This was certainly no red wine hangover like I had ever experienced. Though I didn’t realize it at the time, I had just had my heart attack.

“I don’t think I should go to the party tonight.” Even though she was dressed and ready to go, Denise immediately agreed with that plan.

“You should climb back in bed.”

She got no argument from me. I was now beginning to think that a trip to the hospital was not outside the realm of possibilities. Still, I wasn’t ready to admit that I was THAT sick. I took off my clothes and climbed back into bed.

It would be another six hours before I finally decided that it was in fact time to go to the hospital.

The Doctor's Visit

“150 over 90”

She said that without any emotion. Just as someone might read the ingredients off a cereal box. I have noticed this on previous visits as well. It doesn’t matter what the blood pressure reading is, the nurse just recites it in matter of fact manner. She leaves the editorializing to Dr. Diener.

Steve Diener is my primary care doc. I like him personally but his office sucks. A typical appointment will involve at least a twenty minute wait in the waiting room (it’s called that for a reason) and then at least a fifteen minute wait in the exam room. The exam room waits are the worst. At least in the waiting room there are magazines to read. In the exam there is nothing but some model of a backbone. I’ve taken that thing apart and put it back together more times than I can count.

“You say you are having some chest pains?”

“No. It is more of a nagging tightness.”

“We going to do an EKG, take off your shirt and I’ll be right back.”

I am getting good at EKG’s. Since we began trying to get my blood pressure under control two years ago, I have had four or five of them. I’ve also had two stress tests which all means that I’ve had a fair number of chest hairs ripped out as a result.

She administers the EKG, rips the leads and more hairs off my chest and informs me that Dr. Diener will get with me as soon as he finishes up with another patient. This is what they always say.

After taking apart and reassembling the back bone model several more times, Dr. Diener appears. He is not pleased.

“Your blood pressure is still too high. We need to get this under control.”

Okay. When we first started working on my high blood pressure problem over two years ago he put me on a mild regime of Linisporil (5mg twice daily). That didn’t do much. After my second stress test, my cardiologist, David Jackson, upped that to 20 mgs once daily. On my last visit to Dr. Diener, three months before this particular visit, he added 40 mgs of Benicar daily to the mix.

“I’m going to start you on Coreg instead of the Linisporil and add a diuretic called HCTZ. Your EKG looks fine but if that tightness gets any worse I want you to go to the emergency room. I also want to see you again in a week in the meantime, no exercise.”

The EKG didn’t mean shit and I would not see him next week either. It was three days before my heart attack.

The Treadmill Incident

“You don’t look too good.”

I’ve noticed that guys never hesitate to say that to each other, especially a buddy. Richard is my buddy. He and I ran together on the treadmills at the Coliseum Gym every Monday and Friday morning. I would get to gym first and spend a half hour with Tim, my personal trainer, before joining up with Richard on the treadmills.

We had been doing this on and off for a few years. For the past year we were frequently joined by Fred and Phil. I mention this because the four of us represented four different decades. Fred is in his seventies, Richard is in his sixties, I am in my fifties and Phil is in his forties. I swear to god that we didn’t consciously set it up this way but we were usually aligned in that exact chronological order. Fred was in the best shape of all of us. I was the only one who had a heart attack.

It had been two days since I first noticed “tightness” in my chest. That morning I went through my normal half hour weight training with Tim. Surprisingly, I made it through the weight lifting regime as I normally would. It would not be accurate to say that it was without difficulty because at 5:30 on a Friday morning everything is difficult. This particular day did not seem that exceptional, except of course for that nagging little tightness in my chest. At this point I am beginning to add the word “nagging” to tightness.

After Tim and I finished I headed on over to the treadmills. Fred and Richard were already going at it. Typically Richard will go for an hour while I usually settle for fifty minutes. God only knows how long Fred goes. He starts first, followed by Richard, followed by me, and followed by Phil, again, in that strangely coincidental chronological order.

I started up at a pace of 6.2 miles per hour. After about five minutes I was completely gassed. I look over to Richard on my right. “I don’t feel too good this morning.” Apparently I didn’t look so hot either.

“You don’t look so good.”

“I think I’ll call it quits.”

Richard quickly endorses this decision. “You should go home and lie down.”

I’m all over that. I headed on home and went back to bed. Denise tells me to make an appointment with Steve Diener, my primary care doc. Another good idea.

It was nine days before my heart attack.

My First Indication

“How do you know if you are having a cardiac event?”

We were standing in the kitchen. It was around 6:15 on a Wednesday morning. Denise was getting ready for work and I had just come in from a run. My chest felt tight.

“What are the symptoms,” she asked. In the interest of full disclosure here I should note that Denise is a registered nurse. It’s nice to have a RN in the house.

“My chest feels tight.” I am a 52 year old male. After fifty a feeling of tightness in various body parts is not that unusual. Combined with the fact that I had been on a “get in shape, lose twenty pounds” kick since March. This all started out when a bunch of my John Carroll buddies and I were in Naples for our own unique version of Spring Training. While sitting around the pool with our shirts off and beers in our hands, Stan made a comment that perhaps some us should try to take off a few pounds before our 30th college reunion coming up that June. I was one of the guys he was referring to.

So I took the challenge. By June I had dropped twenty pounds. I accomplished this goal the old fashioned way of diet and exercise. For the diet part I cut out the things I love like cookies and ice cream. I gave up French fries. Denise was a big help in this regard. She cooks pretty healthy and nourishing meals for our little household so eating at home helped. When I went to lunch at work with the guys at the office I would eat salads…like a girl. I also gave up alcohol on week days, sort of. I mean by Thursday, I was ready for a drink.

For exercise I started running. For years I have had this on and off thing with running. The bottom line is that I hate running. The only thing I like about running is being finished. It is akin to banging your head against the wall; it feels good when you stop. That said, I have a grudging respect for the effectiveness of running in weight loss and overall conditioning. So I bit my lip and started running. I ran an average of four days a week both inside on a treadmill at the gym and outside in my very hilly community in Ellicott City. Before this particular morning I was averaging 20 miles a week.

This morning it was an outside run day. As I stated, the only thing I like about running is finishing. Today the last mile and half were a little more difficult than usual. At the end of the run I didn’t feel great. My chest felt “tight.”

“Is it a chest pain?”

“No it’s just tightness. Not painful, just a little tight.”

“Any other symptoms?”

“No, other than that I feel fine.” I sub consciously forgot to tell her about how I felt on that last mile and half. I didn't think that was significant. As with any regular exercise regime you have your good days and your bad days. This was just a bad day. At least that’s how I rationalized it.

“Maybe you should take a day off running.”

I was actually thinking the same thing. Over the previous two weeks I had increased my running days from four days to five days. I figured that maybe I was overdoing it a little bit. I just needed a recovery day “Okay. No running tomorrow.” That would turn out to be my last run for quite awhile.

This was Wednesday, September 19th. It was eleven days before my heart attack.

How This Got Started

“Your EKG is fine.”

Somehow that is not very comforting when you are lying on a bed in the Emergency Room recovering from your second nitro tablet of the night. The first one wasn’t bad; the second one packed a punch.

This bit of medical news was soon trumped by the results of the blood test they had seemingly just taken. Time tends to get a bit distorted for me in situations like this, not that I’d ever been in a situation like this. “Well Mr. Lane, you’ve had a heart attack.”

Okay, so far I’ve learned that the EKG didn’t mean shit.

To tell you the truth being told that I had a heart attack was a little anti climatic. I mean I knew something major had occurred after all I was laying on a table in an emergency room with oxygen in my nostrils and three IV drips in my arm. Since my blood pressure had already been running high, a heart attack was high up on the list of probabilities. Still this was big news. I had a heart attack. People die from heart attacks.

The thing was, it really didn’t feel like a heart attack. At least it didn’t feel like I always thought a heart attack would. A heart attack sounds like something that should knock you to your knees. Mine didn’t. It also didn’t kill me which has allowed me to start this blog.

This is a place to share the everyday experiences of regular folks who through the luck of the draw live with heart disease. This is the non clinical view from the pointy end of the needle. This is a place for folks who have had a heart attack and those who think that having one in their life is a distinct probability. This is a place for humor, real stories, and perhaps some useful advice. I am your host, the heart attack guy.