My Life-Changing Saturday

At this time last Saturday, 5:30 pm, I was in the Cath lab having a stent put in my heart.  

Around 3 pm last Saturday, I did some sit-ups and push-ups while watching basketball.  I had started the new year doing daily exercise, but had fallen off the wagon in mid-February.  Last Saturday, I was motivated to get back into my routine.  At 3:18 pm, I tweeted that I had just completed said exercises, and was about to go for a bike ride.  My wife and kids were out of town for the day and I was home alone.

I went for that ride at around 3:30 and rode for maybe 10 minutes.  It was the first time I'd been on my bike since late last summer.  Just before turning into my driveway, I made a last minute decision to go on down the street to the cul-de-sac and come back up to the house.  It's downhill to the cul-de-sac, thus uphill back to the house.

I made that decision thinking that I needed to "push" myself, because I was already tired and wanted to stop.  As I came back up the hill I realized very quickly that it was too much and I should just get off the bike and walk it back up to the house.

However, there were some young adults standing in front of one of the houses near mine, and I felt embarrassed having to walk my bike in front of them.  Instead, I pushed on and rode all the way back to my garage.  

As soon as I got off the bike, I knew I had overdone it.  I went into the garage and tried to catch my breath, but I felt like I couldn't.  My body, and especially my legs, felt very weak.  After several minutes, I finally decided to go into the house and get some water.  As I walked up the two steps from the garage into the house, I nearly fell because my legs were so weak as I tried to go up the steps.  

Not long after getting into the house I began to feel panicky, worrying that I might have seriously harmed myself in some way.  I felt this way because I could not seem to catch my breath.  As the symptoms of a panic attack started to come over me, I felt lightheaded and dizzy and even more weak and breathless.  I assumed that these symptoms were primarily resulting from the panic, and that I just needed to calm down.

In an effort to lighten my mental state, I tweeted at 3:54 pm that I had just returned from a bike ride and was dying.  "Good bye cruel world," I joked.  I hoped that joking about my very real panic would help it to subside.  

I spent probably 15 minutes trying to calm down.  I took the normal steps I take when having a full blown panic attack, but for whatever reason, I couldn't get calmed down and I couldn't catch my breath.  

And then I started having chest pain.  

I don't know exactly when it started, but I felt it as a dull ache all across my chest, and it felt like it went through my chest all the way to my back.  In addition, it would occasionally radiate down both arms and also up into my neck.  At one point, both my hands started feeling numb and tingly.  The pain was dull, not sharp, and spread across a wide area of my upper torso, rather than a single spot or region.  It was not horrible pain - I think I later told the EMT's it was a 5 out of 10.   

This was something new that doesn't typically occur when I have panic attacks, but I still continued to try to calm myself down for a few minutes and deny that I was actually having a heart attack.  Finally, after speaking with my mother, who is a nurse, I drove myself to the local Urgent Care, which is just a mile or so up the road.

They gave me an aspirin and said I probably wasn't having a heart attack (based on my age and lack of family history), but they wanted to send me to the ER to be checked out.  They called an ambulance, which I recall arriving very quickly, and I was loaded into the back, put on oxygen, and hooked up to an EKG.  Because I was shaking so much with panic, the EKG would not read properly.  

The EMT's decided to take me on a non-emergency run to the local hospital.  En route, however, while I lay in the back of the ambulance, they were finally able to get a good read on the EKG and it indicated I was, in fact, having a heart attack.  

The instant he told me this, the chest pain stopped and never returned.

I have suffered from anxiety and depression my entire adulthood, and much of my panic disorder is expressed through severe hypochondria.  It is well-controlled with the anti-depressant that I take, but I have frequently worried about my health throughout my adulthood, and went to the doctor a number of times in my 20's (prior to starting the anti-depressant) over concerns about my heart (which were always without merit).

To be in the back of an ambulance with shortness of breath and chest pain, and be told I was having a heart attack, was literally a nightmare come true.  

Yet, as I noted, the moment he said it, the chest pain stopped.  Furthermore, I felt a sense of calm wash over me and I just laid my head back and began breathing deeply as he started an IV and told the driver to switch to an emergency run and go to a different hospital.

Everything after that is a blurry sort of dream.

I called my wife and sister-in-law from the ambulance, but could not reach either of them, so I called my brother-in-law.  Then I called my mother.  I remember as they unloaded me from the ambulance, worrying they would drop the stretcher.

I recall meeting the eyes of a unit clerk at the desk as they brought me into the ER and smiling sadly at her, and she sort of smiled and looked away quickly.  Everyone was staring at me but no one wanted to meet my eyes.  

I remember realizing, from my own work in emergency rooms, that they were on squad alert for me.  For me.  

I remember a kind doctor's face hovering over me and confirming I was having a heart attack.  I remember him telling me he had gone through this too.

I remember being asked if I had done cocaine that day.  

In the end, I had one artery that was 100% blocked.  This artery was stented in the cath lab at St. Elizabeth's Hospital.  Another artery showed a 40-60% blockage but nothing needs to be done about it at this point in time, other than monitoring and medicine.

I am on five new medicines - a blood thinner, an aspirin, two heart medicines, and a cholesterol drug.  Prior to this, I took only my one anti-depressant every day.

I have also been told to get below 200 pounds, which means losing about 50-60 pounds from where I was before the heart attack.

I have been told to never use nicotine in any form again.

I have been told that I can make a full recovery with no long-term damage if I do what they tell me to do.

I was told about 7 or 8 years ago that I had high cholesterol, but my doctor did not put me on cholesterol medicine at that time, and I never had it checked again.  I started smoking in 2007 and had just quit at the start of 2013, though I was still using nicotine with an electronic cigarette.  I have also been steadily gaining weight since about the time I went back to school in 2006, having gotten into the low-end of the "obese" scale on the BMI calculator for the last few years.

So I had several risk factors for heart disease, but one notable risk factor I did not have was a family history of early heart disease.  In fact, no one in my family - parents, grandparents, aunts and uncles, cousins, or siblings - has ever had any sort of heart disease, much less a heart attack, even less a heart attack before 40.  

Obviously those "good genes" didn't matter in the face of my diet, smoking, and cholesterol.

I am slowly getting better.  For me, getting better is as much about my mental state as it is about my physical state.  Obviously, a heart attack will cause anxiety and depression for anybody, but especially for someone who already suffered from it, and someone who has a history of anxiety-related hypochondria.  But I have resources and tools at my reach and I am putting those to use.  

From here, I am just taking things one day at a time, learning to get used to a radically new normal with my lifestyle habits.