Anatomy of a dissection

Sometimes it can be difficult to explain to people what a spontaneous coronary artery dissection really is. This is an animation of a dissection. See how the inner layer of the artery separates, and creates a false channel (lumen) for the blood, and the blood pools in there and eventually blocks the artery? That's what happened to me. Heart attacks are caused when blood flow to the heart is blocked.



Mine happened in the Right Coronary Artery, which you can see on this image:


The six stents I have are pushing the torn inner layer back up against the outside wall of the artery, where it should be. I have six because they had to repair almost the entire thing. I do remember hearing the doctors discussing placing a seventh stent, but they were worried that it would poke out into the aorta. Looking at the image above, I can see more clearly what they meant by that.

Watch Dr. Oz on Dec. 17th, and have a heart-healthy holiday!

When you get involved with WomenHeart as a WomenHeart Champion--meaning you've gone through the training program at the Mayo Clinic--you get paired up with a more experienced volunteer, usually someone local to you if possible, and she's called your Big Sister (on the WomenHeart message board, we refer to each other, Champion or not, as "heart-sisters," since we're all united by our cardiac problems).

My "Big Sister," Marietta, is going to be on The Dr. Oz Show on Thursday, Dec. 17th. His program that day is about people who've had heart attacks during the holidays, the so-called Merry Christmas Coronary and/or Happy New Year Heart Attack, which you can read about here:

http://sitemason.vanderbilt.edu/news/campusnews/2009/12/07/doctors-warn-against-holiday-heart-attack-spike.101760

To reiterate the tips listed at the end of the article:

Don't stuff yourself.

Watch your sodium and alcohol intakes.

Do what you need to do to reduce your stress.

Be vigilant about taking your medicines.

And--if you experience any symptoms, get medical help immediately. You're not doing anyone any favors by ignoring your chest pain; delay now could be costly down the road.

A Change of Heart issue 2 is on!

After the success of my first heart-related fanzine, A Change of Heart, I've decided to put out another issue.

This one will be timed to come out during February, which here in the United States is American Heart Month. If that issue does well too, then I may have an annual fanzine on my hands. :)

So if you wanted to submit something for the first one but didn't get around to it, or if you want to send me a letter of comment (LOC, in fan-speak) on the first issue (link goes to pdf version available from efanzines.com), here's your chance.

I'm looking for essays, poems, artwork, and short fiction--from fans with any type of heart disease/heart failure, on the topic of being a fan with heart problems. See first issue for examples.

As before, emailed submissions are greatly preferred--to laurahcory at yahoo, but if you know someone who doesn't do email, ping me and I'll get you my snail-mail address.

Deadline for submissions is Jan. 30th, 2010.

Dipping toes into golo

One of the local tv stations has a website with an active GoLo (GoLocal) community; I've joined and started posting a few blog entries over there.

http://www.wral.com/golo/profile/5880574/

I'm pretty much just focusing on heart-health related things with it.

Quick Symposium Notes

Tired, but here are some quick Symposium thoughts:

My brain is full. Crammed full of knowledge--medical, scientific, networking skills, so much to remember.

My heart is full. Full of love and appreciation of my new-found heart sisters from around the country.

Here are a few quick photos on my Flickr page from various events throughout the five days at Mayo:

http://www.flickr.com/photos/tags/womenheartsymposium2009/

From our tour of the Mayo Clinic: the cardiac cath lab--good to see while standing up instead of lying down, let me tell you. Two pictures from the day we spent out at Assisi Heights: the statue of St. Francis is from the inside, and the courtyard shows the snow that greeted us that morning.

Jyl is a belly dancer and a WomenHeart Champion. Jan, beside her, is local to me and a WomenHeart Champion. I am a WomenHeart Champion. Stephanie, in the picture with me, is a WomenHeart Champion. The pictures of us are from our dressy dinner/reception on Tuesday night.

I will upload more pictures soon but I'm also hopeful that other Symposium attendees will share some of theirs; a lot of mine ended up being blurry, alas.

Clinical Trials

One statistic that always leaps out at me is that women only make up around 27% of the participants in heart-related research. I honestly feel like this is one reason why women die more frequently from their heart attacks than men do; there's simply not as much known about heart disease in women.

We can start to change that by participating in clinical trials. Here's a good source of clinical trials:

http://www.clinicaltrials.gov/

In fact, searching that site, I just now found a study that's currently enrolling young women who've had heart attacks. As soon as this post is up, I'm going to email them and sign up, and I would encourage other women to seek out research opportunities as well.

Heart Walk Success

The Heart Walk went well yesterday. Thanks to generous friends and family, I raised over $250 for the American Heart Association! Thank you all so much for all your help and support.

Here's a link to my pictures on Flickr:

http://www.flickr.com/photos/47904085@N00/tags/2009heartwalk/

We had a warm, sunny day for the walk; I understand that last year was unseasonably cool. There were over 200 people on the team from UNC, and it was great to catch up with the rehab staff and some of the people who were going through rehab at the same time as me.

There were a lot of dogs at the walk, everything from huge friendly golden retrievers down to mini-poodles that people were carrying.

I'm looking forward to walking again next year.

Medical IDs, and SCAD discussion

At the local WomenHeart meeting last night, my group leader was admiring my new medical ID bracelet. I already had one, but this one is my new dressy one, with lavender and purple beads.

My feeling on medical ID jewelry is this: just because it's functional, doesn't mean it has to be fugly. ;)

Here are the two places where I got my bracelets, Fiddledee Ids, and Lauren's Hope.

I already have a plain black leather strap bracelet for everyday wear--the Kingston, from Fiddledee Ids. For swimming, I have a waterproof one of these, in purple.

My new one looks similar to this style from Lauren's Hope. I did the build your own option and chose two different shades of purple for the beads. I also have this purple adjustable waterproof bracelet.

So yes, I have four. Two for daily wear, and two for exercise. Both of the exercise ones are waterproof and both of those have been tested in swimming pools and the ocean.

I'm happy with the quality, engraving, and shipping speed from both Fiddledee IDs and Lauren's Hope; you can't go wrong with either place. They both have plenty of options for men, women, and children, and lots of choices to make your medical ID jewelry pretty as well as functional.

On another topic, I'm trying to round up as many SCAD survivors as I can and get them posting in one place, so we can find each other easily. The discussion I started over on the WomenHeart board is here: All the SCAD Ladies Put Your Hands Up.

Triangle Heart Walk, Sept. 27th

OK, last place I'm posting this. I'm only posting it once, but I'm posting it to 2 different FB accounts and 3 different blogs, so my apologies to those of you who see it multiple times. After today, I'm not going to mention it again, because I don't like asking for $.

This year, I'm participating in the Triangle Heart Walk, which is a fundraiser for the American Heart Association. If you're wondering why I'm doing this, see here (though most of you know the story).

I'm uncomfortable asking for money, so this is the only time I'm going to post the link:

My page for HeartWalk donations is here.

Annoyingly, the online form only seems to let people give in $25 increments; if you'd like to give a different amount, you'll need to print out the donation pdf and mail it--sorry about that. :/

Meanwhile, here are some heart disease stats from WomenHeart:

* Heart disease is the leading cause of death of American women, killing more than a quarter of them.

* Over 213,000 women die each year from heart attacks--five times as many women as breast cancer.

* More women than men die of heart disease each year.

* Women are less likely than men to receive appropriate treatment after a heart attack.

* Women account for only 27% of participants in all heart-related research studies.

* 23% of women and 18% of men will die within one year of a first recognized heart attack; 22-32% of female and 16-24% of male heart attack survivors will have another heart attack within five years.

* 12-25% of female and 7-22% of male heart attack survivors will be diagnosed with heart failure within five years.

* 34.9% of deaths in American women over the age of 20, or more than 450,000, are caused by cardiovascular disease each year.

* Over 166,000 women die each year of congestive heart failure, accounting for 56.8% of all heart failure deaths.

A Change of Heart fanzine now available

This is to announce that my one-shot fanzine, A CHANGE OF HEART, as announced here, is now done and available.

At the moment I can email you a .doc or .rtf, or send you a printed version if you send me your snail-mail address. There will be a pdf version later this evening, and once I have the pdf, I'll send it over to efanzines.com for inclusion there.

Thanks so much to everyone who sent something, and to everyone who helped get the word out, and to my friend Warren for carrying the first batch, still hot off the presses and containing a typo or two, to WorldCon for me.

I got into the WomenHeart Symposium!

Great news--I've been accepted into the WomenHeart Science & Leadership Symposium!

http://www.womenheart.org/programsEvents/programs/national.cfm

It's four days at the Mayo Clinic in Rochester, MN and is a fantastic opportunity not only to train to become a champion spokeswoman for women with heart disease but to connect with other women who've been through similar things. I'm really excited. :) I sent my application off, then tried to just put it out of my mind, because at that point the decision was out of my hands.

I was a little nervous opening the big envelope from WomenHeart last night; I cracked it open and peeked in cautiously, saw the word "congratulations," grinned, and only then opened it the rest of the way.

I'm done with rehab!!

Or as my co-worker Hank said when I got to work this morning and showed off my stylin' new red shirt, "I survived cardiac rehab and all I got was this lousy T-shirt." [Let the Star Trek red shirt jokes commence ;)]

Actually, it's a pretty cool shirt, and rehab has been, for the most part, a really good experience for me. There were a couple of bumps in the road, but when I look back at where I was 12 weeks ago, more psychologically than physically even, it's been a tremendous benefit, and it's a tragedy--a health emergency I'd almost say--that a lot of women never have cardiac rehab mentioned to them.

Last thing I read said that just over half, 56 percent, of patients who need cardiac rehab actually get referred, and women get referred at a much lower rate than men.

That's been borne out by my experience--for most of my time in rehab I've been the only woman in my class. For part of the time there was an older woman, then she left and I was alone again. Then a couple of weeks ago another woman, maybe in her mid-50s, joined. But we're still far outnumbered by the men. Heart disease is the #1 killer of women in the US, but cardiac rehab is still very much a man's game.

When I started rehab, my total cholesterol was 225: HDL of 54 and LDL of 149, triglycerides at 109. Now my total cholesterol is 172: HDL 57, LDL 94, and triglycerides at 105. I've been on Zocor (well, the generic) since my heart attack, so I can't claim all the credit.

Blood pressure has stayed about the same, in the 110/70 range, though when they checked it right after I'd come off the beta blocker, it was 102/64.

When I first started, I was so scared and anxious that I stopped my initial treadmill stress test after only 5 minutes, so the upper end of my target heart rate range was 87. Plus also beta blocker. Now, with no beta blocker, my THRR is 126 for the upper end. :)

I did 8 biceps curls in 30 seconds at the start of rehab; now I can do 15.

But more than anything else, I know that I can go swim for a half hour and not collapse. I can run on the treadmill with no fear. I can go for a bike ride just a like a normal person. There are a lot of things I can do like a normal person now, and that's the point of getting up at five-freakin-thirty in the morning three days a week for twelve weeks.

Don't think because I won't be at rehab anymore that I'm going to turn into a slacker, though. I've signed up for the Triangle Heart Walk on Sept. 27th, and I'm looking over the super-sprint triathlon options.

Can I get a hallelujah? :)

Heart update

I had several cardio-related appointments yesterday and today. Yesterday morning was a blood draw, then in the afternoon was my cardiology follow-up appointment. Let me just say again that it still seems so surreal, almost four months out, that I freakin' have a cardiologist.

Since I'd told the nurses at cardiac rehab that I was nervous about having my blood drawn, they sent me over to the Heart Center for the phlebotomist there, Joel, to do it. He's supposed to be very good, although when he took blood from me back in April it hurt a lot--though he said it was because my veins were still scarred from all the repeated blood draws from the hospitalizations.

So I wasn't too confident, but my veins have recovered, and Joel did fine, and there was minimal pain. This blood work is to check a couple of things: cholesterol levels, and liver enzymes. The liver enzyme check is because the Zocor can rarely cause liver problems.

After that, I went to Brig's for breakfast because I hadn't had anything to eat since around 8pm the night before, and I hadn't been there since right after I got out of the hospital... So hello omelet, and pancake (and leftovers for today). Then home to chill out for a bit before my cardio follow-up at 1pm.

The cardio visit was pretty routine: they did an EKG, as usual. They took my blood pressure, which was high for me, at 113/78 (I sometimes get "white coat syndrome"). OTOH, my resting heart rate was around 42, thanks to the beta blocker.

My doctor cleared me for pretty much everything: lifting weights, flying, sitting in the hot tub--the place where I swim has a hot tub, you see. My EF is well over the magic number of 55 percent, he said.

He asked how well I was sleeping. I said that the only anxiety I had, really, was about the chance of it happening again. He was pretty straight with me; he said that it was such a rare, 1 in 1000 thing that happened, that he could see where I would be worried. But given that I don't have any other contributing factors--I'm healthy, I don't have any connective tissue disorders--he said I'm more in danger of having a car accident on my way to and from work every day than of having another spontaneous dissection.

They don't know why it happened. They may never know why it happened. And mostly I'm OK with that; sometimes I want answers, but I'm growing more accepting of the fact that I'll probably never have any.

The best news is that he took me off the beta blocker, whee!! My heart rate is already pretty low (see above), as is my normal blood pressure. I was a little worried because when I first asked if he had a timetable for reducing my dose, he said that some people stay on it for life. But after he conferred with another cardiologist and they both looked at my EKG and my heart rate and such, they decided that I could come off it. I go back for another visit in four months.

This morning I had my end-of-rehab treadmill stress test. This one is a compare-and-contrast to the one I did when I first started rehab, to mark my progress. And I passed, if you will, with flying colors! I just about doubled the time that I was on the treadmill, from five and a half minutes to ten minutes, and I got my heart rate up to 130--which is almost a normal range for a woman of my age and weight. The rehab nurses were thrilled, and the doctor who was monitoring my stress test said I deserved a gold star.

My last day of rehab is July 31st. I'm pleased that things are going well.

Rehab and blood draws and follow-ups, oh my

I'm coming up on the end of my time in cardiac rehab. It will be good to switch from Meadowmont back to my old gym, Duke Health & Fitness. Meadowmont is a good facility, but I miss my water aerobics classes, and being able to lift weights--I'm not really a fan of the giant rubber band school of resistance strength training.

Tomorrow I have medical stuff all day. Blood draws in the morning for cholesterol and liver checks, and cardiologist follow-up appt. in the afternoon. So no food for me after 8pm tonight.

I hate hate hate having my blood drawn. It got to where near the end of my hospitalization, I would cry when I saw the phlebotomists coming in--because after nearly a week of three blood draws/day, they'd just about run out of places to stick me and had resorted to poking the backs of my hands. The only reason it wasn't worse was because for a couple of days, I had an arterial line in and they were able to take blood straight from that for awhile, until the line got kinked and they took it out (I was terribly sad to see it go).

I know I sound like a wimp--they stuck my femoral artery twice and threaded a catheter up to my heart, for cryin' out loud--but for that, they had me on a morphine/valium drip, so I didn't give a crap.

Now is a good time to practice my deep breathing and relaxation. Now is NOT a good time for the loud, boisterous child to be in the office, when I'm already anxious...

Must remember to write out list of questions tonight for the doctor. #1, how long will I have to be on the beta blocker.

Worse than I thought, ack

Apropos of this, Paul says I missed a few; the actual total is closer to $116k. This is how people who are un- and under-insured go bankrupt and end up homeless. We need healthcare reform NOW.

Need a fresh pair of eyes

Hey everyone, especially my editor and proofreader friends--do any of you have a few minutes to look over my WomenHeart Symposium application for me, to catch any typos or other embarrassing mistakes?

If so, please ping me at whatever email address you have for me, and I'll send you my application. It's due tomorrow, but I'd like to get it turned in this afternoon if possible to beat the last-minute rush... Thanks very much. :)

Are they *trying* to create a repeat customer??

There was a fat-ish envelope from my insurance waiting for me when I got home from work this evening. I opened it up and just about fell over. Unless more bills come in, we're looking at a total cost of right around $100,000 for everything.

If I didn't have good health insurance, that would bankrupt us, really and truly. I read a statistic online the other day that said that something like 65% of new bankruptcies in the US are related to medical costs. I believe it.

And even though the vast majority of it IS being taken care of by insurance, we're still going to have to pay a decent chunk ourselves, and I have a lump in my throat and my chest is a little tight.

Not to sound whiny, but we're going to end up selling some stuff, probably via yard sale. I'll most likely start making jewelry and soaps again and get serious about selling them. Costs will be cut. Whatever 10th wedding anniversary travel plans we've had have gone out the window.

But we'll get through this. Things could have been much worse.

Progress: I can bike and swim again!

My cardiologist has given me permission to ride my bike and start swimming again, yay! I don't know if I can fully articulate how happy this makes me--please just take it as given. :)

Paul says thanks (and so do I)

Paul's posted a big health update and thanks, so I figured I'd link to it:

http://paulcory.livejournal.com/155724.html

Pretty much seconding what he said. We've really appreciated everyone's support these past few months; it's meant a tremendous amount to us both.

Call for Submissions: A heart-related fanzine

Since my heart attack and angioplasty/stents, I've been trying to think of a fannish way to get the word out about heart disease. I was pondering this more over the weekend while I volunteered at a health expo on Saturday, at the WomenHeart booth, handing out brochures and information.

Well, on my way to work this morning, a lightbulb went off. Fans don't want to read brochures, we want to read *fanzines*. So I figured I'd try to solicit as many stories from as many fannish heart patients as I could, put them all together in a one-shot, and distribute it far and wide. Maybe even make a nifty, limited-edition button to give to all the contributors.

The last page would be an "In Memoriam" page, or as one my favorite TV shows, Babylon 5 says, "To absent friends, in memory still bright..." with a list of fans who've passed on from heart disease/heart attacks/etc.

Toward that end, this is a call for contributions for my one-shot, tentatively called A CHANGE OF HEART. Stories, poems, letters of comment, and artwork from fans who've had heart-related illness and/or surgery are welcome. If you yourself aren't the heart patient, but an immediate family member is/was, I'd also be glad to hear from you. Emailed submissions are strongly preferred; please send to laurahcory [at] yah00 -- but if you know someone who doesn't do email, ping me and I'll send you my snail-addy to pass along. And I need names for the "In Memoriam" page.

Deadline for submissions is July 24th. That's more than six weeks out and gives me time to put the thing together and send some copies up to Worldcon.

Permission granted to forward this to other fannish places.

Call for Submissions: A heart-related fanzine

Since my heart attack and angioplasty/stents, I've been trying to think of a fannish way to get the word out about heart disease. I was pondering this more over the weekend while I volunteered at a health expo on Saturday, at the WomenHeart booth, handing out brochures and information.

Well, on my way to work this morning, a lightbulb went off. Fans don't want to read brochures, we want to read *fanzines*. So I figured I'd try to solicit as many stories from as many fannish heart patients as I could, put them all together in a one-shot, and distribute it far and wide. Maybe even make a nifty, limited-edition button to give to all the contributors.

The last page would be an "In Memoriam" page, or as one my favorite TV shows, Babylon 5 says, "To absent friends, in memory still bright..." with a list of fans who've passed on from heart disease/heart attacks/etc.

Toward that end, this is a call for contributions for my one-shot, tentatively called A CHANGE OF HEART. Stories, poems, letters of comment, and artwork from fans who've had heart-related illness and/or surgery are welcome. If you yourself aren't the heart patient, but an immediate family member is/was, I'd also be glad to hear from you. Emailed submissions are strongly preferred; please send to laurahcory [at] yah00 -- but if you know someone who doesn't do email, ping me and I'll send you my snail-addy to pass along. And I need names for the "In Memoriam" page.

Deadline for submissions is July 24th. That's more than six weeks out and gives me time to put the thing together and send some copies up to Worldcon.

Permission granted to forward this to other fannish places.

Talking to Rehab

OK, so as I've mentioned here and here, there've been a couple of times where I've felt like a square peg being pounded into a round hole at cardiac rehab. Their usual patient is older, male, and has had a bypass. I'm young(ish), female, and had angioplasty and stents. No prior risk factors. I know how to eat right, how to exercise, all that jazz, and I'm pre-menopausal.

After cardiac survivors' support group on Wednesday, I spoke with the head of the rehab program. Longtime friends and readers know how much I loathe direct confrontation, but this is my health on the line here. So I told the lady that there had been a situation earlier in the week where I felt like I hadn't been heard, like I wasn't being listened to, that it seemed like the rehab group leaders were treating me like "Generic Cardiac Patient X," instead of seeing me for what I am: a woman under 50 years old who had a heart attack caused by a freak occurrence (arterial dissection), not coronary artery disease, or high blood pressure.

She actually seemed to hear what I had to say, and genuinely seemed appreciative of the feedback. She said, "What can we do?" I told her that I needed some reassurance that the nurses were actually seeing ME when they looked at me, and that they recognize that I'm not a 70-year-old male with hypertension and a triple bypass. I needed to know that they realize that I'm a woman who still has menstrual cycles, and that they won't refer me to the nutritionist the next time I gain 3 pounds of water weight in the days right before my period. She seemed to understand, and she asked if there were any staff members in particular that I felt more comfortable with--I named two.

It felt good to speak my mind in a constructive way. It's my hope that by speaking up, I'm making things easier for other young women who may come through the program.

Speaking my mind

I'm off to cardiac rehab, early, to talk to them about what happened on Monday.

Wish me luck.

IT'S JUST MY PERIOD! IT'S JUST MY PERIOD! IT'S JUST MY PERIOD!

OK, so last week there was this, where the cardiac rehab nurses were threatening to refer me to the dietician for my period-related weight gain. That every woman gets. That had subsequently disappeared by the time they expressed their "concern."

Today, near the end of exercise class, while we were moving from the gym back to the room where we do our warm-up/cool-down, the dietician showed up--and made a beeline for me. Oh hell no.

Sigh. She reiterated the "concern about your recent weight gain." I said, "OH MY GOD," and did the facepalm thing, and said through my hands in an obviously irritated voice, "Do you people never deal with any menstruating women here?! IT'S JUST MY PERIOD! IT'S JUST MY PERIOD! IT'S JUST MY PERIOD!"

The instructor at the front of the class glanced in our direction and tried to hide a smile.

The dietician tried to "shush" me. I told her that the weight was already gone, even (it is). She looked very nonplussed, said they did have some women of child-bearing age in the program, one of whom gained and lost six pounds every month. She mumbled something about being caught off-guard and left. It wasn't really fair of me to hit her with both barrels, but seriously now.

We have at least three things going on here.

1. The nurses were completely ignoring me the other week when I said the weight gain was just related to my monthly menstrual cycle. Being ignored makes me cranky. Yes, I know I've had a heart attack; that doesn't mean I don't know anything about my body.

2. If they weren't willing to listen to the patient, me, they could have at least bothered to check the facts on the ground before calling in the nutritionist. The fact that the weight gain has been reversed is documented there on the chart that we fill out every exercise session.

3. They lied when they said they were going to "monitor the situation" before calling in the dietician. They blindsided me by calling her in when they led me to believe they were going to at least look at my stats again first.

I feel disrespected and unheard and like I can't trust them now, and that's not good.

I had a meltdown today

I had a meltdown in cardiac rehab this morning. I feel like a big ol' crybaby. And part of me wants to just BE that two-year-old, and have a typical terrible two-year-old's temper tantrum. I want my old life back!

What happened was that I started having some pain in my left arm. When I had my heart attack at the end of March, I also had left arm pain, so as I'm sure you can all imagine, I was freaking out a little.

The nurses did a paddle check--minds out of the gutters, you pervs; it's not as fun as it sounds. ;) They hooked me up to the defibrillator and printed out a little EKG strip and said everything looked normal, but they could tell I was stressed so they had me sit down and drink some water.

At which point I started crying, because I'm tired of being the person who freaks out about a tiny bit of arm pain. I'm tired of worrying about every small twinge and ache. I DON'T WANNA ANYMORE. I want my old life back.

They also checked my blood pressure, which was a little elevated (for me--118/80), so they gave me a nitro pill under my tongue and called the in-house cardiologist over. She reassured me that the arm pain by itself, with no other symptoms like shortness of breath, was highly unlikely to be indicative of a problem. And also that the location of the pain meant that it most likely wasn't my heart.

And lastly, since the nitro wasn't helping, they said that was the most indicative of all that I wasn't having any heart trouble.

It'll be two months tomorrow. The heart attack and SCAD are a big black line that divides my life into "before" and "after," and I'm tired of living in the "after." I want to go back to the "before."

Obviously I know this isn't possible, and I think that's why I was crying this morning. It's all the anger and grief finally coming out. I haven't really had a complete and total meltdown about what happened to me yet, and I think I'm finally starting to. :/

It didn't particularly help that there's a lot of stress at work today--several important things that we sent to a major conference that's going on right now in New York City have been lost, one of our authors didn't get his plane ticket reserved, and another one's reservation got messed up.

None of which were my screw-ups (thank GAWD), but I was running around trying to fix at least some of them this afternoon, and I'm feeling very fragile right now. In fact, I need to go take a minute and blow my nose.

I'm seeing my therapist again next week. I really like her. I'm on an antidepressant already, one that I've been on for years. Maybe I need a little more help for the next little while. Anyway, thank you all for being here. As I've said before, I know my blog has somewhat turned into the "all heart all the time" blog of late.

Bless their hearts, as we say down here

At rehab this morning as I was doing my bit on the treadmill, one of the nurses came up to me and was all concerned. Among the stats we record every session is our weight, and last week mine bumped up--like three pounds. Ladies, you know what I'm talking about: it was right before my period landed, so it was all water weight. Bleah.

Anyway, the nurse was "concerned." She said, "You've been gaining weight. Are you doing anything differently? Sometimes once people start exercising, their appetites increase, and they start eating a lot more." I was like no, really, it's just my period. She said, "Is it fluid?" I said yes it's fluid!! Of course, the word "fluid" when you're a heart patient suddenly takes on a whole new meaning. She asked if I was on Lasix and I said no. Honestly, it's just my period. Seriously.

She was like, well, we'll monitor it this week and maybe refer you to the nutritionist next week if we need to. *eyeroll* FFS, lady. IT'S JUST MY PERIOD. HONESTLY.

And voila, when I stepped on the scale today, the three pounds had magically vanished.

I bet the same thing's gonna happen next month, too.

And the month after that as well.

It's almost as if it were on a ... cycle. *headdesk*

I know they're just doing their jobs, and they have to keep a close watch on these things, and also that some of the medications that they put people on can cause weight gain, and that fluid retention can be a sign of a problem. But really. It's just my period.

When I told Paul about it, he reminded me that they probably don't see very many pre-menopausal women there. Which is true. But most of the nurses themselves appear to be fairly young, so you'd think that their personal experience might give them a clue.

Ah well. Just another amusing anecdote in the annals of my recovery...

Birthday thanks, and adventures in baking

Thanks to everyone who helped celebrate my birthday (belated) yesterday, and thanks to everyone who sent good wishes. The best present of all was getting to see so many friends and spend time with people I hadn't seen in some cases, literally, in years, as well as getting further acquainted with people I've previously just interacted with online.

Miranda deserves mad props for making me not one but TWO cakes. See, now that I'm on a low-sodium diet, I thought it would a smart thing to find replacements for baking soda and baking powder which are made from sodium bicarbonate. There's one baking powder substitute that's made from calcium carbonate, and I'd bought some.

So I gave some to M. for making my cake. Everything on the container and on the company's website said that calcium carbonate works just like baking soda, but it's completely sodium free, and that for best results, you need to just double the amount called for in recipes. So I passed that along to Miranda.

Well. As the kids today say, this calcium carbonate is MADE OF FAIL.

For those who don't know her, Miranda is in fact a first-rate baker. She made mine and Paul's wedding cake 10 years ago and has seriously considered opening her own bakery, so I highly doubt the problem was at her end...

First, she told me that the cake wasn't rising as much as expected.

Then when it came out of the oven, all the rising it did, undid itself.

THEN, it kept... shrinking. Finally, she was left with a tiny brick that she threw away, after tasting it and determining that it even tasted like @ss, too. She told me that at the point when she tossed it, the end product had less than half the volume of the batter.

We were joking that all those people who thought the LHC was going to end the world were correct--they just had the wrong LHC. It's not this one, it's my failed birthday cake, which has turned into a black hole in her garbage can, where no doubt it continues to collapse in on itself.

So she started again and did another version, which looked and tasted terrific--there was not a scrap left at the end of the night. Is that awesome or what? After the first one turned into The Singularity That's Going to Destroy Us All, most people would have said, "Screw it, you're getting a store-bought cake."

Good friends, good food, lots of hanging out and visiting. I couldn't ask for a better celebration. Thanks, everyone.

Though I do wish that whoever anonymously bought me Where the Deep Ones Are from my Amazon wishlist would say something so I could be properly appreciative... :)

A Good Day

It was a good weekend, really, but yesterday was an especially good day, for several reasons. One, good friends Izzy and Dan (minus Christine who was having neck trouble, alas), and the Sanford Pottery Festival. Funnel cake and kettle corn for lunch, woo! Also lots of cool pottery things which I gamely resisted buying--even so, I still came home with a very small bowl, a Christmas tree ornament shaped like a black kitty, a crescent moon magnet, a small outhouse for my dad, and some citrus-scented body powder. Yes, that's restrained, shut up. ;)

Two, for the most part, it was a normal day. I hung out with friends, doing fun things. Then came home, washed my hair, and chilled out in front of the TV, hung out with Paul when he came in from his tennis match. We did dishes. He made pizza. And it was fine. It was normal. It was good.

Other good things from the weekend:

Friday = First of May; see this funny but NOT WORK-SAFE VIDEO:

http://www.youtube.com/watch?v=O-77ElyvRxI

Saturday = gaming group. First time playing our rpg since the end of March; it felt great to get back to the characters and dice again.

Three, cleared out the pantry of some stuff I can't really eat anymore and gave it to someone who can, so that was good.

I'm not sure if I'm explaining it well. It was just good to have a normal weekend.

One month ago today

One month ago today, Paul and I were sitting in the emergency room at UNC Hospitals, wondering what the hell just happened. It would be almost 12 hours more before we would find out for sure that I'd had a heart attack, and it'll be a month tomorrow that they did the cardiac catheterization and found the tear and the SCAD and put the stents in.

Not surprisingly, I'm having a few anxiety twinges this morning. I've already done a meditation/relaxation CD and had my morning devotional and prayer time.

At some point, I'm sure the heart attack won't loom so large; it'll no longer be one of the first things I think about upon waking and one of the last things I think about before going to sleep.

I'll eventually get back to a point where I'll take for granted that I'll wake up the next morning.

There are new challenges now. A low-sodium diet for one. Remembering to take a lot of pills is another. Working on improving my stress management skills so that people and situations don't get the best of me. Finding my new limits while trying not to feel limited, if that makes sense. Making time to see friends and family.

Still trying to make sense of it all. SCADs are so rare and so random, I haven't really started too far down the path of "Why me???" because there's no good answer, physically OR spiritually.

Physically, it's "idiopathic," which is medical jargon for "we have *no* fucking clue." Which brings us back to why me, then? Dunno. Bad luck.

Spiritually, I have to ask: Did the hand of God come down and rip my right coronary artery apart to punish me? Dude, the worst thing I ever did was some petty shoplifting when I was, like 12. There are serial killers on the loose. Which brings us back around to why me? If God/dess had no hand in it, then it was truly random, bad luck.

There are lessons here, yes. This has been a big, spiritual and physical shake-up. I'm eating healthier. And while my triathlon training has been sidetracked, I'm slowly getting back into an exercise plan.

And I'm trying to remember to say "Thank you" and "I love you" to people in my life. That includes all of you (still) reading this. Regardless of when or how we met, or whether we know each other in real life or just online, thank you for being here.

Duke Study: Stress can damage your heart

Duke researchers say that stress can damage your heart:

http://www.wral.com/lifestyles/healthteam/story/5032370/

Things are tough all around right now, but take it from me--try not to stress out (easier said than done, I know).

The heartbeat of an elite athlete--without the matching body

So, I went in for my cardiac treadmill stress test this morning. As usual with these things, it took more time to set up and take down all the blinky, beepy, sticky, ouchie monitoring stuff than the actual test itself.

Now that I'm on all sorts of medications, my resting heart rate tends to be incredibly low. Elite-athlete low. As in, 49 bpm. And my blood pressure, not high to begin with, is likewise amazingly low, like 90/58. After getting really winded on the treadmill, my heart rate was all the way up to 94, and my blood pressure had hit 108/70.

Today was also the first of three one-hour educational classes that I need to take before my cardiac rehab exercise program begins in earnest next month. Today's was about making changes, and not to my surprise at all, the first Powerpoint slide was Prochaska's Stages of Change (though it didn't mention Prochaska by name). I first learned about these when I was working at MicroMass in Cary, at the brief tech writing job in late 1999-early 2000.

Over the weekend, my medical alert ID bracelet came. I'm wearing it now, but I'm not used to it yet. When I opened the package, my first thought was "it's a little small." Other thoughts: "It's kind of like a pet's rabies tag." "Didn't think I'd be one of those people with one of these." I figure I don't need to have it on all the time. Don't need it when Paul's around, for example. Do need it if I'm by myself, or at work, or out with friends and Paul's not there.

When I was a teenager, I used to have one of those bracelets with my name engraved on a plate. This is like that, only... not.

Also found an online store selling lots of low- and no-sodium products, the Heart Healthy Market. Additionally, I'm trying out a low-sodium crock-pot sloppy joe recipe--I'm using ground turkey breast to make it even more healthy; it's simmering away even as I type and will be ready for supper tonight.

ETA: Two thumbs up on the low-sodium sloppy joe recipe! Tastes great, and has around 105 mg of sodium/serving, compared to ... holy shit, 800 mg in my previous favorite pre-made sloppy joe mix, Hunt's Bold Manwich Sloppy Joe sauce. 800 mg! WTF???

Addendum

Addendum to yesterday's entry.

I talked with my sister via phone last night, and she told me that our mom the retired nurse has now figured out how to use "the Google."

And has thus started finding, and telling my sister about, all the sites that talk about how rare spontaneous coronary artery dissections are, about how 70% are only discovered on autopsy, about how there are only around 200 cases in the literature going back to the early 1900s, several case studies where all the outcomes were "death," etc. It's true that if you Google "spontaneous coronary artery dissection," you have to go through several of the search results to get to a positive outcome, granted. But hey, there's me--a living, breathing positive outcome. :)

My sister says our mom is about as wigged out as our mom ever gets about medical stuff. Which is saying a lot, because with her background, she's usually pretty level-headed about that kind of thing. Historically it's been the rest of the family freaking out about something medical, and we would turn to her for calm, reasonable information.

Mama's also decided, and my sister concurs, that it's best not to show these sites to our dad, who has a pessimistic nature anyway. I mean, when my folks came up this past weekend to visit and bring me lunch and whatnot, Daddy, bless his heart, said to me--"Good thing this isn't 50 years earlier; they would have just sent you home with a prescription for digitalis and waited for you to die..." Now mind you, he was talking about the advances in medical science and how far things have come, and he referenced his own case of detached retinas and how if they'd happened several years earlier, he'd be blind in both eyes. But still, he can definitely be a "glass half empty" type, and I can be too.

But I'm trying to focus on the fact that my toast landed butter side up. I'm in the 30%. My dissection happened basically right there while a team of professionals could fix it on the spot. I mean, I even get to be a teaching tool; how cool is that?

But Heaven help me, my mom can Google now.

More health stuff and thinky-thoughts: the good, the bad, and the amusing

Monday I had scans of my carotid and renal arteries to look for structural abnormalities. Yesterday I had another introductory session at cardiac rehab, and I had my first follow-up appointment with my cardiologist.

Mostly it was good. My non-heart arteries looked good, so it doesn't appear that I have a rare connective tissue disorder. Marfan syndrome, for example, is a connective tissue disorder, and people who have it are prone to having aortic dissections (but people with Marfan's also tend to have a distinct phenotype, which I don't have). Other connective tissue disorders can leave people with weakened arteries throughout the body. But I don't have any of those; my arteries looked fine.

The cardiac rehab session went well; it was another "getting acquainted" session--I met with the nurse, who went over my medical history with me, reviewed all the meds I'm taking, and did a very small bit of exercise testing: how many biceps curls can I do in 60 seconds? Sitting with my legs straight out, how far can I reach toward my toes? That one was a flexibility test. I'm not very flexible.

Lunch was a forgettable pizza at Brixx (note to self: despite what you think of as pizza, if it doesn't say "tomato sauce," you apparently don't get tomato sauce), then it was on to the cardiologist, after a brief consolation prize stop at the nearby bakery for a chocolate croissant. Note: chocolate croissant actually had chocolate in it.

The cardiology appointment was mostly very reassuring.

The small chest-area pains I've been having are in the wrong location to be heart-related--that's the good news. Plus good news that the rest of my arteries are fine.

The doctor is about 99.999% certain that they're being caused by a combination of anxiety/depression/stress. Most of the time I'm doing OK. I'm holding it together pretty well. I go to work, I come home, I take walks, I read books, I watch TV, I futz around online.

But honestly? Really and truly? There's a small part of me that's retreated to a little corner of my mind, and she's back there gibbering incoherently about how freakishly rare this thing that happened was, and OHMYGODOHMYGODOHMYGOD I had a freakin' HEART ATTACK. And I have a feeling that if I start crying I may never stop. I don't know how to explain it.

The bad(ish) news is that there's no regular maintenance schedule for this kind of stent; they're so new, there aren't any studies out about them that go past three years. They may last 10 or 20 years. And how will I know that they've started going bad and need to be replaced, we asked the doctor. Well, you'll start getting the kind of pain that brought you to the emergency room in the first place. Oh great.

The amusing: a bunch of the cardiologists who worked on me are all going to a conference this coming weekend, and they're taking my pictures with them to present. These are from my first catheterization, where there's initially just the small tear in my right coronary artery, but after the contrast dye is pumped in, it starts coming apart the rest of the way, dissecting in a corkscrew pattern. So what they have, essentially, is a film record of a spontaneous dissection happening in real time. Paul wants copies of the pictures--I'm not sure if I'm ready to look at them yet. Maybe in a few months.

And we learned a valuable lesson. We learned that if you take blood from me several times a day, then do two procedures through my femoral artery (which despite their best efforts, DO bleed at least a little initially), then I get my period, THEN you test me for iron deficiency--WHY YES I SHOW UP AS IRON-DEFICIENT. Raise your hand if you're surprised...

Under more normal conditions, I don't have an iron deficiency, which is good, because the ferrous gluconate was tearing up my stomach (and was another culprit for the chest pain I was having). So yay for not having to take those supplements anymore! The doc says I can just take a regular multivitamin with iron and be fine.

Work is going OK. There was a mild bit of stress this afternoon, right as I was trying to leave. It was getting the whole office in a tizzy, but I just kind of mentally put myself in a bubble and didn't let it touch me.

So good news on the scan results, updated blood tests, and mild chest pain. Not so good on figuring out when the stents will need replacing. And amusing about the pictures. As for the other, I've put a call in to my old therapist and am waiting to hear back from her.

What's baby and what's bathwater?

As you might expect after a life-changing event, I'm contemplating some changes in my life, a rearrangement of priorities, a sorting of the wheat from the chaff.

This is going to be a slow process. I'm not going to make any rash decisions about which hobbies to toss or which activities to curtail.

I'll probably keep Facebook but end up killing all the assorted apps attached to it; I mean, do I really care about Superpoking all of my friends--really?

Do I care about what the crackpot fundaloonies are saying? Probably, but I don't have the hit-points to respond, and I need to work on reducing areas of stress in my life.

My top priority for the next three months is obviously going to be cardiac rehab.

As for the rest, the trick is to make sure I don't throw the baby out with the bathwater, as they say.

Do I like fanzines enough to keep producing one? I'm not sure. Do I enjoy the local sf club enough to keep on being the social coordinator? Probably, but we'll see. As for gaming, I have some thoughts there but want to talk it over with the gaming group first.

Then there's the fact that if he doesn't find a job, my best friend in the whole world may well end up moving back to Asheville in four months, and I want to spend a lot of quality time with him before he leaves town (possibly for good, because my fear is that if he leaves the Triangle this time, he won't make it back again).

So. Lots to think about.

The "hospital food" diet plan

Whether it was from almost a week of icky hospital food or what, I'm down another few pounds; so far since I started in August 2008 I've removed 21 pounds total. I still have a lot of work to do, but this is a big milestone for me, and I'm pleased to have gotten here.

Also this morning was my orientation session for cardiac rehab at Meadowmont. It's a very nice facility, comparable to the gym I've been going to since August, Duke Health & Fitness. The cardiac rehab program is 36 sessions, roughly 3 months. There's a lot of careful monitoring involved, a cardiologist always on site, etc. Next week is my stress test and educational classes, and I start the exercise program in earnest on May 11th.

You know what sucks?

Having a very small bit of chest pain, not being sure if it's something to worry about or not, calling your cardiology clinic, and having them tell you, "We can't see you today, why don't you call your primary care physician?"

WTF, UNC Cardiology? Seriously?

So I called my primary care physician, who also said WTF, UNC Cardiology? And also, please come in, we will see you, and also, oh, and we have a cardiology clinic that we refer people to that we're almost 100% certain wouldn't have said any such thing to you had you called them and said what you did.

Paul: Brief Update

Better day by day:

http://paulcory.livejournal.com/150891.html

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Laura says: And that's pretty much the story of my heart attack, in real time, as Paul and I blogged it. As I'm writing this now, on August 23rd, 2009, I've cut and pasted our entries from our various journals here to consolidate them, but what you're seeing is what we wrote at the time.

Go back to the beginning

Found some other women who've survived SCAD

One thing that's helped is that I've found some other women who've survived spontaneous coronary artery dissection (SCAD), and I've joined an online support community. This is mostly for my own info, but in case anyone else ever needs to refer a female friend or relative to a support group for women with heart problems, here's a little banner thingie:



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Gah, the Internet is both blessing and curse

Last night I spent a lot of time researching the particular make and model of the stents I have. Turns out that the ones they installed--the Xience V--are pretty much the top of the line. There are no studies going out past three years, but for those three years, these stents perform better than any of the others on the market. So that's all reassuring.

Moving on to research topic #2, I discovered that 70% of spontaneous coronary artery dissections are only discovered on autopsy. That wigged me out. I had to get off the computer at that point and go collect lots of hugs and kisses from Paul before I could stop being freaked out enough to go to bed.

In other news, it has been suggested that nail polish remover might suffice to get all the @^$%#$ tape residue off, from all the heart monitor sensors, various ekgs, assorted iv lines that were taped down on my arms and neck, etc. Perhaps I will go try that now.

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Paul: Frickin' Monday!

Back at the hospital:

http://paulcory.livejournal.com/150036.html

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And back home again, again

Got home around 6. Napped, just finished supper. Basically, all my tests were fine, heart enzymes are still appropriately trending downward, it's just, as suspected, slight loss of some lung function due to being bedridden for nearly a week. Now that they've given me the lung-exercizer thingy that one of the docs as much as admitted to Paul that they should have sent home with me the first time around, we expect everything to be OK.

Thanks again for all the support and for listening to me vent. :)

Now it's Paul's turn: we got home, he reached for a couple of SweetTarts and promptly broke a tooth on one. :/

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One step forward, one step back

So, I'm back in the hospital.

Sigh.

Much as I really, really, REALLY didn't want to admit it, late last night I had to confess to Paul that I was having trouble occasionally getting a full breath. And that's one of the red flags that we've been told to watch for, so at roughly 11:30pm last night, we packed ourselves into the car and drove back to UNC Hospitals for another round of EKGs, blood draws, and endless waiting.

I'm not in the ICU; I'm just in a room in the regular unit.

The other good news is that pending a 1pm-ish blood draw result, we'll be able to go home.

My cardiologists don't think we were silly to come in. OTOH, they're pretty sure that what happened to me is a fairly common side effect of being laid up in bed for the better part of a week: a very small part of my lower left lung has slightly collapsed--they even have a special breathing exercise device that they usually send home with open-heart surgery patients to help prevent this exact thing, but they apparently didn't think to give me one because my surgery was all done through the leg cath.

The general feeling is better to be safe than sorry, and this is all new territory for Paul and me, as we're learning a whole new standard of what's "normal" for me. :/

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Home, Yay!

I'm home, I'm home, I'm home!!!

Thank you all so much for your prayers, well wishes, lit candles, positive thoughts, etc. They meant the world to Paul and me both. It was such a thrill to sleep in our own bed, beside Paul, uninterrupted for 10 hours straight last night. Being home with him and the cats is a wonderful restorative.

Here's an amusing tidbit from the past few days: you know you're in a hospital in the South when they serve you *fried chicken* in the cardiac ICU.

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Paul: Laura Update - Home at @$%#$!!! Last!

Ahhh, finally home:

http://paulcory.livejournal.com/149992.html

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Paul: Laura Update - Waiting for the Doctor sucks

Waiting for the doctor--will we be home before the UNC men's semifinal NCAA basketball game?

http://paulcory.livejournal.com/149697.html

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Paul: Laura Update - Waiting for the vampire sucks

One last blood draw:

http://paulcory.livejournal.com/149485.html

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Paul: Laura Update - Continued Improvement

Maybe home Saturday?

http://paulcory.livejournal.com/148790.html

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My recent escapades

Most of you already know, thanks to Paul's regular updates to his blog, but for those who don't know: I had a heart attack on Monday morning. No, this isn't a late April Fool's joke; I wish it were.

Details on Paul's blog, starting here: http://paulcory.livejournal.com/146142.html

We appreciate all the comments, prayers, good thoughts, etc that people have been sending. this is my first time online since this all started Monday, but Paul has been reading people's comments to me and they really do help lift my spirits. If all goes well, I'll be moved from the cardiac ICU today and into a regular room, then maybe home tomorrow. Thanks again to all of you, and I'll post again as my energy level permits.

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Paul: Laura Update - Good News

Good news:

http://paulcory.livejournal.com/148519.html

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Paul: Laura Update - Grrr, and Worry

Another heart cath, sigh:

http://paulcory.livejournal.com/148157.html

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Paul: Laura Update - Improvement

Improvement:

http://paulcory.livejournal.com/147924.html

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Paul: Laura Update - How Low Can it Go?

Post-cath blood pressure through the floor:

http://paulcory.livejournal.com/147587.html


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Paul: Laura Update 4

More info:

http://paulcory.livejournal.com/146991.html



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Paul: Laura Update - With Extra WTF?!?

In the cath lab:

http://paulcory.livejournal.com/146604.html

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Paul: Laura Had a Heart Attack Monday Morning

Here's Paul's first post:

http://paulcory.livejournal.com/146142.html

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