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.