Friday, July 31, 2009

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? :)

Wednesday, July 22, 2009

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.

Monday, July 20, 2009

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.