Thursday, April 30, 2009

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.

Tuesday, April 28, 2009

Duke Study: Stress can damage your heart

Duke researchers say that stress can damage your heart:

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

Monday, April 27, 2009

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???

Thursday, April 23, 2009


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.

Wednesday, April 22, 2009

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.

Monday, April 20, 2009

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.

Friday, April 17, 2009

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.

Tuesday, April 14, 2009

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.

Monday, April 13, 2009

Paul: Brief Update

Better day by day:


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

Saturday, April 11, 2009

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:

Together we're better - WomenHeart Support Community

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Wednesday, April 8, 2009

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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Monday, April 6, 2009

Paul: Frickin' Monday!

Back at the hospital:

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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.


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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Sunday, April 5, 2009

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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Friday, April 3, 2009

Paul: Laura Update - Continued Improvement

Maybe home Saturday?

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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:

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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