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.

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.

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.

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.

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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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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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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