Saturday, September 5, 2015

Sometimes, I am right

I want to apologize for the lateness of this post. I have had a lot going on over the past couple of weeks and I have not had the time. It is that time of year for my work to start getting busy, the kids are going back to school, and I just can't seem to find ten minutes for myself. I will try to do better in the future. I do want to catch you up on what has been happening and I will try to give as much detail as I can.

I am pretty sure that my new cardiologist hates me. I really don't care what she thinks. I am doing my best to educate myself on my condition and all the medications that are prescribed to me. She wants me to be a sheep that blindly follows what she wants me to do. I am no sheep. I had to go in and have some blood work done to monitor my cholesterol, insulin, and sugar. My cholesterol is not that bad. My overall cholesterol is 155, my HDL is  43, and my LDL is 95.6. According to what I have read, your overall level should be less than 200, your HDL should be greater than 60 and your LDL should be under 100. My HDL is improving with every test they do. My sugar is at 112 and it should be under 100 and my insulin is at 42.9 and it should be less than 25. I have developed what the doctors call insulin resistance.

Insulin resistance is when the cells in your body are non responsive to insulin, which keeps your body from absorbing glucose (used for energy), which makes your glucose rise and the pancreas create more insulin.This is often referred to as pre-diabetes. The cause of my insulin resistance is where my doctors and I disagree. They want to blame my family history (it is worth noting here that only one person in my family has diabetes). I believe it is the statin (cholesterol) medication that I have been taking. I have been on Lipitor since I was released from the hospital. Everything was fine until June of this year. Out of nowhere, my insulin shot into the forties and my glucose started to increase. They were fine in May, but went crazy in June. At that time, my family doctor told me that researchers had discovered that statin use increased the risk for diabetes so she cut my dose from 20 mg to 10 mg. In July both my sugar and my insulin were down. My glucose was 104 and my insulin was 27. They were still a little high, but were getting close to normal. Then in August, they jumped again. I took this to mean that I just couldn't tolerate the Lipitor. My cardiologist did not agree.

I called her and told her that I was having issues with my insulin and muscle pain (another side effect). She wanted to lecture me on the importance of keeping my cholesterol low. I told her that my levels were within normal range and she said they weren't. I still need to drop my LDL another 20 points. I got sick of arguing with her and told her I would no longer take that statin and she needed to prescribe a different one. She prescribed 40 mg of Crestor, which has almost the same diabetes risk as Lipitor and the dose was 4 times what I was currently taking. I emailed her and told her that I would not be filling the prescription. The next day they prescribed 20 mg of Zocor, which cuts the diabetes risk in half compared to the other medicines. I received a letter from her in the mail detailing our conversation and had some printouts of articles about the importance of lowering cholesterol. I just laughed. I am not arguing that fact with her. I get that I need to get that number down to help prevent another heart attack, but I don't think that I should have to develop diabetes to accomplish it. Especially when there are other medications that work just as well without that added risk.

So now we wait to see if this medicine is going to work or if I need to change it again. I don't think my cardiologist was prepared for a patient like me. I believe that if a medicine isn't working, you should change it. She believes that you should just prescribe more medicine to offset the effects of the first medicine. And we wonder why the pharmaceutical companies make billions every year. They create customers, not cures. I refuse to be taken advantage of. I do not believe that doctors know all. I know that their opinion is just that, an opinion. It is not fact and should not be treated as such. If you ever think something isn't right with what a doctor tells you, get a second opinion. Always trust that initial instinct. It just might save your life.

Sunday, August 23, 2015

Widow Maker

None of my doctors have ever used the term "widow maker" because doctors don't like to scare their patients. Instead they just told me that my blockage was in the LAD or left anterior descending artery. I, of course, did a google search for LAD blockage a few weeks after my heart attack. This is the first time I saw the term "widow maker." Let me just say that reading about it is far scarier than the term itself. I am going to give you a brief over view of that artery, what it does, and why it is so dangerous. This is just based on research that I have done myself.

There are three arteries that run over the surface of the heart and supply it with blood. There is one on the right side and two on the left. The one on the right side is the right coronary. On the left there is the left anterior descending and the left circumflex. The left anterior descending supplies the front and mail wall of the heart and the left circumflex supplies the side. So when there is a blockage in the beginning of the LAD it cuts off blood flow to the rest of the artery. That means that the whole front wall of the heart is cut off from it's blood supply. As far as heart attacks go, that is the big one.

From what I have read, when there is a blockage in an artery, the heart muscle stops working within minutes. If the blood flow is not restored within minutes to hours, the muscle typically dies. Now that being said, I did not have the blockage removed for almost 24 hours after the onset of symptoms. Luckily, my blockage was smaller. The doctor never gave me an exact percentage of the blockage, but we know it wasn't a complete block. If it had been, I probably wouldn't be here right now. In fact, most people don't even make it to the hospital with that type of blockage. They just suddenly die. The survival rate for a "widow maker" is only 5-10%. That means that only one out of every ten people that suffer that heart attack survives. To say that I am lucky is an understatement.

I know that I am lucky. I don't always feel that way, but I am. Since December I have just been trying to get my mind around what happened. It is not easy to describe how my life has changed. Almost everything about me has changed. Not always for the better either. I am trying really hard to focus on living and enjoying every moment, but the fear that I have developed can sometimes be paralyzing. I am trying to conquer as many fears as I can. Almost dying at 33 definitely threw me for a loop. Once the initial shock wore off, the fear settled in. It is hard to explain, but I am afraid of the most average things that most people don't even think about.

I was afraid to drive for the longest time. I made my husband drive me around a lot. I eventually made myself drive again. I have almost been in a few accidents (people pulling out in front of me or running stop signs) and it makes me not want to drive again, but than I realize that I am not going to be any safer with someone else driving and I suck it up. If you let fear determine what you do in life, you won't do anything. I have discovered so many things to be scared of and most of the time there is nothing you can do to make it less scary. You can face those fears head on or you can let the fear take over. I am choosing to face my fear and by doing so I hope to get back to having a normal life.

If anyone is interested in learning more about the widow maker follow this link:
http://myheart.net/articles/the-widowmaker/

Thursday, August 13, 2015

Anger

I can't tell you when the anger started. I don't know if it came on gradually or if it was sudden. I do remember when I became aware of it. I was at my first solo doctors appointment and she was trying to convince me to take the anti-anxiety medication she prescribed. She said that depression was common in young people who suffer a heart attack. What I was feeling was "normal." I was so furious. I just wanted to scream. Nothing was normal.

It is not normal for a 33 year old woman to have a heart attack. It is not normal to have to take about a pharmacy's worth of medication every day. It is not normal to be exhausted all the time. It is not normal to be scared that I might die at any time. It is not normal to get winded from the simplest things, like walking up one flight of stairs. Every day brings a new nightmare for me to deal with and I am doing it alone.

My anger has fluctuated over the last 8 months, but it never goes away. It's always there, just under the surface, waiting to rear it's ugly head. There are times that I find myself getting angry over the dumbest stuff. Stuff that normally wouldn't bother me. I realize it after the fact, but in the moment I just react. My husband has been on the receiving end of that rage quite a bit. I always apologize later, but I still feel awful.

It's just really hard to watch other people my age doing all this wonderful stuff and I can't even exercise without my doctors' permission. I got sick a few months ago and I couldn't take anything to help alleviate the symptoms. Every label read, "If you take blood thinners or have heart problems, consult your doctor." The simplest things, like vitamins, have this warning. I can't make any decision without checking with a doctor. It is ridiculous and frustrating. I am so scared to see what is going to happen if I get the flu or something.

It is also frustrating dealing with Cardiologists. They are the worst. I was prescribed a blood thinner, aspirin, cholesterol meds, and blood pressure meds when I left the hospital. I have never really taken a lot of medication so being put on all of those meds at once was quite a shock to the system. I quickly learned that I am one of those lucky people that get almost all of the wonderful side effects of the medications.

I started cardiac rehab in February and the side effects of the medication started about that time. The nurse that was in charge of rehab set the goal of me losing 10 pounds over 8 weeks. Pretty much had the opposite happen. I gained about 11 pounds and my legs were swelling like crazy. She sent me to see my cardiologist who told me I have sleep apnea (What?!) and gave me a water pill. That pill did nothing but make me feel gross and my legs kept swelling. So I made an appointment with my family doctor. We talked and I told her what was going on and that I had done a little research and the side effects for my blood pressure medicine were......You guessed it, swelling of the hands and legs, unexplained weight gain, and fatigue. Ding ding, I think we have a winner. She changed the meds and the swelling went away in about a week. I was still tired and still not losing weight, but I had conquered one problem.

My doctor also decided to do a full blood workup to see what else could be going on. We discovered that I had become insulin resistant. Which is a nice way of saying pre-diabetic. The funny part was that my sugar and insulin was normal in May and high in June. She did a little research and found out that my cholesterol medication (Atorvastatin) has recently been found to cause sugar problems and diabetes, especially in women. She cut the dose in half and a month later, my sugar and insulin had come way down. They are still not normal, but they are way better than they were. I have lost 10 lbs. and I get my sugar checked again in a couple of weeks.

Of course my new cardiologist (I fired the sleep apnea guy) thinks that statin medications are the greatest thing ever and doesn't want to take me off of them. I have news for her. I will not take a medication that is going to give me diabetes. It is not going to happen. If it comes down to maybe someday I might have another heart attack versus for sure diabetes, I am going to avoid diabetes. Seems like a no brainer to me, but what do I know? After all, I didn't go to med school. I just used my common sense.

Wednesday, August 5, 2015

Denial

I have never been so happy to be home. Hospitals are awful. The food was gross and inedible. I didn't eat for the better part of two days. When I got home, I slept, a lot. For the first week or two I took three naps a day and then still slept at night. I guess you could call it sleep. I would wake several times a night in a panic. Have you ever had that dream where you are about to fall out of bed and you jerk back and wake up with your heart racing? That is how it felt, but it was several times a night. That went on for about a month before it finally calmed down.

I was also sent home with a very long list of things I was not supposed to do. I was not allowed to lift more than 10 lbs., no pushing or pulling, no baths, no bending, stooping, or straining, no excessive stair climbing (that one was fun, our only bathroom is upstairs), no violent coughing (like you could help it if you had to), no sex until I see a cardiologist (6 weeks later), and go on a heart healthy diet aka the no flavor diet. I also had to monitor my blood pressure, take my temperature and weight every day, and watch for a very long list of things that could go wrong. It was tons of fun.

My husband tried to be helpful while I was off work, but I wanted to get back to normal as fast as I could. I didn't want to admit that it had happened and I didn't want to talk about it. I didn't tell anyone what had happened. I hate to say that I was embarrassed, but I was. I can't explain it, but I was embarrassed. I couldn't even go shopping without needing to take a break or two before we were done. It was horrible realizing that my whole life had just changed without any warning.

I lost a lot when I had my heart attack. It was really hard trying to deal with everything that was going on and I just shut down. I just wanted to go back to normal, but my body wouldn't let me. The doctor that discharged me, put me off of work for three weeks. I went back to work on January 5th and I quickly realized it was too soon. I couldn't make it a whole day and had to leave early every day. I finally saw my doctor on the 8th and she put me back off for another three weeks.

She tried to give me anti-anxiety medication to help me relax and sleep, but they made me feel worse. She also suggested I go to therapy. Apparently younger people that have heart attacks really struggle afterwards. I would guess it is because it comes out of nowhere. One day you are fine and the next you almost die. It's a lot to take in. I never did go to therapy. I just kept trying to ignore that it had happened.

You never know how you are going to react in any situation until it happens to you. We all like to think about what we would do, but you never really know until it happens. I had always figured I would probably develop cancer at an early age and I thought I was prepared for the fight, but this took me by surprise. You can't fight a heart attack. If you are lucky enough to survive it, the road back is long and extremely hard. I am lucky that I survived and I know that, but that doesn't make things easier. They say that time heals all wounds, but I am still waiting.

Thursday, July 30, 2015

12/12/14

I was pretty out of it when the first doctor woke me at 6:30 A.M. on December 12th. I honestly don't remember anything he said other than they were going to run another blood test. I drifted back off to sleep and was awoken by the Pulmonologist at 7 o'clock. My CT scan was clear and he thought it was more likely a heart problem than a lung problem. He said I could follow up with him in a couple of months to get more testing done and he left. My husband took our son to school at 8 and then came to see me. I still had not heard anything at that point, but I finally had my tablet so I had something to do at least.

My husband doesn't like hospitals, so he didn't hang out for long. I promised I would let him know as soon as I knew anything and he went home. It must have been about 9 or 9:30 when the nurse came in to let me know what was going on. She said that my cardiac enzymes were 3 times higher than they were the night before and she was waiting for the doctor to call her back to see what they were going to do. She said that I would most likely need a heart catheter done and I would have to be transferred to another hospital to have it done. She said she would let me know as soon as she heard from the doctor and she left. I just sat there stunned for a good 5-10 minutes.

I called my husband and let him know what she had said and he asked what he should do. I didn't know what to tell him. I was in such a state of shock that I couldn't process the situation, let alone tell him what to do. I finally told him to go get Jake out of school and be ready to go. After I hung up I just sat there for a minute and then realized I wanted my mom. She would know what to do. I sure as hell had no idea what to do so I called her. I was at least considerate about it. I told her I was alright before I filled her in on the whole hospital thing and the whole need a heart cath thing. Talking to her was the only time I cried. I was just so overwhelmed and scared at that moment that I couldn't stop myself. I quickly regained control of myself and finished the conversation.  I promised I would keep her updated as I knew what was going on. Then I was alone. My husband and son came to my room around 11 A.M. and we talked briefly. The nurse came in and said that I would be going to Bay City to have my heart cath done and they were just waiting on the transport to show up.  She gave my husband directions to the hospital and they went out to pull the truck around where they could follow the ambulance.

The EMT's came to get me at noon and we were on our way. I don't know how long it took to get there, but it felt like the longest ride of my life. My mom met us at the hospital and I was taken to my room. The nurse asked me the same questions they asked in the E.R. What is your pain level? Describe what happened, family history, etc. Every time someone came to my room for the rest of that day and the next, they asked those same questions again. I don't know if they just didn't read my chart or if they were checking my cognitive function, but it was really annoying.

I would like to point out that I have not eaten anything this entire time. The last time I ate was spaghetti the night before. The nurse decided the doctor probably wouldn't do my cath that day because it was getting late. I had already missed lunch so she brought me some apple juice, graham crackers, and applesauce. Of course, the doctor showed up around 5 o'clock and decided that he was going to do the heart cath that night. This is the first time I heard anyone say, "heart attack."  The surgeon said I had a heart attack and I needed a cath done right away. He was confident that he probably wouldn't find anything, but he had to do it to make sure. He no more than left the room and the nurse's aide was there to prep me for surgery. My transportation showed up at the same time and they had to wait in the hall until the prep was done then I was on my way to the pre-surgical area.

My family got to come in and see me briefly before I went into the cath lab. I didn't have to wait long and I was being sedated. When I came to the doctor was talking to me and my family was there with me. He was showing me the images from my cath and the blockage he removed. He said the blockage was in my LAD, which didn't mean anything to me. He removed it and put a stent in there to be safe. He then disappeared and I didn't see him again until a month later.

Post catheter was the worst experience I have ever had. They threaded the cath up my femoral artery, with they access through the groin, to my heart. After surgery I had to lay on my back for an hour before they removed it. When the nurse finally removed it, I wanted to die. That was one of the most painful experiences in my life. She then had to apply lots of pressure to the area to keep me from bleeding to death. After she was done torturing me, they put a pressure dressing on the wound and I had to lay on my back and not flex any muscles for 6 hours. If I did move I could re-open the wound and the process would start all over. Luckily, I was able to complete the process the first time around. Using a bed pan was not fun or easy so I really had to go by the time I was able to get up. It was around 1 A.M. when they got me out of bed and took me for a short walk. I then disappeared into the bathroom for the next 10 minutes. After that I didn't get much sleep. I slept for a few hours at a time and then I would be wide awake for an hour or 2 and then I would fall asleep again.

I got a really obnoxious roommate while I was sleeping and I really wish I could have slept until they released me. Every time the nurses came to check on her, they checked on me too. Every time a new one came in they would look at my chart and ask about my heart attack. Then they all said the exact same thing, "But you are too young for that." Apparently, I am not too young for that. I was so annoyed ready to go home. The doctor that was on call for the weekend didn't show up until almost 7 P.M. on December 13th to send me home. I have never been so happy to be home in my life. Little did I know, the fun was just beginning.

12/11/14

December 11th started like any other day. It was so ordinary, in fact, that I can't give you any details about the first part of the day. I got up, brushed my teeth, and got ready for work. Nothing significant happened during my work day and I can't tell you what I had for lunch. I know that I was very busy. Winter is a very busy time at my job and I was doing 3 jobs at the time. I was working a lot of over-time. I guess you could say that I was a little stressed, but I don't think it was too much more than normal. My husband had quit his job in November so my income was all we had. That is why I volunteered for the over-time. I thought I had everything under control.

I got home from work a little after 5 o'clock and we made and ate dinner. I do remember that we had spaghetti. I decided not to do any over-time (I do my over-time from home). I was relaxing in my chair watching T.V., this was about 6:30. The pain started in the center of my back and it was just a dull ache. It felt like my back was out of place. I kept moving around in my chair, trying to get comfortable. The more I moved, the worse I felt. I got up and stretched and that didn't help either. I figured I would just have to deal with it. I have had back problems for a long time so I didn't think much of it. I had a twisted vertebra in that area about a year before and I just figured it was out of place again.

After about 10-15 minutes, pain in my left arm started. It started in my wrist and was extremely intense. It was just a ring a pain around my wrist. That is when I told my husband that something wasn't right. He asked if I wanted to go to the hospital and I reluctantly said, "Yes." By the time we got our shoes and coats on, the pain had started around my elbow. I now had 2 rings of pain, 1 around my wrist and 1 around my elbow with no pain in between. We only live about 5 blocks or so from the hospital so it didn't take long to get there. There was no snow on the ground and there was no frost so we didn't wait for the car to warm up, we just piled in and left.

The hospital staff was very quick to see me. I told the receptionist in the E.R. that I was having chest pain and pain in my left arm. She said to have a seat and a doctor would be right out. I would say the doctor was out in under 5 minutes, which was not quite fast enough for my husband. I could see the worry in his face, but I still didn't think anything really serious was going on. I did my best to reassure him that I would be fine. The doctor came out and took my vitals in lobby. My heart rate and oxygen levels were good and he took me back to get an EKG right away. I was then taken to my own curtained area in the E.R. The doctor said my EKG was fine and he started the usual line of questioning, what were you doing? how would you rate your pain on a scale of 1 to 10? do you have any history of blah, blah, blah? The usual questions you get whenever you go to the hospital. The next test was a chest x-ray, normal. Then they did blood work and got a urine sample. The pain had stopped and I figured it was due to my gallbladder or something and wanted to go home, but they wanted to run more tests.

By this point it was getting pretty late so I sent my husband home with our son so he could get some rest. At around 11 o'clock they decided to send me to get a CT scan. Surprise, surprise, that was normal too. I remember flagging the nurse down around midnight to find out what was taking so long. I felt fine and just wanted to go home. Like I said, work was crazy busy and I didn't want to leave anyone hanging. The nurse said I could leave, but I would be leaving A.M.A (against medical advise) so I toughed it out. I figured they would have answers soon and I had already waited this long. I started to drift off to sleep around 1 A.M. and that is when the nurse told me that my blood work came back and my cardiac enzymes were elevated. She said it could be a sign of damage to the heart or an infection. They were going to keep me overnight to monitor me. She didn't act concerned so I wasn't worried. I got to my room around 2 A.M. and drifted off to sleep pretty easy. I was awakened around 4 and again around 6 for more blood work and vitals. Needless to say, I didn't exactly rest.

In the interest of not going on forever, I am going to end this post here and start another one to detail what happened the following day. I hope you will all bare with me while I get through the rest of the details. I am not trying to ramble on forever, but I want to fully describe what happened.

Wednesday, July 29, 2015

A Brief History

I wanted to make my first post a brief overview of my life until this point. As I am now 34 years old, this is going to be a very brief history. I will not bore you with every detail of everything that has ever happened. I only want to give you a sense of who I was, who I am, and who I hope to become.

I have been mostly happily married for 11 years and I have a son who is going to turn 10 in January. He is crazy smart and funny and I adore that kid. It is never a dull moment with him around. He does come with his own set of challenges, but every struggle is worth it. He is going to be starting in the gifted class this fall and I could not be prouder of him. He is an over-achiever like his mom. We believe he suffers from anxiety and he has an overwhelming need to be perfect. The two make for a tumultuous combination, but we are doing what we can to help him cope. The poor kid just got a crazy mix of genes, but he seems to handle things better every year.

My son isn't the only one who didn't win the genetic lotto. I come from a long line of women that don't survive to old age. My grandmother died at 62 from colon cancer. My aunt was 48 when she died from melanoma. My mom is 54 and has stage IV colon cancer. I even had cervical cancer. I was lucky though, they were able to cure mine with surgery. I had a hysterectomy a year after I had my son, but I have been cancer free for 7 years. My doctor knows my full history and I get all my tests done regularly. We have always focused on the cancer history and didn't even think about my dad's health issues. My dad is a diabetic and he has heart problems. I don't know why I never worried about inheriting my dad's issues, but I never did. Even my doctor didn't really dwell on it. I had a stress test a few years ago and she checks my cholesterol, but there have been no warning signs.

So you can imagine my surprise when I suffered a heart attack at the ripe old age of 33. It came out of nowhere and blindsided me. I think I am still a little shocked now, almost 8 months later. They say it is really hard for young people to go through something like that. I think it is because it is just so unexpected. You are just sitting there minding your own business and the next thing you know you almost die. That shakes a person up a bit I think. I will go into the details of what happened in later posts.

I am glad that I waited this long to start talking about what happened. For the last 8 months I have gone through an entire range of emotions. I think I am better able to understand what happened and all the things I thought and felt than I was at the time. For the first 2 months I was in a fog of shock an disbelief. It is so hard to understand if you have never been there. I am hoping this blog will educate people a little bit about heart disease and help the families of those that have suffered a heart attack. I am hoping that sharing my story will also help me to heal in a way. I hope that you will stay with me through this journey. Please feel free to email me with questions along the way or post them on here. I promise to do my best to answer them.