Long Road Ahead

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Quite the week dear reader, quite the week. I headed off to my cardiac stress test on Tuesday as scheduled, expecting to demonstrate my cardio fitness and be on my way. 

It did not go that way.

I found the test easy, slow walking speed and no elevation. The goal of these tests is to raise the heartbeat to a specific target rate. That rate is determined by subtracting your age from 220, then taking 85% of that. For me that was 129, a rate I don’t often see hiking but do hit on occasion.

We sped up and raised the angle of the treadmill while they watched the EKG and other data inputs. We got to a speed a little faster than I normally hike, brisk but not running, and increased the treadmill angle and my heartbeat got to 120 and continued to climb slowly up to 129. 

They suddenly announced that they were ending the test and asked me how I was feeling, which I answered “fine – a little winded but fine.” 

They insisted I sit down and then gave me a nitroglycerin pill to place under my tongue while someone went to get the cardiologist. When he came in he explained to me that my EKG had begun exhibiting some dangerous results and that there was decided cause for alarm.

He told me thatI needed a angiogram as soon as possible, preferably this very afternoon. In fact he asked if he could call an ambulance to transport me to the hospital. I agreed to go but was able to convince him that I could drive myself. Based on physical examination and my EKG, which had now returned to normal, he agreed.

In at least a moderate state of shock, I hopped into the truck and headed off. I briefly debated heading home first so I could tell my wife in person, but the tone of the cardiologist still ringing in my ears prompted me to head straight to the ER and leave the news to a phone call.

He had called ahead so they were ready for me and in minutes I was being assessed in triage and given another EKG. They rushed me off to a gurney and then into to a room seemingly not normally used for patients, but given how flooded the ER was, I guess it was overflow capacity.

This was around 1PM; the cardiologist had told me that I needed a angiogram and the earlier I got there, the better chance of getting into the catheter lab that day, and hopefully receiving a stent. Nope.

I waited alone in that room, hooked up to an EKG on the gurney, with the door closed, for the next 9 hours, only seeing an ER nurse every 45-60 minutes. A cardiologist did stop in for a couple of minutes to tell me he was trying to get me into the catheter lab; never saw him again. To use the bathroom I needed to be unhooked from the EKG so I had to wait for someone to come in so I could go.

Around 11PM someone came in and moved me to one of the main ER treatment rooms, where the whole waiting process repeated itself until about 1AM when someone came in and told me that they had a real bed for me now, instead of the gurney, and just a few minutes after that someone showed up to move me up to the second floor to my room.

Now this whole time, no food and no water. I couldn’t eat or drink before the stress test so I had a single small sip in the morning to wash down my pills. Once in the hospital, I was told no food or water due to the expected angiogram. By the time I was brought to a room it became clear there would be no angiogram for me that night, but hopefully in the morning. Which meant no food or water until I had the test.

Around 10AM I found out it would not be this day either – it was Juneteenth and the catheter lab was closed. Seriously???? So at least I got to eat and drink, finally, up until midnight when the order went back into effect.

Woke up Thursday to the promise I was on the schedule. No food and no water once again, but I was perfectly OK with that in exchange for the angiogram. 

Around 1:30PM the nurse came in to tell me that they were not going to be able to take me that day. Seriously??? However since the catheter was off, they told me to order lunch. I called food services and went into a waiting queue. I hung up, and wondered to myself if maybe I should wait to eat, just in case.  But I called back and this time got to place an order, so I did.

The food came up around 2:15PM and was gone by 2:20PM; at 2:25PM someone came in announcing they were from the catheter lab and they were going to squeeze me in after all; then she spied the empty plate and said “Oh, you’ve eaten – never mind” and left. Seriously?? 

Turns out they had a doctor plead my case to the lab and they brought in another doctor to get me in and get it done. Of course the staff up on my floor were horrified and were so apologetic. The lab should have never called up to say I wouldn’t be going in until they were positive. 

So Friday morning came, no food or water, but I was assured I was going. And sure enough, at 7:30AM someone showed up with a gurney to take me down. Lots of prep work, shaving, IV’s, meds, etc. but about 45 minutes later they rolled me in and got me on the table.

I won’t get into the actual procedure because I couldn’t see anything and I was on some light slumberland drugs. But I do recall hearing the lead doctor say “no stent – shut it down”.

They wheeled me out for recovery and after a while the doctor came over with a piece of paper showing all my coronary artery blockages as well as the percentage of each blockage. It was literally overwhelming.He told me I needed to go to Brigham & Women’s hospital in Boston for coronary bypass surgery. 

After another 45 minutes there they finally took me back to my room where I knew my wife was waiting. Telling her was horrible beyond words. It shook her to her very core…devastated. 

That was Friday, this is Saturday night. I am still in RI waiting for a bed to open up in Boston. A cardiac surgeon has agreed to take my case and they anticipate a bed for me opening up tomorrow, on Sunday. Surgery will be Thursday June 27.

I remain in disbelief; I just hiked over 14 miles Saturday and the same amount the previous Sunday; almost 29 tough miles in a week and without issue. How could this be? 

Frankly the doctors have all been astounded at all I’ve been doing with all these blockages, one at 100% and a couple at 90 and 95%, and many more ranging down to 50%. Hiking, shoveling and hauling dozens of wheelbarrow loads of dirt, clearing all that brush, splitting, hauling, and stacking all that firewood. Nonetheless, I am apparently severely compromised.

At some point tomorrow I expect to be transported to Boston to begin part two of this incredibly wild tale. My current slant on this is find it, fix it, and move forward. I just want to get through this and regain my life so suddenly put on hold. 

My research leads me to expect a 4-6 hour surgery. It varies wildly but the post-op stay in Boston could be as little as four days up to a week. I am lucky in that I have not had a heart attack, an event that adds considerable time to the recovery. 

It is an ambitious surgery, sternum cracked in half, flayed open like a gutted fish! They stop the heart and you exist on a heart bypass machine while they graft the new arteries. However that is internet information; only my surgeon can tell me exactly what he plans to do to fix me.

This hospital does have less invasive robotic technology but as of now, I have no idea if that might be an option for me. We’ll see!

The hardest part of all this for me is the pain I’ve brought upon my family. There have been a great number of tears and anguish, worry and stress. My wife, my children, nieces and nephews, sisters in law (who are really just sisters we’ve been together so long), and so forth. 

And the disruption to all their lives! My daughter has had to drive my wife up here to see me every day and then repeat the trip in the evening to pick her up – with two small children no less. She has done so happily  but I know what a struggle it is to load a 3yo and a 9mo into their car seats for an hour round trip twice a day. 

And I am embarrassed at my weakness. I always strove to be strong and fit and age-resistant. And I did fairly well at that until now my shameful hidden weakness has been revealed. A dad tries his mightiest to always seem like Superman, and now this will mar that image (which of course is nothing but a mirage anyway). My goal now is to move through this with strength and dignity without complaining or bemoaning my fate. To set a good example hopefully.

The worst part is that I’ve done this to myself. At least 40 years of smoking probably tops the list of sins. And heavily for more than a few years. I quit 11 years ago, and had gone down to only a few cigarettes per day for a few years before I quit but the damage was already done by then.

 Next is probably not managing my health properly. I went a lot of years without having a physical. And even though I had exhibited high blood pressure for decades, I tried to pass it off as white coat syndrome when I should have been addressing it. 

I had a doctor throughout my 50’s and had an annual physical each year with him. But he never pushed me on my blood pressure and really never even talked about my cholesterol (which was high even then I’ve come to learn).

I’ve always had a terrible diet – a lifelong junk eater. That would possibly never have mattered had I tended to my smoking, blood pressure, and cholesterol. But I didn’t so the diet surely affected me too.

I yielded to my doctor and started on blood pressure meds a few years back, but it was just in the last year that it became apparent they were inadequate and allowing my pressure to remain higher than desirable. Thanks to my new doctor my dosage has been increased and I am finally living with pressure readings well below the desired values. 

It is only in this past year that I have acted properly with my cholesterol; even just a year ago I pleaded with my doctor for the chance to correct it with diet and exercise. And I made a concerted effort to do exactly that, I made small gains but nowhere near enough, so early in this year I finally agreed to take a statin. I had heard horrible things on the side effects and was really unhappy in doing it. 

And I did have issues, my legs and hips were painful and almost weak during hikes. I have been able do 7 miles without much effort at all for years but all of a sudden by the seventh mile I was hurting and limping. 

My doctor agreed to reduce my dose and it made all the difference in the world; no hip or leg pain and  no more limping. And my cholesterol remains well below the desired levels. I have also made changes in my diet: I eat fish twice a week, I eat nuts and fruit instead of cookies or crackers, and I eat far less red meat than I used to.

As responsible adults, it is our obligation to be our own primary care givers. We cannot rely on the medical community to make decisions for us, only recommendations. And when recommendations are not offered, it is up to us to ask why and insist on greater input from the doctors. 

This Post Has One Comment

  1. JJ

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