Authors Note: As someone who fancies himself a writer, I’ve decided to chronicle my new journey into heart health here. These long-form posts will allow me to keep those interested up to date on my journey and, in years to come, help me look back on how much progress I’ve made. Heck – maybe there’s another book in here somewhere, too. Some of you have already heard this story, but committed now to the record… my own sort of journey there and back again.
On Thursday, April 6th 2023 I left the office looking forward to a long three day weekend – thanks to the Good Friday market holiday.
I don’t remember exactly what caused it, but for whatever reason my wife and I decided to fall out of synch with our recent diet habit and eat some junk. We settled on a local Mexican place – the meal was filled with crispy chips, ice cold margaritas, and fried burritos. I point this out not because I think this caused my heart attack, but because of all the decisions it influenced later. In any event, we ate our weight in chips, rice, and beans and then went home. I felt fine, obviously very full, but otherwise had no issues to report.
The next morning, my wife went to work and I ran some errands – casual adulting stuff for a day off, I guess. I got my oil changed, returned some books to the library, and hit the grocery store. Afterwards, I headed home to relax before going out again that night. Around 4pm on Friday afternoon I started experiencing the first instance of what I assumed to be heartburn. This was pretty close to twenty-four hours after I’d had all those beans, chips, and rice. To me, the fact that I’d have some heartburn after all of that made sense. I gave it basically zero thought. I popped a few Tums, the discomfort went away, and off I went. That night, we went to dinner where I had a lean grilled steak and with French fries (it’s called balance, look it up). After dinner we went to a movie and, naturally, shared a bucket of popcorn. I went home that night and felt great, I slept like an absolute rock.
Saturday, April 8th, was more of a mixed bag.
The plan that day had been to go to a late-afternoon church service, for the Easter holiday, and then spend a relaxing evening at home. That morning my wife and I went to the grocery store for Easter Sunday supplies (buttermilk coconut pies were on the menu) and, while there, the “heartburn” started to come back. Looking back, the discomfort had definitely increased with this wave. It was not hard to walk, stand, or see. The pain wasn’t, by any stretch, “blinding.” But it was…uncomfortable. And noticeable. When we got home from the store I was also starting to feel what I would describe as “sluggish.” I laid down for a nap and we resolved to watch church at home, instead of going out. Between the nap and some more antacids, the discomfort continued to go away. Later that evening, around 6pm, it was the same: heart burn came on and the Tums knocked it out.
At no point so far in this story – Friday or Saturday – did I think I was in any serious trouble. Since leaving work on Thursday afternoon I’d eaten a large plate of Mexican food, an order of French fries, a bucket of pop corn, and various other snacks. For four or five weeks prior to all of this I’d been eating very lean and light. Now, after two to three days of “falling off the wagon” it continued to make sense to me that I’d have some indigestion. I viewed it as sort of a “you get what you get” scenario. Want to eat like garbage? Well, you’re going to feel like garbage. I’d seen similar situations play out countless times before.
That evening, though, I felt… great. We had a lighter dinner. Watched TV. Hung out. Things were going well. At 8pm, 9pm, 10pm, 11pm… nothing unusual was happening. I was very relieved by this. I still did not believe anything more serious than run of the mill heartburn was happening. But it had been going on for a while and I wanted to feel good and sociable for Easter Sunday and all the festivities. I genuinely believed I was in the clear. As I got ready to head to bed that night, I resolved to eat as light as possible on Sunday (as to not reignite the heartburn) and even committed to calling a doctor that week to talk about getting on something for persistent heartburn.
As the clock struck midnight that night, now Easter Sunday, I turned the television off and laid down to get some sleep. At the exact second that occurred, the heart burn came back. The sensation and the location – right in the center of my chest – was the exact same as all the instances before. This time, though, it was more… pronounced. The pain and discomfort were stronger, but still not pulsating or entirely alarming. I took some more Tums and waited for the pain to subside. By sometime around 1am the pain was still there. Still more Tums didn’t knock it out. I tried laying on my side, my back, my stomach, all hoping to find some sort of position that would provide relief. There seemed to be some sort of lessening of the discomfort (probably psychological) when I sat straight up. Hoping this would help, I got out of bed and sat on the couch all night long hoping for something to change. I drank a cup of ginger tea and ate some blueberries – foods associated with reducing acid reflux – but they, too, offered no help.
At 8am on Sunday morning I asked my wife to take me to an urgent care. The chest pain was still there, it had never gone away since it came back on at Midnight, and I hadn’t fallen asleep at any point in the night. I still wasn’t terribly concerned. More than anything I was frustrated and a little delirious. I’d been looking forward to spending a day with family, instead I was exhausted, had heartburn that wouldn’t go away, and was just… tired.
At the urgent care I explained that I’d been having intermittent heartburn since Friday evening that, now, just wasn’t clearing up. I asked if there was any sort of prescription, super strength antacid that they could give me. The Physician’s Assistant also appeared to think this sounded pretty reasonable. “But, since you’re already here,” she said, “let’s run an EKG… just to be safe.”
My first reaction to that statement was that this was overkill, unnecessary. If anything, I figured they were just trying to bill my insurance and get some extra cash flow. But, she was right, I was already there. Hook me up, let’s do this.
A tech came in to run the test. As he was hooking me up he explained that I had to be still while the test was actually running, and that they run two instances of the test to have something to compare it to. After the second test he says “Well… lets run one more.” That struck me as odd. But whatever, I’m not an expert on these things. The tech then packed up his machine and told me the PA would be back in a few moment to go over my results.
When the PA came back into the room she was accompanied by another lady I hadn’t met before. After forty-eight hours of on again/off again chest pain… this was my first inkling that things were accelerating. The new lady introduced herself (I can’t remember the exact title) as some sort of regional director for this particular chain of urgent care facilities. Bells were going off. She explained that, based on my EKG results, that they wanted me to go the hospital… and they wanted to send me in an ambulance.
I’ll never know if they were saying this to keep me calm OR if they were actually feeling as indifferent as they sounded. The PA explained that they weren’t actually “concerned” and that the EMT’s (they’d already spoken on the phone, they were on their way) weren’t concerned either. The test had showed an abnormality, and they wanted a hospital – with their more advanced imaging abilities – to check me out. I saw logic in this. I still believed I was suffering from a severe case of heartburn. Like the EKG a few minutes before, I still rationalized that this was unnecessary. But hey… whatever. Let’s do it.
When the EMTs arrived they hooked me up their EKG and ran more tests. They looked at the results and seemed to explain (again, paraphrasing) that where there should be four evenly spaced heartbeats that I, in contrast, had two… then a gap where the third should be… and then the third and fourth in quick succession. The EMTs seemed calm about this. They gave my wife and I choice of which hospital to go to, we picked one that was actually a little farther away. They didn’t seem concerned by the additional delay.
In the ambulance (we didn’t even have sirens on) the EMTs started giving me nitroglycerin spray, which is known to reduce chest pain and offers other assistance when a heart attack is suspected. Other than making my mouth taste like peppermint, I never noticed a difference. The whole ride there, the EMTs were very relaxed. There wasn’t a lot of alarm, similar to the PA and staff at the urgent care. In retrospect, this could have likely been a tactic to keep me from freaking out. At the time, though, it reinforced my belief that I really wasn’t in any sort of danger. This was all a lot of caution, “just to be safe.” I was happy to be safe, but it still felt unneeded.
At the hospital, the first medical professional I saw, reviewed all of the EKG results. He, too, didn’t seem too worried. He asked “Has anyone ever told you that you’ve got a Bundle Branch Block?” I told him I’d never heard of that. A Bundle Branch Block, he explained, is (again, paraphrasing) basically a blockage in the heart that can delay electrical impulses in the heart. He explained that this is usually benign and can usually be treated with medication.
Someone was finally making some sense, I thought. There was, it seemed, something happening. But some meds and speaking to a specialist about how to move forward… all of that sounded like exactly what I expected to hear – albeit a somewhat different approach than antacids and less greasy food. Nevertheless, I was rolled into a more private room for additional analysis. They took a few vials of blood to run some tests, I figured be out of there before too long.
Forty hours after I had first experienced chest pain on Thursday afternoon, and after nine consecutive hours of zero relief… that blood test told the story. Troponin is a protein in the heart that usually does not appear in the blood stream. When someone has a heart attack, though, Troponin is released into the bloodstream and is typically the bellwether that someone is in the middle of an active heart attack or that they’ve experienced one recently. I don’t remember all of the numbers and technical jargon – but my Troponin level was dramatically high. With that result, I was – quickly – prepped for a cardiac catheterization.
In the operating room the doctors “went in” through a tiny hole in my right wrist. From there, they inserted a thin, flexible tube into my heart. Once there, they discovered that my left anterior descending (LAD) artery was 100% blocked. They inserted a stent that allowed the flow to resume.
It wasn’t until after I woke up that I heard the term “heart attack” used for the first time in reference to my condition. At first, I couldn’t really wrap my head around that statement. Heart attack? I was only thirty-three years old, was relatively healthy, I didn’t smoke, and didn’t have any of the normal bellwethers of heart problems. But then, within just a few moments, I realized that my chest pain – though still lingering – was dramatically reduced. Whatever they had gone in and done, it had worked. If they told me it was a heart attack, I believed them.
Hospitals are notorious for being challenging places to sleep. Between the noises, the constant tests, the lights… everyone always complains about the lack of quality sleep. That night, though, after having been awake for close to forty-eight consecutive hours… I slept like a newborn puppy. I’d never slept as well before that, I don’t think I ever will again.
On Tuesday, April 11th I walked out of the hospital. I learned later that the American Heart Association estimates that only 12% of those that suffer a heart attack in the LAD survive. Those that make it to a hospital have somewhat better odds, their survival rate increases to 25%. For these reasons, the LAD is commonly referred to as The Widow Maker. At the time, and even to this day, I still contemplate that fact a lot. What was special about me? What twist of fate put me directly in harms way but left me, miraculously, capable of absorbing the blow? From a medicinal standpoint, those answers are likely unknowable. But, ultimately, I believe I know the answer. The height of my pain hit right as Saturday turned into Sunday – Easter Sunday. On a day known for miracles, I definitely needed one. I’ve thanked God every day that I got it. And I’ll continue to do so.