Another Diagnosis

FRIDAY, AUGUST 20, 2010 4:11 PM, MST

We have friends and then we have TRUE friends. One such true friend of mine is Julie. Actually, we're twins because we share the same birthday but I remind her that she'll always be one year older than me. No running from the truth. We've been through thick (have we ever) and thin during our nearly 20-year friendship. Julie and her husband, Tom are relocating to Denver and their going-away party is tonight. It's not as sad as it sounds (or so I keep reminding myself) because their two children are ASU students and they have ties here that will bring them back.....often, I hope. Nevertheless, I will miss having them close-by (they're only about a mile from me), and wanted to publicly acknowledge and thank Julie for her never-ending support, love, and true friendship.

Results from this week's blood test came back and my iron and hemoglobin levels have returned to normal range so I can stop taking my iron pills but the results further indicated that I now have hypothyroidism. I'm not sure which is worse! So, I'm starting a new medication for that. As you can imagine, I have many questions most importantly if it's somehow linked to my heart disease and is this chronic or temporary? Dr. Heuser's office will be closely monitoring my thyroid levels, and in the meantime, I will visit Wednesday with my cardiothoracic surgeon to review the CD of my most recent catherization procedure to verify that the bypass artery is working efficiently.

Although I have learned so much from my medical condition, the lesson that seems most relevant in this case is the importance of going with the flow and living for today. I guess I used to be a hard-core type A personality, but for the most part, I'm working on regularly reminding myself that if it's not life-threatening I just have to let it roll off my back . It doesn't do me any good to agonize over the past or get anxious about the future because I can't do anything about either. So, I really focus on what I can do about the here and now. As Julie says, "When life gives you lemons, make lemonade."  

My First Fill Mile

WEDNESDAY, AUGUST 18, 2010 9:21 AM, MST

I ran my first full mile (10:20) yesterday on the treadmill (my least favorite) at the gym 13 weeks after the surgery. I think it would have happened a tad bit sooner had I not had the complication with the low iron but I'm just glad it happened! There really isn't anything that gives me a more natural high than running, and I can tell that my mood is certainly improving as I'm (slowly) increasing my physical activity including lifting some weights.

I had more blood drawn earlier this week to get an updated count of my iron and hemoglobin and some other levels (ie: thyroid). I'll get the report early next week from Dr. Heuser's office.  Although I am feeling better than I did since leaving the hospital two weekends ago, I still have some moments of lightheadedness and some fatigue due to the anemia (and the latter from surgery).  

Isn't this combination of heat and humidity absolutely unbearable? I can't believe I used to train in this stuff. I wonder if my body will ever be able to handle the stress of running in our summer weather. I'm sure it will just not this summer. 

Stay cool but don't let the excuse of our summer temps keep you from exercising your heart! 

Answered Questions

SUNDAY, AUGUST 15, 2010 8:43 AM, MST

"You absolutely did the right thing by going to the hospital."  These were the first words I heard Friday from Dr. Heuser's nurse. My friend, Nancy from the Heart Association told me that my nurse at the hospital made the same exact statement immediately following my catherization last week (although I don't remember). These unsolicited comments from medical professionals drive home the point I try to reinforce whenever I get a chance:  listen to your body (it's talking to you but you need to sit still long enough to hear what it's telling you) and get medical advice if you have symptoms that persist or you get a nagging feeling that something just isn't right. I've read and heard far too many stories of women (especially) who had symptoms, didn't get medical attention, and the end result was tragic. I'm very passionate about this because there's no shame in going to your doctor or even the ER especially for cardiac patients. To get back on track.....

It looks like the mystery behind the cause of my symptoms is solved. Friday, Dr. Heuser's nurse (Karen) confirmed that all looks o.k. from a cardiac standpoint. She added that there is definitely one, and possibly two reasons for my extreme fatigue and weakness. 

The first possibility is that there is competitive blood flow between the mammery artery that Dr. Smolens peeled down and used as the bypass artery and the portion of the LAD that was bypassed. The latter is still open because I'm taking plavix (blood thinner) but may eventually close off leaving the mammery artery to take over completely. 

The second, and more definite answer, is that based on blood work from last week, I am anemic. My iron level pre-cath was below normal and it dipped even lower post-cath. Lack of iron equates to lack of oxygen which explains why I felt better on oxygen in the hospital! By the way, the extreme fatigue and weakness was one of the symptoms I had whenever I had a blockage which resulted in stress. This stress caused angina (chest pain) resulting from inflammation of the arteries and leading to spasms of the arteries. Are you beginning to see how all of the symptoms are connected? Given Karen's news, you can imagine how relieved I was because this is a much easier fix. So treatment includes taking prescribed iron pills and a multivitamin with iron. I'm also going in tomorrow for further blood work that will also help determine the exact cause of the iron deficiency. Karen said I'll be feeling better in one to two weeks, and I have a follow-up visit with her in four weeks.

Had I not gone into the hospital last weekend, I may still be sitting here with the symptoms worrying needlessly.

Unanswered Questions

WEDNESDAY, AUGUST 11, 2010 1:46 PM, MST

Well, I'm not feeling as well as I did in the hospital. Although the chest pain/squeezing/tightness are gone, I still am getting quite fatigued which is leading to weakness and then the inability to pretty much function. How incredibly frustrating after feeling so great! I had a follow-up appointment next Wednesday with Dr. Heuser but will now go in this Friday to see the nurse practitioner who has always been extremely helpful. Is it the mere fact that I pushed too fast and too hard too soon? Could it be a side effect from any of my meds? Is it something completely unrelated to my heart stuff? Possible but my gut feeling is that it's not. Perhaps I just really need to scale back my activities because physically I really am still recovering? Maybe my expectations of myself are too high? As of tonight's class, I'm taking a leave of absence from teaching the RE class much to my disappointment. I hope to get some clarification Friday when the nurse can review with me my cath report and hopefully provide answers that will give me some peace of mind. 

Here's an uplifting thought:  we're one day closer to cooler temps :)  

Back in Hospital

MONDAY, AUGUST 9, 2010 12:11 PM, MST

I was hit with the stark reality this weekend that as "healed" as I may look externally, I really still am recovering internally. Last week, I pushed the envelope to the point where I ended up in the hospital Saturday and Sunday. I went in through the ER early Saturday afternoon and was admitted to telemetry almost immediately. The EKG was normal and my cardiac enzymes showed I had no heart muscle damage. That is critical because if heart muscle is damaged due to a heart attack, the longer left untreated the less likely it is to be restored....forever. So, even though I've had two previous heart attacks, I was told again that I have no muscle damage whatsoever. That is a blessing! Sunday, I had a catherization and more positive news: the bypass is working as is the stented area in the LAD. I thought it would have closed off by now but the cardiologist said the plavix I take is keeping that area open. Unfortunately, I had a cardiologist I had never seen before (imagine that) so he wasn't at all familiar with my care. The doc's best explanation for my symptoms of tightness/squeezing/pain in my chest along with the extreme weakness and fatigue is from spasms of the arteries. Kids had been back to the school for the second week, and I was really starting to feel more energetic, and I revved it up a gear (or two) and forgot to slow down until my body forced me to. So, I have a new med to the mix and the bottom line is I have to continue to pace myself. As my nurse told me, I have new plumbing but my disease is and will always be there. It's my job to learn to manage and monitor my symptoms and control stress. We each need to focus on living today because the present is all we can control.

I got home about 7 p.m. yesterday, and I feel and look so much better. My word of advice is to never feel ashamed about seeking medical attention especially if presenting with heart symptoms. The best news you can receive is that you're not experiencing a heart attack. Turn-of-events can happen in a heart beat. 

I have absolutely the BEST group of friends who jumped into action again. Dianne was my dependable taxi driver, Laurie and her two girls took Katrina to the mall yesterday so Katrina was in her glory, and Sonja and Jim and their two girls took Kyle (hey, Kyle wanted to spend the day with Caitlin and Brooke but who can blame him). Nancy and Carolyn were my support crew at the hospital (the three of us can't seem to coincide schedules to get together for lunch so the impromptu hospital gatherings seem to work best) and others called or texted messages of support. Of course, my parents are always at my side.....thankfully! 

It's time to put my feet up and take a few deep breaths before picking up the kids from school......
  

Three Month Op Update

TUESDAY, AUGUST 3, 2010 7:18 PM, MST

Twelve weeks post-surgery, I'm still bumping into people who tell me how much better I look: more color in my face, don't look as tired, don't have that grayish undertone. I appreciate hearing such comments because they're encouraging. I just have one question:  If my appearance now reflects how terrific I feel post-surgery, I wonder if I truly looked as horrible as I felt pre-surgery? I think I know the answer.

I'm continuing to make strides in my physical strength which is easy to do given where I started out. I logged four miles for the first time today on the treadmill. I am now able to run half-a-mile at a 10:30 or so pace....not blazing speed so I guess I'm actually only jogging. I've been running every third day but am going to try every other day because I'm not experiencing any discomfort of my incision either when I'm running or afterwards! I can't even begin to tell you what a relief it is not to have any lingering discomfort! I'm also continuing to increase my time on the bike and elliptical, the latter of which is actually my favorite given that it simulates running so much. Overall, I'm extremely happy with the progress I'm making, and I never take for granted that I'm feeling better than I have in years. There's such an enormous number of people who, over the last four years, have played a role, whether large or small, in getting me to this point in my journey. I'll always be thankful to each one of them, to each one of you, because as a result I can continue to tell my story.

What are you going to do today for YOUR heart?  

Cardiologist Visit

WEDNESDAY, JULY 28, 2010 8:48 PM, MST

I saw my cardiologist, Dr. Heuser, this morning for the first time post-bypass. He walked into the room with a huge smile asking, "How's my favorite patient?" :) I think we were both happy to see each other after going through such a traumatic procedure. Based on my physical exam, everything looks great....blood pressure (111/69), heart rate (61), healing of incision so that's a tremendous relief. I am to remain on my same regimen of meds. I'll return to his office in four months for a nuclear stress test and a chest x-ray. He noted that it'll take 6-8 months for the chest wall to completely heal. This first year post-bypass is critical not only for the healing of the chest bone but to make it through without any blockages or scarring that would need stenting. If I can get through next May without any heart crises then my long-term prognosis will look bright. We are both optimistic that I'll sail through the next 10 months without any incidents. In the meantime, I can continue to resume running and working out, and in two more weeks, can slowly begin increasing my upper body weights. Doctor's orders.