Saturday, March 02, 2013

Two months later, what have I learned about the problems of the human heart in conflict with itself?

Polished red blood cells zipping along the Stent Highway 
Two months ago today, my heart revolted. A plaque logjam blocked the blood flow in my Lower Anterior Descending coronary artery or LAD. Lack of circulation caused my heart muscles to stop working. My ejection fraction fractured. My pump was on the fritz. Fluid built up in my lungs. I couldn't breathe. The EMTs hauled me to the ER. Congestive heart failure. Me?

Yes, me.

Two days later, I was in the CRMC catheterization lab with Led Zep blasting on the stereo. Dr. Chapman and crew installed a stent in my LAD. I wasn't totally under but I remember nothing until they were hauling me and my new hardware out of there and back to my room. I spent five more days in the hospital.  I recuperated at home for a month. My keister caused a permanent crease on the couch. I knew all 500 TV channels by heart. I was too wrung-out to read and write. Not even enough energy to blog!

So, as they say on TV news shows, what have we learned?

Heart attacks happen to all kinds of people. My colleagues in cardiac rehab are in their 40s to 80s. I'm somewhere in the middle. Some of them had a history of heart disease and others (me) did not. Broken hearts can be mended, although it depends on many factors. Some are out of your control and some art not. What kind of shape are you in? How severe was the blockage? How long did it take to clear the blockage? This last factor seems to be the key. Twenty minutes after I hit the ER, Cardiologist Chapman and his trusted assistant were at my side. The good doctor announced that I had experienced a heart attack and they were whisking me off to the cath lab. Not so fast, said the ER doctor. This man is in congestive heart failure and, since his breathing is compromised, can't lie flat for an hour while you work your magic. They conferred. Meanwhile, I watched and waited and tried to take some cleansing breaths -- any kind of breaths.

I waited two more days for my stent. It was worth it -- I have a nice long stent that keeps he blood flowing. I take medication to make sure that my blood doesn't try to clot around the stent. Blood does that when it detects a foreign object. The med is called Effient. The good folks at Eli Lilly sum it up on its web site:
Effient taken with aspirin helps reduce the risk of a future heart-related event, such as a heart attack or blood clot in the stent, in patients who have had a heart attack or severe heart-related chest pain that was treated with angioplasty. There is no generic form of Effient.
I take Effient with aspirin and approximately another dozen meds. It seems to be doing its job, as I continue to feel better and have had no signs of a gummed-up stent. I visited my cardiologist on Wednesday. Actually, I visited with the P.A. at the Cardiologist's office. She called me a "Problem child" because I had so many low blood pressure readings. It seems that many of the meds I take lower the blood pressure. This is handy because so many hearty attack patients have high blood pressure, which is one of the risk factors. Oddball patients like me who have normal blood pressures, see them drop into the low range. So she and her colleagues have been juggling my meds to see if they can raise my blood pressure without raising it too high. So much of this is a guessing game. "Educated guesses" might be a better term. There's an amazing array of heard medications. Some goose the heart muscles and some increase blood flow. Some thin the blood and others polish the surface of the blood cells. It's fascinating, really, that so much research had been conducted on the heart. Cardiovascular disease is the nation's number one killer, one of the main byproducts of the so-called "obesity epidemic." That has something to do with it. There's big money to be made. That's fine with me, as Eli Lilly & Company's products have kept me alive. I'm just happy to be insured, especially after I took a peek at my hospital bill. There apparently is an obesity epidemic when it comes to hospital bills. But I have to pay very little of it. What do people do who have no insurance, or are under-insured? That's been at the heart of the debate over the Affordable Care Act.

So I take my meds, attend cardiac rehab and think healthy thoughts. Eat well, too. The other day a friend gave me a New York Times article about the benefits of the Mediterranean diet.
About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study has found.
This is something that I'm going to explore. My roots are more closely-linked to the Irish Sea than the Med. But maybe it's possible for a Celt to change his culinary habits from beer and potatoes to olive oil, beans and wine. More on this subject in future posts...

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