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Term Limits?

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Post  nkrichards on Wed Aug 21, 2019 7:25 pm

@Mark B wrote:
@ounce wrote:I'm not in a good position  to type much.
1 blocked artery.  Circumflex. Stent installed.  Went the femoral artery route.  I was awake for the whole thing.  Now laying mostly flat for 6 hours until 6:15 PT. Getting 18 hour blood thinner drip.  No idea on discharge.  Thinking Friday morning.
Nancy, I asked about electricity and he doesn't believe there was any  damage there.
Doc and I haven't chatted yet.  That was during the procedure.  

Seen a 45 bpm, which makes me wonder what is the wiggle room accuracy of those machines?

Thanks, y'all!  More tomorrow, I figure.

When you talk to the doc, find out how blocked. It's amazing what they can do with angioplasty now.

Glad they didn't have to do the whole chest-cracking routine. That has a much bigger impact, obviously.

But once you can get back out and run, I bet you're going to notice quite a difference. Bloodflow!
Thanks for the update Doug.  Pass on details as you're able but mainly rest and take care of yourself!

Also curious how blocked the artery was...and which one?  The others must have looked fine.

It may take a few days to assess the damage if any.  They continued to test me for several weeks and my RBBB didn't turn up till much later.  See if you can find out what your EF is.  It's a fun number to track as you recover.

Blood thinners may become part of you life now.  That's common with stents.

Rest up.  You can run next week...or the week after.   Running
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Post  ounce on Wed Aug 21, 2019 7:39 pm

I saw the before and after photos. To me, it was BLOCKED. Lol. Even the after photo showed a much wider bloodflow ahead of the where the block was.

So yes, I should notice a difference.
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Post  Michele "1L" Keane on Wed Aug 21, 2019 9:38 pm

Checking in as Mark and Nancy let me know what happened - glad all seems to be on the mend, and glad you did indeed get yourself to the hospital after the "snag".  If it makes you feel better, another friend of mine in ATL, had a mild cardiac incident last December and had a stent put in.  He ran a marathon in March and has run two more since then.   So - nope it certainly doesn't have to slow you down.

Happy you are on the mend!  We would have missed you.


Last edited by Michele "1L" Keane on Thu Aug 22, 2019 10:07 pm; edited 1 time in total
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Post  nkrichards on Wed Aug 21, 2019 10:26 pm

@ounce wrote:I saw the before and after photos. To me, it was BLOCKED.  Lol.  Even the after photo showed a much wider bloodflow ahead of the where the block was.

So yes, I should notice a difference.
Curious to see how much difference it seems to make when you get back to running. 

Sounds like you caught it early before it did much if any damage.   Very Happy  That said, don't be surprised if it takes some time to get to feeling full of energy.  Your body and your heart in particular has some healing to do.  Give it time.

They made me make the rounds around the hall and then walk up and down a set of stairs before my release.  Hope you pass the test quickly and are allowed to head home to recuperate in the comfort of your own home.

Take this time to rest!!
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Post  Mark B on Thu Aug 22, 2019 10:42 am

How are you feeling this morning, Ounce? Hopefully, they'll have you doing laps around the ward today.

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Post  ounce on Thu Aug 22, 2019 11:25 am

Nancy, my EF is 60%, which he said was normal. The other arteries are in fine shape. I made 2 laps around the floor in fine fashion, although I was a bit winded due to talking with the woman escorting me.

I've jumped through all of the hoops for discharge.
I can drive. No lifting >10# for five days. Plavix and 325mg aspirin until death do I part.

This is the before stent screen Term Limits? - Page 20 20190810
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Post  ounce on Thu Aug 22, 2019 11:27 am

This is the after stent heartbeat

Term Limits? - Page 20 20190811
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Post  ounce on Thu Aug 22, 2019 11:58 am

Miche1e, thanks for the kind words, too.
Yes, Mark, I wanted to do more, but there wasn't anyone to escort.
The entrance point on the femoral artery hurts like a groin pull. I'm told it heals like one, too.
No running until I see the cardiologist in clinic in 2 or so weeks. I plan on walking on a treadmill, in the mean time as I can tolerate it.

My platelet donation days are over. Bums me out. Same for white blood cells, too.

Hey, Nancy, on blood thinners, do you bruise like a banana, now? Purple blotches all over?

Well, that's it for now.
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Post  Mark B on Thu Aug 22, 2019 4:11 pm

Now, I'm not a cardiologist, nor do I play one on TV, but those look like a happier EKGs after the stent placement. Especially the green track.

I'm not surprised about how careful you have to be for the femoral artery site. That's a touchy area, so to speak. What a Face

Is it the blood thinners that mess up the platelet donations? That's too bad. It was good of you to be such a regular donor, but you've done a lot for people already. 

My dad bruised pretty easily after he got his stent put in. It was usually a "Huh. Where did that come from?" sort of thing. 

(Also, please share what it was that got you into the ER in the first place. Some specific symptoms, or just a sense that you needed to be seen?)

Enjoy your freedom!

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Post  ounce on Thu Aug 22, 2019 5:20 pm

@Mark B wrote:Now, I'm not a cardiologist, nor do I play one on TV, but those look like a happier EKGs after the stent placement. Especially the green track.

I'm not surprised about how careful you have to be for the femoral artery site. That's a touchy area, so to speak. What a Face

Is it the blood thinners that mess up the platelet donations? That's too bad. It was good of you to be such a regular donor, but you've done a lot for people already. 

My dad bruised pretty easily after he got his stent put in. It was usually a "Huh. Where did that come from?" sort of thing. 

(Also, please share what it was that got you into the ER in the first place. Some specific symptoms, or just a sense that you needed to be seen?)

Enjoy your freedom!
Mark, I will explain probably tomorrow.  I am home, now.

In a nut shell the 'snag' started last Thursday, then again on Friday.  Monday afternoon, it took 4 rest stops to cover 125 feet.  The camel's broken straw was Tuesday morning when the pain took 45 minutes to stop.  I woke up at 2 a.m. in pain (4 on a scale of 1-10).  After getting things in order, I walked into the ER at 9:45 a.m.

that's the Cliff Notes version.

The blood thinners and the 81 mg aspirin.  Aspirin is probably the first question out of the Blood Center's mouth, "Have you taken aspirin or aspirin containing drugs in the past 24 hours?"
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Post  nkrichards on Thu Aug 22, 2019 6:38 pm

Wow...home already?  I was going to advise you not to chase the nurses around the hallway...that's frowned on today...but I guess it's to late for that.  You're an overachiever!

So...sounds like a combination of lack of energy and chest pain?  I definitely experienced the lack of energy but no chest pain.  My description was chest tightness which I attributed to catching Marty's chest cold.  I had a few other minor symptoms as well...which I didn't recognize until I read the list of symptoms.  Glad you listened to your symptoms and checked yourself in.  

An EF of 60% is good especially at this point.  Mine was only 50% when I left the hospital...definitely on the low side of normal!  It's recovered pretty well with time.

They do worry a bit about the femoral artery.  Hope you have someone to help you for a few days if necessary.  I flew home near the end but within that 5 day period and they had gone in through my femoral artery twice so I was under strict instruction not to carry my own luggage...even my carry on.  I'm not sure they would have released me to fly if Katie hadn't been there to help.  I was on my own for the last flight from Portland to Redmond and Katie delivered me to the gate and gave them strict instructions that I was not allowed to carry my bag on or off the flight.  They escorted me and carried my bag.  I looked fine from the outside so it was a bit awkward and embarrassing.

My anti-platelet was Brilinta combined with 81mg aspirin.  The Brilinta was EXPENSIVE.  If I remember correctly it was nearly $300/month and that was with my insurance coverage.   What a Face  Fortunately I only had to take it for a year.  (One of the reasons that I was pleased I didn't require a stent.)  I did have some bruising but didn't really notice it much.  I was warned...and heeded the advice...not to do anything that would risk head or internal injury and bleeding while on the Brilinta.  I think Brilinta has a slightly higher internal bleeding risk than Plavix.

Interesting that they didn't put you on a beta blocker.  You'll appreciate that when you get back to running.  Running while on a beta blocker is not fun!  I was supposed to be on it for 3 years but Dr. B let me off at 21 months because my HR was to low.  And I'm surprised they didn't put you on a statin before they released you.  They had me on 80mg of Atorvastatin from day one.  I've gradually reduced the dosage but Dr. B insists I stay on it.  I've done more research recently and I'm actually OK with a low dose statin.  

Current meds...for life...are 81 mg aspririn and 15 mg Atorvastatin.  I add a fish oil tablet but that's my choice.  Dr. B doesn't care either way.

Let us know how things go when you meet your cardiologist.  It will be interesting to see if he recommends any changes in your meds.  

Did they mention cardiac rehab?  You may not need it...sounds like there was minimal if any permanent damage and the stent takes care of the blockage.

I was shocked at how tired I was for several weeks/months after my event.  Don't be surprised if it takes longer to recover than you expect.  Modern medicine gets you in and out quickly but you need to allow your body time to heal.  I know they restored your blood flow but your body went through a lot.

Take care and know that I'm thinking of you as you recover...
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Post  ounce on Fri Aug 23, 2019 11:13 pm

@nkrichards wrote:Wow...home already?  I was going to advise you not to chase the nurses around the hallway...that's frowned on today...but I guess it's to late for that.  You're an overachiever!

So...sounds like a combination of lack of energy and chest pain?  I definitely experienced the lack of energy but no chest pain.  My description was chest tightness which I attributed to catching Marty's chest cold.  I had a few other minor symptoms as well...which I didn't recognize until I read the list of symptoms.  Glad you listened to your symptoms and checked yourself in.  

An EF of 60% is good especially at this point.  Mine was only 50% when I left the hospital...definitely on the low side of normal!  It's recovered pretty well with time.

They do worry a bit about the femoral artery.  Hope you have someone to help you for a few days if necessary.  I flew home near the end but within that 5 day period and they had gone in through my femoral artery twice so I was under strict instruction not to carry my own luggage...even my carry on.  I'm not sure they would have released me to fly if Katie hadn't been there to help.  I was on my own for the last flight from Portland to Redmond and Katie delivered me to the gate and gave them strict instructions that I was not allowed to carry my bag on or off the flight.  They escorted me and carried my bag.  I looked fine from the outside so it was a bit awkward and embarrassing.

My anti-platelet was Brilinta combined with 81mg aspirin.  The Brilinta was EXPENSIVE.  If I remember correctly it was nearly $300/month and that was with my insurance coverage.   What a Face  Fortunately I only had to take it for a year.  (One of the reasons that I was pleased I didn't require a stent.)  I did have some bruising but didn't really notice it much.  I was warned...and heeded the advice...not to do anything that would risk head or internal injury and bleeding while on the Brilinta.  I think Brilinta has a slightly higher internal bleeding risk than Plavix.

Interesting that they didn't put you on a beta blocker.  You'll appreciate that when you get back to running.  Running while on a beta blocker is not fun!  I was supposed to be on it for 3 years but Dr. B let me off at 21 months because my HR was to low.  And I'm surprised they didn't put you on a statin before they released you.  They had me on 80mg of Atorvastatin from day one.  I've gradually reduced the dosage but Dr. B insists I stay on it.  I've done more research recently and I'm actually OK with a low dose statin.  

Current meds...for life...are 81 mg aspririn and 15 mg Atorvastatin.  I add a fish oil tablet but that's my choice.  Dr. B doesn't care either way.

Let us know how things go when you meet your cardiologist.  It will be interesting to see if he recommends any changes in your meds.  

Did they mention cardiac rehab?  You may not need it...sounds like there was minimal if any permanent damage and the stent takes care of the blockage.

I was shocked at how tired I was for several weeks/months after my event.  Don't be surprised if it takes longer to recover than you expect.  Modern medicine gets you in and out quickly but you need to allow your body time to heal.  I know they restored your blood flow but your body went through a lot.

Take care and know that I'm thinking of you as you recover...
Thanks, Nancy, seems like I received the Lite heart attack.  One day or weekend, the 4 of us will have to get together.  Miche1e is the only one that's met all of us, I believe.

I'm not real enthusiastic about the doc.  Doesn't seem like he wants to let me ask all of my questions.  I should know after the first couple of visits.  Seems like he likes his patients on anesthesia, best.

Today has been a good day.  Zero pain.  Went to the grocery stores, did some laundry, etc.  Seems like I can walk in my usual stride for a while, before the need to breathe more makes me slow down.  Guess that goes back to 'allow your body time to heal' comment from Nancy.  At 2:30 CT, I noticed I was slowing down.  So, it was a good time to write a post.

My scripts are:
Plavix 75 mg 1x/day.  Blood thinner - Plavix keeps your blood from coagulating (clotting) and can make it easier for you to bleed, even from a minor injury.
Coreg 3.125 mg 2x/day.  This is a low dose.  It's a medication used to treat high blood pressure, congestive heart failure (CHF), and left ventricular dysfunction in people who are otherwise stable.  Carvedilol is a diuretic or "water pill" used to control high blood pressure.

Aspirin 81 mg 1x/day  Blood thinner
Zocor 20 mg 1x/day (simvastatin)  cholesterol lowering.  I haven't filled this prescription.

Have to do the blood thinners, so the platelets don't clot on the foreign object...the stent.  The doc said the Coreg could be temporary and is fine with me taking the tablespoon of Potassium Citrate powder.

Mark, sorry that I haven't gotten to the story, yet.  But I will.  Also seems like the Aug 12 7 mile run was a masked symptom of what was to happen later that week and this past Tuesday.  I had stopped at 1/3rd mile because it seemed like the body wasn't responding.  I had no pain at all and finished the other 6-2/3rds miles.

I appreciate y'alls concerns and thoughts.  A bit mind boggling, as was the heart attack.

Y'all have a good weekend.
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Post  ounce on Sat Aug 24, 2019 9:46 am

Okay, let me write in as I can about the events leading up to Tuesday, August 20.

Thursday, Aug 15.
Headed out for a tempo run of 3-880s with 440 recovery.  After about a tenth of a mile, I was experiencing a sensation under the sternum.  It was new.  A little later, under my right upper arm it was feeling as if you pushed your finger on the artery to make it feel like it had fallen asleep.  THIS was not unusual for me.  Over the past 5 years, it infrequently happens and I just raise my elbow and it resolves itself.

Not this time.

The sternum sensation between the nipples had grown into an area of discomfort, not pain, about 2 inches in diameter and began to travel to the right arm.  It wasn't going away.  So, I stopped and began to walk back home.  The discomfort maintained for about 5 minutes, then slowly stopped.  After a few minutes, I went to the gym and lifted weights. I never had any other pain for the rest of the day.

I was curious, but had no frame of reference from which to draw.  I had a family commitment that was going to last from the 16th to the 25th and I was going to adjust my activity to execute the commitment.

Tune in tomorrow for another excrutiating episode of "Oz Isn't A Wizard, After All" same Bat-time, same Bat-channel.
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Post  nkrichards on Sat Aug 24, 2019 1:58 pm

@ounce wrote:Okay, let me write in as I can about the events leading up to Tuesday, August 20.

Thursday, Aug 15.
Headed out for a tempo run of 3-880s with 440 recovery.  After about a tenth of a mile, I was experiencing a sensation under the sternum.  It was new.  A little later, under my right upper arm it was feeling as if you pushed your finger on the artery to make it feel like it had fallen asleep.  THIS was not unusual for me.  Over the past 5 years, it infrequently happens and I just raise my elbow and it resolves itself.

Not this time.

The sternum sensation between the nipples had grown into an area of discomfort, not pain, about 2 inches in diameter and began to travel to the right arm.  It wasn't going away.  So, I stopped and began to walk back home.  The discomfort maintained for about 5 minutes, then slowly stopped.  After a few minutes, I went to the gym and lifted weights. I never had any other pain for the rest of the day.

I was curious, but had no frame of reference from which to draw.  I had a family commitment that was going to last from the 16th to the 25th and I was going to adjust my activity to execute the commitment.

Tune in tomorrow for another excrutiating episode of "Oz Isn't A Wizard, After All" same Bat-time, same Bat-channel.
Can't wait for the next episode!

Glad to hear you're feeling better.  Not surprised that you tire quickly.

If you have trouble finding a cardiologist that you like...especially if you're struggling to find one that will support your return to running....let me know.  The closed Facebook group "Ironheart Connect" is an awesome support group for cardiac athletes.  Participants range from young, super competitive athletes to older/struggling athletes.  It's a great support group.  Folks are excellent to answer questions.  In addition the founder, David Watkins, has a list of excellent cardiologists all over the US and even overseas I think.  He'll connect you up if you need help.  Dr. B is an advisor.  You might want to check it out.  I find it very helpful.  

Also check out Heart: Flatline to Finish Line.  It's a documentary directed by David Watkins.  It's awesome.  I watched it in Portland a couple years ago at one of Dr. B's kickoffs for Heart to Start.  I also met David and a couple other Ironheart members.  I think you can stream it on Amazon...I don't have that capability.  Would love to watch it again someday.

Love the idea of a get-together!  Yes, I think Michele is the only one who has met all of us.  

Take care...
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Post  Mark B on Sun Aug 25, 2019 1:35 am

@nkrichards wrote:
@ounce wrote:Okay, let me write in as I can about the events leading up to Tuesday, August 20.

Thursday, Aug 15.
Headed out for a tempo run of 3-880s with 440 recovery.  After about a tenth of a mile, I was experiencing a sensation under the sternum.  It was new.  A little later, under my right upper arm it was feeling as if you pushed your finger on the artery to make it feel like it had fallen asleep.  THIS was not unusual for me.  Over the past 5 years, it infrequently happens and I just raise my elbow and it resolves itself.

Not this time.

The sternum sensation between the nipples had grown into an area of discomfort, not pain, about 2 inches in diameter and began to travel to the right arm.  It wasn't going away.  So, I stopped and began to walk back home.  The discomfort maintained for about 5 minutes, then slowly stopped.  After a few minutes, I went to the gym and lifted weights. I never had any other pain for the rest of the day.

I was curious, but had no frame of reference from which to draw.  I had a family commitment that was going to last from the 16th to the 25th and I was going to adjust my activity to execute the commitment.

Tune in tomorrow for another excrutiating episode of "Oz Isn't A Wizard, After All" same Bat-time, same Bat-channel.
Can't wait for the next episode!

Glad to hear you're feeling better.  Not surprised that you tire quickly.

If you have trouble finding a cardiologist that you like...especially if you're struggling to find one that will support your return to running....let me know.  The closed Facebook group "Ironheart Connect" is an awesome support group for cardiac athletes.  Participants range from young, super competitive athletes to older/struggling athletes.  It's a great support group.  Folks are excellent to answer questions.  In addition the founder, David Watkins, has a list of excellent cardiologists all over the US and even overseas I think.  He'll connect you up if you need help.  Dr. B is an advisor.  You might want to check it out.  I find it very helpful.  

Also check out Heart: Flatline to Finish Line.  It's a documentary directed by David Watkins.  It's awesome.  I watched it in Portland a couple years ago at one of Dr. B's kickoffs for Heart to Start.  I also met David and a couple other Ironheart members.  I think you can stream it on Amazon...I don't have that capability.  Would love to watch it again someday.

Love the idea of a get-together!  Yes, I think Michele is the only one who has met all of us.  

Take care...

Oo. You've got me on the edge of my seat. Interesting how, with hindsight, weird things in the past start making sense. A very good reason for writing stuff down, eh? 

A get-together would be fun. The person who might advise against it is Michele, who has, indeed met all of us. Are we safe when combined? 

Keep working on the recovery. And I'd make use of Nancy's contacts with runner friendly cardiologists. There's got to be one in Houston who also works with your insurance. No need hitching yourself to a grumpy Gus. 

Keep at it! Maybe a little Maffetone would be a good way to start?

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Post  ounce on Sun Aug 25, 2019 5:52 am

Thank you.  Thank you.  Up at an odd hour, here, so I will reply later because I want to get back to sleep.

Friday, August 16.
The sorta long run was on the agenda.  4 miles.  Knowing that I have something completely different brewing in my chest and a 9 day commitment coming up, I was approaching this run with a quick yank on the parking brake at the first sign of trouble.

Thursday, it was new and 'let's see if it goes away' kind of reasoning.  Friday was, 'could being a slower pace run be more agreeable than a tempo run?'

So, I headed out on yet another 81 degree morning.  Nah.  I got about two-tenths and shut it down.  Hrrumph.  So, I proceeded with the day and forgot about running for the upcoming 9 days in the hope that it would resolve itself.  Saturday was uneventful, compared to Thursday and Friday, and I concentrated on not doing anything that would disturb the monster in my chest.  Same for Sunday and a usual, weekly 'burn some burgers' grilling.  Easy, predictable, and uh, heart friendly. Two days down, seven to go of the 9 day commitment.  I felt like as long as I didn't run, I could limp along another 7 days.  Although I noticed a small discomfort in the heat of the day, as I walked, but abated after stopping.

Monday, August 19 -
I saw my best friend and we chatted for 20 minutes or so.  Early afternoon came around and the storm clouds were coming in unnoticed.  I had taken some trash to the dumpster and was on my way back the approximately 125 feet.  Last Friday's discomfort was coming on. 

I'm a cold and calculating person in times of adversity.  I learned some 25 years ago that being calm in adversity calms others.  Even being jovial in the maelstrom gives you more credibility in that you might know what you're talking about to a degree.  In a hospital situation, the staff is relieved that they're not going to have to manage you, while fixing the patient.  Most of that is because I absolutely know that God knew this was going to happen billions of years ago and there's a reason for everything that occurs and will occur.  I rest in that faith.  Makes a difference.

My 125 feet journey (and I do mean 'journey') occurred with 4 stops along the way. 4 stops.  "I have to get back to the apt.  Pace yourself.  Easy.  When you get back, you can rest and carry on."  It took about 15 minutes to abate.  I had broken out in a sweat.  (That was a sign of the heart attack was occurring or fixing to, I was told on Tuesday.)  I never felt light headed, nor dizzy.  None of the symptoms the hospital rattled off on Tuesday.

The rest of Monday rolled along without event and I was looking forward to Tuesday's movie.  3 days down, 6 to go.  It wasn't that failure was not an option, it was just that I was going to limp along, if I had to.

Tune in tomorrow for another heart-wrenching (literally) episode of "Oz Isn't A Wizard, After All" same Bat-time, same Bat-channel.
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Post  KBFitz on Sun Aug 25, 2019 9:04 am

Welcome to the club none of us wanted to join. You'll bruise more easily than an over-ripe peach for a year. And you'll do just fine. Wink
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Post  ounce on Sun Aug 25, 2019 7:29 pm

@KBFitz wrote:Welcome to the club none of us wanted to join. You'll bruise more easily than an over-ripe peach for a year. And you'll do just fine. Wink
Thanks, Kevin.  That's great of you to say and was a mouthful.  I was thinking the same thing on bruising, but with a banana. Laughing   I read a 9 year old story on Runners World that said that blood thinners don't affect endurance, but if you get a scrape, you will bleed.  As I thought about that, blood thinners don't 'thin' the blood, it affects platelets and their ability to clot blood.  Hence the free bleeding.

Kevin, if you check back in, could you confirm, por favor.  Nancy, you too, if you would.
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Post  ounce on Sun Aug 25, 2019 8:53 pm

Episode 3 - The Big Day or Welcome to the club none of us wanted to join
(Thanks, Kevin!)


I went to sleep Monday night relaxed and ready for Tuesday.  A normal Tuesday, that is.  It wasn't in the cards.

I woke up at 2:05 with the tempo run discomfort in full bloom.  I would later find out that I had gritted my teeth prior to waking because my lower lip on the left side had evidence of biting.  I went to the bathroom and sat there for 10 minutes, waiting for it to abate.  It didn't.

I went into the living room to begin making arrangements via text for others to take responsibility of my family commitment.  Trouble was...everyone was still asleep.  At 2:50, (zero+45 minutes), the discomfort abated.  I unlocked the front door, in case I couldn't later.  I was busy writing a health history on myself for the doctors and EMS, should I lose consciousness.  Then, I evidently got a shot of adrenalin or similar because my hands and arms began to tremor.  It was affecting my writing.  I was breathing fine, alert, and no chest pain.  But I had accepted the fact that I need to get checked out.

At that point, I never had any other symptoms for the rest of the day.  Odd, eh?

By 6 a.m. (zero + 3:10), people were checking in, discussions were being had, taken a shower, and I finished my personal health history plus a Medical Power of Attorney.  When I had to meet people at the gate, I was concerned the symptoms would re-start, but it didn't happen.

By 9:45 a.m. (zero + 6:55), I went over to the apt office and acquired 2 persons to sign the PoA as witnesses for my signature.  I had half a hamburger for breakfast before leaving and carried my things to the car.  After that, my brother and I left for the ER at the hospital. 

We arrived at 9:55 and I walked into the ER.  They quickly ran an EEG and set me up in a room and drew blood for enzymes and the other stuff.  I've never been to the ER for myself.  Always a family member and a BUNCH of times.  I talked with the ER doc who saw the EEG after about 30 minutes.  He was a runner and older than me.  He told me that I had a myocardial infarction with 'unstable characteristics.'  That's the purpose of the blood enzyme test.  When a heart attack happens, an enzyme is squirted into the blood stream and it's the marker to confirm one. But, I just didn't have the usual palpatations, dizziness, nausea, no elephant sitting on my chest, etc.  My pain level for the 2:05 event was a 4 out of 10.

I asked the ER doc to assess my example of how bad my heart was.  I said, "So, I guess I didn't have a Large heart attack because I'm still here?"  He shrugged and said, "That's a good way of putting it.  You had either a small or medium.  We'll just have to get you to the cath lab and find out.  Had you had a large heart attack, you would already BE in the cath lab."

By around noon, I was on the heart problem floor of the hospital.  Another round of the same questions.  At least it wasn't a teaching hospital.  Hate those.  So, I had been tapped in my right arm for the purpose of administering fluids or meds, should I need it.  That was the only way one could tell that I was a patient.

I was walking around the room, outside the room, answering questions like, "You're a patient?  What are YOU here for?  You don't look sick."  Later, I was hooked up to the monitor for BP, HR, and O2Sat.  BP was 141/85, but as the afternoon went on, it soared to 165/90. 

They gave me a nitro patch to dialate the arteries and, boy, did they dialate.  My BP dropped to 107/70 and my HR was dropping, too.  On more than one occasion, the staff asked, "Is this 55 HR normal?"  "Yes," I said.  "Oh, you're the marathoner.  THAT explains it.  As reported in another post, the lowest I saw was 45.  I imagine the nitro had a lot to do with that.

By 4:30 p.m., I had an appointment for the cath lab on Wednesday at noon, talked to the cardiologist.  Surprisingly, he was fine with me taking the 6 grams of potassium citrate powder to keep my blood pressure down.  I've been taking it all year.  He didn't know what he would find on Wednesday, but he never talked about anything other than a stent.  Guess he was trying to exercise good bedside manners.

I wasn't worked up or scared.  I was just trying to assimilate the info, so I can ask questions.  Since I don't know what I don't know, I can't ask a question.

I ordered dinner (2 Raisin Bran, 2 milks, 2 peaches), then my brother went across the street to get some Chinese that could pass for 'heart healthy' and it was broccoli and chicken.  I was NPO after midnight, so I wanted to eat while I could.

I went to sleep as best as I could with wires or hoses around me.  But I wasn't ever hooked up to an IV pump until after the cath lab.

By the way, it's quite normal to get a nuisance headache from a nitro patch.  It never went away until they stopped patching me.

So, that's Tuesday, August 20.

Tune in tomorrow for another wordy episode of "Oz Isn't a Wizard, After All" same Bat-time, same Bat-station.
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Post  nkrichards on Sun Aug 25, 2019 10:05 pm

@ounce wrote:
@KBFitz wrote:Welcome to the club none of us wanted to join. You'll bruise more easily than an over-ripe peach for a year. And you'll do just fine. Wink
Thanks, Kevin.  That's great of you to say and was a mouthful.  I was thinking the same thing on bruising, but with a banana. Laughing   I read a 9 year old story on Runners World that said that blood thinners don't affect endurance, but if you get a scrape, you will bleed.  As I thought about that, blood thinners don't 'thin' the blood, it affects platelets and their ability to clot blood.  Hence the free bleeding.

Kevin, if you check back in, could you confirm, por favor.  Nancy, you too, if you would.
That's my understanding as well Doug.  The meds you and I are/were on are anti-platelets that prevent clotting hence the bleeding issues.  I think blood thinners is just a term used for convenience as it's easy to understand.

I forgot Kevin was a member of our...not so exclusive...club.
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Post  nkrichards on Sun Aug 25, 2019 10:07 pm

I can't believe how calm and patient you were.  I wouldn't have been under those circumstances!  Glad your brother was there to take you to ER.  I'd forgotten that you had family stuff planned.  These things never happen at a "good time".

Waiting for the next episode...
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Post  ounce on Sun Aug 25, 2019 10:50 pm

Nancy and Kevin,
Are we considered to be lumped in to the broad category of "Coronary Artery Disease" with our heart problem?

Nancy, I joined that FB group you mentioned. The fools let me in!
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Post  Mark B on Mon Aug 26, 2019 1:45 am

Eagerly awaiting the Roto-Rooter Chapter of The Wizard Ain't Oz.

(Just for the record, I suspect that some cardiologist at some point will point out the obvious fact that you're very fortunate to have been a runner. Your genes might have determined that you had an MI in your future -- but your fitness level determined how well you -- and Kevin, and Nancy -- would be impacted by it. This is a good thing. A very good thing.)

So let's finish the story!

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Post  ounce on Mon Aug 26, 2019 8:20 am

@nkrichards wrote:I can't believe how calm and patient you were.  I wouldn't have been under those circumstances!  Glad your brother was there to take you to ER.  I'd forgotten that you had family stuff planned.  These things never happen at a "good time".

Waiting for the next episode...
At the risk of seeming too simplistic...for me, it all goes back to faith.

Never happens at a good time.
@Mark B wrote:Eagerly awaiting the Roto-Rooter Chapter of The Wizard Ain't Oz.

(Just for the record, I suspect that some cardiologist at some point will point out the obvious fact that you're very fortunate to have been a runner. Your genes might have determined that you had an MI in your future -- but your fitness level determined how well you -- and Kevin, and Nancy -- would be impacted by it. This is a good thing. A very good thing.)

So let's finish the story!
Telling the ER doc (a runner) and the cardiologist that I was up to 13 miles for the week probably did help.  And talking shop with the ER doc helped both of us to understanding my situation.

And thanks for naming the next chapter.
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Post  ounce on Mon Aug 26, 2019 11:13 am

Episode 4, Roto-Rooter


I woke up a few times, during the night, for the usual foreign place factors.  I was only disturbed once by this high-strung phlebotomist at 5 a.m. to draw blood.  Ceiling lights pierced my eyelids, making daylight in the nighttime.  She hits the BP cuff button on the monitor to start a cycle (so she wouldn't have to use a tourniquet), finds the vein on my left arm and sucks out 2 vials of sleepy blood.  She didn't use the access IV on my right arm for some standard pat answer that really didn't make sense.  Gauze pad and tape covers the needle hole.  Lights off and she is gone to find her next victim.  Super fast.

I later find out that the right arm access IV is the sole property of the nurses on the floor because if someone screws up that access and I have a problem, there will be hell to pay.

I go back to sleep.  Around 8, I was semi-awake with eyes closed.  (Nurse shifts are 7 to 7).  I here this light tap on the door and the door open quietly.  "Mr. Spence?", the shy voice said.  I played possum.  Didn't move.  Would she say, "It's time to start the day.  How are you feeling?", in this perky voice?

The door quietly shuts.  I WON!

I wake up about 10 minutes later and hear a knock on the door.  "Mr. Spence?", the shy voice said.  In my best Texan Mrs. Doubtfire voice in 3 octives, "Come INNNnnnnnn."  She says, "I thought I had the wrong patient for a moment."

We discuss the day's events of which there is only 1.  The noon cath lab schedule.  One must be flexible as the noon time is a target, not set in stone.  It ended up being 1:15.  No big deal because I was on the 'schedule' and not being 'fitted in' between scheduled appts.  I was told I would be sedated akin to a colonoscopy.  Also, the doc may want to go into my wrist or the femoral artery.  His choice.  He had told me the day before that it would be the wrist.

I was transported up to the cath lab, fitted with a nasal cannula, and told the femoral artery would be used.  The tech whips out a barber's hair trimming machine and commences to groom me.  "There are germs down there," he says.

I'm given the juice, the doc comes in, the music turns on.  80's music.  Joan Jett, Heart, etc.  There's this huge monitor to my left to show what will go on.  They begin the process and I'm not feeling a thing.  Oh, did I mention I'm not asleep or even groggy?  Yup, awake for the whole thing.

We discuss who the artist that's singing.  The tech assisting the doc is a cut up, like myself, and we get along.  There was a song where he starts singing.  Then I start howling like a wolf to a full moon.  "Hey, are you howling at my singing?, he says.  "Yup," I reply.

The procedure didn't seem to take long to put the stent in, but there was one point for about 10 minutes where the pressure on my chest seemed to be a 5-6.  The doc said to hang in there.  What was my choice?!

Afterwards, he shows me the before and after picture.  He says there was only 1 blocked artery and the others looked fine.  Let me see if I can describe it.

Let's imagine that you're looking at a satellite picture of the Mississippi River at normal flow.  It looks thin and dark, right?  This is the left circumflex artery (LCX).  Now imagine at Vicksburg (75% of the way to the Gulf), the flow is gone. Then a much, much thinner flow begins south of Vicksburg.  THAT's the blockage and the Before picture.

He inserts the stent at Vicksburg and the After picture is the Mississippi River at flood stage from Minnesota to New Orleans, plus the rivers that feed into the Mississippi are at flood stage, as well.  Granted, the LCX feeds the subsidiary rivers, not the other way around, but you get the idea.

Instead of a nurse pressing on my puncture site for 20 minutes to plug up the femoral artery (which I'm told is painful), the doc uses this stuff called "Angio-Seal, a vascular closure device."  From my vantage point, it looked a hot glue gun.

I was wheeled down to my room and had to keep my right leg still for 6 hours beginning at 2:15.  Left could move.

Ever tried to eat food, while flat or 10 degrees elevation?  It ain't easy, but being the lover of food that I am, I made it work.

I was put on an 18 hour strong blood thinner IV, with some normal saline.  6 hours was up and I wanted to move.  An hour later, the nurse comes in and says I can sit up, then 15 minutes later I could dangle my feet off the bed.  After that, I stood up for 10 seconds, without dizziness.  I did that twice.

Then the nurse comes in and figures out that I'm more mobile than she would like.  She confines me to bed because there's a bruise developing on both sides of the puncture site.  She was concerned.  She presses gently around the area to make sure it's still soft and tells me she will check in during the night for softness.  I'm approved to move my leg around, but not bent and not standing.

It's Thursday morning.  The puncture site continues to be soft and I'm allowed to raise the angle of the bed to normal eating position.  I ask the morning shift nurse about it for a 2nd opinion.  She said, "Of course it's going to bruise around the puncture site, you're on a blood thinner.  As long as it's soft and not bleeding, you're fine."

I had been duped.

I walked around the floor twice with a staff member after breakfast.  I was cleared for discharge.

The puncture site recovery pain described akin to a groin muscle pull was, for me, wayyyyy off.  It only hurt on odd movements that morning.  On Friday, when I lengthened my stride, I got a small pinch.  And this morning, when I stretched in the bed, to wake up the muscles, it pinched.  That has been the only discomfort.

Saturday, I was a little gassed after doing a normal Saturday chores, but no pain at the puncture site.  But sat for a few hours in the afternoon.

Sunday had fewer chores and I did fine.


THE END
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