Phase one - The Pain
Heart pain comes in many forms – emotional, physical, your own, feeling someone else’s…..
Whether it’s a little
bit of pain or excruciating…..
Its still pain.
And it can alter your entire world.
Ask any woman who has given natural
childbirth with little to no pain medication, (myself included times 3), or
anyone who has been in a horrific body altering accident. That physical pain can be
intense.
Move that pain up into the center of
your chest, and you’ll know how I felt when my first heart attack happened.
Laying on that cold sterile cath lab
table trying not to move as doctors frantically tried to fix my fully shredded
artery – I experienced the worst pain of my life at its peak, comparable only
to childbirth. It was so bad the nurse had to move up to my head hold my
shoulders down and whisper calming words to me as I cried in pain and tried to
hold still while they worked on me.
But all I really wanted to do was roll
off that table, curl into a ball and make everything go away.
I have a pretty high pain tolerance
most of the time, but for me on that 19th day of March 2009 that altered
my world, my pain threshold had been reached.
My heart attack story actually begins
the night before. I had been sitting in a recliner watching tv with my family for an hour or
two. When I got up to go to bed my left arm immediately went numb and tingly,
like it was falling asleep, or like I’d hit my funny bone. It was weird because
I hadn’t felt it falling asleep like you often do when in a position for a long
time. But figured maybe I’d pinched some nerve, so I shook my arm a bit, it
went away, and I went to bed.
Doctors tell me that my artery had
begun to tear in that moment. Umm, what?! Just from standing up out of a chair?
To this day it still doesn’t make sense to me – but then neither do the rest of
my events.
The next morning was a typical start
to the day – got the kids up and off to school (then aged 15, 13 & 11), husband went to work, threw a
load of laundry in the washer, then I went down to the basement to do my normal
workout program. A workout I had done dozens of times before – some basic body
weight moves, aerobics, and light/medium strength training. Nothing new, nothing
overly intense.
In the middle of my workout, after a
set of shoulder presses, I bent down to put the dumbbells on the floor, stood
up, and my left arm went numb again. My immediate thought was – what the hell
nerve did I just pinch? Again. I began stretching my arm out to unpinch it, but
the pain only got worse. I sat down on the floor noticing I was having trouble breathing - not
uncommon when working out, but this was different – there was a heaviness and
pressure building in my chest. I laid down still thinking maybe I just pinched
a nerve and trying to stretch it out, but my chest began to really hurt - radiating
to my back, my jaw, both arms….I was getting nauseous, dizzy, and my heart was
pounding.
This was NOT a pinched nerve.
I had seen enough movies and shows to
know what left arm and chest pain means. But I was 37 years young, training for
a half marathon, and in great overall health and weight. A heart attack made
absolutely no sense to me.
Yet there I was on the floor feeling all the symptoms of one, this horrible sense of doom and KNOWing something was seriously wrong.
I also knew I was at home alone and there was no phone in the
basement with me. I could NOT stay there if I wanted to survive whatever this
was.
So, I willed myself to roll over and
crawl to the stairs and climb them. I couldn’t seem to stand up without wanting
to pass out – and I knew that would be BAD – so crawling it was.
I was also doing some serious praying
to the Universe too – Please don’t let this be bad. Please don’t let this be
the end – my kids are not old enough yet to be without me. Please let me live until
they can take care of themselves. Its too soon. PLEASE don’t let this be bad.
Please please please please PLEASE!!
Don’t.
Let.
This.
Be.
Bad.
This is the part of the story I don't often mention to people as I'm a bit embarrassed to have not taken this situation as serious it was. But I seriously could not fathom I was having a heart attack and this was an emergency.
Once I got upstairs, I would love to tell you I grabbed the phone and called for help immediately. But I must confess, on my hands and knees, while having a freaking heart attack..... I stopped in the laundry room which was right there at the top of the stairs….and put the wash in the dryer.
I have time for that right?!
I couldn’t leave wet clothes in there if I potentially wasn’t gonna be around to dry them later now could I?! I mean seriously – no one wants to have musty smelling clothes. And what if my husband and kids are too upset or busy and don't realize the loads need to be switched this evening?
What kind of mom (and people pleaser
who puts others first before their own pain) would I be if I left them wet and their clothes smelled?!!
Clearly I was out of sorts and trying
to act like this wasn’t a life or death situation.
Which it totally was.
Laundry drying, I then crawled to the great room grabbed the phone, laid on my back and called my husband first. I told him I wasn’t sure what was going on, but it sure feels like it might be a heart attack as all the signs are there. Him concerned and on his way home, I hung up and called 911. By this time things were getting bad (clearly the laundry stop did not help matters). I was struggling to breath, in Severe pain and on the verge of passing out or throwing up or exploding…..or something.
I just knew whatever it was....it was not good.
Soon there were 2 ambulances and a
firetruck out front, and I had a room full of paramedics taking all my vitals with
extremely concerned looks on their faces, which is what my husband walked in to 15 minutes later, freaking him out a bit as he realized this might be more
serious than he thought too.
Then the most ridiculous conversation
happened in my opinion. I realize now emergency personal need consent to treat
and transport you, but it still seemed like a crazy conversation to me at the
time.
They asked me if I wanted to go to the hospital, which I thought was strange – clearly something was wrong – so shouldn’t I go to the hospital?
So I said – do I
need to go to the hospital?
They said…..Yeeeaaaah, we think you should
go to the hospital.
Okay, I said, lets go to the hospital.
Okay Andrea. Which hospital would you
like to go to?
Seriously? Whichever one will make
this go away!! I thought.
I said – I don’t know, which hospital
should I go to?
They all looked at each other and
agreed on one that was a bit farther away but had the better heart facilities.
So they loaded me up and off we went. My
husband following close behind.
This is the part of the story that almost
caused my husband to have a heart attack too.
Just before getting to the freeway (a few miles away from my house), the ambulance pulled over, the guy in the back with me threw the door open and began running towards my husbands car. All he saw was me on a gurney hooked up to stuff and a paramedic running towards him – Holy Shit, WTF?! Something REALLY Bad must have happened to me. But they were just letting him know they were about to turn on the sirens and GO and he couldn’t follow them with the sirens on. He would just have to follow the rules of the road and meet us there.
Whew! But
still.
In the ambulance I was semi out of it –
eyes closed, fighting tears, and just trying to breathe, which was difficult, very
short, shallow, and pain filled. The chest pain was non stop and getting worse.
They had given me aspirin and morphine I believe, and started giving me nitro, which dilates the arteries so more blood can
flow thru during a typical heart attack blockage. However it wasn’t working for
me, which seemed to confuse the paramedics as I was clearly having a heart
attack on the EKG, making the situation more dire.
What no one knew at the time was nitro
wont really work if your inner artery is shredded like mine turned out to be –
there was nothing to dilate.
After a brief evaluation stop in the
ER, I was rushed to the cath lab. In a catheter procedure you are still conscious,
so I was aware of most things going on around me - as much as I could be anyway with my eyes closed concentrating on breathing. Logically I knew they were
somehow inside me trying to fix things, but by this time it had been over an
hour since onset and the pain was excruciating and I could barely breathe. My entire
Left Anterior Descending (LAD) Artery was torn, top to bottom and 100% blocked. The LAD supplies oxygenated blood to the left
side of the heart and out to the body – and my heart and body were being
deprived of that and suffering the damage.
When the nurse had to come hold me
down, telling me it would be okay, that they almost have it, just hold on, you’re
doing great - I remember hearing the doctor working on me say – get Dr (So and
So) in here NOW, I can’t get this. And get an OR ready we may have to open her
up.
This is not good.
Outside in the cath lab waiting area my
husband heard the pages and codes being called for me over the speakers, felt
the intensity of the situation, and began fearing the worst. My quick trip to
the cath lab (so he was told it would be) ended up being almost 2 ½ hours long
and complicated.
But thankfully, I did not need open
heart surgery. With some help and luck, the team of doctors managed to finally get
a stent in place, then another one, and a third one, and partially opened the
artery back up to stop the attack.
But after almost 3 hours of attacking, the damage had been done. To this
day my artery remains shredded below the stents and the bottom third of my
heart no longer functions - its just dead scar tissue now. Which of course affects
some of my day to day functioning.
When I arrived in the ER my heart
function was down to 20%. A normal heart functions between 55 - 75% allowing
room for when higher activity is needed. When I left the hospital a week later I
was at 30%. It took almost a year to get there but I have settled in at around
40-45% - basically meaning my heart now works at a third less capacity (or that
much harder to do normal activities) than
the average heart due to the permanent damage done.
But it still works. And that’s what
counts.
I would like to say my story stops
there. That once the attack stopped and after a brief recovery all was good. But my recovery was long and complicated –
The first hours in recovery while lying flat on my back not allowed to move for 4+ hours while the arterial incision in my groin started to heal - I had a horrible allergic reaction to all the nitro I’d been given and began vomiting....all over myself. I leaned over the side of the bed to continue purging, which of course ripped my incision open. After one nurse cleaned me up, while another pressed on my incision with all her might, they then had to clamp me (I kid you not – it was a giant C clamp) to the bed, for several more hours pressing on my fresh incision, to stop the bleeding.
That HURT!!!!!!! (with all the capitals and exclamations I can use!)
I had a lot of internal bleeding and blood loss during the catheter procedure – I remember thru slitted eyes seeing the nurse lifting my arm up to clean it after the attack stopped and before going to recovery because it was covered in blood. Why is there so much blood?! Where did that come from?! My foggy brain thought.
I needed 3 blood transfusions
in the following days due to that and anemia.
I was in the CCU for 3.5 days, then moved to a regular room for another 3.5 days, staying in the hospital for a full week.
I had a giant black and blue hematoma in my lower abdomen, groin and right leg around the incision site – basically from my waist to my knee. My right leg was one and half times the size of my left leg and every time I stood up that first week it felt like someone was pouring hot prickly water down the inside of my leg as all that blood and fluid buildup shifted and rushed downward. It was the weirdest sensation and also very painful. I hated needing to stand up the first two weeks or so as it slowly dissipated.
I could not walk without a walker for at least a week after I got home, and it was about 8 weeks before I could walk normally again (without limping) because of the hematoma and severe bruising.
It took every ounce of energy I had to get out
of bed go to the bathroom and get back in bed to sleep – for months. I just had
no energy at all and slept constantly.
And my memory and brain function were
affected too – I had a difficult time finding words and using them for many
many months. My short-term memory, which I always prided myself on before my
attack, has gone out the window. I still
get brain fog and have trouble remembering what I was gonna say even while I’m
saying it sometimes to this day, and with age that is just getting worse.
I also went on to have 3 more heart attacks and catheter procedures in the following 7 years.
The second one
happened the day I finished cardiac rehab, 5 months after my first attack,
while sitting holding my next door neighbors newborn baby who had just come home from the hospital. All of a sudden, all the symptoms were there. It was much milder than the first one, so I wasn't sure what was going on - is it just angina? I made an excuse to go start dinner, handed the baby off not alarming anyone to what I was feeling, went home and waited it out a bit to see if it got bad like my first attack. After an hour or so though, it went away. But two nights later it came back, and two nights after that again. I finally called my cardiologist the next day who told me to immediately go to the hospital and they would be waiting for me, went in and sure enough they found another tear, this one in the circumflex artery, a branch of the LAD. Another catheter, more bruising and limping for weeks, as well as ongoing angina (heart attack like) symptoms for months.
The third one happened 4 years later in September 2013 while drying my hair one morning. I had my head upside down blow drying my hair, flipped my hair over and BAM! It slammed into me. Again, it was milder than the first and while in my gut I KNEW, my head was still like...Is it? My husband came into the bedroom saw me and said - you've got all the symptoms, and you're sitting on the floor crying in pain - we're going to the hospital. Again, Sure enough, there was a tear in my right posterior artery this time. My third groin catheter, and again - more black bruising and limping for weeks.
Three heart attacks from tears in 3 different arteries. WTF?
My fourth event in 2016, while it felt the same and doctors did see/say something was going on in my circumflex artery again, it currently remains undiagnosed by
even the top heart doctors at the Cleveland Clinic, who I went to see for a second opinion. That 4th cath procedure went in thru my right wrist artery this time, (instead of the groin) which they told me was less invasive and an easier/quicker recovery. Great, lets do that - no more black bruising and limping! However during the procedure, my upper arm artery started spasming around the catheter which was super painful. They quickly pulled the catheter out while it was spasming, gave me something to stop the spasms (Not nitro as I now know I am allergic to it) then proceeded. But that whole incident caused some serious nerve damage and I could not use my right arm or hand for almost 3 months. I'm right handed and an artist who paints for a living and I couldn't even hold a fork or brush my teeth. Arrgghh! I still have some numbness in that arm today.
Note to my future self - do NOT let them go in thru the right arm ever again. Limping and bruising sucks, but not being able to use my dominant hand for months sucked more.
My first attack was by far the worst.
The others had all the same symptoms but were not nearly as severe in intensity
or damage, thankfully, and only needed medicinally managed to heal. But in my gut I KNEW something was wrong with each one of them. Once you've had a heart attack, you never forget those feelings. And even tho part of you really wants to believe it can NOT be happening again.....you just know it needs to be checked out and taken seriously.
All of my physical/medical heart attacks were caused by SCAD – Spontaneous Coronary Artery Dissections – where the inner lining of the artery tears and collapses causing blood to go to the wrong place and pool, which causes a blockage, and thus a heart attack. An attack occurring in the LAD is often called the widow maker as it is the main artery of the heart and without it functioning properly…..well, you know.
Emotional heart attacks can also be
just as traumatizing. I have had my share of that pain as well – childhood
traumas, breakups, loss of loved ones, kids leaving the nest, divorce after 24 years, and starting over
on my own all alone for the first time in my 40 some years of life, to name a few.
The pain whether physical or emotional
can have deeply marking, long lasting effects.
Pain so dark at times you can’t imagine ever seeing the light and feeling whole again.
But from that pain, if you can process
your way through it well enough, you can Rise again. And again. And again.
Stay tuned for Phase 2 – the Processing.
What the hell just happened to me, and what happens next?
You can also follow my journey of processing thru my Art on this blog and at
