History Repeats Itself (Catchin’ Up – Part II)

Where the “Catchin’ Up” story left off, I had been out on a run at some point in late December or early January, and started to feel some pain in my left wrist and chest, just below armpit. At first I didn’t think much of it. It had been a bit of a stressful time at work, and that or other sources of stress can sometimes trigger a bit of chest pain in the armpit area around the ulnar nerve where I had previously had a lump of fatty tissue removed.

So for a few weeks I blew it off.

I was convinced it was nerve pain, not cardiac pain.

Very quickly the pain in the wrist became worse, and regardless of what the underlying cause was, I needed to go see the doc and do something about it.

The doc pointed out that it was more important to rule out the potential cardiac cause before worrying about nerve irritations, and I agreed. Especially when combined with the fainting symptoms.

When I pointed out that I had had a stress-echo less than a year ago that came back normal, he suggested we do a nuclear stress test this time.

I was immediately on board, even though I knew it would be a lot more expensive. It was a nuclear stress test that finally revealed that I had coronary blockages fourteen years ago, when all the other tests came back inconclusive. This seemed like a really good way to get a definitive answer.

Of course, I had convinced myself that it would be definitively “normal” and that I’d have to go about figuring out the nerve thing.

Unfortunately, when I went back to the doc to get the results, he told me that the test came back “abnormal”, and that I would have to undergo a heart catheterization.

During this time I continued to ride my bike, but backed off the running to long walks. Partially at my doctor’s instruction, but mostly because it simply hurt to much to run.

Even though I wasn’t running, I was still holding out hope that I’d still be able to “run” the Asheville Marathon and Half at Biltmore in mid-March. And by “run”, I mean walk. I was signed up for the Backyard to Vineyard Challenge, which is both half and full marathons on consecutive days, which I had done the previous year. I figured I’d bail on the half and just walk the full… with just enough easy running to ensure I could finish in the 6.5 hour time limit.

It may sound nuts, but I was still convinced this was a minor thing… and I certainly didn’t expect to get scheduled for the heart cath before marathon weekend.

I was both lucky and unlucky enough to get scheduled quickly, just five days before the marathon. I asked my doc, the two different cardiologists if I’d be able to walk a marathon in five days. The answer was never quite definitively “no”, but I could tell they thought I was nuts.

If the procedure had only involved the heart catheterization to find the source of any blockages, but no treatment was done, I might have pulled it off. But things work a little different in cath labs these days. Thanks to advances in technology, if the docs are able to find and fix a blocked artery, they do it right then and there, in the same procedure.

Which is exactly what happened.

I was awake for the entire procedure, though not quite alert enough to remember it clearly. The heart cath I remember, but once they found a blockage, they gave me an extra dose of medicine and the rest gets a bit hazy. In a nutshell… I had an 80% blockage of the Left Anterior Descending (LAD) artery, also known as the “widowmaker” because it is the most commonly blocked artery and also a pretty common source of sudden cardiac arrest.

Scary, huh?

This is the same artery, or one of, that was blocked back in 1992, at roughly the same percentage. The first time around I also had blockages in two other arteries, but nothing else was found this time.

And this time they also put in a stent.

And cut off a secondary artery by using said stent. I’m still not sure exactly what that means, though.

For what it’s worth, I briefly documented this first angioplasty procedure a while back in a story called “Bump In The Road”

Recovery Time & Time For A Change

After the procedure, I was admitted overnight for recovery and observation. It was a long period of time – about six hours without being able to move due to the incision in the groin – and another 12 (?) hours before I was released.

During that time any number of people came in to monitor heart rate, blood pressure, draw blood, administer meds, prescribe meds, and one nurse in particular apparently came in to berate me about not doing anything so stupid as to pretend I could walk a marathon in five (now four) days. I don’t really remember that part, I was still pretty groggy, but my girlfriend recalls it pretty clearly.

One of the other people that came to see me was a nutritionist who presented me with some literature about a couple different cardiac rehab programs that are available, and she gave me what I assume is the standard lecture about eating a healthier, low-fat diet, getting exercise, yada yada yada.

Except that this time it wasn’t just yada, yada, yada… I was very interested.

I had made it 14 years on extreme amounts of exercise but only partial improvements to diet and nutrition.

I decided very quickly I wasn’t interested in going another 14… or maybe only 12, or 10, or fewer years before having to do the same thing all over again.

And I sure as hell don’t want for there to be a third time, but with no warning at all.