Wednesday, October 15, 2014

At Least I Know I Have a Heart

So when we left the story hanging last month, I was just getting my shit together after scraping a new low of depression: I was seeing a psychiatrist for my meds, a therapist for my head, and a social-worker to coordinate it all.  I was still depressed but I felt really hopeful about everything, which was new and quite pleasant.

Then I had a heart attack.  It wasn't a bad one, but on the other hand there's no such thing as a pleasant heart attack, so the fact that it could have been worse doesn't really make you feel better. And it was really the last thing I expected, heart disease doesn't run in my family and I'd never been diagnosed with high blood pressure or exceptionally high cholesterol.

Nevertheless, that's what happened.  All that day I was feeling short of breath and kind of dizzy, very weak, and kind of sickish; but I often feel that way and didn't think much of it.  But when I was at the grocery store I sat down to rest at the little blood-pressure machine and took my blood pressure since I was there.  It registered really high, which alarmed me a bit, but then those machines are famously inaccurate so I didn't get too terribly alarmed.  I finished my shopping and went home, where I hit the couch and rested a while.

Around 6 o'clock I started feeling a pain in my chest... not where my heart is, but where my diaphragm is, and it felt a lot like a pulled muscle or ligament.  No big deal, I took some Advil and got in bed.  But the pain increased as the evening wore on, in the center of my solar-plexus, feeling more and more like a pulled muscle and getting more and more sore.  By 10 o'clock it hurt so much I couldn't sleep.  I put a heating-pad on it and waited for it to pass.

But then finally the pain moved into my left arm, which I knew was a warning sign of a heart attack, and the pain in my chest settled very distinctly in the spot where I knew my heart to be.  I didn't really think I was having a heart attack, it was all too vague and floaty, but I knew something was wrong.  A little after 11 I got up and got dressed and drove myself over to Highland Hospital.

Now, last time I went to Highland Hospital's emergency room was over twenty years ago, 1992 when Ariel was a newborn and we lived across the street.  It was grungy, then, though not as grungy as my first experience of the place when Grandpa was taken there after choking on a hunk of sweet-and-sour pork back in 1986.  So my expectations were pretty low going in.

But golly, it was nice in there!  I didn't even get sat down in the waiting-room, I was seen by a triage nurse immediately (though I know I caught them at a dull moment, midnight on a Wednesday, so they weren't overrun), then was ushered into a private waiting-room to wait for a bed, then into the bed within the next half hour.  Before 1 a.m. I was laid up in a room by myself, pumped full of morphine, and being tended by the cutest young man imaginable... not a nurse, I don't think, but a physician's assistant or intern or something of the sort.  Anyway, a pretty pleasant setup.

Of course that's when things slowed down.  I had to wait for a doctor, only one of which species seemed to exist in the whole trauma center, and have a lot of blood tests done, and a few EKGs, and get rolled off for a bunch of x-rays and rolled back again, then wait for the doctor to come back, then diagnosed with a heart attack and slated to be transferred upstairs for treatment.  But I was high on morphine, which is really the nicest drug, and I had my tablet to keep me entertained with card games and Kindle books.  I got upstairs a little before dawn, plopped into a bed in a very noisy ward (everyone was asleep but all the staff were moving around and talking as they worked), and was enjoined to get some sleep.  I got about half an hour, I couldn't turn over off my back because of all the wires and nodes attached to my front.  Then The Robert Show started.

First it was the hospitalist, the general-practice sort of doctor in charge of hospital patients, who led a flock of twenty-somethings in white coats into my cubicle and started asking me a hell of a lot of questions; Highland is a teaching hospital you see, and during daylight hours every doctor is accompanied by such a flock.  Then the cardiologist came with her own flock and asked a lot more questions, and the flock asked questions, and Caroline had turned up in the meantime and she asked lots of questions of the cardiologist, and it was quite a little kaffeeklatsch but without any coffee or pastries.

Speaking of which, I was ravenous by then, they hadn't let me eat or drink anything since I arrived a little before midnight and it was now getting on for 9 a.m.  Caroline kept me company anyway, and I lay there watching the comings and goings of the ward and the little flocks of doctors-in-training as they learned at their masters' knees.  About ten or eleven it was decided that I was going to get an angioplasty, and then things started moving fast again―less than an hour between decision-making and being wheeled down the hallway.

Odd to say, the angioplasty was almost the highlight of my stay.  The guy who was stationed at my head and kept an eye on my vitals and prepped my groin (more embarrassing than titillating) was really funny, gay as a paper hat and full of jokes and good nature; and I was given even better drugs (something called Twilight or like that... dreamy) and told what was going to happen in reassuring detail.  Best of all I was allowed to watch the procedure on the x-ray screen.  Utterly fascinating!

So I watched on the screen as this object was inserted in at my groin and run up through my arteries like a drain-snake, slowly slowly slowly but I felt every centimeter of movement (pressure but no pain, the weirdest sensation) until it reached the clogged artery on my heart that was causing all the trouble.  Then a leeeetle balloon inflated and left behind a teeeeny piece of medicine-treated metal (or "stent") to keep the artery from closing again.  Then they slowly pulled the apparatus out and I was done.  Unfortunately the local anesthetic wore off while they were pulling out and the last few minutes of the procedure was excruciatingly painful, alleviated only by the euphoric drug, but it was only a few minutes.

Afterward I was wheeled into my own room in the ICU... not because I was in any danger but because it's standard procedure to put all post-op cardiac patients there, from major open-hearts to minor angioplasties.  People were very nice to me, though I still wasn't allowed to eat or drink for a long time, for fear of something going amiss and my needing further surgery.  But Caroline was still there, had been waiting while I was in the procedure, and she kept me company for the rest of the afternoon.  About the time she had to go home, they finally brought me a tray of food, and I was so hungry it was the most delicious fish filet I'd ever eaten in my entire life.

Then began one of the longest and most unpleasant nights of my life.  As before I was unable to turn over (I always sleep on my side) because of all the nodes pasted to my torso and the tubes of saline and oxygen; and then being the ICU it was full of people dying and their relatives being really dramatically unhappy about it, and the noise was extraordinarily disturbing; and then when I did manage to doze off, a nurse would come in and take my vitals and ask me questions and poke me here and there.  And when I had to pee, I was made to go in a bottle, which I found incredibly disgusting.  Really, a hospital is no fit place to be sick in.

But the night passed eventually, and my morning began with a visit from three different fledgling cardiologists from the previous day's flock, who asked me a lot of questions, often the same questions; then the cardiologist came with the rest of the flock and asked those questions again and quite a few more, displayed my shaved and punctured groin, then decided that I was good to go and would be discharged.

Then I was moved to another room in the same ward for reasons that were never made clear to me, where the nurse was stationed right outside my door and kept me company when she wasn't busy tending to one of my neighbors.  I got fed again (OMG the eggs and sausage were sooooooo good and the one cup of coffee was utter heavenly ichor) and then settled in for the wait to be discharged.  A wait that lasted most of a day, but which was meant to end any minute now so I couldn't just settle down and rest.  I watched a lot of really bad daytime television (the TV only got one station) including my first-ever experience of the new Price is Right with Drew Carey (not too bad, but not what it was), had lovely chats with the nurse, had another meal (an unimpressive tuna sandwich and chicken soup), all while listening to people sob in the hallways and someone with dementia yelling "help me!" at five-minute intervals.

But finally, finally it was all over with, I was given bags of pills and sheet after sheet of instructions (including and especially what my new diet was going to be like: 1400mg maximum sodium, 1800 calories, and 20 grams of fat per day), a plastic basin full of toiletries and an extra pair of slipper-socks that would have been most welcome if I was staying in the hospital but were quite useless to me at home, and finally allowed to get dressed and go to an actual bathroom to eliminate.

My uncle came and picked me up at around 4pm, then went back later for my car, and I hit my bed at a run.  I slept for ten hours solid, then napped and dozed and slept off and on for the next twelve hours, and spent the rest of the day watching television before going back to sleep at midnight.  After another refreshing night's sleep I finally got out of bed and faced my new life bright and early Sunday morning.

The first order of business was to arrange all the new pills.  I was on metaprolol, clopidogrel, atorvastatin, and aspirin daily as well as my regular medications and OTCs, so I had to get my pill-boxes out and refill them, making a handy little list to keep in my now-full medications shoebox.  Then I had to organize my diet.  First the sodium: I went around the house reading the nutrition information on all of the foods I ordinarily eat, and discovered that each of them contained more than my whole day's allowance of sodium―a Cup O' Noodles, one of my favorite staples, contained double that amount, and a chicken pot pie was practically poisonous with salt―as well as more fat than you would have credited (one begins to see why I had a heart attack in the first place, the way I was eating).

So I went online and bought a low-sodium recipe book to keep on my tablet and study, and did a lot of research about the minimum amounts of sodium, fat, carbohydrates, and protein a body requires (so I know I don't go too low and malnourish myself), and a lot of research into prepared low-sodium and low-fat foods (none of which were low enough... prepared foods are shockingly unhealthy).

It was pretty quick and easy, developing the new diet.  I was going to have to cook more, but the diet book I bought featured a lot of energy-saving shortcuts for prepping your food on Sunday and then arranging it into meals as you go during the week.  You roast up a couple pounds of chicken breast or beef chuck or pork loin one day, and then cook steambag veggies and stuff like that for each meal.  I organized small meals, five three-hundred-twenty-calorie meals each day, eaten at regular clockwork intervals, and reduced my sodium to practically nothing.

Well, that went extraordinarily well, and I lost twenty pounds in the next six weeks, so that when I had my follow-up appointment with the cardiologist in September, I was in the very pink of health.  And during the rest of September I continued eating healthy, and lost another ten pounds, so I was finally back to the weight I'd been when I left work the year before (250lbs).  Sadly, my work pants still didn't fit, but that's another gripe (damn you, gravity!)

But then the depression came back.  I had been feeling pretty damned great all this time, meeting with my therapist and my psychiatrist and eating well and getting exercise, but then like a gopher-hole in a racetrack the first week of October threw me flat on my face, groaning and crying.  I managed to hang on to a lot of my healthy eating habits, but I lost my grip on the eating schedule and the neatly arranged meals, going back to snacking when I felt hungry―but still snacking on very healthy low-sodium low-fat foods.  So it wasn't as bad as it could be.  I felt like my depression was stable, at any rate, not the bottom-scraping terrors I was feeling in July, so I felt like I had at least made some progress.

So all in all, the heart attack was a good thing.  It was the short sharp shock I needed to get me out of that rut of depression I was in and make me take an active part in my life again, even if only for a little while, and to end a lot of the behaviors and conditions that were keeping me down.  It also gave me a really good argument for when I am feeling suicidal: considering the amount of money and effort that had been invested in keeping me alive, it would be a disgusting waste to kill myself now.  I mean, my little trip to Highland ended up costing Medi-Cal a whopping seventy thousand dollars... if nothing else, I am worth that much!

So though I am wallowing at the moment, I am feeling kind of hopeful about the future.  I'm thinking about what I want to do for NaNoWriMo next month, working on my anxieties and fears and interpersonal relationship issues in therapy, and thinking about ways to make my life better.  I really feel like the sadness I'm in now will pass and that though it will also come back I will be better prepared for it.

Anyway, that's what's going on in RobertWorld these days.  I'll check back in next time something happens, hopefully before some months have passed.  Cheers!


1 comment:

  1. This comment has been removed by a blog administrator.

    ReplyDelete