The aftermath and interim

Beth headed home about 8:30, and left me to my own devices. I read for a while and flipped through the TV channels. Once I was allowed up, I went to the bathroom and checked the location. Although the site in my groin was covered by a four-inch square bandage, it was clear that the bruise was going to be a doozy. I finally shut off the lights at 10:00.

Several times during the night, I had the obligatory wake-ups from the nursing staff. Blood pressure checks, meds, and even a blood draw. Finally, I woke up for good at 7:00.

About 9:00 Beth called and told me she was hitting the shower and would leave soon thereafter. About 10:00 I started entertaining a parade of visitors, all getting me ready for departure. First was a dietician, telling me how to eat healthily. She left me with a booklet, which I have yet to open.

Some words about eating: Since my clean stress test in 2002, I’ve monitored my cholesterol and triglycerides aggressively. While somewhat high back then (in 2002, my total cholesterol was 265 versus a target max of 180), it has been below 200 since 2004 and below 180 since 2006. Since 2002, I’ve had my cholesterol checked more than a dozen times. For many years, I have tended toward salads and almost never eat red meat. Chicken and shrimp probably represent the majority of the animal protein I eat. What I have always struggled with is portion control: It’s the old joke about see-food diets… I see food, I eat it. I made a vow to focus on portions, since I was already eating better than many people.

Next up was a cardio-pulmonary rehab nurse. She told me that I would be in rehab, and my local hospital would be contacting me to set up a schedule. This was the first time it really hit me that my life was going to change, and change in a significant way.

Finally, the cardiac physician’s assistant came in. She did an exam to check the puncture site, asked me how I was feeling, did the usual doctor things, and added new prescriptions for me. The final thing she did was to go over the procedure, tell me what was coming (the second procedure on June 1), and then she gave me a “stent card.” Who knew that you’d have to carry a card with you at all times explaining that you had a small tube stuffed inside a coronary artery?

How big is a stent? Do this: Open a typical ballpoint pen. The tube that holds the ink (in slimline pens, at least) is about 3 millimeters in diameter. Now, for the metrically challenged or resistive among you, there are 25 millimeters to an inch (25.4 to be exact), so 3 millimeters is an eighth of an inch for all intents and purposes. Hack off a piece of the pen tube 18 millimeters long (again, about 3/4”). That’s what saved my life; that tiny medical miracle was holding open my widowmaker (the left anterior descending coronary artery). To put in perspective just how small the stent is, see the accompanying photo.

The PA set up a follow-up visit for a couple of weeks away, gave me a slew of literature, and left me to get dressed. Beth showed up, and we headed out of the hospital. I was moving slowly (I was sore), but we headed home. I was told to take it easy (no driving for 48 hours). In the next installment, the joys of cardiac rehab and the second procedure.

The Doctor Visit

I went to the doctor’s appointment on Wednesday. I had convinced myself that it was anxiety (I’ve had anxiety attacks before), and the doctor would tell me that I had been worrying for nothing. What I got was something else.

But first, some background. I have a family history; my father had his first heart attack at age 45, ended up on permanent disability, and died at age 54. He died six weeks before my daughter was born, who would have been his first grandchild. It wasn’t a heart attack that killed him. Rather, he died from a ruptured aneurysm on his abdominal aorta. The aorta is a huge vessel, about the size of your thumb. The University of Maryland Medical Center web site says “Many patients do not even survive long enough to make it to the hospital, and among those who do, more than half eventually die of complications. In fact, ruptured aortic aneurysm[s] are the 13th leading cause of death in the US…” (Source: http://www.umm.edu/vascular/aaa.htm). Back in 1988 when my father died there wasn’t a good treatment for abdominal aortic aneurysms (AAA), so he never had bypass surgery; it was simply too risky.

Because of this history, I had been aggressively treating my cholesterol and getting screened for AAA, both of which have hereditary components. I have an annual physical, I’ve had a couple of stress tests before (both clean), I've had an abdominal ultrasound to check for AAA, and my blood work numbers were pretty good (target numbers are in parentheses):

Total cholesterol: 159 mg/dl (110-200)
Triglyceride: 189 mg/dl (38-150)
Good cholesterol (HDL): 43 mg/dl (60+)
Bad cholesterol (LDL): 78 mg/dl (0-100)

All this lulled me into a false sense of security: How could it be anything but anxiety when I had numbers like these and I was taking statin drugs?

Blood work at the doctor’s visit showed that I hadn’t had a heart attack or pulmonary blood clots; the doctor diagnosed me as having “exercise-induced angina” and scheduled me for a stress test the next week. The stress test involved two days of tests, first under exercise and then at rest. I went through the weekend convinced that it was anxiety, bolstered by the fact that I tried to induce the angina over the next few days without success (in hindsight, this was kind of like the old Bugs Bunny cartoons where a character bangs a cannon shell with a hammer... But more on that later).

I will also post recipes here as Beth and I try to get back into healthier eating. Only good stuff... If a recipe doesn't make the grade (we're foodies, you know!) it won't be in here. And in the next installment, the test.