Heart Battles Require Discipline and Knowledge
Don

Heart Battles Appear Unending

Heart Battles Are Hidden

Heart Labels

The Heart

Heart battles are not clearly evident at the beginning! They start slowly and gradually make themselves known. I write this article in the hope that it will prevent others from going down the same dangerous path I have traveled. Most of us are aware of contributing factors, but tend to ignore them because it is too much trouble to pay attention to avoiding the factors that will someday weigh heavily on our lives. These factors include diet (red meat, mayonnaise, sweets, sodium intake, fats of various types), cholesterol unchecked, high blood pressure, etc.

My own problems were detected in 1993, some 23 years ago. Prior to that time I paid little attention to my diet, eating whatever suited me (I traveled extensively on my job, eating in restaurants), and extra exercise beyond what was necessary for daily life was largely non-existent. However, I did make honest attempts due to life-long weight problems and subscribing to many of the diets that appeared over the years. Some were successful for a short period of time, but the weight always reappeared and usually to a greater extent. These factor exclusions and the results “came home to roost” in 1993. I reached a point where I could hardly get around due to exhaustion and shortness of breath. I would return home from work, sit on the couch, and fall asleep while my wife was talking to me.

Heart Attack Symbol

The Heart Attack Symbol

Upon consulting a cardiologist and undergoing several tests, I was offered the options of angioplasty, or medical treatment and diet with walking exercise, without any guarantees. I had four major heart blockages. I chose medical treatment, diet, and exercise. I had heard of too many problems with angioplasty and multiple procedures due to failure. I did well with this approach, with minor problems, for about 22-23 years. During the intervening years I had yearly cardiologist checkups, cholesterol monitoring and blood work every 4-6 months, and several cardiac catheterization procedures. No invasive heart procedures other than the catheterizations were ever performed. And then the boom fell, but short of a heart attack which would have introduced serious heart damage beyond the blockages!

Messages from the Heart

What Message or Story is Your Heart Sending?

Messages from the heart arrive in many forms. Historically, as far back as I can remember my discussions with a doctor, I have had a low pulse rate (in the 50s), but doctors have said that this condition was true of some percentage of the population.  They weren’t too concerned.  I was even turned down for life insurance in my 20s, but the decision was later reversed and I was allowed to purchase the needed level of coverage. That was about 50 years ago. However, during the last couple of months I started having episodes where I thought I was going to “pass out.”

On Saturday, April 31, 2016, I had several episodes of dizziness, and along about 8:00 pm my wife insisted on calling 911.  On the way to the hospital the ambulance crew monitored several episodes where my pulse dropped to around 30 and would then shoot up very high.  Upon admission to the hospital an MRI and other scans were performed. Doctors immediately said that I needed a Pacemaker.

I was admitted to the hospital as an in-patient and various preparations were started. I was already on blood thinners, but another thinner was substituted – one that would flush out of my system very quickly. Since this was on the weekend, I had to wait until Monday for installation of the Pacemaker. Many blood samples were taken and vital signs monitored throughout Sunday and Sunday night. The Pacemaker was installed Monday evening, late, about 3:30 pm.  Only light anesthesia was given and I recovered quickly from it. Only a couple of Tylenol tablets, 2 times, were needed for the very small amount of pain. I was discharged with instructions to restart all my previous medications. I was also provided a monitoring station developed by St. Jude Medical, as was the Pacemaker. The station monitors the Pacemaker data, whenever I am within about 15-20 feet of it, and transmits it to the hospital (Heart Center) automatically by landline. I am then notified when I need to make an office visit.

I returned home on Tuesday around 11:00 am.  I had no more episodes for a while (that I was aware of), my rate was set at a minimum of 60, and the Pacemaker monitoring system performed its functions.  The data is automatically transmitted to the hospital and they will notify of any monitored problems.  So, I will benefit from close observation.  My movements were restricted for the first 6 weeks until the site healed and heart electrodes are “anchored.”  After that my activities were expected to be pretty normal other than avoiding magnetic fields and heavy lifting.

My heart had been sending me messages for a very long time, but I did not take heed. I did not often admit to having issues, especially to my wife, because I knew she would become more concerned about me seeking medical attention. She got me to go this time “just in time” I believe. The issues had shown themselves over a long period of time during my walking activities and through early fatigue while performing other tasks. We should all listen to the messages of our heart as well as other organs. The cure may well be much less painful than the ignored condition.

Heart Battles Increasing Pace

Echocardiogram and Chemical Stress Tests

Following installation of the pacemaker, my cardiologist requested that I visit him on July 25, 2016. He had not been a party to the Pacemaker installation. He then conducted an Echocardiogram and a chemical stress test. Those tests didn’t indicate a serious problem and he was preparing to release me. However, he then asked if there was anything else that he should know about. I then told him (I had not planned to mention this) that sometimes, shortly after I finish a meal, I would get a dull pain down the center of my chest, but it would go away after a short time. He immediately said “I think we need to do a heart catheterization on you!” Arrangement were made.

Heart Catheterization

Heart catheterization was performed by the cardiologist on August 11, 2016. At completion of the procedure (I was under anesthesia) he notified my family that I needed triple by-pass surgery. Arrangements were made!

Triple By-Pass Surgery

By-Pass surgery was performed on September 9, 2016, along with a four-day hospital stay. I spent all that time in a recliner, rather than a bed, because it was easier and less painful to get up for bath-room visits and walking. During the surgery I had incisions in several locations with installed drainage tubes. A vein was taken from one leg to use as a by-pass, and the mammary vein was used for the third. I spent one day in intensive care, then to critical care, and finally to another step-down care on the cardiac floor. I was up walking on the first day in critical care and for the rest of the time there. Taking of “vitals” readings and blood sampling were frequent, as were trips to the bathroom. I gained about 15 pounds of fluid retention during my stay. Meals (low or no sodium) were more plentiful than those I usually ate at home. I was released from the hospital on September 13, with strict instructions on meals, exercise (walking), and precautions in care of the incisions (they had to be cleaned twice daily). Upon returning home I slept on a recliner rather than in bed due to the problems in getting out of the bed. I continued on the recliner until about the first week of December. The recliner had been purchased in anticipation of the need. I joked and kidded my wife about having to have a by-pass before she would let me have a recliner! And that was the truth!

Fluid Build-Up and Breathing Problem

A Near-Death Experience

I was hospitalized for the by-pass from September 9 until September 13. After release I was required to return for office visits with the surgeon three times. Prior to each visit I was required to have a chest x-ray, EKG (2), and blood work. I was released from this routine on October 20. During this time I used a recliner for sleep (to prevent damage to the separated rib cage and incisions). I also walked daily and was on additional medication, including heavy dosages of Lasix to remove fluid build-up (I had gained about 16 pounds of fluid while in the hospital, but had reduced it by about 10 pounds during the stay). Upon release from the hospital I was down to about 206 pounds.

As I continued heavy doses of Lasix and continued my walking (I attained in excess of 2 miles on most days, and more than 1 mile on others. My weight dropped to 197 pounds and my Lasix dosages had been decreased (my personal decision based on comments made by the surgeon prior to my release). And then the weight started climbing again to about 201. Along about this time I started having shortness of breath, and about the same time I strained the calf of one leg and quit walking. I assumed the weight gain was related to the combination of factors.

On Saturday, November 26, 2016, my wife and daughter were putting up Christmas lights and called me outside with a couple of questions. Before I could answer their questions I had some odd feelings and told them I felt we should go to the hospital. As we were getting into the car something changed and I told my wife that I thought she should call an ambulance.

On the way to the hospital, and while being monitored by ambulance personnel, things got worse and they said I was having Atrial Fibrillation (I was taking medication for this and an ablation was done during the surgery). I should not have been having the AFib problem. I was later told by the cardiologist that it often takes several months to determine success of the ablation. One must wait for adequate scar tissue to form.

I was taken directly into an emergency room and procedures were started. By the time I got there I was gasping for every breath, and I told them I was suffocating. I felt like, and thought, that I was dying! People seemed to be standing around not knowing what to do, but then someone arrived with a breathing mask (which they had been waiting for). The mask forced air into me and I had immediate, but strained, relief. The mask was a BPAP, which I had never heard about. One definition I found for this device is:

BiPAP (also referred to as BPAP) stands for Bilevel Positive Airway Pressure, and is very similar in function and design to a CPAP machine (continuous positive airway pressure). Similar to a CPAP machine, A BiPAP machine is a non-invasive form of therapy for patients suffering from sleep apnea. Both machine types deliver pressurized air through a mask to the patient’s airways. The air pressure keeps the throat muscles from collapsing and reducing obstructions by acting as a splint. Both CPAP and BiPAP machines allow patients to breathe easily and regularly throughout the night.

I was then transferred to the Intensive Care unit for 1 day, and then to the Critical Care unit. My problem was diagnosed as “Congestive Heart Failure with Atrial Fibrillation.” The fluid build-up and AFib were smothering me (congestion). I was then given massive doses of Lasix by IV and various other tests were performed for the rest of the hospital time. I was released on November 30, and was placed on a strict, low sodium diet of less than 2000 mg. I continued a heavy dosage of Lasix. As of December 6, 2016, my weight was down to less than 192 pounds, and I started sleeping in a bed about a week prior. I feel much better and am signed up for a heart rehabilitation program of exercise, under closely monitored conditions, for 39 sessions. I plan to continue my dieting to a much lower weight. I believe the removal of much sodium is the reason for the results received. It is a small price to pay for the results I’ve received. Fight your heart battles early for a more stress-free life.

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