Wednesday, December 12, 2018

My heart is broken

I have decided to resurrect this blog so that I can document my latest adventure. I think it'll help me organize my thoughts, and maybe it can be informative to others.

I am a very active person- I am constantly on the go. I hike, walk, backpack, run, work full time, and have my fingers in a lot of pies. Over the last couple of years, I have felt increasingly tired. Short of breath. My weight has ballooned. Hikes that I previously did without trouble were incredibly difficult. I blamed my failing energy and stamina on the weight gain, and there was a lot of self flagellation. I would talk to Jim about it, but didn't mention it to doctors because I thought the cause was obvious- I was getting fat because I wasn't working out enough, hiking fast/far enough. I would still hike, but a lot of the joy was gone because it was so hard, and I was so ashamed of myself for how slow I had gotten.

In my family, we have a strong family history of high blood pressure. While we usually die of heart attack or stroke, it doesn't happen terribly young, most of the time. My parents are in their 60s and healthy, though both are on high blood pressure medication. My grandparents lived to their 70s-80s (my grandma is still alive and kicking!). Two died of a heart attack and one of a stroke. Similar story going back to the greats. My paternal great grandmother died of a heart attack in her 50s, but that was a couple generations ago, so doesn't count, right? My maternal great grandfather died of a heart attack at age 48, but he'd also had black lung from working in a coal mine, so most of us figured that contributed to his early death. I also had a great grandmother on my father's side die So I fully expected to need blood pressure medication at some point, and for a heart issue to eventually kill me, but not for a really long time.

All that is to say that when I went to give blood in July 2018, I was startled but not entirely shocked to hear my blood pressure was really high. It had been fine at the end of May when I donated. I don't remember the exact reading, but it was high enough that I couldn't donate. They suggested I relax in the office for a few minutes, and then we'd get another reading. This time, we got 148/85, which was acceptable and donation went as planned. When I got home, I called my family practice doctor to get in to be seen so I could get on medication. I knew that untreated high blood pressure can be deadly and wanted to get going. It took about 3 weeks, but I got in. Long story short, we tried a couple medications before we found something that didn't make me violently ill. It felt clunky though- I'd leave messages that the medication was making me sick, or making my feet bloat to double their size and it would take days to get it resolved. Even after it was "resolved", my feet were often too swollen to even fit into my hiking boots, which was deeply upsetting.

At Jim's urging, I researched and found a cardiologist.When I called to make the appointment, the receptionist was a little surprised and implied that garden variety hypertension didn't really warrant a visit with a specialist. I insisted. Quietly, I thought to myself that I was glad I wasn't a *real* cardiac patient and that I was just being indulged. Ironically, I was able to see the cardiologist far more quickly than my GP. She did a couple tests, found that things seemed ok. However, given my family history and the pre-eclampsia I had with my fourth child, decided to order a stress echocardiogram to check for damage, just in case. I have great insurance (after a massive deductible), so I thought this was fine. She also switched over my blood pressure meds because she could see I was really upset by the fact that I had cankles.

On November 16, I was scheduled for the stress echo. Basically what happens in a normal situation is that they hook you up to a whole bunch of wires with stickers (I'd wager around 15-20). They do an ultrasound of your heart while at rest, laying on your left side.Then, you get on a treadmill. They slowly increase speed and incline until you scream uncle. Then you rush back to the table and they do the same ultrasound, but this time when your heart rate is high.

So, things started out the way described above. However, the tech seemed to take a long time with the initial images. Then, she says she's done with that part, and is going to let the cardiologist know the first test is done and is ready to go to the second part.

Uh oh.

I appreciate Tech trying to not panic me or anything. However, my cardiologist is a very busy woman. I felt very confident she wasn't just hanging around her office, wondering how my stress test was going.

Tech comes back in the room and announces that Dr N will be there soon. Dr N arrives, and she looks over all of the images. She then decides to stay for the stress part of the echo.

Bigger Uh OH.

I know that I'm hysterically entertaining and funny (ha), but not so much that a busy cardiologist is going to hang around and visit with me about my upcoming trip to Morocco and life in general for 11 minutes and 45 seconds while I huff and puff away on the treadmill.

I reach my personal breaking point (which, honestly was partly mental. I think I could've gone to 12 minutes but I was pretty freaked out by this point because something is pretty clearly WRONG with me. I was scared that I would have a heart attack or something there on the treadmill, so when my anxiety got the best of me, I stopped).

They did the second part of the echocardiogram. The tech did part, the cardiologist did part. Dr N asked me if I had trouble swallowing. Uhhhh, well, I never did until you asked me and now I'm convinced I do!

Once she finished, she turned to me and told me that my mitral valve has moderate to severe regurgitation. As a result of the extra work, the right side of my heart is enlarged and I have pulmonary hypertension. She seemed worried that I will be angry with her for sharing this terrible news. She felt that I am stable enough to leave in 2 weeks for a week vacation to Morocco, but wanted to schedule further, far more invasive testing for as soon as I get back. She urged me to not worry too much about this, and to enjoy my trip. I pressed her for more details- "Will I need surgery?" She admitted that yes, most likely. I ask if it'll be open heart surgery and she nodded.

I walked out to the car kind of in a daze. I'm a heart patient. I am sick. Maybe all of the horrible things I have been saying to myself about my lack of cardiac stamina were unfair.

I am upset and scared. Learning your heart has some big problems is terrifying. However, I am so, so grateful that my cardiologist decided to order that stress echo. As weird as it sounds, I'm glad that first blood pressure medication I tried made me really sick. My dad takes the same medication and he does beautifully on it. If I had started taking it and my blood pressure dropped to normal and I felt fine, I am absolutely sure I would've left things at that. I probably would have been out backpacking with Jim and died of a massive heart attack, hours from civilization. I can't even fathom the trauma that would've caused him. Our family. I am 42, which isn't exactly a spring chicken, but too young for people to expect me to die of a heart attack.

No comments: