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January 8th, 2021

Our Bodies Don’t Always Fit The Standard Models

Almost four years ago, I posted the following to my Facebook page after I read it on someone else’s page. I was trying to be helpful to the women in my life, and any lady who might see it.

A nurse has heart attack and describes what women feel when having one:

I am an ER nurse and this is the best description of this event that I have ever heard. Please read, pay attention, and send it on!…

FEMALE HEART ATTACKS

I was aware that female heart attacks are different, but this is the best description I’ve ever read.

Women rarely have the same dramatic symptoms that men have … you know, the sudden stabbing pain in the chest, the cold sweat, grabbing the chest & dropping to the floor that we see in movies. Here is the story of one woman’s experience with a heart attack.

I had a heart attack at about 10:30 PM with NO prior exertion, NO prior emotional trauma that one would suspect might have brought it on. I was sitting all snugly & warm on a cold evening, with my purring cat in my lap, reading an interesting story my friend had sent me, and actually thinking, ‘A-A-h, this is the life, all cozy and warm in my soft, cushy Lazy Boy with my feet propped up.

A moment later, I felt that awful sensation of indigestion, when you’ve been in a hurry and grabbed a bite of sandwich and washed it down with a dash of water, and that hurried bite seems to feel like you’ve swallowed a golf ball going down the esophagus in slow motion and it is most uncomfortable. You realize you shouldn’t have gulped it down so fast and needed to chew it more thoroughly and this time drink a glass of water to hasten its progress down to the stomach. This was my initial sensation–the only trouble was that I hadn’t taken a bite of anything since about 5:00 p.m.

After it seemed to subside, the next sensation was like little squeezing motions that seemed to be racing up my SPINE (hind-sight, it was probably my aorta spasms), gaining speed as they continued racing up and under my sternum (breast bone, where one presses rhythmically when administering CPR).

This fascinating process continued on into my throat and branched out into both jaws. ‘AHA!! NOW I stopped puzzling about what was happening — we all have read and/or heard about pain in the jaws being one of the signals of an MI happening, haven’t we? I said aloud to myself and the cat, Dear God, I think I’m having a heart attack!

I lowered the foot rest dumping the cat from my lap, started to take a step and fell on the floor instead. I thought to myself, If this is a heart attack, I shouldn’t be walking into the next room where the phone is or anywhere else… but, on the other hand, if I don’t, nobody will know that I need help, and if I wait any longer I may not be able to get up in a moment.

I pulled myself up with the arms of the chair, walked slowly into the next room and dialed the Paramedics… I told her I thought I was having a heart attack due to the pressure building under the sternum and radiating into my jaws. I didn’t feel hysterical or afraid, just stating the facts. She said she was sending the Paramedics over immediately, asked if the front door was near to me, and if so, to un-bolt the door and then lie down on the floor where they could see me when they came in.

I unlocked the door and then laid down on the floor as instructed and lost consciousness, as I don’t remember the medics coming in, their examination, lifting me onto a gurney or getting me into their ambulance, or hearing the call they made to St. Jude ER on the way, but I did briefly awaken when we arrived and saw that the radiologist was already there in his surgical blues and cap, helping the medics pull my stretcher out of the ambulance. He was bending over me asking questions (probably something like ‘Have you taken any medications?’) but I couldn’t make my mind interpret what he was saying, or form an answer, and nodded off again, not waking up until the Cardiologist and partner had already threaded the teeny angiogram balloon up my femoral artery into the aorta and into my heart where they installed 2 side by side stints to hold open my right coronary artery.

I know it sounds like all my thinking and actions at home must have taken at least 20-30 minutes before calling the paramedics, but actually it took perhaps 4-5 minutes before the call, and both the fire station and St Jude are only minutes away from my home, and my Cardiologist was already to go to the OR in his scrubs and get going on restarting my heart (which had stopped somewhere between my arrival and the procedure) and installing the stents.
Why have I written all of this to you with so much detail? Because I want all of you who are so important in my life to know what I learned first hand.

1. Be aware that something very different is happening in your body, not the usual men’s symptoms but inexplicable things happening (until my sternum and jaws got into the act). It is said that many more women than men die of their first (and last) MI because they didn’t know they were having one and commonly mistake it as indigestion, take some Maalox or other anti-heartburn preparation and go to bed, hoping they’ll feel better in the morning when they wake up… which doesn’t happen. My female friends, your symptoms might not be exactly like mine, so I advise you to call the Paramedics if ANYTHING is unpleasantly happening that you’ve not felt before. It is better to have a ‘false alarm’ visitation than to risk your life guessing what it might be!

2. Note that I said ‘Call the Paramedics.’ And if you can take an aspirin. Ladies, TIME IS OF THE ESSENCE!

Do NOT try to drive yourself to the ER – you are a hazard to others on the road.

Do NOT have your panicked husband who will be speeding and looking anxiously at what’s happening with you instead of the road.

Do NOT call your doctor — he doesn’t know where you live and if it’s at night you won’t reach him anyway, and if it’s daytime, his assistants (or answering service) will tell you to call the Paramedics. He doesn’t carry the equipment in his car that you need to be saved! The Paramedics do, principally OXYGEN that you need ASAP. Your Dr. will be notified later.

3. Don’t assume it couldn’t be a heart attack because you have a normal cholesterol count. Research has discovered that a cholesterol elevated reading is rarely the cause of an MI (unless it’s unbelievably high and/or accompanied by high blood pressure). MIs are usually caused by long-term stress and inflammation in the body, which dumps all sorts of deadly hormones into your system to sludge things up in there. Pain in the jaw can wake you from a sound sleep. Let’s be careful and be aware. The more we know the better chance we could survive.

A cardiologist says if everyone who gets this mail sends it to 10 people, you can be sure that we’ll save at least one life.

*Please be a true friend and send this article to all you female friends.

Now I want to add something to all this for any gay males, and family and friends of gay males reading this. I can’t speak to the effect what I’m about to discuss has on lesbians or transgender folk because I am not one of these. But I am a gay male and I’m here to tell you that the above was how it was with my own heart attack in October of 2019. Mostly. I didn’t have the back spasms and jaw symptoms that lady did, but the sensation of having a very severe bout of heartburn was my experience too.

Almost four years after I posted this to my Facebook page, I had my own heart attack. In retrospect I should have kept this in mind, that it might, just might, hit me more like it does women then men. After all, I was, and still am, convinced that my sexual orientation is a matter of my physiology…that is, it’s how I’m made…at least brain wise. Perhaps, I sometimes wondered, there is more to it than just what’s going on in my brain. But when it finally came down I initially ignored the symptoms which could have led to disaster. What happened was for a moment the heartburn sensation became so severe…like it was a horse standing on my chest…it scared me and I called 911, still thinking there was a problem in my esophagus. I like my cigars and worried that this was the first sign of throat cancer. When the doctor in the emergency room told me I was having a heart attack it actually surprised me.

Pay attention to this my fellow gay males! My sense of my sexual orientation being wired into me physically, not as a psychological effect (distant father domineering mother blah, blah, blah…every bar stool blowhard bigot theory of homosexuality…blah, blah, blah…), has always been there. But as I’ve grown older I’ve had to wonder if there is more to it than just the grey matter. There is much better research going on now then there was when I was younger about gender differences in how disease presents and progresses, and in patient responses to treatments and medications. This is good for women. But gay males might need to pay more attention to this effect too, regardless of how cis gender we see ourselves to be, and how comfortable we are inside our male bodies.

Our physiology may be just slightly different enough from heterosexual males that it makes a difference in our healthcare.

by Bruce | Link | React!

October 10th, 2020

Heart Patient In The 21st Century

I’ve not said much about it here on the blog…mostly on Facebook where I do most of my online socializing (here I just spill my guts), but some of you may recall my posting about a year ago that I had a heart attack. ,Which makes me a heart patient now I suppose. That counts as a preexisting condition doesn’t it. I’m still fine, mostly. I have the usual pill regimen, and I’ve been going to cardio therapy twice a week. But I’ve been finding it hard to take too seriously.

When I was a small boy my maternal grandmother, who was living with mom and I at the time, had a heart attack. It was the early 1960s and there wasn’t much the doctors could do for her other than prescribe some meds, keep her in bed, and wait to see if she survived it. For two months she was confined to bed in our apartment, and then it was a slow slog back to a semblance of wellness and her usual bitter crankiness. I had mine here in the 21st century, right in the ER where I’d gone thinking I was experiencing a really bad case of heartburn, and fretting about damage to my esophagus due to all the cigars I’d been smoking. They wheeled me right up to a surgical room where they inserted a snake with a drill of some sort into a major blood vessel in my right arm, drilled out the blockage, put in two stents, wheeled me into the cardio unit for observation, and in total I was in and out of the hospital in about a day and a half. When I got home orders were to relax for two weeks, but I was feeling great. Not exactly what I was expecting of a heart attack.

Of course I was lucky it wasn’t a very severe one. I didn’t die on the spot. It crept up on me slowly, like I was having heartburn more often than normal, then more frequently, and then finally constantly. When it suddenly felt like a horse standing on my chest it scared me and I called 911, but I was still convinced it was heartburn. There was none of the stabby pains I was told to expect in every TV and movie episode where someone has a heart attack. There were no cold clammy sweats and numbness of the limbs…except for a little at my fingertips that in retrospect I should have paid more attention to. But I was lucky it wasn’t worse. And that when the moment finally came I was already there in the ER. I haven’t had any subsequent heart problems. Until a couple nights ago.

I was lounging on the sofa watching the Smithsonian Channel’s Air Disasters…which seems a kinda grim form of entertainment but bear with me…in a time when contempt for science and reason is epidemic, and alternative facts shouting out actual facts, I really appreciate a series that walks you through how men and women of science, reason and logic work step by step to suss out a sequence of events that made a terrible accident happen, out of a lot of twisted and burnt metal and some data points in flight recorders and ground radar, and then put together a plan to keep it from happening again. The TV police procedurals that show how autopsies often point the finger directly at the killer have nothing on this. Twisted metal, pieces of wreckage, broken instruments, marks on a runway, ghostly radar echos, it isn’t just dead men who tell tales, to the scientific mind, everything tells a tale. I love it. What I don’t love is how…faithfully…the series shows us the accident itself.

So I’m watching this and the part where everyone dies is coming and my heart starts racing because I really don’t like watching that…and pretty soon I’m noticing my heart is really pounding. I mean…Really Pounding. So I stick on my blood oxygen and heart rate monitor and it’s showing my heart beating at 187. I wait for it to slow down and it doesn’t. Now I’m waiting for the other shoe to drop. Am I about to have a stroke? Another heart attack? What the f*ck is going on!? I’m feeling no chest pains, no sweats, nothing but the creepy feeling of my heart pretending to be a machine gun. It doesn’t slow down. So I call 911. And back I go to the ER. One of the EMTs says to her teammates that she’d never seen a heart rate as fast as mine that night. It peaked in the EMT truck at something like 210+. 

When other means of getting it to slow down fail, drugs are given. That works. In the ER they draw some blood, take an x-ray to see if there is any new heart damage, and keep me under observation. Early in the morning they decide whatever it was that happened it’s over now, and I can go home. I was told I’d had an atrial fibrillation, which became a supraventricular tachycardia, or SVT as the ER nurses kept calling it. Basically my heart went nuts for a while, but it didn’t kill me. In fact, that I was in absolutely no pain and had no other symptoms, and that nothing like this had ever happened to me before, was something the doctor seemed to find worrisome. I asked him if he knew what caused the event. He said no. Atrial fibrillation can start suddenly and stop on its own. I asked him if mine would have stopped eventually. He said…maybe.

My manager at work tells me to take it easy for a couple days. In the meantime my cardiologist’s office gets news of my ER visit and asks me to come in…like right now…to discuss it. I get another cardiogram. I get another appointment for an echo EKG, like the one I had after the heart attack. And I get one of these…

 

It’s a heart monitor, which will record everything my heart does for the next two weeks. Then I mail it back and my cardiologist will take a look at the data. This sudden rapid heart beating has never happened to me before, but the thinking for the moment is I may have been having small-ish episodes of irregularity I just haven’t noticed because they came and went so fast. So they want a long duration record.

Look at that thing. This, as a co-worker says, is what has come of ubiquitous computing. Tiny but powerful CPUs and support chips so cheap to make you don’t even bother making a memory card slot for it. The entire thing is just a little stick-on device. A temporary flight data recorder for the human body. Not too long ago, according to a classmate who worked in healthcare, I’d have had to carry around a box and a bunch of wires connected to me. Now it’s just this stick-on thing.

Not looking forward to having to pull it back off though.

by Bruce | Link | Comments Off on Heart Patient In The 21st Century

November 12th, 2019

The Oddness Of Life After Heart Attack…

It’s an odd frame of mind you find yourself in this modern world, after having a medical event that would have killed you in any other day and age, knowing as you walk through your day that you have pieces of metal in your beating heart, and yet you’re still alive.

by Bruce | Link | Comments Off on The Oddness Of Life After Heart Attack…

October 18th, 2019

My Little Heart Attack Diary

As they were wheeling me into the elevator to take me to the room where they put the heart stents in, the doctor told me I looked very calm for someone who’d just been told they’re having a heart attack. But until the moment I got the diagnosis I was full of all kinds of dire imaginings over what was happening. It just didn’t feel like I was told a heart attack was supposed to feel. It felt more like a massive heartburn, or damage to my throat because of all the wheezing and coughing I did after the flu I’d just had, or worse…damage from throat cancer maybe, from the cigars I like to smoke. But now I knew…I was having a heart attack. It wasn’t the fearful unknown anymore. And I was in the ER, surrounded by one of the best hospitals to be having a heart attack in on the east coast. I felt myself to be in good hands. And I was.

It sorta started on my Walt Disney World vacation last month. I’d taken two weeks this time because it was a milestone birthday. I would be old enough now to draw full Social Security benefits if I wanted to. Which I didn’t…my plan is to keep working at Space Telescope at least through launch of James Webb. If I can keep working until age 70 I’ll have a very good retirement package, and since my job isn’t very physical I reckoned that was possible. But in the second week of it I came down with a flu. After that I started feeling my age more than I’d expected. I had a really bad cough for weeks afterward, and I was fatigued beyond anything I had known before. In retrospect, that fatigue was probably a symptom of what was to come.

Back home, I checked in twice to a local walk-in clinic for the cough, which just wasn’t going away. They diagnosed me as having bronchitis, which so I’m told is basically you have a cough. They gave me some meds which took care of the cough, but then I started feeling heartburn, every night, in the middle of the night.

It would wake me up, and I would sit it out. At first it all seemed pretty routine. Sometimes I’d take a Tums for it, and it would go away. Daytimes I felt fine. But at night the heartburn kept coming back. And it was getting worse. I began to worry there was damage to my throat from all the coughing I’d done. Then I began to worry about something else. I am an occasional cigar smoker. And by “occasional” I mean I can go for months without smoking one, or I can get on a jag about it…usually because of some life stress…and smoke one every day for a while, usually at night after dinner. First week of my Walt Disney World vacation I was smoking them every night a the Sosa Cigar Company in Disney Springs. They have a nice little cigar lounge were you can smoke a nice one and watch the people go by. But while cigars aren’t likely to give you lung cancer (you don’t inhale the smoke), they can give you cancer of the esophagus. They also stress the heart and blood vessels, but I was more worried now about cancer.

For several days the night heartburn just kept getting worse and worse. Daytime was fine…except now I was getting severely out of breath walking to and from work. I figured it was an after effect of the bronchitis. Maybe I’d damaged my lungs in some way. Maybe the cigars Had given me a lung cancer. One of my coworkers recently died of it. Suddenly. She was a pretty heavy cigarette smoker, but I was stunned at how fast it took her from us. I’d run into her on The Avenue just the previous week and she looked fine. Then she was gone. I was starting to get a bit scared, but not of my heart. The stabbing chest pains I’d been told to expect in every Hollywood movie or TV show when somebody had a heart attack weren’t happening. It just felt like heartburn. Really really bad heartburn, and slightly above my heart, and just below my throat, in the center of my chest. But there was another factor, that caused me not to rule out the heart attack entirely: When the pain came on, I got noticeably numb at the tips of my fingers. In retrospect I should have paid closer attention to that.

Last Monday morning, in the wee hours. It woke me up again and it was really bad. I think I might have snarfed down half a bottle of Tums. It came and went…something else I didn’t think a heart attack did. When it was gone I felt fine. Great even. Then it would come on me again, a bit worse than before. What I failed to fully appreciate then was there is a stage before the actual heart attack comes on, when the blockage in one or more blood vessels is starting to cut off the flow of blood in a significant way and a patch of your heart stops getting enough blood. That’s when you need to take action to prevent the damage from happening. But I was 4/5ths certain it was damage to my throat I was feeling.

By the time morning came, I’d decided I needed to go to the ER to get it looked at. The pain was getting scary. I figured I’d get a ride to Union Memorial, which is nearby, in my network, and one of the best. I was trying to avoid the ambulance ride because of the possible expense. It’s the abysmal way we have healthcare set up in this country. Is the provider “in network” or not? How can I tell? It’s not like they wear their insurance company credentials on their lab coats or the ambulance doors like race cars wear their advertisers. I was sitting down composing an email to my coworkers and manager, telling them I was taking a sick day, when the pain came back pretty forcefully. It was now officially scary enough that I called 911.

When the EMT truck came the pain had gone away again. The EMTs gave me an EKG and saw nothing. But I’d told them about the numbness and they strongly suggested I go to the hospital. I agreed…I was going there anyway…and they strapped me in and away we went, sans lights since this didn’t seem to be an emergency.

By the time they wheeled me into the ER the pain was coming back. The ER techs took another EKG. The doctor sent back a request for another, but by then the pain had gone away way. He asked for a third and the pain was back. He came into the room and told me I was having a heart attack. Not had…having. And that I was going right away to get it taken care of. Stents, not a bypass, though I wouldn’t have been surprised about a bypass: two of my high school classmates have already had major bypass surgery. 

But for me it was the stents. Union Memorial is state of the art…I was to get them inserted through a major artery in my right arm, not the groin. The procedure was completely painless. I was laid out on a table, drugged up, oxygenated, my right arm strapped to a board flat and straight out, some sort of device hovering over me that I assume was a scanner that could see into my chest. It moved about here and there over me like a curious large bird, while the doctor and the technicians and nurses chatted. Occasionally they’d call out numbers which might have been related to the position of the device they were moving up my artery, or heart and blood data points. I felt very calm. That might have been the sedatives. And curious. But I played rag doll the entire time so they could do their jobs. It was over in just a few minutes. Or seemed to be anyway…that might also have been the sedatives. The chest pain was gone.

They moved me to the Cardio Unit, and kept me overnight for observation. Two stents had been put in, and a third was staged for insert, but determined to be unnecessary. I was wired up to an EKG machine and an automatic blood pressure tester. Eventually they hooked the wires up to a portable EKG device that talked wirelessly to the big one in my room, so I could take short walks around the unit, so they could see how my heart behaved. The next morning they gave my heart a sonogram. It was…interesting…to see it beating there on the screen. Sixty-six years and a few weeks it’s been beating without stop. It’s the one muscle in the body that never rests. Now mine had damage, because I’d let the chest pain go and tried to tough it out and maybe it’ll go away and it wasn’t what I thought it was. It was my heart telling me to take action.

But I was unreasonably, fantastically lucky all the same. I’d had the actual heart attack in the hospital, where I was surrounded by a first rate cardio care facility. Within minutes I’d had the blockage causing the attack cleared. When the head cardiologist talked to me before I was discharged, he was almost bubbling over with satisfaction at how little actual damage to my heart there was, because they were able to get me into care so quickly. He had a small group of intern trainees there with him, and I was his case study for them, probing me with his stethoscope, telling them here’s where you look for this sort of damage…but he doesn’t have it…and here’s where you look for this other sort of damage…but he doesn’t have it…

But I have damage. It’s the minimum amount of possible damage that could have happened, given the sort of heart attack I had. But now my heart has damage. I have heart disease. Now I have to deal with that fact.

But here’s one amazing thing about all of this. I have better blood flow now, because the blockage is gone. The fatigue is gone. Mostly. I’m feeling the after effects of the heart attack and that’s to be expected. For the next several weeks I will be on strict orders to take it easy. I won’t be allowed to walk to work like I normally do, possibly for months. No road trips for months probably, although I’ll be able to drive locally, and in fact driving is what they would prefer I do. I will have to be careful and not stress my body and heart. But I can see that if I follow doctor’s orders and get into a regular exercise routine I will end up feeling Much more energetic than before I had the heart attack. Much more. This is wonderful! And I think, one reason why so many people don’t follow instructions and stick to the plan after a heart attack. You have better blood flow, and the effect of it is really Really noticable. Hey…I’m feeling great…and that eggs Benedict is looking so very nice… But energy is the least amazing part of what I am now experiencing.

I haven’t had this level of mental alertness since I was a young man. It’s hard to describe it, and I never really noticed much how fuzzy the world around me was getting because it happened so gradually. When I did notice I just put it down to getting old. But when I take my brief morning walks around my block now, and moving about inside Casa del Garrett, the world around me just seems so much more…there…than before the heart attack. It’s a really striking difference. Like the difference between watching something on an old analog TV set and a new 4k digital. Really. Seriously. It is like that.

I Never want that to go away again if I can help it. Plus…I got lucky. Unreasonably, fantastically lucky, having the attack in the hospital where I could get immediate and high quality care. It would be churlish, disrespectful, not just tempting of fate, but laughing in its face, to just go on as before. It’s hilarious, but while I was waiting at the drugstore for my meds, the in house music system was playing Second Chance by 38 Special…

This heart needs a second chance…

Okay…I get the message. Really. I take pride in my common sense. 

One other thing. I was hearing that song in that drugstore because a coworker graciously picked me up from the hospital and took me straight to the drugstore to get my meds, and then to home. She also organized an email chain at work to get a group of my coworkers together to help me out with groceries and moving things while I was confined to quarters during recovery. That, and all the expressions of care and support I got this week from family and friends, online and off, really touched me deeply. I have never felt so loved.

 

by Bruce | Link | React! (1)

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This page and all original content copyright © 2015 by Bruce Garrett. All rights reserved. Send questions, comments and hysterical outbursts to: bruce@brucegarrett.com

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