Well, on top of all that was one other thing I haven't talked about in the blog yet, and that's the results of my second stress test. To recap, back in early February I was shoveling snow and I felt a weird pain in my chest, unlike anything I could ever remember feeling before. I paused, the pain stopped, I resumed shoveling, and I felt the pain again. It was right in the middle of my chest and somehow did not seem related to a muscle. So I set down the shovel and walked around a little, talked to the kids (who were helping shovel), talked to our next-door neighbor, and after a while resumed shoveling -- very carefully. I did not feel the pain again, but a few days later, when I had an appointment with my new doctor, I told her about the pain and she flipped out. She ordered an EKG right then, which showed nothing, but she also put me on blood pressure medication and referred me to the cardiologist.
I saw the cardiologist a week later, and he decided that because of all my risk factors (diabetes, being fat, high blood pressure, bad family history) that we should do an echo stress test. That occurred on March 1st, but it was somewhat inconclusive because I couldn't last even a minute on the treadmill. Consequently, I was rated Class IV Functional Capacity, which is very bad. But because we still couldn't really tell what was going on with my heart, the cardiologist ordered another stress test, a nuclear stress test, where they inject you with a radioactive tracer and look at your heart before and after you walk on a treadmill again. I had that done last Monday. And the results were... bad. According to what was posted on "My Health Connection," it was:
Abnormal myocardial perfusion scan, findings consistent with obstructive CAD with ischemia in the territory of the proximal LAD. Additionally there is a fixed inferior defect without prone imaging performed. There is normal wall motion and thus may represent attenuation artifact over inferior MI.
That was not what I was expecting.
I saw my regular doctor the next day, and she wasn't happy with these results. She started me on a statin, with CoQ10 which I guess is supposed to counteract some of the side effects of the statin, and then I got a message from my cardiologist putting me on low dose aspirin as well. So I now take 8 pills a day, not counting the occasional calcium and vitamin B complex (I've stopped vitamin D for now, since the calcium includes it).
In the morning with breakfast I take
- 2 metformin
- 1 rosuvastatin
- 1 coq10
In the evening with dinner I take
- 2 metformin
- 1 losartan potassium
- 1 baby aspirin
I figured out quickly that CoQ10 causes insomnia, so I moved it to the morning. The statin I'm taking can be taken any time of day.
I don't like being a pill-taker, but I like the alternative (heart attack? stroke? death?) less. So I take my pills.
I see the cardiologist again tomorrow (Monday) to discuss next steps. My regular doctor thinks the next step will be a cardiac catheterization, possibly with a stent put in, depending on what they find. A cardiac catheterization is a fairly serious procedure and might require an overnight hospital stay. Even if I get to go home the same day, I will need to take it easy for a few days -- which basically means that Rocket Boy needs to come home when I have this done, because the kids are so unhelpful. I thought of asking the cardiologist if we can delay this until May, when Rocket Boy was supposed to come home for another month. But now his new boss is making trouble, disagreeing with HR's decision to let him spend every other month in Colorado. So I may just go with whatever the cardiologist wants to do, whenever he wants to do it, and ask Rocket Boy to fly home for a few days, using family medical leave. That, at least, I don't think his boss can object to.
***
While we were on vacation in Nebraska, I took my blood pressure religiously every morning and night. On Wednesday and Thursday nights I took it after swimming in the hotel pool with Rocket Boy and the kids. Both of those times, my heartbeat was irregular, which my blood pressure monitor duly noted and told me to report it to my doctor. "It could be nothing," the blood pressure monitor acknowledged, "or it could be something very serious."
BEFORE, I would have thought, oh, it's nothing. But now, of course, I'm freaking out. Anyway, BEFORE, I wouldn't have had a blood pressure monitor and so wouldn't have known my heartbeat was irregular.
All this past week, since the stress test, I haven't exercised. No walks at all. Each day I have a different excuse, and one day, Thursday, I did do some raking (because compost pick-up was Friday). But no walks, after nearly a year of regular walking (interrupted, more recently, by all our snowstorms). The weather is fine now. I need to start my walks again -- people with obstructive CAD with ischemia can still take walks, in fact they SHOULD take walks. But I'm freaking out. I keep thinking I'm feeling chest pain, or shortness of breath. I think, what if I go on a walk and I start feeling chest pain? Both of my doctors told me that if I feel ANY chest pain, I must go to the emergency room immediately. "Call an ambulance," my regular doc told me. Jesus Christ.
***
It seems funny that I would remember something so specific, but I did. The LAD is called "the widowmaker," not only by Joan Didion's husband's cardiologist, but by every cardiologist, apparently. According to the website Medical News Today,
The authors of one 2018 study found that widowmaker heart attacks led to the highest increased risk of death, heart failure, and stroke in comparison with other types of heart attack.
I thought of Didion's book the moment I saw my test results, but I didn't pull the book down and re-read it until yesterday. I was afraid to. But actually, when I paged through it, I was slightly reassured. Her husband didn't have a LAD heart attack out of nowhere. Seventeen years previously he had an angioplasty, and in the months preceding his death he had increasingly uncontrolled arrhythmia and a pacemaker inserted. In other words, he'd been dealing with heart disease for a long time. I, on the other hand, just found out about mine this week.
Of course, they say about 50% of people find out they have heart disease when they have their first heart attack.
***
It's actually a little bit like what I was dealing with last weekend, when we had that fire. Walking around the house, deciding what to bring with us if we evacuated, deciding what was important to me, what really mattered.
Now there's no fire, but there's a sort of disaster happening inside me, and I'm doing some of that same sort of evaluation. Something along the lines of, if I died tomorrow, what would I want to have accomplished? What do I need to do before I die? Interestingly, it's apparently not important to me to have written or published anything. I guess I knew that already. I really like to write, and I've always felt bad that I never pursued that more seriously, but when confronted with my own mortality, doing some more writing is not high on the list. I have thought a little about writing a life story, an abbreviated one, and maybe I'll work on that, I don't know. It's certainly been nice to have my mother's life story available to refer to, and also Uncle Bob's.
But the big thing, the big screaming thing that's keeping me awake at night is my kids! What can I do to help my kids, if something happens to me? Yes, they'd still have their father -- assuming nothing happens to him, and given what occurred last summer I don't think I can assume that -- but how terrible for two 14-year-olds to lose their mom. Even a totally inadequate mom like me. Nobody loves you like your mom loves you, nobody takes care of you like your mom takes care of you. The thought of leaving my boys motherless is terrifying.
Anyway, I guess I'll stop here. After my appointment with the cardiologist tomorrow I'll post an update, just so I don't leave people hanging.
***
Update: Well, I saw my cardiologist today and it was interesting. He said he and a colleague reviewed the results of my stress test and both came up with the same answer: they don't know what's going on. I might have serious heart disease and I might not. He said with a "diagnosis" like this, studies show that treating me with medication has just as good an outcome as doing a cardiac catheterization and putting in a stent (I had read this too, and wondered about it). So he could just put me on medication for the next 30 years and that's it. However, he would much prefer to do a cath so that we actually know what's going on with me. And I agreed. I hate the mystery. I want to know whether I really do have heart disease, and if so, what it looks like.
So, I have an appointment to do this on Tuesday, April 19th, two days after Easter. Rocket Boy is going to fly in that Saturday, which is kind of fun because it means he'll be here for Easter for the first time since 2018. He'll stay a week to be sure I'm OK -- if the cath shows nothing, I'll go home the same day and all will be well, but if the cath shows something serious I might end up staying in the hospital overnight or for a few days, so it's best to be prepared. The procedure will be done in Loveland, so we'll send the kids off to school that morning and then drive to Loveland, which takes about an hour.
And in the meantime I have to start taking a beta blocker twice a day, oh joy, more drugs, and not do any strenuous exercise. Just in case. And after the cath, if they do find something and put in a stent, I'll have to take Plavix and something else for a year -- so he asked me if I had any elective surgeries planned, because if so, I'd better postpone them. I said no (good thing I've already dealt with my parathyroid problem).
I feel better. Of course, now I have to get nervous about the cath -- but just the thought that maybe I'm actually OK after all is like a window opening. And if I'm not OK, we'll know for sure. Both would be good outcomes, though one is better than the other. Anyway, on we go.
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