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Archive for the ‘gratitude’ Category

A week ago I completed my Cardiolite Exercise Test at the cardiology lab. My heart rate was a little elevated so I reached the 85% of max a little sooner than I usually do. No worries… it stands to reason after having two interventions in as many months, not to mention running on a 14% incline is nothing to sneeze at.

On the weekend things took an interesting turn. On Halloween I was taken to the ER at Hamilton General with similar symptoms as before when I had a 90% blockage. Let me say that the ER is a very strange and unusual place on Halloween especially when there is a full moon and a time change causing the nurses to have to work 13-hour shifts amidst the craziness. On Sunday I was transferred to the cardiac ward and scheduled for an angiogram to see what was causing symptoms that the doctors believed to be unstable angina. At first I shrugged off the discomfort and figured it was from running so soon after coronary intervention.

This brings us to Monday evening post-angio. There was nothing wrong from a cardiac perspective and anxiety had also been ruled out as well. The two places where I have stents are “widely patent” which in layman’s terms means that they are clear and blood flow is really good. The one bit of scarring that has caused a blockage they can’t do anything about is “well collateralized” which means I have new arteries handling the blood flow. That’s a good thing. So what was causing this pain? It turns out, or so we suspect, that I was experiencing a well-known side-effect to a blood thinning medication called Brilinta (ticagrelor) although there was some differences of opinion between my doctors. I started on this medication three weeks prior by the same doctor who I ended up reporting because he didn’t take my heart condition seriously. This certainly didn’t help my confidence levels that the medicine was the right one for me. On Tuesday morning I discontinued the Brilinta against the wishes of the doctor on the cardiac floor at Hamilton General. Instead I took a loading dose of the blood thinner that I was on up until early October. With that, the pain has completely vanished and I feel better than I have in months.

Once again there were issues with having to be aware of my condition and voice concerns to a doctor from the cardiac ward. He was going to prescribe a medication to help with the symptoms rather than remove the medication that was triggering the issue. The thing is what he wanted me to take lowers heart rate considerably. As a runner, my resting HR already sits around 50 bpm and if it were to be lowered further that could be actually a bit dangerous. When I spoke up the doctor realized his mistake and agreed. This puts me back at the realization that so many people would have just done what the doctor said without question. Being educated about my disease and advocating for myself has proven to be such a vital thing.

I came home after that, on Tuesday, and called my cardiologist, Dr. J.’s office. His assistant spoke to him about my refusal to take the Brilinta, my return to the other blood thinner, as well as the results of my Cardiolite Exercise Test. Yesterday morning when I was having tea with a dear friend I got that call that he felt going off the Brilinta was a wise choice. She also relayed that I had done very well on the treadmill, my heart is stable and I can resume running, cycling and most things at the gym in a few weeks. The only reason I can’t return immediately is that they did the angio on Monday via my femoral artery and I need a bit of time to heal. I can also resume weight training in late November or early December.

I have a few tidbits of running news.

I’ve signed up for the 5K distance at the Mercedes 10K race in Oakville on April 24, 2016. My husband Bryan will be running the 10K and it we will so some of our weekday runs together.

The other bit of running news is wonderful and it involves another Spring race… but I can’t share the details just yet. As soon as I am able to make things public I’ll post my news. What I can say is that a tremendous and exciting opportunity to make a difference has sprung out of the heart health hurdles I’ve had to jump these past months. I’m going to take this wee bit of down time to make a realistic training plan with the mind and there may be some shoe shopping… oh and my running playlist could use an update.

It’s all part of moving forward with strength, courage, and strong spirit… i mua.

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Here we are again with yet another of my post-hospital updates and I am hoping that this is the last one for a very long time. This was quite the adventure so you might want to get comfy for the long read. I’m going to start off by thanking my family and friends who were such a big support last week while I was in hospital and Bryan was stuck in Germany. I am grateful to have such wonderful people in my life.

You are likely wondering what happened seeing as I had an extremely mild heart attack in August and everything seemed to be going quite well. Things went a little haywire and I’m posting my story to illustrate how imperative it is that we advocate for our health—to realize that not all physicians know our bodies as well as we do.

I was back to running and feeling better than I had in a very long time. I had the all-clear to train for events again but I needed to build my base first. A Spring half-marathon was on my mind and my Cardiologist, Dr. J. was on-board with that as well. I went for a run on the trails with my teenaged son on the Sunday and then to the gym on Thursday. There was lots of walking on the days inbetween. It was almost 35K in a week which was more than I had done in some time but I was very cautious about not overdoing things. Friday evening I was tired but I figured that was because I was getting up really early every day and reading late into the night. Saturday I started to have warmth on the back of my neck, shoulder and arm. I went out to the camp gathering we were hosting and came home early. By Sunday it had worsened. My husband Bryan was heading to Germany for an important work project so I sugar-coated how I felt and he flew out Sunday on schedule. By Monday morning the pain was so horrible that I made the decision to go to the Emergency Room at Brantford General Hospital (BGH). I was sent home as the doctor felt it was muscle strain. Tuesday morning I walked my daughter to school and I also walked her home at the end of the day. The pain was worsening. About an hour after she went to bed it was as bad as it was before I went to the hospital back in August. I tried the Nitroglycerin spray that I had been prescribed and, after the third dose didn’t provide any relief,  my son helped me get ready for the hospital. I was on the verge of collapse so an ambulance was called.

Once in the ambulance the paramedics were having a tough time deciding if I should go to Hamilton or Brantford. My ECG wasn’t bad enough for them to take me straight to Hamilton General so BGH it was. I was taken immediately into the ER and my Troponin levels were tested repeatedly… they came back negative for heart attack. During the last round of blood work the technician couldn’t even get a teaspoon of blood from my right arm which was strange. The fact that I wasn’t having a heart attack was a relief however there was still gripping pain like someone was squeezing my heart. Sometime in the wee hours Wednesday morning I had relief from the pain because of a multitude of nitroglycerin doses and pain medications. I finally saw an Internist who told me he had a strong background in cardiology. We’ll call him Dr. A for now. We talked about my horrendous family history of heart disease, what I had been through, and then he said “I’m not accepting patients right now but I’d like to take your case on in my private practice.” Then he went on to say that he felt this was unstable angina and that he thought my cardiologist gave me false hope about the collateral artery business. Dr. A. acted as if Dr. J. was clueless. He wanted to send me home with an increased dosage of blood pressure medication, a nitroglycerin patch, and a pain medicine that I believe he said is normally used for gout so I wouldn’t feel the symptoms. I don’t have gout so I wasn’t sure how that would help but maybe I was missing something. I asked if I would be able to exercise. He bluntly said “no”. I asked if I would be able to walk Kaia to school. He said “no” again. So there it was… his solution was to cover the pain and have me become completely sedentary—a couch potato.

Not acceptable!!

My intuition told me I was heading for another heart attack. I knew I had a blockage… after all I’ve been in this position before and remember all too well what it felt like. I told him that I have a cardiologist that I quite like and that I live an active lifestyle that I am not about to give up on that easily. I insisted that he send me to Hamilton General for an angioplasty. Dr. A. told me that this idea was “ridiculous” as I had just had one in August. He said I “would be wasting everyone’s time” and that I just “need to learn to live with this unstable angina”. He told me I had done this to myself and I had to take my lumps. I let him know that if he discharged me I would go above his head at BGH or straight to Hamilton General’s emergency department. I mentioned that I know my body and that this felt just like it did the last two times. I asserted myself and he reluctantly relented. Dr. A. learned just what a strong advocate I am for my health. I told him that it seemed to me his policy was to wait until the patient has a heart attack rather than try and prevent it while my cardiologist’s approach is prevention. I reiterated that I was not about to go home and sit on my ass and wait for something more serious to happen.

Unbelievable!

Finally, after I protested quite strongly, Dr. A. gave in and said he’d call Hamilton General to see what they thought but that they would not likely take me in for an angiogram. He felt that they would deem it as useless as he did. He was being very pompous and clearly didn’t like that I dared question his judgement. He seemed very frustrated with my denial that his first choice of treatment was the right course of action. I didn’t care because this was my life hanging in the balance.

Come Thursday morning Bryan was still trying to get a flight home but I insisted that he stay and finish his work. Everything here was under control. I was booked to go to Hamilton for 10 am with the procedure to be done at 1 pm. Dr. A. came into see me before the transport and said “You can still stop this and save everyone a lot of resources. They will not find anything!” I retorted “You’ll find out today just how much I know my body.” I was upset that he would even say this to a cardiac patient before an invasive procedure. He was quite snotty about the whole thing and seemed aggravated that I even questioned his diagnosis and treatment plan.

I was transported to Hamilton shortly after the doctor left. The nurses remembered me from last time and were shocked to see me back. One of the nurses left my file where I could reach it so I decided to read through the report from the doctors in Brantford. Dr. A. and the doctor from Monday’s ER visit had put in my file that I suffer from acid reflux among other falsehoods. I think the only time I’ve had anything remotely similar to that is when I was in my last weeks of pregnancy and when I had the heart problems in August… that was my heart not reflux. It was also stated that I saw Dr. J. in September because of continued chest pain. More BS. I saw him because I underwent testing to see if I could get back to running and the gym. The notes painted an incorrect picture which I assume was because the staff didn’t pay attention to the history I was giving them or perhaps it was to cover someone’s ass. Who knows? Still, it was incorrect. The nurse reprimanded me for reading my file when I drew this to her attention. Oops. Apparently I am not allowed to see my medical file without permission even though it is about my health. Go figure.

The angiogram started right on schedule which is quite unusual—it’s a busy place. This time I had Dr. T. who is the same surgeon I had for the first angioplasty in March 2014 when I also had a similar battle about getting checked out. He is a fabulous surgeon and back then had found a blockage that many doctors would have overlooked as it appeared to be a shadow on the imaging more so than a blockage. This was due to it being near an abnormal bend in the artery. I was conscious, as always, during the procedure which is rather freaky. I couldn’t feel my body but my I was lucid and aware of what was going on. He accessed the heart through my right wrist and found a blockage, with the similar shadowing issues at a bend—this time in the other side of my heart. He looked at my right coronary (RCA), for what seemed like an awfully long time. He called in another surgeon to look as well. The contrast dye was increased and sure enough my RCA had a 90% blockage. He used a balloon and a stent to repair the issue. The investigation and procedure took just under two hours. It went flawlessly and I was sent to recovery. I had a slight hematoma starting in my wrist as the clamp was loosened but the nurse was right on top of things unlike last time with my leg.

Later Dr. T. came to see me and I asked if this was a new blockage. He said that was somewhat unlikely for a blockage of that size to pop up in less than two months but it can happen. He also told me that I have a myocardial bridge. That’s something I would have been likely born with but, despite two previous PCIs no one has ever mentioned it. Dr. T. said it was brilliant that I knew my body so well and advocated for the angiogram because had I not this would have resulted in a heart attack causing a great deal of tissue death or, even worse, my demise.

Gulp!

I was transported back to BGH at 7 pm. I got settled back into my room and Nurse Judy came to see me. I told her what had happened and that I wanted to see Dr. A. in the morning to talk with him. She said that she already saw the report and of course he would see me… after all he would be the one releasing me so it wouldn’t be an issue.

Fast forward to last Friday morning. Nurse Judy came with my release papers and they had already been signed by a doctor without anyone coming to see me. I signed everything and reiterated that I would like to speak with to Dr. A. I could hear his voice down the hallway. Two hours passed and Dr. H. came to see me instead. She got quite the earful albeit very politely as it wasn’t her fault that Dr. A. put her in this awkward position. Dr. H. also saw me back in August and knew a bit about my situation. I explained to her that I was upset with what had transpired and that I planned to pursue the matter of his unprofessional behaviour with the proper governing authorities.

What angers and scares me about this is that some most patients would have just accepted what he said to be the right course of action because he is, after all, the Doctor. I can’t fathom that Dr. A. was going to put me at risk for a potentially fatal heart attack so he could drum up business for his practice and how much he was belittling me in the process. I’m upset that he didn’t take my symptoms seriously and treated me like I was wasting resources. I’m appalled that he didn’t have the integrity to come and face me when it turned out he was very wrong. He could have at least apologized but I suspect this is a case of ego. What an… insert whatever expletive comes to your mind.

The bottom line and the reason I share this is to remind all of us that we need to advocate for ourselves because sometimes doctors are driven by agendas other than doing the best for their patients. We have to educate ourselves and be assertive about our care because, in many cases, the reality is that we are just another number. I was “bed 1 in room 558 on the 5th floor”.

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If you’ve been following my blog ramblings for any length of time then you’ve read about my battle with heart disease. If not, let me get you up to speed. If you already know about my journey then feel free to skip ahead to the update.

My History

I have horrible family genetics when it comes to premature coronary disease causing death and there is also a history of diabetes. Couple that with my former self being severely overweight and sedentary… well you have a ticking time bomb. That would have been the case but I decided, after watching family member after family member suffer from heart disease, that I was going to change my life. I lost weight. I lost a lot of weight. Then I was diagnosed with diabetes. I became even more proactive about my health and reversed the need for diabetes medications. I fought for my life and fought hard.

I saw a cardiologist for a full work-up when I first started running. I had to push for this because it isn’t a standard part of a physical from a family doctor. I was diagnosed with left ventricular hypertrophy (LVH) and my aortic valve had a very mild stenosis. The LVH was likely due to my former size as it was reversing. Things were going swimmingly and I ran my first half marathon. Then I accidentally kicked a dumbbell and broke two of the toes on my left foot. After they healed I returned to running and my cardio was worse than it was when I was obese. It didn’t make sense. I thought something wasn’t right, that this was more than a setback due to the toe business. I went to the cardiologist and failed a treadmill stress test but before I got the results I decided I should go to the emergency ward. I still felt really off. Less than a week later I was at home recovering from what is called Percutaneous Transluminal Coronary Angioplasty. In other words, I had two stents placed in a branch off the left circumflex artery. You can read the whole story in the blog post named Fixing My Broken Heart.

I had to come to terms that no matter how perfectly I did everything, genetics will always play a role. My cardiologist, Dr. J. has explained to me that I am doing everything right and that is why I didn’t have a heart attack or heart damage despite having a significant blockage. He told me my heart was strong. I was cleared to run a full marathon but I was to avoid things like heavy lifting. What followed was months of anxiety. Panic would set in when I would run longer distances. I was stressed and upset. I dropped out of all my races including the marathon. I had worked so hard to prevent heart disease and I was very disappointed in myself even though I didn’t have control over much of it due to genetics. I was bummed.

The update

So, now that you have the background, here is what happened on Friday’s visit to Dr. J. I stressed for days about it. I went to my appointment expecting to be told that I had to limit things like weight lifting at the gym and serious hill training for races like Run for the Toad. What happened next caught me off guard. Here is how the appointment went…

I had an echo-cardiogram first, followed by an EKG and measurements for blood pressure, weight and abdominal circumference. Finally it was time to consult with the doctor. Dr. J. is a rather pompous guy but not so with me. Well, not since the first visit when he started to lecture me about weight loss and I handed him my before photo. He knows I’m really proactive and that I take his advice very seriously.

So I am still dealing with Familial Hypercholesterolaemia (say that five times fast) and that is something genetic which I have no control of. In other words, I will likely be on a cholesterol lowering medication for the rest of my life no matter how healthy a lifestyle I lead. Thanks Dad! We talked about some new research into a monthly injection that has had great success in Europe and is going through trials here. It won’t be available to me for several years but it could be an alternative that is less harmful to the body.

The verdict… everything is great… really great! I can go off the blood thinner in 60 days. No more polka dot bruising from having NERF dart wars with my kids. No more anemia! I asked about lifting heavier amounts at the gym. I asked about training for Run for the Toad and other trail races where there are wicked hills. When I heard his response I was compelled to ask him two or three times to be sure my ears weren’t deceiving me. I have the all clear for anything I want to try. He said run hills, climb mountains… whatever I want. In fact, I have NO restrictions whatsoever!! I had to completely restrain myself from doing a happy dance in Dr. J.’s office. NO restrictions!!

Much of the success of this appointment and all of what I have been through with my heart and with diabetes has been due to my dedication to having a healthy lifestyle. Losing weight in a healthy way, keeping fitness fun, and having a balanced way of eating has proven to be the best medicine. I may not be skinny but I am healthier than I have ever been.

PS I did the happy dance in the driveway when we got home… lol.

PPS I’m going to tackle Run for the Toad again. It’s redemption time!

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Seven months ago today I had been transported, by ambulance, from Hamilton to Brantford after undergoing the Percutaneous Coronary Intervention (formerly known as angioplasty). Later that afternoon I was released and I began the process of recovery.

Physically I recovered very quickly but emotionally the journey has been a little more difficult. It has been hard to try and wrap my head around the fact that I am okay. It freaks me out to know I have something foreign in my body. I underwent all sorts of post-procedure testing and that indicated that there could be a mild and reversible issue or that my ample bosom was interfering with the scans. In other words, I’m fine. As you know, I had been cleared to train for a marathon so that in itself was pretty positive. Yet, here I was struggling with runs and breathing. Five minutes into things I would start having troubles and my mind would automatically go to thoughts of it being my heart again. It seemed to be getting worse… until…

Starbucks with Carla.

Back at the beginning of October, Carla and I decided to catch up with one another over coffee at her favorite coffee shop. The next thing I knew my dear friend had convinced me to go for an orientation at The Athletic Club (TAC) here in Brantford. I can’t remember how we actually got on the topic but next thing I knew we were touring the brightly lit facility. She didn’t pressure me but she did share her passion for working out there. I could see why. TAC is open, bright, and not the least bit intimidating. It wasn’t at all what I had anticipated. So, on October 4th I committed to becoming a member for a year. Quite honestly, I have toyed with the idea on numerous occasions but Carla gave me the gentle push I needed.

With membership at TAC you receive a fitness assessment as well as a personal training demo. I went in to see Kelly Harker and we spent well over an hour discussing my history, current health, lifestyle, and goals. Kelly did all sorts of fitness tests and gave me a copy of the results. I have some work to do. Body fat is still a concern, but I knew that going in. I still can’t do a push-up to save my life. Well, okay… I managed one and even that was modified. Apparently I have average strength biceps… that one shocked me. I would have expected a poor rating there. My flexibility is shot… I used to be able to sit and reach well beyond the tips of my toes (lol – I’ll just blame that on being a runner).

I had gone in with extremely low expectations surrounding cardio-fitness because, when it comes to my health, I’m a realist. I had been off with broken toes, heart issues, and bronchitis that verged on pneumonia—it was one hell of a year. With the time away from training I had expected my cardiovascular ability to be close to rock bottom. After all, every time I would run I would feel like I was immensely out of shape in that regard.

face your fears

face your fears

I braced myself for the news that my suspicions were correct, however, my VO2Max was much better than I thought. I had expected to be in around the 21 V02Max range which is quite low. The actual assessment was much higher at 33.2 which is considered good. What!? At first, I thought maybe she had made a mistake. It was at that moment I realized the breathing issues I have been having when I run are not physical… I was dealing with anxiety. Knowing that has been a gift that has allowed me to move beyond fears that my heart issue wasn’t fixed. That one simple act of going to Starbucks with Carla that day started me on a course of action that would lift a great weight from my shoulders.

While I have your attention, I should update you on The Fall Challenge that I decided to do in order to support my friend Kim.

Here is where I am at…

Nutrition

I have done well with all the goals I set out for myself except I still need to focus more on breaking the habit of having lunch in front of the computer. I could still do with incorporating more dark leafy vegetables too.

Fitness

I’m walking, running, and working out at the gym where I am concentrating on the areas that need some attention. I met with Jenn Jones, a Personal Trainer at TAC. Jenn gave me some pointers on how to achieve my goals which are to increase strength especially in the core, reduce body fat percentage, bring up my V02Max even more, increase flexibility and lose a little more body weight in a healthy way that I can maintain over the long term.

I am somewhat lacking in discipline when it comes to doing the daily yoga flows and will continue to work on that during the last bit of this challenge. Soon enough it will be second nature.

Posture

I’m continuing to work on correcting decades of poor posture. It’s tough but I am determined to stand tall. The gym has mirrors and that certainly helps me check my form when I am lifting and such.

Other

I’m sleeping better. There are a few exceptions to this, like when my little girl has been coughing in the night. Cutting down on the caffeine and exercising more has been quite helpful in this regard.

So there you have it. I’m back to my run-bunctious self.

I feel good great for the first time in over a year. I’m starting to sign up for running events that will take place in 2015 and my enthusiasm for fitness has returned.

And… I couldn’t have done this without the people who have encouraged me, believed in me, and lifted my spirit.

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A mere month ago I underwent a percutaneous transluminal coronary angioplasty also referred to as a percutaneous coronary intervention.  Before I could return to running I had to get the all-clear from my cardiologist which included having some tests.  I had one left to complete and after having to cancel and reschedule this cardiology appointment a few times, I finally underwent the myocardial perfusion on Friday morning.

What is myocardial perfusion? Well, it is a test to check blood flow in and out of the heart. They use a nuclear isotope called Cardiolite as a tracer which is injected through an IV in the arm and a gamma camera takes photos. To make a long story short, I had two of these photography sessions. One was prior to exercising and the other after running at a good incline on a treadmill. I believe I was at 18% incline when I asked to have the test stopped. Don’t be alarmed, it wasn’t my heart but my lungs. I’m recovering from what feels like bronchitis. I was almost 11 minutes in when the coughing reared its’ ugly head. The whole process took about 4 hours or so.

At the end of the day I decided to call for results. What can I say? I’m not a very patient person when it comes to this. The cardiologist, Dr. J., had the images but didn’t have time to look at them. I really didn’t expect that he would and the kind lady told me to call back Monday morning. I was naughty and I went for a little 1K run on Saturday before getting the all-clear from Dr. J. I knew from past experience that everything was okay and I took it easy because this cough still lingers. I made sure that someone was close by. I threw myself into other things so that I would stop thinking of the “what ifs”. In the back of my mind I kept thinking that the coughing somehow affected the treadmill portion of the test.

Monday came and I called. A different lady answered my call and said it would be 7 to 14 business days!!

What?!?!? My heart sank.

Dr. J. had promised that he’d have an answer for me within a day or two of the test and that I’d be running before the end of the month. She said she would send him an email. I politely thanked her and then waited until late in the day to call back.

When I called back this time I was talking with the lady I usually do. She opened my file and said that there was a note on it giving me the go ahead to train for the first full marathon but to really listen to my body. He also left a note that he doesn’t want to see me again until October. The test was a success despite my hacking session!

I can run again!

The first word that comes to mind is gratitude.

I am grateful for my children and my husband. Their unconditional love means the world to me.

I am grateful to be here for my children and that they can have a Mom who is active and vibrant.

I am grateful that I can run again and that my choices over the past decade have made that a reality.

I am grateful for all the people in my life and that I made a courageous choice to only surround myself with people who lift my spirit. The support I received through all of this shows that I have made the right decisions there. The visits, phone calls, emails, and messages kept me moving forward even on the days when I couldn’t see that a positive outcome was possible.

Now I guess it is time to look at training plans. My first full marathon is a mere 25 weeks away and I have a tough summer of training ahead of me. Scotiabank Toronto Waterfront Marathon… here I come!!

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