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farewell to 2015

In a few days 2015 will be drawing to a close. In many ways it was a wonderful year but part of me is glad that it is almost over. Don’t get me wrong, there have been some tremendously special moments even if it was quite the roller coaster ride.

The year started out positively enough with my cardiologist lifting all restrictions and I began to kick things up a few notches at the gym. It was much fun and without the restrictions I was able to work on lifting more weight. I was getting stronger. I would often go with my friend Carla and then we’d go out for tea or on a shopping excursion.

I started to knit more especially seeing that one of my very best friends was expecting. I swore at the beginning of 2015 that I would not end up with a yarn stash bigger than a single Rubbermaid container. My knitting and crocheting friends laughed but I insisted I wasn’t going to stash yarn. Well, I’m close to starting my third container. Oops. We won’t talk about the KnitPicks needle purchases. I managed to finish quite a few practical items including a blanket and hat for my friend’s baby, several winter hats for my daughter, baby washcloths, dishcloths, and a few cowls. I still have a poncho, a left yoga sock, a baby sweater, and another baby blanket to finish. Knitting really helped me get through some of the more difficult moments of the year.

I re-evaluated many relationships and made great change there. There were a few toxic people in my circle that I needed to distance myself from. This has been a recurring theme in my life as I tend to be overly accepting and kind even in instances where I probably shouldn’t be. I also tend to be too forgiving. My life has been much less stressful without the drama. While they may have been lovely people, sometimes that just isn’t enough. When someone is not respectful or honest with me then I am forced to make difficult choices and that meant that I had to put myself first by distancing myself from those who are not mutually supportive. These changes made room to grow relationships with other people where there is a balance between give and take.

I booked quite a few races for 2015 including a half marathon but unfortunately only managed to run at one event. It was painful for me to have to drop out of event after event and let my friends down. I did manage to run and walk at the Long Point Eco-Adventures’ Smugglers Run Trail Race in July. In hindsight, that might not have been such a good idea but at the time I was oblivious to the fact that my body had created scar tissue inside my stent and into my left circumflex artery. Still, the run was fun and memorable.

aerial

aerial obstacle course

We took our children to Santa’s Village in Bracebridge, Ontario for four or five days and they had a blast. So did Bryan and I. The guys completed the aerial obstacle course and did the whole ziplining thing at Sportsland. My little girl did her first flips on the trampolines there too. Santa’s Village is included in the camping package and is quite a lot of fun. The Sportsland side isn’t and it can get expensive, however, the adventures great albeit geared to the older kids and kids at heart. Santa came to our campsite a few times and the Elves even dropped off a gift in the middle of the night—it was like Christmas in July. My five-year old daughter was delighted and full of wonder. I think she may have even overfed Dasher. When we weren’t across the street at Santa’s Village, we were in the swimming pool cooling off.

One of the highlights of that trip, for me, was being able to perform a random act of kindness. As we were packing up to leave I took a half bag of wood to a family at a neighbouring campsite. This is something we always do when we are camping. This time around we had some extra Sportsland tickets to pass on as well. A grandmother was sitting at the picnic table while her grandchildren were at the nearby playground with my children. A tear streamed down her cheek as she thanked me over and over again. Then she struggled to her feet and gave me the warmest embrace. Sometimes we receive the best gifts in giving to someone else. You see, Grandma had mobility challenges and a limited income but took every cent she had to do this trip for her grandkids. She was their only guardian and wanted them to have some wonderful summer memories. She went on to mention that, after she paid for the camping package, she’d had only enough money to buy wood for the first night’s campfire and they wouldn’t be able to have a fire all weekend. It was Thursday and now they would have wood for a second night which she would save until Saturday. She was so grateful because she would get her pension on Monday and only then would she be able to buy more wood. I wished her well, told her I was glad that the wood would go to good use, and said goodbye. I spoke with Bryan and we agreed that my son and I would walk up to the office and pay for wood, as well as kindling, to be delivered to her campsite each day anonymously. The owner of the campground, Sarah, was so moved by what we were doing that she covered the cost of half the wood so that the family wouldn’t have to worry about a campfire for the rest of their stay.

A few weeks later, I learned how to shoot a handgun. Our family belongs to a local shooting range where Bryan and Tobias like to target practice with the bows and firearms. Bryan thought it would be a lovely to have a date night at the range. Firearms aren’t really my thing at all but I support his hobbies just like he supports mine. The handgun we were using was a Smith & Wesson M&P 9mm. Bryan was positive that he was going to show me how it was done so he suggested a little friendly competition. I’m pretty sure that he figured it was beginner’s luck at first. By the time the third target sheet was finished he was ready to admit defeat. I’m a pretty good shot. It makes me smile to think that after two decades of marriage I can still get him to look at me with a twinkle of surprise. My arm was pretty sore from the recoil but it was much more fun than I expected.

sunset-cyprus

sunset at Cyprus Lake

Then it was off to Bruce Peninsula National Park, the Grotto and Cyprus Lake. We opted not to go canoeing again this year. While we adore paddling there are other things we want to do as well. Looking back, it was likely a good thing we weren’t in the wilderness this summer. I didn’t feel well on this trip but I thought maybe some of that was because my arm was sore from the adventure at the range and too many late nights. Later I found out it was because of scar tissue in the arteries of my heart which lead to the mild heart attack two days after coming home. Had I come home when this first reared its ugly head, I could have possibly have avoided some of the issues. It is what it is and there is no sense dwelling on how things may have been different. I wouldn’t trade hiking to Indian Head Cove with my son for the world but I should have listened more carefully to my body. Lesson learned.

September came, school started and I had the all-clear to start running again. Bryan headed off to Germany at the beginning of October and I ended up in the hospital again. This time there was an issue in another part of my heart and I had to fight to get the care I needed. A third hospital visit was necessary at the end of October. Thankfully that one turned out to be a mere reaction to a new medication that was prescribed by the hospital a few weeks before.  At the beginning of December I was given the all-clear to start running and going to the gym again.

This year, for me, was not just about physical survival, it was about surviving emotionally too. The loss of my Mom in 2013 returned with another tremendous tidal wave of grief and the heart issues also hit me really hard mentally. This wave of sadness wasn’t just because of missing her and the realisation that I came a little too close to having my own children grieve for me—this summer our friend Chuck passed away. I couldn’t attend his memorial because of my own health so I will be running in his memory for the 10K Run at the Ride for Heart as my way of honouring him. Chuck’s passing is one of the reasons I chose to accept the role of Run Ambassador for the Heart & Stroke Foundation. I am still here and that is a great gift not to be taken for granted.

The rest of the year was the same as any other. Many weeks I was a single parent and that wasn’t without challenges. Fortunately I was able to work from home so that helped tremendously as did my in-laws when I had to be rushed to the hospital. Bryan’s promotion to manager for Canada meant that he was busier but he loved the challenge, so it was all good. He was away a great deal including a second trip to Germany which occurred shortly after the attack in Paris.

It’s a good feeling to be on the threshold of a new year. There is a saying about it being akin to a book with 365 blank pages waiting to be filled with all sorts of wondrous adventures. I love the anticipation and excitement about what is ahead for me.

This year was about i mua (pronouced ee mooh-ah). It is a Hawaiian saying that means to go forward with strength, courage, and strong spirit. That theme will carry on throughout 2016. On Friday I will welcome in the New Year and give you all a glimpse of what is to come.

 

a run for heart

I chose last Saturday for my return to running because it was the anniversary of when I started a Couch to 5K program to train for my first race (2011). It felt amazing to run after being off pretty much since summer, even though the reality is that I have to rebuild my running base from the beginning again. As much as my lacing up again is good news, it isn’t all of the news I have to write about today. In my last post I mentioned that I had something to share about an opportunity to make a difference that is tied in with a Spring Race.

Back in mid-October I wrote a blog entry that illustrated how very important it is for people, especially women, to advocate for health care when it comes to matters of the heart. I often share the link on twitter and, a few days after, I received a direct twitter message from Seanna at Running Well. She told me how moved she was by my experience at the hospital and asked me if I would consider being a Run Ambassador for a new running event being held alongside the Becel Heart & Stroke Ride for Heart on June 5, 2016. It is a Run/Walk along the Gardiner Expressway in downtown Toronto. As far as I know this is the only run to ever be held on this particular street. There are 5K and 10K runs as well as a 5K walk. Even better, it’s a family friendly event.
I didn’t even have to think about it.

YES!

RFH_F16_Ambassador_Facebook_1200x1200_v1I didn’t take this decision lightly as I have a tough road ahead when it comes to rebuilding my fitness. There are so many positive reasons to take this on that saying “no” was not an option. This run is for an organization that is close to my heart because I am a survivor and because of my family’s history with heart disease. I would love to have my story inspire more people to take the first step and do something to change their lives. While I hope that I have been able to do that already, I’m always game for other opportunities to help people find their fit side. Of course there is that message that my experiences send about the need for all of us to be proactive in our own health care whether that be with heart disease, diabetes, or any other health challenges we face. Running has been such a big part of my healthier life and being able to share that motivates me to keep moving forward.

I will be running the 10K. My goal is to run strong so I’m starting with a 5K program and then I will jump into a 10K program once my 5K base is solid. With the event being in late Spring it gives ample time to do this well.

It is my hope that people will choose to train alongside me using social media. I would love to have you share your efforts with me too because I find it very inspiring. You will find me on twitter and instagram as @innerpossible plus on DailyMile. I will be posting all of the fit things I am doing to work back up to the 10K distance and using the hashtags #RideforHeart, #CreateSurvivors, and #RunforHeart. You may also want to follow @TheHSF on twitter, Instagram, and Periscope.

If you’ve never run before, seriously consider this race as your first event. Running is a wonderful way to get active and events, such as this one, are fun. If you decide to do this, please send me a note. I would love to offer my support and encouragement. If I can do this, you can too!

Registration for the event opens December 3rd, however, I will be sharing a discount code soon. Stay tuned!

i mua

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.

There is a Hawaiian saying that I love… i mua (pronouced ee mooh-ah). It means to go forward with strength, courage, and strong spirit.

I wish that for all of you.

Today is about moving forward for me as well.

I finally have a plan of action from my cardiologist. Dr. J.’s patient coordinator, K., and I have worked out a plan after several calls and emails back and forth. He doesn’t want to see me before I do another Cardiolite Exercise Test which will happen two weeks from now. It means I have to get up at the crack of stupid but what runner doesn’t do that—I’ll be running and even if it is only for a test, I’ll embrace every wonderful moment!

This time around, Dr. J. doesn’t want to consult with me after and instead he’ll let K. know if I can start running and going to the gym again. She said she’ll just wait for my call after the test but to give her 24 hours—apparently I have a bit of a reputation as the exuberant runner who calls the very next morning for results. Even though we both feel that I can be back to regular activities by early November Dr. J. just wants to be thorough given my history of surprises. The treadmill test with the cardiolite scans will show what is going on under the duress of exercise. It uses something called the Bruce Protocol which increases speed and elevation in timed increments. Generally it reaches an intensity that is above my norm. Think of a really steep hill that never ends and then, as you go higher, a grizzly bear starts to chase you so you have to run all out. It’s difficult but wonderful because it means I get to run even if it is for about ten to twelve minutes. From this testing the technicians and doctor can see many aspects of my heart function before, during and after the exertion.

I already have a follow-up echocardiogram and consult booked for December because of what transpired in August and we decided that I should continue with that appointment. I’m not at all surprised that Dr. J. doesn’t need to see me before then. I suspect this is because he knows that I am a very proactive patient that will do what’s best for my health by taking the necessary steps if an issue arises.

The best part is that if everything goes well I will be back to running in the next two to three weeks!

Yes… i mua seems to be the most fitting of sayings—moving forward with grace. 

on being an advocate

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”.

leaving the comfort zone

You might be wondering why I chose “leaving the comfort zone” as the title for this entry. It seems fitting given what has transpired in the past seven weeks and I believe pushing my limits is what saved my life.

In my last post I had shared the wonderful news that the doctors felt I should be able to run again. I was still fearful that the Cardiolite Exercise Test results were going to reveal something entirely different that would mark the end of certain fitness activities for me despite how confident the doctors were about my continuing to run and cycle. I couldn’t get it out of my mind that I had a heart attack, although a very mild one. September 8th finally arrived and it wasn’t soon enough for me. After seeing the kids off to school I headed to a meeting with my cardiologist so we could go over the results. It was the longest drive. Every second went by like a minute and every minute seemed like an hour. When we got there I waited with nervous anticipation. Finally, Dr. J. came into the room with a gentle but huge smile on his face.

So here’s the scoop…
There is a new lateral defect and the existing mild defect found after the procedure in 2014 has become slightly more intense. The new defect is very mild and reversible so it’s likely from what happened in early August. The surgeon wasn’t able to deal with all of the blockage because of the location in my heart where the minor artery, the one originally stented, connects with my left circumflex artery. The scar tissue extended into the left circumflex. The surgeon had to choose between the two arteries so it means that I may experience some discomfort. That’s the bad-ish news.

And the good news… first and foremost there is no progression of the heart disease. This was merely a very atypical restenosis of the stent caused by my body creating scar tissue and because of the position of the scarring, as I mentioned above, it affected two arteries making it difficult to deal with in the angioplasty. The restenosis is unusual because this usually happens in the first three months or so and not 14 months later. What can I say? I’m medically weird.

It gets more interesting. When I wrote my last blog entry, I mentioned that my body had caused an additional artery to surface so that it could provide more blood flow to the heart. This collateral artery is basically creating a natural form of bypass. What causes this? Getting out of my comfort zone when running, cycling and hiking. Pushing my limits compels the heart to increase demand and then the collaterals start to do their thing. It is fascinating because most of us have capillaries waiting to turn into collaterals but it won’t happen without endurance types of exercise. If you’d like to learn more about this please read the full article Natural Bypasses Can Save Lives by Steffen Gloekler, MD; Christian Seiler, MD that was published in Circulation from the American Heart Association.

From what I understand it takes three to six months for these vessels (collaterals) to come to full-fruition. While they are tinier than regular arteries, it is possible for dozens to form and increase health to the heart. You have to exercise at a certain level for this to happen. My cardiologist explained if further. “Let’s say you are driving to your city and there is only one highway because no one bothered to build side roads. If there is a traffic jam you just sit there and wait. You will be at a standstill until the roadblock is cleared because there is no other route. Now, if someone had built side roads you could simply get off the main thoroughfare and continue on your way. The arteries in your heart are like that. If you are sedentary and sit on your butt you will never build up these collaterals and when there is a blockage. Whammo! Too late!”

The prognosis… Dr. J. wants me to run, cycle, and go to the gym. Even if I get some discomfort or angina, I’m to work through it, within reason of course. There is definitely a fine line and I’m not to push so hard I have a heart attack. It will require being attune to what’s going on in my body. The physical demands should cause more of these collaterals to surface thus improving my heart even further and continuing to help me battle being a diabetic with heart disease. As the collaterals increase any angina will start to disappear. I asked about the gym and lifting and I asked about hill training. He said as long as I listened to my body, that I could do whatever I felt up to doing. The only thing he suggested was that I wait until the New Year to run any races. So with a copy of the test results in hand, I left his office feeling a wave of overwhelming relief.

If you have been putting off exercise, please take my story to heart and stop procrastinating. Get out there! Find a fitness activity that you enjoy, are medically cleared to do, and be kind to yourself. Leave your comfort zone!

it wasn’t anxiety…

It has taken me three weeks of soul searching to decide if I should post this on my blog. This is a very personal account and it’s difficult for me to put it out here for the whole world to read. I finally decided to go ahead with it because I’ve been quite open about everything thus far and maybe, through the sharing of my journey, I can help someone else who might be experiencing something similar.

As many of you know I underwent a PCI in March 2014. I had a blockage in a small artery and it was discovered, thanks to having a fit lifestyle, before there was a heart attack or any damage. Time passed and I tried repeatedly to train for races earlier this year. I couldn’t seem to train well. I knew I had lost cardiovascular ability but I assumed it was just because I hadn’t run enough. My blog posts spoke of anxiety when I ran but it wasn’t anxiety and what happened next was a bit of a shock to both my doctors and to me.

indian head cove

indian head cove

The first week of August we vacationed at Bruce Peninsula National Park. The first night at Cyprus Lake was simply awful. I had aches in my right arm that I attributed to shooting a 9mm at the range a few days before. I felt fatigued all week but continued to enjoy hikes on the rugged shorelines of Georgian Bay. I had been burning the candle at both ends for weeks so I chalked the exhaustion up to that and pushed through. My neck and left shoulder were a little sore but I figured that was from sleeping on the ground in a backpacking tent. We ended up having a wonderful week and the fatigue eventually passed. We came home, unpacked, and started to settle back into our routine.

Early Sunday morning (August 9th) I went to the gym with Carla. I overslept and basically grabbed an energy bar on my way out the door. I wasn’t feeling the best but I figured a good workout would energize me. I did my usual warm up on the bike but it was much slower than usual. Then we did upper body with free weights before going to the machines to do legs. When I was on the leg press machine I had some mild heartburn which I attributed to the energy bar and being in a reclined position. I was quiet on the ride home which is unlike me. When I got home the heartburn wouldn’t go away even with multiple doses of an antacid. I went to lay down for a bit because the fatigue became extreme. Finally the heartburn stopped, nausea started, and I napped. I got up for a light dinner and felt slightly better but I was still beyond tired.

At 11:20 pm I made the decision to get Bryan to drive me to the ER. I packed some essentials because my intuition told me this was my heart. I was admitted immediately and it was suspected, due to elevated Troponin levels in my blood, that I had suffered a very mild heart attack. What!? I thought maybe I was having warning signs but was utterly shocked that this was an actual heart attack. Where was the gripping pain? The sudden collapse? I mention this because often women don’t have obvious symptoms and a lot comes down to intuition. I knew things weren’t right and I had known since that night at Cyprus Lake. I was ticked. I had worked so hard since I started running to prevent heart disease from being such a big factor in my life, yet here I was.

The next step was to find out why and I was admitted to the Cardiac Ward. Less than 48 hours after arriving at the ER I was transported to the Cardiac Clinic at Hamilton General Hospital to undergo an angiogram to see what was happening inside my heart. I was terrified and thought that I had done all this hard work for naught… thinking the heart disease has progressed. So, what was the cause? A new blockage? Not exactly. The original stents (two drug-eluting stents that overlapped) that had been placed in an offshoot artery last year had closed because of my body creating scar tissue inside the foreign object. This is called in-stent restenosis… bleh. I have other names for it!

I was taken to the surgery for the angiogram and possible angioplasty.  I’d been here before so I knew what to expect, however, the procedure wasn’t as simple as it had been for me in 2014. They had problems going through my wrist and had to abort because of oozing and resume by going through my femoral artery. That went well enough from what I can see in the surgery report. They fixed the restenosis by using something called a Pantera Lux Paclitaxel Releasing Balloon. This is a relatively new solution that has only been approved in Canada for a short time. It is a medication coated balloon that is used to open the stent back up. The balloon is inflated and then removed leaving the medication behind.

After the surgeon did the angioplasty he came to talk with me. The doctor said he didn’t see any damage and his interpretation is that this was very severe angina and not a heart attack because there was no damage. When I questioned him about his opinion vs what the internist at Brantford General said, he put it this way… “If you gently bump another car in a parking lot and there is no sign of damage whatsoever is it still considered an accident? That depends who you ask.” Either way, it was a good thing I hadn’t delayed going to the hospital any longer than I already had.  The surgeon also mentioned that an additional artery had started forming. Creepy. We all have these lying dormant in our bodies but because of a relatively active lifestyle one of mine came to life, so to speak, in order to compensate for the restenosis. He informed me that they couldn’t fix the problem with the blocked stent 100% because it also affected a secondary spot and that I may experience some some discomfort when I run but that if I could exercise through it this “new” artery will continue to grow. That could eventually eliminate the symptoms and improve my heart health even more. That seemed promising.

Here’s where it got a wee bit scary. Three hours post-procedure the nurses went to remove the shunt from the artery in my leg and I started to hemorrhage. They applied pressure until the bleeding stopped. Then the ladies left the room and within 5-minutes I was screaming for them to come back because I now had a hematoma on my upper thigh the size of an American football. The nurses applied pressure to reduce that and tipped my bed so my head was at the floor. About this time I passed out so I’m not sure what happened next. When I awoke the nurse helped me to get up and walk around but the pain in my leg was excruciating. I looked down only to see one of the ugliest and biggest bruises I’ve ever had. Finally at 5 am I was transported back to Brantford.

my bruise - 2 weeks later

my bruise – 2 weeks after

My bruising from the hematoma was so severe that they were concerned about micro-aneurysms and clots. I was sent for ultrasound on that leg and also for blood flow on my left leg. Everything came back inconclusive although they had a hard time seeing sections of the bruised thigh. The bruise went right up to my hip and was starting to creep down my leg. I had to find a balance between walking enough to prevent blood clots and dealing with the pain of a growing bruise. I managed. I had a few other issues while at the hospital and was finally released the afternoon of the sixth day. I was happy to be going home.

When I arrived home I immediately called my own cardiologist to make a follow-up appointment. Rather than see me first and then send me for tests, Dr. J. decided that I should have a Cardiolite Exercise Test on the treadmill so I did that day before yesterday. The doctor didn’t pull me from the test but at almost 11-minutes I asked to stop because of hypoglycemia. Silly diabetes. Thankfully I had reached 87% of my maximum heart rate which was more than enough for their purposes as they only needed me to get to 85%. I felt good and it was really nice to run again but I won’t really know anything until I meet with Dr. J. next Tuesday. Then I will have a clear idea of where I am at with this and if there are further issues.

So that’s the scoop. If this was indeed a heart attack it was uber-mild. Once again, I was very fortunate and listening to my body played a big part in this. I’m doing everything I can but I’m also battling genetics which makes this a really tough fight. I’m grateful that this was not a new issue in another part of my heart and that the disease has not progressed, as far as we know. I’m relieved that all the fitness and nutrition wasn’t for naught.

I’ll share an update once I see the cardiologist in a week but I’m quite confident that this is not an issue of if I can run again but more a matter of when I can run again. When I do start back it’s not going to be easy but as Bethany Hamilton says… “I don’t need easy, I just need possible.”

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