Listen to your heart

image“I have cardiovascular  disease.”  I feel like I’m  at an AA meeting, “I am an alcoholic.”  But I’m admitting “I have heart disease.”  I’ve never paid a lot of attention to medical issues.  Until my prostrate cancer three years ago, I thought I was in good health. Heart disease ever crossed my mind.   My father had a pace maker and I know a few people that have had heart attacks or heart surgery but I never got too involved in the details.  Sure there were the articles and TV spots, warning that heart disease was a leading cause of death.  But it didn’t seem to apply to me.

Today I find that amazing.  What wasn’t I thinking?  I had high blood pressure, high cholesterol, a former smoker, heavy drinker, limited light exerciser.  Environment – heredity?  I didn’t have a family history of heart disease. But environmental factors?    The  picture becomes much clearer when we look backwards?

Prior to my September “fistula” surgery, I walked almost every morning.  At least a mile; many days two or three.  Several times a week, Diane and I might take an afternoon walk.  Thinking back, I may have had a shortage of breath if it was a steep climb but no problem on flat or gentle walks up.  Don’t remember any chest pain, dizziness, or other symptoms of cardiovascular disease.  Last February, John Paglione and I worked for a week freezing cold, on James Madison’s Montpelier, helping to reconstruct a slave cabin, using hand tools.  It was a challenge, I got tired but felt great. Nothing that suggested heart disease.   I had a EKG and met with a Penn cardiologist prior to the September surgery. No problem detected.

After the September surgery as I began to walk, climb steps, return to normal, I frequently had shortage of breath, sometimes major, and ocassionally chest pain.  I attributed it to weakness due to the surgery and low blood pressure intensified by the high blood pressure meds the nursing home continued to force on me.  No one on the hospital staff or Manor Care staff ever brought up the issue of heart disease.

At home in October, I was disappointed at what seemed like a very slow recovery.  I tried to walk daily, climb up and down steps, but felt weak, would become short of breath, and if strained (carrying fire wood upstairs) had some chest pain.  It went away once I stopped pushing myself.   Lengthy surgery, slow recovery, slow recovery, I thought.

When I went for heart clearance related to additional surgery related to the fistula, the cardiologist on hearing about my symptoms recommended a stress test.  I’d never had one.  Heart disease, not me.  But this time I sensed it was going to be different.  How right I was.

Results from the stress test and I was scheduled for a cardiac catherization  to determine if there was any blockage in my arteries.  I went in expecting I would probably need stents. Instead I hit the jackpot, three severely blocked arteries, a leaking mitral valve and blockage in a carotid artery.  No stents; bypass surgery is needed.   Several tests have looked at the mitral valve, each showing differing amounts of leakage.  So it’s not 100% clear whether it needs repair.  Seems that decisions related to the actual number of bypasses and whether to repair the valve may happen after I am opened up.  Amazing.

So the heart surgery has taken precedence — the fistula related surgery is postponed.  And in a Catch 22, the heart people are very concerned with potential infection.  They have concerns about any possible infections related to the fistula surgery.  So I have been seeing an infections doctor.  There is an abscess that they want to drain.  Everything is interconnected.

I am wondering about screening for heart disease.  Sure seems a stress test would have been a good idea for me several years ago.  I want to read a bit about what type of screening is recommended for what profiles.  For now I just suggest listen to your heart.






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