Thursday, December 21, 2006

I Am Andy's Heart

Anyone who's just here for the book I-don't-call-them-reviews will want to skip over this post; it's boring personal stuff. Caveat lector.

So I had my first cardiologist appointment in about eight months today -- I'd last seen him in April (I think), and he wanted me to take a stress test. But I kept calling the office (at about six-week intervals), giving them good days for the test, waiting to hear back, and then beginning the cycle again. After three or four times through, I just stopped. (Apparently, there was some trouble getting it approved through my insurance.) Eventually, when I renewed my prescription, there was a plaintive "Make an appointment!" in the middle of the dosage instructions, so I did.
Should I back up? Oh, OK. About four and a half years ago (May 9th, 2002), I thought I was having a heart attack at work -- I had chest pains that didn't go away, cold sweats, pains running down my arms, the whole scary package. (I'd been on a serious diet and exercise regiment from the beginning of the year -- I called it the "jelly bean & ice cream diet," but I was down forty pounds at that point. That's my ironic life -- I have a heart attack as soon as I get into the best shape of my adult life.) It didn't get better as the morning went on, so, around lunch, I thought I should go to a hospital. I got down to the lobby, asked a security guy what the closest hospital was -- yes, I guess I thought I was walking there -- and was sent upstairs to see the building nurse, whose existence I hadn't previously dreamed of.

She stuck a nitro pill under my tongue, and then checked my blood pressure and all that stuff. She told me that she didn't think I was having a heart attack, but she didn't seem happy, and she called an ambulance for me. Soon afterward I was wheeled out of the building, popped into a small converted van, and whisked off to Roosevelt hospital. There, I was stuck in a small room off to the side of the ER area, since they weren't sure what was wrong with me, and I wasn't bleeding anywhere noticeable.

They hooked me up to various scary machines, and some sort of alarm kept going off, bringing some sort of junior doctor at a quick saunter every time until he got used to it. (Eventually someone told me the thing was measuring my heart rate, and that the alarm went off when it dropped below some level.) The young doctors were clearly nonplussed to see me smiling and waving at them when my heart rate was dropping to 18 beats a minute, but I felt mostly OK at that point -- the nitro (or whatever else they stuck in me) had gotten rid of the pain and other symptoms, so I just felt tired. But, according to them, I shouldn't have been conscious at that heart rate, let alone coherent.

Anyway, I eventually got wheeled upstairs and into a bed. I stayed overnight, and all the medical types kept agreeing that I hadn't had a heart attack, and noting that I wasn't in bad shape, but insisting that I shouldn't leave. I spent much of that day pacing the hall, perhaps trying to prove to them that I was healthy enough to get the hell out of there. The Wife and my mother came to visit that evening, hoping to take me home. I eventually got so frustrated that I checked myself out of the hospital around 10 PM -- "the specialist" had been supposed to come see me for about the previous six hours, for what was supposed to be a perfunctory check to make sure I could leave, but he never showed up, and eventually they told me he wouldn't come at all that night (and that they wouldn't release me by choice). I got the big "you could die" speech, and hobbled out under my own power.

(Checking yourself out of a hospital is the rough equivalent of acting as your own lawyer when being sued by a big scary government agency. I don't recommend it. But I also don't recommend being stuck in a big, badly-run old heap like Roosevelt in the first place.)

I got in to see my family doctor the next day (Saturday), but couldn't get to see a cardiologist until Monday, so I had a very nervous, quiet weekend. (As I heard several times, "If you checked yourself out of the hospital, you can't be that worried about your condition." It felt like they wanted me to keel over right there, just to teach me a lesson about Doing What the Doctor Says.) I don't think I was on any medication yet, so I probably didn't fall sleep at random (as I did starting a week or so later), but I felt very fragile and tried not to do anything more strenuous than breathing.

Anyway, to cut the rambling short, I learned that what I had was "heart failure," which is basically the opposite of a heart attack -- the heart muscle gets lazy and slows down, and, eventually, if left untreated, stops working entirely. I was put on medication, which ramped up for the first year or two, switched around a bit in the middle, and has been declining for the last two years. The effect of the medication (beta blockers and ACE inhibitors) has been to slow my blood, making me very cold for a couple of winters and giving me very interesting effects when I stood up for about four years straight. The changes in dosage were also quite entertaining.
Back to now. Dr. Das (my heart guy) said I looked thinner (meaning he remembered me at my porkiest; I put back on most of the weight I'd lost in early 2002 by the end of 2004, and dropped 30 pounds last year -- not quite the same ones, since I started 2002 somewhere over 300 and I started 2005 at 290 -- and have slipped back up about ten pounds this year). My blood pressure was...

...and this gets its own paragraph...


(though I think I've been not much higher than that for the last year and a half). This was very good news. My heart and lungs must have sounded good, too, since he wrote me a prescription for a heart scan (to check my injection fraction -- if I can get above 50% I'll be basically normal), and told me to reduce one of my prescriptions to a pill every other day.

So, to sum up: I'm not falling asleep in the evenings, I can stand up without all of the blood rushing out of my head, my blood pressure is great, and I might finally stop being a heart patient some time in 2007. I can't frikkin' wait.


Anonymous said...

I'm glad to hear you're doing better.

Anonymous said...

Wow. Great improvements. So glad you are better.

Wishing you and your family a lovely holiday.

Anonymous said...

Good news. Did they ever want to do the pacemaker thing? Or was that unhelpful?


Andrew Wheeler said...

Diana: As I recall, a pacemaker was mentioned, very early on, as a remote possibility, but it wasn't a good fit for me. Pacemaker batteries only last something like ten to fourteen years, so doctors try not to put them into anyone expected to live longer than that.

(Since I was thirty-three at the time, I was happy with their confidence in me.)

I also think anything involving surgery is generally a less-favored option; if you can treat a condition non-invasively, it's usually better to do so.

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