My First (or maybe second) heart attack

Two months ago I had a heart attack.

I actually probably had two attacks. It was hopefully one of the best things that could have ever happened to me. I’d like to first thank all my friends, family, and colleagues who have been so thoughtful and supportive since it happened.

I’m 42 years old, though I think my attitude has been frozen at about 28. I’ve ignored the grey creeping into my beard. I’ve shrugged off the huffing and puffing, the annual increase in pant size, the ever growing lethargy of always feeling drained. “I’m not an old man!” I told myself. “I’m just a little out of shape. I’ll get this in gear after I get this project done. I’m super busy with work so I’ll just run through the fast food for lunch/breakfast/dinner.” The lies I’ve been telling myself instead of listening to what my body has been telling me.

So, I’m an old man now at 42 with old man problems. But the blessing is it’s happening now and not after another 20 years of increasing pain, misery, and yes denial.

Did I see the light? No. In talking to my friend Greg last night about the experience it was strangely surreal like other brushes with death that I’ve had. More of a WTF moment than anything. I was at work in Waynesboro, and suddenly felt a tight pressure in my chest and upper back, clammy, and not able to focus. Two nights prior I woke up in the middle of the night with the same symptoms, had a glass of water and walked it off telling myself if it was REALLY a heart attack that I would be dying faster, not walking around with a glass of water.

When it happened again two days later at work, I tried to walk it off for a few minutes but it wasn’t going away. For me it wasn’t like a movie where you clutch at your chest and gasp and then croak. It felt like I had swallowed a big piece of food that you can feel SLOWLY crawling down your throat, except it just stopped on it’s way down and wasn’t moving. Not a choking feeling, but this sensation of intense physical pressure and tightness. It wasn’t a pain like a cut, but an annoying discomfort that came out of nowhere and wasn’t letting me focus on anything other than the pressure. That was my heart attack. Or given the symptoms in the night, it was probably my second heart attack.

I had a co-worker drive me to the urgent care, and then decided on the way that if I was actually having a heart attack that they would just be sending me to the emergency room in an ambulance. So I saved everybody some hassle and saved the insurance company some money (which I’m sure they won’t appreciate or give me any credit for) and detoured straight to the ER.

There was no line at the triage nurses station, and they didn’t seem in any rush to finish their bantering with each other before recognizing my presence. I guess this is a reason to come in on a gurney, they take it a little more seriously. I told them I thought I was having a heart attack, and they took some vitals and a quick EKG, gave me a wristband and sent me out to the waiting room because they were full. “I guess it’s not that bad - maybe even not a heart attack” I told myself. I mean, people with heart attacks don’t get tossed back out into the land of bad chairs, bad television, and empty vending machines, do they?

About 45 minutes later I was placed on a gurney in the hallway, hooked up to a blood pressure monitor with a “DO NOT USE - DEFECTIVE” tag on it (seriously), given a patch of nitroglycerine, and had my blood drawn. Starting to feel better, I was sure this was all about nothing. And my wife Jenni arrived, which was a bit of a trek for her. Waynesboro, where my company’s offices are, is about 75 minutes from our farm. I commute there a few days a week, but for the most part work from home. Another 45 minutes go by, and they walk me into an actual room with a brief bathroom stop. This is the last time I walk anywhere in the hospital, by the way.

By this time I’m feeling pretty well back to “normal.” We’ve got a big project on deadline at work, with a couple other big projects behind it, and I’m ready to be told this was all nothing. If it WAS a heart attack, wouldn’t I be “dying” more and the ER doing more of something?

The ER doctor finally makes an appearance, bringing the news that yes, I’ve had a heart attack. I’m stable now, the damage is already done, and there isn’t much from an emergency medicine point of view that can be done immediately. They determined this by a blood test which measures some very specific chemical enzymes that the heart gives off when it’s had a heart attack, and only when it’s had a heart attack. So, I guess it’s not nothing. What next?

A while later the on-call cardiologist stops by. He doesn’t have much more to offer right now, other than a rough plan of what will happen from here. I’ll be admitted to the hospital tonight. Tomorrow they will do an echocardiogram to measure how effectively my heart is performing, and then a cardiac catheterization to measure and hopefully repair any blockages in my cardiac arteries.

The next morning I am woken up bright and early to be the first patient in the catheterization lab. I’ll skip over all the medical procedure stuff and write about that another day. The short version is I had a cardiac catheterization procedure which showed an 80% blockage in my LAD (left anterior descending) artery. This is such a common place for blockages (and causes so many heart attacks) that this artery is called “The Widow maker.” An angioplasty was performed and a stent placed at the blockage.

I was pretty wiped out after all this, and spent the day in the hospital. I was released the next morning, and spent the next few days living as a toddler: wake up, eat, go back to bed. I didn’t go to work that week, and they were very supportive and made sure not to bother me. The following week I started working partial days, and was back to “full-time” a week later. That’s air-quote full time, because previously I had been consistently working 50-60 hour weeks. I haven’t gotten back to that level yet, and I really hope I don’t since work stress and work lifestyle were probably a big contributor to my heart attack.

Two months down the road, a lot has changed: diet, exercise, stress, work. I’ve changed my diet to be plant-based, whole food - to the extent that I can. I have basically eliminated meat, and I’d like to quit cheese and eggs as well but am finding that VERY tough. Giving up meat has actually been a lot easier than I had thought. I’ve cut way back on alcohol as well, mainly because it’s a poor trade for the calories. The biggest part of my diet is just keeping a diary (I use the Under Armor MyFitnessPal app https://www.myfitnesspal.com/ ). This keeps me mindful of what I’m putting into my body, and helps me make conscious decisions about meals and snacks. It’s very scary to me what that diary would have looked like before my heart attack.

I exercise three days a week at cardiac rehab, though turning those appointments into daily routine at home is going to be a challenge. Part of that needs to be making it a priority, and doing exercise before starting my day. I’m amazed at how much the heart attack took out of me, but also amazed at how much I am recovering and excited about how much stronger I’m going to become. It is very frustrating how much attention this rehab is placing on my exercise and how little on diet and stress. Even one of the cardiologist that I have seen hasn’t really been on the same page with me on the diet part. Maybe it’s because they’ve seen too many people not stick to it, or maybe the cultural forces behind what we eat are just too insurmountable for them.

Stress and work have gone hand in hand. This is probably the most difficult change for me, because for a very long time I have identified myself with my work, and worn work effort like a badge of honor. I enjoy the professional challenges, but I need to keep learning how to not make them the driving force in my life, how to better balance work-time with life-time, and how to maintain perspective on the daily fires and crises at work.

16 pounds as of this morning (8/5/18). That’s how much less of me there is. Granted the first pounds are the easiest, but I don’t feel I’m doing anything all that extraordinary. Sticking to my calorie goal with the food diary app is really the biggest piece of it.

But the biggest and most important change is outlook - that I have the power in me to make change. And that is a VERY exciting thing. And it’s causing all these thoughts in my mind about my experience, and how this can also be an opportunity to help others find this power to make a change.

There are so many guys out there marching straight into the same traps that got me. Our culture keeps reinforcing all these things for men that, it turns out, are really, really bad for us. It’s sad that “being a guy” leads us into all of these behaviors that ultimately make us less as men: less able to be there for our families, less able to do the activities we enjoy, less able to be strong as a society.

I hope to start writing more on these themes, to find how to still be a “guy” while being healthy, to figure out how to be a vegetarian without being a crunchy-granola-hippie. And that’s the hardest thing to change in all of this, the culture. But if I can make the change in me, and I can help make the change in my friends, maybe together we can change what it means to “be a guy.”

And I feel very, very thankful that I had a heart attack at 42. I want to look at this as an incredible gift of an opportunity to make positive changes for myself, and for the people around me. And I am so thankful for all those people: my wife who has been by my side through all of it, and has been so amazing in helping me with my diet and exercise. My friends who have reached out to let me know how glad they are that I’m still around. And my work colleagues (also very glad I’m still around) who have helped me have the space and time and support to get healthy.