Tuesday, September 4, 2018

Spontaneous Coronary Artery Dissection

At 3:30am Tuesday morning I woke up to the most severe symptoms yet. Chest pain, neck pain, profuse sweating, nausea. Couldn't get comfortable. Got up and washed my face off, waited a bit then felt better. Back to bed. Fell asleep so fast I don't remember what I thought of it.

At 4:45am alarm for the Tuesday run goes off and I dress for a run. Around 5:15 the symptoms returned, not as bad as earlier but bad. This was event #4. This was not my back. I texted BE that I was going to ER, walked the dog (seriously, with chest pain, I walked my dog telling her to hurry da fuq up so I could get going), and left. Yup, drove myself to ER.

The whole drive over, I kept thinking to turn around. Every exit, I thought "what a waste of time", "it's just my back", "they'll think I'm a hypochondriac", "last time they misdiagnosed me as having a muscle sprain"....etc, but I don't think I seriously would have turned around. By this time, I knew something was wrong. But I still had that denial.

Around 6am I was at St Mary's ER, it was familiar and I knew I'd get in faster. (Again, in denial, chest pains put you at the top of triage so it didn't matter how long the ER wait list would be!). I stood at the check-in counter with my pink swim bag, probably looking just fine. When asked, my pain was a "5 or 6", there didn't seem to be a terrible rush. I was immediately taken to an EKG, while being asked about my gallbladder, anxiety attacks, and my back 'injury' (that's how I'd described it). She took 10 seconds of EKG, tore the paper off, went left out the door.

Then to my right, blood draws started and suddenly a cluster of activity. This was for the troponin test, I knew, and whatever other differentials they'd come up with. Then off to a bed, where I met Dr Lesserman who happened to also be a runner and cyclist. We talked, he left, and there I waited. SO texted me and I told him where I was. Waited. Lesserman came back shortly and in what I took as disbelief, said I was likely having heart attacks. I had all the symptoms, an abnormal EKG with inverted T waves, and a positive troponin test. It seemed he couldn't understand it, seemed shocked, and said he was calling for a cardiology consult.

Things get messed up in the time line a bit here, at 7:15am I texted my sis to have her call me. I didn't want to unload this on mom, as just yesterday she was released from her own hospital stay. But sis was on her way to her own Dr appt, driving, so I couldn't unload this on her either. Then I sat a few hours, doctors in and out, Dr White the cardiologist came in, confirmed the heart attacks and said she expected a dissection, or a tear in the artery walls. She was apologizing for having to tell me this, but to my surprise I took it all in calm. Couldn't change the facts of it, took it just one minute at a time. By this point, they said I was being admitted and I knew I had to make some hard phone calls. I had a dog to take care of! Ha!

At 9am I texted mom, told her to call me, and telling her was so hard to do. How do you deliver bad news like this to someone 4hrs away? First thing she said, was that she was coming down immediately. :)  Called Dad, more hard news, talked to Michelle, the start of practicing this conversation over and over and over.

At 9:30 I texted Tori, who said she'd come ASAP.  I left the ER to a bed in the telemetry ward right before TH arrived, and she sat with me while they settled me in with multiple IV lines for saline and a heparin drip. The plan was catheterization at 12:30. Still in denial and disbelief at this point. Really though, how do you process this?

Texted TV. BE texted for a followup. SO check in often. All we could do was wait for the cath procedure, for my family to arrive. TH was a blessing, kept me calm and kept my head from spinning out. I didn't roll out to the cath lab until 2:30, and there I met the Dr doing the procedure, he expected to find a pericarditis. 45 mins exploratory procedure, unless they find something then perhaps 90 mins. Throughout all this, I was identified by all medical personnel as a "triathlete", I joked that there must be a big red flag on my chart warning them of me.

Into the cath lab, where I was stripped down, shaved, belted onto a table, briefly learned what was happening. Still, I'm calm, like this was routine. I don't remember falling under the anesthesia.

I do remember watching two screens to my left showing the dye flowing into my heart. I could feel movement on my right leg at the groin of the cath tools going in and out. I could hear them talking, and once they knew I was awake ("she's awake, she's just watching") the Dr spoke to me. About lab, about work, (seriously dude, focus on what you're doing!), about WashU. Move movement, more dye. I could only guess as to what I was looking at, I had ideas but wasn't sure. And I was still sleepy. The clock on the screen said 4:42pm, I thought the clock was wrong! I didn't realize that I'd fallen asleep, thought I was awake the whole time.

Wrapped up the procedure, rolled out to see Mom, Mic, TH, and TV all waiting on me, the first two blurry eyed. I smiled, still calm, joked a bit. Sensed something off. Back to the room. There I learned the details.

Three blocked arteries. 80-95% blockage. Two stents. One more blockage not repaired and they're planning to do a second cath in another day or two. But --no more running, NEVER AGAIN, she has to stop. If she would have run this morning, she would have died. So said the procedure Dr to my Mom.

At this point, we're thinking blockage due to atherosclerosis, plaque blockage due to cholesterol deposition. This was incredible to all of us, but for now my concern was the next 5 hours in which I couldn't move at all due to the Angio-Stop in my right femoral artery. No laugh, cough, sneeze, lift head, or move leg. This until 10pm.

TV and MP went off to let poor Shoogs out. At some point TH had to leave. SO came to visit with a collection of the most wonderful items -- playdoh, pokemon shorts, cleaning supplies, and oh yes mouthwash!! Not that I could enjoy most of it now. Mom and Sis left for Schnucks, SO stayed a bit and all I wanted to do was just hold his hand :) I almost started to cry, not for me but for mom and sis. Their faces said so much, gawd what a day for them! But only a few tears. And I haven't cried over it since.

TV and MP came back, SO left, Mom and Sis back, Dad was still driving down. I encouraged them to leave to meet Dad back at the house. They left, I had some salad bar and olives and sunflower seeds and hard boiled eggs, and another hour to wait.

10pm was my "times-up", at 10:05 I called the nurses station, they said I could carefully get up. Bathroom, wash up. More wash, more bathroom, more wash, more wash. Just repeatedly cleaning up. Then.... well now what? I'm awake, rested, with time to kill. So naturally, I ask if I can walk the floors, and thankfully I could. So with my remote telemetry in pocket, I paced up and down, back and forth, repeatedly across the short hallways, joking that I needed to get my steps in.

Back to the room, made the bed, got a late-addition room mate, made the bed again, washed up more, and more. Then to bed.

I say all this factually, leaving out the mental processing and thoughts, as they haven't really happened yet. And here on Sept 13th, 9 days later, it still hasn't happened yet.

I started a countdown on the phone, for Sept 4th, 2018 at 10pm. For Bee 3.0.

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