2nd SCAD recovery week

All written in retrospect, from notes and memory.

Monday Sept 10th Drove out to St Chuck with Mom to pick up my new dining room chairs, then out to antique mall to look at a new fainting couch for the living room. Mom found a pair of black/gold chairs to add to our shopping list. Got in two hours at work, by then I was tired out. Tired...from what? I'm not doing anything.

Tuesday Sept 11th ONE YEAR HIP SURGERY! But that's not the point anymore. Today was visit to Dr L and JH, for me I hoped to get some athlete-level conversation and for mom some reassurance that I'll be OK. At Dr L's office, Debbie said I "gave him quite a scare". When he came in the room, he was serious, as I updated him and joked about being able to pass people on the bike hill while having a heart attack. My jokes are a cover? Or just how I deal with it?

He discussed a lot and as usual I wish I could get a transcript. He graphed out Load and Capacity. Load being how much training I did and Capacity how much my body could handle. My Load was high, and my current Capacity low (or was it the other way around?). He said a race like Sunset is "nothing" for someone like me. He stressed that I follow up with testing and considerations of metabolic, nutrition, inflammatory, and genetic factors that lead into this. He said I needed to severely restrict activities and treat this like a soft tissue injury -- for a minimum of 4 weeks and up to 8 weeks. Also that this is just another soft tissue injury on the heals of other similar -- the hip, back, etc -- and that it was 'suggestive' of a problem. Then a check of the back, neck, and hip -- all good with just minor maintenance.

I'd hoped mom would be reassured after this, but instead she just saw cautious fear. I took away a to do list of things to think on and follow up with.

Then off to JH, who set aside some time to talk to us. My goal was to update him on my return to training (I didn't even have to ask Dr L what the answer to that would be, I could read that on my own) and get some of his positive vibes. Again, wish I had a transcript. He pointed out that I recovered before, I'll recover again. That my pain scale reporting needs 2-3 points added to it since I'm good at pushing and ignoring pain. That a joint injury is not to be thought of as an internal/head/heart injury, that I can't push through and use the same recovery trajectory line of thought. It was all good, for me a boost and some crucial definitions of pain -- the where and how.

Then off to the antique mall to get our couch and two chairs! Rest of the day, redesigned the living room with mom's uber good designer help.

Wednesday. Relaxing day and morning, more time in rearranging the living room and talking, before mom left on the 3pm Lincoln. I confess to shedding a few tears here, but as much as I wanted her to stay that wasn't a sustainable solution. Back home, it was my first quiet time since....Monday the 4th, which came after a week of being home for the wedding. What a whirlwind.

Thursday and Friday, partial days back at work.  6-7 hour days. Talked to Dr Ravi in depth, and the boss, otherwise kept to myself about it. I don't want this to define me. 

Saturday met with TH for a walk in CCP. She's got a stress fracture in her left heel bone so we were both limited. I could have walked all day. Went home after a stop at Fresh Thyme and a coal bucket sale in Kirkwood, and felt sick to my stomach. Again. Hope the SIBO doesn't take advantage of this stressful situation. Saturday wasn't a good afternoon, and I skipped out on going to TV and MP's birthday party.

Sunday I decided to hike one of my faves -- the Chubb trail. So perfect outside! I kept the HR low and didn't get over 120 at all, most of the time 90-110. It all felt good, 3.5 hours of nature and quiet and butterflies. SO called right at the end, admonished me for going alone. But something could happen anytime, not just in a hike, and again I don't want this to define me! Home for a better day than yesterday.

SCAD recover, new moon, Bee 3.0

Friday. See the amazing thing about all this is how good I seemed to feel. I mean, aside from the continuing chest pain (Dr said as long as it doesn't get worse, and the can't give me beta-blockers to help it because of my low BP) I really did feel OK. The cath side in my groin hurt, and that lump gets bumped by everything, but that's it.

I felt tired, I will say that. But I'm always tired after sitting around for a long period of time! Denial.

Short dog walk, with Dad walking Sugar. Butcher shop visit for 1 lb each of liver, heart, ground beef, and some porchetta and heart pastrami. The irony of that not lost on me. Visited an estate sale, found a great lamp - white with gold painted flowers.

SO visited and met dad (already met mom and sis in hospital on Tuesday), helped plant my roses and butterfly bushes. Later on made his lasagna, I'd picked up the ingredients Monday.

Saturday. Rain and Thunderstorms! It was supposed to be severe storms, so severe that the MS150 was canceled. Mom helped me list the sewing machine and leather chair and other living room furnitures, drapes, and rug in the basement. I've been talking for 3 years now about selling this stuff, and time for Bee 3.0 to act on it.

By the end of the day, $50 for sewing machine and $350 for the leather chair. Whoop!

Visited Fresh Thyme, a consignment store, Dad and I fixed a broken kitchen drawer. Making lasagna is hard on a kitchen!

The cath site in my leg looks awful. Black bruising, is it really bruising? You can see where blood just leaked out under the skin. Dinner at Hodak's with Meisha's gift card. Couldn't help but wonder why I had heart problems when the mordidly obese regulars who couldn't fit in the booths didn't.

Sunday. Woke up to light rain. Hung out at the house, since I was up early I made my pickled peppers, pepper pestos, cooked my liver and some ribeye. Mom dyed my hair purple and pink! That finished at 1pm, the same time as a New Moon!  Went to Benton Park Cafe for lunch, another gift card from Meisha. SO came for his lasagna, in a nice white t-shirt like I love so much. He'd run a 10K this morning and won 2nd OA!! Then Dad had to leave, ooooh so hard to say goodbye. SO helped me walk Sugar by running her up and down the sidewalk. Mom touched up my hair dye, then we relaxed. Lots of resting these days.

SCAD Day 3, released from hospital

Another visit with Dr White, mom and dad there too. She immediately offered cardio rehabilitation. I asked what's involved --a treadmill and EKG-- and that's all I needed to hear. She said it would help with my confidence in returning to activities. Oh yeah!

She didn't see evidence of FMD. My keto diet is OK. My IUD is OK. Genetic testing maybe. The work at the wedding had nothing to do with this. +Sounded all good to me. I told her I'm still hesitant on the statins, seems like something we'll need to talk more on.

Released! And I could walk down on my own, no wheelchair. The sunshine and fresh air and freedom all felt so good. Off to Walgreen's to drop Rx (aspririn, Brilenta, and a statin), off to Park Ave for coffee, then to gift shop in Lafayette where mom discussed laser printers and business, then Walgreens, Fields. Then message from SO -- he brought me roses-- real roses not the cut ones! They were on my front step when I got home :)  He also cut down the front grass, he said it'd grow back overnight, lol.

Imagine Dragons Natural played while at Fields. Just days ago I heard that song for the first time. Songlist?

Home to rest, and see Shoogs!! Poor Shoogie was boarded from Weds 29th to Monday 3rd morning, then with friends and family from Tuesday 4th through Thursday 6th afternoon. Then another week of family around. She just rolled with it.

Still hasn't settled in yet. So still talking about this as a sequence of events, not addressing the meaning of it.

Scad Day 2

Mom and Dad and Sis came in early, I was again pacing the halls and writing up a long list of questions for the upcoming meeting with the cardiologist. My room mate was sleeping so I kept out of the room and we hung out in the visitor's lounge. Dr White found us there and sat down for a meeting.

She'd reviewed my angiogram with another cardiologist and they decided I had SCAD, and not a plaque blockage. All morning our family discussed my issues as a plaque issue, looking for family history and patterns, this changed all that. Also, she didn't seem to think that I'd "never" run again, there seemed to be some hope in the future. I had so many questions, they aren't as relevant right now I guess.

Also, no second cath procedure. They were going to let the remaining long tear heal conservatively on its own, the length of the tear seemed to be a risk factor. They'd go back at a later time to measure healing and decide from there.

The morning changed after that. No more procedures, but I was to stay in hospital at least until tomorrow. We went down for breakfast in the cafeteria. Hung out in the visitor's lounge and talked, sis and I played with Playdoh. The she had to leave to get back to her family. The rest of the day was resting with mom and dad.

Throughout the day, talked to Donna, DaveK, Grandma, Jess, texts to many others family and friends. Thankfully TH contacted the Club group and training partners, it was getting hard to keep saying what happened over and over again.

The staff noted that i wasn't in my room all day (avoiding my room mate) so they moved me from 485 to 477 where I'd be alone. IT and BE came to visit!! Then I pace some more, read some more of the PDF's TV sent, colored in my new coloring book. Sleep.

Still hasn't sunk in yet. Even after learning from SO that one of his coworker's wife died of a heart attack yesterday. She was the same age I am.

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.

Titanic wedding and Labor Day weekend

Nothing!

I left for home Weds morning after the Rosario 800s to help Mom with the Titanic wedding. Weds evening, all Thursday and Friday, and Saturday morning dedicated to this big event. It went great, but no running or biking or swimming.

On Saturday, Mom was admitted to hospital for her legs. Bilateral swelling and redness, likely a cellulitis. That night, K & J stayed with me and Dad. Next morning spent with them, wonderful family time. Waiting to hear if Mom would be released or staying longer. I sadly had to go around noon, and didn't get to see her.

Returned to St Louis Sunday to get stuff done. Once unpacked and settled and stuff done, realized that without dog it was a good opportunity to see SO. Got there kinda late, saw just-born butterflies, headed off to sleep....and more chest pain.

It started maybe in my chest? But I really first noticed it in my throat, the same pain that signals a throat infection. I'd spent only a few hours with the kids, but that's all it takes to pick something up. However this was an aggressive throat pain, rapidly spreading and becoming intense. Soon enough I realized the pain down my back, some into my forearms, and behind my sternum. My next thought was my back. I tried stretching, rolling, moving, from the bed to the floor to the bed. Poor SO tried to help but I couldn't get words out, I was too focused on staying calm and managing the pain. I measured my HR at 46, and at that point ruled out my heart. It would be higher if I was in distress, right?

The pain subsided and I was fine after that.

Next day, LOTS of chores done, rightly so for Labor Day. Wash dog, fully clean truck, clean house, laundry, lots of infrequent chores too like cleaning ice machine in fridge. Towards the end I ran errands for groceries. Then home. Then saw SO and got a video of another just-hatched butterfly. At the time I was mesmerized by the little guy, I just wanted to watch him all night long. In retrospect, I see him as a sign of rebirth and change.

SO prompted me all day to see a Dr about my chest pain, I joked that he "wasn't going to let this go" and he said no. That Monday night I seriously considered going to the Urgent Care on Grand, but it was closed by that time (or that's my excuse in retrospect). I weighed out the differential dx: back problem, anxiety, heart. And in about that order of probability. I googled the blood test for a heart attack, saw that the test comes back positive for about 1-2 weeks, and decided to re-evaluate tomorrow instead of going to Urgent Care late at night for back pain.

Rosario 800s, kicked out by JH to Dr L

RUN 3.9 miles in 32 mins (total 45 mins 4.7 miles)
BIKE COMMUTE 5.6 miles
PT with JH, ez day

As per the usual, I went to the track doubting what I could do, then pulled out a run to be happy with. I'm learning to avoid that voice of doubt, like I said last week it just needs a good punch now and then.

BE suggested "Rosario 800s", Ben's modification of Yasso 800s. I'm not fully clear on what the pacing and timing and etc of these are, I just do the basic idea of the workout. I think you run the first 800 at marathon pace, then the next 800 at 25s slower pace. Then repeat for a total of 8 or 10 sets. That's not an exact description. I looked up and read about it, but didn't really read it. I did ask McMillan what my marathon pace would be based on my recent 5K and 10K times, but got back some ridiculous number of like 3:11. Yeah, McMillan needs to know that I haven't run over 10 miles yet.

Anyway. It's dark at the track, we had a moon but no sun at first. The sprinklers were on but only at partial pressure so we had these piddy little squirts of water hitting the track. WU, then run. BE takes off at his pace with his paper-list of goal splits per 200 tucked under his watch. I didn't think about doing it that way -- by 200s, I just tried to do the math as I went.

First 800 in 4:21 (lane 3 800 so really 0.57 miles), then I slowed to 4:20 for the next 700 (really 0.50 miles), then walk 1 min and 100 y back to start line. To my surprise, I held these numbers very constant for all 3 repeats. Felt great, no specific complaints from the body, aside from the chest feeling that's still there but much better than Sunday.

Off to work, so swim due to to-do list for Titanic wedding. Then off to JH, and all morning I'd been debating how much and what to tell him. I've noticed that I'm more honest to him and Dr L than I am to myself. Looking back now, I realize I barely met his eye all morning, what a loser move on my part! So I described it, and the workout seemed to go ez and fast. In the ball/hamstring curls, I definitely could feel problem in my back, those have never been that uncomfortable before. Then lunges, a new modification of the forward lunge right and left, then lateral right and left. This was like a moving meditation. I couldn't worry on anything else while doing these. Calming.

Then JH "kicked me out" and said I need to go NOW to Dr L, don't call, drive, and either get seen or get a face-to-face discussion. And to seal the deal, maybe I didn't look convinced, he texted Dr L to let him know the story. I felt punished in a way, that I totally earned and only blame me for, and I hate to admit that I seriously thought about not going to Dr L!!! In the face of my issues, what I admitted to JH, and the knowledge that it was the right thing to do!

But I don't like imposing myself on others, inserting myself into Dr L's already busy schedule, advocating for myself. I felt the urge to apologize. Instead I gave thanks.

I was lucky enough to get seen in what would have been an otherwise normal appt. Described the symptoms since Thursday -- the feeling to need to bend over and "unweight" my back, the urge to roll and massage it. Sunday's chest symptoms. To me pieces of a puzzle that may or may not fit together.

Checked my slouch and rotation. Yup and OH YUP. When I did the knees-together, hold-the-bar-at-shoulders rotation, I was 55 left and 24 degrees right!! I tried but couldn't go further. He asked where I felt it, checked and sure enough, a postural stabilizer (thoracic rotalis something, I'll have look it up) was "the worst he'd seen" for that muscle. I like challenges, I guess.

This took some major pressure and twisting from him, and afterwards it hurt. But....my chest pain is gone?  Earlier I could still feel vestiges of it? Or am I just distracted by this new pain? New measurement --61 degrees and feeling much better!

There's nothing specific I did to cause this, and nothing specific I can do to avoid it again. It sounds like it was a slow-load on the muscle, layering of adhesion probably during swimming, then the race just put it over threshold. Since there was compression on a nerve, I had the feeling that I needed to bend over to relieve that pressure. Since it's connected to the ribs and sternum, it could explain why I could feel twinges of rib discomfort like a band around my chest, and my explain the reaction across my sternum.

So now it hurts, I'm supposed to ice it. I'm supposed to be packing and getting ready for leaving tomorrow morning for home. Yet here I am, more interested in getting these notes down before they leave my head.

So. Litchfield? Hahahaha.  And the Equinox half?? HA! (Why not?!)