Sunday, July 1, 2012

Weekend Gratitude: A Healthy Heart (Featuring The American Heart Association and Doctors Without Borders)

Dear friends,

This weekend I'm grateful for a healthy heart.

My red, white and blue is a little early
for Independence Day!

I can't take that for granted.

On Saturday morning, I had a headache and felt a bit dizzy and nauseated before breakfast.  Then, while driving home from dropping one of my kids off for a day with friends, I started feeling chest and arm pains on my left side.  They subsided enough that I decided to go grocery shopping, but when I was bringing the food into the house, I started feeling short of breath and generally cruddy.  I decided to lie down and rest while my husband took our five youngest children to the pool for a few hours.  

While resting, I played Words with Friends with my cousin Jean on my iPod for a while.  We chatted via the little message box on the screen.  As an experienced nurse, Jean reminded me that I was having the symptoms of a heart attack and advised me to get it checked out, preferably at the ER.  

The shocking statistic is that heart attacks are the Number 1 killer of women, with 250,000 women dying each year from heart attacks.  Why? Some of their symptoms are not even recognizable as heart related.  One study shows that women under the age of 55 having a heart attack are seven times more likely to be misdiagnosed than men in the same age bracket.  For instance, some women do not experience chest pain or squeezing pressure like men typically do.  Females  might feel abdominal pain, upper back pain, fatigue, or shortness of breath as their main symptom instead.   Time is of the essence!  The longer treatment is delayed, the more damage is done and the more likely death occurs. (See Women and Heart Attack and The American Heart Association's article Heart Attack Symptoms of Women and WebMD's Her Guide to a Heart Attack.)

Anyway, with those symptoms and knowing I am already at high risk for heart disease because of my weight and family history, I asked my daughter Rachel, a nursing student, to take my blood pressure.  It was higher than normal and my left jaw started to hurt -- another potential heart attack symptom -- so she and Joanna insisted that I go to the ER.  I popped several baby aspirin before we left, since that can reduce damage from heart attacks and strokes. 

Thus my unplanned weekend adventure began.

Nurse Rachel

I love little divine coincidences!  One of my ER nurses, Rachel, knew my older daughters from the NHE EXCEL home school co-op that we were in 8-10 years ago.  She was very helpful, and quickly informed me that I would be staying overnight.  I hadn't even thought to bring a toothbrush because the girls hustled me out of the house so fast!  (I did, however, bring along my iPod and its charge cable to stave off boredom and get information.  Florida Hospital has wi-fi, so I could access the Bible, e-mail, Facebook, and Words with Friends, as well as do Google searches on medical terms.  I read some Kindle books, too.  And I took all of the pictures in this blog post with my iPod.  So versatile!)

My daughter Rachel (the nursing student) had a great time chatting with all of my nurses, learning more about what goes on in the emergency room and what area might be best for her nursing practicum this year.  She also worked on knitting a baby blanket for her nephew.

My daughters Rachel (who brought me)
and Mary (who came to visit)

 Lots of diagnostic tests!

Blood pressure every few hours

Endless rounds of tubes, blood draws, injections, OUCH!

The telemetry box constantly monitored vital signs with cords attached to my chest.  The box tucks into the chest pocket of the hospital gown for easy mobility. 
Lots of sticky back electrodes!


More tests scheduled for the morning, but first a good (?) night's sleep -- if you can call it that with people coming in to poke and prod, and wires sticking out of me everywhere.
Down the hallway to the
echocardiogram room.

Hard to capture this shot of the echo (ultrasound)
machine and lie very still at the same time.

No luck getting a larger needle into my veins for a CTA contrast scan, so they substituted a stress test.  I still had to have the radioactive dye injected in the nuclear medicine area...  Does this mean I am now radiant?

Since I had to lie very still on my back looking up for 15 minutes at a time (twice!) at least they replaced the ceiling light panels with colorful, glowing pictures!  When it finished, I was so busy taking pictures of the light panels that I forgot to take a photo of the scanning machine, which looks somewhat like an open MRI. 

I hadn't been allowed to eat breakfast before
they injected the Lexiscan to make my heart 
beat faster (stress)
 and dilate the blood vessels for the second scan.  They can either do that or make you run on a treadmill for a while, but my orthopedist has cautioned me not to run or use a treadmill because of the damage I've already done to my feet and joints from the impact. Instead, when I go to the YMCA, I use an elliptical machine at a fast walking pace.

Once that part of the stress test was done, they gave me a big snack of cheese, crackers, peanut butter, yogurt and juice. I am always fascinated by small things, in this case the ripply texture of the peanut butter on the knife as I was spreading it on the graham crackers.

Oh yes, they needed to keep me well hydrated, too.  The Healthy 100, mentioned on the water bottle, is both a public health campaign and a book sponsored by Florida Hospital, an Adventist organization.  The Adventists are well known for their emphasis on healthy living and eating.  I already had this book. Now I just need to read it!

Arriving back at my room, I noticed the chaplain has stopped by and left an encouraging card for me...  Yes, the Adventists are known for their spiritual nurturing in health care, too.

While waiting for my lunch, I played a few more rounds of Words with Friends.  Yes, NURSE is a terrific word right now!  My nurses were amazing!
Grilled chicken sandwich on wheat bread, cream of potato soup, green salad, and a small tub of low-fat (or fat free?) chocolate ice cream.  I wish I could order their room service from home! 

My husband helpfully cleared up my lunch dishes from the bedside table.  This is so typical of him, as I mentioned in my Father's Day post!  

Well, now that I had eaten, it was almost time to go home!    But first I had to wait for the cardiologist to check the scan results and decide if he wanted to discharge me.  Fortunately, he did.

What?  You mean you want to know what my diagnosis is?  

OK.  My heart is fine, mostly.  I didn't have a heart attack.  I don't have a visible PFO hole like my sister did until she had her surgery.  (PFO, patent foramen ovale, is a risk for both strokes and migraines.  At least two of my friends have had strokes caused by PFO.)  I do have level 1 -- or first degree -- AV (atrioventricular) heart block, which means there is a slight delay in the electrical impulses between the chambers of my heart.  It's probably been there for a while and it does not need treatment.  Second and third degree AV blocks are more serious and can require a pacemaker. Sometimes an AV block also indicates the presence of a PFO, and I might still have a small undetected PFO that doesn't need treatment.  I also found out at my follow up appointment two weeks later that I have a minor mitral valve leak, probably caused by a season of high blood pressure, perhaps during one or more of my 10 full-term pregnancies.

I do still need to be checked for sleep apnea since my snoring loudly every night and always being tired during the day are classic symptoms. Excess weight, older age, and family history are two of the many risk factors. Sleep apnea causes you to stop breathing for short intervals because your throat muscles relax and obstruct the airway. This can cause heart problems, so it can't be ignored. The treatment is a CPAP machine that keeps you breathing steadily via a face mask worn while you sleep.

I'm still not sure what caused the chest pains -- maybe a combination of stress, muscle strains and indigestion?   So was it a waste of time and money to go to the hospital?  I don't think so!  First, you never know and better safe than sorry!  I don't want my ten children to lose their mama.   Second, I needed to have a good cardiac workup anyway, due to my risk factors.  Now they have a baseline to compare in the future if I have more problems.

Right now I am thankful for my (mostly) healthy heart, which I will try to keep in good shape by improving my diet and exercise.  I think the teen and adult members of our family also need take a first time or refresher course on CPR and first aid.

I am also thankful that even though my husband and I are not covered by traditional health insurance, we are members of an excellent Christian health cost sharing program, Samaritan Ministries, so most of my hospital bill will be reimbursed by fellow members.  We were also able to take advantage of an astounding 75% self-pay patient discount with Florida Hospital by paying the bill yesterday (at least what had already been performed).  Because we did this, the other charges from Florida Hospital will also be discounted.  Unfortunately, some of the outside charges -- like from the ER doctor's practice -- will not be discounted.  But, as I said, Samaritan will cover most of it.

I'm grateful, too, for our modern American health care systemI said this over and over again this weekend, to whomever would listen.  When I think about Third World countries where medical technology, basic sanitation, clean water and healthy food are virtually non-existent in the few health care facilities they have...  It makes me sick. It makes my heart hurt.  We have so much.  They have so little. Just read this CNN article and watch the video about efforts to improve obstetric care in Afghanistan, where every two hours a woman dies in childbirth: Helping mothers, babies in one of the worst places for survival.

This picture, "The Family of God" by Nathan Greene, hangs prominently in the Emergency Room waiting area as a reminder of Who is our Great Physician.  (Sorry for my poor photo quality.  You can order your own copy of the real picture at the link above.  The unframed 5" x 7" size is less than a dollar but bigger ones are available, too.)  

This beautiful painting is also a reminder that there is a big world out there, with people of many cultures who need adequate health care.  Let's not get so tied up in knots about the health care debate in this country that we forget about them.  When we serve others, we serve Jesus himself.

A Worthy Cause (Or Two!)

I recently started a new blog theme, A Worthy Cause, in which I highlight charitable organizations that are making a difference in their communities and/or globally. Here are two related to the topics in this blog post:

Doctors Without Borders / Médecins Sans Frontières (MSF) works in nearly 70 countries providing medical aid to those most in need regardless of their race, religion, or political affiliation. Learn more about their principles, work, and impact.

American Heart Association  "Our mission is to build healthier lives, free of cardiovascular diseases and stroke. That single purpose drives all we do. The need for our work is beyond question. Read more.."

So there you go.
What are you going to do to take care of your own heart?
What are you going to do to take care of those in need?

For healthy hearts here and around the world,
Virginia Knowles

1 comment:

  1. Knowing that the symptoms of heart attack in women are not necessarily like men's heart attack symptoms made it so hard to make the decision to actually go to the ER. My mother-in-law, before she died, had spent an entire summer having extreme shortness of breath. She just chalked it up to "age"(she was 76). She mentioned the problem once, I think. I suggested she make an appointment with her cardiologist, but she said she had an appointment the next month, so she'd mention it then.

    Her youngest son(45), my husband's brother, died suddenly of a heart attack the next week. She was devastated(she lived with him and found his body). She suddenly looked terribly weak herself. Her closest and last living brother then died the day before her son's funeral. She looked even weaker.

    THe day after her brother's funeral, I called her to check on her.(we live 45 mins away from her home). She couldn't continue to talk because the shortness of breath was terrible. I called her daughter and her neighbor who was a nurse. She was rushed to the hospital.

    Even there, they didn't diagnose a heart attack...her enzymes were only slightly elevated. They suggested that it was anxiety. A heart cath the next day revealed ELEVEN coronary artery blockages!!! They said it looked like she'd had a series of heart attacks over the previous weeks....

    She had surgery, but by then her heart muscle had weakened so much that she did not survive. I've often wondered if we'd "caught on" to her symptoms sooner.....would she have lived a bit longer. Only God knows, and He had a plan all along....but we've just become very aware of it all since then.


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