On 20th August, I had a minor heart attack. I've written a couple of posts about it and have mentioned it in various replies. It occurred to me that, instead of a scattering of updates, it would be better to keep it all in one place. Hence this "Journal". My plan is to keep updating this text so that those of you who are interested can follow my progress and those who aren't shouldn't see much more about it.
This probably warrants a “long post” warning, maybe it didn’t to start with but it does now. It could be argued that it would be more appropriate on another community aimed at heart health but I feel that I’m talking primarily to my VRBs hence it’s on the Marathon Running and Race Support community.
Day 0, Tue 20 Aug 2019: Started out as normal work day. I’d arranged to go out running with colleagues at lunch time because the weather had cooled down. The run started off fine. I tried eating a jelly baby as an experiment for fuelling on longer runs; I found that it’s no good unless you have water to wash everything down. Anyhow, after about 10 minutes, I found that I was struggling to keep up with the group (usually, I find their pace easy to maintain). I walked back to the office and sat down to eat lunch. That’s when I had the tight feeling across my chest. Can’t be sure, but I think it lasted for about 20 minutes. Looked up the symptoms online, they included a tight chest but also things like arm and neck pain. Since I only had one symptom I was unsure about how serious it was. ADVICE: if you get a tight chest feeling that’s unexplained, call an ambulance! Since I was unsure, I decided to call in at my GP surgery on my way home from work. I finished my lunch, took a shower and worked till 5 pm then drove to the surgery. After I described the problem to the receptionist, I was relieved that she arranged for me to see a GP within a few minutes (I thought the typical three week waiting list might be a bit excessive in this case). Anyhow, the GP ran an ECG, spoke to paramedics about the results and called an ambulance. That took me to Southmead hospital where a blood test confirmed that I’d had a heart attack.
Day 1, Wed 21 Aug 2019: Transferred from the admissions ward to a cardiac ward. Expecting an angiogram any day now (apparently, with the coming weekend being a bank holiday, the hospital staff are keen to clear the waiting list before then). In my words, an angiogram is keyhole surgery. The probe is entered via an artery in either the wrist or the groin. The probe is used to inject a dye close to the heart which allows the heart to be examined with x-rays. If any narrowed arteries are found, the probe can inflate a balloon in that area to help clear it. Usually, a stent is inserted. This is a hollow metal cylinder which the balloon presses into the artery and which remains in place holding the artery open.
Day 2, Thu 22 Aug 2019: Had an echocardiogram (ultrasound scan) this afternoon. The operator said that the results would be ready for the doctors to examine in a few hours.
Day 3, Fri 23 Aug 2019: A senior doctor came around speaking to patients this morning. It’s easy to identify the senior doctors when they’re accompanied by a number of other doctors but, beyond that, I’ve no idea what the role of the various doctors is. I asked about the echocardiogram results and was told “we’ll have a little look and get back to you” (I can feel a “hurrumph” welling up at this point). By lunch time, one of the nurses confirmed that I wouldn’t be scheduled for the angiogram until next week. I’m not being treated as an emergency case which is good because that indicates to me that it’s not really serious but it does mean that I’m going to have to wait. Since I arrived, I’ve had a needle in a vein around my left elbow. I don’t recall it having been used since it was inserted. Apparently, it’s used during the angiogram. The nurse agreed to remove it because it wouldn’t be needed until Tuesday at the earliest.
Day 4, Sat 24 Aug 2019: I asked one of the nurses about the echocardiogram as a result, another doctor came to explain the results to me. He said it showed that the two main chambers (ventricles) of my heart are OK but there’s some damage to the smaller chambers (atria). He also said that my heart isn’t relaxing properly (I think the chambers relax when they’re filling with blood prior to the contraction which forces blood through the arteries).
Day 5, Sun 25 Aug 2019: I see lots of reports about the Severn Bridge 10k & HM. Apparently; it’s really hot out there! Seems the hospital has a working air-con system. I started to wonder how I would have coped if I’d entered (with a fully functional primary pump).
Day 7, Tue 27 Aug 2019: I’m on the rota for an angiogram today (“yipee!!!, oh no, HELLLP!!!”). A nice new needle is inserted into my left elbow (hurrumph, again). After breakfast, I’m not allowed to eat (to make sure that I’m not sick during the operation). My choice for lunch goes out the window (not literally). I’m wheeled down to pre-op in my hospital bed. The procedure is explained to me and I sign an authorisation form. After about half an hour, it’s my turn and I’m wheeled down to the theatre. Since I’m somewhat concerned by now I changed my mind about the tranquiliser that I was offered earlier. Since it’s delivered via a tube connected to the needle in my arm, I’m not aware of it being administered but I think I started to feel calmer. I noticed that the staff are all wearing heavy waistcoats, I assume that’s protection against over exposure to x-rays. My right wrist is used as the entry point. I can see the screen showing the “live action” but it’s not very clear because it’s at an extreme angle (although, on balance, I think it’s good that the surgeon has the best view of what’s going on). The procedure shows two constrictions in the left anterior descending (LAD) artery which are treated with a single long stent. After the procedure, I’m offered a sandwich from the “emergency” supply and I managed to scrounge a second one. Back on the ward, I accepted the offer of another sandwich. Come tea time, I wasn’t that hungry but ate it anyway.
Day 20, Mon 9 Sep 2019: My initial appointment with rehab. This was a discussion about my current status and some details about the rehab programme. Apparently, I'm much fitter than the average heart attack victim! The programme is made up of eight group sessions, each of which entails monitored exercise followed by a talk about health. My first session is in about two week's time. I'm currently doing a gentle walk for an hour a day. My next step is to introduce a short period of moderately paced walking in the middle then gradually increase its duration. This should be at a "conversational" pace (which was covered in way too much detail for me because I already know about it from running).
Day 21, Tue 10 Sep 2019: Added a two minute “moderate” walk in the middle of my slow walk today!
Day 22, Wed 11 Sep 2019: Chest felt a bit uncomfortable today so I just did a slow walk.
Day 23, Thu 12 Sep 2019: Taking it easier than yesterday, chest felt better.
Day 26, Sun 15 Sep 2019: Included 5 minutes of “moderate” walking today...progress! Also strolled over to the start / finish of the local school’s 10k which was to have been my first race: big hurrumph here.
Day 37: Thu 26 Sep 2019: My first day at cardiac rehab. This is basically an hour of circuit training followed by an hour of talks about heart health. Blood pressure and heart rate are checked at the start and heart rate is re-checked at intervals. There’s a very gentle warm up followed by the exercises then a gentle cool down. I found it useful in that it gave me confidence to start pushing my exercising a bit.
Day 38: Fri 27 Sep 2019: Since it was wet outside, I walked on a running machine in the gym for 40 minutes. I also did the NHS knee exercises (with hindsight, it would have been better to start with just one set, not all three!)
Day 39: Sat 28 Sep 2019: Went out for a walk & covered 6k in 1 hour 5 minutes. A few weeks ago I could have done that distance in half the time, still, it’s a start.
Day 40: Sun 29 Sep 2019: Headed out for another walk but had to cut it short because of shin splints. Time to get the foam roller out!
Day 42: Tue 1 Oct 2019: After having chest pains overnight, I went into casualty early this morning. A blood test showed that everything was OK, as did a follow up test a couple of hours later. I’m starting to think that I’m going to have to get used to “a new normal”, at least for a while.
Day 44: Thu 3 Oct 2019: Attended rehab for my second week. Instead of stepping, I tried pushing some of the exercises by jumping instead. This pushed my pulse up to 160 which is higher than it used to be on some runs. Maybe I should have a go at some gentle jogging?
Day 46: Sat 5 Oct 2019: Volunteered as timekeeper at Pomphrey Hill ParkRun. Afterwards, I tried walking the course and completed it in 47 minutes so my walking pace isn’t too far off what it used to be. I then tried a gentle jog and managed 500m in 4 minutes. Back in August, I was going quicker than that at the end of 20 miles but it’s the first time I’ve run after my heart attack and it felt OK so I’m pleased with that. It’s good to be able to run again!
Lifestyle: On the whole, there’s not much that I can change. I’m going to be on statins to lower cholesterol but there are some things I can do: cholesterol lowering spread instead of butter on toast (I found that Tesco’s spread tastes fine); no more jam on my toast; don’t skip evening meals. The other thing is alcohol! On a typical week, I go out on a Friday afternoon and have four pints (beer, not pure alcohol). That’s going to have to drop to two. The rest of the week, I don’t usually drink anyway. What’s really going to have to change is that once every couple of moths I go on a “historic buildings tour” around Bristol. That typically starts at lunchtime and goes on till mid evening. On the last one I think I managed to hit double the recommended weekly allowance. I’m going to blame the guy who organises it for that so I’m preparing for a severe ear bashing when I start talking to myself.
State of mind: I've always kept in mind that my main reason for running is diabetes control and general health. Targets of pace, distance and events are great for motivation and providing a challenge / focus but they're not my primary focus. I'm therefore OK about taking things easy for now. I suspect that my rate of recovery will start to ramp up, that kind of thinking helps, as does being told that I shouldn't have lost much fitness. I've had to give up my plans for a full marathon within a year of starting C25K but I've accepted that ( for now, I'll have to be content with having reached 20 miles in training which indicates that I was on course).
Worry: Initially, I didn’t know if it was something or nothing so I was concerned but not panicked. I was more concerned about trying to get to sleep at night without knowing. By the time the heart attack had been confirmed, I was already in hospital so I wasn’t unduly concerned. Having been thoroughly checked over (and now on a rehab programme), I’m now confident that my heart’s going to be OK. The most worrying time for me was at the start of the keyhole surgery; I think tranquilisers helped at that point.
Warning signs: Disclaimer: I'm not a medic (but I did pass O-level biology over 40 years ago), this is a collection of what I've read, what I've been told and my experience. Being a diabetic, I have an annual blood test. My overall cholesterol level was 4.5 which memory tells me it had been for a number of years. On the NHS website, I read that it should be below 5 so I figured I was OK. On the Saturday, I had an appointment with a diabetic nurse who said it should be below 4. Didn't have much chance to do anything about it because I had the attack the following Tuesday. I'm now unsure as to what's a "good" level; taking to a health professional is probably the best option. As for other indicators, my parents lived to well over 70 which put me at "low risk" (I don't have any siblings). My dad's brother died of a heart attack at 55 but that, supposedly, isn't a factor. The only other diagnostic tools that I'm aware of are an electrocardiogram (ECG) and an echocardiogram. An ECG isn't normally used on otherwise healthy people because the risk of false positives is too high. Just after my attack, the ECG showed "an inverted t-wave" which is an indicator of a restricted coronary artery which is what I had. The echocardiogram (an ultrasound scan which I think is similar to that used for babies in the womb) will show damage to the structure of the heart itself, I don't know if it's any use for predicting an attack, l suppose it could give warning of any structural problems. After an attack, a blood test will show a high level of some particular hormone. It's used to confirm a heart attack but wouldn't seem to be any use in predicting one (I think that high levels can also be seen if other muscles have been pushed to the point of needing major repair work).
In addition to the main bit about staying alive, it's good to be checked out straight away because a blood test can confirm whether or not it's a heart attack. If you leave it for a while, there's always going to be that nagging doubt.
Women! I just learnt that the symptoms in women can be (are?) different. Please see the reply from EB43 below and do bear in mind that this is a summary of my experiences and what I’ve learnt, it’s not a diagnostic manual but, hopefully, it will spread some awareness.
It's happened again 🙁 I've put the details in a new post: healthunlocked.com/marathon...
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