I really didn’t think I’d be back here again.
After my first MI in August 2019, I really thought that the medication I was on would prevent a repeat of this. However, 3 ½ years on, it’s happened again. Seems that I’m in the small minority (less than 2%) for whom the standard medication doesn’t prevent another occurrence.
The idea with this post is to document my progress so that anyone who wishes to see how I’m getting on can do so without everyone getting lots of posts about it from me.
I documented my original experience in this post: healthunlocked.com/marathon...
After my first MI, I started on the standard medication (aspirin, ACE inhibitor, statin and PPI plus ticagrelor for the first year). Over the following 12 months, I very gradually built back, finally returning to running half marathon distance most weekends. About a year after the original MI, I experienced jaw pain (which can be a symptom of an MI) which resulted in me having a second angiogram. This found that my arteries were completely clear i.e. no change from when I’d had the stent fitted. The cardiologist told me that, if I did have another MI, the symptoms were likely to be those that I’d experienced the first time (a tight feeling across the chest in my case). Over the next 2 ½ years, I continued to build up, running three or four times a week, completing one 45 mile run (in 13.5 hours), four marathons and a few shorter races.
Which brings me to Sunday 16-Apr-2013, the date of the Newport marathon. With interruptions due to bad weather, going on holiday for a week etc, I wasn’t quite as prepared as I’d have liked but I was sure that I’d be able to beat the time of my slowest marathon. I took my usual approach of running it at a comfortable pace (although, towards the end, I did find the run harder than I would normally expect). As it turned out, I shaved 90 seconds off my previous best marathon time.
As soon as I stopped, I became aware of a sharp pain in the centre of my chest (i.e. not the same as the pain that I’d experienced the first time). I completed my post-run stretches, strolled back to my car to change out of my top (about 10-15 minutes from the finish) then sat down on a bench to see if that would relieve the pain. When that didn’t work, I decided to go and get checked out by the medics by the finish line before driving home. They ran an ECG, said that I needed further checks and took me to a local hospital by ambulance. Tests in the hospital confirmed that I’d had another MI (the normal troponin level is below 20, my first reading was 230, three hours later it was 2921). I spent a really uncomfortable night trying to sleep in the AMU ward (my chest still hurt and my legs were a bit stiff). I was told that I’d have an angiogram the following day (Monday) and would be going home on Tuesday.
Monday 17-Apr-2023 (day 1) I was transferred to a room in the cardiology ward where I had a much better night’s sleep. An echocardiogram was done which showed an ejection factor of 40%. Normal is above 50% although I think I was down to 40% after my first MI so it’s possible that this second event hadn’t done much more damage.
Tuesday 18-Apr-2023 (day 2) I’m last on the list for an angiogram today so “clear fluids only” after breakfast. By late afternoon, it’s clear that I’m not going to be seen today so I’m given some sandwiches.
Wednesday 19-Apr-2023 (day 3) I’m half way down the list for today so back on clear fluids after breakfast. Taken up to the X-ray room about mid-afternoon. However, another emergency case came in so I’m sent back to the ward.
Thursday 20-Apr-2023 (day 4) Second on the list today, so fluids only from midnight. Taken down about 10 am. Was due to go in around 11:45 but then another emergency patient turned up. That patient came out at 12:15. Then the staff went for lunch. It’s finally my turn at about 1:30. Seems that one of my main heart arteries (the LAD) is severely clogged. The congestion that’s built up in my original stent is cleared and a second stent is fitted further along it.
On discharge, I’ve been prescribed ticagrelor for the first year (at the full 90mg * 2 dose) then 60mg * 2 for the following two years. I’ve also had a beta blocker added to my regular heart medication (although my resting HR is now down to 42).
So, it seems that I should be OK for the next three years. My big concern is that, once the super aspirin is stopped, is the blockage going to build up again. It seems that the only way to check is with an angiogram but that won’t be done unless I have further problems (although it’s much less intrusive that having an open chest procedure, it still needs a lot of highly trained staff and there are risks involved so it’s not something that can be done just to check).
Although being on then off then on for three days is frustrating, I understand that emergency cases should take priority. In some ways, it’s good to know that I’m considered stable enough to be able to wait.
Friday 21-Apr-2023 (day 5) I’m sent home about lunch time. I was told that I’d be given a copy of my discharge notes and a sick note before I left. Unfortunately, I forgot to chase this up so I left without these. I’ve been told that I should receive a letter from Cardiac Rehab next week.
Sat – Sun (days 6 – 7) Went for a few gentle shuffles locally.
Monday 24-Apr-2023 (day 8) Had a phone appointment with a GP to discuss this. At this point, the GP hadn’t received anything from the hospital. I was, however, issued with a sick note.
Tuesday 25-Apr-2023 (day 9) Went for a longer stroll today. Although my pulse was OK for a while (around 80), it started peaking way too high (175). Seems I’m going to have to ease back for a while.
Wednesday 26-Apr-2023 (day 10) Cut today’s shuffle short because my pulse went up to 136.
Saturday 29-Apr-2023 (day 13) Received a message from my GP saying that my notes have been received from the hospital and that a copy has been left at reception for me to collect. Unfortunately, it’s a bank holiday weekend and reception won’t be open until Tuesday.
Tuesday 2-May-2023 (day 16) Finally receive a copy of my discharge notes. They confirm that I’ve been referred to Cardiac Rehab. Somehow, it’s no surprise to me that I haven’t heard anything from Rehab. After my first event, I have a phone number for the unit in my local hospital so I called them and asked if they’d received the referral. They’d heard nothing so I explained what has happened and they said that they’d contact the hospital in Newport. I then called the number from my discharge letter. It took me half an hour or so to get through to the right department. I then explained the situation and gave them the number of my local Rehab.
Wednesday 3-May-2023 (day 17) Went for a slightly longer shuffle today. Since the spike on day 10, my pulse has been nice and steady so I upped my pace a bit today. Even though I went a bit quicker, my maximum pulse was 76 so it seems that things are settling down.
Thursday 4-May-2023 (day 18) Received a phone call from my local Cardiac Rehab saying that I’d been referred to them by the hospital. Can’t help thinking that I may have had something to do with making this happen. Anyhow, my first appointment is on 19-May.
Race cancelled due to low numbers