I haven’t really spoken about this publicly yet, but I figure few enough people will read this post that I can test the waters a little bit…
For the past few years I’ve been making small changes to improve my life. Eat better, walk around more, things like that. Last march, I decided it was time to add a regular exercise program, so I started Couch-to-5k. C25k is a program where over the course of 8 weeks or so, you work up to running for 30 minutes constantly without a break. The first day felt really good to me, and I was excited. But the good start did not last. I kept pushing hard, but a few weeks into the program, it was clear that I was not getting better. In fact, I was getting worse. I felt like I was hitting a wall where if I put more effort in, the worse I got. The data supported this – I was covering less distance even though I was running for the same amount of time. I decided it was time to see the doctor.
The doctor listened to me and started running tests. Blood workup was first, and the doctor told me to continue exercising, which I did. The lab here in WA is very fast, and I had the results the next day. Everything we normal, except for elevated White Blood cell count. An infection could explain my symptoms, so the next round of tests was ordered. We ran more blood workup looking for proteins related to muscle degeneration, and there was a chest xray and sleep lab appointment scheduled. I was nervous about the xray, because I knew the differentials with a positive result on that test were not pretty at all. The results were negative.
This all took a couple of weeks, and over that time, my symptoms were getting worse. I started getting these episodes where my heart would feel like it was racing. I would just be sitting at my desk, or on the couch, and my heart would feel like it was trying to burst out of my chest. I would feel like I *should* be out of breath, but I wasn’t. It got weirder when I tried to measure my pulse. It would look perfectly normal – 70-80 bpm. A few times, it was even very slow – in the 40-50bpm range. I didn’t know what to make of this, but the feeling would pass after a few minutes.
At my next doctors appointment, the nurse had trouble for a moment taking my pulse. She asked me if I was “afib.” I didn’t know what that meant, but it’s a type of irregular heart beat. I said no, but combined with my new symptoms, focus turned to my heart. An EKG at the doctors office showed normal, but a stress test was scheduled a month out – the earliest available appointment. The doc told me to keep exercising, so I did.
My symptoms continue to get worse. The racing heart episodes started happening every other day, and then every day, and then multiple times in a day. When I was jogging, it felt like I was working against an inverted gear. The harder I pushed, something pushed back even harder. It felt wrong, but in a way that is very hard to explain. It felt like impending doom, as though something very bad was just about to happen, but hadn’t happened yet. I started experiencing sudden fatigue while biking, where I wouldn’t be able to lift my leg to peddle. These things really scared me.
I was getting frustrated with the lack of information about what was happening to me. I started looking at EKG’s online to buy, so that I could get readings at home, when I was actually experiencing an episode. It turns out, they are not complicated devices, so I was able to build a three electrode EKG out of an arduino. After some tuning, I was able to get a good reading at home, and my hear looked normal. I waited for another episode to happen so I could catch my heart in the act.
This turned out to be more difficult than I thought. This was because the episodes only last a few minutes, and it takes that long to get the device all connected up and a good read. Plus, I had to put the electrodes on and calibrate it each time, all while feeling like I had just ran a marathon and was about to die. The first time I got what I felt like was a good reading, I was very puzzled. Heart rhythm looked completely normal. Heart rate was fine, too. I wondered if I was experiencing panic attacks. I started thinking that perhaps my symptoms were just psychosomatic, so that made me feel better.
The last day I exercised was a few weeks before my stress test. I was sure that the problems were all just in my head, so if I just push hard, my body would just fall in line. So I pushed hard, and then I couldn’t push at all. I couldn’t lift my legs, and in fact I couldn’t support my body. I was laying on the ground feeling like my heart was about to explode and completely sure that I was about to die.
But I didn’t. About five minutes later, I had recovered. I was able to stand up, and then I started the long and very slow walk back to my apartment. I had no idea what to do next.
My symptoms progressed rapidly. The episodes occurred more frequently, but I felt like all I could do was wait for the next test to happen.
I was super excited for the stress test. I was finally going to get some more information, and I could push myself in a controlled environment, which helped to counteract my fears of suddenly falling over dead. If you don’t know what a stress test is, they hook you up to an EKG and then stress your heart. This is usually done by running on a treadmill, though can also be done chemically. I was going to go for the treadmill. They record your EKG throughout the test, take blood pressure measurements every minute, and there are pauses where they take a sonogram of your heart. All that data is then sent to the cardiologist for analysis.
They hooked me up to a twelve electrode EKG and get some base readings. I watched my heart pattern very carefully, and I started to notice that there was a blip every once in a while. A heart beat that didn’t quite work right. I tried to correlate it to something I was feeling, but it was difficult, and I couldn’t be sure that what I was feeling was actually due to the blip or to my observation of the blip.
When I got on the treadmill, they told me my goal was to reach 160bpm on the heart. I knew from previous exercises that my symptoms could be triggered by getting my heart rate to 120-130, so this was great. The treadmill started, and things seemed just fine to start. But pretty quickly, the EKG started showing an erratic heart beat. At first, it was just one or two, but that grew and then it was 10 or 12 or more in a row, and the feeling of impending doom returned. But I kept pushing, because I wanted to get the most data possible. But they stopped the test before my heart rate even hit 130.
Regular Hearth Rhythm
Irregular Heart Rhythm
I didn’t know what that meant. I was sitting there and very confused. I felt like we hadn’t got the data we needed. One of the nurses asked one of the others if we had reached 160, and was answered with a very quiet shake of the head. I was feeling as though something had gone very wrong. Then they asked me if I had a scheduled appointment with the cardiologist to go over my results, and I said no. The test had been ordered by my GP, and I assumed I would follow up with him at some point yet to be scheduled. They told me to go wait in the lobby.
About ten minutes later, they told me that I had an appointment with the cardiologist later that day. Clearly something was wrong. I let work know that I wouldn’t be back until much later after all, and found a coffee shop to kill a few hours in.
The cardiologist showed me some of the results of the stress test and told me that something was definitely wrong with my heart. He didn’t know what, but we would start with some more tests. Given the tests that had been done, he felt pretty sure that it wasn’t Coronary Artery Disease. My lab results were all green, and I was so young. But Due Diligence says we need to take a look, and if that didn’t work out, we’d take a look at electrical issues. We scheduled a cardiac catheter procedure. Because of scheduling, it was a month away.
My symptoms began having a big impact on my life. Any movement for more than a minute or so would trigger it. I began to walking very slowly. I dreaded moments at work where I need to walk with other people, because I wasn’t able to keep up at all. Something would trigger it even while I was sitting still reading. I visited the Jet Propulsion Lab during this time, and while I was able to see the highlights, I wasn’t able to see everything and had to leave early.
I was really looking forward to going through the procedure at the hospital. I was going to get more information about what was wrong with me, and I figured it would be a nice little adventure. I was feeling pretty depressed and it gave me hope to think that some progress would be made. I arrived and got prepared. The cardiologist stopped by to take a look at my right arm artery where they would be inserting the catheter. Everything looked great and he gave me some encouragement. He told me that he thought it unlikely that we would find anything specific, but it would be a good test and was the next logical test. I was very impressed by the cath lab when I first entered.
It seemed that time stopped while I was in the lab. I don’t know how long I was in there. There was a lot of preparation, and they gave me some pills that would help me relax but not fall asleep. I was aware, but things didn’t really register. Things happened. I could feel the catheter snaking up my arm, but was surprised to find that it didn’t bother me. My mind wandered until I felt a tugging on my arm from the cardiologist. He said that they had found something and that they would try to fix it so that I wouldn’t need open heart surgery. I thought that was a great idea. I heard them doing some planning, but not understanding the details. Then they were done. All in all it took a few hours.
They explained that they found my left anterior descending artery was occluded almost completely. They called it 99% blocked. They placed three stents and opened it back up. Everything looked good again, and I was a 34-year old with a diagnosis of coronary artery disease. I didn’t understand what they were saying exactly. I accepted the facts, but didn’t understand the why. And I was cold – the coldest I think I’ve ever been. I think it was a bit of shock. My teeth were chattering so hard I couldn’t think, but they wrapped me in these amazing warm blankets and it got better. They kept me at the hospital over night, and I decided it was indeed an adventure, and one I never want to experience again.
Heart stents are magic. I was immediately seeing results. Once I got through the 48 hours after the procedure, I was feeling fantastic. The best I’ve felt in years. I could walk without trouble I spent that weekend just walking around. They told me not to do anything but walk, and I followed directions. It would be a few months before I could jog. I entered a cardiac rehab program.
Cardiac rehab is great. It’s data driven exercise. They hook you up to an EKG while you work so they can see if something is wrong. They take you blood pressure at certain points to make sure it’s looking good. They adjust your program as things get easier to make sure you keep pushing yourself. It last 12 weeks. I finished the program during the first week of September.
Yesterday afternoon, I ran for 2 miles straight in 33 minutes. I am full of gratitude for the people that have helped me out along the way: the doctors and nurses at Virginia Mason here in Seattle. They saved my life and have set me up to have a long life ahead of me. I look forward to what that future might hold.