Sunday, February 10, 2013
Women’s Heart Health & Sci-Fi Conventions
February is Women’s Heart Health Month.
Many of you know about my weight loss journey. Of course living between two and three hundred pounds for the better part of a decade and hovering around two hundred pounds for a decade or two before then took its toll on my body. I was diabetic, had a lot of aches and pains and I could barely walk three few feet without getting short of breath and having chest pains. The times I went into the Emergency Room the doctors said it was angina, not a heart attack. I had numerous stress tests, echocardiograms and even an angioplasty in which they found some plaque in one coronary artery, but not enough to require a stent.
I was lucky—especially the day I nearly blacked out while singing on the ward at the VA. I finished the song (clinging to my cane) and then sat down next to my music therapist. Another patient in the program was playing the piano.
Paula leaned over and whispered, “Rochelle, are you alright?”
I shook my head, which was clearing slightly.
“Do you think you need to go to the ER?”
I nodded. “Let…Jim…finish.”
Paula got the ward nurse while Jim finished his piano piece and they got me a wheel chair. That day in the ER they gave me four baby aspirin and three nitroglycerine tabs, but still called what happened angina. I passed both stress and echocardiograms, so they kept me for a day or two and sent me home, telling me I needed to lose weight—like I hadn’t figured that out thirty years and several failed diets ago.
That was when I asked the difference between angina and a heart attack. When the arteries to the heart muscle are blocked and oxygen can’t get through, you get chest pain. That’s angina. If the heart muscle is deprived of oxygen long enough to actually die, it’s a myocardial infarction or heart attack. You can tell you’ve actually damaged your heart muscle because it will show up on your electrocardiogram and because when heart muscle dies it releases certain enzymes into the blood stream. You can have cardiac chest pain and even a funky EKG but if those enzymes are not present, you’ve had angina or a “cardiac event,” but not a “heart attack.”
At some point a doctor ran a test and asked when my heart attack was. There were times when I had chest pain but did not go to the hospital. I can think of two off the top of my head. If you have chest pain that lasts more than twenty (20) minutes Get Thee to the Hospital FAST to paraphrase Shakespeare. And whatever you do, DON’T DRIVE YOURSELF! Here’s a good rule of thumb for us women caretakers who don’t want to disturb anyone. Ask yourself this question: If this was happening to my husband or my child, would I call 911? Treat yourself you the way you would treat the people you love. And don’t ask anyone to drive you. If you code in the car, they can’t treat you. Do you want that on their conscience? If you want to be around for your family, you have to turn the Golden Rule back onto yourself. I know it’s difficult. We want to take care of everyone else and we don’t want to bother anyone.
Don’t necessarily look for chest pains if you’re a woman. We have the strangest symptoms when it comes to heart attacks. I attended a seminar conducted by a group called Women Health at the VA where they talked about many of the ways heart attacks can be different for women than for men. Neither of the ladies there had typical heart attacks. Neither knew she was having a heart attack when hers occurred. They also told us that heart attack is now the number one killer of women. That’s partly because we have such atypical symptoms we don’t always go to the ER and often when we do, we get left sitting in the waiting room with heart muscle dying while patients with less life-threatening problems get seen before us.
One of the times I did not go to the hospital, I had chest pains, but they were radiating to my right shoulder instead of my left. Every book I read and movie I saw showed the person clutching his left arm. I was a guest in the home of a bunch of smokers and it was late at night after having inhaled a bunch of second-hand smoke and about coughed up a lung or two that the pain started. I bundled up and sat on the porch for three hours trying to catch my breath with pain in my chest and right shoulder, thinking maybe I tore a muscle coughing. When I finally went inside and went to bed, I dreamed I was in pain and woke up because of it later that night. I’m probably lucky I woke up at all. Most fatal heart attacks occur between three and five a.m.
So, what the heck does any of this have to do with science fiction conventions? I’m getting there.
Two weeks ago after a busy day, I came out of Wal-Mart, got into my car and my head exploded. I dialed 911 thinking I was having a stroke. My blood pressure was 198/80-something and my pulse was down around 50. A C-T scan of my brain showed no sign of a clot or bleed so it wasn’t a stroke. I told the doc I was having an anxiety attack because I had some chest pain. Guess what? My cardiac enzymes were slightly elevated. I had a mild heart attack. If I hadn’t asked for something for anxiety, chances are the docs would never have looked at my cardiac enzymes. They would have treated me for a migraine or sinus problems and sent me home.
I should have realized something was wrong. Leading up to the incident I’d been tired and unable to walk or work out as I did before. I would do my morning walk wondering, “Why do I feel tired? Why do things seem a bubble or so off plumb? Where are my endorphins?” Other signs of a heart attack can be pain in your back, jaw, neck, throat or shoulder. Women often have an upset stomach. Many people mistake chest pain for heartburn. I’ll post links at the end for more resources. Before they let me go home, I passed a stress test/echocardiogram, but since I’m still feeling all of the above symptoms, I’m taking it easy and planning to ask for more tests at the VA where I’m normally seen. The paramedics took me to a civilian hospital that night, and I’ve not yet been able to see my Primary Care Provider at the VA.
Okay—I’m not sure what the deal is with the headache. It’s never quite completely gone away. During the day, I can sort of feel it lurking around the edges. By night, it comes back if I don’t keep ahead of it with some sort of medication like Tylenol or nsaids. I’ve gone back to my volunteer work at the VA and even done one or two abbreviated work-outs. This past Friday (Feburary 8, 2013), I had an appointment at the VA and from there I went to CapriCon a science fiction convention. My intention was to just attend Friday, but I checked my purse with my coat and left my meds in it. The headache caught up with me fairly early in the evening and I didn’t feel up to driving home. Some friends allowed me to crash in their hotel room.
One of those friends is an RN. I quit using my CPAP a couple of years ago. It was uncomfortable and my sinuses are so badly congested, I felt as though I couldn’t breathe at all with the CPAP on. Besides, I figured I didn’t need it anymore since I’d lost 145 pounds. I was wrong. My friend said my snoring woke her and I stopped breathing several times in the hour or so I kept her awake that night. Sleep apnea can cause heart damage, which could be one explanation to why I had this heart attack now that I’m thin. I dug the thing out of the closet last night and used it with mist. I still felt congested, but I soldiered through and woke up an hour before my alarm went off feeling more refreshed than I have in awhile. I plan to follow up with the sinus problems as well as cardiology when I see my Primary Care person.
Since I woke up at the hotel yesterday morning, I decided to pay for the full con and stick around. I’m so glad I did. Gene Wolfe, one of the few remaining classic sci-fi writers was there. It turns out he lives in a Chicago suburb. He’s being honored this year by the Science Fiction and Fantasy Writers Association with a Damon Knight Memorial Grand Master award for "lifetime achievement in science fiction and/or fantasy," so they had a special interview with him. The room wasn’t nearly as full as I expected, which made the interview very intimate and cozy.
Later in the day they had a panel that was right up my alley entitled “Girl Cooties! Someone put Romance in my Sci-Fi!” Who should show up and ask if the seat next to me was taken? Mr. Wolfe! What a lovely, gracious man. He’s a Korea veteran, so we compared a few notes on military experiences and talked about writing sci-fi romance. He was there because that’s what he’s working on right now. I gave him my cards and he says he’s looking forward to reading my books! Wow! Instant silver lining! I’m so glad I was too sick to drive home Friday. Still, I can’t wait to see my PCP. She’ll be out all next week so I can’t get in to see her until the week after. Meanwhile, I’m taking it easy.
For more information on women and heart attacks:
The American Heart Association: http://www.aha.org/
Women Heart: http://www.womenheart.org/