Not Your Average Heart Attack

 

Excited to share with you a guest blog today from Heather Meyer another SCAD survivor.  SCAD, touches all people, no matter where you live or what your lifestyle is. You can follow her blog at https://www.unbreakablefitnesscoaching.com/blog

 

 

Monday morning 5:30 AM, just like any other humdrum Monday morning, sitting with that feeling in the pit of my stomach knowing that I had a day full of client meetings, agency pitches and an entire week of 10-12-hour days, so I paid no mind really to the pain radiating across my chest. I exercise vigorously including running, riding, snowboarding, hiking, and strength training every day of the week so I attributed it to muscle pain which I experience often. It never occurred to me that it could be anything else. Plus, I was distracted, more focused on my work tasks than on myself, pushing through everything like I’ve always done. 

 

This particular morning, the morning of February 8th, 2016 was different, the kind of different that changes your life forever.  In an effort to get the pain to subside I took two Advil and laid down to see if it would fade away, or if I could mentally ignore it.  As I struggled with different positions, massaging my chest, experiencing increasing pain, and fairly sure that 20 minutes had passed with no relief, I finally began to think that something could possibly be wrong.  

 

 When I decided that the pain was a signal of something else going on, I got myself dressed and then went to find my husband who was on a conference call.  In the short period of time it took me to get down the steps into the kitchen I was doubled over in pain. The look on my husband’s face as I rattled off the symptoms told me that he was worried and it was only then that I started to considered that ok, well maybe this is a little serious but nothing too serious. My rational was backed up by a few factors; I was only 40 years old, I was vegetarian, with no other risk factors, and completely healthy, so my unwillingness to believe something was wrong was validated in my head. My husband after some discussion decided we would drive to the Emergency Room. My first mistake in the entire event was this decision. I should have called an Ambulance but made the decision not to based on two factors: 

 

1)   I lived in Colorado in High Country at 8,300 feet on a dirt road off of a road called Magnolia Road famous for the hair pins and steep grades that drops 3,000 feet down into Boulder. I thought it might be faster to drive myself, which as an after-thought is not accurate.

2)   I didn’t truly believe that anything was really wrong with me.  I was still in denial that even though the symptoms all read heart attack, that it was an impossible scenario that something like that could happen to me.

 

My husband and I casually got ourselves together and drove down the mountain. We were so casual about it that our first stop was at a Hospital that didn’t have an Emergency Room, oops. As we made our way to the correct hospital we caught red lights, got stuck behind slow people, it was rush hour, everything was working against us in terms of time. We still chatted away though, shifting conversations between my symptoms and casual topics.  I do honestly believe now, that this casual calm approach helped protect me. It kept me from having anxiety which would have probably exacerbated the situation.  

 

Arriving at the emergency room they took me right away, as they always take chest pain very seriously, plus it was a quiet morning there. They kicked into high gear taking blood work, hooking up IVs, EKGs, and running the whole gamut of tests.  

 

After a few hours the ER Doctor who I now attribute to saving my life approaches me and indicates that nothing is showing up in the blood work, but something still doesn’t seem right to her so she doesn’t want to release me, she wants to keep me for observation.  This decision to admit me would be critical in saving my life. If she sent me home, which happens often with SCAD patients, I may not have made it.  It’s also important to note here that the Troponin protein that shows up in your blood when you have a heart attack sometimes doesn’t show up in your blood for 6-12 hours after the initial attack, and this was the case with me, so still no indication of a SCAD heart attack at this time.

 

The hospital then set me up in my cushy private room with my organic food menu (I was starving), and I ordered up food and texted my oldest sister as a precaution to let her know that they were going to admit me but assured her that there was nothing to worry about. 

Hunger trumps everything for me so after I eat, I’m focused again on this persistent pain that is not improving, and not responding to Toradol which they gave me because they thought I might have pericarditis. Just as I’m trying to process the situation again, a cardiologist walks into the room and pulls up a chair.  He says, your blood work came back, and there is Troponin in your blood, we need to rush you into catheterization surgery. We think you are having a Spontaneous Coronary Artery Dissection. Just then my whole world shattered. What is SCAD? What do you mean Cath Surgery???  How could this be happening? I look over at my husband who is now white as a ghost, mouth gaped open, dumbfounded.  

 

As they prepped me and asked me to sign release waivers indicating the risk of mortality during the surgery, I texted my sister saying “Shit Just Got Real”. Call Mommy and let her know. At that moment I regretted not telling my Mom, because if I didn’t have the chance to speak to her again I knew she would be devastated and it wasn’t fair for me to do that to her or anyone in my family for that matter. All I could do now was hope that I made it out, that they could confirm the SCAD and that she would have the opportunity to set me straight about keeping her in the know J.

 

To provide a little background and thought process before moving on.  I have a very large, close knit family who all lived at the time 1,900 miles away from me back on the East Coast.  I knew based on this I needed to be careful about how I communicated what was going on with me in order to prevent total chaos, so I made the decision to only text my oldest sister who during times of adversity I know can be discreet and maintain a sense of calm.  Talking to my mother wasn’t an option at this time because I know she would feel helpless and I didn’t want to put that stress and pressure on her, so I decided I would wait until I was out of the hospital. I was fairly sure that I would be out in a couple of hours and could let everyone know after the fact so I wouldn’t cause anyone any unnecessary worrying.  Another mistake. Let your family and those close to you know immediately when you are in the hospital, you never know when it might be your last moment, and they deserve to know. 

 

The trip down the long, cold, hallway to the catherization lab was a blur. Once inside it was freezing, filled with stainless steel equipment and a flurry of people buzzing around in masks and scrubs. I spoke briefly with the interventional cardiologist and within minutes I was out.

After the procedure I woke up in the recovery room feeling groggy, disoriented but happy knowing that I was in the right place. The surgery confirmed that is was indeed a SCAD and that the best treatment approach was to let the tear heal on its own. It’s a less invasive approach, and arteries do heal on their own.

 

The next morning however after the surgery, I woke up in the hospital bed with excruciating pain again in my chest, arm and neck, so they gave me some morphine and did an EKG.  Within minutes of hooking me up to the EKG, the tech sprinted out of the room and I knew it wasn’t good.  With the drop of a hat I was off to the Cath Lab for my second surgery. 

 

My cardiologist walked me down to the lab, and I bluntly asked him if I was going to die. He looked at me in a matter fact way and said “I don’t know”.  Something strange then happened.  I accepted what my fate could be and I wasn’t afraid. I thought it’s out of my hands now and nothing I do will change my outcome. Acceptance is peaceful, and it allowed me to go into the lab unafraid.

 

As they wheeled me into the Cath Lab, I made jokes along the way. I told the interventional cardiologist in the lab that I was embarrassed that I was wearing the same outfit as yesterday, making light of the situation.

 

I woke up again in the recovery room, this time I felt rough. Two surgeries, so invasive to your body and heart is hard to handle.  As it turns out, the SCAD had completely blocked the blood flow to my heart, I had a myocardial infarction and I was now outfitted with two brand new shiny stents. Woo hoo, I was finally bionic (just kidding), well sort of.   In addition, I had a massive hematoma on my groin where they went into my femoral artery that was the size of a grapefruit.  When a second Catherization is required the Cardiologist cannot use the same collagen plugs, so they simply use pressure. The pain was off the charts as the doctor put his entire body weight on the hematoma to get the bleeding to stop for 45 minutes. Now I’ve been through many things in my life, but nothing could compare to this, it was the rawest edge of emotion and pain I’ve ever experienced.

 

 Day 3 comes, and I’m stabilized or so I think.  I could start to process some of the feelings, and it was like my whole world just got flipped on its head. I didn’t know who I was anymore, my whole identity as an athlete was taken from me. It was a whirlwind of emotions. 

 

The party was not over yet though. I started to feel worse again, like I was going to pass out. I told the nurse, but she just told me I was just anxious and said I would be fine.  I trusted her, but as more time passed I had a gut feeling, you know the one where every part of your being knows something is not right, and as I passed out I pressed the call button and told my stepdaughter to get help.

 

It is my understanding that the entire code team was in my room that day, and that my blood pressure and heart rate were dropping at a drastic rate and they couldn’t stop it.  I believe it was in that moment that I think I experienced a Near Death Experience.  I wasn’t afraid, I felt at peace, and I felt sorry for my family around me because I knew that they would be sad if I passed. I wanted them to know that I was going to be ok, and even if I passed that that I would be ok and be in a better place.  My emotions were peaceful, and it was the most peaceful thing I’ve ever experienced in my life. I felt calm, accepting, and there was no fear. I didn’t fight to stay alive, I let things just flow, and just then a thought popped into my head. The thought that today wasn’t my day to die. Then I became conscious again, and saw the entire Code Team in my room, with my husband and step daughter in the back of the room crying. I was back, and that fateful day was apparently not my day to go.

 

Since my SCAD I’ve been sick with re-occurring pericarditis, in and out of the hospital at least 4 times, but never catheterized again like many other SCAD patients. I’m on my way finally over 2 years later on a path to wellness with the right care and medication.  I’m grateful for the amazing doctors at Boulder Heart who knew enough to admit me, and knew enough to identify the SCAD.

 

I also made a decision to leave my stressful corporate job and move into a profession where I could give back. As such I went back to school and became a Certified Personal Trainer and started a fitness coaching business. My focus is on helping other cardiac patients or people from special populations to help them improve or develop a healthy lifestyle.

 

Extreme situations that bring you close to death change your perspective and the way you view life. Sometimes it brings more fear, sometimes it brings less fear, but the most important thing it does is remind us how precious life really is and how quickly it can be taken away from us.

 

My advice to everyone, not just SCAD patients is to get up every day, breath in the fresh air, hug your family, tell people you love them, play with your pets, and most importantly project out love and kindness, because I’m convinced that’s the only way to be truly happy. 

 

SCAD changed my whole life, but good things come with bad things all the time and set me on a path to enlightenment, change, and gratitude. 

 

Heather Meyer

SCAD Survivor

National Academy of Sports Medicine, Certified Personal Trainer

NASM, GPT

Precision Level 1 Nutrition Certification (in process)

www.unbreakablefitnesscoaching.com

SCAD not SCAB

Time to take a road trip to Kansas City to learn about SCAD!

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While most people head to Kansas City, MO for barbecue my trip took on a different mission. I loaded up the car with my daughter Brenna as my co-pilot and set the GPS for St. Luke's Hospital. Our mission: To learn as much about SCAD, Spontaneous Coronary Artery Dissection.

My daughter happened to be studying hearts in science and wanted to go along to see what caused my heart attack. I was a little hesitant at first because she's only 12. What if she hears words such as morbidity or mortality? Will it freak her out? Will she have more questions than when we set out? In the end, it ended up being a fantastic experience for both of us.  Not many 12-year-olds get to hear a public forum on SCAD conducted by two amazing Cardiologists.

The SCAD talk conducted by Dr. Jason Lindsey and Dr. Tracey Stevens at Muriel I. Kauffman Women's Heart Center in Kansas City, MO. The 90-minute discussion flew by! I ended up with pages and pages of notes and still wanted to hear more. At one point I looked over at Brenna, and she was taking notes. I was in shock. Here a 12 year old was taking notes on a subject where there's no test!   Although there are more questions than answers known about SCAD, it's so intriguing to see what might be the cause. 

 

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While I was at the talk, the American Heart Association put out a scientific statement on SCAD. This inspiring news and the massive step in the right direction. Many times when I tell people my story and tell them my heart attack cause was SCAD and not plaque they are confused. My goal is to educate everyone and let them know that it can happen to anyone.

Here are some of the key takeaways from the SCAD town hall: (These are from my notes taken from Dr. Lindsey and Dr. Stevens town hall

1. SCAD accounts for less than 0.5% of heart attacks, but it accounts for 25% of heart attacks for people under 50 years old.

2. 9:1 ratio women to men. Still not understood as to why

3. The person is healthy without risk factors

4. There can be a hormonal relationship, most common cause of pregnancy heart attacks.  Non-Pregnancy related SCAD is much more common. 

5. Genetic link??

5. Medical management, no approved drugs for SCAD. 

6. SCAD Symptoms: 45% Chest Pain, 24% Palpitations, 21% Shortness of Breath

7. Ask to have your doctor rule out Fibromuscular Dysplasia ( seen in around 60% of patients)

8. 57% postmenopausal,  rare in 65y/o and higher, 10% malignant arrhythmias, 5% Connective Tissue disorder, 12% Systemic Inflammatory disease

9. Exercise: STAY ACTIVE POST SCAD

10. Prognosis: Recurrent SCAD around 10%

11. 10-year mortality 1.1%

12.  Most dissections will heal in 1 month. Not placing a stent is a better treatment plan.  Avoid hormone replacement, Usual medicines Asprin and Beta Blockers. Cardiac rehab has been shown to decrease rates of recurrent SCAD.

Future Direction: Genetic Predisposition? Determine how to prevent the 1st event and recurrent events.  Ask for a CT coronary angiogram for follow up if needed and not a PCI.

THE NEED to have a prospective registry.

If you are a SCAD Survivor,  join the SCAD ALLIANCE at www.scadalliance.org #SCADheart

 

As Brenna and I drove home we discussed what we had learned. I was shocked at how she retained the information from the night before. We both agreed that more research needs to be done, still too many unanswered questions. 

In the end, it's up to us to get out there and not only educate ourselves but others! I'm just one SCAD survivor trying to make a difference!

 

 

 

 

 

 

Keeping my heart story going... CNN Health.com

My goal to help others continues this week with the sharing of my story on CNN health.com.  When I started my blog two years ago, never could I have imagined sharing my story at a national level! Blogging has helped me through my heart attack recovery. My hope in writing my blog is to help others who are going through the same thing. 

Attached you will find the article published on CNN Health.com.   This article discusses a new study published in the Journal of Circulation highlighting the difference between men and women's cardiac symptoms.

https://www.cnn.com/2018/02/19/health/heart-attack-symptoms-women-study/index.html

 

 One of the first pictures taken post heart attack.

One of the first pictures taken post heart attack.

 

Together, we can all work to advocate and prevent others from having to experience this crazy journey of heart attack survivor.

 

 

When your week begins with an ambulance ride and a Nitro prescription...

It began as a normal Monday and ended up with a call to 911, an ambulance ride to Mercy and hours in the ER to simply leave without answers. I started the week with the excitement of Go Red coming up on Friday and ended up truly understanding why February, Heart Month is so important.  As we sat and ate supper, I started to have severe pain in my left neck that radiated down my left arm. All I could think of is "not again!" I looked at Joe and told him what was going on, and we both decided to call 911. While we waited for the paramedics, I kept thinking about the odds that this could happen twice in two years? Is it stress? Heartburn? Gas? Ironically, almost two years since my last heart attack, Ryan the paramedic comes into my house and say "hey, we have to stop meeting like this." 

On a side note. You can take it from me. The fear of embarrassment subsides quickly when help arrives. Plus, it keeps the neighbors on their toes when the neighborhood is lit up like a 4th of July parade. What can I say, humor can be the best medicine.

They ran an EKG; Troponin levels were drawn, chest x-ray and a CT scan to rule out another dissection. All were normal thank GOD! But that's when it truly gets scary, what is it? Over and over I explained to the doctors and nurses that this is what happened the week before my last Dissection (S.C.A.D. Spontaneous Coronary Artery Dissection).  Two years ago, I went to the doctors, and they kept telling me I must have slept wrong on my neck and they tried to give me muscle relaxants. No cardiac workup was done. At that time I would have never dreamt that it was my heart. 

Monday night I was sent home from the ER and told that everything looks good and it must be a musculoskeletal pain. You have to be kidding me! Joe and I were beyond frustrated! We wanted answers and most of all a guarantee that it was going to be ok. I knew it was time to get ahold of my cardiologist.  

On the car ride home that night Joe and I kept saying over and over to each other that this is what  I had two years ago same exact pain.  Why won't the doctors listen? We were beyond frustrated and concerned. As I laid my head on my pillow that night all I kept praying  was "please God let me wake up tomorrow!" I called my cardiologist the next morning, and he had answers.

The problem, nobody knows what causes dissections and what you can do to prevent them.  So, Cardiologists are treating the symptoms with cardiac medicines indicated for other problems. Leading me to my new Nitro prescription. My doctor thinks that my neck pain on Monday night is due to a spasm in my coronary artery or a small dissection that is not large enough to cause EKG changes, cardiac enzyme changes or need cardiac interventions. With small dissections, your body has a natural way of healing them without the need for cardiac intervention. As my Cardiologist stated " we can go into the cath lab and look but you just end up chasing them." During this time,  your body sends out pain signals, i.e. my neck pain to let me know that something is going on.  Almost a week later and my neck still hurts, and I'm experiencing sporadic chest pain. With time, I hope this pain will go away.

So remember, February is HEART MONTH for this reason. Women's heart attack symptoms don't just slap you in the face and say "hey, she's having a heart attack!" Many times its very subtle changes in the way you feel that makes you question what's going on. Be your advocate. Question medical staff and ask for a second opinion. If you’re not comfortable with what you are  told... ASK more questions and demand more answers. No one knows you better than you!

Heart Attack Signs in Women

1.      Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.

2.      Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

3.      Shortness of breath with or without chest discomfort.

4.      Other signs such as breaking out in a cold sweat, nausea or lightheadedness.

5.      As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particular shortness of breath, nausea/vomiting and back or jaw pain. 

(American Heart Association)

If you have any of these signs, call 9-1-1 and get to a hospital right away.