The Yoga Teacher's Heart Attack
Chapter 11: ER Visit Followup
"Your chest pain is in your head..."
April 12 2017
Ironically, my long-awaited let's talk about the treadmill test meeting with Dr. Worth-the-Wait is just two days after the ER visit.
James drives me, since I'm still not allowed to use my right hand.
I'm stoked to get some answers and I'm hoping that the angiothing and the treadmill test showing no blood flow to my heart ... well, I'm hoping that we can stop referring to me as a fainting goat and instead treat me as a patient with a heart problem.
one week after he threaded a wire into my heart and found the artery tunnel thing. Or was it a bridge? I’m still in shock that he found a problem in my heart. It feels like there’s a news ticker in my brain now.
“Our heroine is now stuck in an epic traffic jam with a heart problem.”
“Our brave heroine is now standing on one leg in 110-degree heat with a heart problem.”
“She’s riding her bike to work and feeling chest pain while she rides up a steep hill with a heart that isn’t getting blood flow due to her heart problem.”
I’m excited to see Dr. Worth-the-Wait now that he’s found the issue at hand and I’m thankful that he seemed so chill about it all after the angioplasty. That’s probably a bedside manner technique he’s honed over the years.
He remembered to ask about my awesome Seattle Town Hall event – he is living up to his billing.
I bring up the angioplasty, the tunneled artery.
Again, there’s just a wee micro expression, a sneer.
“Actually, it is called a myocardial bridge.”
“But the artery is tunneled into the heart muscle, right? I don’t understand the terminology.
He turns on a high-wattage charming smile. “Ah, you must have been an English major. Good question. The word bridge refers to the muscle that’s built a bridge on top of the artery.”
“Do you have a brochure or a treatment plan or something? This sounds serious.”
He puts his foot up on the wheelie stool and leans in, placing his forearm on this thigh. It feels like the sort of thing you’d do when you want to make eye contact with a tantruming toddler.
“Listen, this myocardial bridge is completely benign. That’s why there’s no brochure, there’s no treatment plan per se, you’ve had it your entire life.”
“But the other episodes? And the chest pain? And the shortness of breath … I have had inexplicable shortness of breath for well over 15 years, so wouldn’t a blocked artery be a cause?”
Micro sneer. Foot taken off stool. Stool kicked back into place.
“The only reason you have chest pain is because you are stressing out about what I told you. Anxiety can really do a number on you. Also, your hormones are … (dramatic pause as though he went to a seminar about how to talk plainly to the little wimmin) … shifting and that can often cause the heart to feel a little off.
And remember, you come from a long line of fainting goats. There’s a decent probability that the myocardial bridge and the fainting are completely unrelated. Any more questions?”
“When an artery is blocked, how do you treat that?”
“Well, when I find a truly blocked artery, I start with medication to address symptoms and if that doesn’t work, then there’s surgery.”
“What kind of surgery?”
“Very minor, actually. Similar to the angioplasty I performed on you last week, I go in through a vein, slide a guidewire into the heart and then insert a stent. Sort of look like a metal mesh straw.”
“Then I want that, the stent. I want my blocked artery unblocked.”
Now he’s turned off his charm mode and slid straight into I’m-a-sneering-annoyed-god mode.
“Listen, heart surgery is not something you just jump in to. Myocardial bridges, yes, they are rare. But are always benign. You should think hard about this. In the meantime, the only drug that’s recommended for a bridge LAD is a beta blocker. Let’s start you a low dose for a month.”
“What happens after the month?”
“Well, that’s up to you. On your way out, make an appointment for a follow up in six weeks. I do tend to book up quite a bit. Course, as I always tell patients who are mad about how hard it is to get in to see me: you never regret waiting for quality, right?”
* * *
I take the beta blockers and they deplete my will to live. I have a vise-grip headache that starts about three days into the beta blocker. I’m exhausted. Like if postpartum nursing twins in a 10 on the exhaustion scale, beta blockers put me at an 11. I gain weight. Four pounds in two weeks, and, no, I wasn’t ‘stress eating.’
In fact, I whipped open myfitnesspal.com app and track every morsel as I had read that weight gain was common. Extra fluff is the last thing a gal in her 50s needs, right?
I have a check-in with Dr. Vivian, just to review the whole myocardial bridge / no blood flow to the front of the heart thing. I tell her I loathe the beta blockers and admit that I stopped taking them and was hoping she’d have some kind of homeopathic magic trick up her sleeve.
Sternly, she says “This is a serious heart problem. You have to ride out the full dosage of the beta blockers.”
I tell her that Dr. Worth-the-Wait mentioned stenting as a surgical option and that James and I agreed that surgery was the way to go. Dr. Vivian also agreed that, yes, if it were her, she’d want it structurally fixed.
To me, this blockage is sort of like having a kink in a section of a rain gutter. Yes, you could run around on the inside and waterproof everything with cans of Scotch Guard … or you could unkink the gutter to fix the problem once and for all.
I return to Dr. Worth-the-Wait six weeks later, determined to schedule surgery. The stenting open, that’ll fix the problem and then I can stop thinking about my heart problem.