}

Monday, August 07, 2017

The day I could have died, but didn’t

One year ago today was the day I could’ve died, but didn’t. The fact I didn’t die is partly due to a huge amount of luck, but the fact I’m unlikely to die any time soon is because I did something I thought was too difficult: I talked to my doctor. Because I did, and what happened afterward, I’m here to tell the tale.

Some of you will remember my adventure last year, and the developments since. This post covera all that, but is mostly about what preceded that tale.

The story actually begins a couple years ago. My dentist had referred me to a periodontist to treat gum disease, and at the conclusion of the exam he asked me when I’d last seen my GP. It had been years, because I was one of those people who didn’t go to the doctor unless I was sick. “You’d better make an appointment for a check-up as soon as you can,” he said. “Gum disease can lead to heart attack and stroke”.

So, I went, had the routine blood tests and found out that my good cholesterol was bad, my bad cholesterol was worse, and I was veering close to being pre-diabetic. I also had high blood pressure. The doctor wanted to put me on medication, but I resisted, convinced that if I just lost weight and got fitter, it would all resolve itself. It didn’t work out that way.

Despite my “best” efforts, I didn’t lose enough weight nor get fit enough. I was often tired, which I thought was because I was unfit, or maybe I needed a multivitamin. And, even though I did significantly improve my cholesterol levels, my blood pressure was still high, and I felt terrible.

Because I felt bad, I agreed to go on blood pressure medication, a low dose to start, which is the usual procedure. It didn’t really help, which isn’t a surprise. So, they raised my dosage, and I felt even worse. I thought the higher dose was the cause, that it was giving me chronic indigestion.

August 7, 2016: That very nearly fateful day.
August 7 of last year, Nigel and I went to Auckland’s CBD to meet up with family for lunch to celebrate my sister-in-law’s birthday. We walked up Wellesley Street toward Sky City. It was uphill. I became extremely winded and had to stop frequently. I was sweaty, but it was a kind of cold sweat. We finally got to the restaurant and I sat down. I felt for a short time that I might be nauseas, but it passed. I felt terrible. As I sat and rested, I eventually started to feel better.

I knew this wasn’t right, and that I needed to go back to my doctor. Nigel coached me on what to say, how to be clear about how badly I was feeling and how to insist on a different drug. That was the plan, anyway.

As planned, I told my doctor about how badly I’d been feeling, and about the incident in the Auckland CBD. She took notes, then listened to my heart and chest and was concerned. She had an ECG taken, saw an unusual rhythm, and the next thing I knew I was in the back of an ambulance on the way to hospital. I felt like a bit of a fraud because that day I felt fine. I thought it was an awful lot of fuss for a bit of indigestion.

The Emergency Department hooked me up to monitors and devices, and the heart rhythm they got was abnormal, but not necessarily definitive. The attending doctor wanted to have me do the cardiac stress test on a treadmill, but the earliest outpatient appointment was two days later, and he didn’t want to wait. So, he admitted me so the test could be done the next day.

The next day, they hooked me up to wires and monitors and had me walk on the treadmill as they increased the incline and speed. They watched my vitals every second. They stopped the test after only a couple minutes. I felt fine, no pain or discomfort, but they didn’t like what they saw.

Later that day, I was seen by the cardiologist who said I needed an angiogram, which is where they insert a probe into an artery and direct it to the heart to check for blockages. That procedure would be done the next day.

When they did they angiogram, they discovered I had a 90% blockage in the main coronary artery feeding one entire side of my heart. They immediately inserted a stent to open up the artery (in other countries, this is often a second procedure). I’m told that my colour immediately improved after the procedure was done, and I felt really good.

I learned that what I’d thought was some sort of reflux was most likely angina, a pain caused by heart or coronary artery disease. I was also told that I was lucky that I’d never had a heart attack, and, in fact, they were surprised about that. And that I was still around.

What’s now obvious is that the day one year ago today in the Auckland CBD was about as close as one can get to having a heart attack without actually having one. But the truly sobering part is that if I’d had a heart attack that day, it very possibly—probably?—would have been fatal.

According to the New Zealand Heart Foundation, 172,000 New Zealanders are living with heart disease of some sort, and 33% of all deaths are caused by cardiovascular disease, making it New Zealand’s leading cause of death. It kills a New Zealander every 90 minutes; many of those deaths are preventable.

Since that day last year when I could have died, I’ve continued to lose weight (8.6 kilograms, or 18.95 pounds so far), had medication adjusted, and have done really well. My cholesterol is not only in the normal ranges, it’s actually better than that (as is recommended for people with a stent), and my blood pressure is well controlled. And all of this—all of it—is because I spoke up and told my doctor how I was feeling.

One of my childhood friends had a heart attack a couple weeks ago. Actually, he had two, because he ignored the symptoms of the first one and rationalised it away, just as I had done. He was lucky, too, and is still here to warn others not to ignore the signs of a heart attack.

The message here is simple: First, pay attention to your body, and take action when something isn’t right. Second, talk to your doctor! Doctors are amazing people, but they’re not mind readers: They can’t always know to look for things that could be wrong if we don’t tell them how and what we’re feeling. We’re not “bothering” them by telling them about something that doesn’t seem right—we could be saving our own lives. Your doctor is your ally in this goal—help them help you.

I learned this lesson before it was too late. Now you have, too.

Some footnotes: This post is a revised version of something I posted to my personal Facebook today, and that was a revised version of an article that's about to be published in a small community newspaper. The photo of Nigel and me is cropped from a larger photo taken a year ago today (I cropped the others out to preserve their privacy). I’ve hated that photo, yet refer to it all the time for the same reason: I see death in my face. All the colour had drained out of my skin, and I was pale and ashen. I was also so much bigger then, and so clearly unwell. This photo reminds me of how close I came to checking out. And the reason all of that changed is what I said, and one more thing—sitting right next to me: Nigel. He was strong for me when I couldn’t be, and helped me get where I am. He still does that. So, he had to be in the photo, too; besides, just look at him! 😀

Also, the graphic about the signs of a heart attack at the top of this post is from the New Zealand Heart Foundation website. The commercial below has been in heavy rotation on New Zealand television:

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