The Incredible Life of Jimindy: 2016

Feeling Unlike Myself

I felt like crap for most of the day Monday, due mostly to the lack of a good night's sleep Sunday night after eating too much pizza at Bella's adoption day celebration at Minelli's. Add to that, for most of the weekend I was experiencing an occasional, mildly sharp short burst of pain across my upper right chest (not near center) and that was bugging me.

Anyway, we had dinner reservations with the Imber's for 630pm at 229 - a special five-course Argentinean wine dinner. I was determined to go despite feeling tired and dealing with those darting pains. And as Mindy will attest, I was in a crabby mood, too. Near 6pm, when it was time to leave for 229, Mindy asked why I was being so grumpy. Up to that point I hadn't mentioned anything to her about those chest pains and didn't plan to. Through the weekend I had hemmed and hawed about sharing that with her, but at the same time I didn't want to be an alarmist. Besides, I knew full well what she'd recommend or do.

Nonetheless, just before we were set to walk out the door I decided I better tell her about my malady. She insisted I check my blood pressure which I hadn't done for a month or so. Seemed like a sound idea. Well, the machine kept erroring out, but that's not too unusual when I try to take my BP over a thick shirt or sweater, which I was wearing. After two failed attempts, Mind wanted to help which only made me more nervous. I finally got a reading after the machine errored numerous times, one which was really high - 170/98, or something like that. Now, not only was I grumpy, but I was really nervous too!

Mindy asks me out on a Date ... to the hospital

Mindy asked if I wanted to go to the hospital. At first I said no. Then she wanted to call a squad. No! please. But after a brief moment of silence, and after thinking through it and applying some logic I thought it best to go to the hospital and have it checked out. She sent the Imber's a text sharing that we wouldn't be making it to the dinner after all and then we headed off to Riverside hospital. I asked her more than once to avoid speeding. All sorts of thoughts were coursing through my head as we made our way to Riverside. And just as you might expect, all depressing. For one, how could my body let me down as good as I treat it? I tried to be rationale but no matter what, I couldn't see this ending well. Among other things, the very thought of arriving at the hospital ER and having them run tests and then the prospect of them coming to me with that "come to Jesus moment" was very scary. I knew that within the hour I would almost certainly be handed my cold hard fate, whatever it was. And while it's good to know for sure, let's face it, sometimes ignorance is bliss.

Riverside Urinal

At Riverside, Mindy insisted I get out at the ER entrance while she went to park. Inside, there was a line of at least 10 arriving patients simply waiting to be checked-in. I was also a little taken back by the metal detector one has to pass through just to get in the ER waiting room. That's new to me. Ugh!

Add to that, and I don't mean to be cruel, but the place smelt like piss. Couldn't see myself waiting in the line. I immediately celled Mindy asking her to come back around and take me to the new Dublin hospital (she actually gave me that option initially but I chose Riverside). Off to Dublin.

Dublin Methodist Hotel ... ugh, hospital

Arrived at Dublin hospital near 630pm. Same drill. She let me out at the door and went to park. I was the only patient there and subsequently had their undivided attention. Very pleasant folks quickly ushered me back to an ER exam room. Bonnie was the initial attending ER nurse. Awesome lady; friendly, attentive, and a great sense of humor. Apparently, uttering something about chest pains gets everybody moving. By the time Mindy was parked and was inside, I was already gowned up and being triaged. It all happens so fast. An EKG, an IV into my right arm, blood drawn, and a urine sample (more on the urine sample in a minute). Lots and lots of questions. Symptoms, name, birthdate, and repeated by almost everyone who came to check me out over the next 30 minutes. Pretty quickly they shared that the type and area of my pain was almost certainly not heart related, especially after reading my EKG. No correlation.

My own Lil Sippy Cup

Urine sample problem. I had to pee like a race horse ( race horses, I think, must pee big!). I headed right across the hall with the sippy pee cup Bonnie handed me. Well, my gown wasn't tied in the back and as a result, kept falling down. I also had wires attached to the EKG patches that kept flopping around, all the while trying to hold the pee cup. So inevitably, while trying to keep the robe up, the pee cup fell into the john. The water looked clean so I quickly fished it out and shook it dry - well mostly, and easily and quickly filled the cup then headed back to the exam room. I decided to share my faux pas with the nurse. She didn't bat an eye. No biggie. Mindy was a bit taken back when I shared the ordeal with her. A couple more doctors came in to see me, eventually sharing that my urine and blood were all free of the tell-tale signs of a heart attack. And the rare occasion when those darting pains recurred, there was not even a blip on the heart monitor, which according to them was another reassuring sign that they weren't related to heart issues.

Sealing my overnight fate

All that said, somewhere along the line when prompted by another doctor for any other symptoms or physical issues, I shared that for the past few weeks I've noticed that I tend to get a little more winded at the outset of my run but only for a few hundred yards then all's well - normal. I didn't realize it at the time, but that sealed my fate as far as staying or leaving. Despite almost certainty that I was fine, they insisted I stay the night for observation and possibly a stress test and a visit by the resident cardiologist in the morning just to make sure they hadn't overlooked something. As inconvenient as it sounded at the time, I appreciated and understood their logic. It may sound silly, but one of the first things I considered was how a stay might jeopardize my running streak.

Running Shoes and tooth brush

It would be an hour or so before they'd be able to get me to a room. Seizing the opportunity, Mindy opted to head home so she could arrange coverage for the kids as well as to grab a few things I insisted that I would need, none more important than my running shoes and a toothbrush. I joked with the doctor that I would need to do four miles on the treadmill stress test. He laughed but also said they would likely let me do that. He was in awe of my running streak, which I so vainly shared. In fact, he shared that his wife is also a streak runner but a rather new one - currently at 400 days. Said he likely would not be sharing my streak for not to discourage her.

Room 3306

Mindy got back to the hospital just as they were about to wheel me off to my room - 3306. She brought me a Wendy's single. With doctor's approval I woofed it down before we rolled off to my room. Until then, I'd eaten only carrots, half a tomato, nuts and oatmeal all day long. I was really hungry. The staff told me that I would love the room. They were right, at least as far as hospitals go. The rooms are very nice and big. The bed was much more comfortable than the exam room bed too. There, I was introduced to my nurse, Sandy. She was most pleasant. Offered me all sorts of food, but i declined. Fetched me some ice water too. Mindy hung out in the room with me for an hour or so but then begged off for home. Said she'd be back early AM. I think she wanted to be there when the cardiologist showed up, which they offered might be as early as 7am ... ish.

Caucusing at Dublin Methodist

Sandy gave me plenty of attention. We talked about kids and stuff. She offered late night snacks again, too, but I again declined. I decided to make the most of my hospital stay. I popped on the TV where I watched the Iowa Caucus results pour in. But soon I could take it no more, at least with the volume turned up. I muted the sound and read from my Kindle. Ahh, the life; in bed watching TV, reading my Kindle with a big cup of ice water at my side. Sandy came again near 1145pm and asked one last time if I wanted anything, including some yummy Italian ice. No thanks. I shared that I was good with ice water. Oh, she said, I will have to take that at midnight - doctor's orders. Can't have food or drink after midnight in preparation for stress test in the AM. Huh? Just after midnight she came back in and shared that she would let me keep it until 1am. :)

Holding Water

Meanwhile, as comfortable as I was, I just couldn't fall asleep. Didn't feel one bit sleepy. I also want to share how quiet it is there. I can only guess that they have the walls heavily insulated to dampen the usual hospital noises that most of us are used to hearing. At some point ahead of 1am, I decided to get up and fill the Gatorade bottle I brought with me with water so I could have a swig middle of the night. I keep water at my bedside every night and with few exceptions enjoy a couple swigs through the night. I opted not to hide it very well. I left it behind the large plastic urine bottle resting on the side table. I dosed off briefly around 115am - ice water still there. I watched TV a bit longer before dosing off on my left side. I woke again near 4am incredibly thirsty and noticed my water was gone, both what Sandy brought as well as my Gatorade bottle stash. Drats!

Poked in the Night

I should also share that Sandy warned me from the outset that they would be coming in to take more blood around midnight and then again around 4am. Said they were required to check my blood for any new signs of heart issues. She said not to worry, their phlebotomists are very good. They actually came in at 1140pm and then again at 310am. Nothin' like being jostled awake by a large women jabbing a needle in your arm all the while making small talk. Hi, come here often? :)

Daybreak

I was up around 645am to pee and brush my teeth. I couldn't do too much else, so I watched TV until Mindy showed up which I'm guessing was somewhere near 730am. The nurse came in with a menu but I wasn't thinking about food. After almost 19 years, aside from coffee and an occasional banana, my mind and body are trained to pretty much ignore food until after a run.

Heart to heart

The cardiologist came by around 8am. His name is Jerry Sterkowicz (Polish I believe), a personable fella with a fairly thick accent. He let me know that he'd been brought up to speed about my case by hospital staff and also knew that I was an avid runner, but he wanted to hear about my situation directly from me too. He also said that he didn't think any of my symptoms were related to issues of the heart. Additionally, he said that it would be a waste of time to put me through a standard stress test given that my daily run is far more taxing than the treadmill stress test. He recommended a heart CT scan instead just to rule out any arterial blockage or heart muscle anomalies that might otherwise be masked by blood and stress tests. He also quizzed me on my family medical history, as well as my recent cholesterol readings and any past EKGs. Never had an EKG until the evening before. He quickly pooh-poohed the notion that my excellent cholesterol readings were a sign of excellent heat health, but I also sensed that he was doubting my readings. Granted, I didn't have them there with me to quote with 100% certainty but was fairly certain of the number ranges, and definitively knew that my family doctor rated them outstanding. At any rate, he said the CT scan would assure us of my heart health and/or expose any underlying problems. Said the nurses would arrange the scan and then he would stop by to share the results later and then I could go home.

5 hour Wait then a Reprieve

I was a little discouraged when the day nurse came by a bit later to tell me that my CT scan was all set up but wouldn't be until 2pm. 2pm? Hell, it wasn't even 9am. I'd be sitting around doing nothing for 5 hours. I contemplated asking if I could go for a run. However, all I had was my running shoes - no running clothes. I watched TV and read from my Kindle while Mindy napped on the sofa bed. When the nurse came by I smiled and asked if she could try to move up my CT scan. Said she'd try, but I didn't put a lot of hope in her reply.

It must've been around 1015am when she stopped in again to share that they'd arranged to get me in for a CT scan in the next few minutes. Yeah!!! An orderly of sorts was called in to wheel me down to the radiology department all the while Mindy waited in the room.

CT Scan/Nitroglycerin

Wearing only a thin hospital gown, it was a chilly ride to radiology. Looked like a lovely day out the window - sunny and already approaching 50 degrees. In the CT radiology room I met a couple specialty nurses along with the radiologist, Leisha. They explained the entire process, which made me more than a little nervous. Bottom line, you're lying flat on a table with at least four sticky tabs and wires attached then slid into a large, metal donut shaped device that captures layered photos of your heart, ultimately creating a life like image for the cardiologist to review. Leisha shared that they would scan me first without dye and then again with a dye injection to look for a difference. The dye, she shared, would make me feel very warm and like I am peeing my pants. She quickly added that you won't actually do it though. Want to bet, I immediately thought to myself. The mere discussion of peeing made me have to go. I thought about asking if I could go but didn't.

Just before beginning the procedure, Leisha was marveling at my resting heart rate, which she commented was unusually low for a heart scan patient. The nurse shared that I was a runner. She shared that she was a runner too. She also shared that I would be instructed by voice to breath in, out and hold it during the process What she didn't tell me was how soon and when I would hear the voices. Also, they're so quick to share that the radiation isn't that dangerous but in the same breath they're quick to vacate the room while the process is underway. However, I guess if you're exposed to it over and over, you'd likely glow after a day or two. All of the sudden she was out of the room and the process began.

I thought I heard a quiet male voice but largely ignored it as someone maybe out in the hallway. But then it dawned on me that it was the instructions for me to breath in, out, and hold. Let's just say that the commands were not congruent with my breathing pattern, which was much slower than their prompts to " breathe in, breath out, breathe in, now hold. That in and of itself left me anxious.

A minute or two later they injected me with the dye and at the same time placed a nitro glycerin crystal under my tongue. Somehow I missed that piece of info. I wondered if something were amiss that prompted such a move. My mind was now racing. Said I'd feel tingling under my tongue while it dissolved. They did the imaging sequence again, and just as Leisha described, I felt a very warm sensation throughout my body all the way to the tip of my fingers and toes. And yes, I felt like I was peeing my pants. However, resting on her word that I wouldn't actually do it, I didn't stress over it. Instead, I followed the fast breathing instructions best I could. One interval they made me hold my breath for what seemed like a whole minute. I was just about to gasp for air when I was instructed to breathe normal again. Ahhh! I was done.

Ugh, what about this nitroglycerin crystal under my tongue? The nurse was amazed that it hadn't fully dissolved. She let me spit it into her hand. She wished me luck on my continued running streak then the orderly wheeled me back to room 3306.

All tests now complete, the floor nurse said I was free to have whatever I wanted to eat or drink. I asked only for a simple cup of coffee. I planned to eat half the banana Mindy brought the night before too. Enjoyed the rather bland floor coffee and half banana. Gave the other half to Mindy. She napped while I read and napped.

The Prognosis - My Calcium number 44

Must've been around 130pm when the cardiologist, Jerry came in. I immediately tried reading his face as he seemingly nervously went to the nearby monitor to pull up my scan result pictures. He was babbling about how challenging it is sometime to get the pictures to come up. For whatever the reason, I got an uncomfortable feeling that he might have some really bad news. In the meantime, he joked around with Mindy a bit about her sleeping on the sofa bed.

He turned to me while pulling up the images and asked if I'd ever heard of a calcium score or number. Initially I didn't even understand what he'd said. Again, he has a fairly strong accent. I asked for a repeat but still wasn't that clear. By then the 3D image of my heart was up on the monitor which as you might guess, had my full attention.

While orienting me to the picture of my heart muscle, he insisted that there was nothing seriously wrong but that he wanted to point out something. He then pointed to a tiny white spec near the bottom of my heart which he called the widow maker area and shared that the spec was calcium, which over time is the body's natural reaction to plaque build-up in the arteries - a band-aid so to speak. The good news he shared was that it was very, very minimal, a 44-45 rating on a scale that goes from 0 upwards to 1000. He added that for my age that put me in the 25-50% percentile, which means that 50-75% of men my age have more plaque than me. Equally he shared that that was the only artery with any sign of calcium. But it was in the LAD (left anterior descending artery) He added that readings over 400 are those to be most concerned about but that any reading means that you are accumulating plaque/calcium so preventative measures should be taken to reduce if not eliminate further accumulation. He said he wanted to put me on statins and revisit. Feels that we can reduce the soft, or malleable calcium which was likely half of what we could see. Lastly, he reiterated that my symptoms - the pains and my running breathing were unrelated to the heart and that I was otherwise heart healthy. His point being that having the CT heart scan was somewhat of a blessing that I now had the advantage of knowing where I stand and can do something about it before something bad happens down the road. He said this is why you read about marathon runner, or other folks who are otherwise healthy specimens even with good cholesterol readings, dropping over dead because they have a lot of undiagnosed calcium and plaque build-up in the heart arteries. Further, he went on that cholesterol readings and stress tests alone are by no means a be all end all test.

Said he wanted to see me in about 3 months and would order an in-depth cholesterol particle panel test, which isn't your standard cholesterol test, as well as some liver test in the meantime. Said I was free to go and to run every day. :)

A Pleasant Discharge

I was happy to be discharged but at the same time still a little rattled with my prognosis. The realization, or shall I say proof, that I am not invincible and/or bullet proof.

Homerun

At home I couldn't wait to run. However, before setting out the door I enjoyed a quick cup of coffee. It was warm but with a very brisk wind. Turned out, my run was incredibly taxing. Despite not wearing a jacket, I soaked my shirt with sweat. I reckon it had everything to do with the stress of what I'd been through, little to no food since the evening prior, not to mention the dye I was injected with a few hours earlier. The important thing was that I did it.

Reflection

Several times during my hospital stay my thoughts turned eerily to my dad's death spiral last spring in Mt Carmel hospital. Suddenly, there I was outfitted in a similar gown, attached to similar equipment: monitor, a bird nest of wires and intravenous tubes, and a pulse monitor on my finger. I couldn't help but draw on the similarities. No doubt, it left me a little spooked! I couldn't help it. One minute you're otherwise vibrant and healthy and then before you know it your lying in a hospital bed at the mercy of fate.

Follow-up

The following day I read as much as I could about calcium scores, (Agatston score), atherosclerosis, it's origin and how it's best managed. I plan to send the link and/or document to friends and family to read for themselves.

And in the end, I agree that it's a blessing that I opted to take action on my symptoms, otherwise I wouldn't have the knowledge and tools I now have to treat the issue (plaque and calcium build-up) while it's still in its infancy.