I Found Out By A Fluke

I’ve spent a considerable amount of time writing this and trying to find the right words. I’m not sure I would start Thursday over if I could, unless I knew the results of the day would turn out differently.

On Thursday, July 14, 2011 I received what for me has been the worst news of my life. It was both devastating and shocking to me, and I spent most of the day bawling my eyes out. I’m too old to be a big crybaby, but I did it anyways. I simply couldn’t hold back. Now I’m contemplative, fearful, and perhaps a bit paranoid. I’m really tired and worn out from thinking about it. I know I will have lots of research to do and questions to write down and ask my new medical team.

Let me start from the beginning of this very long story so you will know what I’m talking about.

I applied for health care at the VA Northern Indiana Health Care System (HCS)-Fort Wayne Campus here after I lost my last job and insurance benefits in the early part of this century. I qualify for free services because of campaigns served, time in service, unemployment, and single status. Scott and I have been together eight years and engaged almost that long — longer than many young couples stay married nowadays. He is able to claim me as his dependent for taxes, but we have never officially tied the knot only for financial reasons. Unfortunately, it is more economically sound for us to remain unmarried. Still, I often tease him that if I ever win a trip to Las Vegas we’re tying the knot anyways.  Now I’m not so sure.

I heard that it happens all too often while I was at the hospital all morning. A widower who receives a pension from her deceased spouse lives with another man and they never marry because she would lose that income, for example. On a side note, I don’t believe Obama’s health care plan is the answer to anything.

My first doctor at the VA Northern Indiana HCS-Fort Wayne Campus was from India — they outsourced many doctors at the time. He was very hard for me to understand and I’m not sure how well he understood me either. His wife who is also a doctor worked out of state and he was finally able to find a job with her. He was never replaced with another doctor. I see a nurse practitioner now for primary care and annual medical checkups. I was going twice a year, but refuse to travel in inclement weather.

My last checkup was on June 27, 2011. Hospitals are all too often too busy and tend to ignore anything except specific complaints and requests. I’m not complaining about the service I’ve received — just stating the obvious. I couldn’t think of anything when my NP asked if I was having any problems, but I did ask if I was due for a physical. I remember the Air Force gave us a complete physical once every five years. She checked my medical records and saw that it had been several years, 2003 I think, and agreed. She sent me upstairs for a quick EKG, then I left for an appointment with my periodontist.

While I was gone, the NP called home and left a short message with Scott that I needed to come in for a heart stress test. I never thought to call and follow up because I’ve had dental and periodontal problems on my mind. I was under anesthesia for another perio scaling scaling and root planing just last week. A filling came out during surgery and more decay was detected. I have another appointment with my dentist this afternoon.

I had no idea why the heart stress test was ordered. I’ve never had one before and that alone was enough to stress me out! Wednesday night I went to bed early and woke up early for a change. No caffeine of any kind was permitted 12 hours prior to testing; and no food, drink (including water), or smoking for six hours prior.

I showed up ten minutes early just a wee bit nervous, but the technician put me at ease. My four-hour testing included a nuclear stress test with a radiotracer injection before (resting) and after a cardiac stress test. I’ve often been told I have small veins. The lab sometimes has a hard time drawing blood or I get a hematoma. The technician painfully rooted around trying to find a vein in my right arm and finally gave up. I ended up with an intravenous line on my left forearm. I was given a meal voucher for the hospital cafeteria after the IV line was placed and could have anything without caffeine. I usually never eat breakfast (bad habit, I know) and just had a danish and orange juice. Following that I had to drink lots of ice water the rest of my time between tests.

The Siemens gamma camera reminded me of an MRI without the full outer enclosure. It looked like this:

The machine automatically moved to take several films and only took 15 minutes.  After that I waited drinking more ice water before taking the cardiac stress test. I was told earlier I would have a choice of the treadmill or drugs and told the technician I didn’t think I would have a problem using the treadmill.

When I went into the room across the hall my cardiology nurse, Cynthia Burman (Primary Care Provider/Nurse Practitioner) had me sit down. She told me I couldn’t use the treadmill and I asked why not. She said that my nuclear stress test indicated heart damage and my previous EKG showed I had a (major?) heart attack in 2003.

You know those stories you hear about people who have heart attacks and never know it? I’m one of those statistics now. I lost it and started bawling my eyes out. She explained that there’s no telling why I was never notified and nothing was ever done, and that blame couldn’t really be laid. More options would probably be available if action had been taken then. We would have to wait to see what the next nuclear stress test showed. She promised to show me all of the x-rays and go over them with me.

I experienced every side effect of the administered drug in the one minute test: severe chest pain, severe shortness of breath, abnormally high blood pressure, abnormal heart rhythm, and dizziness. It only took two minutes for those side effects to wear off.

After another wait drinking more ice water I walked across the hall again for my final test of the day, another nuclear stress test. It was the same easy routine. The hard part was sitting down with my cardiology nurse to review x-rays. They show extensive dead tissue (scarring) that makes my heart irreparable. An example is that one x-ray was supposed to look like a donut. My “donut” is almost totally black (dead tissue scarring) at most of the top half. A normal left ventricle (LV) ejection fraction is 55 to 70 percent — mine is only 30%. I will likely need a heart transplant in the next five to ten years. Of course when I heard all this, I started bawling all over again.

So, I officially have heart disease and am a cardiac patient. I had the option of going to the cardiology unit at Indianapolis (Indiana University) or Ann Arbor (University of Michigan). Both are associated with cutting edge hospitals and fairly the same distance from our home. My cardiology nurse has served in the critical care cardiac unit for a top-notch local hospital. She is more familiar working with the staff at Indianapolis, so that’s where I’ve decided to go. Most of my continuing medical care will be located there except for an annual general examination at the VA Northern Indiana HCS-Fort Wayne Campus. I’ll be working with a team of two others besides Cynthia who I have yet to meet: Linda Kimmel and Barb Goines in Indianapolis.

I’ve been taking preventative low-dose aspirin for a couple of years. Maybe it’s already saved my life. Now I have new prescription medicines to take. Niacin and Simvastatin at night for high cholesterol, and Metoprolol (a Beta blocker) for my heart. My prescriptions are only filled for 30 days because they will likely change again in Indianapolis. I have to discontinue taking fish oil because it can affect women’s LDL and resume flax seed oil instead.

I don’t have a cell phone and wasn’t able to share my news with Scott until I got home. We’ve been thinking about replacing our land line with an additional cell phone for me, but haven’t gotten around to it yet. The NP and I tried calling Scott from the hospital, but it turns out he was busy hanging a 60-inch TV at the time. Scott has decided that he will probably lose a lot of workdays driving me back and forth to Indianapolis. I hate to drive anywhere anymore, even locally, much less long distance. Can you believe I used to drive cross-country and 20 hours straight fueled by caffeine and cigarettes?

After talking to Scott, I called my younger sister Joyce and we literally talked for hours. It’s the first time we’ve talked in a long time and we both had a lot to say and get off our chests. It was good to clear the air. I felt like a weight was lifted from my shoulders.

My oldest brother Michael and I talked on the phone shortly after that. It was a coincidence that I heard from him on the same day on an entirely different matter. He and his church are praying for me. I hope you will keep me in your thoughts and prayers too. It would be a true show of friendship.

I believe in a higher power, but even so I don’t consider myself religious after growing up and a career in the church. Please don’t hold it against me. Perhaps I’m past due in recapturing my faith. I was never able to find the same fellowship I enjoyed in the Air Force, and eventually gave up.

I tried to reach my youngest brother, but was unable to. He will read this or not. I’ve always considered my family dysfunctional and many of us are not close for one reason or another. My mother’s funeral was the straw that broke the camel’s back. That’s another long story in itself. My baby sister and I had a ginormous rift at that time and she lives in Australia.

I had already planned to finally quit smoking soon, but this was the kicker. This is my wake up call — not for the first time, but more seriously than ever. I have a family history of heart disease (both parents), diabetes (both parents), bad toenails (ugh! father), and bad teeth (mother). I often felt like a human time bomb in my thirties. No one lives forever, but I’m facing my own mortality in a way I haven’t expected to. I feel fragile somehow now. I’m overdue in writing a personal bucket list. I’ve never made a last will and testament or living will. I’m feeling an urgency for all of these things now.

I believe that no amount of cardiology care will help if I don’t take better care of myself. I have to eat right and exercise, rest and relax, enjoy life and not get upset so easily over little things. Nothing matters more right now than my good health and I’m pivotal in making it happen.

On the bright side, I’m glad I asked for a physical. Even though this problem wasn’t detected early on, I can be happy that it was detected at all. My nurse cardiologist says that if I hadn’t found out I could(/would?) be dead in a year or two. Another plus is that I feel fine. She says that’s promising

I’ve felt chronically tired many times over the last few years. I figured it was from an unhealthy lifestyle of odd waking hours and self-inflicted sleep deprivation. I’ve also been told that oral infection from perio may have attributed. Now I blame it on my poorly functioning heart

I’m off to see the dentist now!

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