Wednesday, December 21, 2011

Guest Post

I'm completely breaking from theme, with a post that's not related to running or pool-running.  I think it's worth sharing anyway.  And I get to engage in the blog cliche of the "guest post", so that's a plus.

Us.  In September in Philly,
the night before I raced a half-marathon.
Anyhoo...In early November my sig other/love of my life, who smoked for many many years, started experiencing what we thought was heartburn after we went out for dinner.  At first, we didn't think much of it, but it ended up being the entry point to a downward spiraling healthcare voyage that we rode through the end of November, before starting to ascend again.

Below is his post from about 3 weeks ago, copied from some of his online accounts (with his permission, of course).  And since this is my blog, I've inserted some editorializing, though I've made no other changes.


Long story short - what started about a month or so ago as some chest discomfort that I was convinced maybe was acid reflux or something similar rapidly deteriorated into advanced coronary artery disease and eventually resolved itself with quadruple bypass surgery.

Never before been under the knife so, hey, go me for jumping in with both feet.

I've only just started the recovery procedure thus while I've been assured the worst is over there is still a long road ahead before I can consider myself "recovered." Right now so much of the body's resources are directed to repairing the trauma of opening up the chest and gaining access to the heart that the simplest of tasks are exhausting and time consuming. All hail my wonderful girlfriend who has moved in until I'm able to at least navigate my house and property without killing myself.

Ed: moving into his house, which is right next to a) the track, b) the pool, and c) my favorite running trail does not make me a wonderful girlfriend.  Cleaning his cat's litterbox daily for several weeks?  That makes me a wonderful girlfriend.

All told I ended up being in the hospital's combined cardiac ICU/step-down unit for about 13 days.

The cardiologist I had seen middle of the week prior to the odyssey put me on some heavy duty anti-coagulants because the plan at the time was to do some imaging through an arterial catheter and maybe install a stent or three depending on what was found. Who could blame him? Risk factors were evident, certainly, especially smoking, but youngish guy and no family history of heart disease, plus a nuclear imaging stress test had been administered about 3 months prior and it indicated absolutely nothing wrong. The NIST is only designed for 80% accuracy but, c'mon, it'd have to be some unlucky son of a bitch to hit a false negative on that AND have coronary artery disease advanced to the point of active symptoms while at the same time being below the age of 65 or so.

Greetings, I'll be your unlucky son of a bitch this evening.

Ed: Luck's a matter of perspective, sometimes.  Taken from the perspective of..."we caught it before a myocardial infarction," I think we were extremely lucky.

As I said most of the time spent in the hospital ward was in the 'waiting for stuff to happen' phase. The anti-coagulant used needed 7 days to flush out of my system to minimize the risk of my bleeding out on the table or soon after. If you are under the impression that a hospital is a restful environment please allow me to correct you of this fallacy.

Unless "undisturbed bed rest" appears on your orders you will be awoken almost hourly; sometimes for the simple collection of some data (BP, blood O2 levels, body temp.) but seemingly just as frequently so a wide array of someones, with varying skills, can stab you with something. You will develop a complex against people coming into your room at night because you will be convinced they are there to stab you. Everyone is *very* friendly, but that's quite possibly because they can do so knowing full well they can come into your room in the middle of the night and stab you.

Ed: Yup. On the plus side, he doesn't complain anymore about me waking up early and making kitchen noise while preparing to go for a run.

I was the youngest person admitted to the ward in some years and thus was somewhat of a curiosity for the staff there. Not much clinical experience with guys in their mid-40s who are there because they might stroke out at any time and thus require constant watching. I ended up receiving the unofficial award for "person with the longest stay in the cardiac ward prior to any cutting being done on their body" as well as the overwhelming feeling I'd become some combination of mascot/pet/fixture. 

Ed: We were definitely the odd balls of the ICU.  I think we were the youngest people there by 20 years at least.

Something else noted that should be passed on; the words, "I'll be right there" when uttered by a nurse or PCA/tech has no relation to clock time. It roughly seems to translate as, "if you're not in some sort of medical distress and I can't resolve your issue without leaving the room, this probably won't get done for a while." It's not that anyone is lazy or being spiteful, it's that they have their own prioritization algorithms and a multi-vector interrupt queue that you cannot comprehend without several years of education or one very, very fortunate acid trip.

The cardiologist(s), the surgeon(s), the nursing staff, my GP - all went to great lengths during my extended stay in the cardiac unit to explain just how lucky I was to be in this situation.

O_o Lucky? I was freakin' terrified.

While bypass operations are serious, majorly invasive surgery they are also performed thousands of times daily on people in far, far worse health than me and the clinical knowledge is extensive so it is about as routine a surgical procedure as one might encounter. I also lucked into getting one of the best surgeons in the area. Any cardiac surgeon where our pre-op/post-op facility also contains multiple repeat customers of his that are back for additional (not warranty) work and have a decades-long history with him is ok by me. Met some fascinating people. Didn't realize retired Admirals were so prone to heart disease.

Ed: I feel compelled to note that the care at Virginia Hospital Center was outstanding.  Really good.  Really really good.

As for the "self" acceptance and what my future looked like post-op it was made very clear that there is a vast difference in long-term clinical outlook for those who had a bypass at a result of a heart attack and those who were found to have advanced coronary artery disease but not yet have suffered a myocardial infarction.

My heart is as-yet undamaged, is normal for pumping performance otherwise, and with the plumbing rerouted then what I had to look forward to was in effect a do-over after decades of abuse. Clean pipes feeding the heart, no more blockages to suddenly fragment and kill off part of the heart muscle, and quite possibly even a better quality of life since the circulatory system will now be more efficient than it's been in years. Nothing but upside.

As long as I don't pull a dumb-ass and not make the necessary "lifestyle adjustments" which in my case translates directly to "quit smoking." That was the single biggest contributing factor to my situation, and once the mechanism of precisely *how* smoking affects arterial plaque was explained, the decision to quit came pretty easily. That said - if one more health care professional suggests Chantix to me I'm there's going to be another operation in my future involving the removal of my foot from someone's anus.

So here I sit, one week into recovery, maybe 11 weeks to go to return to normalcy, and an unknown amount of time to fully rehabilitate myself to where I was so I can get closer to where I want to be. 

Ed: Regarding rehabilitation, it's kinda funny.  I've never been one for the "long romantic walks on the beach" thing, but modify it slightly to "long rehabilitative walks around the high school track while tracking with Garmin and building up distance", and I'm a bit more open to the concept.  Shows where I'm focused.


So there you have it.  The Cliffnotes version (do those still exist?) is long-time smoker develops coronary artery disease at a very young age.  The more he's poked and prodded, the worse the news, with the eventual finding being disease that requires a quadruple bypass just before Thanksgiving.  But, since it was caught BEFORE the imminent heart attack, he's got a clean slate.  A do over.  And I'm excited to do whatever I can to help (without pushing).

A bit eye-opening for me -- despite the massive education programs that are out there, I had always assumed that the biggest risk from smoking was lung cancer.   Nope.  Coronary artery disease.

Before this episode, I'd always been a supporter of smokers' rights -- which surprised others, given that I'm a competitive runner with health conditions that are aggravated by second hand smoke (asthma and Raynauds).  Self-interest and all that.

And after this...I still support smokers' rights.  To each of us, as individuals, belongs the right to choose our own means of health or destruction, to live our lives as we see fit.  But I'm hoping the above is at least educational, and assists others in making their own decisions.

If he started smoking again or stopped exercising, I'd be upset, but I wouldn't nag or fight.  In the end, his life is his -- I'm just fortunate that a) he shares it with me and b) that we've hopefully got a bit longer together than we did before.

And heck, right now I get to do track workouts with my boyfriend.


  1. I'm so sorry to hear about this, but I'm glad to hear that recovery is going relatively well.

    I cannot emphasize enough how important it is to get out and walk as much as the medical professionals allow. I added 0.1-0.2 miles a day after a surgery I had a few years ago and my recovery rate was astounding. Keep him at the track.

  2. That is so scary. I'm glad they caught it in time to intervene, he is lucky for his health and his supportive girlfriend! Best of luck in recovery and in making those big lifestyle changes!

  3. Great post Cris - on so many levels. Being in the hospital and just observing opened my eyes to so much. There are so many unhealthy people out there and most of it is because of bad choices. But, as you said - "To each of us, as individuals, belongs the right to choose our own means of health or destruction..." I am glad he is OK. He is lucky to have you.

  4. I didn't realize that was why you'd moved in! So glad he's going to be ok. As someone with a long family history of heart disease and stroke (including an uncle who had a heart attack AND stroke in his 30s), I'd say you guys are very lucky.

  5. Wow, Cris - obviously none of us realized that this was going on, but just - wow. SO glad that he was lucky enough to catch something like this early. And your final comments really struck me, especially this, " In the end, his life is his -- I'm just fortunate that a) he shares it with me and b) that we've hopefully got a bit longer together than we did before."

    Yes. Exactly.

  6. I had no idea any of this was going on. I am so relieved they caught this and that he's going to be okay in the long term. That is so scary. You ARE a great girlfriend and he's so lucky to have you helping out! This post was also very educational for me because I thought that lung cancer was the biggest concern for smokers.

  7. So glad Brian caught it in time and very glad he has you. I hope that his recovery goes well and he's healthier in the long run (pun intended).

    As runners, we have addictive personalities, so whether it's walking or whatever he chooses to do to keep the heart strong, he may find it easy to swap out for the smoking addiction.

    He seems to have a good sense of humor, despite all he's been going through, but I hope he never sees that hospital ward again! :)

  8. I'm glad to hear that this was caught relatively early and the prognosis is good. Certainly we don't always get a chance to start over with a clean slate. Best of luck to both of you during the recovery process!

  9. Oh wow - I can't believe this was happening and none of us knew about it to support you! It is so good to hear that Brian is ok and making the changes in his life that hopefully will keep him that way. And you're right about getting to do track workouts together - that's a huge win! Thinking of you and definitely don't hesitate to let me know if I can do anything!