I was always going to have to do this – to process and vent. To find my way through with words, and here it goes. A warning, reader, it will be fresh and raw and medical. It will be long and it will be self-indulgent. An info dump typed through fat, hot tears. It will be all mine because that is all it can be.
What does a heart attack feel like? Not like the movies. I was thinking about Mr. Big clutching his chest on the Peloton, or maybe Phoebe Buffay in the episode where the Friends live in an alternate universe in which Pheebs is a high-powered executive who wears 90s power suits and chain smokes until she clutches her left arm and says, “A heart attack. Yes, that is what I am having.”
It was quieter than all that. Gentler. More profound and drawn-out. I had arrived home from New Zealand on a Friday in late January and spent most of Saturday and Sunday in bed, getting over jetlag by bingeing my way through Yellowstone and ordering pho for delivery. There was a little hint of something or other – maybe a chest cold coming on, which would make sense given all that airplane travel. I thought nothing of it.
Monday morning, I awoke still feeling a bit of the ‘chest cold’ (readers: it was not a chest cold). I rose, made breakfast and showered, readying myself for the first workday of another year (readers: it would not be just another year). Somewhere in there is when a mild burning sensation came across my upper chest. Gently brushing over my clavicles. The oddest sensation, unlike anything else I’d ever experienced. Like prickles of hot ash being dusted over my shoulders. It persisted through the shower and through getting dressed. I readied my work bag, slid my laptop into the sleeve, gathered my things. The burning persisted. I sat down for a few minutes. The burning went away. Oh fine, I’ll head to a coffee shop. I rose and gathered my things. The burning rose with me.
Heart issues run through my maternal line. My grandfather used to proudly show off a long scar that ran from his sternum to his belly button where he’d had his chest and heart sliced open to clip an aortic aneurysm. My grandmother suffered a stroke. My mother passed her excessively high blood pressure to me. And my dad gave me high cholesterol and his family’s stout, Viking body shape to help ensure my cardiovascular system had no chance.
I hate even writing the above, but of course, you have to give context because people automatically assume that health problems like a heart attack are the victim’s fault. Like some manner of overindulgence, and this is my penance to pay for some type of immoral lifestyle.
In my personal cosmology, we as souls choose the lives we will lead before we enter the Game of Earth, right down to the karma we’re going to work out with the various souls that enter and exit our lives, and the bodies we will choose to inhabit. In some respects, I seem to have chosen to incarnate into a fairly tough level of the game, but then I can also feel it is not my first go-around on this little planetary school and also maybe with a more challenging level comes more reward.
My body is my choice, is what I’m saying, and I hold her with the greatest respect and love. In all her imperfection, she is perfect for me, for this life that I am living out, for these lessons to be learned this go round.
I can say in advance of anything further, there is no grand takeaway from a heart attack. No giant lesson or blast of enlightenment. No sudden and all-consuming, renewed zest for life. If anything, it’s been the opposite. We’ll get to it later.
The burning was completely new and not normal. The high blood pressure running in my family meant I had been trained from a young age not to ignore chest pain.
If you ever get chest pains, or any pain running down your left arm, sit down, take an aspirin and call an ambulance, my prescient stepfather told me more than once. He also had high blood pressure.
The thing was, on this particular Monday, there was an ambulance strike going on – one of many strikes in the UK over the last many months as we the people battle it out to keep frontline workers paid and the NHS in tact while greedy Torys empty our collective bank account to fund their mates’ silk pockets. This meant there were no ambulances to be had. I stayed calm and continued to hope it was nothing, but better get it checked anyway. I was not in writhing pain. On a scale of 1 being no pain to 10 being the worst pain I’ve ever experienced (menstrual cramps), this was about a 4. I could easily have ignored it, but I had Dan’s voice in my head. Sit down, take an aspirin and call an ambulance.
I took a few things out of my work bag and packed some essentials. Just in case I need to stay at the hospital. I remembered last year when my aunt and uncle had been in a car accident and I needed to take some essentials for my aunt in the hospital.
Phone charger. Spare battery. Kindle. A few pairs of underwear. Slip-on shoes. Hand lotion.
I called an Uber. It would be a few minutes so I sat and waited. While I was sitting, the burning was not bad, but every time I stood up and moved around, it flared across the top of my chest again. I stayed scarily calm and kept an eye for the Uber, and then sat in the back for the 10-minute drive over to Lewisham Hospital A&E.
A&E was busy with walk-ins because of the ambulance strike. I took a number and filled in a form. It was about a 10-minute wait. A receptionist saw me and asked about my symptoms. I explained and said I’d just come off a long-haul flight from New Zealand two days earlier. He wrote “pulmonary embolism” on my form (readers: it was not a pulmonary embolism) and told me to walk around out the front door to the ambulatory care walk-in centre next door.
I sat there for about half an hour until a nurse called me and hooked me up to an ECG machine, took my blood pressure and asked me to wait. A few minutes later, she came over and said, “Madam, I don’t want to alarm you but I’m just going to take you over to A&E. Could you please sit in this wheelchair, thank you.”
She wheeled me outside across a car park. It was bloody freezing outside, a cold spell having fallen across London with frigid wind.
In A&E, they did an echocardiogram, which is essentially like an ultrasound on your chest that shows your blood vessels. There are three types of blood vessels: arteries, which take blood out of your heart; veins, which take blood into your heart; and tiny capillaries, which connect the first two.
Three different male nurses came around to have a look and I made a joke about them squeezing my boob with the ultrasound stick and they laughed in British nervousness. Finally they agreed that there might be something of concern on the scan and told me they’d send me to another hospital – King’s up the road in Camberwell – by private ambulance. They had a private ambulance service on hand for true emergencies to cover for the public NHS ambulance drivers’ striking.
The EMTs loaded me in. It was my first time in an ambulance. They hooked me up to a blood pressure monitor and one guy stayed in the back while the other drove with the lights and siren on. The guy in the back with me gave me a little spray under the tongue which he said would open my blood vessels but might also give me a headache, but not to worry, the headache was completely normal, and somewhere in there, I made a joke in response about not joking around like that or he’ll give me a heart attack, which I can’t even fully remember except that he laughed loudly and said no one had ever made a heart attack joke while having a heart attack in his ambulance before.
“Is that what I’m having?” I asked, suddenly serious.
“Yes,” he said. “Well, I think so. Hard to say for sure but the guys over at King’s are the best in the country. If there’s a blockage, they will just pop a little bit of wire mesh in and you’ll be good as gold.”
In between all of this, I had texted my best friends – GG who lives up the road and Lauren who lives in Kansas – and a couple family members and asked the girls to keep my family posted. GG said she would come straight to the hospital after work.
At King’s, I waited a long time in the cardiac emergency room, but finally an incredibly smart, reassuring woman doctor came by and spoke to me by first name and looked worried but warm and said they were going to go in and do an angiogram, where they would check out what the blockage was and see what needed to be done. I got asked my name and date of birth about 50 times. GG arrived, so it must have then been after 5pm, which means I’d been in the hospital all day already.
Finally, they were ready to give me an angiogram. I would later have a second angio procedure done, an angioplasty, and I’m going to describe it in a fair amount of detail, so reader, if you are squeamish like me, please skip over this next bit.
They wheeled me into a big operating theatre where a surgeon and several techs and nurses began prepping my right arm. Angio procedures involve making a tiny incision in your wrist and inserting a very thin catheter tube up one of your blood vessels. You are awake for the whole thing, although they do give you the good drugs. First they numb the wrist and make the incision. I didn’t feel that, but when the catheter went in, I could feel it and it was like a deep, fiery ache in my right arm.
The first procedure – the angiogram – involves shooting a special dye into your veins and taking an x-ray to determine the extent of the blockage. When the dye goes in, you can feel it despite the drugs and I can remember it felt like a splash of ice water up my arm or a bit like the pins and needles you get when a limb goes numb. I cried out a little and could hear the surgeon saying to a nurse to change the meds they were giving me because I was still too lucid.
They kept reassuring me. “You’re doing fine, you’re doing really great, love. We’re almost done.”
Apparently all of this took about 30 minutes or so, though it could have been five minutes or two hours, I have no idea, but finally, it was over and the catheter was pulled out, which hurt the most. But it was done, it was over.
I slept for hours and the next day the surgeon saw me and explained that there was a narrowing, but not a full blockage, at one of the coronary arteries near the top of my heart. They had discussed my case and we had two options: open heart surgery or another angio procedure to introduce a stent that would hold open the narrowed artery.
I didn’t remember much from my high school anatomy class so this was a rapid-fire reintroduction to the human cardiovascular system. The way it works is that cholesterol, a natural fatty substance in the body, can get built up in your arteries and form a plaque (not unlike on your teeth) on the walls of the blood vessel, narrowing it or eventually closing it off altogether. Your heart is a muscle, and if it doesn’t receive blood, the muscle tissue can be damaged or die altogether. If your blood vessel gets totally blocked, you could go into cardiac arrest (heart stops pumping) and die, which is (spoiler) what happened to Mr. Big. Cholesterol builds up naturally and in some cases a person (like me) is genetically prone to have more of it. But a diet high in saturated fat, as well as smoking and alcohol all contribute to high cholesterol. There are also now excellent medicines to keep cholesterol down if you are genetically predisposed to it.
My artery was narrowed, not totally closed. The surgeon said I had two options: open-heart surgery which would totally solve the problem forever but be more invasive, or a stent insertion, which would involve lodging a tiny piece of wire mesh into the narrowed artery, blowing it up with a mini balloon and magically opening the artery. This was far less invasive but there was a continued risk that my heart disease could worsen and still require surgery in the future.
The doctors gave me a choice. I asked them if one was preferable. They said in my case it was 50/50, and I said if I had a choice, please do not cut my chest open. Let’s try to manage this with medication and a stent first. If I need surgery later, we can plan it.
A couple of days passed in the cardiac ward, where I – a 41-year-old woman – sat with 5 other patients, all of whom were old men. There was a lot of farting and grunting. My blood pressure was high and I was in and out of consciousness from the drugs and the lack of windows or daylight. Hours passed where I did nothing at all, not even think. I only knew it was nighttime when they switched the lights down, suggesting we should try to sleep. Sleep some more. Sleep again.
Finally, it was my turn to go in for the stent. I ruminated about it because I knew what was coming – another painful, torturous hour of that arm aching, semi-lucid surgical room with doctors standing over me as shadowy figures behind bright lights, my eyes clamped shut hoping for the end.
To make things harder, my right arm had already been sliced open once and due to the set-up of the room and the surgeon’s handedness, they had to operate on the right side. It was either go into my right wrist – already bloodied, bruised and tightly wrapped in an inflatable compression bandage – again, or go in through my groin, which was a hell-fucking-no.
The handsome surgical tech smiled at me and made jokes and said not to worry, and I made jokes about how they already ruined my right hand so might as well just finish it off. If it wasn’t for the warm and joking way that every person at King’s treated me like I was their pal or sister or cousin, I would not have survived any of it.
Back into the surgical room, and honestly the trauma of thinking about it now makes hot tears spill out of my eyes as I write this, because I would not wish this procedure on anyone, even though it saved my life and fixed me. Remembering it all and having flashbacks about it is why I am writing this lengthy spill of a post. I have to have this all out on the page or else it will sit in my memory and swallow me.
I reminded them to please give me the strong drugs this time because last time it really hurt, and it still hurt again this time, and I could feel the catheter slithering up into my vein and making my right arm ache and ache. At some point, the little piece of wire mesh, tinier than a Barbie’s bracelet, must’ve reached my heart and I could hear the surgeons focusing and saying technical things to each other about placement and movement and all I could do was lay there and groan a little when the aching got too bad. And then they said, “We know love, it’s ok, you’re doing fine and it’s almost over.” I couldn’t move from the drugs, but I could feel the ache.
Finally it was over and the catheter slid out and I could hear them saying, “This looks good, yes great, very good.” and I felt the greatest surge of relief I’ve ever experienced hearing those words and hoping to god that the stent would stay in place and do its job.
My arm was by then completely ruined and would remain black and purple, swollen and useless for several weeks after. Today, there are two little scars next to one another on my right wrist. They look like staple holes and recall Castor and Pollux, the twin stars at the top of the constellation Gemini. I hope the scars don’t fade. And I hope the stent keeps working.
After another day, they released me and GG came to take me home and we got in an Uber after dark and everything felt strange and vivid, as if I had been reborn into a world I already knew. The streets were wet from cold January rain and the water streaked down the sides of the car windows as we drove across south London to my little home. They said I will make a full recovery, though my heart was damaged and needs a lot of care and rehabilitation.
I did not come away with any new lease on life. I came away with PTSD and did not anticipate how long it would take to once again trust that my body wasn’t going to break. I don’t fear death, but I do fear having that angio surgery again.
I had to write this in great detail because I have been suffering severe PTSD flashbacks about the procedure and the ambulance ride and I needed to process it. I can’t imagine anyone would have read this far down, but if you stuck it out this long, thank you for being witness. I know many people have had angioplasty, and many people have had surgery, and many people are undergoing medical procedures far more horrifying than this every single day. It’s just that this is my story to tell.
I guess it is my lot in this life to have a tattered heart.
I always used to say that I followed my gut. But that’s not true. All along, I was following my heart. From now on, she will get the credit.
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