Have you ever wondered what it would feel like to have a heart attack? Yeah, I never did either. It was not something I ever wanted to imagine or think about. Heart attacks happen to other people, older people. They don’t happen to me.
In May of this year, I did start thinking about it, though. And I realized, it could happen to me. While I’m not “old”, I’ve had to accept the fact that I’m not young anymore, either. But my mind still thinks I am young.
I remember the day I realized that I am getting old. I was 51 years old and had gotten down on the floor. As a young person, when you want to get up from the floor, you jump right back up! That is what I was used to doing, get down, get right back up. But this particular day, I got down on the floor and when I “tried” to stand, my knees retaliated against the abuse I was surely trying to inflict upon them. They would not lift me up! I had to try 3 times before I finally crawled over to the couch and used it as a weight bearing device, and was able to stand. In between those 3 attempts, I was sitting on the floor, laughing like a mad woman.
Why was I laughing hysterically? Because, in that moment, that VERY moment, I realized, “I’m getting old.” My day job consists of providing case management services to elderly and disabled people. Not even a week prior to my knees staging a protest against me, one of my clients told me that her first realization that she was getting old was when her knees would no longer support her weight to lift her from the floor. This was an 80+ year old woman. She told me, “Sweetie, it will happen to you one of these days.” She just didn’t realize how quickly her prophetic statement would come to pass.
So I sat on that floor, laughing for a good 5 minutes, tears streaming from my eyes, because the first time it happened, I was confused. “Is something wrong with me? Why aren’t my knees working?” The second time I tried to stand and my knees didn’t work, “This is just ridiculous! My knees have always lifted me before. Why have they stopped working now?” The third time, “Oh my gawd! She was right!” In that moment, I faced the infallible truth, “I’m getting old!” And then I crawled to the couch, used it to support my weight, and lifted myself from the floor. That was almost 2 years ago.
What does this have to do with ol’ ticker? And TIA? In May of this year, I think I had a heart attack. I was driving, out visiting clients, and was in the middle of nowhere. There were no houses around, no traffic on the road I was on, and I would not be able to tell anyone where I was. I often just plug an address in my GPS and go on my merry way, but sometimes you can see roads that cut off and still go in the direction you want to go in, but there are no names, just a line. This particular line looked like it would be a shortcut to where I needed to go, and I took it.
Halfway down that road, I felt a pressure in a sort of band across my chest. It followed my bra line perfectly, and I wondered, “Why does my bra feel so tight all of a sudden?” I start adjusting it, pulling it away, trying to get the pressure off my chest. Then I got a bad pain in my back, between my shoulder blades. “Ouch! This hurts!” Thinking that maybe my posture had been bad while driving for the hour and a half that I’d been driving, I try to sit up straighter, taking the pressure off my back and chest. Then the right side of my neck, jaw, and shoulder started hurting and down into my right arm. “No, this isn’t a heart attack. That’s always your left arm, right?” Throughout all of this, I’d noticed that I was extremely hot, sweating hot, but I had put that off to my air conditioner in the car not working properly. While I had been hot before, this had hit as suddenly as the pressure in my chest, in which I became overwhelmed with the heat.
I call the office and ask the receptionist to look up heart attack symptoms in women. I describe to her what I had been experiencing and she said, “You sound like you are having the symptoms. Do I need to call an ambulance to get you?” I look at that line on the GPS, the one with no name, the one I am now on. “Umm, I wouldn’t know where to tell anyone to go to find me. I’ll just keep driving until I get somewhere.”
In case you are wondering, heart attack symptoms in women can be atypical of those that are often used to describe heart attacks. For women:
1. Chest discomfort—including pain, tightness, squeezing, or pressure.
In women, it may be more likely to manifest as a sense of pressure or tightness
2. Pain or discomfort that radiates into the jaw, shoulder, neck, back, or either arm.
3. Shortness of breath, especially if it’s new.
Women may notice they are getting short of breath easier, for weeks leading up to a heart attack.
4. Feeling faint, lightheaded, or dizzy.
5. Sweating that comes on suddenly.
For women, my age especially, if we start sweating, getting hot, we think of hot flashes. But those are flashes, they come and go. But if you start sweating suddenly, and it doesn’t go away within a few minutes, then you need to talk with your doctor about it. It could be a sign of a heart attack.
6. Nausea or vomiting.
Don’t automatically assume that you ate something that didn’t agree with you, especially if you have discomfort in your upper abdomen region.
7. Unusual fatigue.
I never went to the doctor after that episode. The company I work for is extremely small and doesn’t offer health insurance. Out of pocket cost for health insurance for me is, you know, along the lines of giving an arm and a leg, or at the very least a kidney or two. I have a pre-existing condition which makes the cost extremely high and well, I’m a social worker. Much like teachers, we aren’t truly paid for the work we do. I earn too much for assistance but not enough to pay out of pocket.
Since that time in May, I’ve been getting a lot of “skipped” heartbeats. Every single day, the ol’ ticker decides to do the Funky Chicken but is out of step with the music. I’ve always said the only rhythm I have is the beating of my heart and even it gets out of step every once in awhile. That “every once in awhile” was before the suspected heart attack in May. Now? The ol’ ticker is like a stumbling drunk, who thinks he can walk in a straight line but is actually performing amazing acrobatics in their attempt to remain upright.
I’ve had two recent Emergency Room visits to deal with chest pain, shortness of breath, and palpitations. The first one, my heart decided to straighten itself out and fly right. By the time I got to the ER, the symptoms had stopped. They told me to follow up with my doctor and a cardiologist, that they did see “something irregular” but nothing of major concern.
The next time, I was working my part-time job, delivering pizzas, when I developed chest tightness and shortness of breath. My heart was on a dancing frenzy that evening, too. I also had a pressure in my head and could hear my pulse in my left ear. I went to Urgent Care and my pulse was 105 and irregular, it was acting all drunk again. The doctor pulled the triage nurse out of the room and told her to send me to the ER because I may be having Afib. They reimbursed me the $100 I had to pay upfront to be seen.
I was going to go, I really was, but my heart must have worn itself out from all that dancing, because it finally started walking in step with me again. Knowing if I got over there with no symptoms, they would just tell me to go home and follow up with my doctor and a cardiologist, I didn’t go.
A day or two later, I wasn’t feeling good, pressure in my chest, drunk heart again. I’m worrying about the cost of these ER visits, no insurance remember, but if I was having a heart attack, the cost wasn’t important. So I went to the ER. This time, I went to a different hospital that actually has an emergency department for cardiac events. They got me back right away and did a lot of lab work and testing. They scheduled an appointment for me with a cardiologist and told me that I would need to wear an event monitor and have a stress test done. That appointment is now scheduled for the 20th. (Two days from now.)
In the meantime, the ol’ ticker is still doing its drunk acrobatics off and on and I’m learning to live with that. I have a plan in place, see the cardiologist, and we’ll go from there. But 4 days ago, my left eye decided to get into the mix. I guess I wasn’t paying them proper homage or something because the night of the 14th, I was watching television, and I suddenly lost the sight in my left eye. Now, I’ve neglected to mention that it’s done that before, about 2 or 3 times before, but it was always just for a minute or less, and I put it off to an ocular migraine. On the 14th, it lasted about 20 minutes, which I’ll be honest, scared me.
I had been noticing the drunk acrobat was performing again, much longer and more frequently than usual, so I thought I would just take it easy that evening. I was watching television, when I felt dizzy, sort of the kind of dizzy that’s more like your head is swimming, and all of a sudden, my vision was all wonky. With both eyes open, I could still see the TV but it was like there was a part of it missing somehow. I closed my left eye, and my right was fine. I closed my right eye, and there was a grey shadow over the lower half of my vision. I could only see partly out of that eye, where the grey wasn’t covering it. It didn’t move when I moved my eye, so I knew it wasn’t an ocular migraine. I also felt a pressure in my face and head, which was really weird.
Most people would like, you know, call an ambulance or something. But me? The cost of another emergency room visit, the cost of an ambulance drive… I can’t afford any more. So, I rode it out for the 20 minutes or so, and my vision came back just as quickly as when it went out. I had a slight headache on the back of the right side of my head, and wrote it off to that. But about 2 days later I talked with a nurse friend who said it could have been a TIA.
As a medical social worker, working with elderly patients, I had seen TIA before as one of their diagnoses, but didn’t really know what it was. So teasingly, I said, “A TIA? Is that like a secret government agency, like the CIA? You know, I may enjoy a good conspiracy theory, so let’s hear it. Are they sending out microwaves? Or do they use sound waves to disrupt my left eye? What is it?” It got serious when she said, “Mini stroke.” … But I wasn’t like paralyzed on one side of my body. My face didn’t droop, I don’t think, not that I can look at my face while I’m lying on the couch watching television, but I don’t think it did.
So I talked with my boss and she wanted me to call my doctor, to make sure I was okay to drive until I saw the cardiologist on Monday. You know, because if I were to lose my sight while driving, yeah, that would be bad. I call my doctor, but of course, that was a Thursday, my doctor’s half day. They put me through to a triage nurse instead. She told me to go to Urgent Care, as she was more concerned there could be an issue with my retina. I trudge off to Urgent Care and the doctor came in and I explained what had happened, that the triage nurse was afraid it was something with my retina and I just wanted to get my retina checked out. He said, “She doesn’t know what the hell she is talking about.” 😮 He told me that with my symptoms, with the issues I’d been having with my heart, and with my history of deep vein thrombosis and pulmonary embolism, that he thinks it was a TIA. There’s that acronym again. He said that essentially a clot could have blocked a part of the veins that feed my eye, and once that clot moves again, or is resolved, the vision will come back. He explained that one of the hallmarks of a TIA is that it comes on suddenly, and the symptoms will leave suddenly, and that yes, it can affect only your vision without any other typical stroke hallmarks. He told me to make sure that I have the cardiologist check my carotid artery for any blockages. Then he asks me, “Did they tell you that you had a heart attack when you went to the ER after leaving her last week?”
Umm….Hmm…. Sheepishly, “I didn’t go.” Doc: “WHAT!? What do you mean you didn’t go?” Me, sheepishly again, “Umm, the symptoms stopped after I left here and I was afraid I’d go and they’d just tell me to follow up with my doctor and the cardiologist and it would be a waste of money and I really can’t afford to go for symptoms that come and go only to have them tell me to follow up with someone else and I was afraid they wouldn’t believe me since I wasn’t having symptoms right then and…” Doc: “Brenda! I ought to spank you! It doesn’t work like that. They know heart attack symptoms can come and go. They know what to look for! I can’t believe you didn’t go! You are smarter than that!” Me, looking down, saying nothing. Doc takes a deep breath, lets it out slowly, “Next time, you go, whether you still have the symptoms or not.” Me, quietly: “Yes, sir.” I felt properly chastised.
This brings us to today. I sit and wait for the cardiology appointment on Monday and wonder how in the heckles did I get to the place that I’m having to see a cardiologist for a possible heart attack and possible mini strokes. My only answer is, “I’m getting old.”