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Heart Attack hindsight - Warning signs you ignored



I would be very interested in hearing your accounts of your personnal experience with heart attack. Primarily, the warning signs prior the event, which you might have ignored, or took lightly, but now with hindsight, after surviving the heart failure, would have acted differently. And then about the event and recovery.Your experience can help the others.I had an unpleasant experience of sudden weakness during exercise last month which may or may not be a symptom of heart problem.

Please help.

I didn’t find the right solution from the Internet.

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Here is my whole story.I’m hoping by relating a lot of detail it may be helpful to some of you.

My name is Jim Goodman. I’m 63 and live Raleigh, NC, where we have world-class medical research universities and healthcare. I’ve always liked building things, and following a brief stint in banking after college, I began working in construction. I became a very skilled carpenter (still my favorite job to this day) and had the opportunity to work on once-in-a-lifetime custom projects around the country, along with projects in the Caribbean and Japan. Eventually, I started my own custom home building business. That evolved into a small manufacturing business, making building products, and I was fortunate enough to sell that to my largest competitor in 2006. I have been working for that company ever since. My employer is located in a small town in Alabama, and I have been traveling to company headquarters for a few days, about every 6 weeks. On April 6, 2016, I was on one of those trips when I had my heart attack. At 9:00 AM, I was walking from the offices out to the plant when I felt what seemed like a knot in my esophagus. In retrospect, I had had that feeling a couple of times the day before, but it went away in about a minute, and I didn’t think anything of it. But this time, it did not go away. The pain spread across my chest and into my upper left arm. I did a u-turn and walked back to the office. I sat down in a chair and waited for the pain to abate but it didn’t. I asked one of my colleagues to take me to the emergency room in the little regional hospital 3 miles down the road because I thought I might be having a heart attack. I had gone from feeling perfectly fine to this point in less than 10 minutes.

I walked into the hospital ER and told them I thought I was having a heart attack. I then promptly threw up my delicious Hampton Inn breakfast. They ran an EKG on me and did blood work. The EKG did not show any anomalies and my blood work came back clean…no troponin. The ER doctor then thought that maybe I was having a gall bladder attack. They did an ultrasound of my gall bladder and that also came back negative. By this time, 2-1/2 hours had passed. I was moved up to a hospital room and was being given blood thinners. I frankly don’t know all that transpired between noon and 5:30. I am not sure if I was continuing to have blood tests and EKG’s or not. The bottom line is, a blood test was done late in the afternoon, and at that point, the troponin showed up in my blood, and they knew I was having a heart attack. At 5:30, they put me in an ambulance with a nitro drip, and we drove down to Dothan Alabama, where the Southeastern Alabama Medical Center had a full cardiac care unit and cath lab. I was met in the ER by one of the cardiologists, and they did immediate blood work and another EKG. My troponin level had dropped from the mid 7’s down to the mid 6’s. My pain had also decreased significantly with the nitro drip. The cardiologist looked at all this information, along with the amounts of blood thinners that were in me, and he made the call that the catheterization needed to be delayed until the blood thinners worked their way out of my system, because I would be at high risk for bleeding out on the table…and my symptoms had seemed to have stabilized.

The catheterization was done at 6:00 AM the next morning. By this time, 23 hours had passed since the onset of my symptoms. They found that my LAD was 100% blocked (and calcified) and with some difficulty, they were able to get the catheter through it and implant a large stent. I had no other blockages, though a large branch artery did have 40% blockage, which would be dealt with medicinally. Once the big artery was opened, the pain began to go away.

Next came the echocardiogram and this revealed that my heart muscle was damaged, my ejection fraction was around 20%, and I have hypertrophic cardiomyopathy…all bad. I now had heart failure. Because of the extent of damage and the weakness of my heart, my interventional cardiologist inserted an aortic balloon pump to take some of the load off my heart. I was put in the ICU and had this device in me for 5 days. My condition was stable but guarded. I was now at high risk for cardiac arrest. I was not permitted to bend my legs at all for that 5 days, but the wonderful nurses I had in the ICU helped to make me as comfortable as possible. As my oxygen saturation and blood pressure numbers improved, the time came to remove the balloon pump, and I was moved into a regular hospital room. I was shocked at how weak I was. You hear the stories of people not being able to walk across the room, and that was me. A 10’ walk to the bathroom and back left me huffing and puffing. With my low ejection fraction, I was fitted with a Zoll Life Vest external defibrillator, that I will be wearing for 90 days. My entire stay was 7 days. My wonderful wife had flown down for the week, and we now prepared to fly home to Raleigh. Fortunately, I did not need supplemental oxygen, as that is a complication for the airlines that requires several days of preparation. However, I did need to be wheeled around in a wheelchair as I had nowhere near the strength required to walk the airports.

When I got back to Raleigh, I was able to quickly get an appointment with my PCP, and she quickly got things in motion. She was able to get me an appointment with the cardiologist I wanted and also with a sleep doctor (more on this later). I have had my first meeting with my cardiologist and liked him very much. I have a high level of confidence in him and the entire team in his practice. I was hoping, but not counting on my EF recovering above 35% so that perhaps I could escape an ICD; but it didn’t, and I did have to get an ICD.

So that was my story up to right after my heart attack. Now I want to talk about what went with me emotionally and what lessons I have learned.

Being in the ICU for 5 days, I had nothing I could do but start researching what I was dealing with on my smart phone. I didn’t know what heart failure was, and the more I read, the more depressed I became. I asked the exact same question you are asking, because all the info I was seeing seemed to indicate that within 6 months I would be on a ventilator, dying. I was suicidal. I started researching how I could painlessly kill myself before I ended up on a ventilator. But then I came across this article’t-believe-what-you-read-on-the-internet/ and that gave me some hope.

I started looking for information on what, if anything, I could do to slow or stop the advance of my heart disease, because the stent did not address the underlying cause. I started seeing lots of encouraging information. I wasn’t looking at social media, I was looking for clinical trials, National Institute of Health articles, and other information coming from the medical community. There a lot of encouraging information. I really dug into diet and read a lot of different ideas about that. I personally came to the conclusion that Dean Ornish and Caldwell Esselstyn were on the right track with their very low fat, vegan or almost vegan diets. Though the clinical data is limited and the study populations very small, there is clinical data going back almost 30 years (Ornish) supporting their approach to diet, and I have bought into it. When I got out of the hospital, I immediately changed my diet to following Ornish/Esselstyn and in 6 months I lost 55 lbs. (I’m 5’9" and had weighed 235 when I had my heart attack. I now weigh 180); and it was not difficult, no kidding. I was motivated. I certainly miss foods I used to eat, but the choice between either eating my old diet and dying, or living longer was a no-brainer. I had NO PROBLEM changing my diet, because I did NOT want to die yet. I could not have another heart attack, because with the damage already done to my heart, if I had another one, I was going to be a dead man. I started feeling better within a few weeks, and in the almost 2 years since my heart attack, my lipid numbers have plummeted. Before my heart attack – total cholesterol was 185, LDL cholesterol was 135, triglycerides were 180. Within 2 months of changing my diet, my TOTAL cholesterol was 90, LDL 40, triglycerides were 85. I have had multiple blood tests since then and the numbers are still in those ranges. And I feel very good. I am a believer in that diet.
With my heart failure, in addition to going plant-based with my diet, I have been very vigilant about my sodium intake. I rarely eat more than 1000mg of salt per day. This meant I’ve had to learn to cook. My cooking is woeful, but I’m slowly learning. Processed foods are OUT! They are loaded with salt. Eating out at restaurants is a challenge, not because you can’t find meals with healthy ingredients, but because restaurant kitchens load up their food with salt. I tracked my eating in a food diary on the My Fitness Pal website for several months until I was knowledgeable about sugar content, sodium content, and caloric content of the foods in my new diet. I take my meds religiously as prescribed. With a vegan diet, you can have nutritional deficiencies, and I take vitamins and supplements, including a multivitamin, Ubiquinol CoQ10, Omega 3 fish oil capsules, flaxseed powder (Omega 3’s), and nutritional yeast (B12). I checked with my cardiologist before taking any non-prescription meds or those supplements.

I went through cardiac rehab and have continued with a cardiac maintenance program 3 mornings per week at my hospital. I plan to be in that program the rest of my life, however long that is. Everyone in this class has had major cardiac problems, including heart failure, transplants, valve replacements, multiple bypasses, etc. I have classmates in this cardiac maintenance program in their mid to late 80’s who have been in the program for over 20 years and are still alive and vigorous. They are inspirations to me.

Because my EF was so low, I also got an ICD. Mine is a subcutaneous ICD (S-ICD) and I have not had any problems with it. I don’t have any pacing or synchronization issues with my heart, so I was able to get a S-ICD which zaps you if you go in to V-tach or V-fib, but can’t do any pacing.

In that first 12 months I was hospitalized 5 times: 1. heart attack, 2. acute heart failure episode & fluid on my lungs, 3. surgery - implant ICD, 4. surgery – fix lung from heart failure episode and remove tumor from thymus gland (discovered during heart failure episode), 5. chest pain scare (false alarm). BUT, I got through it and have recovered from it all. My last hospitalization was 1-1/2 years ago, and I have had no serious problems since then. I weigh EVERY DAY and chart it. I take my heart rate and oxygen saturation levels twice a day, EVERY DAY and chart it. I take my blood pressure twice a day, EVERY DAY, and chart it. I see my heart failure cardiologist every 6 months. With my strict diet, If I start gaining weight, I see it in my daily log and I know it’s fluid. I follow my heart failure cardiologist’s instructions on taking additional Lasix to bleed off the excess fluid. You become skilled at listening to your body and knowing when you are feeling off, and then promptly doing something about it. It becomes part of your routine. My health now is good. By taking my meds as instructed, exercising, and eating healthy, my EF has increased from 20% to 35%. Other than occasional fluid retention, that I stay right on top of, I have no symptoms of CHF. I am grateful to be alive.
and to have a second chance. When I was in that ICU, having come close to dying, all the frivolous, insignificant stuff I had been worrying about INSTANTLY went out the window. Talk about a reassessment of your priorities! I don’t know why it took something like this to get my attention, but it certainly did. My family and friends are now absolutely my top priority, as they should have been all along. Nobody on their deathbed wishes they had worked more at their job. I know it will be a balancing act between lifestyle, diet, meds, exercise, stress management and medical care to beat the odds and live another fulfilling 20 years. But that’s my goal and it gives new meaning to my life.