Wednesday, March 28, 2018

Understanding Heart Stuff

A few years ago, I had some heart problems (I'm good as new). When I tried to explain it all to friends, I found that not one understood even the first thing about heart stuff. They kept, like, tearing up amid my explanation, which seemed totally weird to me (per below, I'm far safer than they are, heart-wise!).

You really need to understand about all this, and not have it be some terrifying blob of mysterious badness. Heart stuff isn't as scary as you think. In fact, it's mostly good news these days. Take five minutes to read this overview, which will almost surely surprise you and transform your outlook:

Note: I'm not talking about the various rare and strange ways things can go wrong...or might have been wrong since birth. This is just the scenario most people mean when they talk about heart disease.

The heart's just a pump, and it needs oxygen. The oxygen comes from the arteries that feed in. If the arteries get blocked, oxygen gets cut off, and that's bad (and that's why you should take your Lipitor).

When the oxygen gets cut off, that’s a heart attack. You need to clear that blockage ASAP, before the heart gets starved of oxygen (which is bad). The clock's ticking!
Bad News: It's not going to happen in time. No one is going to crack open your chest and ream out the blockage at the baseball game, or even in the ambulance. That blockage will remain there for at least a day or two.

Good News: That's actually ok, because the moment you're in medical care - ambulance or hospital - you'll be given nitroglycerin tablets, which open things right up. It's one of the greatest "time outs" medical science has devised; a cheap, easy miracle. Now, you shouldn't go rock climbing at this juncture, but if you'll just patiently sit there, with the nitroglycerin under your tongue, danger is averted. The heart gets oxygen, and no further damage will be done. No harm, no foul! Sit back and relax....and schedule your angiogram. The clock has stopped ticking. Time out!
A day or so later, you'll have that angiogram. It's a procedure everyone should want, but it’s bestowed exclusively upon those of us with Scary Symptoms. It's far too expensive to offer to everyone, but you, lucky one, get to jump the line and have your heart thoroughly inspected from the inside!

They slide a probe through a vein in your wrist or pelvis that sends a video camera into your heart, and it finds any/all blockage, and can even remotely clear a bunch of it. If necessary, the procedure can also insert a stent, which opens up even super-blocked arteries, permanently. None of this hurts. All of it's wonderful. It's the thing you point to when people say snide things about modern medical science. This is the sweet spot. This is why it's great to live in the future!

Everyone else is sending you sympathy cards, but I'll congratulate you! You now have something 99% of your fellow humans don't have: complete assurance of clear arteries. Run up the steps or chase the bus; you won't have a heart attack, and not many people can say that! Your friends and family - pitying you for your dramatic-seeming heart condition - might, for all they know, be dangling by a thread. You, however, are the only superman in the room, with a heart that's 100% scanned and mapped and tested and good to go. It's an immense privilege enjoyed only by a lucky few.

The only thing to fear in any of this is failure to get timely medical help (i.e. nitroglycerin). That ticking clock must be responded to, and if you don't, that's a whole other thing. My strong suggestion is that you practice yoga and meditation to develop body awareness which will help you notice the problem way, way before the damage point. The people who don't notice are those whose bodies seem like numb and distant slabs. With body awareness, you'll be fine. In fact, better than fine. You'll be among the privileged few.

Let's talk about stress tests, which very few people understand. A stress test is an attempt to determine whether you're dangling by a forcing a heart attack. Please have a heart attack! Run faster! Keep going! It is literally a stress test - a violent shake-up to see if anything breaks. But don't worry, because the technician has plenty of nice juicy nitroglycerin, which is - remember? - a Time Out. So if that scariest of phrases - "heart attack!!!!" - gets uttered, you're a few seconds from a time out, and probably just down the hallway from an angiogram. Easy peasy. And then you'll have the privilege of knowing your heart's okay all within a safe and controlled environment.

Not to say that a heart attack is no big deal, but it's nothing awful in and of itself. All it means is that the danger clock has started running. The danger isn't the attack, it's the duration before nitroglycerin. Learn to be less terrified of the phrase, but very diligent about responding to symptoms.

It's counterintuitive, but the best thing that can happen to you, heart-wise, is to have a heart attack, get a speedy Time Out before damage occurs, and qualify for an angiogram so you have firm assurance that your heart is cleared for action. That would be awesome! Much, much shakier would be to assume you're healthy, and go shovel snow, uncertain of what's going on in your chest. You, snow-shoveler, may feel terrified of what I've been through. But I'm fine (zero damage, happy stent, I run up steps and scamper like a pup). Really, I'm just worried for you!

So: take steps to develop body awareness. Get help fast if anything seems funny in your chest (angina isn't just pain; it can feel like a lovely fullness). Take your Lipitor, if it's been suggested for you. And understand that a heart attack, in and of itself, is not some unthinkable dramatic horror. This is not 1960!

Slog technical advisor Pierre Jelenc asked me to add that a clean bill of cardiac congestion (from angiogram) "is not a license to commit all sorts of behavioral sins; other arteries can get clogged (although most patients will die of something else first)."

For more on the the Sublime Bliss of Stress Tests, see this posting

For more paeans to the beauty and joy of stents, see the bottom comment beneath this posting.

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