OK, I’m ready to talk. I haven’t blogged in months. Lots of things have happened. I’ve been too overwhelmed to write. I finally have a quiet morning so I want to give this a shot.

We went on an amazing trip to Italy this summer. We  spent time in the middle of no where in Italy. A month after we got home I was told I needed emergency quadruple cardiac artery bypass surgery. What?

I’m 57. Great cholesterol. Diabetes type 2- well controlled. Overweight but not too bad. Severe Rheumatoid Disease. Heart problems? No way.

Emotionally it’s been hard. Recovering from such a darn big surgery took all my time and spirit for the first 3 months. How in the world did this happen? Where do I go from here? I’m being told to change everything in my life. Like now! I’m not good at change. How can I possibly change all theses habits? People blamed my weight. Others said it was the DM. The doctors said it was the RA. Even with all those risk factors, who every heard of the very first complication being the need for a multi vessel cardiac bypass surgery? Its hard for me to change anything and I’m being told I need to change everything. I sat and cried.

Even as a pharmacist, I admit that the first time I had chest pain, I didn’t immediately know what it was. I was in squatting position to pick something up. Oooo. What’s that squeezing sensation in my center left chest? It feels like pressure too. Shit. Now my arm hurts.  I felt a dull ache down to my fingers. I started to sweat. Ok, calm down. It’s probably anxiety. Oh crap, now in the middle of this I get a toothache? My right bottom jaw throbbed. Oh Damn….is this heart pain?? I think theses are the classic symptoms! Shit. Shit. Shit.  Wait….it’s starting to go away. Yes, its dissipating.  I’m OK.  I’m OK. What do I do now? I made a plan. I decided to pretend it just never happened. Yes!

My plan worked for about 2 weeks. Then the big one came. It was all the same stuff but way more intense. I couldn’t breathe. I started to fall. I struggled to sit down. It kept getting worse. I was sweating and getting nauseous too. I knew it was bad. I got to the bathroom and to the medicine cabinet. I had a bottle of sublingual nitroglycerin for my mother. I grabbed it and forced my clumsy hands to open the tiny bottle and place the pin head sized pill under my tongue. It burned. I waited. Everything started to slow and finally it all just faded away.  Shit.  If Nitro makes it better…its my heart. I have to get to a hospital, fast.

I got to big teaching hospital in the city. They saw me quickly and admitted me to their observation unit. I had 3 more episodes of chest pain requiring IV morphine. They did blood work and a nuclear stress test. Both negative. Hmmm. The nurse practitioner on my case told me I should go home and comeback if it happens again. They thought it was probably indigestion. Take some Nexium. But……I’m having chest pain every 6hrs or so…. the nitro….the symptoms! We argued. Jolene lost her temper. They told us pretty much to leave. We did.

The chest pain started again that evening. What should I do? They told me nothing was wrong…but this pain! I knew something had to be wrong. I went to another hospital. I told them my story and asked for them to do a Cardiac Cath.  It’s the only way to know for sure what is going on in there. They were hesitant. A cardiologist friend called and pushed for a Cath too. They gave in and scheduled it for the next morning.

I remember waking up after the procedure wondering if they found anything. The doctor told me I was in serious condition. It was more than they could treat in the Cath Lab. I needed quadruple bypass surgery stat.     Wait…..What?

It turned out the blood work was negative be you had not had a heart attack. I was getting ready to have one. The nuclear stress test gave a false negative because it compares the blood flow in the heart arteries. Mine all matches because… the were all clogged!

Everything moved fast after that. I was transferred back to the city hospital and in surgery in no time. I woke up in Critical Care getting several units of blood and drugs to stabilize my blood pressure. The pain of breathing and moving was blinding. I spent a little more than 2 weeks in the hospital. Then 2 weeks at inpatient rehab and then I went home with people hired to help take care of me. Recovery is a long and difficult process.

About 3 weeks postop the thought occurred to me. The surgeon said he did two bypasses. What about the other two they said I needed? I talked to the surgeon. He said the left side of the heart was complicated. He did an alternative kind of bypass since the “Widow Maker”  artery was too clogged to just hook into. The right side arteries were too diseased to do anything with, he had to just leave them as is.

This is a lot of information. I mean a month ago I was wandering the countryside in Italy. I took long walks in the mountains to a Chianti wine tasting and Cooking Classes at a hilltop Medieval castle. Now my chest had been cracked open and they couldn’t fix half my heart. My head was spinning. What was happening to me?

I started Cardiac Rehab. 3 times a week for 12 weeks. I’d never been to a gym. The machines looked intimidating. The nurses said things I didn’t understand like, have you used the elliptical today? What the hell is an elliptical? I was wired with cardiac monitor equipment. I was miserable. After my sessions I would sit in the car and cry. I didn’t want to be a patient anymore. I want my life back. I’m tired of doctor appointments and trying to explain what happened to every doctor I meet. I hate my scar. It’s big and ugly. They don’t use staples anymore so it’s not the zipper look like in the old days but it’s still horrifying. I’m tired of advice from people who think it was caused by Diabetes. I’m tired of idiots that tell me it couldn’t be my Rheumatoid Arthritis because there are no joints in the heart. I joined an RA support group online and told my story. People responded with demands that I be removed from the group for trying to scare them with made up stories. The administrator said although she believed it was true, it was just too upsetting for most RA patients. For them? How about me? Isn’t that why you join a support group? I deleted myself from the group.

Open Heart Surgery is weird. Did you know it causes depression? It also inactivates you taste buds for a while, it causes insomnia, you can get Brain Fog or Pump Head -where you just can’t seem to think clearly or find the words you want. Some people have outbreaks of severe anger. Other operations don’t cause this. It’s well documented and strange.

Support groups say it takes 6 months- 1 year to feel normal again. I am roughly 3 months postop. In addition to Cardiac rehab I am going to Acupuncture, therapy, trying to go meatless at least once a week, Meditating and trying to write again. I feel like I am in mourning for my old life. I worry more than I ever did before. I cry a lot.

Rheumatoid conditions predispose us to Cardiac Disease. I knew that. I just didn’t know it had already happened. I wish my doctor had been more aggressive with my statin treatment due to having RA. Maybe I would not have been this far gone at just 57 years old. I wish the ER doctors had listened to me and my symptoms, not just the test values when they decided to send me home. I wish the surgeon explained to my family exactly what he did and what he could not do when he spoke to them postoperatively. I wish someone told us about the side effects of this surgery. You feel like you are crazy until you Google it or ask around.  So many things I wish I knew or did differently.

My Rheumatoid Disease is still not under control. They tell me to reduce my stress and avoid pain. Both these factors increase inflammation and chronic severe inflammation is what caused all this. But just how do I do that?

Stay with me for future blogs. I need to tell you all about our adventures in Italy. I will take you along on my journey to figure out stress, pain, diabetes, physical therapy, going to the gym, weight loss, denial and the upcoming holidays. And feeling overwhelmed.