So, I had a heart attack ...
October 12, 2015 6:24 PM   Subscribe

Nine days ago I had a heart attack. A week ago I had two stents placed in my right coronary artery. Today I'm back at work. Whoa ... WTF just happened??

I'm 55, overweight and was a smoker until the day of the heart attack. I was moderately active, walking 2 to 4 miles a day at least 5 days a week and had shed 15 pounds since the end of August.

The heart attack came without warning, not while exercising, but while standing in front of my kitchen sink washing dishes . I got my ass to the ER, stat, got good care and seem to have avoided any permanent heart damage.

I feel fine physically. I don't feel like I just had a heart attack. I'm not smoking. I'm eating healthy. But I do feel kind of lost at the moment.

YANMD and I'm not seeking medical advice. I see my cardiologist for follow-up next week and presume I'll begin cardiac rehab then. I was instructed on discharge from the hospital to take it easy ("no exertion that would make you sweat") until I follow up with the cardiologist.

Currently going through a gamut of emotions, ranging from feeling lucky and blessed to have survived to feeling devastated and shattered and ashamed.

Trying to get some perspective on this and wondering if anyone else out there who's been through something similar can shed some light on what happens next, or at least how best to get through this amorphous period between discharge and follow up.
posted by jrchaplin to Health & Fitness (21 answers total) 9 users marked this as a favorite
This is your body and your life. You can get scared and sad and panic or continue to do the smart things (ditching the smokes, etc.) and manage your body and your life. You got an early warning, you are strong and smart and will take advantage of that. Red wine is good for the heart.
posted by vrakatar at 6:32 PM on October 12, 2015 [5 favorites]

Trying to get some perspective on this and wondering if anyone else out there who's been through something similar can shed some light on what happens next, or at least how best to get through this amorphous period between discharge and follow up.

This isn't quite the level of our situation, but I just had major surgery out of the blue, and it came all of a sudden during a routine examination for something that I thought was a cough. Here I am a month later, and I'm less one body part and I had a major tumor removed, which was thankfully benign.

The reason I bring this up is because I remember feeling pretty lost. The call came in for follow-up from an office admin staff, and it was somewhat cryptic. There were days between appointments in which I didn't talk to anyone who might know what is going on, as they can't say anything until tests are conducted. Even after surgery, there is wait time for follow-up evaluations and confirmations of results.

All this to say, it's kind of lonely between things. Nothing is every said conclusively, or even speculatively most times, until you are sitting with a doctor or surgeon who is holding definitive test results. And that between space can feel very, very surreal. The first week after my surgery, if it weren't for the pain, I might have thought it was a dream.

I found that it felt vague and undefined until I got to talk to someone. If your doctor is good, they will allow you to ask all of the questions that you need to know to feel like you have a solid perspective on your situation. Perhaps knowing this is the case will allow you to feel more grounded until then. If you need others to talk to, perhaps you can seek out online or in-person groups, just to talk about how you are feeling. I'm sure they are out there for things like this.

Oh, and one other thing that came to mind. Sometimes mild to more severe cases of depression occur after different types of surgery, and from what I hear, it's more common with heart surgery. If you are feeling a bit down or out of place, sometimes this can be a natural reaction not only to the trauma you have been through, but also to general anesthetic. There are ways to follow up on that possibility, of course. Sometimes just knowing this possible side effect can be helpful for dealing with it.

Good luck to you.
posted by SpacemanStix at 6:37 PM on October 12, 2015 [10 favorites]

I've heard that this emotional upheaval is fairly common for people who have survived a close brush with death. Your doc may be able to give you a referral for therapy so that you can talk this through. You might also look into groups for heart attack survivors that are set up by your local hospital. Best of luck!!
posted by PorcineWithMe at 6:39 PM on October 12, 2015 [2 favorites]

I have had two stents put in two different times. I am about your age. I was not a smoker but overweight is a fair characterization.

My cardiologist insisted I speak to a therapist afterwards. He talked about how we start to go through a freak out about our mortality. He also mentioned pretty much what you are asking. Talking to a therapist can address the now what part. He said a lot of heart patients face depression.

In the days after I was released from the hospital, I too went home and was like, "That sucked, now what?" I went to work a few days later and pretty much resumed my life except that I ate less and started exercising more. I did talk to the therapist. I think it helped.

Good luck.
posted by AugustWest at 6:39 PM on October 12, 2015 [8 favorites]

Be gentle with yourself, emotionally I mean. I had a pulmonary embolism scare and while I was fine while it was happening I found that in the weeks afterwards I would burst into tears for no reason. It's really hard to get your mind around a near-death experience. It took me ages to stop dwelling on it. Your "whoa... wtf just happened" is just how I felt. I was in major denial, even as I was heading to the hospital I remember thinking "no, I think I'll stay home and clean the house, I don't feel like dying today. Nope, no thanks, moving on".

You've gone from feeling fine to omg life threatening condition back to normal again. It'll take your mind a little time to catch up.
posted by kitten magic at 6:58 PM on October 12, 2015 [4 favorites]

Check with the hospital where you had the procedure - there should be a social worker who can connect you with support groups, counseling, etc.
posted by SMPA at 7:00 PM on October 12, 2015 [1 favorite]

First, glad you are still around. ;)

Around 10 years ago, I was not taking care of myself and got a cold. It got worse and worse. A doctor I saw mistreated it and two days later I was in the ICU with double pneumonia and sepsis. My wife was told to prepare for the worst. I spent 3 days in the ICU and four more days in the hospital. Then a week or two at home to gather my strength to resume work.

A tough thing to realize how close I came to death. Afterwards, the lead doctor told me I was lucky to have survived.

I spent some time looking out the window, at my wife, and at my daughters and realized that the path I had been on was going to lead to me being gone sooner than later.

I ended up actively working to reduce my stress and live a healthier lifestyle. After a few more years, my wife got me into cycling, and now I am in good health, active, and relaxed most of the time. Sleep is important, I had been getting a minimal amount.

I wish you the best.
posted by Argyle at 7:01 PM on October 12, 2015 [4 favorites]

I didn't have a heart attack, but I did go through kind of the same thing about 10 years ago. I had a pain in my arm that started suddenly and was so bad I went to the doctor in tears. A week later I had two herniated discs taken out of my neck, a titanium stabilizer and some screws put in, and a permanent scar on my throat.

One of the things nobody ever really thinks to tell you, when your body betrays you suddenly and unexpectedly, is how devastating it can be mentally and emotionally. I went from pretty damn healthy to fragile and in pain so fast it spun my head around. The pain was everywhere, all the time, unrelenting... all the stuff I found easy a week ago was now hard or impossible... I couldn't sleep... it was wrenching.

I went through about a year feeling like my life had ended, like at thirty I was just hanging out waiting to die. I didn't think I'd ever get better. I took every pain as evidence that I'd somehow ruined my life and my health and I'd lost my chance at ever feeling normal or good again.

The thing is, it wasn't just pain. Surgery fucks you up - chemically! Trauma does the same thing. Combine the two, and you get instant depression. I didn't identify it until much later, but that's what it was. I don't know why health care professionals don't talk about it more before they cut into you, but they don't. The pamphlet I got before my surgery had a line in it about some people suffering minor depression for a few weeks after a surgery. One line, never spoken to me by a person -- it just wasn't enough.

I would encourage you to be good to yourself right now. Not just in terms of making physically healthy choices -- but in terms of being loving and gentle toward yourself. Be aware that your body has been through a trauma that your mind can barely process, and until the two can sync up again, your emotions are going to be highly variable.

Don't make any important life decisions right now - don't get married or divorced or quit your job or join the Peace Corps or anything. :) If you start to feel really bad, talk to your doctor about it right away, and be honest about your feelings so your doctor knows what's going on with you. There's help to be had if you need it and ask for it.

Also, consider that you had one job -- survive! -- and you did your job really well, because here you are. That's one success already. Quitting smoking is another. Congratulations!!
posted by kythuen at 7:30 PM on October 12, 2015 [14 favorites]

Best answer: On a practical note, if you have insurance, there's a very good chance your insurance company has a cardiac care management program for people who have had heart attacks. This is AWESOME. Call and find out. Your doctor may not think to refer you, and your insurance company won't know you had a heart attack until claims for services and meds start rolling in - and that can take up to three months or longer.

If you self refer, you will instantly get either a care coordinator (good) or a nurse care manager (great!) who will literally (not really, but you know, colloquially literally) hold your hand as you go through this. That's their job. They know what you're dealing with, and they are generally trained to spot emotional trouble and get you help if you need it.

They also know exactly what goods and services are available to you in your area, and can help you get access if you want it or need it. You don't have to sit and wonder what's next until you see your cardiologist. They can give you a broad outline of what's next and help you get more comfortable with what to expect when you DO see your doctor.
posted by kythuen at 7:53 PM on October 12, 2015 [4 favorites]

I've heard that depression is actually quite common after heart surgery. Be kind to yourself and consider seeing a counselor as you work through some of these feelings.
posted by Toddles at 8:04 PM on October 12, 2015

7 years ago, I went on my last motorcycle ride, the one where I got hit by a car and sent to the hospital for 5-6 weeks. Artificial hip left side, lots of hardware, lucky to be alive and walking.

I remember going through a very depressed and angry period. For me it started when I began to get well physically. As long as I was preoccupied with getting well, I was actually on sort of an emotional high. Once I got back to "normal life," it began to sank in with me how much had changed about me.

You (and your body) are dealing with a lot of change, stress, and BTW, you've quit smoking, which is not a picnic (absolutely what you need to do, but not a picnic).

As a fellow toiler in the IT fields, I would particularly emphasize that you need to get out there walking, and manage workload stress.
posted by randomkeystrike at 8:06 PM on October 12, 2015 [2 favorites]

There is such a thing as medical PTSD, though there's sort of a six-month diagnostic hang-time between trauma and post-trauma, but if you get some support now you're likely to avoid any sort of ongoing issue later.

Plus there appears to be a correlation between major surgery and post-surgical depression that is still kind of an unknown in the causation department (is it caused by the illness/injury? The anesthesia? Immune system running at full blast? Just the shock of it all? Nobody knows.) but is a thing and there is treatment.

Also, you've had one of those "staring down the barrel of your mortality" moments. It's worth having someone you can process that with.
posted by Lyn Never at 8:08 PM on October 12, 2015 [2 favorites]

I never had a heart attack. I do work as a nurse and have found that major health events like a heart attack can catalyze people to make enormous changes which have profound impact on their quality of life.

I read from your comment that you are already making changes because of this. Quitting smoking is the the action which makes the single biggest impact on your longterm health of any other intervention. Bravo to you! You have already use this event to change your life, to improve your life, and to lengthen your life.

I can see why this is all overwhelming and confusing. I urge you to use this opportunity to evaluate everything, and make conscious choices about what you want your life to look like.

So glad you made it through OK, wishing you the best going forward.
posted by latkes at 8:39 PM on October 12, 2015 [1 favorite]

You may become hyper-vigilant--noticing and then stressing over every little thing going awry in your body. That's normal after something like this. If you're worried about something and you can contact your doctor online or call an advice nurse, do so without worrying about it. They're used to it, and they'd definitely rather you called on a false alarm than didn't call in a real crisis.
posted by wintersweet at 10:42 PM on October 12, 2015

Currently going through a gamut of emotions, ranging from feeling lucky and blessed to have survived to feeling devastated and shattered and ashamed.

Please be kind to yourself about this.

My grandfather had a heart attack in 1977. He thought he had heart burn and put up with it for a couple of days. He passed away over night because he didn't think to get checked out, just decided on going to bed early instead. You did amazing by getting yourself to the hospital instead of just ignoring what was happening. I really wish that I had had the chance to meet my grandfather, but alas.
posted by kinddieserzeit at 12:58 AM on October 13, 2015 [1 favorite]

One of the side effects of anesthesia is depression. (another fun fact that they don't tell you when you have surgery ). I'm sure a lot of your feelings are emotional in origin, but they might also be chemical, and need to be treated as such.
posted by Green Eyed Monster at 4:05 AM on October 13, 2015

My father experienced post-surgery PTSD following triple bypass surgery several years ago. An example: He said he came to in the cardiac ICU, rang for the nurse, and told her, "I don't know what's wrong, but all of a sudden, I'm terribly afraid." She held his hand and talked him through it (Maine Medical Center nurses FTW, BTW).

Dad was already physically active but had to ease back into his usual routine. He usually does a lot of rowing on a nearby lake, but his wonderful physical therapist tracked his performance on a treadmill before she gave the OK for doing anything more strenuous.

And insomnia has also become more of a thing for Dad, though his age (78) no doubt plays a part as well.
posted by virago at 5:48 AM on October 13, 2015

So, um, several years ago, I had an accident in the lab. I cut off the corner of my thumb with a microtome. I mean, it was enough that it temporarily changed the shape of my thumb, and it bled a lot, but let's be honest. It was a sliver. I got help from someone in the lab and went to the occupational health clinic, and they put a big bandage on it and a little hunk of styrofoam-like stuff to help the thumb grow back.

And you know, I felt sick and nauseated and weak and horrendous for an entire day afterwards. I remember just laying on the couch, shaking. I felt so stupid for feeling that bad, because, dude, it was my effing thumb. And not that much of it.

That kind of shock does crazy things to your body. My injury was trivial compared to yours. You had a heart attack. But I felt a number of the things you're describing - shame and anger at having been such an idiot as to not lock the microtome, anger that I'd needed to be in the lab microtoming things at 7am in the first place, relief that it wasn't worse, fear of what it could have been... So my point is, it was a tiny, scaled-down microcosm of what you're feeling, but the core components are the same.

All you can do now is focus on your health going forward, and there's no shame in talking to a counselor if you need to. There's no need to suffer in silence. What you're feeling is really, really normal, and it will fade over time (there was a recent thread about getting mugged that carried some similar sentiments). Time heals all wounds, except heart attacks you don't seek treatment for. Good on you for seeking treatment, and hang in there with the not smoking. I know from awful personal family experience how hard quitting smoking can be, but it can be done.
posted by telepanda at 6:48 AM on October 13, 2015 [3 favorites]

I am so glad you survived! What everyone is saying about surgery and depression is spot on. I had major surgery a year and a couple of months ago, and I went through the same thing. Of course mine was planned in advance, so I had some time to prepare mentally. I can't imagine how I would have felt if it fell out of the sky at me like yours did, but nevertheless I still found recovery to be depressing and at a few points kind of hopeless. Like active weeping for no reason hopeless. I have to say that it's taken until the last two months or so before I started to fully feel like it was in my past. It took about 4-5 months for me to get over the hyper-vigilance about my health, and then I went the opposite way and didn't care at all. Which is just as bad, right? But about 9 months in I started to pull out of that and started to be ... reasonable? about everything.

One thing to note: I had to see a pulmonologist because my lungs weren't clearing up and they had to remove several liters of fluid from them, and while I was there a short walk raised my heart rate to crazy levels. Doing the extensive stress tests and other tests that resulted from that, they found a mild heart issue. I met with a cardiologist who then told me there wasn't much to do about it other than exercise and lose weight. So what I'm trying to say is your meeting with your cardiologist might be underwhelming and not give you the closure/plan forward you're looking for. Be prepared for that.

Another note: I recorded that meeting, because I wasn't entirely there mentally to hear and remember everything he was saying. I just turned on voice recorder on my phone. Might be worth considering! It was helpful later when I was reading his report and was very confused.
posted by clone boulevard at 7:51 AM on October 13, 2015

Best answer: I had a heart attack at age 38. I'm active, a vegetarian, overweight, but not excessively so. I just make too much cholesterol, and my body hangs on to it for dear life. At the time, Rob Ford was mayor of my city, and seemed to be in rude health. Life just isn't fair some times.

Any advice I could give you would be drawn from the book my post-cardiac care programme recommended: Thriving with Heart Disease by Dr Wayne Sotile. The book is excellent. I am about to reread it.

Don't rush your recovery, but don't be afraid to push yourself a little bit, either. Get better. You can, and probably will.
posted by sincarne at 9:00 AM on October 13, 2015 [1 favorite]

Best answer: Been thinking about this a bit more. Here's some mixed thoughts about things I found out myself:

Put a system in place as soon as you can to ensure your life style changes continue once the initial rush wears off. It will be much easier to make and maintain changes now.

Your pharmacist is an incredibly important, but often neglected part of your health care team. Choose wisely, ask lots of questions, and take their advice.

If you get even the inkling you might be depressed, start acting on it. Enlist those closest to you to watch, too. Some doctors won't want to put you on a course of treatment while you're starting all your heart-related stuff. Push for it, it's important. If you don't know what to look for, a depression inventory is a good place to start:

You're going to notice your short-term memory sucks. This is mostly from the statins, but it's also often a side effect of your brain being briefly starved of some oxygen. Get strategies for dealing with this. I bought cool looking notebooks to take the sting out a bit. Statins can also make you a bit more distractible, and make it harder for you to focus.

Keeping track of how you're supposed to eat can drive you nuts. In the time since I've really been following this, the following things have remained true: use lots of spices, both for their incredible health values, and to get off of relying on fat and salt for flavour; ensure your plate is a rainbow; watch your servings; cook from scratch as much as you can; get lots of variety; eat lots of dark, leafy greens.

Start socializing as much as you can as soon as you can. Don't let yourself get isolated.

If stress or anxiety is an issue for you, ask your cardiac care team about the availability of a Mindfulness-Based Stress Reduction programme. Many hospitals offer them.

You're going to need more sleep than you used to. Part of this is from your meds. Part of this is because you're healing. Part of this is your new normal. Don't fight it.

You can feel free to contact me through the site if you have questions. This offer is open to anyone who wants to talk about CVD.
posted by sincarne at 9:38 AM on October 13, 2015 [4 favorites]

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