Diary of a Wimpy Heart
Alternative Titles:
The Good, the Bad and the Cardiomyopathy
Dr. Strangeheart or: How I Learned to Stop Worrying and Love my Meds
This story starts in February of 2018. It actually goes back further, but that's all backstory and it makes me look bad. I can't afford to look bad this early in the story. It's important that I establish myself as the lovable and pitiable protagonist before peppering in the details of how this is all my fault.
Let's venture back to the far away time of five months ago, when I was just starting to wrap up training for my new job. It was refreshing to get rolling with a new job, especially after escaping my old one with my wits barely intact. After a year and a half of abuse, I finally told them to shove it by putting in my two week's notice, training my replacement, and thanking them for the opportunity. That'll learn 'em.
The new job brought with it a few benefits, one being the ability to work evenings. I'm not much of a morning, noon, or early afternoon person, so it worked best for my lifestyle. Plus, getting off late meant I could go to the gym at a time when it's nearly empty. I'd have unfettered access to any equipment I wanted to use and I alone would decide which TVs were playing HGTV (all of them). It was going to be marvelous.
The only thing keeping me from accomplishing my dream of going to the gym at the time was a pretty bad cold I was starting to develop. It wasn't surprising to be sick in the middle of winter, but this cold brought with it a pretty violent cough that kept me awake at night, unable to lay down in between fits of hacking mucus (and sometimes a little blood) into the toilet. A more responsible person would have went to the doctor immediately, but I figured I'd ride it out. After all, I told myself, it's probably just from my sinuses draining.
I only made it a few weeks before realizing that I couldn't do much of anything without getting extremely winded. Just walking up the stairs to my apartment would require about two to three minutes of recovery. On my birthday, after finally admitting to myself that I wasn't getting better, I decided I would go to Urgent Care to get myself checked out. I remember telling the woman at the front desk that I believed I had a mild case of bronchitis, but one x-ray, one CT scan, and one trip to the emergency room later, the diagnosis was bumped up to full-blown pneumonia. They were surprised I lasted as long as I did, what with having an entire right lung all pneumonia'ed out. The staff in the emergency room was really interested in keeping me overnight for observation, but me being the smooth-talker I am, I managed to convince them to send me home with antibiotics and an inhaler. Equipped with that medicine, I was sure to get better.
Except I didn't. I definitely felt better than when I left the hospital, but my lungs were still terribly weak. A bit of web-searching led me to believe that it's not uncommon for the lungs to take time to recover after having pneumonia, so I decided to be patient. But when my breathing started actively getting worse again, I went back to Urgent Care to see if maybe I still had a little pneumonia hanging around. My lungs looked better on the x-ray and CT scan this time around, which suggested progress, so they sent me home with a different antibiotic to fight the pneumonia and a bottle of codeine for when I needed to get turnt.
Things continued going downhill. I was having more and more trouble sleeping horizontally and I eventually resorted to sleeping in my recliner while I waited for the pneumonia to clear. My breathing was still trash and, as an added bonus, I started retaining water in my legs. I chalked it up to sleeping in the recliner and maybe a possible side effect of the antibiotics, but once I was finished with the medication, the swelling remained and even got worse. I tried a handful of things to get the swelling down, but nothing worked and as I began to google my symptoms all together, I was getting some pretty grim results (don't google any of them, you'll spoil the plot twist).
I decided to go to Urgent Care again. I figured they would tell me the swelling was from the antibiotics, give me some water pills, and then we'd all have a good laugh about things. I'll never forget the look on the Urgent Care doctor's face as he listened to my symptoms, checked out my legs, and finally told me I needed to head over to the emergency room. He knew what was going on, but he didn't want to be the one to tell me. So, I left for the hospital in my car, found a spot in the middle of the parking lot, and walked for what seemed like a hundred miles to the emergency room entrance. It was early April at this point and still absurdly cold. By the time I reached the emergency room check-in, I was just coherent enough to tell the lady sitting there my name and that I'd been sent from Urgent Care.
After a short wait, I was brought to a small room in the emergency wing of the hospital and tried relaxing as well as I could while watching "Futurama." After speaking with a few medical professionals about my symptoms, they decided to get me started on an intravenous diuretic while they continued figuring out what was wrong with me. For those who don't know what a diuretic is, it's something that will make you pee. A lot. I only made it about five minutes before I was able to fill up the liter "urinal" (piss bottle) they left next to my bed. I was about a bottle and a half in when the nurse practitioner I spoke to minutes earlier came in and confirmed my worst fears.
"I want to admit you to the hospital," he said, himself quite surprised. "I think it's heart failure. I could be wrong. You're young, so it may not be, but we want to make sure."
I couldn't smooth-talk my way out of this one.
To be clear, I could have easily told him "no", signed an "Against Medical Advice" form, and went home to probably die. It was myself I was unable to trick this time. For months, I managed to convince myself I was getting better and that each new ailment would go away with a little time and patience. Hearing those words come out of his mouth made it clear to me that something was very, very wrong.
I agreed to be admitted and was pushed in a wheelchair to a room in the inpatient wing of the hospital. I did a little more peeing when I got to the room and the attending nurse asked me if I would like anything to eat. I'd only eaten half of a cookies n' cream Pop-Tart that day and was a bit peckish after learning I was probably going to die, so I graciously accepted the offer. She brought me a sandwich, which isn't the most exciting meal, but you'd be surprised how enjoyable a turkey sandwich can be when you're starving and the only things you have to look forward to for the next twelve hours are watching "Forensic Files" and having the worst night of sleep imaginable.
At this point, I'll cut back on the detail a bit, because one can only be so descriptive of a six day hospital stay. I continued to pee a lot. On the second night of my stay, the nurse on duty asked if I wanted to weigh myself just for fun to see how much weight I pissed away. I ended up at thirty-five pounds lighter than when I was weighed at Urgent Care. It was impressive to lose so much weight, but the main benefit of dropping so much water weight was my regained ability to breathe. I slept like a baby the second night of my stay and by the end I was finally able to sleep while lying down.
I also went through a variety of different procedures during my stay. One of such procedures was a "cardiac stress test." A cardiac stress test involves having a patient run on a treadmill for a period of time and then having their heart function recorded with an electrocardiograph and some sort of giant MRI machine. Since I was not a fit candidate for running at the time, I got to experience a special type of stress test known as a chemical stress test. A chemical stress test substitutes the running with an injection that makes your heart go from zero to holy-shit-I'm-dying almost instantly. I remember a pleasant conversation with the nurse being ruined by the sudden urge to grab the rails of the testing room bed and scream for about thirty seconds. It was fun.
Another procedure I got to experience was an echocardiogram. Of the multiple tests and procedures, this one was the most important. The echocardiogram would determine my ejection fraction, which, simply put, is the amount of blood your heart is squeezing out with each contraction. The ejection fraction for a normal person is usually around fifty-five to sixty percent. I didn't expect my numbers to come back that great. By this point, I was just hoping to avoid getting a dead guy's heart shoved into me. As far as the procedure goes, an echocardiogram is basically the equivalent of having a pregnancy ultrasound, but for your heart. And instead of getting to see images of a future bundle of joy, I got to see several snapshots of my garbage heart giving me the finger.
After the test, it took several hours for the cardiologist to get around to analyzing the results. After much waiting, my mom, who had hung around all day in anticipation of hearing the results and speaking with the doctor, finally decided to head home after concluding we wouldn't be hearing from him that day. She must have walked right by him on her way out, because he came into my room only minutes after she left. My cardiologist is a nice guy and has remarkably good bedside manner, which is something you want when you're dying. As I look back on that moment, one thing I vividly remember about talking with my cardiologist that day was the smell of his cologne. It was a very distinct scent that's been linked so strongly in my brain to that moment in time that whenever I do happen upon it in public, I immediately expect my cardiologist to be near with bad news.
It turned out my ejection fraction was only about twenty percent, well below that of a normal person and barely above that of a person who should start making funeral arrangements. I was devastated, but not entirely surprised. The cardiologist told me the likely cause of my heart weakening was extremely high blood pressure.
This is the part where we collectively realize I did this to myself.
I knew for well over a year that my blood pressure was too high. I kept telling myself I was going to get it under control, but I never set up the doctor appointment or made the necessary lifestyle changes. High blood pressure can be sneaky. It's not a pleasant thing to know one has and, because there are often no noticeable symptoms, it's easy to push to the back of one's thoughts.
The one bright side of all this, I learned, is that congestive heart failure can be almost entirely reversible at such a young age and the chances of a full recovery are even greater when the condition is caused by high blood pressure as opposed to something like a birth defect. Recovery wasn't going to be easy, but I was willing to do whatever it took, because, you know, I'm quite fond of being alive.
Aside from taking medicine, the most important thing I had to do now was stop eating salty garbage. Too much sodium in one's diet can lead to excessive water retention, which in turn puts unnecessary stress on the heart and lungs by way of pressure. Instead of going to fast food restaurants to consume their trash, I had to start buying things like fruits and vegetables and start scanning nutrition labels for sodium content. Which foods have the most sodium, you ask? All of them. I learned from reading nutrition labels that a solid majority of foods are bathed in salt to preserve shelf life and appeal to the modern American taste bud. Because of this, I realized that I basically couldn't eat meat and other favorite foods again until I started cooking my own. So I did. I bought a slow cooker and learned how to make food with that. I've actually gotten pretty good with it and can make a low-sodium version of just about anything I'd like to eat with the help of that and the other kitchen tools at my disposal.
Despite the awful circumstances I found myself in, I remained pretty positive about most things. Most things, of course, except the LifeVest. The LifeVest is what is known as a "wearable defibrillator." This particular device is able to monitor the heart for erratic behavior with a series of sensors and administer a corrective shock automatically via three pads, two on the back and one on the front. Even though the device gives a decent amount of warning before administering a shock, I was terrified it was going to zap me for no reason at any time. Because my heart was in such bad shape, I was required by the cardiologist to wear it at all times, taking it off only to shower.
I hated it.
I hated it so much and I wasn't allowed to leave the hospital without it. The advertising for the product boasts how easily concealed the vest is under clothing, which was true; the vest was very difficult to see under a normal shirt. What wasn't difficult to see, however, was the giant, fanny-pack-sized battery/control unit that I had to clip to my belt. I felt like a moron walking around with a cord hanging from the back of my shirt and the device as a whole kind of looked like an explosive vest setup, so I had to trim my beard to avoid looking like a potential Unabomber. Even worse was when I had my shirt off. The LifeVest looks and fits like a backwards bra and the sadness of that fact is fully realized when staring at your unsmiling face in the bathroom mirror as your man boobs sag over the strap on the front side.
Learn from my struggles. Don't end up in a LifeVest.
About a month after my hospital stay, the cardiologist had me schedule a cardiac MRI to check up on my ejection fraction and rule out a few possible heart failure causes, which we had to do even though we were certain it was from the blood pressure. Now, I'm sure an MRI is a pleasant experience for those who enjoy lying in tubes while a loud machine shoots magnetic waves or some crap through them to take pictures. I did not enjoy it personally, but I was thankful the technician allowed me to keep my arms above my head while in the tube, because I learned that being in a small cylinder with my arms trapped by my sides terrifies me in a very primal way that I don't want to revisit in my mind.
Later that day, I received a call at work about the results of my MRI. Terrified, I snuck away from my desk to answer the call and learn how things were progressing. As it turned out, things were coming along nicely. The results of the MRI indicated that my ejection fraction had improved from twenty percent to thirty-nine percent in only a month. If that wasn't good enough news on its own, I was also informed that, having passed the thirty-five percent threshold, I was now allowed to remove my LifeVest and mail it back to Hell or Pittsburgh, wherever it came from.
It was good to see that level of improvement in such a short amount of time. And at the time of this writing, just three months after being hospitalized, I'm happy to say that a recent echocardiogram has my ejection fraction in the range of fifty to fifty-five percent, right around normal.
I couldn't be happier with the progress I've made, but I still remain cautious. Heart failure stories don't often end well and even with my heart getting better, it's still something I have to monitor for the rest of my life. In the mean time, however, I'm just happy to be alive. I have a lot to be thankful for: the medical professionals who saved my life; the family and friends who supported me while in the hospital and while recovering; and the people who make defibrillator vests even though they suck and I hate them.
But, above all else, I really owe a special "thank you" to my heart. Thanks, pal, for hanging in there when things got rough and then stayed rough for awhile and then got really rough. Even after all that abuse, you decided to bounce back and give this relationship another chance and for that I am truly grateful. I promise I won't let you down this time.
The Good, the Bad and the Cardiomyopathy
Dr. Strangeheart or: How I Learned to Stop Worrying and Love my Meds
This story starts in February of 2018. It actually goes back further, but that's all backstory and it makes me look bad. I can't afford to look bad this early in the story. It's important that I establish myself as the lovable and pitiable protagonist before peppering in the details of how this is all my fault.
Part One: Coughing Up Exposition
The new job brought with it a few benefits, one being the ability to work evenings. I'm not much of a morning, noon, or early afternoon person, so it worked best for my lifestyle. Plus, getting off late meant I could go to the gym at a time when it's nearly empty. I'd have unfettered access to any equipment I wanted to use and I alone would decide which TVs were playing HGTV (all of them). It was going to be marvelous.
The only thing keeping me from accomplishing my dream of going to the gym at the time was a pretty bad cold I was starting to develop. It wasn't surprising to be sick in the middle of winter, but this cold brought with it a pretty violent cough that kept me awake at night, unable to lay down in between fits of hacking mucus (and sometimes a little blood) into the toilet. A more responsible person would have went to the doctor immediately, but I figured I'd ride it out. After all, I told myself, it's probably just from my sinuses draining.
I only made it a few weeks before realizing that I couldn't do much of anything without getting extremely winded. Just walking up the stairs to my apartment would require about two to three minutes of recovery. On my birthday, after finally admitting to myself that I wasn't getting better, I decided I would go to Urgent Care to get myself checked out. I remember telling the woman at the front desk that I believed I had a mild case of bronchitis, but one x-ray, one CT scan, and one trip to the emergency room later, the diagnosis was bumped up to full-blown pneumonia. They were surprised I lasted as long as I did, what with having an entire right lung all pneumonia'ed out. The staff in the emergency room was really interested in keeping me overnight for observation, but me being the smooth-talker I am, I managed to convince them to send me home with antibiotics and an inhaler. Equipped with that medicine, I was sure to get better.
Except I didn't. I definitely felt better than when I left the hospital, but my lungs were still terribly weak. A bit of web-searching led me to believe that it's not uncommon for the lungs to take time to recover after having pneumonia, so I decided to be patient. But when my breathing started actively getting worse again, I went back to Urgent Care to see if maybe I still had a little pneumonia hanging around. My lungs looked better on the x-ray and CT scan this time around, which suggested progress, so they sent me home with a different antibiotic to fight the pneumonia and a bottle of codeine for when I needed to get turnt.
Things continued going downhill. I was having more and more trouble sleeping horizontally and I eventually resorted to sleeping in my recliner while I waited for the pneumonia to clear. My breathing was still trash and, as an added bonus, I started retaining water in my legs. I chalked it up to sleeping in the recliner and maybe a possible side effect of the antibiotics, but once I was finished with the medication, the swelling remained and even got worse. I tried a handful of things to get the swelling down, but nothing worked and as I began to google my symptoms all together, I was getting some pretty grim results (don't google any of them, you'll spoil the plot twist).
I decided to go to Urgent Care again. I figured they would tell me the swelling was from the antibiotics, give me some water pills, and then we'd all have a good laugh about things. I'll never forget the look on the Urgent Care doctor's face as he listened to my symptoms, checked out my legs, and finally told me I needed to head over to the emergency room. He knew what was going on, but he didn't want to be the one to tell me. So, I left for the hospital in my car, found a spot in the middle of the parking lot, and walked for what seemed like a hundred miles to the emergency room entrance. It was early April at this point and still absurdly cold. By the time I reached the emergency room check-in, I was just coherent enough to tell the lady sitting there my name and that I'd been sent from Urgent Care.
Part Two: Emergency Doomed
"I want to admit you to the hospital," he said, himself quite surprised. "I think it's heart failure. I could be wrong. You're young, so it may not be, but we want to make sure."
I couldn't smooth-talk my way out of this one.
To be clear, I could have easily told him "no", signed an "Against Medical Advice" form, and went home to probably die. It was myself I was unable to trick this time. For months, I managed to convince myself I was getting better and that each new ailment would go away with a little time and patience. Hearing those words come out of his mouth made it clear to me that something was very, very wrong.
I agreed to be admitted and was pushed in a wheelchair to a room in the inpatient wing of the hospital. I did a little more peeing when I got to the room and the attending nurse asked me if I would like anything to eat. I'd only eaten half of a cookies n' cream Pop-Tart that day and was a bit peckish after learning I was probably going to die, so I graciously accepted the offer. She brought me a sandwich, which isn't the most exciting meal, but you'd be surprised how enjoyable a turkey sandwich can be when you're starving and the only things you have to look forward to for the next twelve hours are watching "Forensic Files" and having the worst night of sleep imaginable.
At this point, I'll cut back on the detail a bit, because one can only be so descriptive of a six day hospital stay. I continued to pee a lot. On the second night of my stay, the nurse on duty asked if I wanted to weigh myself just for fun to see how much weight I pissed away. I ended up at thirty-five pounds lighter than when I was weighed at Urgent Care. It was impressive to lose so much weight, but the main benefit of dropping so much water weight was my regained ability to breathe. I slept like a baby the second night of my stay and by the end I was finally able to sleep while lying down.
I also went through a variety of different procedures during my stay. One of such procedures was a "cardiac stress test." A cardiac stress test involves having a patient run on a treadmill for a period of time and then having their heart function recorded with an electrocardiograph and some sort of giant MRI machine. Since I was not a fit candidate for running at the time, I got to experience a special type of stress test known as a chemical stress test. A chemical stress test substitutes the running with an injection that makes your heart go from zero to holy-shit-I'm-dying almost instantly. I remember a pleasant conversation with the nurse being ruined by the sudden urge to grab the rails of the testing room bed and scream for about thirty seconds. It was fun.
Another procedure I got to experience was an echocardiogram. Of the multiple tests and procedures, this one was the most important. The echocardiogram would determine my ejection fraction, which, simply put, is the amount of blood your heart is squeezing out with each contraction. The ejection fraction for a normal person is usually around fifty-five to sixty percent. I didn't expect my numbers to come back that great. By this point, I was just hoping to avoid getting a dead guy's heart shoved into me. As far as the procedure goes, an echocardiogram is basically the equivalent of having a pregnancy ultrasound, but for your heart. And instead of getting to see images of a future bundle of joy, I got to see several snapshots of my garbage heart giving me the finger.
After the test, it took several hours for the cardiologist to get around to analyzing the results. After much waiting, my mom, who had hung around all day in anticipation of hearing the results and speaking with the doctor, finally decided to head home after concluding we wouldn't be hearing from him that day. She must have walked right by him on her way out, because he came into my room only minutes after she left. My cardiologist is a nice guy and has remarkably good bedside manner, which is something you want when you're dying. As I look back on that moment, one thing I vividly remember about talking with my cardiologist that day was the smell of his cologne. It was a very distinct scent that's been linked so strongly in my brain to that moment in time that whenever I do happen upon it in public, I immediately expect my cardiologist to be near with bad news.
It turned out my ejection fraction was only about twenty percent, well below that of a normal person and barely above that of a person who should start making funeral arrangements. I was devastated, but not entirely surprised. The cardiologist told me the likely cause of my heart weakening was extremely high blood pressure.
This is the part where we collectively realize I did this to myself.
I knew for well over a year that my blood pressure was too high. I kept telling myself I was going to get it under control, but I never set up the doctor appointment or made the necessary lifestyle changes. High blood pressure can be sneaky. It's not a pleasant thing to know one has and, because there are often no noticeable symptoms, it's easy to push to the back of one's thoughts.
The one bright side of all this, I learned, is that congestive heart failure can be almost entirely reversible at such a young age and the chances of a full recovery are even greater when the condition is caused by high blood pressure as opposed to something like a birth defect. Recovery wasn't going to be easy, but I was willing to do whatever it took, because, you know, I'm quite fond of being alive.
Part Three: Salty, but Not Salted
Despite the awful circumstances I found myself in, I remained pretty positive about most things. Most things, of course, except the LifeVest. The LifeVest is what is known as a "wearable defibrillator." This particular device is able to monitor the heart for erratic behavior with a series of sensors and administer a corrective shock automatically via three pads, two on the back and one on the front. Even though the device gives a decent amount of warning before administering a shock, I was terrified it was going to zap me for no reason at any time. Because my heart was in such bad shape, I was required by the cardiologist to wear it at all times, taking it off only to shower.
I hated it.
I hated it so much and I wasn't allowed to leave the hospital without it. The advertising for the product boasts how easily concealed the vest is under clothing, which was true; the vest was very difficult to see under a normal shirt. What wasn't difficult to see, however, was the giant, fanny-pack-sized battery/control unit that I had to clip to my belt. I felt like a moron walking around with a cord hanging from the back of my shirt and the device as a whole kind of looked like an explosive vest setup, so I had to trim my beard to avoid looking like a potential Unabomber. Even worse was when I had my shirt off. The LifeVest looks and fits like a backwards bra and the sadness of that fact is fully realized when staring at your unsmiling face in the bathroom mirror as your man boobs sag over the strap on the front side.
Learn from my struggles. Don't end up in a LifeVest.
Part Four: Better, but Not Bitter
Later that day, I received a call at work about the results of my MRI. Terrified, I snuck away from my desk to answer the call and learn how things were progressing. As it turned out, things were coming along nicely. The results of the MRI indicated that my ejection fraction had improved from twenty percent to thirty-nine percent in only a month. If that wasn't good enough news on its own, I was also informed that, having passed the thirty-five percent threshold, I was now allowed to remove my LifeVest and mail it back to Hell or Pittsburgh, wherever it came from.
It was good to see that level of improvement in such a short amount of time. And at the time of this writing, just three months after being hospitalized, I'm happy to say that a recent echocardiogram has my ejection fraction in the range of fifty to fifty-five percent, right around normal.
I couldn't be happier with the progress I've made, but I still remain cautious. Heart failure stories don't often end well and even with my heart getting better, it's still something I have to monitor for the rest of my life. In the mean time, however, I'm just happy to be alive. I have a lot to be thankful for: the medical professionals who saved my life; the family and friends who supported me while in the hospital and while recovering; and the people who make defibrillator vests even though they suck and I hate them.
But, above all else, I really owe a special "thank you" to my heart. Thanks, pal, for hanging in there when things got rough and then stayed rough for awhile and then got really rough. Even after all that abuse, you decided to bounce back and give this relationship another chance and for that I am truly grateful. I promise I won't let you down this time.
