Monday, June 10, 2024

It Has Been a Minute

Info-dump ahead. I have been posting extremely sporadically on the blog since early December, and, not only did I not achieve my 2023 Goodreads goal, I am very behind in my very scaled back 2024 goal. 

I have been through a bit of a health care slog since last summer. I went to my PCP for a physical late last August, but also complained of extreme fatigue. Summer, for teachers, is a time of recharging and becoming re-enthused for the coming school year. I found that I was not recharging. I needed to lie down after any strenuous activity for most of the summer.

My diligent PCP took a ton of blood for many tests, all of which came back negative. I went back to school and found myself barely able to get through the school day. I stopped going to yoga classes, exercised my dog as best I could and went to bed early each night. Definitely not my usual routine.

I started noticing that I got mild chest pain on my dog-walks, especially when I went up hills in late November. I mentioned it to my PCP, who then advised a trip to the ER. My EKG was mostly normal, except for my extremely low heart rate. A five-beat run of v-tach was recorded as well. One of my cardiac enzymes were elevated so I was admitted.

The following day, I had a stress echocardiogram, which I passed "with flying colors!" Perfect, they said. Other tests were negative, but I still felt like crap. When I followed up with my PCP a week later, my enzymes were still elevated, but he was at a loss. A few weeks later, I was still feeling lousy and he, clearly frustrated, suggested that I see a psychiatrist (!) and consider antidepressants. 

I will not deny that my anxiety has been high for some time, even preceding my husband's death, but, I just did not feel well. Whatever. Okay. I met with the psychiatrist he recommended. I could not get an in-network appointment with a psychologist for at least three months. Luckily, this psychiatrist was "old school" and still did talk therapy. She started me on Zoloft.

I returned to school after the winter break, still not feeling well. I had made an appointment to follow up with the cardiologist for January 8. Unfortunately, I ran a fever within six days of returning to school, so I rescheduled the cardiologist appointment (earliest appointment was late February!), then tested positive for Covid the next day. I was so bummed because I was no-vid for almost four years!

I ran a fever for a few days, slept, lost my appetite, lost ten pounds that I didn't need to lose, and my fatigue worsened. In addition, I had shortness of breath when I exerted myself. I took a medical leave from school and slept 12 - 16 hours each day. 

When I finally saw the cardiologist in late February, he was skeptical, told me my stress echo was perfect, and my symptoms are atypical. I told him that my maternal aunt dropped dead of a massive heart attack at age 57 and that my father had one of the first angioplasties in the early 80s for a 95% blockage of his left anterior descending artery (the widow-maker). He was a runner who played tennis almost daily, and had atypical symptoms. Some years later, my mother went to her PCP complaining of extreme fatigue and lightheadedness. Her stress test was normal, but her PCP wasn't convinced, and sent her for an angiogram, which showed five blocked coronary arteries. My point being, I have a strong family history for bad coronary artery disease. My aunt had no symptoms, my dad had few symptoms and my mom's were "atypical" yet she ended up with a quintuple bypass.

School librarianship is my second career. I went to nursing school when I graduated from high school and went on to work in, first a cardiac floor, then the Emergency Dept. I learned in nursing school some forty years ago that women present with atypical symptoms for coronary artery disease. 

Reader, if I hear one more male physician comment on my atypical symptoms, I will scream. Why has nothing changed since I went to nursing school? Even though my cardiologist paused when I told him of my family history, I had to pull the "I know a cardiologist at <insert prestigious institute here> who said he would order a cardiac CT Angio for me, because he knew my parents and aunt. That tipped him over. His office got the test approved and I had it a week later.

I had the test on a Thursday afternoon in late April. The nurse who injected the dye was someone I worked with in the ER some 38 years ago. She said that I probably would not hear from my cardiologist until the following week. Imagine my surprise when I was awakened from my nap the following afternoon by a call from his office. He sounded extremely surprised when he told me that I had three coronary artery blockages! "But you're not ready to go under the knife yet." He wanted to see me the next week to discuss medical management. 

Simultaneously, I felt, "Yes! It wasn't all in my head!" and "Shit! I have coronary artery disease!"

He put me on Lipitor and two cardiac drugs and gave me nitroglycerin and wanted to see me in a month. The nitroglycerin took the chest pain away, but bottomed out my already low blood pressure. The two cardiac drugs also helped the chest pain, but further decreased my b/p, so that all I could do was walk the dog and sleep. 

After a month, I returned and say that the quality of my life is unsustainable. He switched up the meds for two weeks. That didn't work. So he said I needed an angiogram and stent. His office got insurance approval and I got an appointment.

My youngest son happened to visit that weekend in late April and dropped me off for the stent before heading back to Massachusetts. I got processed and the interventional cardiologist came in to introduce himself. His first words to me were, "Your symptoms are so atypical." I wanted to scream, "Really?"

I found out later, that he called my cardiologist and said that I didn't need a stent. My LAD blockage was "only" 70%. My cardiologist told me that he said that I needed it and to do some kind of flow test once he catheterized me. It seems the interventionist did so reluctantly. He ended up calling my cardiologist back and said that I needed the stent.

So. My 70% blockage is now 0%. I have been pain-free since the procedure. My fatigue had lingered, but is now almost gone. I have gone from needing two naps of 2 - 4 hours a day, to only one 1 - 2 hour nap a day. Last week, I only napped on two days!

I really thought that I would need to retire, but now I am looking forward to returning to school in September! My energy is returning, as is my ability to read and focus. I was down, but not out!

Folks, especially ladies, advocate for yourself. If you don't feel well, keep advocating even if the tests are "normal."

PS: I have been seeing my psychiatrist since December. Some weeks of Zoloft produced unacceptable side effects, as did some weeks of Lexapro. I was switched to Cymbalta and, you guessed it, side effects. We are now trying... nothing! 

Yes, I am grieving. Yes, my anxiety was high. She's not convinced that I need medication. As for any medication I have taken all of my life, there have always been significant side effects. I had the weirdest side effects while undergoing chemo ten years ago, but, I really had not choice. 

I will continue to take the statins, and will be on blood thinners for some time. I will continue with psychotherapy, but am feeling more myself with each passing day.

Hopefully, I am back and will return to posting daily book talks. I look forward to cleaning up and reorganizing my library (don't ask) and seeing students again come September. See you tomorrow with Teen Tuesday.



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