Caring Hearts

I attended the March for Science on April 22nd. I was also a member of the national Facebook group for the march. The page has a lot of members, from diverse backgrounds. There were mostly very interesting and supportive posts in this group. Some members had beliefs very different from my own, for example, the member who claimed “emotions aren’t real.”

We tend to separate our brains from the rest of our body and our emotions from the rest of our being. Perhaps, emotions are tied to concepts such as spirituality, which are seen to float around and exist apart from us. From a mental health/science perspective, however, the brain is very much a part of the body and emotions are very much a part of the brain and central nervous system.

Stress isn’t an emotion but it is tied to strong emotional states and certain life situations. Stress can be acute or chronic. Stress can be motivating. Stress can harm our bodies when it is excessive.

Last Thursday afternoon, while finishing up with my last patients of the day, I felt sudden achy pain along my upper back, accompanied by nausea. I was able to finish and then felt the same achy feeling under my arms, and in my chest. Although not the smartest thing to do, I drove myself home. When I walked through the door, my husband looked up, gave his beautiful smile, and said, “Hi Sweetie! How was your day?”.  I replied, “I am not well. Call 9-11.”

The fire department arrived less than 5 minutes later, closely followed by paramedics, the latter of which had a portable EKG machine. I was impressed by the professionalism and kindness of the first responders. They didn’t seem incredibly concerned about the readings but recommended that I go to the hospital E.R. rather than wait to follow-up with my primary care physician in the upcoming days. I agreed.

The achy pains had lessened some with the extra oxygen I had been getting since the firemen hooked me up to an oxygen tank at the house. It was rush hour in Seattle. The ambulance driver expertly dodged through traffic. Fortunately, an outstanding aspect of my city is that drivers are very quick to get out of the way of emergency vehicles.

I was admitted to the E.R. I changed into a gown and my blood was drawn for the first of what would be eleven needle jabs over less than a 48 hour period. They were testing my troponin levels and they were able to do the test bedside, instead of having to send it to the lab. Troponin is an enzyme released by the heart when it is damaged. When my nurse returned to the room, he saw the test results. (The test had been started by a phlebotomist.) He said, surprised, “This is elevated. Is this YOUR test?” He confirmed that it was.

Although no one said this outright until I was discharged, from this point until the following morning, the assumption was that I’d had a heart attack. By 6:30 pm, my pains were totally gone. I had an EKG that night followed by subsequent blood draws, one at midnight, one at 2:00 am, and another at 5:00 am. I was surrounded by kind and skilled medical staff. The night nurse, Lorenzo, was particularly good. He was kind, personable, and knowledgeable. (By the way, one thing I love about my hospital, Swedish Medical Center, is that I’ve always had wonderful night nurses. I’ve heard horror stories about other hospitals.) Lorenzo was also excellent at  communication with me as well as with the other services. Continuity of care is a huge challenge in hospitals and he was excellent in his efforts.

At 5:30 am,  I started having back and chest pain again. It was incredibly small but Lorenzo had told me to report any pain, however minor. It was also in the same location as previously. I was given nitro glycerin and when that did not totally eliminate it, I was given morphine. The pains gradually lessened and were gone by 7:30 am.

Due to the recurrence of the pain and my blood test results (the troponin levels had increased over night as well as another enzyme used as a marker for heart attack), I underwent cardiac catheterization. I was taken to the Cath Lab and the procedure was carried out by a cardiologist and a team of four others. A catheter (small tube) was inserted through an artery in my wrist and threaded up to my heart. Contrast dye was also pumped into my body through the catheter, allowing imaging of my heart and circulatory system. I was sedated, but alert, during the procedure. (By the way, it was not nearly as awful as it sounds.) About midway through, the cardiologist asked, “Has something really stressful happened to your recently?” I told him that something had happened. You see, although he could see that my heart was not compressing normally, there was no evidence of a heart attack or heart disease. As two members of the cath team wheeled me back to my room, they were visibly happy for me.

The cardiologist made a preliminary diagnosis of stress cardiomyopathy, also known as, Takosubo cardiomyopathy or more poetically,”broken heart syndrome”.  This diagnosis was corroborated by the results of an echocardiogram. Excessive cortisol, a stress hormone, can affect the heart muscle, preventing it from being able to contract fully. This results in symptoms similar to a heart attack. Unlike a heart attack or heart disease, the heart damage cause by stress cardiomyopathy typically heals in 1-4 weeks.

I was put on three new medications, two of which can have a blood pressure reducing side effect. My regular blood pressure is about 110/70. It got really low after the medications so I stayed another night at the hospital.

I was discharged yesterday afternoon. My treatment was top-notch but being in a hospital is neither restful nor fun. John had been by my side the whole time, spending nights at the hospital. We were so glad to leave!

It is now time to implement a new self-care program. These are difficult times in my country. I think they are causing chronic stress for many. I know it has for me and I’ve been left with a smaller reservoir with which to deal with new stresses that come into my life. I have left a message with the psychologist I saw during my breast cancer treatment. There are some things I really need to process as well as a need to return to a more consistent mindfulness practice.

Having a caring heart is mostly a wonderful thing but it can also be a burden. Life brings unwelcome surprises like chest pain and welcome ones like looking into a woman’s heart and not finding heart disease and blockage.

On the day of the March for Science, I wore a sign demonstrating my ongoing commitment to the importance of fostering caring hearts. Without them, there is no love, no laughter, no curiosity, no passion, and no motivation. We would also not work to protect ourselves from possible harm. Without emotions, there is no humanity.