Sunday, May 29, 2011

Heart Attack, Triple Bypass

I had a heart attack on 3/12/2011, undiagnosed until 5/3/2011. I went in for an angiogram the next day. They woke me long enough from the angiogram to tell me that I needed a triple bypass and get my consent, then they put me back to sleep. I woke up in the ICU, gagging on a breathing tube. They took that out a little after I started breathing on my own. I spent a little less than 2 days in the ICU followed by 2 days in the Direct Observation Unit (DOU) and then got to go home. I've been recuperating at home since then and plan to go back to work next Wednesday, 4 weeks after my operation. I started walking once I got out of the ICU and didn't have cables attached. I had a couple of days where I got up to 8 miles of walking. However that seemed to have taxed me somewhat. So right now, I am walking 2 miles per day and getting on the stationary bike for 20 minutes. Otherwise, I am pretty useless around the house since I can't pick up anything heavier than 5 to 10 pounds and can't drive a car.

My cardiologist told me repeatedly that I don't know how lucky I am. He finally explained this by saying most people drop dead who run after having a heart attack (and with 2 coronary arteries 100% blocked and one 95% blocked). After having the heart attack I eventually ran the same workout where I got the attack. I ran 8 miles on Harding Truck Trail. I rode 24 miles home from work on my bike - twice. My last workout before the cardiologist appointment was 4x400 meters. However, we suspect that my running history helped me survive possibly by developing a somewhat redundant set of capillaries from other coronary arteries. Also my running history made it easier to operate on me (less than 4 hours where they sometimes take 6 hours) and helped my recovery. As to "Why me?", my cardiologist blames heredity (my father had a heart attack at 62 - but after decades of smoking) and I blame at least partially my affinity for stress.

I'm told that i have no other blockages other than those they fixed (bypassed). My ejection fraction was measured at 65% (normal) the day after my surgery. I never got an answer as to whether this (advanced atherosclerosis) could be detected without first having a heart attack.

My symptoms prior to the heart attack were
  • Decreasing running abilities over the last 3.5 to 5 years.
  • The general feeling that eating cheese strains my heart.
  • Pale at the end of runs (at least when I end at the house).
  • Angina (now I know what it is) 2 days prior to the heart attack.

Symptoms of my heart attack

  • Tightness across chest
  • Sense that it would be a really bad idea to keep running.
  • Immediate drop in cardiovascular capacity. I had to walk slowly back to the car with several stops to sit down.
  • General feeling of discomfort. The drive home was really a challenge.
  • Flu-like symptoms the next few days.

Symptoms after my heart attack.

  • Continued diminished cardiovascular capacity.
  • Wierd EKG - dips instead of peaks - once I had it taken (on 4/4).
  • Angina when jogging on flat ground. Oddly enough, I had light to no symptoms when riding a bike, running trails, running sprints up to 400 meters.
  • I definitely improved over time. A 10 mile bike ride early on was tiring whereas 18 and 24 mile bike rides later on were not a problem. I ran the same route that I had run when I had the heart attack without a problem.

Expectations and Hopes

  • Given my ejection fraction of 65% post-op and the fact that I could actually do something prior to my bypass, I expect my capabilities to return to what they were a few years ago.
  • I expect to have little anomalies with my chest like popping ribs (due to the operation) for at least a year.
  • I hope to be able to run by 8 weeks after the operation (end of June). I hope to be able to run hard 4 weeks after that.

Moral: Running does not prevent heart attacks but it did help me survive and recover faster.


mikenuttall said...

This sounds exactly like my experience. I had triple bypass surgery 5 days ago and just returned home. I am very curious how things have been for you since as I am hoping to get back to my ultras within a few months.

Mike Nuttall

Jay Anderson said...

Just saw your comment. At first I noticed that my heart would protest on long uphills and that I would have to back off the pace. However, that has not been the case for the past couple of months. I've gotten my mileage up to 40 to 50 miles per week but have not been able to sustain more than that yet. I don't have any problems riding a bike so now I'm doing two commute days, riding the bike home (until the end of DST). It was taking several weeks to recover from a bad week but the early part of this week was bad, and I think I've recovered from it already. So I see improvement in certain aspects but I certainly do not feel as if I can force my training to get better. I'm just trying to do what I can, try to gradually improve on it and stay patient. Actually, my recent limitation has been my right soleus and ankle which has been a problem for me for years. I think it stems from an injury when I was in college. So right now, I've been icing it more often and stretching more. I'm also switching my workouts if they have a tendency to irritate it.

Jay Anderson said...

I recently saw a runner I know who told me that his doctor actually did catch his atherosclerosis prior to him getting a heart attack. His doctor looked at his test results from a presumably annual checkup and mentioned that it didn't look right. After investigating further (angiogram?), they found that blockage was forming. I think he said he had a stent put it. That doctor is a keeper. I think the majority of general practitioners/ internists would not catch atherosclerosis prior to a heart attack. I think they'd write it off as "well you're getting older so some slowdown is to be expected". Is my cynicism showing or is this realistic?