And along comes a heart attack...

althea · September 2012

I learned this morning that my oldest brother died of a heart attack last night. This came completely out of the blue. He didn't drink, didn't smoke, didn't eat red meat. He practiced yoga and meditation. Of three siblings, he was the only one who never had cancer. Within the last year he developed high blood pressure and was on meds for that. High bp runs thick in my family, but the heart attacks I can recall happened to relatives in their 80s.

It was in September of 2005 that I learned heart damage is a side effect of radiation treatment. I learned this while sitting alone in the waiting room, wearing one of those flimsy gowns. It was the appointment for them to make the mould, and the weather channel was playing on the tv. Rita was kicking around in the gulf, less than a month since Katrina. I sat there pondering, what would it take for me to evacuate? Without hestitation the voice in my head replied "category 5." As if on cue, the weather channel announced Rita had just turned into a category 5 and the models showed her making a beeline directly on my city. I was thinking, who needs radiation to get a heart condition?? All these damn hurricanes are enough to give me a heart attack.

I took a deep breath and turned my focus to the paperwork they expected me to sign before commencing treatment. It's a bit a of blur now, but I remember at least a half dozen serious potential side effects listed as a result of treatment. Heart disease, heart attack and weakened ribs were all on the list. I had to promise not to sue them if any of these things happened. I remember thinking, fat lot of good it'll do to survive cancer just to get a heart attack afterwards!

I've had a lengthy list of experiences in connection with my health care professionals that left me with considerable anger for a lengthy period of time. You know, things like expecting me to sign a waiver like that while sitting alone in a waiting room wearing that damn flimsy gown. Or, how about that bozo of a surgeon who gave my tumor an extra 9 months grow because he apparently didn't know there's multiple kinds of bc and mine didn't feel like a marble.

I've worked long and hard to put all that anger to rest. I've been wanting to get a blog started, and the anger has held me back because I don't want to write an angry blog. On the eve of yet another pink October, I literally had blogging on my schedule for this week.

And now a brand new wave of anger is washing over me, dredging up an old issue that I realize is unresolved to this day. On this day that I've lost my brother to a heart attack, I take pause to reflect on what was done back in 2005 and 2006 to monitor my heart health. Let's see, they'd take my blood pressure, sometimes my pulse. After radiation I complained of what I call 'the bag of rocks.' My heart felt like it had a bag of rocks sitting on it. My bones ached. I was so tired I could hardly lift my head off the pillow. ....for months. I had nausea. ...for years. I told these complaints to my oncologist. I told them to my pcp at the time, and then the next pcp after him.

I remember feeling frustrated at the time that there was so little they could do for my complaints in the aftermath of treatments. I was offered an antidepressant for my fatigue. I received a sonogram of the liver and gall bladder. For my heart -- nothing. Based on my own experience, I couldn't possibly describe what kinds of tests are used to monitor heart health. Unless bp and pulse are all they have, which I seriously don't believe for a minute.

So how about it, ladies of bco, what do YOU think proper monitoring of heart health consists of? And how do you find it?

leggo · September 2012

Althea, I'm so sorry about your brother. My deepest sympathy to you and your family.

chrissilini · September 2012

Althea...my deepest sympathies to you and your family. My prayers are with you all.

As far as the heart health, I'm not a nurse or doc but work in the medical field. There are definitely things that can be done to monitor heart health. Various blood work looking at cardiac enzymes, echocardiogram, stress tests, EKG. Your pcp should direct you to a cardiologist. Heart health, in my opinion, especially when there are other factors involved, should be monitored by a cardiologist.

Hope you get some direction and again, so sorry for your loss.

althea · September 2012

Thank you for your kind words ladies. It sounds like an autopsy will be performed, so more information will be forthcoming. Perhaps there was something there for a long time undetected. chrissi, thanks for that list of tests. My mom gets EKG tests frequently. Of course, she has a pacemaker, a prolapsed mytral valve and irregular heartbeat. The only time I've ever had one was prior to surgery.

I felt like I was receiving so little help from doctors that I gave up on them in 08. Fortunately, we have the ability to order our own bloodwork in this day and age. I've had my homocysteine and c reactive protein levels checked and they're within optimal ranges. The only things out of range are my thyroid and cholesterol, which go hand in hand. My thyroid was out of range from the first time it was tested in 06 yet the cholesterol was the only thing they'd comment on. I was told to lose weight. Another sore topic! Apparently none of the several doctors who saw my thyroid numbers were aware that losing weight with an underactive thyroid is especially difficult. sigh.

I lost a father in law years ago to a fatal heart attack. He was only 55 at the time. That had me paranoid about heart health too. In actuality, though, I've been practicing exceptionally good self care since I finished rads and I feel better with each passing year. That is the best I can do. I also provide care for my mom. I prepare nutritious delicious meals from scratch that we eat together. And with each new day I feel grateful to have her. Ok, so I feel better now. Time to spend some time in the kitchen to make some chicken broth.

Moderators · September 2012

Althea, we're sad about the loss of your brother. Your determination to do the best you can for your own health and the health of your mom is a good lesson for all of us.

• Your Mods

sweetbean · September 2012

Althea,

I don't have heart issues, but I just wanted to offer my deepest sympathies on the loss of your brother. He sounds like he was a wonderful person. I will keep you and your family in my thoughts.

Chevyboy · October 2012

Morning Althea............. That was a beautiful post...It's like we could see into your heart! I'm so sorry about your Brother...

I don't know if cardiologists do "routine" exams if you aren't having problems? It's usually when something goes wrong, that they start all the tests.

I'm glad you still have your Mom..... Your post brings back memories of me losing first my Grandma, then my Mom, and then my Dad. It was during that time...and stress related, that I started having heart problems! Stress can hurt you more than anything. This was all many years ago.

But I found that you have to take care of that heart, even if you can't find anyone to help you...

My morning coffee became decaf...because once you start with those palpitations, and dizziness, any kind of caffeine will make it worse. Don't let this latest sorrow get you down.... comforting your Mom, will help you too..... and take care of yourself.

Chevyboy · October 2012

voraciousreader · October 2012

Althea...I am so sorry to hear about the loss of your beloved brother. My deepest sympathies to you and your family. Thank you for raising this important question about heart surveillance. Heart disease is rampant in my family and my husband's family as well, so I have lots of experience about what we need to do going forward.

First off, for many of us, our risk of stroke or heart attack is probably greater than our risk of dying from cancer. So it's important for many of us, especially with a family history of heart disease, to be under the care of a cardiologist. Having a baseline stress test and echo cardiogram is important, especially once you reach the big 5-0! Recently, the darling sister had a severe gallbladder attack and was hospitalized. The doctors were concerned about doing surgery on her because she hadn't had a stress test in a number of years. Obese and with controlled hypertension, the doctors and I were SHOCKED, that, not only did she not have a recent stress test, but she wasn't under the care of a cardiologist either! Did I tell you she's also a nurse?

Now, for the most important advise regarding heart disease. KNOW-YOUR-BODY. While it is true that some people will die suddenly from a heart event, such as an electrical issue or a massive heart attack, often there are signs of heart issues that people will often mistake or worse, ignore. Likewise, many of the tests that we have are not accurate for detecting heart disease. I won't scare you all with the details of my husband's cardiac issues, but I will say that despite receiving excellent care, he nearly died in June because his issue went undetected by all of the tests he received, including an angiogram. He had life-saving cardiac by-pass surgery to fix two obstructed vessels and an ulcerated vessel that was ready to burst. Even his EKG was normal! The cardiac surgeon said the reason why none of the tests showed any problems beforehand was because the DH was "too healthy." He excercises and had a strong, healthy heart with many collateral vessels that were compensating for the weaker vessels, until the one vessel nearly burst. What saved his life was that he felt something was wrong and we conveyed that to his cardiologist who immediately hospitalized him! Did I mention that he also had normal cholesterol levels. In fact, the dirty secret about cholesterol "numbers" is that almost half of those who get heart attacks have "normal" cholesterol numbers. Yep.

Walking regularly and climbing stairs is not only a great form of exercise, but also gives you an indication of how your heart is doing. If you begin to sweat while walking, have shortness of breath, or have chest pain while walking or climbing stairs, it doesn't matter if you saw your doctor the week before and got a clean bill of health, you need to follow up with your physician, sooner than later.

And reflux.....Yes, more often than not, if you have chest pain or even a sore throat, it is probably caused by reflux. Reflux is a nasty thing to have if you have a family history of heart disease because it can trick you into believing you may be having a heart issue, when in fact you don't. Or worse, you may mistakenly believe you have reflux when in fact you are having a heart event.

A great website that the cardiologists use to discuss recent developments in heart disease is theheart.org. Besides breastcancer.org, it is the website that I visit the most. Anyone can register to use it. I highly recommend you all check it out.

And, finally, if you are overweight, begin walking it off. Losing only a few pounds will significantly reduce your risk of a heart event.

Momine · October 2012

Althea, I am very sorry about your brother. My condolences.

My docs have been careful about my heart, I think. During my first epirubicin (I think that is the heart toxic one) treatment, my onc sat behind me with a stethoscope on my ribcage to make sure my heart could tolerate the drug. Before starting chemo I had a careful MUGA, heart ultrasound. After finishing chemo I had two surgeries. Prior to each I had a very careful examination by a cardiologist, in addition to the usual electrocardiogram.

Once I was done with treatment, they wanted to repeat the MUGA, but since I had just had surgery and a cardiology check, we decided to skip it. However, when I had shortness of breath 3 months later, they sent me for the MUGA pronto. The MUGA was fine, thankfully.

I do expect to continue getting an annual MUGA and to consult with a cardiologist when necessary.

Blessings2011 · October 2012

Oh, althea, I am so very sorry to hear of your brother's passing...my sincere condolences to you and your family.

It's wonderful that you are using this opportunity to take charge of your heart health.

I just wanted to share something that happened to me years ago. I was having chest pain...not really "chest" pain, but "breathing" pain. I called the Advice Nurse, who instructed me to go to the ER immediately. I refused, telling her I was fine, that I was eating breakfast, and that I was NOT having a heart attack.

She replied that if I did not go to the ER, she would call the Paramedics and have them come to my house to check me out. Grumbling, I drove myself to the ER.

When I was in my gown and hooked up to all the wires, the doctor told me that the number one symptom of heart attack in women was DENIAL.

He said that they called it indigestion, anxiety, reflux, whatever - and that they were highly unlikely to want to bother anyone because it was probably nothing.

Doing nothing, or - even worse - driving yourself to the ER Surprised - he said was the worst thing you could do.

When in doubt, call 911. Women's heart attack symptoms are totally different from those experienced by men, and by the time you finally agree to get treated, major damage could be done.

Wishing you the best in heart health....

(p.s. My pain turned out to be a combination of severe asthma and bad air quality. No heart involvement, but I was glad I had it checked out.)

camillegal · October 2012

Althea I am so sorry for u'r loss of u'r brother--What a shock for u and u'r family. My condolances to all of you.

Althea u got good advice from this board so I can't tell u anything that they haven't said.--I now have a cardiologist these Drs. keep adding up, And I'm sure u can get one and u'r concerns are so very valid.

Good Luck Althea and I know how much u'r Mom needs u now but still take care of u'r self too.

althea · October 2012

Thank you again everyone for your kind words. A reminder that women's symptoms of heart attack are different than men's is something that needs to be said more often. I've heard that before, of course, and it was good to hear it again.

Now I'm wondering about what kind of test evaluates plaque developing in the arteries. I still feel tired a lot even though it's been 7 years since treatment. It's probably my thyroid that I've been coaxing into gear for a long time, but perhaps I should look at other possibilities.

My bp is usually fine at home and high whenever some medical 'professional' takes my reading. I became aware that bp readings have a protocol that usually doesn't get followed. I've always had a bad case of 'white coat syndrome', which makes my readings go up. Throw in someone not following proper procedure, and it goes even higher. My daily walks weren't bringing it down. I've since added meditation into the mix and a variety of stress reduction techniques.

While this thread is still going, I want to mention the one thing that brings down my bp without fail -- apple cider vinegar. Unfortunately, I have a huge aversion to it. Don't like how it tastes or smells. Even the thought of it makes me cringe. For a while I was gagging it down with a shot glass -- 2 waters, 1 acv, 2 waters from a 2 oz shot glass. Works like a charm ... as long as it's actually consumed. Since that time, I've migrated to using apple cider vinegar tablets. I've read that some brands are so inferior they barely contain any acv at all. I'll be changing the brand I use to one that uses raw acv. I've been hit and miss in taking the tablets. Even though they're coated, there's still a whiff of the acv smell, which I detest. I'll be taking them with much more regularity in the future.

I also use pharmacuetical grade fish oil. Many of the diseases that kill in this day and age are chronic in nature. A common recurring theme amongst them all is chronic inflammation. According to Dr Barry Sears, founder of the Zone diet, therapuetic doses of fish oil will combat the chronic inflammation. I wasn't particularly moved by his dietary theory, but reading one of his more recent books did convince me to start taking fish oil. Hope these snippets of info will be helpful to others.

leggo · October 2012

Hi Althea, I can somewhat relate to the scary heart attack scenario. I was always fearful of that. Before I was under the care of a cardiologist (and actually, still), I always carry an emergency aspirin on me, just in case. It really does give you a small sense of security. Good to know they make acv in a pill form....that stuff is gawd-awful.

Edited to add: I make hubby and kids carry one around too. It's shocking to hear how many perfectly healthy young men drop dead on the basketball court or something. Very scary.

althea · October 2012

I've never been so happy to return home than I was after this trip. My brother's memorial was last week. The shock of his sudden demise is slowly shifting to accepting what I cannot change. I already had plans to visit him. My nephew (son of my other brother) was celebrating his wedding, and as things turned out, our family had a wedding and a funeral in the same week.

I stayed in my departed brother's house with his wife and his kids who are now young adults. Being there helped get over the shock, his absence seemed nearly tangible. ...and then... I had daily encounters of what his day-to-day life would have included. I was ready to crawl out of my skin by Friday. I began to understand why he would have high blood pressure. I managed to keep my temper in check, but there were many occasions where I was shocked and appalled by some of my sister in law's decisions/choices/behaviors. A week was pushing my limit, and my brother spent almost 3 decades with her. Clearly, he saw something in her that I cannot. He was no cakewalk either. Perhaps, in a sense, they truly were a divine match. His death, and his life also, remain mysterious to me.

And speaking of mysterious, the medical examiner's office seemed somewhat puzzled by his death. I've been told his cause of death was listed as 'natural causes, possible cardiac infarction.' I know some tests take longer than others. Does anyone know why they wouldn't be more certain from the time of autopsy? I'm also wondering if I'm dependent on my sister in law to get copies of the reports. I feel certain I'll simmer down in a few days, but right now, I'm in the process of letting loose all the angst that built up while being obliged to play the part of a polite houseguest.

And along comes a heart attack...

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