When a heart attack isn't
11-24-13, 01:57 AM
#1
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When a heart attack isn't
For a long time now, I believed that in early February 1997, I had a heart attack on a yacht during a race around the Swan River in Perth Western Australia. Now, after a check-up in the past two weeks in order to get a public vehicle (bus) licence, it seems I didn't have an acute myocardial infarction, but rather suffered a bout of broken heart syndrome.
The conclusion at the time about the heart attack was probably right, because Takotsubo cardiomyopathy, or BHS, presents with very similar symptoms. But in 1997, it was not something the medical profession knew about, and hence I was given intravenous heparin, and an angiogram found no evidence of blockage of the coronary artery. In fact, the attending doctor at the hospital, when I saw her later, said she remembered me as someone coming in with a heart attack and a miracle happening in front of her.
There is no doubting that Takotsubo cardiomyopathy can be fatal. It is a bulging of the left ventricle in the heart. It occurs in under 3% of patients presenting with heart attack symptoms. Provided the patient survives the initial attack, the heart restores to its original, unimpeded condition.
It certainly appears to be linked to high stress such as experienced during a break-up of a relationship or some of high emotional event. In my case, it was after a break-up.
I think this has been one of the most important revelations in my life. Firstly, my heart basically has no damage. This has probably been well demonstrated by my cycling adventures in touring, commuting and randonneuring since my cardiac event.
But even more so, my battery of tests involved an exercise that required me to achieve 90% or higher of my predicted max HR. This is where it got really interesting -- my heart specialist wanted me to get to 90% of my predicted maxHR on the treadmill, with the calculation for maxHR based on 220-age... that is, for me, 162. I told him that my maxHR was likely between 182 and 187 based on actual observation. We had a minor discussion about the 220-age being quite accurate.
As it was, I "blitzed the test" and have "a high exercise tolerance" (his words) and my prediction was more accurate than his! I got to 162 and surpassed it with 167 being the maximum shown. And I was still able to converse a little. The maxHR indicated from that result was 185.
Anyway, I have a clean bill of health, and it seems I can dispense with the claim of having had a heart attack. Instead, I just had a broken heart, which of course was well and truly mended on meeting Machka in 2003!!
The week ended with me starting a new "dream" job... and I didn't even need the bus licence to get it.
The conclusion at the time about the heart attack was probably right, because Takotsubo cardiomyopathy, or BHS, presents with very similar symptoms. But in 1997, it was not something the medical profession knew about, and hence I was given intravenous heparin, and an angiogram found no evidence of blockage of the coronary artery. In fact, the attending doctor at the hospital, when I saw her later, said she remembered me as someone coming in with a heart attack and a miracle happening in front of her.
There is no doubting that Takotsubo cardiomyopathy can be fatal. It is a bulging of the left ventricle in the heart. It occurs in under 3% of patients presenting with heart attack symptoms. Provided the patient survives the initial attack, the heart restores to its original, unimpeded condition.
It certainly appears to be linked to high stress such as experienced during a break-up of a relationship or some of high emotional event. In my case, it was after a break-up.
I think this has been one of the most important revelations in my life. Firstly, my heart basically has no damage. This has probably been well demonstrated by my cycling adventures in touring, commuting and randonneuring since my cardiac event.
But even more so, my battery of tests involved an exercise that required me to achieve 90% or higher of my predicted max HR. This is where it got really interesting -- my heart specialist wanted me to get to 90% of my predicted maxHR on the treadmill, with the calculation for maxHR based on 220-age... that is, for me, 162. I told him that my maxHR was likely between 182 and 187 based on actual observation. We had a minor discussion about the 220-age being quite accurate.
As it was, I "blitzed the test" and have "a high exercise tolerance" (his words) and my prediction was more accurate than his! I got to 162 and surpassed it with 167 being the maximum shown. And I was still able to converse a little. The maxHR indicated from that result was 185.
Anyway, I have a clean bill of health, and it seems I can dispense with the claim of having had a heart attack. Instead, I just had a broken heart, which of course was well and truly mended on meeting Machka in 2003!!
The week ended with me starting a new "dream" job... and I didn't even need the bus licence to get it.
11-24-13, 05:42 AM
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About five years ago I too had a "heart attack" while out to dinner with my son. I walked into the local hospital and complained of a tightness in my chest and a weird feeling in my arm. They hooked me up, told me I was having a heart attack and sent me to a major hospital about 25 mi. away. They ran me through all the tests including an angiogram. Kept me there for three days. In the end, the cardiologist told me that my heart was stronger than normal, there was no blockage and my heart was getting all the blood it needed. So what's the problem? Well, it turns out to be something called a heart "spasm." No one seemed to know why that happens but everyone said I should go home and live my life. I maxed all the post-hospitalization tests. Now if I can just stop throwing myself on the ground.......
11-24-13, 08:47 AM
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Bill
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Semper Fi, USMC, 1975-1977
I Can Do All Things Through Him, Who Gives Me Strength. Philippians 4:13
Semper Fi, USMC, 1975-1977
I Can Do All Things Through Him, Who Gives Me Strength. Philippians 4:13
11-24-13, 01:20 PM
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One less thing to worry about (heart disease) is a good thing.
Does the new job involve hauling people around Oz with a pedicab?
Does the new job involve hauling people around Oz with a pedicab?
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11-24-13, 01:57 PM
#5
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Thread Starter
bruce, spasm also has been another description of BHS.
And the job is working on Bruny Island, one of the most beautiful locations you could imagine, working as a supervisor in a cherry orchard and being paid more than I ever could imagine. Outdoors every day, working in agriculture and a wonderful outlook (pics to come)... plus good money. I couldn't ask for any more.
Machka got her job working in State government before we made the move to Tasmania. I waited until I got here, put around 20 applications out there, had an interview for three. Two were in the tourism industry as a tour guide and were happy to have me aboard, but they were seasonal. Then this one popped up, and the deal was done within a week, based on my six years working in orchards in Victoria out of the past eight years (the other two were spent working for a local council).
And the job is working on Bruny Island, one of the most beautiful locations you could imagine, working as a supervisor in a cherry orchard and being paid more than I ever could imagine. Outdoors every day, working in agriculture and a wonderful outlook (pics to come)... plus good money. I couldn't ask for any more.
Machka got her job working in State government before we made the move to Tasmania. I waited until I got here, put around 20 applications out there, had an interview for three. Two were in the tourism industry as a tour guide and were happy to have me aboard, but they were seasonal. Then this one popped up, and the deal was done within a week, based on my six years working in orchards in Victoria out of the past eight years (the other two were spent working for a local council).
11-25-13, 02:55 AM
#6
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Thread Starter
I should also add that the commute to work every day involves a free trip on the ferry across the D'Entrecasteaux Channel. It's a car ferry, but pedestrians are permitted on for no charge in either direction. The trip takes between 10 and 15 minutes, at a sedate pace. And because my boss has been doing this for a decade, he knows all the masters of the vessel, and we get to sit in the wheelhouse. It's a fine way to start and finish a working day!
11-30-13, 11:40 AM
#7
Procrastinateur supreme
So that's enough heartbreak for you and to have found Machka means you're over it for good! Great to hear of the good fortune of both of you.
Your new work sounds like a world away from the modern day pressures that most of us have to endure. I hope Machka's job is reasonably pressure-free too - though I can't imagine that it would be as nice as yours sounds.
I do hope that your employer has an enlightened respect of pesticide use. Quite often, evironmental policies lag behind emerging epidemiological research. Over the years I've developed a skeptical eye towards claims of safety of many of these products, especially w.r.t the workers most exposed to them in the field. Fortunately we have much more online information about local weather conditions, so it's generally easier to make judgements on when not to apply. Also, there's much more access to information about research being done, making management decisions better informed.
Good luck to both of you! It sounds as if you've both found employment which will allow further two-wheel adventures. We look forward to hearing future installments!
Your new work sounds like a world away from the modern day pressures that most of us have to endure. I hope Machka's job is reasonably pressure-free too - though I can't imagine that it would be as nice as yours sounds.
I do hope that your employer has an enlightened respect of pesticide use. Quite often, evironmental policies lag behind emerging epidemiological research. Over the years I've developed a skeptical eye towards claims of safety of many of these products, especially w.r.t the workers most exposed to them in the field. Fortunately we have much more online information about local weather conditions, so it's generally easier to make judgements on when not to apply. Also, there's much more access to information about research being done, making management decisions better informed.
Good luck to both of you! It sounds as if you've both found employment which will allow further two-wheel adventures. We look forward to hearing future installments!
11-30-13, 04:16 PM
#8
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Thread Starter
Thanks Cranky. That's a really thoughtful post.
Yes, our pesticide use is well controlled and in fact has to fall within the very strict parameters imposed by quality control programs for export into Asia. The orchards are well away from residential areas, and there is almost no point in applying sprays when it's windy -- they don't get to the trees. And the cost is something that has to be taken into account, too. There is no point spraying $100 dollar bills into the wind.
I know agriculture has had a bad rap over things such as DDT and lead, but there is a LOT of testing on fruit done these days here in Australia to ensure the protocols on residues and withholding periods as observed. In addition, some of the insecticides, for instance, are moving to parasitic control using organisms that are harmless to humans, but attack the pest from the inside out.
Plus, farmers have an interest in ensuring that predatory insects remain in orchards, along with bees, which are essential to setting of fruit after blossoming.
It's a dynamic industry, and there is always something to learn.
Yes, our pesticide use is well controlled and in fact has to fall within the very strict parameters imposed by quality control programs for export into Asia. The orchards are well away from residential areas, and there is almost no point in applying sprays when it's windy -- they don't get to the trees. And the cost is something that has to be taken into account, too. There is no point spraying $100 dollar bills into the wind.
I know agriculture has had a bad rap over things such as DDT and lead, but there is a LOT of testing on fruit done these days here in Australia to ensure the protocols on residues and withholding periods as observed. In addition, some of the insecticides, for instance, are moving to parasitic control using organisms that are harmless to humans, but attack the pest from the inside out.
Plus, farmers have an interest in ensuring that predatory insects remain in orchards, along with bees, which are essential to setting of fruit after blossoming.
It's a dynamic industry, and there is always something to learn.
11-30-13, 05:03 PM
#9
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Rowan,
I felt that this type of thing was your love when we were talking over pie and tea last November. You seemed animated when you told us about working in orchards previously. I'm glad to read you have found something you enjoy for your self, as you and Machka plan the next bicycle adventure. Be sure you include NW Florida in the rides some time, we would love to ride some and have more meals and chats with both of you.
Frank, you bring out some good points about pesticides and insecticides and our food sources/agricultural workers. It seems that Australia and the Asian countries have taken this very seriously and are ahead of the U.S. right now, China's policies worry me though. We try and shop carefully for our food stuffs. I watch the sources carefully and we now have a local grown market at one of the churches nearby our village area. With my kidney disease this is something I have to be very careful about. As I understand things right now, the U.S. is in real trouble with the decline of our bee populations from some type of fungi or disease that is wiping out the hives. Without these polinators we are in really big trouble, hope the scientist can get this one figured out, soon.
Bill
I felt that this type of thing was your love when we were talking over pie and tea last November. You seemed animated when you told us about working in orchards previously. I'm glad to read you have found something you enjoy for your self, as you and Machka plan the next bicycle adventure. Be sure you include NW Florida in the rides some time, we would love to ride some and have more meals and chats with both of you.
Frank, you bring out some good points about pesticides and insecticides and our food sources/agricultural workers. It seems that Australia and the Asian countries have taken this very seriously and are ahead of the U.S. right now, China's policies worry me though. We try and shop carefully for our food stuffs. I watch the sources carefully and we now have a local grown market at one of the churches nearby our village area. With my kidney disease this is something I have to be very careful about. As I understand things right now, the U.S. is in real trouble with the decline of our bee populations from some type of fungi or disease that is wiping out the hives. Without these polinators we are in really big trouble, hope the scientist can get this one figured out, soon.
Bill
__________________
Semper Fi, USMC, 1975-1977
I Can Do All Things Through Him, Who Gives Me Strength. Philippians 4:13
Semper Fi, USMC, 1975-1977
I Can Do All Things Through Him, Who Gives Me Strength. Philippians 4:13
Last edited by qcpmsame; 12-01-13 at 08:13 AM.
11-30-13, 07:28 PM
#10
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Thread Starter
Yes, Bill, I just cannot explain why it is so, my enthusiasm for work in this particular field. A lot has to do with being outdoors, and it does have a very positive impact on my fitness and strength.
Pollination plays such a crucial role in plant food production. I understand that the fruit set on the cherry orchards on mainland Australia is not very good at all this season, and some of it may have to do with rain right when the flowers are in full bloom. And the bees, being good union guys, won't work in the rain. We've had a very wet season down here, but the bee activity seems to have been right on target for the Black Devil orchard where I work. Bruny Island is somewhat drier that even on the other side of the Channel. So it all looks good, even much better than some other local orchards, according to our visiting agronomist.
Pix of the property and those million-dollar views:
Pollination plays such a crucial role in plant food production. I understand that the fruit set on the cherry orchards on mainland Australia is not very good at all this season, and some of it may have to do with rain right when the flowers are in full bloom. And the bees, being good union guys, won't work in the rain. We've had a very wet season down here, but the bee activity seems to have been right on target for the Black Devil orchard where I work. Bruny Island is somewhat drier that even on the other side of the Channel. So it all looks good, even much better than some other local orchards, according to our visiting agronomist.
Pix of the property and those million-dollar views:
12-06-13, 04:42 PM
#11
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Lovely photos and amazingly wonderful view for sure! What a great place to live and work.
Rick / OCRR
Rick / OCRR
12-06-13, 04:55 PM
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Three years ago on New Years day, I drove myself to the ER, and walked in complaining of chest pains.
DAYUM, I got fast service!
They kept me over night, repeating blood tests every four hours, but finding no evidence of myocardial infarction. By noon the next morning, they figured out it was only pericarditis, i.e. inflammation of the tissue that encapsulates the heart, separating it from the lungs. The treatment was simply to start with a 4 x dosage of ibuprofen, then taper off to zero over a week. 20 minutes after the first dose, i was fine.
After a week, it was gone, and I've never had it again.
DAYUM, I got fast service!
They kept me over night, repeating blood tests every four hours, but finding no evidence of myocardial infarction. By noon the next morning, they figured out it was only pericarditis, i.e. inflammation of the tissue that encapsulates the heart, separating it from the lungs. The treatment was simply to start with a 4 x dosage of ibuprofen, then taper off to zero over a week. 20 minutes after the first dose, i was fine.
After a week, it was gone, and I've never had it again.
12-06-13, 05:47 PM
#13
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Thread Starter
Three years ago on New Years day, I drove myself to the ER, and walked in complaining of chest pains.
DAYUM, I got fast service!
They kept me over night, repeating blood tests every four hours, but finding no evidence of myocardial infarction. By noon the next morning, they figured out it was only pericarditis, i.e. inflammation of the tissue that encapsulates the heart, separating it from the lungs. The treatment was simply to start with a 4 x dosage of ibuprofen, then taper off to zero over a week. 20 minutes after the first dose, i was fine.
After a week, it was gone, and I've never had it again.
DAYUM, I got fast service!
They kept me over night, repeating blood tests every four hours, but finding no evidence of myocardial infarction. By noon the next morning, they figured out it was only pericarditis, i.e. inflammation of the tissue that encapsulates the heart, separating it from the lungs. The treatment was simply to start with a 4 x dosage of ibuprofen, then taper off to zero over a week. 20 minutes after the first dose, i was fine.
After a week, it was gone, and I've never had it again.
I don't want the thread to suggest that people should ignore their chest pains. All too frequently, they do ignore the pain, thinking it might be something else.
There are several TV campaigns that have run over the past few years here that have urged people to not delay getting medical assistance... and that it's better to be safe and have a positive non-MI prognosis, than to be dead.
In the end, I now believe that my incident wasn't an MI, and that in itself is heart-warming, so to speak. But I wouldn't have had it any other way on the day -- it was straight off to hospital.
12-06-13, 05:52 PM
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One of the critical issues, of course, is that any suggestion of heart problems should involve an immediate trip to the ER or to call an ambulance.
I don't want the thread to suggest that people should ignore their chest pains. All too frequently, they do ignore the pain, thinking it might be something else.
There are several TV campaigns that have run over the past few years here that have urged people to not delay getting medical assistance... and that it's better to be safe and have a positive non-MI prognosis, than to be dead.
In the end, I now believe that my incident wasn't an MI, and that in itself is heart-warming, so to speak. But I wouldn't have had it any other way on the day -- it was straight off to hospital.
I don't want the thread to suggest that people should ignore their chest pains. All too frequently, they do ignore the pain, thinking it might be something else.
There are several TV campaigns that have run over the past few years here that have urged people to not delay getting medical assistance... and that it's better to be safe and have a positive non-MI prognosis, than to be dead.
In the end, I now believe that my incident wasn't an MI, and that in itself is heart-warming, so to speak. But I wouldn't have had it any other way on the day -- it was straight off to hospital.
There is a *huge* variation in the symptoms of MI from one person to the next!
I completely understand why the professionals will assume MI until it is ruled out.
12-06-13, 06:55 PM
#15
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Thanks Cranky. That's a really thoughtful post.
Yes, our pesticide use is well controlled and in fact has to fall within the very strict parameters imposed by quality control programs for export into Asia. The orchards are well away from residential areas, and there is almost no point in applying sprays when it's windy -- they don't get to the trees. And the cost is something that has to be taken into account, too. There is no point spraying $100 dollar bills into the wind.
I know agriculture has had a bad rap over things such as DDT and lead, but there is a LOT of testing on fruit done these days here in Australia to ensure the protocols on residues and withholding periods as observed. In addition, some of the insecticides, for instance, are moving to parasitic control using organisms that are harmless to humans, but attack the pest from the inside out.
Plus, farmers have an interest in ensuring that predatory insects remain in orchards, along with bees, which are essential to setting of fruit after blossoming.
It's a dynamic industry, and there is always something to learn.
Yes, our pesticide use is well controlled and in fact has to fall within the very strict parameters imposed by quality control programs for export into Asia. The orchards are well away from residential areas, and there is almost no point in applying sprays when it's windy -- they don't get to the trees. And the cost is something that has to be taken into account, too. There is no point spraying $100 dollar bills into the wind.
I know agriculture has had a bad rap over things such as DDT and lead, but there is a LOT of testing on fruit done these days here in Australia to ensure the protocols on residues and withholding periods as observed. In addition, some of the insecticides, for instance, are moving to parasitic control using organisms that are harmless to humans, but attack the pest from the inside out.
Plus, farmers have an interest in ensuring that predatory insects remain in orchards, along with bees, which are essential to setting of fruit after blossoming.
It's a dynamic industry, and there is always something to learn.
Sounds really interesting.
They're making great progress here (well, back home) with the apple orchards as well.
Congrats on the successful relocation!
12-06-13, 08:36 PM
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They're just a bit too casual about things for my tastes.
12-06-13, 08:40 PM
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One of the critical issues, of course, is that any suggestion of heart problems should involve an immediate trip to the ER or to call an ambulance.
I don't want the thread to suggest that people should ignore their chest pains. All too frequently, they do ignore the pain, thinking it might be something else.
There are several TV campaigns that have run over the past few years here that have urged people to not delay getting medical assistance... and that it's better to be safe and have a positive non-MI prognosis, than to be dead.
In the end, I now believe that my incident wasn't an MI, and that in itself is heart-warming, so to speak. But I wouldn't have had it any other way on the day -- it was straight off to hospital.
I don't want the thread to suggest that people should ignore their chest pains. All too frequently, they do ignore the pain, thinking it might be something else.
There are several TV campaigns that have run over the past few years here that have urged people to not delay getting medical assistance... and that it's better to be safe and have a positive non-MI prognosis, than to be dead.
In the end, I now believe that my incident wasn't an MI, and that in itself is heart-warming, so to speak. But I wouldn't have had it any other way on the day -- it was straight off to hospital.
The rather persuasive wife of my graduate adviser saved his life when she physically forced him into the ambulance at the first signs of heart trouble. An emergency quadruple by-pass later and he is a new man. Well, that and the fact that he now exercises and no longer smokes those horrid cigars. (By the way, his wife was also a biochemist who spent several decades working on synthetic blood for emergency surgeries.)
12-06-13, 09:27 PM
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Hear, hear.
The rather persuasive wife of my graduate adviser saved his life when she physically forced him into the ambulance at the first signs of heart trouble. An emergency quadruple by-pass later and he is a new man. Well, that and the fact that he now exercises and no longer smokes those horrid cigars. (By the way, his wife was also a biochemist who spent several decades working on synthetic blood for emergency surgeries.)
The rather persuasive wife of my graduate adviser saved his life when she physically forced him into the ambulance at the first signs of heart trouble. An emergency quadruple by-pass later and he is a new man. Well, that and the fact that he now exercises and no longer smokes those horrid cigars. (By the way, his wife was also a biochemist who spent several decades working on synthetic blood for emergency surgeries.)
- A person in cardiac arrest has ~10 minutes during which he can be helped.
- The average ambulance call takes 8 minutes to arrive.
- The purpose of CPR is just to keep the blood moving until the ambulance arrives with a defibrillator, _not_ to resuscitate.*
- CPR on an adult _will_ break ribs.
(*) The instructor told us that on *one* occasion in his career, a guy actually did revive before they got a defibrillator on him...and it surprised the hell out of him.
BTW Contrary to what Hollywood may lead you to believe, the odds of CPR saving a cardiac arrest are not good.
12-07-13, 03:20 AM
#19
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Once the fibrillation stops -- that is, the heart stops altogether -- the person is dead and no amount of resuscitation will bring them back.
I was trained to use a defibrillator in an applied first aid course I did a month ago. They are designed to do as their name says -- defibrillate, and get the heart beating properly again.
More and more defibrillators are being located in places such as shopping centres and business centres so a qualified first-aider can act quickly and within the timeframe that Shimagnolo mentions.
I was trained to use a defibrillator in an applied first aid course I did a month ago. They are designed to do as their name says -- defibrillate, and get the heart beating properly again.
More and more defibrillators are being located in places such as shopping centres and business centres so a qualified first-aider can act quickly and within the timeframe that Shimagnolo mentions.
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