Wednesday, November 12, 2008

Rehab - Day 2

When I arrived on Monday, Ed immediately ushered me over to get my workout card and to get my monitor on. He had to remind me of how the monitor goes down on this side up on the other side. Eventually, I won't have to wear the monitor. But for now, it's standard issue.

The workout this time was different. 18 minutes on the treadmill walking at 4 mph and 4% grade. 8 minutes on the rowing machine. 10 minutes on the bike for legs. 4 minutes on the bike for arms. 2 minutes on the Monark. My assessment level was 11 - fairly light workout.

The stress test is next Monday. So I'll have rehab 2 more times with a lighter workout and, pending the results of the stress test, will begin more intense workouts next week.

During this visit, I took a closer look around at the other patients. I spoke to a few of them. I am the youngest by far but the stories don't differ that much. I spoke to one gentleman during his 22nd visit. He told me he recently got out of the hospital for more complications and was glad to be back in rehab. He survived throat cancer 2 years ago and now works harder than anyone in the room 3 days a week to make himself better. Another gentleman could barely ride the bike for 2 minutes when he started. That was 50+ visits ago. Today he claims he reached a new milestone. His muscles tired-out before his heart. A tremendous feat considering.

Others in the room do their thing and keep to themselves. They seem to appreciate the quiet alone time during which they are solely focused on them. I believe some of these people will be my friends before my 12 weeks end.

Rehab - Day 1

As expected, I spent more than half of the 75 minute appointment completing assessments and establishing goals. I was fitted for a monitor that I wear during my work out. They take my blood pressure at certain intervals as well. Gotta make sure I'm still alive. Kathy is my case worker. She is a very warm person who took her time to complete my assessment even though she probably got more information about me than she wanted to know. She showed patience and seemed to understand very quickly that I had no idea how to handle all of this. She showed me how to attach the sensors for the monitor and then how to attach the leads to the sensors. I'm sure I'll never get it right.

The rest of the staff, Pat, Adele and Alese, welcomed me to rehab as though I had some sort of VIP status. They seem to treat everyone with that level of caring and respect. They will surely make the rehab process more enjoyable and less clinical.

The workout only lasted about 20 minutes, but I welcomed anything at this point. Since I have not had a stress test, Ed, the physiologist, ran me through a few light efforts to see how my heart reacted. I walked on the treadmill at 3 mph and 10% grade for 6 minutes. No problem. I worked on the bike...first arms only, then legs only. Speed goals remained low and duration remained short. Again, this was just to see how my heart would react. Finally, I worked on the Monark machine which looks something like a postage meter. For two minutes, I simply turned the handles and kept up a certain speed.

Dr. Newton, my Cardiologist, said that the rehab group would probably try to treat me like a 60+ year old heart patient when planning my rehab. Just the opposite was true. Ed said he recognized my unique situation and said he would create a rehab plan geared towards that. Day 2 would be more challenging.

Injured Reserve Week 2

The second week back showed promise. It proved to be an exciting week. I went to the Redskins game on Monday night with my father. Though the Skins lost, we still had a great time...until we realized someone towed the car. Delaying our return to Richmond by about 2 extra hours, we finally got a cab, got to the impound lot, recovered the car and made it home by 3:10 am. I snuck in about 2 hours sleep before Rachel and I took turns going to vote in the biggest Presidential election ever. I had already taken the time off of work, so I plodded through the rest of the day with the family, trying not to look as I tired as I felt.

Back to work on Wednesday and things seemed a bit easier. I held meetings with my new department and put together an agenda for the next few weeks. I updated myself on my regular duties and suddenly found myself fully engaged for the first time.

The highlight of the week was my first cardio rehab appointment. Jonesing for some actual exercise, I impatiently awaited through every hour, minute and second until I finally hit the treadmill.

Injured Reserve Week 1

I came back to work on October 27th. Nothing felt the same. The company was different. The office atmosphere was different. My motivation was different. It was as if the tiny part of my heart that was damaged was the same piece of heart I put into my work.

The first 2 days were overwhelming. My coworkers walked on eggshells around me and I thank them for that. Some had absorbed my other responsibilities during my leave. Taking those things back did not top my list of to-dos. Plus, I had an entire new department and new staff (of 2) to take on. An obvious starting point eluded me. I was starting over; starting over in the middle.

I spent much of the first week observing everybody as they worked. Trying to find the things I can avoid to lessen the stress load while still accomplishing assignments. I decided to stay out of conversations that speculated on the financial health of the company. I wanted to stay away from talks that dissected the changes and staff losses from the previous week. I wanted to remain complety separate of those speeches and conjectures and venting. Unfortunately, after the third day, I realized I was leading those very conversations which I endeavored to avoid. They provided a catharsis, but still left my ire up...and probably my blood pressure to some extent. Now I work harder to not participate in such unproductive conversations.

By the end of the week, I realized I needed to do more to reduce the stress at work. I left my computer at the office for the first time in memory. When I walked out the door, I disconnected.

I did my best to not think about work all weekend knowing I still had my budget to turn in as well as an annual review of an employee. I knew the importance of both and the consequences of non-compliance, but I didn't let myself worry about it. I slept well over the weekend for the first time in many years.

Tuesday, November 11, 2008

On the Disabled List

Upon leaving the hospital, the looming question for Rachel and I to answer was how do we reduce stress at work and home? A tough question to answer for anyone with two young children, a busy work schedule and the regular high demands of being a grown-up. I spent 3 weeks at home trying to answer the home half of the question.

During that time, I got to walk Morgan to school most mornings and pick her up afterwards most days. I spent a lot of time bonding with Olivia, playing with her and learning to better communicate with her. I also learned how to communicate better with not keep in things I was previously tentative about saying.

The first week was the toughest. I wanted to find the proper balance of helping around the house and resting. Week two, Barry came to visit and help out for a few days. Then Rachel had to go to San Diego for Stroller Strides, so Steven came to visit while she was gone. Their help and company...invaluable.

I can't say enough about the Stroller Strides families who mobilized and came to our aid. We had dinners prepared for us every night for as long as we needed them. Our friends in Atlanta also sent us prepared food. All of our friends had it right...let's help them with the little stuff so they can focus on the big stuff. The amount of support we experienced was overwhelming and wonderful and I thank everyone!

Week three was just the 4 of us again and I spent that week preparing myself to go back to work. Staying at home and eating good for me foods and remembering to take my meds became the big challenges.

Of course, during my leave time, things severely changed at work. We lost a few good people and restructured some departments. I picked up the HR department in addition to my already significantly piled on responsibilities. The transition back to work looked even more difficult now. All I wanted to do was stay home and play with Morgan and Olivia.

Friday, November 7, 2008


Life is a lot like a sporting event. It's played on an open field in a finite amount of time (though we don't know how long the game clock will run). It has its own set of rules and penalties and comes with its share of players and coaches, cheerleaders and competitors...and goals. Life has its injuries, enders;season enders;career enders.

I just suffered a season ender. At 37 years old, I was benched by a heart attack.

The heart attack struck on Friday, October 3rd at 3:25 PM. But it really began about a week and a half earlier and I had no idea.

On Wednesday, September 24th, during a 6 mile run, I noticed a discomfort in my chest when my breathing peaked. It felt respiratory in nature. Like I was breathing bad air. As soon as I ended my run and my breathing returned to normal, the discomfort went away. I suspected it was a symptom of running during a bad air quality day, but the DEQ listed the air as green and clean. Then I thought I might be getting sick and with only 5 weeks until the Marine Corps Marathon.

On Saturday, September 27th, I ran 15 miles with Rachel. We left around 8:00 am and the humidity had already climbed to about 80%. Breathing comfortably became a challenge early on and I experienced the same sensations as on my previous run. I struggled through this one, posting a miserable 11:40 per mile average. After the run, as my breathing returned to normal levels, the discomfort disappeared again. I chalked it up as a bad day and started thinking about what I can do next week to improve the long run.

I took a few days off after that run to recover the lungs. I considered seeing a doctor, but took echinacea instead which seemed to help. The night of the Vice Presidential Debate, the discomfort came back. This time, I wasn't running. I was relaxing and watching the debate. Again believing this was respiratory, I spent 10 minutes in a steam bath trying to loosen up whatever it was. No good.

On Friday, October 3rd, I had a particularly long day planned. At work by 3:30 am to finish up compiling packets for a new client just before a long drive to Roanoke, VA. By 4:30 am, I had the same discomfort in my chest and I began to get worried. As soon as my doctor's office opened, I phoned and made an appointment for later that day.

The rest of the day went as scheduled. We left for Roanoke at 5:00 am and arrived at our meeting at 8:45 am. I felt fine all throughout the meeting. It wasn't until we were about an hour outside of Richmond on the way home that I started to feel bad again. The same discomfort came back, but this time it was more severe. As we neared Richmond, I felt worse and worse. When we were about 10 minutes away from the office, the discomfort had turned to pain and it spread to my arms, my hands and my jawline. I knew something was seriously wrong.

We made it to the office and dropped off Eric and Tarrah. I was considering whether to get in my car and go to my doctor's office as scheduled, or just go to the hospital. When I got out of the car and couldn't stand up straight, I knew the answer. Elizabeth drove me to Chippenham which was fortunately right across the street. On the way I called Rachel. I didn't want her to panic but I began to cry when I tried to tell her where I was going. I simply couldn't grasp what was happening to me and I didn't want to find out the answer.

I arrived at the ER at 3:15 pm. The cardiac team worked quickly to stabilize me. The pain was unbearable now. I got an aspirin and a nitro patch. The nurse said the nitro patch would either make the pain go away, which would indicate a heart attack and probable heart damage, or it would give me a headache, which would mean no heart attack occurred. Within seconds of the patch being applied, the pain began to go away. Good and bad news at the same time.

Rachel made it to the ER within 15 minutes of my call. I was impressed with her composure. I was the wreck. At first I was told it was not a heart attack...that the EKG didn't look abnormal and my first blood test came back fine.

The Cardiologist, Dr Newton, visited after about an hour and looked things over. He initially assessed this was a stress induced event. He said he'd keep me in the hospital over night, do a stress test in the morning and then release me.

However, the longer he stayed with me, the more he realized I was still in a great deal of pain and should not have been. He ran a 2nd blood test and it came back with elevated enzymes. He decided to admit me to the IVCU and said I'd be there for a couple of days.

After settling in the hospital room, the last place I wanted to be, they took a third blood test and hooked me up to the monitors. Rachel stayed the night. She slept in a chair. I'm glad she was there.

Around 12:30, Mike, my nurse, came in and woke me up. He was explaining something I didn't understand. Rachel told me to do what Mike said right away. He handed me a phone and Dr Newton was on the other end. I wasn't quite following what he was trying to tell me, but the result was an emergency heart catheterization. Apparently, my third blood test came back with extremely high enzyme levels. Dr Newton was in his car on the way to the hospital and ordered me to be prepped for the cath lab.

The procedure took about an hour. I was sedated so I don't remember anything other than thinking about my daughters and hoping to see them soon.

My next point of lucidity was back in my room. Dr Newton was explaining his findings to Rachel. They didn't have to put in a stent or do any invasive work. In fact, my heart grew a colateral...that grew its own bypass. Dr Newton said this is something that is genetic, but you have to have a strong heart for it to work. He credited running for giving my heart the strength to do it.

But the news isn't all good. There was damage to a tiny vessel which was blocked, and there was damage to the heart muscle. The extent of the damage will be unknown for sometime. The 2 marathons I trained for were out. In fact, Dr Newton said running is out for a long time. Over the next few weeks, he wanted me to rest. The most activity I could do for exercise is to walk. And then came the meds. Blood thinners, alpha blockers, beta blockers, cholesterol reducers, blood pressure droppers, anxiety reducers, sleep aids and aspirin.

I was in the hospital from Friday night until Monday afternoon. I was glad to get home. I was glad to see my daughters. I was glad it was only a season ender.

The next 3 weeks at home were difficult. That will be in part 2.