Heart failure

So I thought it was about time I did a bit of an update as to where I am a health-wise. It’s taken this long partly due to me trying to take it all in, and also waiting until I got some more information from tests and from my consultant.

I had an appointment this week which has given me a bit more info. It turns out they now think I’ve had a heart attack (acute myocardial infarction) at some point, but I wasn’t aware that it happened. Basically the blood supply to the heart was temporarily blocked when it happened, and this then caused scarring on the wall between the two chambers of my heart, and this has led to heart failure. Apparently it’s quite normal to have a heart attack but not realise it. You kind of think of a heart attack being some big dramatic event, like serious pains or collapsing, but I think I was mixing it up with a cardiac arrest, which is what often leads to death if not dealt with immediately. The doctor told me that a heart attack can even be a feeling of anxiety, so how you’re supposed to know for sure is beyond me! Now I’m on a daily concoction of pills, my current status is NYHA1, which means that I shouldn’t have any limitation of physical activity, although I do find I can get quite tired if I do a lot, but that could be a vicious circle because I’ve not been as active as I might be.

I’ve been trying to think back to when it might have happened – I mean, I was feeling quite breathless last August when I was on holiday in Ireland, and I was kind of aware as I was getting closer to Christmas that my stamina was decreasing, and I’d find that even just walking up the stairs to the office would make me breathless, and my cough (which I’ve always had due to allergies etc) was getting much worse – which actually turned out to be pneumonia and fluid on my lungs. At the time I just put it down to lack of fitness, and having hurt my leg earlier that year, which stopped me going to the gym and being particularly active on shoots.

And then the start of this year, it was a pretty rough time with work, and so I was incredibly anxious and stressed, so don’t know how much of that was linked to my heart health – I guess I’ll never know really. I did know that I probably needed to go to the doctor’s to check it out, but I’d never got round to transferring my GP up to Manchester since when I moved up here in 1999, so that was an extra barrier. Also, if I’m totally truthful, I was scared to find out whether it was serious, which is so stupid, but that’s how I was.

Anyway, I eventually got to a point where it was too much to ignore – there’s more about that, and my time in hospital in my blog post here.

A week after coming out from hospital, I got to see the doctor again at the Stockport Heart Failure Clinic, and he said that I could do exercise at the gym, but not to push my heart-rate too much, and not to do any weights that could cause strain on my chest. I then got a date through for my MRI, which was to be in July, which seemed far enough away (because I was quite apprehensive about having it), but then near the end of June I got a call from the hospital saying that due to a cancellation, I’d be able to have it the following day, which meant it gave me less time to be stressed about my claustrophobia.

I found the MRI itself to be really horrible. I don’t like enclosed spaces at all, so being put in a tunnel where your arms are being held down, and your face is just a few centimetres away from the roof is really stressful – it’s making me feel anxious just thinking about it now! When I first went into the machine to check that the wires for the ECG were working properly, I had a mini-panic and had to ask them to bring me out so that I could get my head together! I’ve got a massive fear of being in a really enclosed space, and me not being able to move my arms above my head to pull myself out. So being in a narrow tube for nearly an hour with them wedged down by my side, and my chest covered by a heavy plate wasn’t too great!

Once in scanner proper, I was continually being given instructions through headphones on when to breathe in, breathe out or hold my breath. I was able to go in feet first though, and that definitely helped – I’d have been so freaked if I’d had to have gone in head first! But I got through it – after a while, I was able to relax a little bit and follow all the instructions, but I’d rather not have another one in the near future!

Following my MRI, I was told that it confirmed that I have severe left ventricular systolic dysfunction (LVSD) with an ejection fraction (EF) of 32% (it should be at between 50% an 70%), but that there was ‘significant residual viability’. Apparently the viability bit is a positive thing – the problem is that when you see all these medical terms, you don’t know what it actually means.

I’m now waiting for a date for an angiogram, which is where they insert a tube into an artery via your groin or arm, and then once it’s in the heart area, they release a dye so that they can then take a close-up x-ray. Once I’ve had that and they’ve got a clearer idea of what’s going on, then apparently there are basically 4 ways forward. The first is to just continue with the medication, so long there’s no deterioration of my health, and it appears to be improving my health. The second option is that if the angiogram shows a restricted artery, then they might insert a stent to open it up – angioplasty. This one worries me a bit, because my dad had to have this procedure back in 2000, and it went wrong and they ended up breaking through his artery and he was rushed into surgery for a quadruple bypass – but I’m trying not to think about that! Next in the list would be they’d look at inserting an ICD device, which is kind of like a pacemaker, but works more like a defibrillator in that if it detects that my heart has stopped, it tries to restart it. This would mean I wouldn’t be able to drive for a month after having the operation, and then if ever it goes off, that would mean I’d have another period of not being allowed to drive. The final option – and the one I really hope to avoid – is heart bypass surgery.

So that’s where I’m at. To be honest, it scares me a lot of the time, and it’s made me much more aware of my mortality. I’m scared that I’m going to die because of this, and I’m trying to take any positives and run with them, but it’s really hard sometimes. I hope if I can get back into a routine and build up some freelance work, that might help take my mind off it all.

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