How To Fail while Still Passing Tests

Not all people suck:

The kindness of strangers as I lay on the seat of that golf cart that day shows that not everyone in the world is callous and unwilling to get involved.

While waiting the 5 - 10 mins for the EMS team to arrive the driver of the cart monitored my vitals and a doctor that was on vacation with his kids stopped and hung out with me. The general consensus was that I was not having a heart attack (always good to have confirmation) and given my strong vitals I was probably just dehydrated (the vacationing doc even gave me a Coke he had as I had finished the water we packed for the hike) or hungry.  I did not believe that explanation, but did not really care either, as I was busy playing "not a heart attack" over and over in my brain.

EMS showed up and they were very polite, thorough, and efficient. They had me wired for sound (12 lead ECG) within minutes. The readings from the ECG were all clean and showed that everything was fine which was nice but frustrating.

Aside: Now I want to take a quick moment here to interject something out of chronological sequence.

As I have been learning about Myocardial bridges I have come to realize just how lucky I have been with mine. Reading on the net, and talking with my doctors, I have learned that many people who become symptomatic with bridges go for a long time, often years, with debilitating attacks like the one I had and no diagnosis of the actual problem. They will have symptoms just like I did (or worse even) but when hooked up to ECGs and given the typical battery of cardiac diagnostic tests they come back as normal (or nearly normal). As a result they are often told things, just like I was told in the beginning, that their issue was dehydration, indigestion, stress, a panic attack, or worst of all "it is all in their head."

In the beginning I knew something was wrong; but, I could not prove something was wrong. So I fell into the trap of thinking it might actually all have been in my head. That maybe the episode was not as severe as I was remembering / thinking it was. At this point I was feeling really relieved, confused, frustrated, scared and pissed off all at once.

This is what, I learned later, is pretty much the universal patient's introduction to Myocardial bridges: "OW OW!…Oh Crap!!…Whew, thank God! … Wait a second …WHAT!?!?"

Passing yet Failing…

Regardless of the clean ECG and the solid vitals the EMS team wanted to take me down the hill to the local ER for a full evaluation and I was not going to argue. Next stop:

In the ER everyone was super nice and very efficient just like the EMS guys. When I mentioned that to the Doctor he told me that cardiac issues were bread and butter to the Sedona emergency community. (Note to self: next time I plan to have a "cardiac event" do so where snowbirds roost). So in the ER (as previously mentioned is normal for bridges) all the blood work, X-rays, ECGs and other tests were clean. They showed nothing amiss. Which was great for calming immediate fears but not so great for not making me feel like some ginormous hypochondriac / fraud. But, hey at least I was not in immediate danger. 

They discharged me but not before one really great nurse there thoroughly impressed upon me that I must follow up with my regular doctor as soon as I got home. This was another big lucky break for me because, honestly, I was sorely tempted at that point to just chalk it up to "eh....maybe I am a big crazy dummy" and do nothing more. (I was definitely rocking an awesome Ostrich vibe)

So we finished a much lower key vacation in Sedona than we expected and headed home. Where immediately upon walking in my front door I scheduled a visit with my regular physician group for the next morning.

Red Rocks, Red Lines and Magic Number 92

Just a simple little getaway: 

Skip forward to the summer of 2015. By then I have managed to find 30 pounds of the ~50 that I lost way back in the mid 2000s. I am not feeling that great with all the extra weight and my 46th birthday is rapidly approaching. So...

Time to put more energy on getting back into shape. 

So my girlfriend and I decide we need to go on a little hiking / nature get-away. The question is where? On a total and absolute whim I suggest going to Sedona AZ (my first lucky break - more later). I have NO idea why that place popped into my head other than I used to live (many moons ago) in Phoenix. 

So it is all set up and we leave shortly after my birthday in September.  Now if you have never been to Sedona I strongly recommend it. It is absolutely beautiful.

On the first day we plan a not too severe hike. A little 5 mile trail that only gains a couple of hundred feet of elevation and goes up a beautiful canyon. I was feeling pretty charged about getting out and doing stuff again.

We made it to the top of the trail head without any issues or problem and in fact I was feeling pretty good and my arm was fine (I had completely forgotten about my "sports" injury). We sat for a quick rest at the "Don't go past this sign or really bad things will happen" sign and then headed back down. 

About 15 mins after getting moving again, going downhill none the less, my arm started it's old nuisance routine. My bicep hurt a little but not severely or anything. So I stopped for a second (which usually made things better) and even decided to take a picture:

But, things did not really improve so I just figured this was just going to be another one of the "lingering" times. I do distinctly remember thinking "geeze ('80s remember) I must be in really bad shape if just the movement of going downhill bugs my rotator cuff."

I mentioned to my girlfriend that my arm hurt. And, pretty much as soon as I finished speaking my life took a totally new direction…

The pain in my left arm became much worse: like someone was squeezing my left bicep in a vice while stretching it lengthwise. A couple of seconds after that the same type of pain materialized in my right bicep – at the same intensity. I decided this was not at all good but still did not really think heart. I was just really confused as to what the hell was going wrong. 

Which is precisely when I felt a crushing / squeezing pain in the center of my chest and breathing went from being simple to a serious effort. Now I figured it out, ah this must be a heart attack. 

That instant going through my head was: "Of course. Radiating pain down the arms. Chest pain. Breathing....... okay dummy, you know what this is: it is a heart attack."

……Wait!……Oh crap (lets just say that was the word I choose okay)…I am having a heart attack!?"

So I explained what was going on to my girlfriend and we took stock of the situation. We were approximately 2-ish miles from the trailhead. We had no cell service. I was becoming very cold, sweating, and my skin on the back of my neck was apparently very white with blue veins showing up clearly through it. A quick check of my watch showed that my pulse rate was around 130 yet I was standing still. 

The best we could come up with was walk very slowly down the hill for as long as I was able to do so breathing as deeply and as slowly as possible. Stopping did not help and this slow movement coupled with the breathing seemed as good as anything. (at least it was not getting worse) 

So we were off. Me watching my heart rate on my watch and she watching me. Over the next 20 mins or so things got a little better. My pulse rate came down with the breathing; and, as it did my chest hurt less and my arms were slightly better. I quickly figured out that a pulse of 92 was sort of the magic line. Keeping my pulse below that number was "good" where a pulse rate above that number became "bad" … fast.

Carefully we worked our way down until we were about a quarter mile from the trail head. By this point (say 50 mins after the episode started) I was doing okay. Chest was good, stomach hurt a bit, and arms were better. Pulse was in the 80s and staying pretty much put. So we discussed options and decided that it would be best if my girlfriend took off for the trailhead and went looking for a land line to call EMS. 

So she did, and I just kept plodding along glued to my Apple watch and it's heart rate readout. I reached the trailhead with a pulse of 88. 

I was completely confused as to what the hell just happened. I was no longer convinced I was having a heart attack. After all, you don't walk off a heart attack and that was basically what I just did; so not a heart attack. But, I was at a complete loss as to what the hell actually was the problem. Because, I was convinced there was a problem. 

At this point a resort golf cart came rocketing into the parking lot I was standing in and a guy jumped out asking if I was the one with the heart problem. 

Yay girlfriend!