Another angina episode

Yet another episode of angina occurring out of the blue as I am sitting at my computer. Not unusual and can and does happen these days 3-4+ times a week. Same symptoms as usual: pressure on the chest, SOB, left arm tingling - just took my GTN nitro spray and waiting for it to kick in which it slowly seems to be doing as pressure and tingling is going away and breathing is better.

Seeing my GP tomorrow to get results for carotid artery scans done today and will bring this latest angina episode up with him.

Knowledge is Power - Stents and Bypass Surgery

Often you hear the term 'Knowledge is Power' and nothing can be more true when it comes to a heart attack and ways to treat this when it happens.

As previously mentioned I had a massive heart attack in July 2007 and had both stents and a triple bypass as a result. Here are two short videos detailing what is involved in both these procedures.

1) Stent Implantation Coronary Angioplasty

2) Coronary Artery Bypass (CABG) Surgery

Diabetes and Driving

After I had my heart attack in 2007 people asked me why didn't I go back to work, to my job as a courier. When I explained because I was a T2 diabetic and now had a heart condition and according to our dept. of transport regulations I am no longer allowed to drive professionally most people understood but the odd idiot said I should just look for another company and not say anything about either my diabetes or heart attack - these are people you call MORONS!!!! 

Three hours before my heart attack I was on the main motorway between the Gold Coast and Brisbane returning from a delivery. You don't have to be Einstein to work out what might have happened if I had had my first of a number of cardiac arrests whilst driving!!!

Given the above I thought this short video clip was important to post.

Having diabetes does not mean you cannot drive, as long as your doctor states that you are safe too, and you have declared your diabetes to the DVLA (or to your local organization where you live that issues driver's licenses) you can drive!

Read the ins and outs of driving with diabetes here: http://bit.ly/1woH1Pc

Mild Mitral Valve Regurgitation

Over the years since my heart attack in 2007 I have had (and still have) numerous episodes of a fast, racing heart beat that sometimes feels like the heart is going to burst out of my chest. I have seen my cardiologist and have had tests and scans to check this out including 24 hour Holter Monitor tests.

Generally speaking, these fast heart beat events are not associated with any chest pain or discomfort. I have been told that Atrial Fibrillation (AF or Afib) and incidents of tachycardia and palpitations are not uncommon for someone like me with my heart history.

The American Heart Association has more information on Atrial Fibrillation and Arrhythmia here: http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/What-is-Atrial-Fibrillation-AFib-or-AF_UCM_423748_Article.jsp

Earlier this year, when I had another episode of 'racing' heart that happened 'on' and 'off' for a number of days I saw my cardiologist and did yet another holter test which showed no abnormality this was my third such test since 2009.

In 2012 after one of these events when I also had issues with mild chest pain and following a holter monitor test and echocardiagram, my cardiologist put me on Duride (Isosorbide Mononitrate) for the above and to help with angina. I still take this medication today.

Here are a few photos of me with the Holter monitor in February, 2014.

A couple of weeks after the holter test I had an echocardiogram which basically showed everything is normal but did reveal I had mild mitral valve regurgitation - was told nothing to be worried about but something to be aware of and to keep an eye on.

Bottom line: there was no explanation for the latest fast heart episode that happened out of the blue and not following exercise. Since then have had a number of similar incidents.

So when I saw this post on Facebook the other day it got my attention:

"October 11, 1958 - Cardiac surgeon Dr. Dwight McGoon performs the first mitral valve repair for mitral regurgitation. Today, Mayo Clinic cardiac surgeons use robotic surgery to surgically repair valves as an alternative to open-heart surgery. Surgeons operate between the ribs and don’t open up the breastbone (sternotomy), which results in less pain and quicker recovery. Robot-assisted minimally invasive mitral valve repair is now performed routinely at Mayo Clinic and has allowed hundreds of patients to be with their families the night of surgery and leave the hospital 3 days later, returning to work within a couple of weeks."

Dr Dwight McGoon

October is National Breast Cancer Awareness Month (in the USA)

October is National Breast Cancer Awareness Month (in the USA). According to the American Cancer Society, about 1 in 8 (12%) women in the U.S. will develop invasive breast cancer in her lifetime. Learn about the disease and what you can do to reduce your risk

 Read more about this at: http://mayocl.in/1vsARw0
(courtesy of Mayo Clinic)

I share this as my wife gets ready to undergo surgery in the coming weeks, including an oophorectomy and a double/bilateral mastectomy, having been diagnosed with triple negative breast cancer in March, 2013 and in August this year being told she has the BRCA1 gene mutation.

Joe Bugner has a Heart Attack

The other day I read about former Australian, British, Commonwealth and European heavyweight boxing champion Joe Bugner having a heart attack whilst walking not far from where he lives here on the Gold Coast. You can read an article about this here: http://www.boxingnewsonline.net/joe-bugner-is-recovering-in-hospital-after-suffering-a-heart-attack/

Earlier this year Evelyn and I had the privilege of meeting Joe at his book launch and he was kind enough to clown around with us.

We wish you a speedy recovery and know the great people at Gold Coast University Hospital will take good care of you and get you fit and ready to 'fight' real soon.

Maybe I will see you at our local cardiac rehab unit on Nov. 06 when I give my next talk!

Still feeling my way around with this blog thingy - My Angina attack in May, 2014

So still trying to work out how this blog thingy works. Do I construct an historical timeline of what happened to me, before, during and after the heart attack in July, 2007? Or do I post about my heart event and intersperse this with things as they happen now on a day to day basis?

Thought about this yesterday whilst doing some exercise and have decided on the latter. Will post about issues as I recall them taking place and ongoing issues as they occur. I think this is the way to go and more REAL in the sense that it will help illustrate that when you have more than one health issue going on at the same time, 'fixing' one does not necessarily mean that all is hunky-dory.

For example: This morning I get up not feeling 100% - just one of those things that happens with my diabetes and can be the way I start a day once, twice or more times a week. Check my sugars as I do first thing each morning and they are 9 mmol/l (163.64 mg/dl) which is not fantastic but not all that bad given I don't sleep all that well which I now know impacts on my sugars.

I get on with it, have a yogurt and coffee after having earlier taken a shot of both Byetta and Lantus insulin for my diabetes which I do every morning before starting my day. I feel better, check what's happening on the internet and then get to preparing the food for our birds a daily routine which I have been doing on my own while Evelyn has been away this past week.

 Byetta

Lantus Solostar Insulin

I take out Gilly (a long bill corella we adopted in 2008) from his room in our house where he spends nights and put him on the patio with the food I have prepared for all of our birds (and even wild birds like this king parrot who wasn't about to wait to be fed!).

This is a photo I took a few days ago. Gilly will sit in his cage watching me feed our other adopted birds and wildlife visitors before I put him into his aviary for the day.

Whilst feeding and watering our birds I start to feel unwell again - headache, bit of nausea, light chest pain and tingling down the left side of my arm/hand. Not uncommon for me, usually happens for no apparent reason like not exerting myself or exercising and been told a while ago I have unstable angina. More often than not, this can happen when I am sitting at my desk at my computer, however, this morning started soon after I got up from bed, improved then got worse as I was outside doing the birds.

Now when this all started a number of years ago I used to get all anxious and even would panic and would pick up the phone, make an appointment to see my cardiologist which a number of times resulted in my having various tests. Over the years since my heart attack I have had numerous stress tests and will talk more about these in a separate post. Even did a CT angiogram a couple of years ago which showed my stents were all okay.

Upshot of all this was being diagnosed with angina and being put on Duride (Isosorbide Mononitrate) to help manage it. I was also given a GTN Nitro spray to be used when an angina event occurred and I guess it would be fair to say that over the past few years I have managed my angina with these two meds.

Nitrolingual (GTN) Spray

So when I felt unwell again this morning, I took a shot of my GTN spray, sat down for a bit to let it take effect and then went back to finishing up with the birds after feeling better.

I guess if there is a message I wish to share about the above it is one about the need for diabetics to recognize the interrelationship between poor sleep affecting sugar levels which in turn can affect the heart and bring on an angina attack.

Throw in additional issues that can arise for someone who has an endocrinological issue such as a thyroid condition, life can become that much more interesting with the continual battle to balance sugar and thyroid levels whilst managing a heart condition. Did I mention I have (had) Graves Disease? And if you have carotid artery blockages we are really getting into interesting territory.

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In May this year (2014) I had what turned out to be a pretty bad angina attack which landed me in hospital for two days and I learnt a lot from this incident about the relationship between sleep, diabetes and angina. I wrote the following about what happened on my Facebook page:

"On Tuesday, May 13 shortly after lunch I sat down at my desk and began feeling clammy and sweating profusely. I also had a touch of nausea, a queasy feeling and felt light headed but these lasted only a minute or two. In addition I had very slight pressure/ache down both sides of my neck going up to the lower jaw on both sides. I took my GTN spray as I thought this was just another angina attack but the sweating and pressure in my neck did not go away - usually within a few minutes of taking the spray any symptoms I have go away. The week before I had two angina attacks two days in a row, both of which were the worst to date, and my GP said the next time I have an attack to call an ambulance to get it checked out.

Because the sweating and neck ache persisted and given that  I have blocked carotids - up to 69% on the right side and up to 54% on the left - I decided that this time I would get this episode checked out and my wife phoned 000 to get an ambulance. On arrival the paramedics checked my blood sugars which came up with 3.8 and they said I may be having a Hypo/low. Now this was strange as just before I had lunch I had checked my blood sugar at 12.30pm and the reading was 5.2 so to be told I was having a Hypo less than two hours after eating a toasted chese and tuna sandwich and not feeling the Hypo symptoms I usually get had me confused.

The paramedics confirmed that I should be taken to hospital to be checked out, especially given the neck issues. They gave a tube of glucose to suck on which I couldn't tolerate so I opted to eat a bunch of my glucose laden jelly beans. En route to the hospital my sugar levels climbed to 6.2 and from memory, by the time I arrived at the hospital it was around 10.

In addition, they gave me four additional shots of GTN en route and by the time we arrived at emergency the ache on the left side had all but gone - the right side ache disappeared earlier after a couple of GTN shots."

From this episode I was reminded about having "silent" hypos at night while sleeping, something I had not thought about a lot.

I wrote more about this in a NOTE on my Facebook page and also highlighted the need for me (others) to be more vigilant in taking control of our own health, specifically when it comes to CHECKING OUR NUMBERS including sugar levels/HbA1C, blood pressure, thyroid/TSH levels, iron levels, etc. especially if you are someone like me with a number of issues going on at the same time. From this incident I also learnt about the need for me to address my poor sleep patterns and breathing issues both of which I was told during my hospital visit would  be impacting on my heart and affecting my angina.

Read the full NOTE here: https://www.facebook.com/notes/784466408244717/

My final comment in this note was: In summary, this week's events were a more than subtle reminder that I need to be more diligent and attuned to what is going on with my various issues and that to fail to do so could have dire consequences.

Here I am after being brought into hospital in May, 2014.

Media & Television Interviews

I talk about 'mind games', emotional stress, depression, anxiety, feeling surreal and these sort of issues when I give a talk at our cardiac rehab unit. I can talk about these because I was confronted with them, had to accept and deal with them and then move on. In another post I will talk more about this but what I wanted to point out at this point is that these feelings and challenges are not uncommon for people who have had a heart attack, or indeed have had to deal with another life threatening situation.

For close to a year after my heart attack I had issues, just ask my wife, she'll tell you! From being self-confident, independent, financially self sufficient and pretty social, I lost a lot of my self confidence after my heart attack and not being able to work brought on financial issues. Having other health issues apart from a heart condition didn't help and having to cope with people who would say 'you are okay now, move on' was pretty difficult to deal with.

Then, out of the blue in early June 2008, I was approached by our local newspaper, The Gold Coast Bulletin, to do an interview and what was supposed to be a two paragraph article grew legs and became a front page cover story and the article was the lead story for that day's edition. Here are some pics from that time:

Poster outside newsagents promoting the day's edition

Front page 

Article appeared on page 4

The interview took place on June 04, two days before my birthday on the ninth floor of the hospital in the cardiac unit where I spent some time after my heart attack and it was published the next day. All sorts of pretty pics were taken with my wife, Evelyn, and Dr Rahman who saved my life that night and whom I still see today.

Dr Rahman and Evelyn

Evelyn

Me clowning around

Click on the following to read the article: Gold Coast Bulletin Article

The morning of June 05 when the article was published was crazy, crazy, crazy. At 5.15am we had a phone call from Channel Seven in Brisbane saying they had seen the article (we hadn't as yet) and wanted to do an interview for that night's edition of Today Tonight, they said they would be down at our place by 7.00am and sure enough they arrived at the said time and we went to a local park to do the interview, it was too noisy at our place with all the birds LOL - a link to the interview is below.

Soon after Seven phoned two local radio stations called as did one from Brisbane to do brief interviews over the phone. Then Channel Nine phoned but because we had committed to Channel Seven they lost interest....LOL. However, Channel Nine did do an interview with me later in the year which was excellent and a link to that is below.

As I said, the day was crazy but one thing it did for me was reignite a belief in myself to tell my story and to promote and advocate for something that until the time of my heart attack I was not aware of:

THAT DIABETICS MAY NOT NECESSARILY HAVE THE CLASSIC WARNING SIGNS WHEN HAVING A HEART ATTACK!!! 

This is what happened to me and if it wasn't for Evelyn calling the paramedics when she did, I would not be here today typing this blog, and that's a fact!!!

It would be fair to say that the newspaper, radio and television interviews and one I did later in the year for arguably Australia's largest selling magazine New Idea, helped me pick myself up decide to do something with what had happened to me and spread the message about diabetics and heart attacks and I guess that is the essence of this post - I stumbled around for close to a year going through the motions of life but not really caring all that much and being a bit of a 'shit' to my wife and possibly others but then we this sort of reawakening, a new direction for me to take appeared and I have been running with that ever since as I will talk about at a later time. Suffice to say, it got me motivated to promote wherever and whenever this message and here are a couple of bumper stickers I created to help me do this.

This is the Channel Seven Today Tonight interview:

The next morning I was at Channel Seven local studio doing a short interview for their Morning Show, was nice being on national TV for my 55th birthday :-).

In October 2008, Channel Seven did a second interview with me for Today Tonight that dealt with the question of NDE - Near Death Experience. I felt this was a bit more of a sensationalist interview but really did not know what I was getting myself into when I was approached, actually had thought I would be able to use the opportunity to share my experience of having a heart attack without any real warning signs.

The interview I did in November 2008 with Margueritte Rossi for Channel Nine's Extra programme went very well and I was able to get the message out about diabetes during the interview. Having Dr Rahman involved with the interview was very important and he also underscored the message about diabetics sometimes not having any of the classic signs when having a heart attack. Here is the channel Nine interview that went to air under the title "29 Lives":

Channel Nine interview - "29 Lives''

Just as finding it rewarding to help Evelyn with her wildlife rescue birds and becoming comfortable and enjoying doing this myself and then rediscovering photography helped me deal with my recovery process after my heart attack I need to stress it was being asked to give interviews about what I had been through that really helped me get my head together. Finding out and understanding the significance of not having any real symptoms when I had my heart attack became the motivation I needed to get me 'out there' to spread this information and no doubt spurred me on into taking and creating opportunities to talk about this. I will talk more about this in a separate post.

Why this blog? Because I did not have the classic warning signs!

A chief motivating factor for this blog has been wanting to share my experiences before and after my heart attack and importantly the fact that I did not have any of the classic warning signs and later found out that this is not uncommon for diabetics (and other groups in the community). As a T2 diabetic I was not aware of this and it is this message I am keen to share and will be doing so time and again in this blog.

A second motivating factor for starting this blog was and is to share information about cardiovascular disease and diabetes and developments regarding these as well as the ongoing impact these two diseases have on my day to day living. There is hardly a day that goes by when new information/research is not being released about heart disease and diabetes and I will be reposting/sharing links to some of these as I see relevant.

In 2008 I started a blog called After a Heart Attack - http://aftermyheartattack.blogspot.com.au/ - but never really went on with it. However, in the six years since then, things have changed and the desire to start over has come about in view of things I have gone through since my heart attack and areas of volunteering I became involved in since my last failed attempt at writing a blog.

Actually, directly as a result of my becoming involved in giving talks at our local cardiac rehab unit and having been told on a number of occasions that I should consider writing a book about my recovery I decided to try again with this blog thing.

As to a book, well, in 2010 I did in fact look at this and even met with a professional 'ghost' writer. We went over a number of scenarios and I even prepared a list of topics to be covered but, as is the case in many new ventures, money was the sticking point and I simply could not afford taking on someone to write of my experiences before and after my heart attack.

The idea of writing a book never really left me, finding the motivation and commitment to actually
doing it has been the sticking point and I say this honestly as having the time to actually do so has never been an issue.

Probably what keeps me thinking about this book idea is the feedback I get from people I speak to after I give one of my talks at our local cardiac rehab unit - the same place I went to after my heart attack in 2007. It is those present who many times have said that what I have spoken about has helped put into context what they are feeling emotionally and physically 4-6 weeks after they have had their heart event.

Although the format over the years has changed, I still give these presentations seven years after my heart attack and surgery and six years after giving my first presentation and to be honest, these sessions are as important to me as I have been told they are to those I am speaking to. Even today, as I say seven years after my heart attack, this experience is cathartic for me and I will cover reasons for this in a later post.

Here is a You Tube presentation I prepared after one of my talks a few years ago which will illustrate some of the material I cover in one of my cardiac rehab talks.

Cardiac Rehab talk on You Tube

Whilst the idea of a book is still there my thinking over recent days/weeks has been to maybe put down what I want to cover in a blog and see where it goes from there. After all, I have the topics for the book already detailed, so how hard can it be to use this as a guideline to put down my thoughts based on these topics here in a blog?

Another motivating factor for starting this blog now is to keep me 'focused' as my wife gets ready to undergo surgery in the coming weeks having recently been diagnosed with the BRCA1 gene mutation. In nine days she will undergo an oophorectomy (surgical removal of one or both ovaries) and two weeks later, a bilateral mastectomy.

My Heart Attack - July 15, 2007

No better way to start this blog than with photos taken the night after my heart attack after three stents have been inserted through my groin and before I was sent up to Brisbane to have bypass surgery - in those days this procedure was not done at the Gold Coast hospital where I live. Did I mention I had turned 54 the previous month.

Looking at these photos, you wouldn't think that just over 24 hours earlier I was struggling to live dealing with a number of cardiac arrests, 29 cardioversions/resuscitation - hence the name of this blog, My 29 Lives.

And did I mention the night of my heart attack on July 15, 2007 I gave up smoking? At the time I was smoking 40-50 cigarettes a day and had been smoking for 33 years and have not had one since.

I should add that the night of my heart attack I did not have the classic warning signs or symptoms and later found out that this is not uncommon for diabetics - I am T2.

Not for the squeamish - photo of my groin through which they accessed the blocked right coronary artery to insert three stents. I can tell you, a few days later this whole area was black and blue. After the procedure they strapped a sand brick over the groin and told me to lie still for four hours to minimize the chance of a hematoma. Due to complications, I had to stay flat on my back for eight hours in total before I was allowed out of bed.

You can clearly see the markings on my chest where they placed the defib pads to 'shock' me 29 times. Those marks were almost like tattoos and were still visible well over a month after my heart attack.

Following are two pics taken three days later and the pad marks are clear.

And here is my groin three days later, it took well over a month for this to completely disappear.

Following is a copy of the medical report prepared the day after my heart attack for the hospital where I was being sent to have bypass surgery. The report details what I presented with, what treatment was given to me at Gold Coast hospital and the comment that I would benefit from bypass surgery - better than the alternative I would think!

The following report was written after my triple bypass surgery which took place at Princess Alexandra hospital in Brisbane five days later after my heart attack. As noted in the report, when the aorta was declamped I had another episode of ventricular fibrillation which required cardioversion.

With the above as a starting point, this blog will trace the journey I then embarked upon which so far still has me going some seven years later.