When I opened my eyes, from a predominantly sleepless night, on the morning of April 14th, my head was throbbing. I had been on a nitro drip all night to ensure a strong supply of blood and oxygen to my heart. One rather painful side effect is a pretty violent headache. There were also about 12 people crammed into my little room - a new doctor (we'll call him Dr. W) along with a few cardiac nurses, some residents, two med students, a pharmacist and a nutritionist. I immediately felt mildly amused, perhaps a little bit like a spectacle or circus freak. In all fairness, it's not every day, week, or month that a post-partum female in her 20s enjoys a stay in the cardiac intensive care unit.
The group had plenty of questions (here's a small sample) -
- Do you drink/smoke/take drugs? NO
- Do you have a history of high blood pressure/high cholesterol/diabetes? NO
- What about family history? NO (My grandpa did have some stents in his 70s)
- Do you have marfan syndrome or any other connective tissue disorder? NO
- Do you have lupus or any other auto immune disorder? NO
That first day was pretty surreal - doctors in and out, nurses drawing tons of blood to test me for everything under the sun, and lots of overwhelming emotions. In the afternoon, a nurse, Amy, from the Cardiac Rehabilitation program came to visit. As everyone did, she asked how my baby was. This, obviously, started the water works. Cameron was only nine days old and I hadn't seen him in 24 hours. That's a long time when you're with someone every minute of every day! And since you really aren't allowed to bring babies to the hospital, I wasn't going to get to see him until I could go home. When I calmed down a bit, Amy handed me a packet entitled "A guide to heart healthy living". She provided a summary of what I would find and how it would help me adjust to my new reality. "Since you've had a heart attack, you're at a higher risk for a second heart attack and a stroke." And I replied "Oh, I didn't have a heart attack yesterday, I had a dissection in my artery." I suppose I hadn't given much thought to heart attacks ever and assumed a heart attack was when your heart stopped momentarily. WRONG. Amy paused for a moment and opened the packet to show me the section on heart attacks. The dissection in my artery had a caused 100% blockage in my LAD, depriving the bottom portion of my heart of oxygen. When the heart is deprived of oxygen, the cells begin to die - and THAT is a heart attack. This new bit of information hit me like a tidal wave. Old men have heart attacks. So do obese people. Not young healthy women. Not me. But sitting in the CICU, I began to realize otherwise. She gave me the packet to look over, along with her contact information, and left me mulling over the new information.
The good news was that I was stable less that 24 hours after the episode and could be taken off the nitro. My vital signs were good - indicative of a healthy response to the medications I'd been started on. Medications that my 89 year old grandpa takes as well- Blood thinners, ACE inhibitors, beta blockers, and anti-coagulates.
I was also visited by a lactation consultant (no more breastfeeding), a nutritionist (new heart healthy diet = low fat, low sugar, low sodium), and a pharmacist (since I am a walking medicine cabinet now). But all day long, I waited for Dr. Pacheco to come by. He had saved my life....I decided he would have all the answers too. He arrived later in the day, when I was finally allowed to get out of bed. Attached to a portable heart monitor, I was allowed to walk up and down the hallway with supervision. Brian and I walked to a window that overlooked Clayton Road. It had rained and the sky was pink and purpley-blue, dissolving the storm clouds to make room for the sunset. We watched cars drive by and traffic lights change. Funny how the rest of the world had continued to march on, whereas mine felt frozen in place. My mom and the doctor found us there. He explained that things were looking good. I was responding to the medication, I wasn't having chest pain, and the incision site from my cath procedure was healing nicely. The research that my team had done indicated that I would be able to get back to close to normal. I would have to participate in cardiac rehab and adjust my diet to prevent future heart problems, but if I wanted too, I'd be able to train for and run in a marathon. AND, he let me sneak Cameron in for 30 minutes!!!
Almost all good news....
...... Unfortunately, there's always a "but". The research also indicated that the high levels of hormones produced during my pregnancy was the likely catalyst to my heart attack. Brian was much braver than me - he found the courage to ask the doctor something I could not spit out: "What are the chances this could happen again?" The answer: "I can't say for sure. You must understand that the reported cases of SCAD are autopsies. There are very few scenarios with survivors available to us. But.... but if it were my family - if it were my wife - we would not get pregnant again." There was my "but."
Talk about overwhelming. I know I'm lucky - and I do feel that way. I have a beautiful son and survived a rare heart attack. Brian and I can foster and/or adopt our next child when we decide it's time. However, that pesky "but" gets in the way. If I'd known I wouldn't be pregnant again, I would have enjoyed and savored my pregnancy so much more. I wouldn't have wished it away at the end when the swelling became intolerable and I was peeing every chance I got and everything was sore. Never had it occured to me that Cameron would be our only biological child. I figured he'd have a little mischief maker sister or brother to pal around with, who shared his same features. I had pictured a future Rachel with another humongous bump, toting Cameron on one hip. It won't happen. And this part feels incredibly unfair, no matter how lucky/blessed/fortunate I feel. Outside of my heart attack, we are healthy people. We could make a healthy child, maybe with Brian's eyes and my lips. And then I remember - I HAVE a healthy, beautiful child. And we'll have another that we'll love just as much, even if he or she isn't a genetic part of us. But it is still hard. And I suppose it will continue to be hard, until one day it fades away and isn't hard anymore.
For some reason, I'm still here. I think maybe for Cameron to have a mama and for Brian and I to grow old and wrinkly together. And I'm sure for a whole host of other things I have yet to find out- and will share in this blog when I do. Thank you for sharing this journey with me. At the risk of sounding super corny, do me a favor - take a minute today and really appreciate who you have in your life - and TELL THEM. Trust me. Circumstances change in the blink of an eye. Don't wait.....