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    Posted June 30, 2014 by
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    First Person: Your essays

    I Had a Heart Attack at 31

    I had an early heat attack. I was 31, and my first symptoms were Christmas night after a big meal. I had anginal symptoms (the feeling of an elephant sitting on my chest) alone for several nights running, then a full-blown heart attack.

    My then-partner recognized my symptoms from her mother's recent attack and got me to Emerg right away, where I was effectively triaged, but then a resident emphatically stated that I was "the wrong age and gender for a heart attack" and said that I was being sent home. I remember lying on the cot unable to form words through the pain to say, "I beg you to keep me," but 3 Tylenol-3s were shoved into a tiny paper bag and I was discharged, leaning heavily on my partner for help walking.

    I don't remember getting home, but I remember how hard it was to climb the stairs where, in bed, I had another approx 12 hours of symptoms. In the morning I stumbled downstairs through the fog of agony to vomit, and for some reason, the attack ended. My partner had already called an on-call doc, who attended me and was extremely unfriendly, insisting that I come up with a rationale for being in bed when the pain had ended. He told me I was lazy. He said to get up. He diagnosed esophagitis, and for about a month, while I had episodes of fairly severe angina day and night, especially on exertion (climbing stairs! lifting kids!), I took Gaviscon, which fixed nothing. Then my GP got my hospital results back and noticed something a small bit awry in my ECG and sent me to a stat cardiology appointment, where my "old infarct" was diagnosed, along with all the consequent heart damage I'd suffered.

    Consequent to this, I had significantly restricted mobility and multiple anginal attacks (I'd guess I’ve had well over 100,000, all told—that many sprays of nitroglycerin, that long on heavy cardiac drugs). About ten years in, I started getting peripheral edema, a sign of heart failure, which continued sliding downhill for another 15 or so years, first stopping me from doing the small amount of dancing (.5 of a song!) I had been able to manage, then stopping me from lifing cameras during photography sessions. 25 years in, after another major stress, the heart failure worsened precipitously, and the angina destablized, and I had a second, this time massive, heart attack, with more damage to my heart muscle. It was hard to decipher this particular November night as different from the months of unstable and severe nighttime angina--it was precisely the same pain as I’d been having nightly for months: crushing diffuse chest pain, upper back pain, jaw pain. When it started, it was already crescendo angina. For months I’d been able to stop the angina within 20 or 25 minutes for maybe a half hour before it started back up (and repeat all night till 7 am), but on this night, I couldn’t. I also had stabbing left arm pain. I had a friend drive me to the ER with paperwork so they wouldn’t question my age or gender. I had emergency stenting and, a month later, open heart surgery. Because of the damage to my heart, I have considerable daily heart failure, along with unresolved ischemic attacks.

    I consider myself to be extremely fortunate, given what could have happened. Originally, I was told to go home and arrange my affairs, and was given about a year to live. I've lived 29 years since then—albeit with the same diagnosis hounding my heels. (Certainly if I'd known I was going to survive, I would have done absolutely everything differently, and would have studied wildlife biology or primatology, but instead I lived with a guillotine poised over my neck that deleteriously affected everything. My children [and presumably my partners] suffered greatly because of my disability, and because of the continuing threat to my life.)

    On the plus side, I have definitely learned happiness. I am quite often made incandescent by what to others might be ridiculously small pleasures (flowers, for instance), and people are continually saying they don’t understand how I can have such a full life, and such a good outlook, when I am so keenly threatened. But this I understand—soon I will be dead. Soon you will be dead, too, whether you’re 20 or 80, but if you’re like most people, that doesn’t sink in very far.

    What is the lesson from this?

    I can say with assurance that even now, even nearly 30 years since my first heart attack, sexism is alive and well in cardiology. My care and symptom management has been grossly affected by my gender, up to and including during my most recent interactions with the medical system. As a woman, you need to realize that you may not get the care a man would be unhesitatingly offered. Plan to agitate for yourself. Talk to your partner about agitating for you. Be the squeaky wheel. Get the grease you deserve. The medical profession is awash with unexamined prejudices, and practitioners are overworked and distracted. No one will care like your loved ones care, so plan to enlist them as your advocates no matter what disease with which you're burdened.

    And most importantly—women's heart attacks can be marked not by the typical squeezing pain I had, but even sometimes by nausea alone. Listen to your body and seek swift help. Young women can and do have heart attacks.

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