Lessons learned

Although heart disease is often thought of as a problem for men, more women than men die of heart disease each year. One challenge is that the heart disease symptoms in women can be different from symptoms in men.

So says an article on the Mayo Clinic website. Reading these sentences once again reminds me that, ugh, I have a heart condition. I guess I've had one for a long time but didn't know it.

I can also look back at the past few months and realize, yes, there were signs. However, they were subtle.

After leaving my job at Walnut Creek Patch in June, I decided to refocus on exercising daily, close to the first thing in the morning, and to get back into running. Through June, July and August, things were going fine with the working out I was getting into my gym a couple times a week to do weights, or hitting a Body Power class. I was getting out early in the morning to run. For me, exercise is the best anti-depressant and mood stabilizer in the world.  Getting my heart rate up, getting those endorphins flowing through my body always leaves me feeling strong, energetic, optimistic, capable.

Then, something with my endurance and motivated shifted, so subtly I was not thinking anything was wrong.

I'd go out and start running, then poop out after going just a few blocks..  A thought would pop up and I'd say, "you don't want to really do this, do you?" And, I would stop and walk.  I couldn't even complete for me what had been short, basic routes.

Walking up hills also became a new challenge, as did ascending flights of stairs. When I reached the top, I'd feel what could be described as shortness of breath. But again, it was all subtle. I'd wonder, "Hmm, what's that about? That's a little different." As for the running, I thought, oh, I'm just being a little lazy, or I'm just going through a phase. ... I'm bored with running. ... I need something to re-spark my enthusiasm. New running shoes?

It didn't occur to me to go see my doctor. I had just had a physical over the summer, and everything checked out OK. My heart rate and blood pressure were fine. I could see myself going in and describing my very vague inability to run like I had been until recently. It just didn't seem there was anything for my doctor to latch onto. There wasn't anything I could really wrap my head around.

Actually, a few years ago, I did a story for Diablo magazine on the Women's Heart Program at John Muir's Women's Health Center. For the story, I underwent their cardiovascular health screening program. It involved a series of tests, including the treadmill test, to assess my heart's health. I passed with flying colors. But then, sometime after that, I passed out at my gym after a work-out. One minute I was standing by the magazine rack. The next minute, I was lying on the floor, with the fitness director hovered worriedly over me. Maybe that collapse was my irregular heartbeat acting up. I went to see the doctor about it, and she did the usual tests. Everything checked out fine.

My recent shortness of breath, I now realize, was accompanied by a slight sense of the gray-green aura that came on me pretty strong when my heart stopped and I lost consciousness on Sunday.

What's concerning is that it still might have been hard for the medical staff to pin down that I had this  irregular heartbeat or that my heart was  stopping had they not been there to witness my episodes and to record it on their monitors.

As soon as I arrived in the emergency room on Sunday at about 12:30 p.m., a half hour after my first fainting spell, a triage nurse brought me into an examination room to check me out.  My blood pressure was normal, and so was my heart rate. An EKG administered a short time later also showed nothing unusual. Blood tests showed I was anemic, which led to speculation that my low hemoglobin levels were somehow connected to my fainting.

But then I passed out six more times in the hospital, and the staff could see exactly what was happening. It was right there on their monitors. The diagnosis came quickly: Sick Sinus Syndrome.

The U.S. National Library of Medicine defines this syndrome as a collection of heart rhythm disorders. They include "sinus bradycardia," which is a slow heart rate from the natural pacemaker of the heart.

That was me. I had sinus bradycardia, though mine apparently was intermittent, with my heart race slowing in sudden, unexpected ways. The cardiologist's recommended treatment was to implant a pacemaker, and to do it as soon as possible.

He scheduled the surgery for Monday morning at 7:30 a.m. Actually, "surgery" makes the procedure I underwent sound more dramatic and invasive than it was. The procedure was very "outpatient" in that I was not put under general anasthesia. I was just given some local anasthetic. I was awake as the doctor made a small cut in my chest, just above my left breast, and threaded a lead into a vein reaching to my heart. The lead is connected to the coin-sized generator--the pacemaker-- that he slipped into a pocket of my skin.

Several hours later, I was in my hospital room, walking around, and feeling a little soreness in my upper left arm and chest. Other than that, I felt fine.

It's Tuesday at 12:30, nearly 30 hours after that operation. The cardiologist and internist have been by, and my vitals looked good and my pacemaker seems to be working just fine. I should go home soon, once all the paperwork is completed.

Now I think, though, that I was one of those women who sense that something isn't quite right with their bodies. But the symptoms are vague, indistinct and easy to dismiss. So I don't go see a doctor about it, and I don't take it seriously myself.

The challenge of diagnosing heart problems in women in well known, especially when it comes to heart attacks. Just to be clear, my arrhythmia-induced cardiac "standstill" is not the same as a heart attack. I did not have a heart attack, as blood tests showed.  Except for this issue with my heart's electrical circuitry, my heart is apparently in good shape, which may be why this issue went undetected for so long

A lesson I learned from this whole experience that I need to listen more to my body and trust my sense of things not being right.  That's a message that can apply to everyone, but of course especially to women when it comes to dealing with heart health.

When it comes to heart attacks, many women don't have chest pain, the classic symptom often found in men. Again, I didn't have a heart attack but I had two of the below listed symptoms that indicated something was amiss: the shortness of breath, and the unusual fatigue when I exercised.

"Women commonly have symptoms of shortness of breath, unexplained fatigue, or pressure in the lower chest, so they easily mistake it as a stomach ailment," said Nieca Goldberg, MD, a cardiologist and chief of Women's Cardiac Care at Lenox Hill Hospital in New York City, in an interview with WebMD. 

The WebMD article cited a study in the journal Circulation listing the common female heart attack symptoms.

• Shortness of breath
• Weakness
• Unusual fatigue
• Nausea
• Dizziness
• Lower chest discomfort
• Upper abdominal pressure or discomfort that may feel like indigestion
• Back pain