WILL YOU BE JOINING US?

Her name was Mary Jean and she leaned over to talk to me as I waited for my first rehab orientation on Monday. "Will you be joining us?" she said.

"Yes," I said. "I had a heart attack last Sunday, and I left the hospital on Wednesday."

"Oh," she said, and paused. I didn't wait for her to ask what I guessed was coming.

"I'm 37," I volunteered. But she didn't say I was too young to have a heart attack, or even act that shocked or surprised. She told me that she was 86, had had bypass surgery and now had a new valve and a pacemaker. And then she said, "You'll like it here. The people are very nice."

They are, and I do like it. Even though the effort is light, it is exercise and movement and it feels good. I'm supervised, monitored, checked, re-checked, and scored. Someone tells me what to do, when, for how long, and at what intensity. Perfect.

We work out in a class (I'm in the MWF 3 p.m. group) and everyone knows each other; they've been together for weeks. They are all at least two decades older than me. Three men and one other woman.

Today was my second day. While we were on the recumbent bikes, Patrick (who had bypass 9 weeks ago), leaned over and said, "You were cruisin' pretty good there on the treadmill," and I shrugged and smiled.

"Well, I was a runner until about a week ago," I said. (At this point the physiologist/trainer monitoring the screens with all our heart rates on it piped up "and you will be again!" Love her.)

"You didn't have heart surgery did you?" Patrick asked.

"Yes, I had a heart attack and now I have a stent."

"But you're too young!"

"Yep, I'm a poster child for it can happen to anyone," I said with a smile, my new stock response for the shocked. Obviously and unfortunately I am not too young and neither are the many others like me. I saw this fact on a poster in the heart clinic: "62% of all people living with heart disease are under 65."

A few minutes later Patrick asked me if my symptoms were indeed different because I'm a woman and I ended up telling the story to the whole group. That the pain started Friday (maybe even Thursday) and I took Advil and explained it away for two days. That it hurt in my back, between my shoulder blades and spread to both arms and shoulders, even my hands (had it been the left arm only, things may have moved faster). That it took nearly 10 hours to diagnose even at the hospital, because every test -- EKG, CT, X-ray, echocardiogram -- came back normal. The only signs were the blood enzyme test (and overtraining was even discussed as a culprit there), the pain, and my family history.

I don't mind telling the story and I hope people share it so that other women listen to their bodies and advocate for quick, accurate diagnosis and treatment. I would like to imagine the trainers telling their friends, or my fellow patients telling their daughters, so that if a woman they know has a heart attack, she too will be joining us at rehab.

We're very nice, and she will like it.

HOW ARE YOU FEELING?

A simple question, really. But it has taken me three days to try to answer it.

The question came in a one-line email from a friend I haven't seen since I was a teenager. It also came at a time when I was feeling, well, miserable. So I didn't answer. (Sorry!)

Here's the weird thing: I really feel fine. Except for some psychosomatic pains, especially when I tell someone the story, my body feels just fine. But one day after getting home from the hospital, my mental and emotional state were . . . not.

I'm told the cardiologist who did the second angiogram spoke to me at length following the procedure. I retained nothing from that conversation since I can't even conjure up his face. Fortunately, he also talked to my husband, Scott.

Scott relayed to me that nearly the first thing out of the doctor's mouth was to watch for depression and that it was common in heart attack survivors. It's a funny thing about depression: just when I should feel happiest (I'm alive, I'm going to recover, my children are here, I'm not in the hospital), I'm the weepiest.

And the dingiest too (is that even a word?). I burned things in the oven. We didn't eat dinner til 8 p.m. or put the kids to bed til almost 10. Bought groceries one meal at a time. Went the wrong way repeatedly when driving to a store I've been going to for almost 20 years. (Scott insisted I be supervised on my walks and errands - thank you to Christine for coming along for the tour of Roseville.)

At first I thought it was shock, and it probably was. And then the crying started.

But here's the other thing about depression, at least for me. As soon as I said the word aloud, and started talking to Scott, Christine, and my mom about it, I started to feel better. And after one of my 30-minute walks on Saturday (on the treadmill, just a little faster this time, actually broke a sweat), I felt more like myself than I had in a week. And by Sunday I visited friends, worked on my almost-four-year-old's birthday party, indulged in a little retail therapy, researched heart disease online, and, with Scott's help, made a super-healthy lunch and dinner on time. I'm humbled and in awe of the body and soul's ability to recover and of the power of people, prayer, friendship, and love.

So, today I'm feeling just fine, thank you. I can't wait for rehab this afternoon. I have this little daydream that they let me break into a run. I think that's just what I need.

I HAD A HEART ATTACK. FOR REAL.



With my niece Lauren, two days before.

Yes, you read that right. I'm 37, a woman, a marathon runner, a healthy cook. I'm in shape with a normal BMI, an active, healthy, young(ish) mom of two. I'm not even stressed out (any more).

And I had a heart attack on Saturday night, late, maybe Sunday morning. It's hard to tell, since it wasn't diagnosed until I was in the operating room. Everyone I know wants to know why.

Me too.

Except I do kind of know: Genetics trumps all. I have a family history of high cholesterol and heart disease, and I've known about my high numbers for 10 years. But, I've been haphazard about treating it, mostly because cholesterol drugs and having babies don't mix and having a family was more important to me. Well, being haphazard is no longer an option.

I also know some other things that I ignored. That heart disease is the number one killer of women. That women often explain away their symptoms: "I must have lifted something funny, hurt myself in yoga, maybe its heartburn," all excuses I used Friday and Saturday when the pain started, even Saturday night as I whimpered through piercing back pain and took eight Advil in the span of nine hours. That women's heart attacks present differently and seem somehow, inexplicably, hard for doctors to spot.

So what happened is this - I started to hurt in my middle back (between shoulder blades) on Friday. I took Advil and used one of the aforementioned excuses. Saturday it still hurt, took Advil some more and the pain came and went. Saturday night I went to bed at midnight and that's when the real pain began. I was sure it was reflux and propped myself up on the couch and suffered. Took handfuls of Advil and dulled the pain enough to sleep. In the morning I sat up and promptly broke into a sweat. Then I knew something was really wrong.

So I  . . . ate breakfast, took a shower, and drove myself to the ER. Sunday was camp drop-off day for my older son, so my husband stayed back in case I didn't make it home in time. I didn't.

After five hours in the ER, the only test that indicated anything was for an enzyme your heart secretes when it is injured or in trauma. EKG=normal, chest x-ray=normal, CT scan = normal. Until the blood test came back, the doctor was about to send me home with Percoset for straining my back. Wow.

I was admitted and brought to a regular hospital wing. Saw a cardiologist who actually said with a straight face "I don't think your back is involved with this," until a nurse took him aside to listen serious about my pain descriptions and the second enzyme test came back even higher. Then things happened pretty quickly.

I was moved to the ICU and prepped for an angiogram. They found total blockage in one artery and installed a stent. There is some early-stage blockage in the other arteries as well.

Back in the ICU the pain did not subside, so I was in for a second angiogram within two hours. The stent was fine, all was as expected, so it became just about trying to manage the pain, which neither morphine nor Percoset would dent.

In the cardiac ward, two
days after.

But, by 7 a.m. Monday the pain was gone and I slept all day (well, as much as you sleep in an ICU where the blood pressure cuff goes off every 15 minutes). By Monday night I was in the cardiac ward, and Tuesday in cardiac rehab with five old guys in hospital gowns walking up steps with a heart monitor. I'm sure it was an interesting sight.

I was discharged Wednesday with five new prescriptions and 4-12 weeks of cardiac rehab ahead of me. It is unlikely there's a marathon in my near future.

But, there is good news. The cardiologist we saw thinks my heart may actually completely heal, and that I should be stronger and healthier in the future, and as my brother worries, probably faster. (If you were running on 2/3 of your oxygen, you'd be slow too!) I'll be running again for sure. I'm out to prove something now. I also know that I will  be alive to raise my sons and grow old with my husband.

So here's the bottom line, my friends, and listen up: Exercise (alot), eat right (mostly plants), and don't ignore your body. If you need meds, take them. See a doctor. Have a plan.

For real.