Seeking My Best Self

trying to make sense of my life – and lose some weight

Learning to Call it Life

broken heartIn my last post, I talked about my recent heart episode: Takotsubo cardiomyopathy, a misshaping of the heart that causes symptoms similar to an infarction. Also known as broken heart syndrome and stress cardiomyopathy, it’s caused by…stress. High stress. High stress with a kicker event. That’s what happened to me.

I’ve mostly recovered physically. I’m still working on lowering my activity levels. During the month I spent convalescing, my ridiculous, overloaded schedule was spread out amongst (many) others. Recently, I’ve noticed the load shifting my way again. It’s partly my fault, as I’ve actively taken things back. It’s partly not my fault, as others send their work my way.

Actually, that’s incorrect. Truth is, it’s ALL my fault, both the items I’ve reached for AND the items that are handed to me. It’s my responsibility to say ‘no’ – both to others and to myself.

That’s not easy. It seems there are too many tasks and too little time in this busy world. Shouldn’t everyone, myself included, just buck up and take on a little more? The answer is NO. If we have too much to do and too few hands, then some tasks just shouldn’t get done.

Heresy! Blasphemy! Horror! That’s not the American way. We’ve built our country on hard work and a willingness to attempt the impossible. But our can-do American spirit has gone awry. We’ve moved from stepping up for a brief time to get a job done to viewing an impossible-to-maintain-pace as the norm. We’ve become a society that runs on cortisol, to the detriment of our bodies and minds.

The average American works 137 more hours per year than Japanese workers, 260 more than British workers, and 499 more hours than French workers. Every European country mandates a minimum of 20 paid vacation days every year; we are the only country that has no mandated vacation. Our breakneck clip isn’t the norm: it’s grossly abnormal compared to the rest of the world.

So I’m learning to pay attention to my pace. I’m learning that a time of increased effort must be followed by a longer time of leisure. For every hour of activity (work or play), I must allocate an hour of inactivity. Reading. A movie. A leisurely stroll. Playing on the floor with my dog. Something that requires no goal, no measuring stick, no reward for doing it faster. Some may call this sloth. I’m learning to call it life.

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Takotsubo Cardiomyopathy – WHAT?

takotsuboRight after my last post, I suffered an episode of Broken Heart Syndrome. It’s not an emotional condition, but a physical one that mimics a heart attack. I had crushing chest pain radiating into my left arm, plus excruciating pain in my right jaw that was as painful as my chest. (When I went to the hospital, I discovered that right jaw pain is common enough to be a check-the-box item on the ER heart attack list.)

The official name is Takotsubo cardiomyopathy. The cause is not infarction, but a bulging of the left ventricular apex with hypercontraction of the left ventricle. This causes a misshaping of the heart that resembles an octopus trap, called ‘tako tsubo’ in Japan, where the condition was first noted.

The cause is not definitively known, but it’s usually a one-time occurrence in response to acute stress. It’s hypothesized that a large jolt of adrenaline in resonse to a highly stressful event stuns or shocks the heart. It’s most common in post-menopausal women (over 90% of the cases, in fact) whose heart protective levels of estrogen have waned.

The good news is that there is rarely heart damage as a result of the episode, and recovery is usually 100% after a few weeks recuperation.

The bad news is, medical personnel are unfamiliar with the condition. Why? Perhaps because it affects women. Perhaps because it affects OLD women. Perhaps because it was first diagnosed in the 1990’s, and doctors haven’t kept up with new medicine.

The ER doctor rolled her eyes when I asked if takotsubo cardiomyopathy was a possible diagnosis. (Bryan first suggested it. It was part of his medical training in the Army, because front-line troops are a large part of the other 10% who suffer an episode.) She clearly had never heard of it.

Plus, she was offended that I was taking an active voice in my own care. I run into that a lot.┬áIn the 1990’s, a nurse injected me – over my objections – with a substance to which I am deathly allergic. Afterward, I refused to pay any part of the hospital bill, including the very costly resuscitation. Not surprisingly, they were more than happy to acquiese, once I told them I wouldn’t sue if they did.

Back to the present. The doctor’s ignorance affected my care, because once it was determined that I hadn’t suffered an infarction (even thought I’d clearly suffered SOME type of heart event) she sent me home. It took almost 3 weeks for the cardiologist to work me into his busy schedule, by which time, according to the Mayo Clinic and other sources, most symptoms would have vanished (they had) and the heart returned to its normal shape.

I can’t help thinking that if I had been male, they would have found an earlier appointment. The cardiologist never even suggested takotsubo cardiomyopathy as a possibility. It was only after I brought it up that he ordered tests – which, I pointed out, would likely be inconclusive more than a month after the fact. Indeed. It wound up being a diagnosis of exclusion rather than a prognosis based on evidence.

Rant over about the poor state of medical care in America. (But we can’t have SOCIALIZED medicine. Because people might have to wait.) Rant truly over now. The moral of this story is: take an ACTIVE role in your health care. Don’t depend solely upon medical personnel. They are not all-knowing. They can and will miss important things about YOUR health.

But definitive diagnosis vs. diagnosis by elimination isn’t the point. The point is, what am I going to do about the ridiculous stress levels that led to the event? Stay tuned. I’ll talk about that in my next post.

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