Category Archives: Heart Attack

What Happens During a Heart Attack?

Posted on by MaryO

This video shows what happens to the body when someone has a heart attack.

Early Detection, Treatment Needed To Reduce Risk Of Death, Cardiovascular Disease In Cushing’s Disease Patients

Posted on by MaryO

Possible double whammy?

 

Even after successful treatment, patients with Cushing’s disease who were older when diagnosed or had prolonged exposure to excess cortisol face a greater risk of dying or developing cardiovascular disease, according to a recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

Cushing’s disease is a rare condition where the body is exposed to excess cortisol – a stress hormone produced in the adrenal gland – for long periods of time.

Researchers have long known that patients who have Cushing’s disease are at greater risk of developing and dying from cardiovascular disease than the average person. This study examined whether the risk could be eliminated or reduced when the disease is controlled. Researchers found that these risk factors remained long after patients were exposed to excess cortisol.

“The longer patients with Cushing’s disease are exposed to excess cortisol and the older they are when diagnosed, the more likely they are to experience these challenges,” said Eliza B. Geer, MD, of Mount Sinai Medical Center and lead author of the study. “The findings demonstrate just how critical it is for Cushing’s disease to be diagnosed and treated quickly. Patients also need long-term follow-up care to help them achieve good outcomes.”

The study found cured Cushing’s disease patients who had depression when they started to experience symptoms of the disease had an elevated risk of mortality and cardiovascular disease. Men were more at risk than women, a trend that may be explained by a lack of follow-up care, according to the study. In addition, patients who had both Cushing’s syndrome and diabetes were more likely to develop cardiovascular disease.

The study examined one of the largest cohorts of Cushing’s disease patients operated on by a single surgeon. The researchers retrospectively reviewed charts for 346 Cushing’s disease patients who were treated between 1980 and 2011. Researchers estimated the duration of exposure to excess cortisol by calculating how long symptoms lasted before the patient went into remission. The patients who were studied had an average exposure period of 40 months.

The findings may have implications for people who take steroid medications, Geer said. People treated with high doses of steroid medications such as prednisone, hydrocortisone or dexamethasone are exposed to high levels of cortisol and may experience similar conditions as Cushing’s disease patients.

“While steroid medications are useful for treating patients with a variety of conditions, the data suggests health care providers need to be aware that older patients or those who take steroid medications for long periods could be facing higher risk,” Geer said. “These patients should be monitored carefully while more study is done in this area.”

From http://www.medicalnewstoday.com/releases/256284.php

 

Recipe: Low-Sodium Chicken Piccata

Posted on by MaryO

Adapted from The DASH Diet Action Plan: Proven to Boost Weight Loss and Improve Health (A DASH Diet Book)

We had this last night and DH really liked it. I didn’t have all the ingredients on hand and my car is still out of commission so I made a few changes 🙂

Original Recipe:

Chicken Breast, no skin, 16 ounces
Yellow Cornmeal, .5 cup
Lemon pepper 1 tbsp
Low-sodium chicken broth, 1 cup
Olive Oil, 1 tbsp
Lemon Juice, 2 tbsp
Butter, unsalted, 2 tbsp

Directions

Preheat broth over medium heat.
pound chicken breasts to 1/4 inch think.
Mex cornmeal and pepper on a plate and dip chicken in it. Heat oil in large nonstick skillet over medium-high heat add chicken and cook for 4 minutes on each side until brown. Remove from pan and keep warm.
Add lemon juice and hot chicken broth to skillet, scraping the pan. Reduce heat to medium, stir in butter. Return chicken to skillet and cook for 3 minutes until done. Serve immediately.

Serving Size: 4 4oz servings

Number of Servings: 4

Nutritional Info
Servings Per Recipe: 4
Amount Per Serving
Calories: 287
Total Fat: 12 g
Cholesterol: 82 mg
Sodium: 94 mg
Total Carbs: 20 g
Protein 28 g
Potassium: 299 mg

My Version:

Chicken Breast, no skin, 16 ounces, cut into thin slices
Mss. Dash Original, 1 tbsp
Low-sodium chicken broth, 1 cup
Olive Oil, 1 tbsp
Lime Juice, 2 tbsp (note change lemon to lime)
Butter, unsalted, 1 tbsp

Directions

Preheat broth over medium heat.
Heat oil in large nonstick skillet over medium-high heat add lime juice, Mrs. Dash and chicken broth to skillet, scraping the pan. Add chicken and cook for 4 minutes on each side until brown.  Reduce heat to medium, stir in butter.
Serve immediately.

Number of Servings: 6

Posted on by MaryO

Ways to prevent heart problems and more…

What causes a heart attack?

Posted on by MaryO

Health information explaining what causes a heart attack.

Another Not-So-Stellar Monday

Posted on by MaryO

Monday

This Monday, February 18, started off just fine.  The problems started when DH tried to fill out the online forms for the cardiologist.  He tried 4 times.  The form never saved, the continue button didn’t continue, the information was lost each time.

So, we decided to go at 2PM for the 3:30 appointment to allow plenty of time to fill out the forms in the office.

We gathered up a bag of meds, a bag of vitamins, all the medical records and got into the car.  The car wouldn’t start.  The horn, radio and lights worked so it’s probably not the battery.

We called a friend who was unavailable but she called her husband who came and picked us and all our stuff up. We headed out Route 66 and traffic was slow, especially for heading east on a holiday.  There was an accident at the 495 exit so we got off an exit early and went that way.

We got to the appointment at 2:45 – plenty of time.  Except that it turned out that the appointment was in a different office.  DH had made the appointment for the office 10 minutes away from our house and had forgotten.

So…we gathered up all that stuff and called a cab.  The driver got there in about 10 minutes and we got in.  First thing I noticed – the driver had cologne on.  Instant headache for me.

He went a way I wouldn’t have gone, possibly to raise the rate, or not.  We got to the Fair Oaks office – right next to the ER where this adventure started 3 weeks ago – by 3:20PM, early for the appointment.

DH got the forms filled out in record time.

Tomorrow, I deal with my car, after my headache is completely gone.

Monday – 3 Weeks Post-op

Posted on by MaryO

I’ve decided to do a sort of timeline in case anyone is interested.  This is all from memory so future posts should be more accurate.

Week Zero, January 28, 2013 was the actual CABG surgery.  The hospital experience  can be found here.

DH came home on Thursday of that week and the first visiting nurse arrived on Saturday. Luckily, DS was able to stay until Sunday and he was a big help.

DH wasn’t allowed to lift any more than 5 pounds, so couldn’t raise himself out of bed.  He slept on a recliner in the living room and either DS or I slept on the sofa in case he needed any meds or help during the night.

Week One, February 4, 2013, one week from surgery.

The visiting nurse came twice and is pleased with wound healing.  Blood pressure is sometimes low.  The nurse thought he should have more fluids.  One lobe of the lung isn’t working to capacity and she wants more use of the incentive spirometers.  DH has two types from the hospital – the traditional one and one that our dog thinks looks like a dog toy that she should have.

incentive spirometer

Week Two, February 11, 2013 two weeks from surgery.  DH continues to lose weight.  He’s still sleeping in the recliner and I’m still on the sofa but there is much less getting up at night.

The Oxycodone is down to half pills much less often than prescribed.

The first (and only) visit to the surgeon’s office this week.  We saw her nurse practitioner who was very impressed with how DH is doing as was his PCP.  The nurse practitioner was so pleased, she said we don’t have to go back unless there are any problems.

The PCP ran blood tests, glucose, liver enzymes, cholesterol and others.

We saw the visiting nurse twice.  She thought DH was doing so well that she discharged him on Thursday.

DH made a few phone calls this week, worked a little, had a visitor on Sunday.

Week Three, February 18, 2013, three weeks from surgery

DH slept in the bed for half the night last night and seems to be doing ok.  He still took a half Oxycodone this morning.

We see the cardiologist this afternoon.  That report will be in the Week Four post. I imagine that we’ll be talking about rehab at this appointment.

Weeks Four and Beyond will have their own posts.

Icy Days and Mondays…*

Posted on by MaryO

* With apologies to Karen Carpenter!

I know I’m not supposed to “relive” events.  I have done that too often with my Cushing’s and cancer adventures and I’m told that reliving causes nearly as much stress as the original event.

So, I plan to write down my memories here and try to let them go…

It all started on Sunday, January 27, 2013 – our 40th wedding anniversary.  I picked up my mom and went to church so I could sing in the choir.  DH went to a meeting of some sort on Benghazi.

After church, I stopped off in the church office for a goodie bag that the Staff Parish Committee had left.

Dropped my mom off at her house and went home.  I put the goodie bag on the dining room table and logged on to the computer to do some work.  I got a couple text messages from DH:

Text message

I figured I’d take a nap until DH came home for that late brunch.

The next thing I hear was my phone ringing, a call from DH.  He was in the ER at Fair Oaks with a heart attack.  OMG!

I immediately leapt up and rushed out the door.  I called one of my pastors and got to the ER in record time.   When I arrived, he was in a bed, all hooked up to monitors, fluids and such.  He was awake and feeling pretty well thanks to the nitroglycerine they had given him immediately after arrival.

When we had a chance to talk, it turned out that he had been in his conference and realized his chest was getting tight.  He found the hotel’s store and bought aspirin – 3 for $11.00 which he thought was extravagant.  He bought them and took them anyway – and probably saved his life.  On the way home, he was feeling pretty good so he stopped at the mall to buy an anniversary gift.  The salesgirl in Zales didn’t know that ruby was the stone for the 40th anniversary and was kind of ribbing DH for waiting until the last minute to buy a gift.  He walked out of there, felt more tightness and headed to the ER…where he called me.

DH was feeling pretty well thanks to the nitroglycerine and aspirin plus whatever else they had in the IV and wanted to go home.  The staff said no way – he had to stay overnight so he could be monitored.

The “automatic clock” on the wall said it was Monday.  Other rooms said Sunday.  Hmmm

A trainee EMT came in to ask some questions as part of his learning process.  Every time DH mentioned to word “Benghazi”, his blood pressure spiked about 40 points or so.  That term became verboten ever after.

My pastor stopped by and we had some nice chats and prayers.

Time passed, tests were done, doctors and nurses stopped by.  Finally, DH was moved to his room upstairs.

About 9 or so I went home and found our dog huddled by the front door – I had left so quickly I hadn’t left her any lights on.  I imagine she was quite worried.

I can’t even remember what I had to eat for dinner but I really wanted something chocolate.  On a whim, I looked in that goodie bag and there was a double-sized brownie.  I think I ate that in record time and it really hit the spot.

Ice

Monday morning (for real!), I checked the weather and found that school was starting late because of icy conditions.  I put on boots and took the dog out.  It seemed to be raining – if it’s raining, it must be warm, right?  So I didn’t really pay attention (and I had other things on my mind!) and completely missed seeing the black ice.  Next thing I knew, I had fallen on one knee, my cellphone in my pocket bruised my other thigh and my left arm hurt where I’d reached out to catch myself.  Luckily, I hadn’t let go of the dog’s leash.

I ended up sitting in a puddle of icy water for a long time, figuring out how to get up.  I finally sort of crawled up the trash can that was sitting in the driveway.

The dog had an abbreviated walk, I changed my wet, cold clothes and headed to the hospital.  I was showing DH my knee and one of the staff bandaged it up for me.  I told him I hadn’t fallen at the hospital and wouldn’t sue but I guess he wanted to be sure.

(Today, Monday February 18, my knee still has a huge lump under the skin and hurts when I touch it, although I’m no longer limping,  The bruise/pain from cellphone finally went away)

The hospital staff decided DH should go to another hospital which is world renowned for its work with heart cases to have a heart catheterization and possible stent.  DH was ready to walk out to my car to drive him to Fairfax Hospital.  He wasn’t thrilled when he was strapped to a gurney and out to an ambulance instead.

I headed over in my car.  They’d changed the entrances to the hospital since the last time I was there and I couldn’t find the “Grey Entrance”.  Finally, after wandering around for a long time, I found it.

I saw DH in the prep room where they got him ready for the heart catheterization – then they rolled him away after explaining all the things that could go wrong.

I went out to the waiting room, got some coffee and a sandwich and hunkered down with my iPad.

Eventually, my beeper went off and I was called back to the room where DH had been prepped.  The surgeon was there this time.  She said that 3 arteries were nearly 100% blocked and they needed to do emergency triple bypass.  They also needed me to convince DH of this since he was figuring he could tough it out.

I started crying but she said I had to get myself together and convince him NOW.  I had to put on scrubs and off I went to the OR.  I got there, DH was on the table trying to figure out the odds if he didn’t do this surgery.  All the medical staff said that he had  a very low chance of survival without the operation.  He stil wasn’t sure.  He wasn’t afraid to die.  Tough Guy, Yadda Yadda.

One of the nurses asked me if we had any kids.  I said only one, in NYC.  She said I should call him and get him here ASAP.  She even dialed the number.  I talked to DS at work and he agreed to come right away.  He was pretty scared, too.  He later revealed that he had been crying on the train ride.

I went back to the OR, told DH that DS was coming and that he was going to do the surgery.  I signed the paperwork and sent him to a very scary surgery.

It was about 4:30 by then and I needed to take the dog out again.  They said I could go home – surgery wouldn’t be over until about 8:00PM or so. Got home, took the dog, made sure that there were lights on, and headed back to the hospital.  Another pastor from my church called.  He said he’d be by the waiting room later.

Two friends from the church office texted me to say they were coming over to sit with me in the waiting room.  They got there about 6:30 and we decided food might be a good thing.  We headed out, following a variety of directions and signs and walked for a l-o-n-g time.  My knee was killing me.  We got to the cafeteria and found out that it was closed.  the 24-hour one was elsewhere.  We finally found that, got some food and my cellphone rang.  The surgeon would be coming out soon to talk to me.

We hustled back to the waiting room and the surgeon came out about 8:00 with good news.  Successful surgery!  DH wasn’t awake yet but we could see him about 9:00PM.

The pastor arrived about 8:30, then DS got there about 8:45.  Finally, they said we could see DH although he still was asleep.  My friends left, pastor and DS went in to see him in ICU, sleeping so peacefully with so many lines attached.  The pastor prayed, then left.  DS and I decided to stay to see DH awake.

About an hour later, the ICU tech said they were going to keep him asleep overnight so we went home.

Monday

Tuesday, January 29 – DS called the hospital fairly early and found that DH was still a bit agitated so they were keeping him under a bit. I took the dog out and we got ready to head back.

I got a call that he was waking up but agitated.  He kept fighting with the nurses on the day of the week.  He kept saying it was Monday, even though it was Tuesday.  Surprise, surprise.  The calendar on the wall hadn’t been changed.  It still read Monday.  No wonder that’s what he thought!

We stayed all day, though nurses, techs, doctor visits and such.  He was in ICU so was monitored very well.  DH was quite confused and repeated himself a lot.  He wasn’t quite sure what had happened.

Monday

Wednesday, January 30.  DH had been moved from ICU into a regular room and we had to follow visiting hours, even though we were family.  We could visit at 11 and had to leave at 1, then back for 6-8.  Actually, this worked out well since I was able to take my first nap since this whole ordeal began.

DH had called DS early in the morning and  said he “needed” his cellphone to make some work calls.  Luckily, DS talked him out of that, saying that he could say some wrong things, given his temporary memory issues.  Thank goodness!  I didn’t want him spending his days talking on the phone.

We got there about 10:45am and they still wouldn’t let us in due to “flu season”.  I’m not sure how we could give him the flu in those 15 minutes before official visiting hours.

I glanced at the whiteboard on the wall where the nurses’ names, doctor’s name and such were written.  Unfortunately, no one had changed this whiteboard since Monday, so that’s what it still said.  <sigh>

We visited – DH got to eat a bit and had started having lines removed.  He thought he might put his shorts on so went into the bathroom to do that.  Unfortunately, he managed to pull the IV out of his hand and bled quite a bit.  The nurse sent him back to bed and said no more of that!

A representative from the group Mended Hearts stopped by with information and a heart-shaped pillow.  They have meetings the first Saturday of the month, so we might go to some of those.

The first pastor dropped by again and we made plans for Friday to pick up DH’s car which was still at the ER.  No one else I know could get it – it’s a standard shift car.

Not much else – visiting, napping, improvements every day.

Not Monday

Finally, it’s not Monday!  Nowhere, nohow.  Just Thursday, January 31 after 4 days of Monday.  Hooray!

DS had a headache so I went to the hospital alone.  He was going to come for the nighttime visiting hours.  As it happened, DH came home this day after lots of testing, last minute X-Ray, discharge notes, complaints about the night nurse…

We got home about 5:00PM.  Yea!

Now the real work began – visiting nurses, medications, doctor visits, rehab.

Since it’s no longer Monday, this post is over 🙂

MaryO

More on CABG (Coronary Artery Bypass Grafting)

Posted on by MaryO

From the NIH: What To Expect After Coronary Artery Bypass Grafting

Checkmark
What DH had

Recovery in the Hospital

CheckmarkAfter surgery, you’ll typically spend 1 or 2 days in an intensive care unit (ICU). Your health care team will check your heart rate, blood pressure, and oxygen levels regularly during this time.

CheckmarkAn intravenous (IV) line will likely be inserted into a vein in your arm. Through the IV line, you may get medicines to control blood flow and blood pressure. You also will likely have a tube in your bladder to drain urine and a tube in your chest to drain fluid.

CheckmarkYou may receive oxygen therapy (oxygen given through nasal prongs or a mask) and a temporary pacemaker while in the ICU. A pacemaker is a small device that’s placed in the chest or abdomen to help control abnormal heart rhythms.

CheckmarkYour doctor also might recommend that you wear compression stockings on your legs. These stockings are tight at the ankle and become looser as they go up the legs. This creates gentle pressure that keeps blood from pooling and clotting.

CheckmarkWhile in the ICU, you’ll also have bandages on your chest incision (cut) and on the areas where arteries or veins were removed for grafting.

After you leave the ICU, you’ll be moved to a less intensive care area of the hospital for 3–5 days before going home. (only 2!)

Recovery at Home

Your doctor will give you instructions for recovering at home (yes to all), such as:

  • How to care for your healing incisions
  • How to recognize signs of infection or other complications
  • When to call the doctor right away
  • When to make followup appointments

You’ll also learn how to deal with common side effects from surgery. Side effects often go away within 4–6 weeks after surgery, but may include:

  • Discomfort or itching from healing incisions
  • Swelling of the area where arteries or veins were removed for grafting
  • Muscle pain or tightness in the shoulders and upper back
  • Fatigue (tiredness), mood swings, or depression
  • Problems sleeping or loss of appetite
  • Constipation
  • Chest pain at the site of the chest bone incision (more frequent with traditional CABG)

Full recovery from traditional CABG may take 6–12 weeks or more. Nontraditional CABG doesn’t require as much recovery time.

Your doctor will tell you when you can become active again. It varies from person to person, but there are some typical timeframes.

Often, people can resume sexual activity and return to work after about 6 weeks. Some people may need to find less physically demanding types of work or work a reduced schedule at first.

Talk with your doctor about when you can resume activity, including sexual activity, working, and driving.

Ongoing Care

Care after surgery may include periodic checkups with doctors. During these visits, you may have tests to see how your heart is working. Tests may include an EKG (electrocardiogram), stress testing, echocardiography, and a cardiac CT scan.

CABG is not a cure for coronary heart disease (CHD). After the surgery, your doctor may recommend a treatment plan that includes lifestyle changes. Following the plan can help you stay healthy and lower the risk of CHD getting worse.

Lifestyle changes might include changing your diet, quitting smoking, being physically active, losing weight or maintaining a healthy weight, and reducing stress.

For more information about lifestyle changes, go to the National Heart, Lung, and Blood Institute’s “Your Guide to Living Well With Heart Disease.”

Your doctor also may refer you to cardiac rehabilitation (rehab). Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems.

Cardiac rehab includes exercise training, education on heart healthy living, and counseling to reduce stress and help you return to an active life. Your doctor can tell you where to find a cardiac rehab program near your home.

Taking medicines as prescribed also is important after CABG. Your doctor may prescribe medicines to manage pain during recovery, lower your cholesterol and blood pressure, reduce the risk of blood clots forming, manage diabetes, or treat depression.

Lower Salt Intake

Posted on by MaryO

More from Johns Hopkins:

Join Johns Hopkins registered dietitian, Arielle Rosenberg, as she walks through the aisles and offers suggestions on how to lower salt intake — but not compromise flavor.