Learning How to Live Again After a Heart Attack.

Life can be like charting directions on a map. From the moment in our early 20s, when we become conscious of who we are, to the moment we draw our last breath. At any given point along our paths, we can choose to be aware of our surroundings and adjust our bearings accordingly. Or we can just keep heading in the same direction we set at the beginning of our journey.

There are, however, moments when false trails or natural disasters unexpectedly choose a different path for us. Sometimes, a radically different path. This post is about a moment in my life when I had to change direction after suddenly having had a widowmaker heart attack, which thrust me onto the trail-head of heart disease.

I had moved back from Texas to my home state of Ohio, where I was working for a small tech firm and spreading myself across four or five clients. My job involved writing code and working with organizations to understand and enable their digital goals – easily clocking between 60 to 70 hours a week.

At the same time, I was trying to get back into my pre-Texas physical shape by working out 5 days a week at the local YMCA. At the age of 46 I was lifting heavy and eating clean as a way to prepare for my upcoming 50s.

Everything was going great. I was on track to level up at my company. As usual, my annual physical assessment showed I was in good health. I was getting stronger and becoming fitter as a result of nearly a whole year of focusing on the gym. Things were good and I felt I was in command of my outcomes.

I woke up one morning with a slightly uncomfortable sensation in my left arm and the middle of my chest. But I wrote it off to the previous night's workout where I’d hit the deadlifts and chest presses hard. Still, I could not shake a foreign feeling that something was wrong.

I felt like I was missing something that I could not put my finger on. I wanted to pinch and zoom in as if it were a high-res image on an iPhone that I could delve into to determine what it was I could not see. The feeling never left me, either. There was no amount of self-talk I could hash out to escape this sensation of “wrong”. Still, I was due a meeting with a client in a couple of hours, so I did my best to dismiss it. I made my coffee, showered, dressed, and got on with my day.

After hopping into the car, and heading out to my first meeting of the day, I noticed my forehead was damp with sweat. It was the last day of March which, if you have spent any time in the Midwest, can be just as chilly as winter. I was not warm or exerted by any stretch at that point in my day.

I got that feeling again. I knew something was seriously wrong at that moment. So I changed course and checked myself into the nearest emergency room and, in short order found myself hooked up to an EKG machine. While my blood pressure was off the charts, for the first time ever, my EKG was totally normal.

So with that, I found myself under observation for the next 12 hours. One of the diagnostic tools medical professionals use to see if your heart is under stress is an enzyme test called a troponin test. The first of three came back totally fine. My second one did not. At that point, everyone but I knew something was very wrong.

The doctor was going to send me in for a nuclear stress test to look for blockages the next morning, but after a close look at my cardiac arteries he ended up sending me directly to what is called a cath lab, for a stent procedure. They found a serious blockage in the left anterior descending (LAD) artery, aka the widow-maker section. Post-op I called my parents, my spouse and my best friend who were all waiting for me as I was wheeled out to meet up with everyone. It was over so quickly and I was in rehab before I knew it.

The beginning of a long journey

In the coming week, I would find out the hospital portion of this experience was the easy part. What happened to me after this was something that people don’t hear enough about:

It’s not uncommon to be struck by severe depression and anxiety after having a heart attack. In fact, studies show that up to 33 percent of heart attack patients end up developing some degree of depression.

I never had to deal with any of these symptoms before my event, however days afterward, I found I could not sleep. My mind was in overdrive. I felt like I had been given a grenade with the pin pulled out, and made to carry it around in my shirt pocket at all times, without ever really knowing when the trigger was going to activate.

I was talking with an aunt of mine whose husband was fighting a long term battle with cancer and she shared one of her coping skills. She told me to face myself in the mirror every morning before getting dressed for the day. Naked. Hair and beard in a bramble. Sleepy eyes.

“Tell yourself: I had a heart attack”, she said.

“Every day?” I asked.

“Yes, every day.”

Facing the depression and anxiety

A few months in, when things had gotten emotionally unbearable, I hired a therapist. He told me that this was some of the best advice I could have got, as it helps position yourself on “the path of the grief process toward the goal of acceptance” faster. He also gave me a technique, which I resisted at first because it was just a little too “touchy-feely” for me. (Not manly enough, if you will).

Yes, I was “that guy.” Shut off. I could solve all my problems on my own. I didn’t need anyone. You get the idea.

The therapist's advice was to picture each anxiety attack as a person who cares about me. All that I had to do was reassure this person that I was fine, thank them for the concern, and just to check back in on me later. As I found out later, this was a mechanism to use the anxiety as a tool to remain vigilant, but to not allow it to drag me down into a dark spiral. It took years of practice, but I finally shook the chip from my shoulder and accepted it.

Truth be told, there is not a day that goes by (it’s about five years later as I write this), that I don’t think about the grenade in my shirt pocket. I suppose that’s why I started running races instead of lifting weights, as I used to. The running got me out of my head.

A meditation book I read compared it to something called the “wind horse”. I think the idea went along the lines of our minds being like a wild horse, who, full of energy just bucks and runs and bucks, and bucks some more, without thought until it becomes exhausted from the effort. After that, our mind is spent and our bodies take over in order to recover and breathe.

Running on the trails near my home down by the river for the first three years after my heart attack was like that for me. I would, more often than not, break out into tears while doing increasingly longer training runs. Sometimes upward of 20 miles as I got stronger and more conditioned. I watched the seasons change. I ran without my shirt on through the warm summer storms. I love how that feels. I watched so many sunrises and sunsets. I ended up blowing through five pairs of running shoes (and for anyone who runs, that’s about 1500 miles). Still, I found that no matter how far I ran, I could not escape my constant companions: anxiety and depression.

All of my annual cardiac check-ups have been great so far. I adhered to the medications the cardiologist prescribed me. I watched my blood pressure and cholesterol levels loosely. I kept my dietary choices in check, while enjoying some of the usual things I like to eat. I worked toward stress reduction. For me, these are all parts of the larger whole when you look at health as a collection of aspects.

I decided to climb up Mount Hood in Portland Oregon with my best friend, up to a peak called McNeil’s Point. This was a huge event for me.

Now, before you take anything on like this, it’s best to check with your doctor first. I did, and was given the go ahead as a result. The thing that scared me about this the most, was that it meant being up on the side of a mountain. No cell reception. No 911. No ambulance. Just me, my friend, and the mountain.

But the funny thing is that I stopped worrying. Just like I did when running. Yes, we were out of breath from the altitude change (that and clocking in over 18 miles on foot that day as we got lost). But that moment of sitting at the top of the ridgeline, by the stone structure, listening to the wind blow over the mountainside, started a five-year track of getting back outdoors for me.

These days, I go out for backcountry overnight hikes about twice a month. I have hiked the Smokies, the Dolly Sods, 100 miles over 6 days through the Olympic Mountains, Big South Fork to Yahoo Falls, the Cumberland Falls area, and so many other places. These trips are a way to force myself to face the choice of living in fear of the grenade in my shirt pocket or to, instead, put it down for a moment and breathe in the fresh mountain air, heavily scented with pine.

I’m able to feel the sun on my chest and just simply feel grateful for such an incredible experience, instead of shrinking into the darkness of my own mind.

Choosing to embrace life, not fear

Today I am much further down the trail of cardiac artery disease and yet I still have no way of knowing where the next obstacles might lie ahead. However, I feel I am better for the struggle. While I had trouble sharing my feelings with people before my heart attack, I am a little more open and less afraid to call out for help when I need emotional support. I don’t keep as much bottled up, or for nearly as long as I used to in the past. I am OK with crying when I need to, or laughing when I feel like it. I don’t feel as hopeless or scared either. I don’t think anyone should have to.

While fear is natural – and in some cases helpful – being defined by fear is a choice. Just as embracing the life we have and enjoying every minute with breath in our lungs, is a choice. Regardless of our physical capabilities or the progression of our conditions, the memories we make, the feelings of joy and the love that we share, all has a way of resonating all around us. Just as the wind echoes through the meadows and pines outdoors.

Planning for the future

With a new year upon us, I have plans to continue doing what I enjoy most these days. Interesting work. Supporting the people in my life. Allowing people inside my head and heart. Spending as much time as I can outdoors exploring the fields, forests, and streams, and wherever the road takes me, with a smile on my face and laughter on my lips.

I hope to share more of these stories in the future with anyone who can benefit from any aspect of my experience. While learning how to embrace life with heart disease, I’ve had to manage my health through counterbalancing a new set of rules with fulfillment, as the owner and operator of a body that has had a heart attack.

To close, I feel that it’s only appropriate to share one of the trail phrases that always makes me smile when the going gets tough out in the backcountry. This means everything to me. It’s the simple act of not focusing on feeling trapped by our conditions, but looking at them as they truly are, a course alteration, not who we are.

“Onward!”