Six months ago to the day (Sunday, 9/13/2021 — my 24th wedding anniversary, actually, and a week before my 54th birthday), I had a heart attack. I probably had it while diving in Lake Champlain, after overexerting myself lugging all our tanks and gear down to the lake. I know I felt my heart racing like crazy while underwater and something just felt wrong. I didn’t really start feeling symptoms until the middle of the night that night, when I woke up to find my left arm hurting like hell and suffering from “bad heartburn”. I remember distinctly getting up twice to slug down Alka-Seltzer and being confused about why it wasn’t helping.
That Monday was confusing and weird. I didn’t feel right but rather than go to the emergency room I just slept a lot of the day. People encouraged me to go ahead and hit the ER but I had the typical worry that I’d get there, spend a lot of time waiting, and get told that it was all nothing and to take some additional ibuprofen. Or something. Maybe I was afraid they’d smack me around with a wiffle bat. Either way, I didn’t go.
Finally, someone (probably Carole) found links demonstrating that “painful left arm and ‘bad heartburn'” are classic symptoms of a heart attack. That Tuesday I finally sucked it up, grabbed a book to read while waiting, and headed to the ER at the University of Vermont Medical Center, expecting to have a long wait before being seen — I was sure I’d find a waiting room full of Covid patients.
Turns out that the waiting area was maybe 1/3 full — and moreover, almost before I’d given them my name and date of birth, they had me back in the exam area getting an EKG, x-rays, ultrasound, blood tests, bam, bam, bam. Unless things are really bad in an ER, words that hint at heart attack or stroke are taken very seriously. (Carole came over to spend the evening with me and was very kind and gentle. For once, she knew better than to harp on what an idiot I’d been.)
One test led to another and then another, and next thing you know I’d been admitted and was scheduled for a heart cath procedure the next day. If certain tests had come out a little differently, I would have been catheterized that night. Next day, the cath showed that I had some pretty serious blockages, not in the main arteries, but in the subsidiary arteries that feed the heart itself. They found a LOT more plaque in there than they expected in a man my age and consequently I wound up with four stents and prescriptions for blood thinners and more blood pressure meds, not to mention a strict ban on eating salt, saturated fat, and cholesterol. I was sort of hoping for some kind of prize, a big stuffed carnival bear or something, but apparently you only get those if you’re a kid.
I asked the docs, and they said that my diet was actually probably not the primary cause of the heart attack. My heredity is just awful — father who had multiple heart attacks and heart procedurs, and mother who had blood pressure that was just off the charts most of the time. I drew the short straw on both fronts.
All in all, it was not a bad heart attack — I had not done any significant lasting damage to my heart. But it was serious enough to need that catheterization — and without said procedure, no one would have ever known how bad the blockages were. In a sense, I was real damn fortunate to have had my little cardiac infarction when I did; otherwise, when my heart attack finally did come a year or two in the future, it probably would have been a lot worse.
Call me Mister Lucky.
I was sent home one day later, my blood troponin levels having started to diminish at last, and everyone we spoke to assumed that I’d need weeks of recuperative time. Doctors, nurses, Carole, my managers, my co-workers, people from church — they heard “heart attack” and figured I was going to be out of commission for quite some time.
They had not factored in what a complete idiot I am.
What came next?
Friday of that week was the first day of my at-home rehabilitation. I got really bored sitting around the house that morning, so I logged in to my work laptop and spent the afternoon reading and replying to email. Along about four p.m. that day I got an instant message from my boss going “WTF?”
Later that day, around 5 o’clock, I went for a two mile walk — just out my front door, down to the bridge over the Winooski, and back again. Just to see how I felt during and afterwards. I felt a little more tired than I’d expected, but not too bad.
So, of course, two days later I went for a nine mile walk.
The funniest part about that was that I was toddling on down Snipe Ireland Road (yes, that’s a real road) when a car slowed to a stop and the driver said “Jay???” in wild incredulity. It turns out it was a member of our church, Kath, whose husband Ernie had helped ferry my car home from the hospital (since obviously I wasn’t going to be driving it home myself). So she knew I’d just had a heart attack, and here I was walking down a long dirt road, not a care in the world, metaphorically whistling a merry tune (disclaimer: I cannot actually whistle).
I confused the folks at church as well that Sunday by showing up at all — they, like most people, sort of visualized me lying in bed with a visiting nurse attaching IV lines to me and looking concerned. People don’t just have heart attacks and then immediately go about their normal daily routine. And here I was saying “Wotcha, how ya doing?” like I’d just gotten back from a day trip to Poughkeepsie.
I refused to take any time off and got right back to work immediately. Over and over during the following days I got messages from people going “What the hell are you doing logged and sending emails?”
I started cardiac rehab about two weeks later. First thing was a stress test, where they stick you on a treadmill and keep increasing the speed and incline until you vomit or you tap out. I didn’t do terribly but I didn’t do well, either. I don’t know how well I would have done before the heart attack — I’d done a lot of walking over the past few years, but very little real cardio.
I was told to get on, and stay on, the “Mediterranean diet” — avoiding saturated fat, salt, cholesterol, red meat, cheese, and Uranium-235 and instead eating as many vegetables and fruits as I could choke down, plus lots of fish (and the occasional chicken). I can’t stand fish so that part was out.
The part I did find rather strange, though, about the Med diet was the insistence that I get as much olive oil in me as I could — and when I say the goal was for me to consume a lot of olive oil, I mean they wanted me to consume a LOT of olive oil — like, over a cup a day, more if I could manage it. I was happy to sauté every vegetable in sight in olive oil and to use olive oil in place of butter in things like mashed potatoes. I think they were in favor of my shampooing with it. All hail olive oil, the universal remedy!
The sort-of hard part was doing completely without salt. I’d cooked a pretty low-salt diet for years and years already; my mom had blood pressure that was up in the stratosphere somewhere, so she almost entirely stopped using salt in cooking when I was around 8 or so. As I tried it in 2021, I found that cutting it out entirely — not using it on potatoes. meats, etcetera — made for some very flavorless meals. At least, until, I found out about the seventeen different flavor varieties of “Dash” (née “Mrs Dash”). I found and purchased salt-free ketchup, mustard, hot sauce, and so on, and so on.
The hardest part was abstaining entirely from cheese. I love cheese. Which, now that I mention it, might help us understand why my blood vessels were so choked with fat and cholesterol.
Rehab went well. I showed up three mornings a week at a building located in a scenic complex right next to I-89 in South Burlington. The rehab center had about ten treadmills, three rowing machines, a set of Nautilus-style weight machines, quite a few exercise bikes of both the recumbent and upright variety, a couple of ellipticals, and one thing they simply referred to as “the Iron Maiden.” I did a half hour intense treadmill session followed by 2000 meters on a rowing machine (trying to get under 10 minutes each time) each day. I did a good bit of walking on my own outside the rehab time, in evenings and on weekends. Then too, that November I walked the entire 60-mile route of the 2021 San Diego Susan G Komen 3-Day.
Back in September at the hospital, they’d changed out pretty much all my meds — my cholesterol drugs, my blood pressure drugs, and so on. My body responded very well to the new regime — my blood pressure went from 155 over 110 (and similar scary numbers) to a routine reading of 110 over 70.
Score 10 for the home team, there. I was ecstatic.
For a decade I had tried every drug in the book and the best we’d been able to do is get my BP below 150 now and then. (I know you’re probably thinking, “maybe the catheterization opened things up and lowered your blood pressure?” I asked, and they said no, the vessels they opened up were not major vessels that would have had a big impact on my blood pressure.) I don’t know why all of a sudden everything clicked with the new regimen, but I was most certainly not complaining.
Between the rehab, my completely overhauled diet, and my revised meds, everything was coming up roses. I lost — and I am not kidding here — 30 pounds. My blood pressure got to absolutely ideal levels. A lipid (cholesterol and triglycerides) test came back with literally the best numbers I have ever had.
This frightened and confused the staff at the UVM Cardiac Rehab department. They noticed that Jay was, week by week, becoming less of Jay. Apparently this was not common among their patients, many of whom took kind of perfunctory interest in pushing themselves on the exercise machines and perhaps cut back from two pizzas a day to just one.
Yes, that’s kind of a mean thing to say, but …
One day the UVM staff actually stopped me and said “You’ve lost a lot of weight and you’re doing really well on the machines, what gives?”
I replied, with some perplexity, “I … did what you told me to do?”
They looked at each other as though I’d just announced the second coming of Lyndon B Johnson and that LBJ would arrive shortly in a UFO pulled by twin unicorns. Apparently, someone actually doing everything they’d been told to do and consequently markedly improving their health as a result was just not something that happened every day, if at all.
I finished rehab on February 1st. Since then I’ve tried to do pretty intense home treadmill sessions on my own and have kept to the diet. I’m now tipping the bathroom scale at 197 — the least I’ve weighed in over ten years, and down from the mid-230s around the time of my heart attack. (Disclosure: I am 6’2″ tall.) If I can lose a couple more pounds I will, per the BMI index, no longer be considered overweight! (I know the BMI is a terrible way of measuring health and weight, but it’s one a lot of people more or less comprehend.)
My goal is the low 180s — and to stay there this time.
Long story short
To make a long story short, I rule. To make it a little less short — I’m doing pretty damn well, proof positive that heart disease can be a manageable, chronic condition if you have the time and inclination to make the hard choices and to realize that actions have consequences. Provided I keep to my diet, keep exercising, and keep checking in with my PCP and cardiologist, there’s theoretically no reason I can’t expect to live a couple more decades, at least.
Now, off on a wild tangent
For 14 years, I’ve taken part in 60-mile, three-day fundraising walks on behalf of Susan G. Komen. I’ve raised something like $60,000 in the course of doing all those events.
Well, it’s not because I have cancer, or because my wife has cancer, or because a close relative has cancer, or because a co-worker has cancer. I have gotten to know, and seen waste away and die, several beautiful women who I met through the Komen walks.
I did all those walks because, at the age of 40, I realized that I was basically just a drone who worked, ate, slept, and otherwise made almost no impact on the world. Certainly no good impact. And moreover, because I know enough about cancer and what an utter bitch it is, I don’t actually want anyone to experience it. I don’t want anyone having to get up in the morning and look in their mirror and wonder how many more of their children’s birthdays they’re going to get to take part in. I don’t want people wondering if they’ll make it to their next anniversary. I don’t like the idea of people spending eight damn hours a day, day after day, in infusion chairs — with all their hair fallen out, and each evening vomiting up their internal organs.
Yes, the morbidity and mortality rates associated with cancer have improved over the last 25 years but we’re still looking at 40,000+ deaths from breast cancer each year, along with hundreds of thousands of new cases. One in eight women will get breast cancer during her life.
And you know what really sucks? I mean, other than the chemo and the loss of taste and the loss of hair and all the vomiting and losing half or more of your body weight and and and … and all that other stuff. But what really sucks is the knowledge that you can do everything your doctors tell you to do — I mean everything — and it may not mean a damn thing at all. In lots of cases, sure, it can and does help. But in other cases, all it really seems to do is put off the inevitable for a few months.
I am very lucky to have drawn “heart disease” in the Bad Luck Sweepstakes. Like I said, if I keep doing everything my doctors tell me to do, I have every expectation of being around for quite a while. Far more people die of heart disease than breast cancer, but of those, at least 1 in 3 are deemed “preventable”. Okay, I don’t particularly want anyone to have severe heart disease either… and my logic and reasoning here may make no sense at all. You don’t buy seafood from a guy selling it off the back of a truck in a vacant lot and you don’t take medical advice from Jay Furr.
But I’m going someplace with this. Humor me for just a little bit longer.
Until recently, I haven’t had a loved one with cancer. Haven’t had a loved one with cancer that gets treated and goes away and then comes back and gets treated again and goes away and then comes back again and then refuses to respond to treatment.
Now I have.
I have had to learn first hand how powerless a family member feels, wanting to make everything better and knowing they can’t. I’ve had to go through at least three of the five stages of grief — I’ve spent a lot of time in denial and bargaining and depression.
I hate cancer and I want like anything to be able to say “It will get better. I promise.” But I can’t. I don’t know that it will. Wanting it to and having it happen are two entirely different things.
I feel absolutely powerless.
Who’s the family member?
No, I’m not joking. I’m posting about my cat.
That’s Marie before the giant tumor showed up on her side. She has a form of skin cancer that is very rare in cats. It has not metastasized inside, not yet anyway. But it looks just God-awful and no, I’m not going to post a photo of the tumor.
Today I got to spend time — twice — mopping up blood off the floor as a result of the tumor opening up and bleeding. Not gouts and rivers of blood — but steady large droplets of blood all across our floors. (We asked the urgent care vet today how to bandage a furry cat and were told that rather than do a half-assed job and wind up creating a nice warm moist environment under a bandage for bacteria to thrive in, we would be better off leaving the tumor open and uncovered. She’s got an appointment with the oncologist in three days anyway.)
Marie has had surgery and medication to reduce the tumor twice now — and each time, it has come back larger. She has smaller tumors here and there that have not so far bulged out of control but the really huge one on her side is flat-out scary to behold.
She’s getting chemotherapy and anti-inflammatories. She still has appetite and still hops up in laps, but we don’t know what each coming week will bring. I lie awake at night talking to myself, saying “I wonder what options we might have if we told the doctors that there was no limit on what we were willing to spend.” Bargaining. Denial.
Are we being abusive by keeping a cat alive just to watch her suffer because we’re not willing to do what’s right? I ask myself that every day. She still seems to have good quality of life. As I said, she still loves her chow and she still begs for lap-time from Carole every single morning and a lot of evenings — and that’s an otherwise standoffish cat asking for love.
I have promised myself that if Marie does begin to suffer and lose a lot of weight…, if the doctors say “We understand that you love your cat, but there comes a point…”, and so on, I will make the hard decision. We’ve had to make that decision three times with other cats, and it’s never been easy, but they were suffering and didn’t understand what was happening and looked to us to make it all go away and we couldn’t.
With Marie, there’s still a chance. There is still a chance that the chemotherapy may make an impact. That the tumor might shrink. Since this is such a rare form of cancer in cats, no one really knows what the prognosis is.
If it’s this upsetting fighting cancer in a cat, I can only imagine how bad it must be to be a family member of a human with cancer, knowing what is happening to them and knowing the odds. Knowing that there’s a chance — a chance — that the cancer might go into and stay in remission… but also knowing that maybe it won’t. I don’t want to be the voice of utter gloom here — survivorship odds go up each year.
I feel so terrible, gloating about how well I’m recovering from a heart attack, knowing that there are people out there willing to work ten times as hard as I have, but who know it may not make a difference at all.
If I thought I hated cancer before, I really, really, really, really HATE cancer now. Every time I see that awful tumor and feel my heart and stomach wrench — I just think unprintable thoughts and wish the black cloud hanging over us would just.
It may seem like the non-sequitur to crown all non-sequiturs, but I’d really appreciate it you’d sponsor me in the 2022 New England Komen 3-Day. I like to think that the money we all raise will alleviate suffering and bring hope — and that’s something that’s priceless.
If you wish to sponsor me, you can do so at this link: http://www.the3day.org/goto/jayfurr
God be with you. Be well.