NO MORE SKITTLEBRÄU

As I woke up late Monday morning, I was filled with a significant sense of relief. I didn’t go to sleep the night before worried I wouldn’t wake up. The thought had crossed my mind, but not in any serious way. Instead, I fell asleep grateful for the amazing healthcare I had received up to that point (as I’ve mentioned before, I’ll write a full post just about the excellence of that care). Waking up, I felt rested and very comfortable. There was no pain whatsoever, and I actually felt better than I had the preceding Friday. That was likely due to several factors. First, serious blockages in my heart had been remedied, so blood was pumping through those areas more effectively. Second, I was on a lot of drugs.

• Nitroglycerin was probably “calming” any angina pectoris that I might be experiencing

• Ondansetron was probably preventing any nausea or vomiting

• Morphine was doing…well…what morphine does

Have I ever told you about my experiences with morphine? I’ve had a few knee surgeries since my late teen years, and each time was prescribed morphine. It felt slightly warm and tingly on injection and as it creeped towards the heart. Then, on being pumped back out again, there’s a lovely, comforting “glow” that quickly spreads out through the body. I can absolutely see how people would become addicted to opiates, and I’m both grateful and privileged to never have formed such an addiction. I hope for a day when our scientific research and healthcare systems are adequately financed to understand addiction generally and opiates specifically. In the meantime, if I’m in a situation where I need morphine, hook me up.

The meds and my improved condition had me feeling generally well. Dr. Shufelt had completed the stent work, but I was introduced to Dr. Ball, the cardiologist who would take over for the rest of my stay. He talked a lot about my condition, what care I would receive, and, later, what my life would start to look like. There was also explanations for a litany of new medications I’d be taking in the long-term. He was yet another consummate professional who helped me feel both heard and safe.

Had I not experienced the heart attack, on the Thursday following, I would have completed the second of three blood tests for diabetes. I’d already been diagnosed as pre-diabetic, but my general practitioner, Dr. Sukerman, wasn’t sure of the complete diagnosis. Tests that had been run on arrival in Peterborough indicated a “random sugar” level of 14 and a hemoglobin A1c of 10.3%. Those levels are both quite high, but could have also been exacerbated by the heart attack event itself. Nonetheless, an official diagnosis of type 2 diabetes followed.

Blllooood…BLLLOOOODDD!!!

If the medications for the heart attack and my recovery weren’t enough, the diabetes diagnosis would add even more. Prior to the heart attack, I was taking only one medication, the smallest dose of cholesterol-lowering statin. Now, i have one of those pill organizers and my medicine cabinet looks like the back area of a pharmacy that they really don’t like you going into. Here’s what I’m on:

• Telmisartan (ARB) - lowers blood pressure

  • Was previously using Perindopril (ACE inhibitor)

• Bisoprolol fumarate (beta blocker) - helps to prevent cardiovascular events

• Metformin hydrochloride - lowers blood glucose

• Rosuvastatin - lowers cholesterol

• Taro-Ticagrelor - inhibits platelet aggregation to help blood flow

• ASA (baby Aspirin) - does a bunch of stuff

• Jardiance - improves glucose control

• I’m also using the Freestyle Libre 2 glucose monitoring hardware, but was originally using the Dexcom G7 sensors, etc.

Even during some of the more acute moments of having the heart attack, I was already starting to think about how this would certainly change my life. I asked myself a lot of questions. Would I be as ambulatory as I was before the event? Could any of my favourite activities be out of bounds? What about sexual dysfunction? What would I be allowed to eat? In those moments, I didn’t even know the diabetes diagnosis was coming. But now I had two major changes to take into consideration. Initially, I thought of it as a Venn diagram with two circles; one that included all the foods I had enjoyed eating in the past, and another including all the heart healthy foods I’d be allowed to eat going forward. But, with the diabetes diagnosis, it would be three circles in the Venn diagram; the two mentioned previously, and a third that was all the diabetes friendly foods I’d be allowed to eat going forward.

So how much enjoyment was I going to get out of that Reuleaux triangle intersection in that diagram?

For those who don’t know this about me, I basically run on cheese. I believe those memes and infographics that talk about the part of the brain that handles addiction and apparently can’t tell the difference between narcotics and fromage. Is there anything better than a well-aged, British cheddar? No, I don’t think there is. I love barbecue, especially smoked barbecue: brisket, ribs (both pork and beef), burnt ends, pork belly, sausages. Toronto is home to several excellent burger joints such as The Burger’s Priest (before the heart attack, I’d rarely think twice about enjoying a lunch of “The Vatican,” cheese fries, and a Dr. Pepper), Holy Chuck, RUDY, and Elijah’s Automatic. Though I have enjoyed many excellent meals at several Michelin starred restaurants in North America and Europe, I wouldn’t consider myself a foodie. That said, I definitely appreciate a good meal. My skills in the kitchen had really been growing before the heart attack, including some great steaks, savoury BBQ, and ever-expanding retinue of pasta dishes. I guess I just take inspiration from the late, great Anthony Bourdain.

All hail Tony

The coming weeks would be filled with major bummers as I discovered what my new diet would look like. I’ll write about mine and Jenny’s first few trips to grocery stores and how that left me feeling very upset. Fortunately, the staff at PRHC were extremely helpful in describing all of this to me. They gave me a lot of hope, and a lot of ideas of what I could eat freely, what I could eat in moderation, and what I ought not to touch if I could help it. The diabetes specialist was especially helpful in making it clear that moderation and reasonable portions would be the key. Every doctor and dietician I’ve spoken to were pretty explicit that eating perfectly every day would not be sustainable.

In that blog post about grocery woes, I’ll describe what my diet looks like now. But, suffice it to say, I’m generally staying away from fatty and sugary foods. I have to avoid anything that will cause future artery clogs, and anything that will either spike or crater my blood sugar. More than six months on, I think I’m doing a pretty good job of this. And, if my test results and numerous collaborations with healthcare professionals are any indication, there’s data to back that up.

The afternoon after the heart attack, I began to reach out to close friends and family to inform them. Most got something along the lines of the following:

So, here’s the thing. I had a heart attack last night. I’m stable in the hospital in Peterborough. Jenny is with me. It’s not severe or anything. I’m going to make a full recovery, so don’t worry about me, just wanted to let you know

I tried to be pretty careful about who I would inform. To explain why more people didn’t know right away, I had a pretty specific thought process at the time. I assumed that many would dispense the information through the network, I genuinely wanted to make sure I didn’t alarm people who I don’t talk to all that often, and I was also a bit exhausted.

Regardless of who I told, the outpouring of support and encouragement was immense. I cannot say enough about my amazing friends and family and everything they did to help me. Our then 17 year-old niece, who was living with Jenny and I at the time, and my adult nephew, who lost their mother to a stroke in 2016, were real champs. I was immensely impressed with how they handled the entire situation, and showed genuine compassion and concern for my well-being. A big shout out should also go to Dr. Jamie who talked me through the whole process and provided additional advice. Alicia is a real star, too, checking in on my niece and nephew, and leaving me with nutritious and healthy food for my eventual arrival back home. I should also give huge kudos to our friends who were staying at the cottage. As Jenny was making her way back and forth between the cottage and my hospital room, they packed up the cottage and our dog, Buckley, and drove my manual transmission car back to Toronto. They also consoled my niece and nephew, and got themselves to the airport to get home. Thanks so much, guys!

It wouldn’t have been practical for people to travel to Peterborough, so I can’t say enough for the remote support from Julian, Nikki, Alvin, Neil, Jeanette, Ryan, Mary-Elizabeth, Melanie, and, of course, my mother. I should also thank the members of my softball team (aptly named Porkfat Rules), as well as the fantastic folks in my Monday RPG group, who were all very encouraging.

Apologies to anyone I missed, as this isn’t an exhaustive list.

I spent almost four days in that hospital room, and had some of the most mixed emotional reactions of my life. I was both intellectually stimulated and bored out of my melon. I watched some episodes of Star Trek: The Next Generation, and played a few games of baseball on my Switch. I read a bunch, and also slept a lot [more on the awesomeness of modern hospital beds in another post]. Jenny and I had a lot of serious conversations about our future, what my life would look like, and preparations we’d have to make.

I never want to go through that experience again, and I really wish I hadn’t in the first place. But, if I ever have to do it again, these are the people with whom I would do it.

WHAT’S NEXT? Getting home, seeing more doctors, more stents, and a new life.