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It took a while to realize it, or maybe to accept it, but it finally dawned on me that I was dying. My congestive heart failure was winning the battle for my life and no one seemed to be able to do anything about it. Back then I really did not understand how insidious congestive heart failure can be. Today, I would characterize it as being sneaky, progressive, and ultimately fatal.
The array of pharmaceuticals to treat this condition is impressive and most often helpful in postponing the inevitable when applied in the right dosages and combinations for a particular patient. To the best of my understanding, my cardiology team was doing all the right things, per the prevailing wisdom, to treat my condition. When they ran out of solutions I seemed to be out of options. At age 70 I finally starting getting grandkids, was financially able to retire, and had a lot to live for, that is, if I could only stay alive and reasonably healthy.
How did all this happen, seemingly out of nowhere? At age 55 years, I was active and healthy, or so I thought. I was only a little overweight, was never a smoker, was only an occasional drinker, and was a fairly regular exerciser. I had lots of stress on the job as a regional manager for a restaurant chain, working long hours under challenging conditions, and no doubt could have had better eating habits.
Suddenly, one evening out of nowhere I had a heart attack. When I presented at the emergency room of a local hospital, no one seemed overly concerned about my symptoms, partly due to my own efforts to seem calm and collected, which probably worked against me. In any event, I did not get a heart catheterization until about 20 h after I had arrived. That was when the attending doctors discovered that my left anterior descending artery, the proverbial “widow maker,” was almost totally occluded. I later surmised that my network of corollary arteries, developed over years of exercise, had probably helped keep me alive for a few extra hours until the catheterization and angioplasty were performed. But much tissue damage was done, resulting in an ejection fraction of <30.
After a week as an inpatient, I was released and shortly thereafter began a program of cardiac rehabilitation. This signaled the start of a whole new phase of my life. At first, I was filled with uncertainty about how to proceed with my life. Eventually, things began to return to something akin to normal, at work and life in general. I was back running 5K road races and even spent a week skiing in the Canadian Rockies 2 years after my myocardial infarction. Subconsciously, however, I had that nagging fear that I was not that indestructible person I had imagined I was and that my life could come crashing down at any moment.
At first, in the early years after my myocardial infarction, there was little noticeable deterioration in my condition. What perceptible decline there may have been I attributed to advancing age and letting my conditioning slip. In other words, I was in denial. In reality, despite what was probably a standard regimen of proven medications and monitoring, I was gradually slipping in advancing congestive heart failure, something I did not recognize or understand. What follows is the beginning of a whole new story.
Story to be continued in the September and October issues…
Please note: Mr. Tatum has reported that he has no relationships relevant to the contents of this paper to disclose.
- 2017 American College of Cardiology Foundation