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As a 54-year-old male, ex-athlete, I assumed my reduced endurance, lethargy at the end of the day, and “foggy” mind was due to getting older and not being as physically fit as in the past. After routine annual physicals and numerous cardiac tests that came up negative, I even came to believe that the acute focal points of random minor pain I felt in my chest periodically were part of getting older as well.
In hindsight, I can recall events where these symptoms had been occurring over the past 10 years, especially the reduced endurance. I still enjoyed activities such as running, mountain biking, and playing full-court basketball, and although my top-end effort had not declined that much, I did notice a reduction in length of time that I could maintain that effort. Additionally, I noticed that while recovering from high-intensity activities, I was unable to take full, lung-expanding, deep breaths. I could only inhale in at about 70% capacity. It felt like my lungs were constrained while exercising, yet while at rest I could take these deep breaths and fully expand my chest and lungs. I continued to accept this as evidence of getting older.
The pace of degradation in these areas was not alarming or noticeable even on a year-over-year basis. I picked up running triathlons 5 years ago and ran these races for 3 seasons. When measuring my performance relative to the prior year’s performance in the same event, in most cases, I improved my times and finished in the top one-half of my age bracket. This further established in my mind that my symptoms were a case of aging, but I fully expected if I worked out enough and more routinely, I could enhance my performance.
Regardless of my level of activity or exercise, I still had this lethargic feeling at the end of most days, and the feeling of foggy mind was with me throughout the day. There were some exceptions to this but for the most part that was the normal state of how I felt. Being a night owl, I attributed my lethargy and foggy brain to not getting enough sleep. I was getting around 6.5 to 7 h on average, but just assumed I needed more.
Throughout this timeframe, my lifestyle, work performance, and activity levels were normal and I was able to do anything I wanted to do at any point in time. To an outside observer, or even my wife and close friends, there was not any noticeable difference in my behavior, abilities, or efforts. It was just something I could tell about myself. I did not take close personal note of these symptoms on a day-to-day or even month-to-month basis.
On October 5, 2018, I woke up at 3:00 am sharp to a very loud piercing sound in my right ear, and my world was spinning. I could not gain my balance and fell back down in my bed.
I was diagnosed by the paramedics as having a severe bout of vertigo. I had not had any form of trauma or allergic reaction that would have caused my vertigo.
A few days later, I met with an ear, nose, and throat specialist who confirmed I had vertigo but also could not identify any causation. He referred me to a neurologist who found via a magnetic resonance image scan that I had a small stroke in an area of the brain that regulates the inner ear, and she believed this is what caused my vertigo. Now what caused my stroke?
My neurologist recommended I see a cardiologist. After several cardiology tests, which eventually led to an echocardiogram “bubble test,” they identified that I had a patent foramen ovale (PFO) which is a hole in the septal wall of my heart between the right and left atrium, which occurs in about 20% of the population.
The good fortune for me was that my cardiologist was able to identify a likely cause for my stroke thus relieving that level of anxiety of another stroke. Additional good fortune was that he had a cardiologist on his staff who was involved in “HeartStitch,” a clinical trial for the “NobleStitch,” which allowed me to receive a PFO closure that does not require ongoing anticoagulant therapy.
I left the hospital 5 h after my procedure was completed. The next day and every day since, I felt like a different person. My energy and my mental clarity were much improved to a level that I could not recall for many, many years, if ever. My sleep patterns, work environment, and daily schedule remained the same, yet I was as alert, energetic, and fresh in the evening as I was to start the day.
The final symptom I was eager to see if it had changed was my physical endurance, but that would have to wait the 30 days until I recuperated from the transcatheter procedure.
After almost 3 months of being mostly sedentary due to the lingering symptoms from my vertigo and now the transcatheter procedure, I was very surprised to find I felt very good on the run. I ran more comfortably at my normal pace, and ran for a longer period of time than I had in several years. But when I did get winded, I was now able to take in a very large breath, fully expanding my lungs, and settling my heart rate and catching my breath again to continue my jogging pace.
I am writing this at almost 4 months out from my procedure. From post-op day 1, I have not experienced any of the symptoms I noted earlier. Even the periodic, random, acute, and focal minor pains in my chest are gone.
Thanks to a seamless network of skilled doctors and staff that quickly narrowed in on the logical cause to my stroke, which eased my mind, I also feel much better.
Please note: Mr. Whitaker has reported that he has no relationships relevant to the contents of this paper to disclose.
- 2019 American College of Cardiology Foundation