I kept my heart rate pretty high on this ride. I usually try to keep it in the mid-140s on longer rides. My actual max heart rate is probably about 170 (even though my calculated max is 154). On this ride it stayed at about 154 for most of the seven to 10 miles along Legacy Parkway and in several other extended stretches on the ride. It climbed to 162 bpm a couple times.
Even though I try to stay hydrated, I'm always somewhat dehydrated after a ride. I finished off a 20-oz bottle of Gatorade by the beginning of the Legacy Parkway Trail in Davis County. And my water was about gone by Layton, so I stopped at the Chevron station on Gentile Street in Layton, where I often stop, and got a 44-oz Dr. Pepper (with sugar for a little kick), a Kind protein bar, and a 20-oz bottle of water to refill one of my bottles.
From the Chevron through Clearfield to about Syracuse is a steady 1-2 percent incline. I like to push myself up this piece, because it's steady and straight, mostly uninterrupted, I know when it ends, and the rest of the trail to Roy is mostly a 1-2 percent decline. I felt pretty good doing this climb at a decent speed, even after I had stopped at the Chevron and my legs cooled down for 15 or 20 minutes. I cruised to the top of the climb and made a turn onto the final six or seven miles to the Roy Front Runner station.
Somewhere around 200 South and 500 West in Clearfield, I started feeling really drained. I considered stopping at the Maverick store on 1800 North and 1000 West in Clinton, but I had stopped at the Chevron, I never stop twice, and I was only a few miles from the Roy station. Still, I had a hard time continuing. I did stop and rest on a bench for a few minutes. I considered stopping and lying down on the grass under a tree in a park, but I kept going. I also had an aching pain across my upper back, which I attributed to my shoulders being out of shape from not riding for a month.
The last mile or so before the Front Runner station is normally pretty easy. I often do about 19+ mph, even though I'm usually tired by that point. Today I was doing about 15 or 16 and struggling, but I also had a 10 mph side wind. The end of the trail is 4000 South in Roy, and there I turned right on 40th South to go up a steep but very short hill to cross the train tracks. I usually like this part, because it gives me a chance to kick hard for a short distance when my body thinks it's spent. Today, I had to walk my bike up the hill, which I've never done before, and I rested against the bike while a freight train passed. I was surprised at how winded I had gotten pushing my bike up that little hill. Then I walked slowly to the turn toward the Front Runner station. I rode my bike the final half block, because riding was easier than walking.
Once on Front Runner, I felt pretty terrible. I decided I was experiencing heat exhaustion. I slept on the train a little. When we got to Murray about an hour and 10 minutes later, I struggled to get my bike untangled from another bike on the rack. After I got off the train, I had to sit on the bench on the platform and rest. I had decided that I needed to go to the hospital, probably to get some fluids pumped back into me. I considered calling 911, I felt that bad, but I could see the hospital across the street. I just had to drive over and be able to walk through the door.
When I took my wallet out to tap my UTA pass on the reader, I dropped the wallet. I bent over and reached my left hand down to pick it up, but I could not get my fingers to wrap around it. I struggled bent over there for quite a few seconds, and I finally picked it up with my right hand. I pushed my bike to the Sequoia and lifted it onto the bike rack. I struggled to put on the zip-tie Ottolock, because my left hand was not working. I had to pull the Velcro on my right glove with my teeth and use my teeth to pull the glove off.
I drove over to Intermountain Medical Center, parked, and walked through the Emergency door. I checked in and sat in the waiting room for a couple minutes, until they called me. They did an EKG, and the ER doctor or the Cardiac doctor (Dr. Miner), I can't remember which one, said the computer predicted I'd had a heart attack, and he tended to agree.
My next stop was the Cath Lab, where they squirted dye into my arteries and determined I had two blocked arteries. One was 99 percent blocked. Dr. Miner fed a catheter up my right arm from my wrist, did an angioplasty, removed a blood clot, which he later showed me in a little cup (it was about the size of a grain of cooked short-grain rice), and inserted a 3mm x 33mm Abbot Vascular XIENCE Sierra stent. He didn't do a stent in the second artery, because my kidneys were shutting down from dehydration, and the dye would put too much stress on them.
I spent the next three days in the CICU, with EKG nodes stuck to my upper body, an oxygen sensor stuck on my thumb or one of my other fingers, blood drawings every four or six hours, two echocardiograms, a couple of 12-node EKGs, two showers, and a bunch of "Cardiac" hospital food, which was actually quite good.
From day one, they kept telling me I might go home "tomorrow," or they were going to move me downstairs to the non-ICU unit, but my heart was having arrhythmia or PVCs, and it stopped for 2-1/2 to 3 seconds at one point. My troponin level was also climbing for the first day or so. Troponin is an enzyme the heart puts out when it's damaged. The doctors are looking for the level to go onto a downward trend, which would indicate no further damage. Mine started at .4 right after the catheter. The nurses said it's usually very low right after an incident. It went up to 49 before it leveled off. The next blood draws showed 45, 41, 39, and I think the last one was about 32. My heart had settled down, and my troponin level was going down, so they let me go home on Friday afternoon.
Dr. Miner said the echo showed my heart is pumping well and sustained little damage. I probably have a little scarring on the inside of the muscle, but it doesn't radiate through the muscle as is normally the case. I attribute that to doing quite a bit of regular cardiovascular exercise. My fuel pump is strong, but the fuel lines are clogged. I guess that's what you get when you exercise well and eat poorly, plus DNA plays a role.
I have to say, I really appreciated all the nurses who took care of me in 12-hour shifts from 7 to 7 each day and night. They were extremely friendly and kind. The doctors--Dr. Miner and Dr. Minder, the cardiologists, and a PA--were also very informative and caring. Considering I was stuck in a hospital with a tangle of wires holding me to within a couple feet of the $20,000 Hilrom hospital bed, my stay was quite pleasant. I felt I made friends with the nurses during the 12 hours they took care of me, and I felt bad when each ended his or her shift, because I doubted I'd ever see them again (at least, I hope I don't see them again in the same situation).
I'm home now and feeling good. I have to go back on August 1 to have the other stent put in, but that will likely be a same-day procedure, where they have to keep pressure on the catheter insertion point for six hours so it doesn't gush open. I should be able to continue riding my bike, though careful not to push myself too hard for a while. I've learned a big lesson about staying hydrated. That wasn't the reason for the heart attack--I had clogged arteries--but it was likely the catalyst, what caused the clot, on Tuesday, and it created its own set of problems with my kidneys.
This is the bike trail I followed. I pushed myself pretty good along the Legacy Parkway, keeping my heart rate in the 150s. I also pushed myself on the long, slow upgrade from Kaysville through Clearfield, with a stop for water, Dr. Pepper, and a Kind bar at the Chevron in Layton. I probably started having heart attack symptoms at about Syracuse (I'm not sure the trail actually goes through Syracuse, but somewhere in that area), although I was thinking heat exhaustion. "Heart attack" never entered my thoughts. I then rode my bike another six or so miles while having a heart attack.
These are the pictures I was planning to post of my ride. I cheered that road workers had removed a set of those stupid trail gates that are hard to negotiate. I hit my shoulder hard on one once, and earlier this year, I was hurrying because some cyclists were coming across the road in the opposite direction, and I hit the top bar of the gate and landed on my back.
Unfortunately, the reason the gate was out was because the whole road was torn up.
This machine was a walk-around.
This is the Front Runner ride to Murray. This ride was more taxing than riding my bike up to where I started feeling the heart attack symptoms. So, I was also experiencing a heart attack for the hour and 10-minute ride on the train from Roy to Murray.
At the Murray station, I dropped my wallet when I tapped off the train with my pass, and although I could bend over and get my left hand on the wallet, I could not get my fingers to grasp it. They also wouldn't grasp the velcro strap on my right glove, or the zip-tie lock on the bike. I started to wonder if I was having a stroke. This is my drive from the Murray Front Runner station to Intermountain Medical Center. Getting from the train to my SUV and to the hospital was more taxing than riding the train, which was more taxing than riding my bike from Murray to the heart attack point.
This is my walk from the parking lot into the hospital, which was more difficult than driving to the hospital.
Finally, I got a blood clot removed and a stent inserted into my plugged artery. I had no more of the "stroke" symptoms and don't know what caused those. The doctor said the body does weird stuff when the electrolytes get messed up.
This is what my artery looked like before the angioplasty and stent.
Blood flow after.
Dr. Miner removed the blood clot, which was about the size of a grain of cooked short-grain rice, fed a balloon, and inserted a stent all through this little hole in my wrist. They kept a pressure bubble on my wrist for several hours afterward, and I'm not allowed to lift anything over five pounds for five days, to prevent it from spurting open.
Jamie took this picture of me unlocking the trailer hitch on our utility trailer so Paul could use it the day after I was released from the hospital. She didn't get a picture of us forcing the lock off with a crow bar when I couldn't find the key. My body feels pretty good.
August 1, 2019
I'm back at Intermountain Medical Center getting a second stent, this one in my left artery. This trip to the hospital was a little more planned and organized. Dr. Miner would have done the second stent when he did the first, but my kidneys were under too much stress from being dehydrated, and he didn't want to pump more dye into them.
This picture was taken after the procedure. I was awake and alert during the procedure and watched it on a monitor in the Cath Lab. I couldn't see Dr. Miner working the catheter, because some big object, maybe the monitor the doctor was using, was in front of me. I remember short moments of the first stent, like when the doctor showed me the blood clot, but not much. Between the sedative they gave me (both times) and my condition the first time, my memory is hazy.
After the procedure, I had to lie in the recovery room for six hours, mostly to keep pressure on the artery where Dr. Miner inserted the catheter. The blood oxygen sensor is on my thumb rather than another finger, because they wanted to ensure the thumb was getting enough oxygen with the artery above it being used for the stent.
Every half hour or so, the nurse took a little air out of the pressure cuff. I could have gone home after about four hours, when they took the cuff off, but as Dr. Miner said, "The hospital has its procedures." I was lucky to go home the same day at all. Every nurse I talked to, including the attending nurse who took care of me all day, said if I got a stent, I would be there overnight. The doctor, however, said I could go home. The nurse added, "Well, you're young and in good shape." I can't remember the last time someone said I was young, probably when I was actually young.
This was my lunch in the hospital, a turkey sandwich on a warm roll. Dinner was also turkey with gravy and mashed potatoes. Having skipped breakfast on doctor's orders, I enjoyed this sandwich a lot.
This is the plaque blockage in my left coronary artery before the angioplasty and stent. Dr. Miner said it was 90 percent clogged.
This thing with the tail is the stent. I forgot to ask, but I assume the tail is still floating around in my artery.
My heart attack was caused by plaque build-up, and plaque "rupturing" (my doctor's word), forming a blood clot and a 99-percent blockage in the right coronary artery. The doctor also discovered the left coronary artery had a 90-percent blockage. Thus the second procedure and stent today.
In case you're wondering if this can happen to you, here's how I got to where I am:
In general I eat fairly healthy food: Chicken, fish, vegetables, and fruit. We don't eat a lot of red meat or fried foods, but I do enjoy a cheeseburger, BBQ brisket, ramen noodles, and Japanese pork cutlet on rice from time to time. I like butter and fresh bread. And we eat in restaurants often. Through diet and exercise, I lost about 40 pounds two years ago and about 60 pounds from several years ago. I've put about 15 pounds back on since two years ago, but I have been working that down again and have lost seven pounds since the heart attack.
I've exercised off and on (running three miles a day, lifting weights) most of my adult life but slacked off a few years ago. I started exercising regularly again about five years ago and now exercise at least three to four times a week riding an indoor bike at medium-high intensity for an hour, lifting weights, and doing some calisthenics like push ups and crunches. I also ride a bike outdoors 35 to 50 miles about once a week, maybe a little less if averaged over time.
LDL (bad) cholesterol should be below 100. Mine was 105 in January but below 100 over the past five years. It was 59 on August 1 and 66 while still in the hospital after the heart attack. (My cardiologist said the current recommendation is below 70 with below 50 as a stretch target. So 50 is now my goal.)
HDL (good) cholesterol should be 40-75. Mine has been 50-67 over the past year and a half. It was 40 on August 1 and 53 while still in the hospital after the heart attack.
Post Script: In a follow-up visit with Dr. Miner and in reading the ER reports, I learned that the ER doctor initially diagnosed a STEMI (ST-Elevation Myocardial Infarction). However, because I didn't have any typical signs like chest pain, arm pain, and so on, and because I told the ER staff that my ECG T-wave has always dipped rather than peaked and that a cardiologist several years ago determined my arteries were clear, even with the dipping T-wave, the ER doctor canceled the STEMI diagnosis. Dr. Miner had arrived and decided to take me into the catheter lab anyway, which is where he found the blockages and blood clot.
2 comments:
Life comes at you fast. Glad you were able to have this situation remedied within such a short time. Keep pedelin'.
I stumbled across your blog looking for some family adventures to do but wanted to comment and say that blood clots form really easy when your fly... Especially a long flight where you are sitting for long periods with the pressure changes. My dad worked at the hospital for 30 years and he said if people had surgery after traveling they'd often throw a blood clot and sometimes die. It is one of the questions they ask before major surgery I believe. Anyway... I'm wondering if your trip to Japan had more to do with your blood clot than you dehydration.... Just a thought from a stranger 😄
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