What would you do if you found yourself waking up in a hospital room, an otherwise healthy man or woman, having just survived a heart attack? Questions are firing through your mind one after the other like bullets assaulting the deadly enemy of a video game. You lie there in the darkness exhausted but too afraid to go back to sleep for fear you won’t wake up again. Tears well up in your eyes when your nurse pokes her head through your door and says, “Good morning, how are you feeling this morning?” “How do I feel?”, you say to yourself, “I’ve answered that question every day of my life but today, I don’t know what to say. I’ve had a heart attack for goodness sake, how should I feel? I’m alone, frightened, there are about a zillion feelings exploding within the core of my being – you really want me to tell you how I’m feeling?” Out of shear bewilderment and frustration you mumble, “Fine . . . I guess”.
“Oh good”, says your well-meaning nurse as she focuses on the IV pump which has been making the most annoying sound for the past 30 minutes, “Any pain?”. Another question you’re not sure how to answer which doesn’t matter because without waiting for a reply, she’s off to the next glorious bit of news - “You’ll be going down for an echocardiogram soon”. “A what?” ... “you know – they need to check your heart for damage”. “I thought they did that last night.” “Oh no”, she retorts with a condescending giggle, “that was the cath – they put a stent in”.
Realizing you’re not making any progress you decide to hold all questions for the doctor when he comes in – surely he’ll be able to shed some light on what has happened to you and what to expect next.
Later, just as you begin to doze off after a morning of tests, blood draws, and your introduction to cholesterol free eggs without salt for breakfast, in walks your cardiologist. Sitting on the windowsill, he looks at you with a wry smile and says, “Well, you’re pretty lucky, you had a 99% blockage of your LAD, but we were able to open it up without too much trouble, so you’ll be ok now. You’re going to be on some new meds – the nurse will explain everything to you when we discharge you tomorrow. Do you have any questions for me?” A moment of panic sets in as you try to remember all the questions you had perfectly formulated in your mind over night but only one thing comes, “so I had a heart attack?” “Yes, you took quite a hit”, he replies as he looks at his vibrating cell phone, “The echo showed some damage, a 35% EF – we’ll check it again in a couple of months to see if it improves. Sorry, I have an emergency – make an appointment with my office and we’ll talk more”.
Now, alone in your room, it all begins to sink in, and you find yourself weeping uncontrollably as feelings of fear and sadness begin to take hold of you. A few minutes later, after washing the traces of tears from your face, you look at yourself in the mirror and say out loud, “I want to live again, I’m not going to let this thing beat me, I want to live again”.
If you were blessed enough to have a nurse or doctor that had the time and sensitivity to recognize your needs and offer help, they would’ve let you know, first, that emotions of fear and sadness are perfectly normal after having a heart attack – so don’t beat yourself up. Second, an echocardiogram is a simple ultrasound of your heart that shows if your heart’s ability to pump blood was damaged by the heart attack. If it was damaged, often this will heal by itself over time. If the damage is severe and does not improve, there are remedies for this – so don’t lose heart if that turns out to be the case.
Third, you need to have an appointment with a cardiologist within 3 weeks of discharge from the hospital. Here you will have a chance to go over new medications, have your prescriptions refilled, and have all your questions answered. It’s a good idea to write your questions down beforehand and it always helps to take someone with you to the appointment to help you remember the answers. In the meanwhile, call or email the doctor with important questions or if you are experiencing any troubling symptoms such as chest pain or shortness of breath (if these are severe, call 911).
If you are continuing to be sad and fearful at this stage, be sure to tell your cardiologist or PCP so you can discuss some treatment options. Remember, this is a common and expected response to your heart attack but needs to be addressed so please tell your doctor or therapist about these feelings.
I hope that your cardiologist will recommend cardiac rehab but not all do. If they don’t, ask them about it or call your local program as this is by far the best way to transition back to your normal life. This program not only provides customized exercise to get you going again but includes education and support to improve well-being and help you get your life back.
You’ve been through a horrific experience – don’t let anyone minimize it just because today, having a heart attack is such a common occurrence. Your decision to “live again” is courageous and will take strength and perseverance. You will need lots of support so don’t try to go it alone. Be encouraged, you can do this; you will live again – maybe even better than before!