The Procedural Costs

While sitting in the cath lab for DH's first stent placement, I couldn't help but worry about what all of this was going to cost us.  I was glad that we knew what was going on, that he was under medical care, that he wasn't having a heart attack, but I still had to push away the money worry thoughts in order to keep myself calm.

To get a preliminary idea, I had our adult daughter Google "stent placement costs".  Well, you could just about pick which dollar range you wanted to believe.  It ranged in cost from $30,000 to $120,000.  So, the Google idea wasn't a good idea.

I'm a control freak, but this is one topic of which I had to exercise patience.  Fortunately, a couple weeks later, DH was able to get the breakdown from the insurance company, and because I had already drummed up considerable medical costs this past year, we were very close to meeting our out of pocket costs for the family for the year, which was $10,000.  My GERD troubles had landed me in the hospital, and with an endoscopy, a gallbladder removal, and trip to the hospital in an ambulance, so I had already spent $7,000 of our deductible plus total out of pocket costs.

Now the bills have rolled in and our bills go as follows (rounding).....

10/18/12 - Cath lab Costs $29,000  and we owe 987.00 with insurance paying the rest. (For a standard stent placement)
10/18/12 - Cardiologists fees, $2,000 and we owe 280.00 with insurance paying the rest.
12/3/12 - Cath lab costs $28,000 and we owe 1000.00 with insurance paying the rest. (For a CTO revascularization plus stent placement)
12/3/12 - Cardiologist fees $2000 and we owe $220 with insurance paying the rest.

These fees don't inclue the CTA Angiography that originally detected the problem, nor the doctor visits, which we have paid about $9.00 per visit.  Nor does it include initial medication costs, which I think we forked out about $30.00.

Cardiac Rehab will be 100% covered by insurance because it is preventive in nature for future heart attacks, and all medication in 2013 will be 100% covered due to it's preventive use, which is a relief because Simvastatin would have been $200.00 per month, and Plavix would have been $80.00 per month without insurance paying for it.

I don't know what will happen in 2014, when Obamacare kicks in, but I expect Clark to be off of all of his medications by then.

I am posting these costs with the hopes this will benefit anyone who might find themselves in our shoes someday.  It would have been a comfort for me to know up front what was ahead for us on the financial end of things.  Thankfully, we had the savings to cover what we did owe.

How to Lose Weight at a Healthy Pace Without Starving

Exactly a year ago, I weighed 196 pounds which is down from 232 pounds.  I had been on Joel Furhman, M.D.'s Eat to Live diet to treat the neurological effects of celiac's disease, and also to treat pre-diabetes, plus,  I had hoped to shrink a breast lump I had discovered.

I was on this program for two years, and had accomplished the healing of the neuropathy that had been triggered by the celiac's disease, and had also totally reversed the diabetes looming over me, and had shrunk the breast lump, but not completely.

A year ago, I discovered Caldwell Essestlyn's diet, which is now well discussed on this blog, and rediscovered Dr. McDougall's diet which I had followed strictly from 1997 to 2001.  I went on McDougall's diet when I was diagnosed with Grave's disease, which is often a result of celiac's.  (At that time I did not know I was a celiac.)  The Grave's disease was quickly reversed on the diet.  I never had to be treated for it.

In 2009, I had gone off of the McDougall plan because I had developed neuropathy in my feet and lower legs, but I later learned that it was the celiac's disease that was causing it. Not realizing that up until this year, I had searched for another vegetarian diet that would help me to improve my health.  My answer was Joel Furhman's Eat to Live, or Eat for Health plan, which did cure the neuropathy.  I could have stayed on the McDougall plan, if I had realized that all I needed to do was substitute out all of the gluteny grains I was eating, but I didn't make that connection until this past year.

So on Furhman's plan,  I healed up some, lost a little weight, and then I plateaued for a couple years.

Now, in 2012, one year after being back on Esselstyn/McDougall,  I am 38 pounds lighter. I weigh 158 pounds, 8 pounds over the line that says I'm overweight.

I did experiement for three months this year with the paleo diet, adding back meats and dairy.  It had been discovered that I had h. pylori and I was put on triple antibiotic therapy to kill the h. pylori.  I went back on meats and dairy, thinking I needed it to heal up after the antibiotics.  Primarily, I was making homemade yogurts to add the friendly bacteria into my system that the antibiotics had killed off.  I also ate chicken thinking the extra protein would be beneficial for healing up my ulcer.  What happened instead, however, was that not only was I not healing the ulcer, I was developing more ulcers in my colon, and I developed severe trouble with my entire digestive tract.  I was in severe pain, and I mean severe.  I also developed gallbladder trouble resulting in it's removal, plus terrible acne and an itchy scalp.  I also gained ten pounds.

This summer I stepped away from the paleo diet for good, went back to McDougall/Esselstyn, and the weight continues to melt off.  I also have had a resolution of all of my symtpoms.  I also had a resolutions of other symtpoms that I thought I was just having to live with, including anxiety, joint pain,  PMS, and menstrual cramps.

Previous to going back on the low-fat plant based diet, when I was doing Joel Fuhrman's nutritrarian diet, I have since learned that while the nutritairan diet helped me to lose weight, originally, through getting my blood sugar under control, I had a hard time keeping full since I couldn't eat enough greens to keep myself full.  I have learned that we vegans either need more starches in the form of whole grains like oatmeal, or more vegetable fats, which make a body gain weight very quickly, and in my case destroyed my gallbladder.

I am forever grateful for the Eat to Live program and the healing it promoted, but I found myself eating more and more nuts and avocadoes, and regaining my lost weight.

Staying full and losing weight has been far easier, and far less expensive on the low-fat plant based diet promoted by Drs Esselstyn and McDougall, and I am continually suprised when I get on the scale that I have lost, yet another pound, without starving and without exercising!

I've been overweight for 23 years, and now, in my 40's during perimenopause, during a time when women usually gain a lot of weight while trying to lose weight, I am losing weight without stressing about it, and without living at the gym.  In addition, I am all physical issues are resolving as I said before.  That breastlump that I had three years ago can no longer be found.!

I don't count calories. I don't count fat grams. I don't count carbs.  I eat until I'm full, and I eat when I want.

All I do is follow the following rules....  Don't eat animal products. Don't eat any added oils. Don't eat oily plant foods like avocadoes, nuts, or coconuts. Don't eat dairy. Don't eat process flours like white flour. Don't eat sweeteners, except I do eat Stevia, and don't drink fruit juices.

What do I eat?  Greens like kale and romaine lettuce,  beans (legumes), vegetables (there are so many different kinds),  fruits of all kinds, potatoes, rice, oatmeal, dried fruit (in moderation), frozen fruit, teff flour, cornmeal, Bob's Red Mill Gluten free flour, stevia, chia seeds and almond milk. I make many recipes out of many combinations of these mentioned foods.

People always ask me how hard it is to get enough variety of food to eat.  It's not hard once you put your mind to it.  I have a lot of recipe books, and get recipes off of the Internet everyday.  Besides, our Creator made a lot of variety of plant foods in which there is no end.

People ask me how I can afford to buy the produce that I buy.  Well, I'm not spending money on meat, ice cream, cookies, or those expensive gluten free junk foods.  It balances out.  I try to buy what's in season and fill up with lots of inexpensive foods like rice, peas, carrots, potatoes, sweet potatoes, foods that are inexpensive pretty much the whole year.

I eat until I'm full and eat when I want.  I don't feel guilty for one thing I put in my mouth, and that is pretty good for someone who, in the past, has felt guilty for every morsel placed in my mouth since I was five years-old.

I have gone down eight dress sizes in one year.  I love the way I look from head to toe.  My kids can put their arms all the way around me when they hug me.  I can climb to the top of the boys bunkbed, and I can run.

My blood sugar is steady, and never spikes and never dips, unless I eat a processed food like Corn Chex, which is something I recently discovered is a problem, and it really doesn't fit the list anyway.

Everytime I go to the doctor now, they say, "nice pulse", or "excellent blood pressure".

Everytime I tell a doctor how I lost the weight they say, "Good for you!  Keep up the good work!"

Regarding fat and food absorption, which I get asked about a lot......  Each one of the foods I eat has it's right amount of fat in it, and helps itself to absorb itself.  I don't need fat from nuts to absorb the vitamins in garbanzo beans.  I might need fat from nuts to absorb my Corn Chex, however.  Eating everything in their natural state eliminates the need for extra fats to absorb nutrients.  I am not suffering from it.  I can tell because my skin is clear and it is not dry, not even in the winter.  I used to have to use hand lotion in the winter, but not anymore.

However, vegans do have some deficiencies.  I have found that I do best if I take a daily supplement of D3 1000 iu, magnesium (which every red blooded American needs), and B12, which I get from nutritional yeast added to my foods for flavoring.  Vegans can also be deficient in phosphorus and zinc.  I take zinc, but I don't take phosphorus, because I have counted the amounts I get, and I'm getting enough.

Years ago, before my celiac's was diagnosed, like I said, I weighed 232.  I prayed and prayed for help to lose the weight, and heal my thrashed nervous system, and the still small voice said to me over and over again, "Follow the Word of Wisdom".  The low-fat plant based diet fits extremely nicely in with Doctrine and Covenenants 89.

Grains are now back to being the basis of my diet, even though I can't eat gluten.  People have asked me many times, "How does the Word of Wisdom reconcile with being a celiac? Why does Heavenly Father tell us that wheat is for the man, when it is poisonous for you?"   Well, the fact is, I am a mortal, and I am subject to my environment and my DNA.  I got the DNA that makes me a celiac from one of my ancestors.  That is part of my mortal testing.

In the Word of Wisdom the Lord declared, "all grains are good for the use of man."  He provided alternatives for those of us who became subjected to faulty DNA, so I can still follow the Word of Wisdom without making wheat the basis of my diet.

I use all plant foods to build my meals, but because we are encouraged to eat fruits in their season, I keep the high fat ones down to times when they are in season, which is in the winter, i.e. avocadoes, and nuts.  I don't eat nuts by the handfuls.  They are not meant to be eaten that way.  They are meant to be eaten by breaking them and picking them out of their shells.  I will rarely eat more than 5 a day on the special occassions that I do eat them.

I do eat some seeds, mostly chia, which I add to my baking.  One once has 9 grams of fat that is extremely high in Omega 3 fatty acides, as opposed to nuts that are high in Omega 6.  Chia is nearly a complete food and it is said that one tablespoon can sustain a person for 24 hours.

D&C 89 says to eat meat sparingly.  I would never judge or tell someone they were a bad person for eating meat, but we are told to eat it in the winter or in times of famine. It hurts my feelings very much when people tease me for being a vegan, so as to treat others as I would like to be treated, I don't do the teasing in reverse.

 I live in a 70 degree house, so my body thinks it's spring in the winter, and I have plenty of plant foods around me, so I don't think my body needs meat, if D&C 89 says I only need it in the "winter or time of famine. ''

If I was walking across the plains in the Willie/Martin Handcart companies, I would welcome the meat served to sustain my life, but I don't wait with baited breath for a 70 degree day so I can grill outside.  I am grateful that the Lord has sanctioned the eating of meat in time of need.  Had he said it was strictly forbidden to eat animals, I would not be alive today because my ancestors would have died crossing the plains.  There were days they were sustained solely by the fish they caught in the stream, or a rabbit on the trail, and nothing else.

On wheter to eat meat or not, one has to decide that for themselves because I have known people that just seem to need it.  We had an elder riding with us back home from the temple whose mother had been a vegan for years and she was ill for many years.  When she added meat back to her diet, she got well.  I would imagine, she just never found out the right combinations of plant foods to help herself heal, or she didn't get enough sunshine, or didn't supplement with B-12.  But, who am I to say.  The story he told of his mom reminded me not to judge.

The Word of Wisdom says we need to use prudence.  To me that means we need to think.  It takes study, and a good working knowledge of nutrition to be a vegan.  I know vegans that have lots of health problems because they think that all they have to do is stay away from meat, yet they eat a lot of vegan junk food like potato chips.  It would be better for them to stay away from the chips and eat a piece of chicken.

I find that the simpler my meals, the easier it is for me to stick to this way of eating, and the simpler the diet, the more it agrees with my digestive system.

It's not uncommon for me to have a bowl of oatmeal with frozen cherries in it for breakfast.  Rice and peas for lunch, and vegetable stew for dinner.  I have found that a bigger spread of food on the table lends itself to more indigestion, and simpler meals lend themselves to a much happier digestive system, and much lesss work, and much more time for family.

My boys don't seem to care if I only put a casserole on the table for dinner with some fruit, as long as there's enough to fill their tummies.

With this way of eating, I don't have one overweight child in my family.  None of them are underweight either, just healthy, and energetic. In fact, three of my boys made it to the top of Mount Elbert this past summer!

 DH has lost 35 pounds this year as well,  and we are very happy with each other's progress!

Just thought I'd share what I have learned as we approach the New Year.

This year is my first New Year in 40 years that I don't have the goal to lose weight on my New Year's Resolution's list.  Instead, I'm going to take a math class.

At 230 pounds and celiac sick in 2002.  I'm the one in the Salmon colored T-shirt under Mickey Mouse

Here I am in 2010 at 200 pounds, and still a suffering celiac.  At this point, I've been doing Eat to Live for a year, and having a lot of trouble with anxiety, dizzy spells, brain fog, acne, but feeling so much better about myself already, even though I had glutened myself that day, and wound up in bed with the pain the next.

DH and I a month ago before his second heart procedure.  I'm weighing in at 160 pounds, and feeling like I did on our first date, happy, pretty, and healthy, and able to do so much more, like going to a symphony with five boys between the ages of 4 and 16.  Anxiety levels are next to nothing, and I'm dealing with the most stress in my life, with the most capability.

Heartmates - Partnering the Heart Patient, an Important Life Mission

When DH was diagnosed with his heart problem, I purchased a book on Amazon entitled Heartmates by Rachael Freed.  The book came in the same box as some other Christmas presents that I had ordered, and I had forgotten that I had purchased the book way until after I had gone through the two stent placements and all of the ups and downs that go with it.

When I got into the Amazon box to wrap the presents, and found the book.  Uggggghhhhh!  I sure could have used that book.  I thought about donating the book, now that I had been through my trial, but then I thought, "No, I still need to read this book."

I still haven't read it, but I have to say that I really like the title.  I just glance at the book, and it reminds me that I am my DH's heartmate.  That because we are partners, he is having a successful outcome, and that I have played an important role in his diagnoses, and his recovery.  It makes me feel very valuable and encourages me to keep being his partner in keeping him well.

This week I was down with the flu, so badly, that I had to go to bed and be incoherant for 24 hours.  During that time DH ran the show.  He snow-blowed the 14 inches of snow off of our sidewalk, made trips to and from the grocery store, did the dishes, and laundry.

Later that night, he confessed, "Without you helping me make my meals, it's hard to find something to eat."

He didn't hear me when I eeked out earlier in the day, "I made spring rolls and bean burgers for you, they're in the second fridge."

I was a little put out that he didn't hear me, but then I thought what he said was a compliment.  He works 12 hours a day and sometimes more.  He can't spend the time I do looking through or creating heart healthy recipes and work in the kitchen the hours I do preparing those creations.  So, he would be somewhat lost without my help for a time.  He would figure it out, but he would have to put some work aside for it.

I feel honored and priviledged to be his Heartmate.  He is a good man, and helping him to stay healthy is very important work.

I've had a good example in this endeavor.  My dad had a quintuple bypass about 11 years ago.  My mom did the same things for my dad.  She still does.  She researched and learned what foods were best for him, being a diabetic, and has prepared and monitored his food for many years.  He continues to get the thumbs up from his doctor on his heart, and he's a miracle because since his heart attack he's built a house, a greenhouse, and works in my brother's foundary making bases for my brother's sculptures.  He also gardens and works as a leader in his local church congregation, and he's 78! When he had his heart attack he sustained permanent heart damage, yet he is able to be so active.  He's amazing, and yet, I also believe there's no way he could do all of this without his heartmate.

Mom has set a very good example for me, and Dad's ability to do what he does has been inspiring.

Before DH became ill, I had a lot of distractions pulling on my mind, but this experience has made me very focused on what is most important.  This experience has made me a better partner, but also a better mother. It has made me a better cook, and a better homemaker.  What used to be drudgery, in my homemaking efforts, has become a life's misson, one that I'm fulfilled in doing.

I'll have to go read the book now, so I can get more ideas on how to be an even better heartmate, and so I can post a review for others who might benefit from reading it.

A Happy Basketball Report, and Reflections of Heart Disease Symptoms, and Spousal Care

Last night was a red letter night.  DH was able to sustain an hour of running up and down the basketball court with his boys. He was so excited, he encouraged me to write this post so that others could have hope in the CTO procedure in bringing back energy and vitality.

 It could have been Christmas for him, as he looked like the happiest guy on earth, realizing that his vitality has returned after his CTO revascularization procedure two weeks ago.  He noted there was no sweating, no pain, only a slight bit of dizziness when he pushed too hard, but we blame that on the blood thinners he's on to protect his new stent.

We have a YMCA membership and we go as a family frequently to play basketball together.  I noticed over a year ago that he was getting sweatier than usual when he played.  I also noticed this sweaty-ness when I hugged him good-bye in the mornings.

That is why I changed our diets to the Reverse Heart Disease diet of Caldwell Esselstyn's back last January 2012.  I now believe that diet saved him from having a heart attack, and I now believe that he was a ticking time bomb some months before we got serious in changing the diet.

Based on his symptoms and the timing of symptom increase, I would have to say that he probably had 70 - 80% blockage in his LCX artery back in January, and probably about the same in the RCA.  I would like to also note that from 2009 to the beginning of 2012 I had strayed from a low-fat plant based diet as I experiment with the Specific Carbohydrate Diet to treat my celiac's disase.

I believe this straying away from being low-fat vegetarians, which we have been off and on, but mostly on for the last 15 years, is when DH's arteries became more clogged.  The SCD is a low carb and extremely high fat diet.  While on this diet both of us had high cholesterol, which we have regularly kept tabs on for many years.  It's also interesting to note that the biggest advocate for the SCD diet died this year, in his fifties, of a heart attack.

I have been told that in regards to heart disease, symptoms aren't usually noticeable until there is a 70% blockage in the arteries.  In women, who can develop microvascular heart disease the symptoms can start sooner.

DH has 40% disease in his LAD, which we are trying to reverse, but his surgeon didn't intervene with the LAD because 40% would not cause symptoms, unless he continued to eat foods that destroys nitric oxide, causing a new and potentially deadly clot.  This is why we have to be so strict with his diet which has some social consequences.

I have been amazed at the the jeering, and skepticism we have gotten from quite a few people.   We are not really even worried about the RCA but both the LCX and LAD could develop quickly from 40% to 100% blockage with just one fatty meal.

So I have to shut my ears when people say, "How can you give up meat, and dairy?  What about nuts?  You can't eat nuts either?  How about olive oil?  No olive oil!  Isn't that heart healthy?  And you're giving up sugar?  Oh, I could never eat like that!"

People don't realize how uncaring it is to talk like that to someone who has just gone through the scariest experience of their lives and is trying to avoid that situation again.

 I sat in the foyer at church the other day and listened to two friends talk about how my kids were gorging on the the sugar and rolls at the Christmas Party because I am so strict at home.  They had a good chuckle over that, but what they don't realize is that my children, due to family history, are candidates for heart disease and, also, if they eat that stuff in front of their dad, it's not fair to him.

To talk that way to me in front of my children is destructive and undermines what we have to accomplish to keep them healthy for the rest of their lives. It's essential that we follow the advice of our three cardiologists who are in agreement that he stay on a low-fat based diet, despite other's expert opinions and judgments.

I believe that his arteries closed up to their lethal levels in the summertime when scouting activities made it hard for him to stay 100% on the diet, although, he did the best he could, and that is when the disabling symptoms began.  But!!!! Despite that, he still did not have a heart attack nor did he sustain heart damage.

How can a spouse help a heart patient recognize they have a problem in the first place?  I really think that sweating is a huge clue.

Now that DH's arteries are all fully open, sweating does not happen, even when he is running up and down the court for an hour.  There was not a bit of sweat under his arms or anywhere on his solid blue dress shirt after the game.

For DH, sweating and breathlessness was an early sign.  If sweating and breathlessness is a problem, why not just have a conversation with a cardiologist as a preventive measure?  It's  much better than winding up in the ER with an emergency angiogram.

The statistics for men are grim.  50% of men don't know they have heart disease until they either find out through a heart attack, or die suddenly.  I don't remember the percentages of those men that die of that 50%, but isn't any number too high?  And of those who don't die, and wind up in the ER with the first heart attack, the pain is one of the worst there is.  Why not prevent such an event?

DH prevented such an event because he listens to his wife, he listens to his body, and he listen's to the Lord's still small voice.  It took some swallowing of his pride to do so, but his confidence in himself in taking charge of his health and having some control over his future was boosted when he realized that he had taken an essential and urgent action to prevent an event that was sure to happen, which would have crippled him and disabled him from being able to support his family for life.

Another sign, and I won't say early sign, because the first signs happen when the disease is already way established, is fatigue.  For a very long time, DH was tired.  Last January, we were on the beach in Florida.  As a kid he surfed a lot in California, and when we go to the beach, he can't wait to get in the water.  When we went to the beach in Florida, he didn't have the energy to swim. He just stayed on the beach and watched the kids.  He thought he was suffering from the flu.

Well, this "flu" lasted for many months, and he just pushed himself through the fatigue day in and day out, thinking this was a new normal for him.  Well, it was.  It was a new normal, setting up to be an acute situation!

The third sign developed in July, in the middle of his High Adventure week in Colorado.  He noticed that he was having numbness in the tricep of his left arm.  Not the bicep which Rosie O'Donell had felt when she had her heart attack pain, but the tricep.  He felt it when he was walking, and even when he was just sitting with his arm around me on the couch.

Eventually, the symptoms progressed to pretty strong angina pain in the upper left corner of his chest where the arm and shoulder meet.  This pain radiated from that point and drew across his upper chest toward his heart.  It is said that heart pain will begin at the center of the chest and radiate to the arm, but his was the opposite, starting at the arm and radiating toward the heart.

This should serve as a reminder that not all people feel the typical heart symptoms.

For a while, we really tried to figure out, was this a back or neck problem, or a heart problem?  I encouraged him to get the heart checked out first, but he went the back and neck route first, which put us at greater risk, and put off the inevitable.  I know he wishes he had gone the other route sooner.

Back and shoulder problems can cause the tricep and chest pain we describe here, but the triad of symptoms that screamed out, "heart disease", was the sweat, fatigue, and dizziness, and shortness of breath combined with the pain.  Pain alone should still be checked out, but the more I read, the more I realize that usually there is another symptom along with the pain, and usually one or all of the symptoms listed above.

For instance, with my GERD, I have chest pain, right behind my heart and when it's acting up, it feels like a heart attack, but I never have sweaty-ness, or fatigue.  Sometimes I have shortness of breath IF the chest pain triggers an anxiety attack, but for me activity will often make the pain go away, and always make the shortness of breath go away.  Exertional symptoms are a big clue!

I knew these warning signs, and had seen them, and I had been trying to push for a cardiology appointment early on, but I learned that nagging didn't help.  What I did say that made a difference was, "Earlier this year, I had chest pain, and you didn't have to ask me to go get it checked out.  I wouldn't ask you to do what I wasn't willing to do myself."  After I said that, he consented to go.

Not everyone reads medical studies for a hobby like I do, and don't have a grasp of the internal organs like I do.  DH is a numbers expert.  Lots of times he has to explain a financial plan over and over to me again until I understand what he's saying, and I'm sure it's the same with me explaining to him the cause of his chest pain, and even though I kept expressing information to him so he could agree to see the cardiologist, this information and conviction was not owned by him, it was owned by me.  Until he owned the information through his own concerted focus, no nagging in the world would help.

We have to focus on informational material and own it before we take action.  I had to be patient while this process was going on. But, I knew the signs of a heart attack and that gave me comfort in knowing, at least I would know when to call 911.  I also have four scouts living in my house that know CPR and that was also a comfort, and I'm glad we didn't have to use it.

I'm hoping that by writing these thoughts down on this blog, other spouses can know how to encourage their heart patient to go see the doctor, and those who are having symptoms of heart disease can realize that it's not a pride issue to go see the doctor.

There is not one cardiologist that I know of, nor one ER doctor that thinks you are wasting his/her time by being cautious. These specialized doctors know the structure of the heart like a best friend, and they know how easily just one fatty meal can totally block an artery, and they know that it's best to get it checked out, even if the patient were to end up with a test as invasive as an angiogram, which really isn't that hard of a test to go through compared to the alternative of suffering a heart attack.

I, myself, suffer from a conditions that cause scary chest pains that mimic heart disease.  I have an inherited motility problem that makes my esophagus hurt much of the time, especially in the middle of the night, and I have been to the ER several times to get my heart checked out, even though this pain is being caused by a disease of another structure in the chest.

 I have never received anything but concern and respect from all of the doctors and nurses I have encountered.  A couple of them blamed anxiety for my problem and prescribed anxiety meds, which I never took, but they were still concerned and respectful.

I might note, that heart disease was ruled out in every case before anxiety was diagnosed, and it took an endoscopy from my gastroenterologist to diagnose the gastroesophageal problem.  In any case, I  have never been treated like I was wasting anyone's time, or that I was a "weenie" for showing up there.

Medical bills are another problem, but if you are or your spouse is experiencing those heart symptoms, a doctor appointment, a stress test, or an ER visit, and even an angiogram, or two in our case, is going to save you a lot more money than a bypass, or long term heart damage caused by a heart attack.  That is one fact we had to keep reminding ourselves as the bills started to pile up.

So if you have chest pain, sweatiness, dizziness, shortness of breath, especially if these occur on exertion, get it checked out, and then deal with the outcome.  It can be a comfort to know there are great people out there that know how to help you deal with the outcome.  Cardiology professionals are the best and most caring that I have encountered in the medical field.

They are good at lifting the burden of worry, and "we are really good at fixing hearts", as I was told by a very good friend of mine from church who works on a cardiac floor.

And she is right.  I know a man, who I met in the "cath lab" who has had three bypass surgeries and three stents.  He was in his eighties and tolerated the angiogram very well.  The point I'd like to make is he knew when to get in for that angiogram and have the stents placed before he put his family through emergency of a heart attack or his sudden death.  Even my own dad, who did have a massive heart attack, that fortunately did not take his life, has had a quintuple bypass, and in his 70's built a 3500 square foot house, practically by himself.

Now, I'm not saying that because we have gone through intervention, my husband won't have a heart attack tomorrow, but we know, because of his two angiograms and his intervention that he has equal or less of a chance that any neighbor down the street has of having a heart attack, because he's on top of it, taking his heart protective medications, and eating a heart disease reversing diet.  He is also being closely monitored by cardiac rehab, his cardiologists, and the stent company researchers.

I feel more confidence in the condition of his heart than I have had for ten years, because I have seen the videos of his angiogram and I know what each of his arteries looks like.  I also have read all of the material about the stent he has, and the medications he is taking, and I know of the chances he has of improving his heart health through this nutritional and medical therapy.

When we lived in Colorado twelve years ago, I attended a meeting which is held in our church twice a year called Stake Conference.  Our "parishes" which are called wards, like the city districts are called in Manhattan, are grouped into about ten to 15 wards called stakes.  The stake leader is called the Stake President.  At that meeting, a new Stake President had been put in place, and he had two counselors to serve in his aid.

One of the counselors had told a story that his wife was concerned about his heart health and had asked him to go see a cardiologist.  He did not give her any argument, he immediately self-referred himself to a cardiologist.  He was in his mid-30's.  He was active and skinny.   He had no symptoms of heart disease.  However, he lovingly did as his wife asked and went to get his heart checked out.  For a fellow, this takes a lot of humility.  Most men would not do this.

I was very impressed by this man's love for his wife and his humility.  It was found that his heart was very healthy.  She must have been concerned from a family history perspective to be so aggressive in her encouragement of him, but kudos to the both of them!

In that same meeting, she was also asked to speak, and she said, "I love that my husband wants to serve the Lord, and I vow to you that I will make nutritious meals for my husband everyday, so that he can have the health and strength to serve the Lord."  I was mightily impressed by this couple, and have referred to them from time to time.

Well, I think I've hashed this topic over quite enough now.  It is a fact that married people live longer than single people, studies show that mortality for single people is 60% higher than it is for married people.

DH and I were talking about the health benefits of marriage.  First being, that a happily married are not lonely, so they avoid the health consequences that come from being lonely.  Secondly, they can help each other out.  He goes to work and earns a living to support me, and I cook for our family and nurture our children.  I would be far more tired and sick if I had to do both of our jobs.  It would be hard for him to do both of our jobs too!

Thirdly, and very important, spouses can sometimes see changes occurring in their partner that the partner may not notice.  This is where I feel I have played a very important role in my husband's extended life.  I know that my encouragement of him, my study of heart disease, my preparation of healthy meals, and my support in giving up personal time with him so he can exercise saved his life, and will probably extend his life.

It makes me feel that I have fulfilled and am fulfilling an extremely important mission in his eyes and the Lord's eyes.  If I never accomplish another good thing in this life, I will still feel that I have made a valuable contribution to society for my efforts because he is such a good man and does so much for so many.

So husbands, (and wives, but usually wives go before husbands have to say something), if you love your wife go to the doctor if she is expressing worry in your health.  If the doctor finds something terribly wrong, you two can muster up the strength to deal with it together with the Lord's help.

If he finds nothing wrong, then you can sleep easier, and move on with the plans you make together.  Of course, my purpose is only to talk about heart problems.  I have no experience with other health challenges, so I'm not weighing on that, but if you have heart symptoms, go ahead and get it checked because as my wise nurse friend said, "We have become very good at fixing hearts."

Garden Bean Burgers

I decided to give this recipe it's own page, since we eat so many of these.  I love how they can be transported so easily for a traveling snack.  When DH was in the hospital, I made a couple dozen of these and brought them with me.  This is what I survived on.  Caregivers have to fend for themselves on the food front, and that's really hard for a celiac to do when your cafeteria caters to a population that demands greasy, bready foods.

1 can garbanzo beans with 1/2 liquid drained
1 can kidney beans drained
1/4 c sundried tomatoes
1/2 c dehydrated peppers ( or you can use a bell pepper diced, or a can of drained pimientos)
1 c finely chopped kale
1 c brown rice cooked
1 c oatmeal
1/4 c Bob's Mill Gluten Free Baking Flour
2 T chia seeds
1/4 t xanthum gum
1 T Mrs. Dash Onion and Herb
1 t thyme
1 T garlic powder
1 T vinegar

Preheat oven to 350 degrees.

In a high powered blender (I use my Ninja that I bought from Walmart), blend beans, tomatoes, peppers, kale, until all ingredients are finely chopped, but not quite as smooth as hummus.  Transfer ingredients to a mixing bowl and add remaining ingredients.  Mix ingredients together with mixer.

Line a cookie sheet with parchment paper.  As if you were making large cookes, glop large spoonfuls of the mixture onto the cookie sheet and then smash down.  Or you can take a handful, like you would when making hamburgers, roll into a ball, and smash into a flattened circular pattie.

Bake on each side for 15 minutes.

For DH, I serve this with no oil spaghetti sauce.  He has trouble with his triglycerides, so we try to keep the sugars down by substituting catsup with spaghetti sauce.  I can eat them just plain.  This tastes delicious with GF Canyon House Bread, if you aren't vegan, but since we are trying to control blood sugars and tryglycerides, and since I am a celiac, we eat them without bread.

  For some reason, I really like to eat them with grapes.  

So We'll Just Deal with It

On October 18th, a couple of hours before DH's first stent placement, and when we were believing that he only had two arteries that were 70% blocked, DH said, on the way to the cardiologist's office to get prepped for his first angioplasty, "Well, Debbie, we'll just deal with it."

Our approach to dealing with my most feared trial, other than actually losing him or one of my children to death, was to deal with it.

Dealing with it.  Comforting words, really.  Had he said, "Oh, no! I'm going todie!  How am I going to keep working! I can't believe this is happening to me!"  I think I would have fallen to pieces, but he just calmly said, "We'll just deal with it."

That is the way he approaches all trials.  He bites off a big job a little at a time and deals with what ever comes.  It reminds me of the talk by Elder Joseph B. Wirthlin, where he said, "Come what may and love it."  I always got a little aingst in my own heart when ever I heard that quote.  How can you love a gallbladder attack?  How can you love your child's mental illness?  How can you love a crippling ice storm?

Now I'm being asked to love heart disease that I worked tirelessly to prevent in my husband.  Knowing that he had a extremely strong family history of heart disease in his family, I cooked healthy home cooked meals, and nagged him not to "eat that cheese" in restaurants.  But he got it anyway, and now I was faced with loving this trial that had suddenly come up, a trial I had tried to avoid, and now I was dealing with it.

Dealing with it was the best approach.  Not looking too far into the future, was very helpful.

"Don't make any  life changing decisions, just get through the procedure and the recovery", I would tell myself.

That is how I surved the first three days, day one being angioplasty day, and day two and three, the days I followed him around with a blood pressure cuff and a pad of paper which I recorded symtpoms, and blood pressure readings.

We were walking on a tight rope for many days, knowing he still had a 100% blocked artery and not knowing exactly what that meant.  But, as we "dealt with it", we in time learned what he could handle and what he couldn't handle.  He couldn't handle walking briskly, but he could handle a stroll.  He could handle a full day at work, but he couldn't handle taking the kids to Seminary.  He could shoot hoops, but he couldn't run the court.  We, in time learned, that chest pain didn't necessarily mean a heart attack, but that his heart was starving for air, and that he had to back down on the activity.

After the six weeks passed, and we looked back, we were were amazed at how well we did deal with it.

We saw six weeks of more time together than we had ever had in our entire 32 year relationship.  More time to cherish the children.  We saw it as a time to take that old ladder and lean it against a better wall.

We had the best Thanksgiving we ever had; good food, simple food, hardly any mess or dishes, more time to spend with each other because we weren't babysitting a turkey.  We climbed the 50 yards of boulders of the shoreline to our local lake and watched the boys skinboard on the shore, even though it was windy and 50 degrees outside.

We walked hand in hand up the gravel road, a 20% incline for 1/4 mile, one small step at a time.  We laughed at the thought that the kids had made it back to the car 30 minutes before us, thinking they were so smart, but we had the keys to the car, and they had been in the water, and it was still windy.

We got the biggest and prettiest Christmas tree we ever had, and I had to help drag it to the car, but that was okay.

Then we spent two days doing early shopping together.  Christmas shopping with him, for me, was awesome, because he tends to spend more on higher quality stuff than I do and I didn't have to worry about him getting upset with me for spending too much money.

We went to the symphony with the boys.  We walked the 20 minutes down the sky walk to the Civic Center at a strolling pace, which we could do because I told him we had to plan an extra fifteen minutes more than we usually do so as not to force him to cause himself chest pain, and at that pace, we saw more things in that sky walk than we ever saw, a huge crane being used to put up Christmas lights on a nearby highrise, fancy people dressed in their concert best walking on the street stories below us, and many beautifully decorated Christmas trees.

"Dealing with it" became a gift from Heavenly Father.  A chance to slow down and enjoy living, enjoy people, and their creations, to enjoy God and His creations.  Dealing with it gave us time to talk, and once we knew we were past the worst, we had the chance to make those important plans we kept ourselves from making on the day of the first procedure.  We solved many longtime family problems that we didn't have time to think about before.

We fell deeper in love, and I learned that even though he was physically weaker than me, at the time, he was still the head of the family, and still my patriarch.

Now we are week past the last stent placement.  Since then, he has replaced the siding on our garage, which is the garage of the house we are renting, played frisbee with the boys, and had several foot races with them.  I am no longer afraid to let him out of my sight, and I am able to ask him to do things like replace the broken garbage disposal.

We are getting back to normal, but with lessons learned that will never be forgotten about what is most important.

Today he saw his cardiologist.  When she saw his weightloss numbers and his lipid profile numbers she got a huge smile on her face and said, "These are not medication numbers, these are lifestyle change numbers.  Congratulations!"  His total cholesterol was 88 and his triglycerides were 110 and he was put on "no restrictions in activity."  He is even allowed to ride rollercoasters in a few more weeks after his incisions completely heal up!

As we left the doctor's office today, he left me briefly to use the restroom, and I was standing there by myself processing the last two months, and the thought came to me, "We dealt with it!"  And I began to cry with a joy I have not felt in a long time.

It wasn't as hard as I thought it was going to be.  It was hard, but not as hard because the Lord was walking by our side and we had much support from family, neighbors, and church family.

We said we would deal with it, but dealing with it meant dealing with it with the help of  many people, not just the two of us, and dealing with it with constant blessings from a loving Heavenly Father.

DH's Coronary Total Occlusion (CTO) Procedure

DH's first stent was placed 10/18/12 in his left circumflex artery.  This was the artery that was 99% blocked.  He couldn't have the second stent placed in the right coronary artery that same day because two surgeons, or interventionalists as they are also called, had to be on duty, and the equipment was not advanced at the hospital where he had the first stent placed.  When he was sent to the hospital on the 18th, it was believed that he had two 70% occulded arteries, not one 100% blocked and the other 99% blocked, otherwise, he would have just been sent to the bigger hospital.  So we had to wait six weeks, and it was a very long wait.

We had been told because he had collateral circulation to this artery from the left anterior descending with blood flowing backward into the RCA, he could try and live without the stent, or a bypass, but we soon learned that that was a painful option as DH could not walk briskly without pain.  So, we decided to go ahead and have the CTO procedure done.  CTO stands for Chronic Total Occlusion, and these are tricky because sometimes the blockage can be as hard as a brickwall and cannot be broken through.

One day I looked through my husband's papers and one report said, "long, severe stenosis (hardening), in the right coronary artery, will attempt CTO".  Yikes.  My mind circled around "long, severe, stenosis".

I had read several articles on what it was like for surgeons to work through these long segments of hardening.  Because they can not see all of the artery due to the blockage, it is hard to tell how long the blockage is.  It could be 1/8 of an inch, or an inch, or unworkable along the whole artery.  From the angioplasty, to me it looked like DH'S was about 3/8 of an inch, but the surgeon said he couldn't tell for sure.

Guidewires are fed through two sheaths which are place through an incision in each groin which is about 1/4 of inch in diameter and stuck up into the femoral arteries of the groin about five inches.  These guide wires go up through the artery branches into the aorta and are fished up until they reach the blocked artery.  The doctors try to reach the blockage from both sides going through different arteries or the collaterals, whichever way they can, and try to route a hole all the way through the blockage.  This is like trying to drill a hole through a cement block in many cases, and if the doctor gets too aggressive, he can slip with the guidewire and puncture the artery.

Doctors try not to do this, and therefore, their efforts to be gentle, but still be able to break through, can make the procedure last hours.

I was very hopeful about the CTO procedure until last Thursday when the nurse at the catheterization lab called me with pre-op instructions.  I asked her how successful the procedure is, and she said, it was a procedure that was not attempted very often and that she couldn't give me a percentage of successful attempts.  "Sometimes they work, sometimes they don't", she said.  That sounded like about 50% to me.

I got online to see if I could find statistics and the best I could come up with was 70%.  That really depressed me, because what options would we have left if DH's CTO was not successful?  The two options we would have would be bypass surgery for a single artery, which I feel is a lot of invasion for one artery, and the other option was to try to just live with it, which to me is not an option when you have to live with pain daily.

Starting to realize the seriousness of our situation on a higher level, our family started to ask for prayers and fasting from our family and church members.  Having seen the report and the blockage myself, I was very concerned about our odds of having a successful outcome.

We are members of the Church of Jesus Christ of Latter-day Saints, and as soon as we started asking for prayers and fasting, we received confirmation from almost all of my family, my husband's family, and many of the members of our congregation that they would set aside Sunday, the day before the procedure, for a special fast for DH, and prayer.

At church on Sunday, the brother (we call each other brothers and sisters at church because we are all children of our Heavenly Father), gave the opening prayer to our Sunday service.  He said, "and bless those who will be having medical procedures that all will go well and that the surgeon's hands would be guided."

Clark and I felt the outpouring and concern that this brother had for us, and tears of gratitude streamed down our faces as we looked at each other.

After church, two other brethren gave Clark a blessing and asked in the blessing that he would be restored to full health and return quickly to be able to take care of his family and to be able to provide for them.  The blessing was so beautiful that I had been comforted that all would be okay.

As prayers and blessings were given, services were also offered.  One sister offered to sit with me at the hospital which I took her up on because of my experience when the last stent was placed.  During that last procedure, I cried a lot, and was very depressed, and I knew it would happen to me again.  I knew this would be a great inconvenience for her to sit with me, but also knew that I was very weakened from the stress of the last six weeks, because those six weeks were filled with constant worry and many sleepless nights. I knew my nerve reserves were very low, and that I could fall into a panic attack without another person with me.

 I rarely accept help from others.  I am quite self-reliant, but I have also learned that when help is offered, and you really need that help, that part of being self-reliant is being honest enough with yourself to accept that generously offered help, so as not to send yourself into a state that would make you more dependent.  I knew that if DH's procedure was not successful, I would have not been able to be strong for him, without some extra support.  Therefore, I am extremely grateful for this sister's offer, and it did prove to be very helpful.

We also had an offer for a meal on Monday evening.  I was also grateful for that offer too, and I was so grateful for the knowledge that my boys at home would not have to scrape for some dinner.

When we have a support network, we can get on our feet so much faster.  This is what I have learned, to be a part of that support network for others when the time comes, to pay forward the service that was rendered to me.

Monday morning we reported to the "cath lab", short for catheterization lab.  DH was taken to a little room, changed into a hospital gown, and then an I.V. was placed.  A medical history was taken, and then he was visited by the Xience rep who is a nurse that will be following him for the next five years for a study her company is doing on the their Xience stent.  They had a lot of blood drawn from him over the course of his stay.  I am glad he is part of the study because it will force us to have regular checkups over the next five years.  That kind of monitoring is comforting when you have had heart trouble in the past.

After that, the doctor came in and basically told us what I already knew, that his was an attempted procedure with no guarantees for success, with the risk of puncturing an artery, and to expect a very long wait, about 5 hours.

I ran out to tell my friend that she could go if she wanted because we were in for a very long day, and she said, "No, I've brought my knitting, I'm good, I'm staying."

Then we were told, he would be taken back in just a few minutes.  "Oh, wait, we have two acute cases that just came in from the E.R. and your doctor will be doing the surgery for one of them.  Looks like it will be another couple of hours, here's a coupon for the cafeteria to say we are sorry."

Well, I had prepared myself for that news too when I read the hospital's patient handbook on the "cath lab".

I want to emphasize in this post how important it is to one's sanity to read up on everything you can before going through procedures such as these so as not to have unexpected disappointments destroy your day.  If you go into the hospital knowing as much as you can about what could go wrong, you won't have to deal with the feelings of anger that could come from unexpected disappointments.

Sure we were disappointed when we found out there would be a two hours delay, but we were able to deal with it because we understood that some poor, unfortunately, person was already in surgery, who had dealt with a night of horrible pain and worry, and was going through a frightening procedure that they didn't know anything about, with a doctor they had never met, putting their lives in his hands.  We felt sorry for the two unfortunate fellows before us, and were glad that we were there in a scheduled manner, albeit, behind schedule, but still scheduled, and that we knew the competence of our doctor and trusted him, and were not in pain or panic.

Finally, at 11:30, three and a half hours after our appointment to start surgery, DH was wheeled into the OR.  I was able to follow him to the door and give him a hug and a kiss before he went in.  I hated that feeling, but it was better than the last time, because the last time, I didn't appreciate the seriousness of it, and just gave him a peck.  This time I savored him, and his spirit, and our kindredness for as long as I could, and it was nice not to regret being nonchalant during that moment of saying good-bye.

After saying good-bye, I took my seat in the waitng room next to my friend.  I felt so comforted having her there.  We have a lot in common and it was not hard to find things to talk about.  At one moment, I looked at the volunteer's desk and noticed another friend from church who was doing the same thing for another friend from church, sitting with her while she waiting for her mom to get done with her angioplasty.

I don't think it was an accident, or coicidence that the four of us found ourselves together to pass the time with each other.  We were a great comfort for each other and had a great visit.

The "cath lab" hands out pagers to the family members who wait for there loved ones.  They give them to them so that the loved ones can walk to the cafeteria, or walk to other places on the hospital campus because the wait can be so long.  I expected to be waiting for hours before my pager went off, but
to my great surprise, my pager went off 1 1/2 hours after DH was wheeled in.

I became concerned because it was so soon.  Did he go into a code blue?  Or is the doctor just wanting to give me a progress report?  The answer was neither.  The surgery was over!!!!  Wow!!!!  The surgery lasted 30 minutes.  DH was in there for 30 minutes before the procedure started.  The procedure last 30 minutes, and the recovery was 30 minutes.

I motioned my friend to follow me into the consultation room.  I recommend that anyone going through an angioplasty with their loved ones bring another person into the consultation room.  The first time, in October, I was so upset about the bad news that I didn't absorb anything the doctor had said, but luckily, my inspired son-in-law showed up just in time to go into the consultation room with me.  This time, I wanted someone with me too, so I had my friend come in with me.

I think it was fun for her to see my husband's heart pumping, and to see the video of the before and after pictures before stent and after stent.

Showing us the results, the doctor was very satisfied that DH had a very easy blockage to penetrate, and just caved when the catheter pushed against it and he didn't even have to use the guidewire to try and drill a hole through.  In addition, the second surgeon and the second catheter was never needed, although the incision had been made and the sheath had been placed.

When I got back into the "cath lab", the head nurse stopped me and congratulated me.  She said, "We have never had a CTO go so fast."  I said, "My husband used to be an LDS bishop.  He is loved by many people and many people were fasting and praying for him yesterday."  She pulled me close to her and whispered in my ear and said, "I believe in fasting and prayer and I know that is what made the difference for you husband. I believe it!"

DH's nurse, Patsy was also amazed at his speedy surgery.  We commented on how it was just as fast as the first procedure, and we told her about the fasting and prayer and she also bore her testimony that she knew that the prayers were the reason he had the outcome he did.

It was such a happy time.  When my friend and I first heard the news, I didn't know whether so bor leap for joy, but I ended up being reflective and quiet instead.  My friend gave me a big congratulatory hug, and I was glad that she had spent the day with me to be someone for me to share the joy with.

Moments like this are meant to be shared with someone.  It's like going on a thrill ride at a theme park. Who wants to sit by themselves?  It's twice as fun when you can scream and laugh your head off with someone else, and have that someone else to talk about it with later.  That was why she was supposed to be there with me that day.

While antioplasty is really quite easily tolerated for a patient, the recovery is quite difficult.

A bit of time after the procedure blood is drawn from the catheters and a drop is put on a monitor to see if the blood has thickened up enough to be able to pull the sheaths out.  While waiting for this to happen, the CTO patients can experience a lot of pain.  Regular antioplasty is not as painful because the sheaths placed in the groin and into the femoral artery are much smaller, but for CTO patients, the sheaths are big and can be felt into the abdomen, which for DH was very painful.  He was so relieved when the nurse said it was time to take them out.

However, he was not prepared for the pain that was to come.  Patsy was proactive and ordered vicodin, and morphine for DH to take just before taking the sheaths out so he could handle the pain.  But, even with the pain medications, the removal of the sheaths was more pain than he had ever experienced.  I went up to the head of the bed and stroked his hair, but he soon arched his back, clenched his fist and kicked his legs as they pulled out the first sheath.  His neck arteries were bulging and his face was very red.  It got to the point that I almost had to leave the room, but since he had been there for me for seven babies births, I stuck it out.

By the time the second sheath was pulled, the medication had become more effective, but he still had a really hard time with it.

After the sheaths are pulled out, the nurse has to put full pressure on the wounds for 15 to 30 minutes.  She places a dopplar radar microphone on the top of each foot so she can hear the pulse coming from the heart to the leg.  In this case, we don't want to hear a pulse.  As she is applying pressure to femoral artery in the groin, the goal is to cut off the blood flow enough to cause an occlusion to keep the patient from bleeding out of the incision.  The nurse should not hear any pulse from the dopplar radar.  This procedure is very labor intensive for the nurse, and all free nurses in the cath lab are accustomed to checking in to see if she needs a break.  In our case, we had two arteries that needed pressure, one in each groin side, so we had two nurses.

The other nurse, asked DH how long his procedure was and he said 30 minutes.  She declared, "praise God, he loves you!"  We told her about all of the fasting and praying that had been done for DH, and she said, "Praise, God, praise God!"

A couple days later we saw her at Walmart and I pointed at DH and said to her, "Look how well he is doing!"  She said, "He's the one with the prayers, right?"

DH's incisions occluded faster than they did the last procedure, and once the nurses were able to release pressure he felt a lot better.  It was then he became very hungry and very talkative, and we had the great blessing to have a couple hours alone together to be grateful for the wonderful events that had transpired that day.  What seemed would be a very trying day, turned out to be a beautiful day of feeling the Lord's love shine down upon us!

We also got some great tips from Kathy the patient tech that works in the cath lab.

1.  To train a dog, you need consistency.  Practice the behavior you want them to do, without a snack, but use a lot of animated praise, and do this 15 to 30 minutes daily.

2.  If you want to buy comfortable tennis shoes at a discount, if you wear lower than a size 9, which I do, then buy your shoes in the little girl's section.  I haven't bought new tennis shoes in 3 years.  It was time for me, so today I bought Nike's at Shoe Carnival from the little girl's section for $20.00, regularly $45.00, but of course it helped to have the second pair half off since I had to buy another pair for someone else in my family.  The same pair of shoes in the women's section was $70.00.  So, thank you to Kathy.

After our experience in the cath lab we were taken to a crowded and pooey smelling floor in the hospital where DH would spend the next 24 hours in a cramped and noisy hospital room.  I sat in the chair next to his bed, where I also slept for the night.

Our first experience with stent placement taught us that if you want to stay on a low-fat plant based diet, and eat their food, forget it.  I made bean burgers, and brought grapes and other fruits for DH to eat, and then he supplemented with side vegetables from the cafeteria.

The next 24 hours were uneventful, and typical of any hospital stay, being woke up every 2 hours for vitals, and waiting forever for the doctor to come and examine you so you could go home.  We could have been released at 9:00 a.m. as far as the nursing staff was concerned, but we had to wait for the doctor to finish his work for that day in the cath lab, so we spent 8 boring hours in the hospital.  Part of that time I took advantage of not having to be on-call for my kids and took a couple naps.

Since coming home DH has felt much better.  He has had a chance to test out his "new pipes".  So far, the only pain he has had are from the incisions.  He has had no chest pains whatsoever and he says his energy is much better than it has been in a long time!

How blessed we feel to have been candidates for the CTO recanalization or revascularization procedure.  Only 1 out of 10 people with totally occluded arteries are able to have this procedure done, and of those 1 out of 10, the odds of a successful outcome are between 50% and 70%.  Thirty percent of all people presenting to cath labs with blocked arteries have totally occluded arteries.  DH really fell into a low percentage of people who live in the shadows of a medical program that 1. thinks this procedure is worth tying up the cath lab for the extra two hours per procedure   2. and is willing to use their resources to train doctors for this very specialized skill set.  How blessed we are!  Had we lived in another city, he would have ended up with a very invasive surgery for one artery!!!!!

We were approached by Xience before the procedure to be a part of their study of their stent product.  We will not be compensated for our participation, but I am grateful to be a part of the study.  Because we are one of the few who were able to undergo an attempted CTO revascularization, I feel like we have been compensated.  The procedure will cost us and the hospital a fraction of what a bypass would have costs, and  DH still has all of his original arteries.

A bypass, when well taken care of will last 15 to 20 years.  I want my DH to be around as long as possible, and I didn't want him sentenced to another bypass 15 years for now, or death.  This is how our surgeon felt too, and I am so grateful to him for his perspective.  He could have made a lot more money filling up his time with bypasses, but instead he has spent his life perfecting angioplasty and CTO revascularization.
Dr. Marc A. Tannenbaum, you are the best!  Thank you again, and again, and again for revitalizing my husband and father of my many boys who can't wait to play a game of full court basketball with their Dad!!!!

GERD Getting Me Down

In our church, the first Sunday we fast for two meals, and we give the money that we would have spent to the poor.  This Sunday, being fast Sunday, I had the perfect opportunity to learn something very valuable related to my own chest pains.  That it is, indeed, my esophagus that is causing one of my too unnerving chest pains. I also have costchondritis, which I've had since I was 30, in the left side of my chest, so that causes me to take notice when it's acting up.

Today, I fasted for 18 hours, and I haven't felt this good for many days.  While I did feel some gastritis pain in my stomach, I did not have the pressing feeling behind my sternum that has plagued me since February (I haven't fasted as long since my four year-old was born, this was my first time really getting back into it), nor did I feel the activity of something moving in my chest, that makes me think my heart is fluttering that I frequently feel after meals.

This causes me to believe that I do have esophageal spasms after meals, and that eating is causing my chest pain.

My Grandpa has nutcracker esophagus, and my mom, and brother tend towards esophageal pain from time to time, so I think this is what is causing my chest pain.

Why would I write about this on a blog about heart issues?  Because some people are like me.  They feel the pain and think it's about their heart.  Sometimes it's just nice to know that someone else is going through what you are going through.  If someone were to read this blog and have exhausted all heart causes, maybe this will a person with non-cardiac chest pain to feel they have an explanation or another thing to look into for the pain.

However, I would never tell someone to dismiss are cardiovascular cause until it's checked out thoroughly by a cardiologist because of what my DH has been through.

Get the heart checked out first, and then see the gastro doctor.  I have, and she and I have this theory about my esophagus, and today's fasting test proved it out.

My Review of Bob's Red Mill Teff Flour

Originally submitted at Bob's Red Mill

Teff (Tef, T'ef) Flour is a pleasingly light, uniquely flavored, whole grain flour. Due to Teff?s size, it is almost impossible to grind in your home mill. We are glad to do the work for you! Ethiopians make a flat crepe-like bread called injera from teff flour. Substitute teff for about a four...

Bob's Red Mill Teff Flour

Amen to the Other Reviews

By Celiac Mom of 7 from Iowa on 11/29/2012

 

5out of 5

Pros: Flavorful, Unique, Satisfying, Vegetarian, Healthy

Best Uses: Cooking

Describe Yourself: Foodie, Simple Tastes, Health Conscious

I agree with all of the reviews below. I make baked goods and pancakes with 1/2 of the flour called for being teff and the other 1/2 being the gf baking flour. I have six boys and all of them love the baked goods. I also don't use sweeteners except applesauce and banana, and no oil, and the baked goods turn out just fine. So healthy! Thank you, thank you, thank you for making this available.

(legalese)

Vagus Nerve Pain Another Cause for "Heartache" and It's Relationship to Empathy and Healing Through Hope

I know my Coronary Chronicle blog is mostly about my DH's experience with heart disease and healing through a low-fat plant-based diet, but I like to give myself license to talk about other matters concerning the heart and chest pain, as I did in my last post, because it was my interest in the health of my heart that caused my intense study in heart matters a couple years ago.  Plus, it was this interest that enabled me to quickly recognize that DH was having trouble before any heart attack happened,

You could say that my tendency towards worry about health may have saved him from having a heart attack, and if my experiences can help others get to the doctor and get checked out when they have symptoms, I'm glad.

On the flip side of being cautious and getting check ups on our hearts, is the over barrage that I believe we get from the media that can make us overly cautious.  I'm a victim of over cautiousness.  In other words, I have been to the doctor, I have been checked out thoroughly, and I still obsess over the condition of my heart, much more than DH who has a known heart condition.

Part of this stems from working in the health field for several years, working with geriatric patients for several years, and reading too much.  Another part of this stems from the fact that I have always been a "worry wart", a nickname I acquired at a early age.

My new quest has been to treat my worry wartism by learning how the mind and anxiety can promote physical pain.

Elder Dieter F. Uchtdorf has given many talks on the relationship of worry and it's affect on the mind, and eventual effect on the heart.  As I have learned more about the relationship between the mind and physical pain, I am realizing that what our leaders tell us is far more reaching than what we give them credit for.

Elder Uchtdorf, having seen much suffering, and mental illness during his lifetime due to being a refugee, understands this mind/spirit/body relationship very well, and when he talks about the relationship between hope and healing the condition of the mind and heart, he knows a deeper meaning than we might focus on.

As I have studied the result of worry on the physical heart, I have come to know for myself that this is true.

What launched me on this study was the literal heartache I feel when I have negative, worrisome,  or sad thoughts.  I had this pain the day my DH and boys left for a week long trip in Colorado.  I knew DH was sick (and he was, as he was a heart attack waiting to happen), and two of my boys were just recovering from the flu.  Did that set the worry in?  Yes, indeed, and hours later I was popping my omeprazole, and calling my friends in tears due to this ache in my chest.  One dear friend came over to spend the evening with me so I would be distracted from worry.

I discovered that weekend that if I rubbed my back on the corner of the wall that the gripping pain would go away, which I have learned to be a treatment for my "heartache" everytime, or I can asked one of my boys for a hug, or a backrub and it's goes away.

The day that DH was diagnosed, I had my "heartache" the whole weekend that he was having and recuperating from his procedure.  I wanted to take my place in line for an angiogram and get my heart fixed.  Interestingly, the pain would only come when I was able to be quiet and think, but when I was needed for caregiver duties the pain would go away.

This has been consistent.  When I have a worry thought and a rush of adrenaline from that worry thought the pain comes, and when I get busy doing laundry, taking a walk, painting, or something physical, or have the boys distract me with a hug, bye bye pain.

Going to my heart and tummy doctors, to rule out the heart and to discover the stomach problems, made it possible for me to release myself from the primary worry of heart disease, and focus on the mental reasons for my pain which is why I would encourage anyone with chest pain, to just skip the middle diagnostic activities, including going to the primary care provider, unless you need a referral, and just go directly to a cardiologist.

But, now that I have done that, I can get busy on working on healing my stomach, and working on my hope.

So, this past week, I have been praying hard for the Lord to help me figure out what is causing my chest pain.  I know that some of it is stomach, but I've been told that the stomach problems won't heal until I get my nerves under control.

Believing in the mind/body connection, that mind problems can cause physical problems, I wanted to figure out what part of the body is my mind problem messing with, and this morning as I was praying, the thought came to me, "check into the vagus nerve."

Aha!!!!  That made so much sense to me.  The vagus nerve has been my go to guy when I have needed to blame other symptoms on something.  In the past, I had learned that it is the vagus nerve that makes both my reproductive organs, and my stomach nauseated during that special time of the month. It is the vagus nerve that makes me dizzy when I stand up to too fast during those times I have not been drinking enough water, and it is the vagus nerve that I think triggers my SVT's when I have eaten too much or am, again, dehydrated.

Well, so, I did a Google Search and found this discussion....

http://www.scientificamerican.com/article.cfm?id=what-causes-chest-pains

The discussion is a  psychologist's  answer printed in Scientific American answering the question, "What causes chest pains when feelings are hurt?" by Robert Emery and Jim Coan both professors of psychologic at the University of Virginia.  It talks about the link between emotions, the vagus nerve, and heart pain.

A few weeks ago, I had read an old description of this from an ancient Roman physician, probably Hypocrates, who talked about pain in the solar plexus, that is a network of nerves, just below the sternum than can develop pain triggered by emotions, so this has been on my mind as an explanation, but my pain comes up little higher in the chest right below where my heart is.

Because I do worry a lot, and because I would like to avoid being on medications, I like to look for explanations for sensations that make me worry and make me uncomfortable.

So, I have been praying for an explanation, and praying hard, and the Lord has sprinkled bits of information little by little as can handle the understanding of them.  This morning as I was praying again, the thought came to me, "Check on the mind/body connection of the vagus nerve."

This made complete sense!!  Knowing that I have already discovered the vagus nerve to cause issues with my reproductive organs and my stomach, then why not go right up the line, higher up, and blame it on my heartache as well!!!!  For those of you who might not know the vagus nerve, or wandering nerve as it was anciently called, wanders from the reproductive organs to the stomach to the heart, to the base of the skull.

Incidentally, as I write this, I am at the time of the month when the reproductive area and the stomach complain together, and I am realizing that I am having a constellation of pain, with all four sites, reproductive, stomach, heart, and neck in pain, but I have been focusing on the heart pain because of the mode of life I am in right now, caring for someone with heart issues.

Let's say that some of this might have to do with empathy.

So here is what the answer from the professors says...
"Heartache is not the only way emotional and physical pain intersect in our brain. Recent studies show that even experiencing emotional pain on behalf of another person—that is, empathy—can influence our pain perception. And this empathy effect is not restricted to humans. In 2006 a paper published in Science revealed that when a mouse observes its cage mate in agony, its sensitivity to physical pain increases. And when it comes into close contact with a friendly, unharmed mouse, its sensitivity to pain diminishes. "

My DH often tells me he has never met another person that has more empathy than I do.  I do suffer a great deal  mentally, and physically, when others are suffering.  Even now as I write this, it prompted me to think of a friend that I have who is suffering right now, and I noticed that my chest was hurting again.  

I'm not equating myself to the Savior at all, but these thoughts did cause me to think about the scripture in John 11:33 when Jesus saw Mary weeping after the death of Lazarus.  It states, "When Jesus, therefore, saw her weeping, and the Jews also weeping which came with her, he groaned in the Spirit, and was troubled."

When that scripture comes to mind, I see the empathy of the Savior, and the uncomfortable sensations that empathy caused for Him.  The dictionary says that groaning is a deep sound in response to pain.

Should we try to suppress the pain of empathy?  For us worry wart types, I don't think so necessarily, but I do think it helps us worry warts to understand it's mechanism better so we can see it as a positive response to what is happening around us.  To see that we are experiencing this due to empathy and know that it is a result of sharing with another human being, and not a health problem, helps immensely, and can help us deal with the stress response.

The professors say that there are ways to minimize this pain once it is recognized, and that is was I was seeking for.  So, I'm saying to myself through this time of knowledge seeking, "I have this pain, is there something I can do about it?"  And the answer is, "Yes!"   The professors report.....

"Soon after, one of us (Coan) published a functional MRI study in humans that supported the finding in mice, showing that simple acts of social kindness, such as holding hands, can blunt the brain’s response to threats of physical pain and thus lessen the experience of pain. Coan implicated several brain regions involved in both anticipating pain and regulating negative emotions, including the right anterior insula (which helps to regulate motor control and cognitive functioning), the superior frontal gyrus (which is involved in self-awareness and sensory processing) and the hypothalamus (which links the nervous system to the endocrine system)."

I experienced such a thing the other night that perplexed me.   I had read about Oprah's (benign) breast cancer scare briefly, and having walked through a friend's breast cancer experience that led to her death, I immediately began to feel pressure in my chest.  While trying to process this pain caused by empathy, I did "feel for" what she had been through, I received a very sad and disturbing phone call from a person going through great suffering.  In my effort to comfort, I noticed the pain was gone.  Based on the explanation from the professors an act of kindness lessened the pain.  This is why I started praying about this emotional connection.  I wanted to know that I was not crazy, that there was a physical explanation to what was clearly an emotional trigger.

Now I know that it's okay for me allow myself to put myself into the path of suffering, to suffer with others, but that I also need to recognize that I can and need to pull myself out of the uncomfortable physical sensations created by empathy, and worry, by getting myself into action and do an act of kindness, or even seek for  an act of kindness from loved ones, by getting a back scratch or a hug.  

So, what is the physical mechanism that causes pain during extreme emotion?  The Professors Emery and Coan report that it's a part of the brain called anterior cingulate cortex that increases the activity of the vagus nerve during times of emotional stress, and that this activity causes a "cascade of biological" symptoms.  

To me this makes perfect sense and gives me great comfort to know, and explains my experience very accurately.  

It supports what Elder Uchtdorf has gently told us for years, that if we allow ourselves to lose hope, we will make ourselves sick, and that if we hold onto hope, it will heal our hearts - not just our spiritual hearts, but our physical hearts.  Why, because it is all connected.  The vagus nerve responds to negative emotions in a negative manner.  Lack of hope creates negative emotions.  Hope and charity (acts of kindness) heal us and  keep the activity of the vagus nerve down and heals minds, our spirits, and our hearts.

It's the Christmas season now.  In four days, my DH will go through another heart procedure, and it will be a stressful time,  a time that could produce a lot of worry and stress, if getting ready for the holidays were not enough; but it is good to know that I can still take care of myself while I'm taking care of DH through caring for him.  He provides an opportunity for me to redirect my worries to acts of kindness towards him.  

Christmas also provides that opportunity.  Now that I know that the stress and worry I have been carrying have triggered a uncomfortable physical symptom that is not a medical emergency but feels like one, and that that symptom can be controlled by redirecting my thoughts and actions, I think I will actually be able to handle this stressful period better than I did when he had his last procedure.

Just before I end here, I'm not trying to minimize the pain that anyone would have by saying, "Just be kind and you'll get rid of your pain."   There are many causes for pain, not just emotional, obviously.   I'm just comforted to know by this information that this is an explanation to the literal heartache that I feel when I worry can be lessened with a positive action related to the human touch.

I am grateful for prayer.  It has been my greatest tool during this time of unusual stress, and I'm really glad that my son directed me towards Elder Uchtdorf's talks that have been cycling around in my head leading me to expect healing through greater hope, and I always think it's pretty neat that science often supports what our church leaders have been telling us all along!   

GERD Can Mimic Heart Problems and Cause Unnerving Symptoms - Get It Checked Out!

I have a condition that is very painful at times and mimics heart attack pain.  It wakes me up almost nightly, and it takes me a while to calm down before I can get back to sleep again.  If I called 911 everytime I had heart attack symptoms, I would be calling 911 almost everyday.

Can you imagine what it feels like to live like this?  I used to be unmanageable.  It paralyzed me to the point where I couldn't function during the day because I was up all night worrying and pacing.

My condition is called GERD, or gastroesophageal reflux disease.  Before this disease took over my life, I thought only people that eat fast food get GERD.  But, I was terribly wrong.  I have been a lower fat mostly vegetarian for many years, and low-fat vegan for a year, and it did not prevent me from getting GERD.

I didn't get GERD from my diet.  I got it from 1. Having seven babies, and losing the tone in my lower esophageal sphincter from having my stomach pushed up in my diaphragm for much of my adult life.  2.  From having a hiatal hernia, for the same reason.  3.  Being high strung  4.  From acquiring a nasty h.pylori infection, for which I am being treated for right now.

I suppose my GERD would be a lot worse if I wasn't eating the way I do.

My GERD haunts me many days and nights of the week.  I can't eat more than a fist full of food at one sitting, or I feel a ripping pain where my stomach meets my esophagus, which lies right underneath my heart and feels like it's ripping into pieces, which gives me the feeling that I'm having a heart attack, which triggers an adrenaline rush, which triggers my heart to beat fast, which triggers me to hyperventilate, which triggers shortness of breath.

I went to the ER one time to have these symptoms checked out, (and $3,000 later because I was hospitalized overnight), and I had many heart tests, and several cardiologists follow up appointments.  The result was a diagnoses of a really badly inflamed stomach, and a good heart.

I also have gastritis and an ulcer in my duodenum which were caused by the post traumatic stress I deal with for some issues I won't go into here, and most especially, the damage done by the h. pylori.

My stomach is severely inflamed and I am told by my gastroenterologist that I will have trouble with it unless I take omeprazole for at least another year.  I have been taking it for three months.  She said it was one of the worst cases she has ever seen.  We are trying to avoid a bleeding ulcer and stomach cancer.

The omeprazole, which is a proton pump inhibitor and cuts down the amount of acid my stomach produces works quite well.  I went back on it a week ago and the ripping pain in my chest is now just a sharp sick pain which is happening less frequently.  I expect to be feeling much better in a week's time.  I think I am also having esophageal spasm which can be caused by GERD and can also feel like a heart attack.

I hate being on the omeprazole because it makes my face feel and look like I have lupus, and it makes my scalp itch.  This only happens when I'm on my period, though, so I think I can deal with nasty skin for a few days a month in exchange for getting rid of the sensation that my aorta is about to explode.

So, how do I know it's not my heart?  The answer is, there was no way I could know without getting the testing done and seeing my doctor, and having my heart monitored thoroughly this past year.  The symptoms are so similar, and everything I have read says to have it checked out by a cardiologist just to make sure.  This is good advice after having been through what we have been through with my DH.

I would encourage anyone who has heart disease symptoms to take the easy step and go see a cardiologist.  Most likely the good doctor will send you home with peace of mind, but if it is your heart, it can be dealt with like we are dealing with DH's heart diagnosis.  There are so many great technologies and protective medicines to help you deal with a heart disease diagnosis that it's not as scary as it used to be.  And there is also the great research that has been done by Caldwell Esselstyn, M.D. and Dean Ornish, M.D. that gives even a bright hope of reversal from diet.

I say going to the doctor is easy because I first thought it would be scary and that I would find out all of this terrible news and that the cardiologist would laugh at me, and that I would be made to feel like I was wasting his time.

Nothing could have been further from the truth for me.  Yes, is was hard for DH to receive the diagnosis he did when he went, but going was helpful for both of us.  On balance, both of us are better off now than we were six months ago.  Both the heart and stomach specialists have played a role in making us more functional than we were six months ago.  Both of us are dealing with conditions that are inconvenient, draining, and we wish we didn't have, but we are getting support to deal with them, and we will be much better a year from now because we went to get checked out, found out what was going on and are dealing with it.

We both go to Iowa Heart and I have not met one person on the staff there that hasn't been respectful or caring.  They have been supportive, patient, and considerate, and thorough.

The scariest part were the bills.  I have a  $6000 deductible, and my stress echo test cost a few hundred dollars, but I had every test available except the thalium stress test and the angiogram.  And that was because I ended up in the ER instead of going right to the doctor in the first place.   Had I gone to the doctor's office when the pain first started, the multiple tests would have been narrowed down to just the stress echo, and I would have avoided bills from the hospital, and bills from multiple hospital doctors, plus X-rays, medications I didn't need, and heart monitoring on the telemetry floor that I didn't need.

My gastroenterologist was shaking her head the other day over the cardiology bill expense as we discussed it.  If they had just done an endoscopy in the hospital, no other tests would have been needed.

My endoscopy was just $600 for a $2500 out of pocket test.  That included the clinic fees, the doctor fees and everything that it entailed.  It was worth every penny because I knew what was wrong and we had a plan for healing that we could set in place.  The treatment for the h.pylori costed me $800 but I think if I had gotten the therapy medications at Costco, I would have paid half of that.  I just didn't think about it.  I was too sick at the time.

Other conditions that mimic heart attack pain are gallbladder disease, and anxiety, both of which I have experienced.

There are other conditions that cause chest pain, costochronditis, but that feels more like a chest wall pain.

So, I just have to say, if you are having heart attack symtpoms, don't freak out right at the beginning,  Try to listen to your body for a few minutes.  If the pain goes away with movement, having someone massage your back, or taking antacid, then you are probably safe, but if it persists after a few minutes, and you get sweaty, dizzy, and the pain increases and becomes severe, call 911.

By all means, any of this type of pain bears having a doctor check it out, and no doctor is going to think you are nuts for getting checked out.  I have talked to several doctors about my chest pains, and every single one of them have listened well, have been considerate, and have taken me seriously, even though I am a woman who has not gone through menopause yet.

I think doctors are starting to take women more seriously now, which is a good thing.

Listen really hard to your body.  Take notes.  Try to see what triggers the pain.  Take your notes to the doctor.  They will appreciate you for the thorough history because they can zero in better on what is going on with you.

This helps when you are dealing with GERD to.  Take notes of food triggers and stay away from those triggers.  For me, this has been the most helpful in decreasing my pain.

There's a lot of scary information out there about chest pain on the Internet.  Hopefully, my experience will help others going through the same thing, and help those people not to freak out over every little twinge of pain they have in the chest, but to also encourage them to see their doctors and not worry about doing so.

I for one don't like going to the doctor, never have, but sometimes our problems can be bigger than we can handle and when they do catch up to us, the doctor can help us deal with it and lessen the difficulty.

The expense of going to the doctor in the first place is also a concern, but like my friend who lives down the street, who put off listening to her gallbladder, you could wind up in the ER with a life threatening condition, and have many months of extra expenses to pay for that you wouldn't have had if you dealt with the problem on a non-emergency basis.

I'm so glad we got DH in before he had a heart attack.  We were able to deal with the problem in a measured and calm manner that did not result in heart damage and very much time missed at work.

GERD can also cause emergency symptoms too, so if you go to the heart doctor with chest pains that you didn't know were being caused by GERD, you still need to find out what it is, and how to heal up, so as not to develop anything condition that would cause severe bleeding.  The heart doctor can quite easily help you rule out heart problems so you can concentrate on the real problem and when those chest pains continue to surface before healing takes place, you can assure yourself that it's not being caused by the heart.