By RJ DyrdekMarch 11, 2016
NOTE: RJ Dyrdek is the energy manager for the Directorate of Public Works at Fort Knox and is well
regarded as an installation energy conservationist. He is a husband, father, and--a heart
attack survivor. This is his story.
So here I am 55 years old, never smoked anything in my life. I have been an avid weight lifter, and I run all the time--about five days a week. I never take medicine--I don't like all the side effects. I might drink a few beers or have a little bourbon, but only on the weekends, never during the week and I am definitely a gym rat. I did the Derby Half Marathon last year.
I visit the Army Wellness team--who, by-the-way, are great--for a little weight and blood pressure maintenance advice because I might be 5-10 pounds overweight, at points in the year. My point is, I have been trying very hard to be healthy. However, in spite of my active life style, heathy habits and routine maintenance checks, I had a heart attack--and heart angioplasty surgery Aug. 3.
So let me tell you how this went down.
For the last 20 years I've been going to the Hardin Memorial Hospital's free blood/ health screenings. I never have a cholesterol number that is over--200-- that's what they say is the magic number. When I am a little overweight my cholesterol number is 180-190. When I lose the extra weight my cholesterol number is 160. "Sounds good," I thought, "I got this completely under control."
I have been told you have good cholesterol and bad cholesterol. But I have since learned that you need to think of the good cholesterol as a wheelbarrow in your blood that hauls off the bad cholesterol into your cells so it is effectively harmless. So when you hear your total cholesterol number you need to understand how much is the "good" and how much is the "bad." This is usually given to you in the form of a ratio. The magic number of 200 needs to be a 100 good and 100 bad. That way you have plenty of wheelbarrows working in your favor. But 120 bad and 80 good is still OK.
But for me, I was having about 40 or less good cholesterol wheelbarrows no matter what my bad cholesterol numbers were. So not enough wheelbarrows were hauling off the bad cholesterol, even when my bad cholesterol number was real low. It has just stayed in my blood stream for years, even though I run, exercise, eat right and try to watch my weight. So then the big awakening occurred.
Aug. 1, a Friday, I finished work and went to the gym, like I always do. Before I could really get into anything, I got a small, very sharp pain in the center of my chest. It was like a knife blade stabbing, dead center. I stopped working out and sat down for a little while and pressed my fingers hard on that spot and it went away in about 15 minutes.
I called my wife and told her I was skipping the rest of my workout and would be home earlier. She was concerned because I had never done that before--cut a work out short. If anything in our 30+ years of marriage, I had always gotten yelled at about staying too long at the gym and not see her enough.
I explained it all away, to both of us, by saying it must have been heart burn, from something I ate. I like spicy food and eat it all the time but have never had heart burn. So I told her I would try some antacid to help the heart burn I thought I was having. And the rest of Friday night went fine. I thought antacid must be a miracle drug.
Saturday it happened again three times. I would stand up, my hands up on the door frame, eat a couple of antacids and convince myself and my wife it was heart burn. Sunday morning before church, it happened one more time. I still went to church but came home and sat
around the rest of the day. My wife and I cut some grass that evening and I thought the heart burn was gone.
Monday morning I was up early and doing fine. I had a big day planned, so I had to dress up more
than usual with a shirt and tie. Before I could finish with my tie, the small knife-like pain started again. This time my wife said I was white as a ghost, and I sweat through that dress shirt like I had been in the gym for hours. She ordered me to the doctor and she called my boss to tell him
I would not be in at work that day.
She mentioned something about beating me to death, if I did not go to the doctors and heart burn was going to be my least of worries.
I drove myself to the doctor's office, located right across from Hardin Memorial Hospital. I met with the physician's assistant and she listened to my story. I asked her where the heart burn could be coming from, and she asked if she could do an EKG.
I agreed so she hooked up a lot of electrodes to my chest.
Once the machine started printing, her eyes got big and she told me to rest and not move, she wanted to get my doctor. As he came into the room he explained that an ambulance was on the way and that I would be going to the hospital immediately.
I said "Doc, slow down, I just need a few antacids and it will go away in a few minutes." He said no, I was having a heart attack right then and there was no time to wait.
I told him I wasn't even in any pain right then. He said I needed to be in the ambulance and taken to the hospital. He said he had called my wife and she was on the way.
Turns out they can run the same EKG from the ambulance and transmit the data directly to HMH. They explained to me from the graph that the EKG put out, I was definitely having a heart attack right then.
So once the ambulance pulled into the emergence room entrance all the difference groups were geared up and ready to make me better. They quickly did a blood test that revealed some high levels of troponin, an enzyme that comes from your heart cells when blood vessels of your heart are ruptured.
These blood vessels rupture when they are not getting the blood they need. So this enzyme is definite proof to the doctors that I was having a heart attack.
The EKG was only a telling sign that something different was going on. But this enzyme test was almost a guarantee that the last few days I had been having small heart attacks every time I thought I was having heart burn.
They let me stay awake for the exploratory heart surgery. I suspect I dozed off a few times. They put a small garden-hose-size entry port in my leg; shaved a lot of parts that made me very nervous, but before I knew much, they had an orthoscopic camera driving around in my heart arteries. The doctor drove the small camera, the robotic X-ray machine and scoped out all the arteries of my heart. He told me the all the areas of my hearts' arteries look great, less than 10 percent blockage in all but one. He said all those areas look like I must have been doing great with my exercising and eating habits. He said it looked as good as a 25 year old.
But in this one place, that doctors have nicknamed "The Widow Makers," was 95 percent blocked. And I could see it a clear as a bell.
He said that the only reason all the heart attacks during the past few days didn't kill me was that my heart, the actual pump, was pushing the blood past that 95 percent blockage and still getting blood to the rest of the heart. So he said that was why everyone was in such a big hurry.
So now for the fix.
The doctor gets a little orthoscopic roto-rooter and comes in with suction and cleans out the blockage. He had to be sure not to rupture the side of the artery, or they would be back to the idea of cutting me open in a big hurry.
After he cleaned it out, he measured for a stent, a stainless steel mesh tubing that went where all the blockage was to help hold that area open for good blood flow. My stent was going to be like a 1-inch long section of a coffee stirring straw. It was made of flexible mesh and would move right along with my heart as I would go on like nothing was different, eventually.
After that all I would have to do is heal and take medicine to make sure none of this got screwed up or would happened again.
The first medicine would stop my body from trying to get rid of or reject the small metal stent, the second medicine would be to keep my blood thin so it would not have much power as it would flow through the metal object. Those two medicines are ones I would only take for about a year and then my body would give up on the idea of trying to reject the foreign object and just get used to it.
The last two medicines I would take for the rest of my life: One was a cholesterol medicine to drive my bad cholesterol down to a very low number, so that I would have enough good cholesterol wheelbarrows to haul it off. And the other was a baby aspirin that will help keep my blood more consistent as I get older.
Seemed like a good deal considering all the mess I was in for be- cause I didn't have enough good cholesterol.
So by 4:30 that afternoon I was back in an intensive care area in HMH. The big thing was to remove that garden hose they had used in my leg. Now it was a little bigger concern than normal because that is a very big artery and I had all those blood medicines in me and my body would gladly bleed them right out. So I needed to lay still for what seemed like forever. But by the next morning the tube was closed up and I was allowed to move around. I felt fine and went home the very next day.
Then I had to schedule rehab and testing. I am going to admit, I was a little gun shy about going to the gym or doing anything that would make my heart race. What would happen if my very strong, good shape heart would push that little piece of metal out of where it belonged?
That's where the HMH cardio rehab people came in to play. I first went to the cardiologist's office and had all the EKG equipment hooked up to me and did a stress test--a run on the tread mill--with everyone watching the monitors and keeping a close eye on me so nothing would get screwed up. I maxed out that test with no problems.
My heart raced up to 160 beats per minute for 15 minutes and cruised right back down to 70-80 beats per minute in no time. Everybody was happy and they released me the team at HMH cardio rehab.
So for the next couple of weeks, all work outs would be with the cardio rehab team of HMH. They gave me appointments, hooked me up with all the heart monitoring equipment and showed me all their stuff. At first you get a base line and just walk around the place.
Then you pick out a few cardio machines and have at it. They can see your heart activities as you work out. They come by and check your blood pressure as you are running/exercising and they even give you sit-down education classes with any of the nurses on things you think you might need like nutritionists, exercise gurus and specialists. As soon as you can show them that you are functioning properly they cut you loose and tell you keep up the good work. Great bunch of people.
So as a recap:
On a Friday a little heart burn antacid would not fix and by the next Wednesday I am a heart attack survivor and carrying around a new little piece of metal plumbing in my heart.
I now have a piece of paper to carry with me for the airport people so they can identify the metal, and small nitro glycerin tablets in case I have a big heart attack, What a difference a couple of days make in your life.
And wow! The way the doctors explained it in several of my follow-ups was, I am very lucky to be alive. They said that if I had not been good with my exercising and not smoking and trying to eat right, that 95 percent blockage would have killed me a long time ago.
So I promised God while I was on that table I would try and tell my story, if he would let me live, to those of you who are just like me doing what you thought was a good job of taking care of yourself.
So check your numbers, check all your numbers closely. If you need some medicine to help your good cholesterol wheelbarrows do what they need to do, take the medicine. Don't be stubborn, listen to your wife/loved ones.
Get all your information figured out before you have a problem. Know what your cholesterol numbers, EKG's, blood pressure and your best weight need to be. Get it figured out now.
For me I have been given a complete release, no permanent heart muscle damage, no restrictions on exercising, running or doing whatever I want--which includes my training to run the full marathon at this year Kentucky Derby.