The Heart Knows

My beating heart and my busy mind will forever be in an inextricable dance, an interminable conversation. I have accepted it as my post-SCAD gift. The world praises the connection of the heart and mind in song and poetry and the bond between the two is venerated as a symbol of being a whole being. Some people walk a long path to achieve the connection. Therapy or drugs. Art or prayer. There are many ways humans find to get there. Perhaps there is no faster way to get there than to have your previously healthy heart suddenly and inexplicably go awry. In a flash, the two become partners in living, companions and guardians of each other. In this, then, as SCAD survivors, we may have become truly blessed. 

The other night as I tried to fall asleep, the dynamic duo was chattering away again. They were getting a little worked up. The heart started it, and started it for a good reason.

Boom-boom. Boom-boom. Pounding away. Louder when I turned to my left side; softer when I turned to my right. 

"Oh, good heavens, now what?"

"Something's not right!" The heart pounded.

"I think it's anxiety, with the first days of the school year starting and all. We shall chill," said the mind. I eventually dozed, but sometime in the night the chatter started again.

"I'm telling you, something's not right!" Boom-boom. Boom-boom.
.
"Go to sleep!"

But the heart continued with its higher-than-normal resting pulse around 90 - 96 bpm.  So I got my stethoscope out. Another post-SCAD gift was my interest in cardiac anatomy, EKGs, and listening to heartbeats. So I purchased a stethoscope from Amazon.com. Everyone in the house has been listened to, from the Boxer with his thunderous rhythm, to the old Boston Terrier with the swishy syncopation of his mitral valve prolapse, to the bearded dragon and his rapid reptilian pitter-patter.  Mostly, I am soothed by the sound of my own heart, its beautiful, steady beat and I listen in gratitude for its healing.

The other night, though, that beautiful, steady beat was indeed faster than normal. Though I felt oh-so-tired from those first days of meeting new students and starting back into the classroom routines, my heart sounded as if it was gearing up to run a marathon or it was a little bird that had just returned from a long flight.

"I'm telling you...." pounded the heart.

"Ok, I'm listening." Mind went into action. The usual run-down of questions: Pain or pressure in the chest? Arm? Jaw? Nope. Breathing ok? Yes. But I was hot and a little foggy. I thought to take my temperature and there I found the problem. 101 degrees Fahrenheit. A fever.

Fun biological fact: heart rate increases10 beats per minute per degree centigrade. I found it after a lot of googling. 

Quickly, very quickly, all the elements of your typical viral infection started: body ache, chills and (I'll spare you the details) the gastro-intestinal events. For the first time ever, I had to take a sick day during the first week of school. 

SCAD survivors, you understand -- the hyper-vigilance we live with, the all-consuming alliance of heart and mind. Sometimes it is lovely, a metaphorical marriage, wise, perceptive, intuitive of all things seen and felt. In this case the alliance proved practical. This was the first time I have been just normally sick with a plain ol' "bug" since I have had my SCAD. No need to panic but I appreciated the tip-off that something was wrong. 

"I told you so," said the heart.

And she was right.

I Had a Heart Attack and It Was Hilarious!

To get an edge on the humor, watch this video from The American Heart Association's Go Red For Women campaign. It features actress Elizabeth Banks showing how women do heart attacks.

A couple weeks ago, our principal asked the teaching staff to post a highlight from our summer on an online survey. The survey results were used to play a match-up game among the staff during our first teacher workshop day and it was a great way to chat and ease back into our school year.  

There was no way I was going to enter what first came to mind. Instead, I said Cruised Casco Bay for my 50th birthday. That wouldn't freak anybody out.

The highlight I really wanted to list? Attended luncheon with four other women and we sat at a table laughing about our near-fatal heart attacks. I know better. This response in my workplace would have gone over like a lead balloon.  

I know about the lead ballon effect because I joked about my SCAD once -- just once-- at a team meeting. We were all very happy about getting a new water fountain, the type that's filters and fills a water bottle. One of my colleagues remarked on how the water in our building tastes terrible and wondered if it was even safe to drink. I replied, "It's probably fine. I drank it for a whole year and the only thing that happened to me was my heart blew up!"

Silence. Horrified expressions. I had put my big survivor foot in my mouth. My colleagues began talking solemnly about how awful that time was, the night they got the call, the weeks of my recovery, having to process with the students. My remark was too much. They had some residual trauma as well, and I had ventured too far into the dark side with my humor. 

Indeed, heart attack humor needs to stay in the heart attack club. What a delight it was, then, to meet four SCAD survivors this summer at the Samoset Resort in Rockport Maine. With the exception of one woman, who was a wonderful support to me right after my SCAD two years ago, we were all meeting for the first time. All of us live in Maine and fit the unexpected criteria for dissecting arteries - young, healthy, educated, active and vibrant.

Before the napkins were unfurled on our laps and forks stuck into food, the stories were flying -- and they were funny! Here were my peeps. Here is where I could let lose with the dark humor. 

Our humor seemed to most often come from the memory of trying oh-so-hard to maintain our composure while we slowly and silently slipped into what might have been our demise. 

This is how we do it. This is how a lady has a heart attack. She might -- oops! -- feel a little pop or pressure in her chest. Maybe a little gas bubble. A little tingle in the arm or a little bit of stress in the jaw. A little flutter. A little shaky. (These are all "little"). She lays down, just for a little. Or she goes on hoping it will pass because there are things to do, work to be finished, children to be brought somewhere, or dinner to be made. (These things to do are all "big" in her mind).  

One thing is for certain, we are most definitely not having a heart attack. Can't be. We demand that EKG machines be rechecked. We question the need for emergency transport. We prefer to drive ourselves to have that little something checked. Maybe later, maybe next week. After we mow the lawn. After we take a walk or massage the kink out of that muscle. That's all it is, right? A pulled muscle. Or maybe a burp.

Our collective stories all had these elements. As we sat there telling our survivor tales, the wide expanse of blue sky and sparkling ocean, which was our backdrop, fogged over into a wall of gray pulling us in closer and closer until there was nothing more to do but to embrace the darkened sky and laugh some more at our own ridiculousness, at our unbelievable predicaments, at our survival.

Before we parted, we hugged and talked about meeting up again and finding more Maine SCAD survivors. I hope we do. Until we meet again, I will keep my dark humor reigned in.

Ferried Past the Fear

Someone had just left her there on the wharf with her legs draped over the end of the cargo cart. Her finger tips gently touched the edge of the fence that separated her from the upright people about to board the ferry. Did I hear a whispered last breath? "Help me...help me."

What a display for me to happen upon  -- ME on the day I would be facing a lingering post-SCAD fear, which was to board a ferry in Portland and travel out to visit one of the many islands we have in Casco Bay. Need I say that she scared the bejeezus out of me? It was only for a moment, but still...

Rescue-Me Rhonda. Saved-at-Sea Suzie. Whatever her name was, she was a sight to behold! There she was, buck naked and wound in rope. Couldn't one of the crew have thrown a tarp or an old rain slicker over her until she was needed for her next mission?

I stopped to take a few pictures just to record the irony of the moment. Here I had arrived early to process my SCAD-related fear and this is what the universe threw in my path! What if something happened to me? Would they cart me back to shore like this?

This type of fear is a slow, simmering worry.  I think of it as a pondering old owl that has been sitting on my shoulder since I had my SCAD two years ago. The owl sits there judging what I should and should not do. It is not always a rational owl, or a wise owl. It likes most to screen situations for safety, sometimes at the expense of joy. 

The owl has been deliberating on this one for a while. Going out to sea and spending a day on one of the island beaches was always one of my favorite things to do in summer in Maine. Every time I thought about going, the owl would hoot, "The boat won't be back for twooooo hours or more! What if something happens with your heart!" 

Two summers have passed without an island trip and the owl still hooting away so I decided it was time to deal with it. After all, the islands are populated. There are emergency responders on each island. There are also emergency water taxis that can zip people right back into Portland. And of course there is the obvious -- my heart is healed and I have had no problems in the last two years. Owl overruled!

This trip turned out to be a great choice to get my sea courage back. I went with good friends to the closest island, Peaks Island, the one most populated and with the most frequent ferry runs. We had a lovely dinner on the deck of The Cockeyed Gull where we watched the sky fade into evening over the city in the distance. A few hours later, the ferry returned us all back safely.

It was a small step but I did it and shut the old owl up, despite Rescue-Me Rhonda at the start of my path! I do not really understand why the thought of being out on an island caused me much greater worry than flying in an airplane. (I have flown three times in two years and the owl snoozed through all of those. Go figure!). 

Fear is not rational. Neither is SCAD. I have no explanation for either.

Mind Over Heart Matters

Two years post-SCAD and still it does not take much to send me into a mind nutty if something seems askew with my heart. Today it happened at the gym --  a thousand shooting fireworks of thought.  Shrieking chimps, Chicken Littles. "The sky is falling! This is it! Your heart's exploding!"

I had strolled up to the recumbent cycle like I always do. There was happy music playing. Felt fine and dandy. I adjusted my seat, hopped on, began to pedal slowly. Got the settings I wanted. Fat Burn. 30 minutes. Age 49. Enter. Then I gripped the side handles to get a read on my starting heart rate. That's when the fireworks began.  Heart rate: 178. 

178! 188! 190 ...and climbing! Bells! Whistles! My mind went berserk. Words ran across my mind's eye in a digital display: tachycardia....cardiac arrest. My eyes darted over to the AED device on the wall. There it was, in a box, lightning bolt down through the heart on the front. Did they train the young man behind the front desk on how to use it? Wait, I'm trained. Can I do it to myself?

Next across my field of vision came Fred Sanford from one of my childhood TV favorites of the 1970's, Sanford and Son. Fred staggered, like he so often did on the show, clutching his chest with his right hand, left hand stretched up to heaven to call to his wife, "I'm comin' Elizabeth!" 

Would I stagger like Fred or drop sideways onto the floor? Maybe I'd just slump forward onto the display and be discovered later when someone wanted to use the bike during the late afternoon workout rush.

The display. It began to flash, sputter, shut down. Off. Nothing but a blank screen. Out of order.  Dead. The cycle display, not me.

Hmm.

When the voice of reason takes charge of the shrieking mind monkeys, it is magnanimous.  "There, there now. See, it's just the machine. Must have had a glitch. Why, that would have scared anybody. You're fine now."

I looked left. I looked right. No one seemed to have noticed the riot that just ended in my head. All of ten seconds must have passed.

I moved to another cycle and began my workout again. Heart rate 86. (Whew) Enter.

These bursts of panic over misunderstandings or slight inconsistencies have come up a couple of times over the past two years. Certainly, I know this is a type of Post Traumatic Stress Disorder. Do SCAD survivors all have it to some degree? I suspect we must. I also think it is very normal given what we have experienced and I accept it as such. 

When it comes to matters of the heart, my mind will always probably be a bit overly alert and sometimes outright ridiculous. Though all doctors and all tests have told me I am well and my heart is functioning normally, my mind remains a vigilant watchdog. So it is. I accept it all as part of my healing.

Don't You Pee on St. Francis!

At the crack of dawn, I am the crazy woman dashing across the grass in my pajamas, shouting and clapping my hands: "No! clap No! clap Don't you pee on St. Francis!"

St. Francis is their favorite target. The Boston terrier hits his robes; the boxer aims for the head and in moments poor St. Francis is sullied in yellow. It's bad enough the man had (as most Catholic saints did) a ghastly end to his short life, but to suffer this indignity in statue form in 2016 is all too much. I scold the dogs but I only get the Jeeze, what's wrong with her look as they trot off together for their morning run in the field.

Friends more doggier than I tell me not to take offense, that indeed dogs pee in places they claim as their own, places they are fond of, similar to when we hit the Like button when something captures our fancy on Facebook.  The problem for me is that St. Francis is in my holy healing garden, the one I created for myself as part of being "whole" and healing from my SCAD. It's mine! (I won't tell you what my friend then suggested I do to keep the dogs away). 

I put St. Francis there because I have always loved his prayer. The jury is out on where the words actually came from but it's still beautiful and the statue is a symbol of it for me:

Lord, make me an instrument of Your peace. 

Where there is hatred, let me sow love; 

where there is injury, pardon; 

where there is doubt, faith; 

where there is despair, hope; 

where there is darkness, light; 

where there is sadness, joy.

O, Divine Master, grant that I may not so much 

seek to be consoled as to console; 

to be understood as to understand; 

to be loved as to love; 

For it is in giving that we receive; 

it is in pardoning that we are pardoned; 

it is in dying that we are born again to eternal life.

To me, this prayer expresses the highest ideas found in Christianity and even Buddhism, Judaism and many other forms of spirituality. The line "make me an instrument of your peace" is one I have latched on to most as part of my thriving after SCAD  and I have done so in a way that may, at first, seem opposite to the prayer's central message. 

In order to be an instrument of peace in the world, I believe you have to be at peace with yourself first, especially if you intend to go on to do all those grand things that are listed in the prayer. To get to a place of peace and healing  -- and to continue to thrive there -- I use the prayer selfishly. Sorry - there it is. I said it. Selfish.  That is because the very first step in healing and thriving -- before you can give to others -- is compassion for self.

There is a lot of guilt and doubt following a SCAD. There may be guilt that you are letting your loved ones down. There may be fear that is holding you back from activities or your goals, and you may doubt your body. 

But in order to heal, you need to have compassion for yourself. And you need to be the instrument of peace to yourself first before being able to give back to others. Buddhism speaks to practicing nonviolence and compassion - always - to pay attention to your thoughts and actions so that you do not bring any form of violence toward yourself or others. To me, "violence" toward self includes putting yourself down or not listening to what you need.

Since my SCAD I often bring my mind back to the question "Am I being an instrument of peace to myself?" Am I being compassionate to myself right now? Common questions I run through: Do I need to rest? Do I need to exercise? Am I hungry? Do I want to do this, be here, go there, listen to this, watch that, think this thought? 

If you are used to always giving to others, surviving a SCAD has now given you the opportunity to listen to your heart. And your heart knows what it wants.

The Prayer of St. Francis is full of hope, light, and joy based on being an instrument of peace. That's a pretty good deal! Why not give yourself that gift first?  For me, it has been essential to do so before I could go forward. 

Our hearts broke. Nobody knows why. Considering the idiopathic category that SCAD is currently in, it takes a lot of trust, pardoning of our bodies, and acceptance of self to reach peace.  

With the dog indignities, not to mention the rain storms, mud splatters, and the two feet of snow I left him under last winter, my St. Francis statue has endured a lot.  But I am grateful to have him standing out there in my holy ("wholy") garden as a reminder of tuning myself to be an instrument of peace. 

There Were No Spiders

 “The first rule is to keep an untroubled spirit. The second is to look things in the face and know them for what they are.” - Marcus Aurelius                                                                                                                     (A stump in my backyard)

A couple weeks ago I had my two-year follow-up with my cardiologist, Dr. Wood, and she asked if I would like to see the digital recording of the angiogram of my dissection from the night I was rushed up to the cath lab from the emergency department. Yes! Absolutely! It had never occurred to me to ask or that a live recording even existed. I had relied on my imagination to make sense of the trauma, and relying on imagination is not the best idea to process an event of SCAD magnitude. 

The imagination is a notorious braggart, if not an outright liar.  It loves to stir up the pot of angst and drag the mind (and heart, if you're not careful) into a hyperbolic stew and drop it there to simmer. It latches on to phrases such as: "You had a classic Widow Maker going on in there!" and "My God, an LAD dissection is lethal!" and "These things are usually only picked up in autopsy."  

All of these were said to me and went into the stew. My imagination stirred them and let them simmer. I pictured black widow spiders in my artery rending at the lining until it detached and cause a dam that blocked the blood flow. And later, the image of a pathologist hunkered over my cold, gray body eating a sandwich saying, "Yup, it was those damn spiders again!" 

The imagination has no boundaries. Great for creating works of art. No so trustworthy, when left on its own, in healing the mind from a medical emergency.

The actual recording of my dissection yanked the event from the dark corners of my imagination and brought it into the light of reality, the truth of science, removed the scare factor. My first reaction was, "That's it?"

There were no spiders.  My dissecting LAD was a wispy line being gently rocked like a strand of seaweed on the undulating waves of my beating heart. The abnormality was a thickening of the strand in the center of the artery that suddenly narrowed into a foggy nothingness where the dye did not reach. That was all it was. A stopped-up sink pipe. A traffic jam. A piece of lemon pulp stuck in a straw.

Things here on earth break and our bodies are among those things. Medicine has come a long way in being able to repair the breakage. The way we are built on the inside is not so different as the things we see outside, in nature. 

Seeing the recording of my SCAD in live action freed me from some of the shadowy thoughts that still lingered in my imagination. A logical connection is now solidified and my mind can now fully believe the first words my surgeon said to me after my bypass graft: "Well, we fixed you!"

I meditate quite a bit on my healthy heart and use my imagination in a positive way during this time. I picture the chambers of my heart happily beating rhythms, my arteries flowing. 

Looking at the structure of things in the natural world helps me to make sense of my SCAD. Nature is not all that original in that it duplicates patterns. Look for the structure of the heart and you will find the chambers and the arteries just about everywhere: granite intrusions in a rocky cliff, the leaf of a tree, the roots from a stump. 

Seeing the parts in nature, seeing the digital recording of my own heart, understanding the dissected piece and understanding the fix of my broken heart has helped me take the drama out and calm my mind to a place of healing. Looking squarely at the truth of our physical structure and the truth of our fix -- whatever our fix may be in this moment --  can help the mind feel whole again.

 

Welome to this Blog!

I read all the SCAD stories with the eye of an English teacher and the mind of a writer. Each story seems to have a strikingly similar character with the same internal dialogue. She is female, she is conscientious, she has always taken care of her health. Her words are the same. “Out of the blue,” “All of a sudden” and “I never thought this could ever happen to me.” 

The expositions all seem to have the same elements. The main character is involved in a productive life. Her career is at its peak. She is involved in her community and stepping into the the wisdom of middle age. Or maybe she has just brought a healthy baby into the world, is tending a home, building a career, and running half marathons.  She hikes or kayaks or gardens or does yoga. She eats kale chips. She loves her dog. In a nutshell, she is a vibrant woman living life. Then, plot twist. 

If our SCAD stories were works of fiction, Maine author Stephen King would applaud. In his book On Writing: A Memoir of the Craft, King shares the formula for creating stories that have impact. He advises fiction-writers to use the power of situation over plot “because our lives are largely plotless even when you add in all our reasonable precautions and careful planning.” And so, to make a story with impact, King says the writer takes an ordinary setting, throws in a startling situation, then asks “what if” questions: “What if vampires invaded a small New England village? (Salem's Lot). What if a young mother and her son became trapped in their stalled car by a rabid dog? (Cujo).” 


What if a healthy 47-year-old woman is standing in her kitchen, minding her own business, and her heart blows up? (My story).

We have lived our own horror stories. It takes a very long time to process that. In the living there has been trauma and pain but we have lived.  Survived. The character has become brave because there is no other choice.

I am beginning this blog for all SCAD survivors, and for those whose lives are otherwise involved in it, as a place to open my heart and connect with all of yours. So little (still!) is known about the causes of SCAD and too few SCAD patients get the correct initial treatment and ongoing support. Progress will come through speaking our stories out loud. Healing comes when we write new chapters, honor our hearts, and celebrate our lives.