I’ve been walking on egg shells ever since the mysterious chest pains two weeks ago described here. The symptoms didn’t match a classic MI, but they didn’t respond quite like an ulcer or a gall bladder deal either, and they seem to get a little worse when my heart rate increased. That last thing scared me shitless. It started when I saw my PCP last week, she suspected some sort of upper GI issues and did a routine EKG as a precaution. A few minutes later she came back in, looking grim, and told me I needed to see a cardiologist immediately. She wouldn’t say what her concern was, I’m not sure if she knew, but the look on her face scared me. So off I went to the cardio and found out I DO have a serious condition …
After checking me out the cardio scheduled some bloodwork, but he was able to put my anxiety at ease telling me “I have a strong suspicion what’s going on”. First he explained that just like some people have larger or smaller hands for their size, hearts also vary a bit. He told me I happen to have a large heart for my size, the exact words he used were “A large, well conditioned, middle-aged but athletic heart.”
It seems I’m just a big-hearted guy! And that can cause little features on the EKG to look markedly different, especially when hooked up by a non cardio PA and read by a non specialist PCP. To the untrained eye, there’s one little inverted wiggle that can superficially signal a number of things, one being a grossly enlarged heart (the feature is called an inverted T-wave). An enlarged heart can mean left ventricular hypertrophy, which would mean early congestive heart failure usually produced after years of hypertension, obesity, high cholesterol, years of alcohol/drug abuse, and/or congenital heart probs. It can be mitigated if caught early, but pronounced LVH means at best a complete lifestyle change, it commonly involves surgery at some point like a bypass or angioplasty, maybe a pacemaker and embedded shock device as it gets worse; LVH is usually progressive and, technically, terminal. People diagnosed early can lead more or less normal lives for a few years, sometimes even fore decades, but more often than not it tends to get worse and in really late stages can only be treated with a heart assist of some kind, transplant, or death.
That’s alway bothered me from a solution perspective. Unlike your liver or pancrease or so many other organs, the heart performs one simple task: it’s a pump, we all know what it does, it’s a mechanical device. Considering that the failure of that pump for one reason or another is the leading cause of US deaths, it just seems like we could and should have more research into better artificial hearts,
But my cardio could tell with tests, listening to it and by examining film that that’s not the case for me. He also poked around, had me lay prone and in various positions and then laid the mostly likely verdict on me: An aggravated upper GI hernia!
Hernias come in two main flavors, hiatal or upper hernia and a lower hernia. Both occur when a pinch of bowel gets in between the GI tract and the holes in the diaphragm where the GI tract goes in right before the stomach or back out right before the rectum, but they produce different symptoms. The upper version is notorious for feeling like a scary chest pains and/or a terrible case of heartburn. Mine had both qualities.
It hurt more when I ate AND when my heart rate increased, but never goes completely away. It turns out it’s not the heart or the stomach per se, it’s the increased stomach activity produced by food moving through and touching the pinched section, diet, antacids and blockers would offer some comfort there but they won’t address the underlying cause. The increased agitation produced by the diaphragm on the hernia from the jostling around, stretching, and especially deeper, faster breathing that activity and particularly exercise entails neatly explains why it seemed to flare up a bit when I was more active.
It’s probably aggravated because I have AS, which can cause any little thing to swell and hurt worse, or it can be extra painful when the part of the stomach involved is at or near more active regions by the gall bladder ports or the valve before the duodenum. Now it makes sense why it superficially resembled an ulcer or GERD — in act there probably was and still is some moderate GERD.
The cardio also noted it’s not that unusual, in fact I’m classic: when a middle aged man dramatically transforms from a big fat flabby guy to a more buff thinner dude over the space of a few short months — because Workout Girl does not fuck around, she hurts me in the gym, and just seeing her beautiful body, a true work of art imo, inspires me — hernias can result. The diaphragm can lose muscle tone, it gets flabby over the years of like any other under used muscle in a sedentary person, and all the gasping and stress from a new rigorous exercise regimen can eventually allow some slippage.
The condition can be serious, requiring surgery in some cases. But I don’t care; this thing can hurt, it has even doubled me over at times, it may become chronic and may even need surgery one day, but it can’t fucking kill me! Best of all the prescribed course of action is a super healthy low-calorie, low bulk diet and losing the last 20 stubborn pounds that are still clinging to my slowly hardening body. Lose enough weight and don’t over strain, and that pinched section can and often does slide partly or completely back into place. IOW, I have to get buffer and thinner! As treatment goes, that’s not exactly the worst fate,.Plus, I got nicotine patches when this shit started and I’m close to being weaned off of them!
I’ll see a gastroenterologist and confirm the diagnosis soon, but my symptoms read like a WebMD post on classic upper abdominal hernia and, compared to finding myself on the emergency heart transplant list, I’m both stoked and grateful that’s all it is. Look out world, 2013 is going to be the year of the buff, healthy Stephen DarkSyde Andrew starting right the fuck now!
Guys I feel so good about all of this it’s almost spiritual in our secular skeptical way. Today is the first day or the rest of my healthy life, at age 50 I want to make every single day count. It’s Jan 9, a cold, rainy morning, I’ve been prescribed a slightly stronger painkiller, plus mild sedatives to sooth my anxiety and relax the smooth muscle tissue, I’m off for three days. So this glorious nasty day has been set aside for me to wait hand and foot on Workout Girl. I’m going to cook delicious healthy meals for her and massage her entire body to show her what a valued wonderful queen she is to me. We’re going to lay on the loveseat wrapped around each other like human vines all day, with our furry little tiny Dachshund/Terrier mongrel burrowed in under the covers next to us, watching movies and hugging and kissing, and whatever else comes with it. Carpe Diem freethinkers, Carpe freaking Diem!
What are you going to do with your New Year and the rest of your life starting this week?