A heart's desire
(A rambling by J. Higgins-Rosebrook,
December 1999)

On a scale of 1 to 10, it was about an 8; a 1 being a pinprick and a 10 being childbirth. It was Monday morning, 15 November about 11 a.m. I was standing on the front porch watching the fog lift from the valley, enjoying the sunshine and slight breeze, breathing the air and listening to birdsong when it hit. You know the feeling when you take a big gulp of cold water and get an air bubble caught and it hurts going down? Well, adding several degrees of magnitude, it hurt like that, only there was no going down part -- just an incredible pain right behind my sternum.

Sitting down seemed like a good idea, so I retreated to the couch. My heart was racing but there was no pain in my arms or jaw. I felt a slight nausea but I thought that might be because I was scared. After about 15 or 20 minutes, the pain subsided and I got up and made myself a cup of sage tea and took a dose of cretaegus (hawthorn) and sat back down and tried to relax.

By now, the pain was at about 3 on the scale and my heart was pounding more slowly, so I got up and continued packing and getting ready to leave the mountain for my trip to town for groceries and my grandma fix. I figured that if I needed to leave earlier than Tuesday, it would be better if I was packed ASAP.

When you have a pain like that and can't explain it, it's really scary. So many thoughts run through your head. How will I decide if I should call 911? Up here, calling 911 is such a hassle -- I get someone in Pierce County and have to tell them to patch me through to someone nearby ... and who would that be? The hospital in Snoqualmie is probably the closest, but I could argue that it made more sense to take me to Harborview in Seattle since that could be done without leaving the freeway except for the last couple blocks.

Trying to be calm and sensible and assess the odds, I couldn't convince myself it had been a heart attack. The only symptom really was the pain. The rapid heart rate could be explained several other ways. Is this da queen of da nile here? Well, my diet surely is great for the heart, I have a no-stress job (usually) and I'm not stuck in some urban frenzy so the risk factors are really low. I know my cholestrol is good and my blood pressure is just fine. I weigh a bit too much but I'm very strong and in quite good shape except for a tummy that won't go flat no matter what I do.

What to do? Was I being stupid not wanting to raise an alarm over something that might be nothing?

Then there was the dread. Not of going on to the Summerland but of leaving things unfinished here.

Lanne's always nagging me to come back down off the mountain and live in town. What if I became debilitated and had no choice? I didn't want to go through the struggle with my daughters over where I should live. I will live where I will live because I think it's the healthiest place for me. It probably won't be in a city where I'll have to take some office job and sit still all day breathing petroleum byproducts.

Then there are my brothers -- "Oh yeah, Ms. Vegetarian Healthnut, look what good all that did you." I know my diet is the healthiest one for me and for the planet but brothers can be a pain in the butt sometimes anyway.

Every time I passed a window, I stood and recorded everything, inspecting each peak and snowdrift and rock and tree, and trying not to cry at the thought that my next trip up might be to pack up everything. I watered each plant and tried to think of where they might go if I ended up not having my own house. How could I move them out of here? The Night Blooming Cereus is six feet long and the Angel Wing Begonia and Hibiscus are just as grand. It just seemed too daunting.

The pain never went away entirely that day, but eventually I got the house all cleaned up and flowers tended and everything packed for the trip to town on Tuesday. I decided to take a shower and get into bed early and read and try to relax and convince my heart to calm down. I didn't have anything new to read that would qualify as escapism and I was too restless to concentrate on anything scholarly, so I read magazines -- Nature Conservancy, Audubon, Utne Reader, World Press Review -- until I felt sleepy and turned off the light. It was hours before I really slept -- probably 2 a.m. or so -- and when I woke at 6, my heart rate was fine but the pain in the sternum lingered.

The trip down with Karen and her baby Camille was uneventful and quick. When we arrived in Ballard, Cole and Ruby were napping and Lanne was dozing with Ruby on the couch so I loaded my stuff just onto the front porch and tiptoed into the kitchen to think about what to do next. Loading the bags into and out of Karen's car had caused some pain across my ribs and that had stirred up a bit of worry in my head again. I decided to call the emergency room at Harborview and talk it out with the consulting nurse.

I closed the door to the dining room and used the kitchen phone, but halfway through the conversation Lanne was standing in the kitchen demanding to know what was going on. The nurse told me to get myself to an emergency room because chest pain was something to worry about, so when I hung up the phone, I told Lanne everything.

Deirdre and Ed drove me to the hospital and dropped me off. I went to the ER desk, and they sent me to the triage cubicle where the nurse decided to admit me, so I got the orange bracelet and sat down to wait. Finally, I got called to an exam room and they drew a bunch of blood and put in an IV hookup. Then they did an EKG and an x-ray.

The EKG showed that I hadn't had a heart attack. That was good news but not an explanation of the pain. So, I spent most of the rest of the week in and out of clinics in cardiology, nuclear medicine, cardiac diagnostics, whatever. After fasting from midnight, I did the stress test on the treadmill and they shot me with something that glows in the dark -- thalium? -- and did an MRI to see what my heart looked like after almost six minutes on the treadmill. Then I had to wear a heart monitor for 48 hours. Then they gave me another injection of the glow-in-the-dark stuff after another fast since midnight and made me rest for an hour and took an MRI of my heart at rest.

They told me I was fine. My heart looked good, I'd done excellently on the treadmill, bloodwork looked good, blood pressure normal. I could go home.

Friday afternoon while I was out shopping, Dr. Frank, the attending physician at the ER, called and told Lanne that I needed to come back that night. He'd been examining the MRI images and had noticed what he thought looked like abnormalities in one chamber of my heart. Maybe there was a blockage that was keeping that chamber from getting enough oxygen.

When I arrived back at the hospital, Dr. Frank was going off shift and the totally humorless, very formal Dr. Desvereaux got me instead. He ordered another EKG and some more bloodwork and let me know he thought I was totally abnormal living all alone on top of a mountain by myself, without anyone around, miles from modern medical technology, in the wilderness. He said I could go home for the weekend only if I had a cardiothoracic surgeon with me. I asked him if he knew any who were free. He didn't laugh.

So, I hung around Seattle all weekend waiting for Monday when a heart surgeon, the MRI folks and Dr. Frank could confer and decide on the best course of treatment. Meantime, I was to get these beta blockers and a bottle of nitro pills just in case and take an aspirin a day. Aspirin? I hadn't taken aspirin in thirty years. It gave me stomach cramps. Desvereaux said to take them after I ate.

Well, now I was a little scared. The weather service wasn't going to want me up there if I had a bad heart. How could I figure out a livelihood that kept me out of town and independent if I had a bad heart?

Monday morning, I met Nana Sotoodehnia, a delightful young woman who actually seemed interested in my diet and lifestyle and was willing to listen and learn about my philosophy about my health. We discussed options for my case and decided on the direct approach -- just take a look inside my heart and see what all this nonsense was about. So she scheduled me to be admitted to the same day unit on Tuesday and she'd do a cardio catheterization and we'd have a look.

After getting Sid to school, Lanne, Ryan and Cole and Ruby took me to the hospital and got me all checked in. Cole didn't want to leave me all alone in that bedroom but Lanne figured he didn't need to watch the nurse poking me for the IV so they took off and went home.

Right on time at 11 a.m. they took me to the OR and got me prepped for the procedure. Again they explained that they'd need to make an incision in the big artery at my groin, insert the tube and run it up to my heart and take a look around and decide what to do. I signed consent forms for an angioplasty and a stint and another for open heart surgery even though they were pretty sure they wouldn't need to do that.

Then they gave me a local anesthetic and left me lying there while they adjusted all the machines and got them in position. They put the TV screen where I could watch most of the time and the doctors came in and inserted the tube.

It was pretty interesting seeing the inside of my heart. It wasn't in color as I expected but maybe color would have made the image less clear. There was nothing wrong with my heart. We could see no blockages in the arteries and veins, which were all round and symmetrical and smooth, expanding and contracting rhythmically, the little spurts of blood gushing in and out very nicely. Everyone who was there agreed it's a very nice heart and it's in exactly the right place.

Next, I had to lie prone for six hours so the artery could close up. That was the worst part, having to lie still for so long. Joanna came by and sat with me but I wasn't very good company. I kept drifting off and couldn't really track the conversation but she stuck with me anyway. After she left, Doris showed up and hung out and went and got me a double tall split shot latte while I tried to pee lying down flat on a bedpan. Finally, at about five hours and fifteen minutes, despite dire warnings that if I opened the vein then, I'd have to start the six hours all over again, I convinced the nurse to let me up to go to the bathroom. Phew!!

At 8 o'clock, Doris went to get her car and I got dressed and signed myself out of there and went to Lanne's, totally exhausted and starving. I baked a big potato, loaded it with sour cream and salsa verde and cheese and gobbled it down and called my mom and went to bed.

As yet, I have no explanation for the pain but my heart's in great shape. I have this enormous bruise on the top of my leg and bottom of my stomach and I'll have to put up with ingrown hairs where they shaved and I can't lift anything heavy for a while and I have this enormous medical bill I'll never be able to pay in this lifetime but I can say unequivocally that my heart's in perfect condition.

Lanne still wants me to move off the mountain.

[ by J. Higgins-Rosebrook ]

[Editor's note: A week later, Jacque's chiropractor pulled a hiatal hernia down from her diaphragm and she's been fine since....]