You Look Tired

“I never could get the hang of Thursdays” - Arthur Dent

No, this is not a railway blog.  Sorry enthusiasts, if the title got your hopes up.

I find writing therapeutic;  a way to deal with things that are on my mind.  

And the latter half of this week has given my mind quite a lot to process.  This weekend has been a little different from what I’d planned.  

This’ll be a long one.

You hear about these things happening to other people, and as cliched as it sounds, you just don’t think it’ll happen to you.  I certainly didn’t.  Were there warning signs?  Well, in hindsight, probably.  Sitting here now in the quiet of my hospital room, attempting to process exactly what happened last Thursday, and what now lies ahead, perhaps it was obvious enough.  I just didn’t take as much notice as I should have.  

I’ve been fighting fatigue for a long time, and lately, thinking back, it had been getting steadily worse.   More and more, people have been telling me I look tired; asking me if I’m ok.  The creeping shortness of breath when tackling the maze of ramps & stairs around my workplace, and deliberately ignoring how increasingly quickly that’d been coming on & then lingering in more recent months.  Even mowing my tiny patch of front lawn has been leaving me a little winded.

Only recently I’d remarked to my wife that I felt I’d been struggling with fatigue on the court lately in my role as a basketball referee.

All of this I just put down to being on the wrong side of 50, carrying many more kilos than I should be, and a pretty busy weekly routine.  

Potentially none of these have helped, but then combine them all with a significant family history of heart disease, and you have all the markers for a less than optimal outcome.  I’ll come back to this further on.

I am just so damned tired.

So you’d think the warning signs were obvious, but when the time did come, it wasn’t what we’re all conditioned to think it’d be.  There was no chest pain, no shooting pains down my left arm, no dizziness, nothing.  The one thing that does ring true though is this:  there was absolutely no warning.

Thursday started for me just like most other weekdays.  The routine that’s been the norm in my house for years.  I’d worked into the small hours the night before, and climbed into bed around 2:30am.  I slept until about 9, then out to the kitchen, switch on the kettle, open the door for the dogs to go outside, and after that the customary WeetBix & coffee for breakfast.  Cathey is always out the door to work by 6am, and the end of brekky is always signalled by her return around 10, and the hustle of two very excited dogs scrambling to meet her at the front door.

On this day we’d organised to take one of the dogs for a vet checkup, but we took them both for the car ride, and while Cathey took one in for the appointment, I took the other for a few laps of the block; maybe a half hour walk.  After that, we were back in the car and off home.  

It’s about midday by now, and so lunch is being contemplated.  I let the dogs outside and headed to my studio with the intention of doing some audio work for a couple of hours.  I fire up the computer, the mixer, and all the gear, and as I’m doing this, I start to feel really congested in the chest.  As if I’d been doing some heavy exercise.  My respiration rate has increased as well, and I just needed to sit on the couch for a minute.  

Thursday was a windy day and it’s early Spring, so I figure this is some kind of allergy that’s started kicking in.  Wouldn’t be the first time I’ve had allergies in September after all.   But now I’m feeling a kind of fight-or-flight sensation, and I have to get up again and walk around.  I remember saying to Cathey, “I am really not feeling good all of a sudden”.  On top of this, my head starts pounding like crazy.

High blood pressure, I decide.  What the hell is going on?

I have a home blood pressure monitor, so I sit in my recliner and strap it on.  177/111.  OK, that’s not good at all, but 5 minutes later it has dropped back below 150, and so like a typical male dummy, I rationalise all of this as allergies, pop an antihistamine tablet, and head back to the studio to get that audio job started.

It is now 12:30pm.  I’m still not feeling the best; still have that heaviness in the chest and I’m a bit winded.  It’s like someone is sitting on my chest.  Maybe it’s time I take Cathey’s suggestion and make a doctors appointment.  Yeah, sure, ok.  Why not?  Can’t hurt after all, just to be safe, but hey, it’s getting a little late to call in sick for my 6pm shift, so I’ll be heading in regardless.   Typical workaholic mindset, I guess, worrying about all the things that don’t need to be so important.

At 2:30pm I stride into my GP’s office.  My regular doctor is away today, and this lady I’m seeing is new to the practice.  Great, I think.  I’ll get this out of the way quickly, confirm my own learned diagnosis of hay fever, and then I can get back and finish this audio job before deadline.

This doctor is a rather serious individual however, and she’s not exactly keen on my diagnosis.  I mean, the nerve!  I don’t have time for this.  I tell her all of the symptoms described above, and I notice she’s looking at me rather intently.  It was a little unnerving at that point, thinking back.  She’s done all the usual checks, and suggests an ECG.  No problem - I ace these things for my CASA and Railway medicals every year.  And oddly enough, this one looks normal too.

The doctor walks out of the room though and returns a couple of minutes later with a nurse.  “How are you feeling?”, they ask.  “You do look quite tired.”

That one again, eh?  Why do so many people ask me this lately?

They suggest that perhaps it might be a good move to pop down to the local hospital for a couple of additional tests, just to be sure.  Oh, and by the way, chew on this aspirin.  I do as ordered, and then they produce a little spray can and fire a shot of whatever’s in it under my tongue.

And with that, the tight sensation in my chest disappeared almost instantly.

I’m not a doctor, but I knew what that meant.  Nothing good.

Time to let work know I’ll be off sick for a day or two.

Five minutes later I’m staring at two paramedics as they wire me up to their diagnostic gear.  We’re heading to the hospital.

The look on the Emergency Department doctor’s face a couple of hours later, after blood tests and other things, told me the news wasn’t going to be good.

“Look, ahh…the news isn’t what we’d hoped for.  It looks as though you’ve had a heart attack.  We need to admit you.”

And I’m not sure what’ll stick in my mind more from the few seconds that followed.  The news itself, or Cathey’s reaction.  I think it’s that shocked gasp that’ll will stay with me forever.

Heart disease is nothing new to my family, on either side of it.  My father died of cardiomyopathy at the age of 61, my mother received a quadruple bypass in 1989 at the age of 43, and her father died of a heart attack at the same age in 1954.  In one form or another, it seems like most of us have it.

It was mum’s diagnosis that triggered all the alarm bells though.  Tests prior to her operation, following a series of angina attacks, revealed levels of cholesterol in her blood that were considered beyond fatal.  Further tests of her four siblings revealed the same for all of them, and a generation down the line, at least one sibling in each branch was found with it.  There’s 15 of us in that particular line, me being the eldest.  But I won the lottery there.  My cholesterol levels have always been within the normal range; my brother’s though, are high.  Lucky me.

Such knowledge though, all these years on, I think has led me into a false sense of security.  In my line of work (my day job anyway), the medical standards are stringent.  Blood tests and ECG’s are standard practice, and depending on your age and other medical factors, they are quite regular.  More so for some than others.  For me, it’s a yearly thing.

While cholesterol hasn’t ever been an issue for me, hypertension is.  That, in my opinion comes from dad’s side.  He was always battling it.  I first discovered it in 1992 when I went through the Australian Defence Force recruiting process at the age of 21.  It’s the reason I was unable to join the RAAF.  They knocked me back on that basis, and precluded me from ever applying again.

I’ve been chasing that problem for all the years since, and my current medication has kept it nicely in check for well over a decade now.

So between that and regular, work triggered tests, I’ve had a good handle on all the relevant data.  

See?  Nothing to worry about!

Or so it would seem.

I’ve always been a big guy.  All Visschers are really.  But with that comes a predisposition to carrying weight if we’re not careful.  I’d like to think I was pretty fit in my teens, but over the years the weight has slowly crept up, and stayed up.  It peaked a few years ago at 147kg and these days hovers in the low 130’s.  Having a solid frame means you can carry more that it often appears, but its too heavy in anyone’s language.

But hey, I’m reasonably active for my age, still reffing basketball games every week, do a lot of walking and generally speaking, I eat well.  It’s easy to kid yourself.  The resulting high BMI though means I have to use CPAP for sleep apnoea, and that data goes to the relevant medical people every year as well.  In my mind, I’m heavy but I’m ok.  How foolish.

Whether it was any of this, or genetics catching up with me, I’ll never really know.

But it really doesn’t matter at this point.  What matters is this.  I have a three coronary arterial blockages, ranging in size from 70% to 90%. They can’t be repaired with stents, and so in the next day or two, I’m joining the zipper club.  Heart bypass surgery.

There’s some silver linings to hold onto, despite this.  There’s no major damage to the heart muscle, and it is pumping away nicely.  The surgeon and cardiologist both assure me this is a pretty straight forward procedure for them, measured on whichever scale they use for such things, and everyone who’s in the know - surgeons, CCU nurses, and the many I’ve spoken to in the past few days who have walked this journey before me - tell me I’ll be a new man post-recovery.  However, let’s not pretend that this is just day surgery.  The journey ahead of me will be many months long.

It is daunting to even think about, and it’s been challenging to mentally process in such a short time.  I have had some periods in the time since where I’ve felt at peace with it, and some dark moments of despair as well.  But I have an amazing support network rallying around me.  I am very fortunate.

I will get through this.  I must get through this.

No sense now in dealing with the what-if’s.  Perhaps except for one:  what if I hadn’t listened to my wife’s advice to make that doctors appointment?  In truth, I’d have probably taken a nap, then gone off to work.  I could’ve died that night, or maybe the next, and I didn’t even know I was sick.

However, none of that happened.  Dwelling on it from here is a waste of energy.

Am I scared at what I have to go though?   Absolutely yes.   But the alternative doesn’t even bear thinking about.

I named this site “Proceed Aspect”.  It’s a railway term well familiar to some who will read this.  For those not in the know, it refers to railway signalling, and forms the basis of everything we do as engine men & women.

On Thursday, the home stick went back in my face, and remained at STOP.  As with all such instances, I didn’t see that coming, but the emergency brake application has been made in time.

I’m looking for the “low speed” aspect now.  As the rule reads, the section ahead may be occupied or obstructed.  I’ve no doubt it will be, but there’s procedures to deal with that.

The goal from here is to get back on the mainline.  But it won’t be set for the straight.  No, my signal at the other end of this will be set for the diverge.  The run from here will be on a different path.  A better one.

Did I mention I didn’t think any of this could happen to me?  I hope that by reading this far, perhaps we’ve both learned a thing or two from that.

Onwards