I didn’t have a heart attack.

I didn’t have a heart attack. I can’t believe how often I have to tell my medical team that I didn’t have a heart attack. You also wouldn’t know that I didn’t have a heart attack based on the overwhelming number of visits I have made to the hospital during the last month.

While the title may seem like clickbait, it accurately describes my medical status. I am thrilled with not having a heart attack. Anyway, this is my story. I hope you like it.

Perhaps the moral of this story is that I want you to take care of yourself, including visiting the doctor.

The drawing above is from Modern Heart and Vascular and does not represent images of my heart.

Living in my RV

Living and traveling full-time mostly in our RV makes it hard to get frequent doctor visits, so I try to group them into a small one-month window at the beginning of winter. So far, it works for me, but each year I have to book my doctor’s appointments very early, and just like making campground reservations, it requires a lot of early planning. I have to keep after it to make sure the schedule works for both my doctors and me.

I have plenty of issues that my doctors and I need to monitor, and my low heart rate (sinus bradycardia) is just one of them, although until last month, I didn’t have a cardiologist (heart doctor).

I am not sharing this because I am unhappy with my medical care. I am thrilled with my medical care at the VA. The reason I have to keep telling the nurses and doctors in my medical team that I didn’t have a heart attack is based on my electrocardiogram tests.

About heart attacks

Graveyards are filled with people who die from heart attacks. I even heard that people with cardiovascular issues fill more than 50% of the graves. Everyone should take this seriously and include daily activities that elevate their heart rate. When you get older (like I someday will), it doesn’t take as much exercise to elevate your heart rate. I don’t exercise like I used to, but I try (with moderate success) to do something every day.

My electrocardiogram (EKG or ECG)

An electrocardiogram measures the electrical signals from the sinus node of the heart and provides doctors with information about your heart health. For at least the last forty years, my electrocardiograms have noted my slow heartbeat compared to most people. My resting heart rate is always less than 60 beats per minute.

At the top of my electrocardiogram, I see the words “sinus bradycardia,” which is the medical term for a slower-than-average heart rate. I “blame” or, actually, to me it is a point of pride that my heart rate is on the slow side. Luck, years of exercise, genetics, and growing up at a higher altitude (Colorado) resulted in my slower-than-average heart rate.

I wish my slower heart rate had also led to lower-than-average blood pressure. For at least thirty years, my blood pressure has been higher than the desired normal range.

A few years ago, an X-ray report mentioned an enlarged heart, and they weren’t talking about generosity. Yet, that X-ray interpretation seems to be a one-off.

I have cancer

With the exception of skin cancer on my shoulder at least ten years back, I have dodged the cancer word. I was surprised last month when one of the doctors used the cancer word straight up (as if it wasn’t a big deal). Previously, they also didn’t use the word carcinoma, and even though that is doctor talk, I would have known they were saying cancer.

Until last month, I would have said I didn’t have cancer. Same for a heart attack. Until a few years ago, no one mentioned a heart attack. But I will get back to the heart attack story later. Keeping with the title of this section, the subject is now about my cancer.

Some people (like me) know they have cancer. Other people say (I used to be in this club) they don’t have cancer, but they really mean that they don’t have cancer that they know about. The important part of having cancer is to keep after it so that it doesn’t expand and kill you.

Until my visit to the emergency room in January 2024, I had no indication that I had cancer. Here is a link to the story about my emergency room visit, where they first “discovered” that I may have cancer. You can’t leave, you have Pneumonia!

Until a month ago, they didn’t say the word cancer (at least not to me), but rather they said “mass”. During my pneumonia hospital stay, I got a CAT scan of both my head (which “proved” I didn’t have a stroke) and my chest, where they discovered an extra body part, which they described as a mass next to my adrenal gland. They never used the cancer word.

The doctors were worried that the mass was also producing extra adrenaline, but tests and more CAT scans have determined that the mass next to my adrenal gland was not growing and was not making extra adrenaline. I hope this doesn’t change next year.

This year, I went through more tests and CAT scans, and again, the hormones are good, and the mass remains the same size. But this year, unlike the previous years, the doctor used the word cancer. I told her I preferred the word mass.

If it (the mass) grows, I will be getting a lot of attention from the doctors, who will then start talking about removing it. I sure hope to stay out of that line. It probably won’t be a little hole and a quick recovery.

Cancer and heart problems are not the only problems I have. Each doctor from my eye doctors who are concerned about glaucoma, the dermatologist who keeps taking skin samples, and the ear doctors who want to give me hearing aids, has some concern. I take the concerns seriously, and each year it seems I am going to the doctor way more often.

The doctor’s schedule this year also included multiple visits and physical therapy, all caused by my broken elbow I had last July in London. If you missed the story, here is a link. My Crash landing in London

Don’t ever break your elbow. Half a year later, my physical therapy isn’t done. I still have daily pain and a functional but limited range of motion with reduced strength.

My non-heart attack

For at least the last five years, I have been telling the doctors over and overagain that I didn’t have a heart attack. The question arises from the previously mentioned electrocardiogram. It seems that the electrocardiogram mentions a possible “event” which doctors and nurses then ask about, my heart attack. My response is always the same. I didn’t have a heart attack. They always ask multiple questions, all based on symptoms of a heart attack. Did you have chest pain, shortness of breath, or radiating pain? They all seem amazed when I have always answered no.

I am not stating this based on denial, but I think if I had a heart attack, I would remember.

Arrhythmias

Now both my electrocardiograms and a blood pressure cuff mention the word arrhythmia, and this seems to trigger the questioning again. A slow heart rate is an arrhythmia, so I guess the word describes my condition. Arrhythmias occur when electrical impulses in the heart are abnormal.  Coronary artery disease, previous heart attack, will often scar the heart, and this scarring is identified by the electrocardiogram, triggering the arrhythmia diagnosis.

I have known about my low heart rate for a long time, and I always make a point of telling the doctors about my low heart rate, especially if I am going to have anesthesia during a procedure. In the past, I scared the doctors with my low heart rate while under anesthesia. It seems like a low heart rate isn’t universally appreciated by doctors.

Switching Doctors

Last December, I switched doctors and, during my first visit, met my new medical team. Of course, during this visit, they recorded my vital signs, including my blood pressure and heart rate. Again, my blood pressure was higher than I wanted to see, but my sitting heart rate was 32 beats per minute. We started the test again, same result, 32 beats per minute. Then we did the old-fashioned fingers-on-the-wrist test: 32 beats per minute.

They also used a blood-oxygen meter, which showed a reading in the low 90% range. I wish this were higher.

32 beats per minute

I admit that 32 beats per minute seems really low, and I was pretty surprised to see such a low number while sitting upright. I knew that when I sleep, my heart rate occasionally slows to 40 beats per minute. I don’t typically monitor my heart rate while sleeping, but I know it is low.

While I was meeting my new medical team, each team member, as they walked into the exam room, scanned the monitor, and each one said 32 beats per minute, and I had to confirm the reading. My new doctor, rather than being impressed by such an “efficient” heart and cardiovascular system, ordered more tests. When I was in the hospital in 2024, all wired up, I got multiple visits from the nurses when my heart rate slowed while sleeping.

Monitoring my heart rate

For the next two weeks after my doctor appointment, I had a sensor the size of a bottle cap taped to my chest. This sensor recorded every heartbeat throughout each day for two weeks. Every time I had a heart event I considered abnormal, I was to tap the bottle cap and note why I tapped the sensor. At the end of the test, I didn’t have anything to report.

I also had three more electrocardiograms, and I had to answer the questions about my low heart rate again. I didn’t have a heart attack. Of course, they didn’t seem to believe me about the electrocardiogram notes, including the ones about the “historical heart attacks” they described.

Stress tests

After wearing the sensor for two weeks, I was referred for a treadmill stress test because the sensor readings were normal. The sensor didn’t detect anything other than my low heart rate, which it was concerned about. My doctor, however, wanted further investigation and ordered a stress test and an echocardiogram.

I was surprised when the stress test team didn’t want to test my maximum heart rate during the test. They only wanted an 80% test of my theoretical maximum heart rate. I had hoped to learn where the limit was. The test was done while wired to an electrocardiogram and while taking blood pressure measurements. The team stopped the test when I hit 151 beats per minute, which is my maximum theoretical heart rate.

After taking the stress test and recovering from the exercise, the test team wanted me to repeat the test. I said I was ready to go, but they wanted a new, more advanced test that included images of my heart while it was still beating a little faster. From these images, they could see how well my heart moved the blood and whether my arteries were clogged. Again, the electrocardiogram taken during the test reported a possible heart attack (sometime in the distant past).

The problem was that I was running out of time before our next adventure. It seemed to me that they weren’t concerned about my heart condition until it became a “crisis”. They were still concerned that I might soon have another heart attack (not believing that I didn’t have a previous heart attack).

I took every appointment they offered me as soon as they were available, and after my stress test, the electrocardiograms taken during the stress test on Thursday, only four days prior to our trip, they wanted another test. The stress test team didn’t want to wait for spring to take another stress test, worried that I might have another heart attack. I guess one heart attack leads to another heart attack.

Flying to Singapore

Our flight to Singapore was scheduled for Monday evening. At 6 am on Monday morning, I was back at the hospital waiting for another stress test. We were going to Singapore as the start of our springtime adventure. Like last year’s adventure to Europe, this time we were making a big trip, and I didn’t want to miss it.

So there I was (that is pilot talk for beginning a story) doing another stress test on Monday morning. The only real problem was that we had to leave our hotel before we could eat the free breakfast. They don’t let you eat before a stress test. The day before departing (just before the Super Bowl), we parked our RV in storage, preparing for our trip. This was all part of the plan (except for the stress test and missing breakfast) for getting ready for our trip to Singapore.

The stress test was just like the one four days before, with the exception that I had some nuclear isotopes injected into my blood during the test, so the pictures of my heart would be easier to read. The stress test lead nurse would call me at 3 pm after the cardiologist looked at the results to tell me how the test went.

The results of my stress tests and pictures of my heart

I was already at the airport when the nurse called. I was overjoyed when the nurse said the stress test, electrocardiogram, and images were all normal, and based on the pictures, they agreed. I didn’t have a heart attack.

The nurse told me they didn’t find any scars that would have been caused by a previous heart attack and that my ejection fraction (the way my heart pushes blood into the arteries) was excellent. They also didn’t find any arteries with restricted blood flow.

Due to my low heart rate, I expected to hear something about getting a pacemaker, but so far, they haven’t mentioned needing one.

When I get back from my trip, I will still do the electrocardiogram and have more doctor visits just to be sure I don’t have any heart issues.

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