I haven’t posted in the Writing It Real category of “Writing Makes a Difference” in a while now as I’ve concentrated on writing exercises to keep you inspired. This week, though, I am returning to that category to share Susan Smith’s account of having a heart attack. She wrote this piece because little is discussed and shared publically about the symptoms of heart attacks in women. In her personal story are details that all women and those who love them must pay attention to. As the reader, you will feel close to Susan and to her situation, and, as the reader, you will find valuable takeaways.

Susan has written for many venues, and I am pleased to have the opportunity to share this piece, which will find newspaper publication soon in her hometown of Tucson.

My Heart Attack Saved My Life

by Susan Smith

Sharing details of my heart attack with you is not easy. I am compelled, however, to be an advocate for women’s heart health, so here we are. Please pay attention.

I had a heart attack on February 9^th, 2018. It scared the you-know-what out of me, but it also annoyed me no end! I was so busy—doing things for everybody and being everywhere. My days were planned to the max with no wiggle room for delays. I was irritable with stress and now peeved because things didn’t go my way.

How inconvenient! I was in the middle of a late-life career path teaching writing, publishing a book, running a writer’s group, and tons of other social activities. My to-do list was a mile long. I liked my busy lifestyle.

But something wasn’t right.

I was ridiculously tired to the point of fatigue. I couldn’t get through the day without lying down, and if I didn’t get an afternoon rest, I was uncharacteristically cranky in the evening. I was getting up at 5:30 in the morning to tackle that to-do list, thinking I was just sleeping poorly. I blamed everything from my pillow to the full moon.

Unknown to me, that nagging pain in my collarbone and the occasional lightheadedness were common symptoms of heart attacks in women.

Women experience a heart attack differently than men.

Men have the “Hollywood” attacks we see in movies. You know the kind: pain in the left arm, clutching the chest, collapsing. But I had none of those signs.

However, the day before my heart attack, I had nine symptoms in total and still refused to go to the emergency room. Count them: fatigue, cold sweats, heart palpitations, lightheadedness, pain in my collarbone, cold/numb fingers and toes, shortness of breath, dizziness, and feeling faint.

I believed I was having an anxiety attack, as I was too busy and “didn’t have time” to have a major health issue interrupt my full schedule.

On Thursday, February 8th, I was the spotlight speaker at one of my networking groups.

This meant I had ten minutes to stand before the group and talk about my business, then another ten minutes to run a mastermind exercise. I’d done this talk before to increase the visibility of my writing class and garner more students.

That morning, I started preparing at 6:30. My fingers and toes were icy cold. I was tired and hadn’t been sleeping well, but again, I chalked it up to other things: a poor dinner choice night before, a case of nerves, maybe sleep apnea.

My collarbone ached like someone was pinching it. As I wrote my speech notes onto blue note cards, I felt as if I’d been holding my breath.

I began to pack up my props. I still needed to make copies of handouts, find business cards, and gather crayons and drawing paper for the coloring exercise.

While loading the supplies into my SUV, I noticed I was winded even from that simple effort.

The meeting was being held at a local restaurant.

At the restaurant, tables were set up in a hollow square formation to accommodate 40+ people. I took an end seat so I could get up easily to do my presentation. I heard the buzz of conversations around me and noticed my mouth was dry. I asked the waiter for water.

Then the microphone came out. The leader explained it wasn’t working well. He instructed us to hold it tightly and put it up directly in front of our mouths when we spoke. I watched as others struggled to get through their 30-second “elevator speech” without the mic crackling or cutting out.

Then it was my turn.

I stood at the front—all eyes on me—and I laid out my note cards in front of me. Then I grasped the microphone for dear life.

I talked easily for ten minutes, though I realized I was getting short of breath. Never mind. I dismissed it as speaking too quickly or forgetting to breathe between sentences.

Then my heart started pounding, because, I thought, I was probably holding my breath—until it pounded faster, and I mean really pounded. It took everything I had to appear calm and composed. After all, I was giving a speech!

Then I started feeling lightheaded to the point of dizziness.

I grasped the back of a chair to steady myself while the group got busy on the crayon assignment I’d given them. Then I let go of my tight grip on the microphone, breathed deeply, and tried to regain my composure. I walked around the square of tables and looked at the drawings people were making. This seemed to calm my heart.

At the end of my time, I took a few questions and sat down just before the room started to spin. Immediately, sweat formed at my hairline and trickled down my forehead like a menopausal hot flash. I dabbed at my forehead with a napkin, desperate to be “fine.”

A friend noticed that all the color had drained from my face.

She brought me water and the waiter brought me Sprite. They wanted to call 911, but I resisted, saying, “NO! I’m fine, just feeling a bit woozy . . .”  I figured I’d probably stood for too long, hadn’t eaten my lunch—a hundred excuses!

I sensed I might pass out, and I wanted to lie down, but there was nowhere I could do that. So, I just kept saying, “I’m fine. Honest, I’m fine.”

Finally—after lots of water and napkins to mop up the cold sweat pouring from my scalp—I felt somewhat recovered.

Knowing even I couldn’t drive in this condition, I called my husband to come and bring me home. There, I lay on the couch, very still, and googled my symptoms.

Voila! It’s an anxiety attack. That explained everything! Somehow that made me feel better, even though I couldn’t imagine what I might have been anxious about—but anxiety had to be it.

I rested, ate dinner, and went to bed confident I’d be fine the next day.

It’s Friday, February 9th.

Again, I awoke with a head full of plans and a long to-do list. Among other things, I needed to go to the grocery store to buy food and snacks for my writing class on Saturday.

First, though, I wanted to wash my hair and get cleaned up, so into the shower I went. Raising my arms to wash my hair was an effort. I was quickly out of breath. So, with a towel wrapped around my head, I put on my fuzzy robe and lay down on the bed until my breathing returned to normal.

Blow drying my hair caused the same effect.

Holding a brush in one hand and the blow dryer in the other with my arms above my head, I was short of breath and exhausted me.

Back to bed I went, lying down for the second time that morning—and it wasn’t even 8:00 am. I thought, This is unacceptable. I have too much to do to be lying down every five minutes!

Knowing something wasn’t right, I was still determined to push through and prepare for my writing class the next morning.

So, I charged off to grocery shop.

I knew exactly where to find all my favorite foods for the class. A veggie tray, crackers, cheese, fruit . . . but in the cookie aisle, it hit me. I reached for a pack of gourmet cookies and they fell to the floor. As I bent down to retrieve them, I suddenly knew I’d faint if I leaned all the way down.

I left the cookies on the floor and retreated to the register to check out.

My legs felt so heavy, I could barely move. Thinking a jolt of caffeine and sugar would pick me up, I grabbed a cold Coca-Cola from the case and gulped it down.

I slowly loaded the two bags of groceries into the back of my SUV as if I were moving through syrup. I was again short of breath and recognized the pain in my collarbone as constant.

After I got home, I finally gave in and called my primary care doctor.

“Sorry, he’s out of town,” said the nurse who answered the phone.

“Is someone covering for him? Who can I see?” I begged.

Her answer was short and sweet. I could either call my cardiologist or go to the hospital emergency room.

“I can’t go to the ER. I have too much to do!” I wailed.  Her reply will haunt me for weeks, months, maybe longer:

“You can’t do anything if you’re dead.”

Thankfully, I had a cardiologist to call. The receptionist found my file (it had been ten years since my most recent visit) and said Dr. Marshall could work me in at 1:00 pm that day. I called my husband Tomas and we drove there together.

After I was hooked up to an EKG, the tech shook his head as he watched the needle move. The associate doctor came in, also looked at the machine, and frowned. Then Dr. Marshall entered the room. As they all stared at the EKG machine, I knew something was up.

“Susan, you’re having a heart attack right now,” Dr. Marshall said.  

What? It can’t be. I thought he would just give me blood pressure pills and send me on my way.

Terrified, I looked over at my husband who looked terrified, too. He said we had to go to the ER—NOW.

Then things happened fast.

The tech gave me a baby aspirin and the associate doctor gave me nitroglycerine under my tongue. I heard Dr. Marshall on the phone swiftly making arrangements for me.

Oh, God, I prayed silently.

DAY ONE

Tomas dropped me off at Tucson Medical Center’s ER entrance, which was only four blocks from the doctor’s office. I was whisked inside and placed on a gurney. I winced as the attendant peeled off my brand new black leggings and my underwear. I was allowed to take off my top and bra myself, and the hospital gown went on so quickly, nobody could see my nakedness.

The medics swarmed around me.

Doctors, nurses, techs, all said their names and what they would do to me. Calmly, they took my blood, put in a needle for an IV, and asked about my health history, my medications, and my nail polish.

Yes, my nail polish. They wanted to remove it so they could clip a heart monitor onto my finger. They said the polish would interfere, but I knew it wouldn’t come off because it’s made of shellac. I tried to explain this but to no avail. Instead, they quickly attached a heart monitor to my ear.

I felt a breeze on my face from the speed of the moving gurney. They rolled me to the Cath Lab, explaining every movement and location along the way. But having received anesthesia, I didn’t care.

Surrounded by nurses, equipment, and blinking monitors, the doctor threaded a tiny wire with a balloon on the end through a catheter tube in my groin. From there, he inserted a stent in my right circumflex artery. It was 95% blocked and resistant to opening, but with the stent in place, my blood flow improved to 60%.

Less than twenty minutes had passed since I walked into the ER.

When I woke up from the anesthesia, I found myself in a private room with nurses, techs, and orderlies coming in and out. My husband was there and so was my son Tim.

I was starving, but I couldn’t eat until another round of tests were run. That night was a blur of fitful sleep, bad dreams, a dinner tray at 10:00, and a constant struggle to get comfortable.

DAY TWO

The early morning ushered in more nurses drawing blood, bringing pills, and taking my vitals. My breathing was still labored, and my collarbone pain had moved to my chest.

Three doctors visited and determined I wasn’t better, so they ordered a few tests. They gave me something for the pain and to get the fluid off my lungs, then sent me off for a chest x-ray. After that, I was wheeled out on yet another gurney for an echocardiogram, a test that uses ultrasound to evaluate one’s heart muscle and heart valves.

Hours later, the hospital’s cardiologist Dr. Waggoner told me he was taking me back to the Cath Lab to fix another artery with a stent. I trusted him. I knew something had to be done because I felt so bad—constant chest pains, shortness of breath, fitful sleeping, non-stop sweating. And I saw how the nurses frowned with concern when they took my blood pressure and peered at my monitors.

After receiving a second stent, I improved dramatically.

The second stent opened up the left circumflex coronary artery, improving the blood flow along with oxygen to my body. My test results improved. Everyone noticed!

This fix marked the beginning of a slow recovery as my heart began to grow stronger.

DAY THREE

By the third day after my heart attack, my brain was on overload trying to take in every face, test result, and procedure explanation. I had three cardiologists, four nurses, a dietician, a pharmacist, a physiologist, and a hospitalist who managed my case. One nurse was a counselor who had a soothing voice and wore a fuzzy cardigan.

Dr. Pena, my hospitalist, visited me every day. He’d squat down to look me in the eye, hold my hand, and ask if I knew what’s happened to me. His soft voice calmed me. He made sure I knew I’d had a heart attack and then stent surgery procedures. Whatever the circumstance, he took care to explain the details to me.

Sarah, the nurse with the fuzzy cardigan, told me, “Because you almost died, you’ll find yourself feeling depressed. Just expect this to happen at some time.”

A kid in blue scrubs (a cardiac rehab intern) said he’d walk me down the hall to see how far I could go. This excited me! I wanted to prove I was strong enough to be released. He offered his arm, and we started our walk. Yet I could only make it a few steps out the door of my room before I was so winded, I had to stop. My ankles felt wobbly, my legs weak.

Then came Debbie, a cute manufacturer’s rep dressed in a slim skirt and peplum jacket. I wanted her to meet my bachelor son, she was that cute. Her job was to explain how to use a defibrillator life vest. She opened a color brochure describing a contraption I was supposed to wear 24/7 for six weeks.

The vest, like a fabric sports bra with metal paddles in the back, would shock my heart if I should have a heart attack while wearing it. It’s also full of sensors to monitor everything about my heart and transmit the data to a far-away location via modem.

Because it was a Sunday, though, I wouldn’t get the actual vest until Monday.

The dietician lady wearing red scrubs was sweet as she launched into long explanations of what I should be eating for the rest of my life. I was especially intrigued with her visual of the desired salt intake. “Just make a little mound about the size of a dime in the palm of your hand,” she said. “That’s how much salt you can have in a day. Not just from the salt shaker but from EVERYTHING you eat.” Then she showed me how to read labels on food products, especially the sodium content.

At one point in our conversation, my eyelids drooped as I cradled the stack of brochures she’d brought. “This is a lot to take in!” I declared.

Before I drifted off, I heard my husband and doctor talking about the “ejection fraction” or EF numbers. EF is a measure of how well the left ventricle is pumping blood to the right ventricle, and my EF was low at 15 (with a normal heart putting out 35 to 55 EF). This explained the need for wearing a defibrillator vest.

That afternoon, I ordered heart-healthy chicken soup for dinner, but it tasted like dishwater. Yuck, no salt. So I ate the saltine crackers, I craved salt so badly!

I dozed off again and heard the clicking of heels come into my room. I opened my eyes and saw my best friend bearing a vase of flowers. “Happy birthday,” said Diana.

“I told you not to come, Diana!” I blurted.

“I had to see you with my own eyes to make sure you’re okay,” she replied.

That’s when I started to cry. I didn’t want anyone to see me so debilitated—oxygen tube, catheter bag, tubes and needles in both arms, bruises on every visible surface.

I wanted to tell her I almost died and how scared I was, but my breathing was so labored, I couldn’t get out any more words. We simply hugged.

DAY FOUR

Finally, Monday morning came and so did a flurry of activity. A young man in gray scrubs went through my discharge papers. One by one, he explained what the points meant so I could knowledgeably sign the papers. Most important was getting the long list of drugs, their names, dosage, and what they would do for me.

It felt like a barrage of instructions: Do this, do that, make an appointment for this doctor, that blood test.

Then a chipper nurse dressed in brown corduroy came in with a lot of enthusiasm and a defibrillator life vest. She showed me how to put it together by inserting the paddles into the slots and the round sensors with their skinny black cords. I noticed a two-and-a-half-pound battery pack was attached with a cord on the side.

“Put on the life vest and get me out of there!” I wanted to shout. But no, I’d have to prove to her I could put it together as she did. Like a puzzle, she disconnected the parts, then she made me put them back in place while she watched.

The vest was already complicated, and it came with a long list of things to do EVERY DAY. Its battery must be removed and replaced while putting the spare on a charger and each sensor (eight of them) must touch my body through the thin fabric. I knew that no slacking off was allowed; wearing this vest was serious, life-saving stuff!

The kid in scrubs came to walk me again. This time, I made it farther than before. I wanted to jump for joy, but my arm wouldn’t let go of his.

DAY FIVE: MY FIRST NIGHT AT HOME

Tomas and I decided I should sleep in the guest room and keep the walker nearby. I would need it when I got up to go to the bathroom. I wasn’t strong enough to make it there on my own.

That night, I had a nightmare, awoke with a start, and begin to hyperventilate. My breath wouldn’t come—I was terrified. I made my way to the family room, got into the recliner, and covered up with an afghan. I realized I could breathe better sitting up.

While in that chair, I had a long talk with God thanking him for sparing my life. I asked Him to help me breathe better right now! Then I asked Him what I did to deserve this and what I could do to repay Him for saving me.

I fell asleep mid-prayer.

Over the next few months, I followed my doctor’s orders strictly. That meant attending cardiac rehab three times a week, eating heart-healthy meals, and taking my meds faithfully. The hardest order was eliminating stress from my life.

Weeks passed and gradually I regained my strength. My Ejection Fraction or EF rose to 55, which meant getting released from the defibrillator life vest.

In the meantime, I canceled my writing groups, gave up teaching classes, and reimbursed my students for money they’d paid. I also stopped networking and posting on Facebook, plus I quit being annoyed at interruptions.

Thankfully, I began feeling like a normal human being. I learned to drop the “too busy” persona and practiced my new mantra: “JUST BE.”

SIX MONTHS LATER: GRIEF, GUILT, AND GRATITUDE

When I had my heart attack, I almost died. I mean, I could have died. But I didn’t. Faced with my mortality in this drastic and incontrovertible way, I realized it was possible I might live a shorter life than I’d anticipated.

I suffered GRIEF for the life I’d lost.

No, I didn’t die, but my old life was gone for good. I grieved over what I might have missed with my husband, my children, my grandkids, my sisters, my friends. And I grieved for all I will miss in the future when I do die.

Now, I make it a priority to fill my heart with memories of love, joy, and togetherness with those I hold dear. I try extra hard to say how much I appreciate them and make an effort to spend time together.

Then there is the GUILT, which can take on many faces.

A dear friend of mine recently died from breast cancer. She fought it for eight long years, and still she died. Maybe she’s in a better place and is no longer suffering, but I feel a sense of GUILT. I’m still alive. And she is not.

Then there’s the GUILT over my life habits: smoking years ago and all those fatty foods I shouldn’t have eaten. Even worse was the GUILT of thinking my “busyness” was so damn important! I am guilty of all that, and yet I lived.

My counselor told me these feelings are normal.

That brings me to GRATITUDE.

Today, I’m so grateful God gave me a reality check and a second chance. I know He had a different plan for my life. I wanted the last part of my life to include writing a book or two, teaching and recording online writing classes and creating a clever website where all my creations would sell while I went about living my life.

I dreamed of developing multiple income streams, so I could spend summers on the Oregon Coast and winters in Tucson.

The Internet gurus were teaching this, and I was eating it up. I had been a go-getter, a “make-things-happen” kind of gal from way back. After all, I bought my first power suit in the 1980s.

I loved challenges. I thrived on them. I believed I could power through any situation. I would keep going and achieving, no matter the cost!

In 2018, that mentality nearly killed me.

I was in the middle of a fresh writing and coaching career living my dream. At the same time, I kept up my social presence as if I were still 32, attending networking mixers, handing out business cards, promoting programs and classes, and loving every minute of it. And then I tackled social media, posting strategically, deliberately, at specific times of the day.

All that stopped with my heart attack.

My busy schedule was NOT the most important thing in my life.

I thought stress was anything that caused me great upset or anxiety. But I learned from a soft-spoken cardiac nurse that stress is more than that.

“Basically,” she said, “it’s taking on too much. Doing too many things without enough time. many women take care of everybody else before they even think about caring for themselves.”

“Hmmm,” I thought, “she’s describing me to a T!”

I would help a friend needing advice, or take a seat on a committee, or play host to promote this person or that cause. It became an addictive behavior, and I couldn’t stop myself from running around in circles with all my “busyness.”

I had to face facts: my stress was self-induced.

I didn’t have any energy left for myself. The old me always said “Yes!” to everything, never thinking it was causing stress. But I’m not that person anymore. I can now say “No” to things that will get done without me. I have to pull back. I know my strength doesn’t have to come from a laundry list of accomplishments. I can relax.

I am very lucky I didn’t die.

But my life as I used to live it? That’s over.