Jack

Angina

Mind over matter?

A series of frightening symptoms led Jack into a maze as he tried to locate the cause and solution to his pain. This is his story in his own words.

Even though both of my parents had succumbed to heart disease at reasonable ages (69 and 78) I had never given any thought that I would suffer from a similar illness. I had for the most part led a fairly healthy life with lots of exercise, good food, very little smoking or drinking and was always fairly thin.

Up until my mid-50s I had jogged daily, played sport almost every week – both winter and summer – and had regular medical check-ups.

The first indication that I could ever suffer from heart disease was when a blood test in my 40s indicated that my cholesterol was slightly high. The GP reassured me it was probably in my genes and because I had a half-sister who was in her 80s and healthy, it was nothing to worry about. He suggested I take a statin tablet daily and said he would monitor my situation.

About 20 years later on a lovely sunny day in May 2008 I was fishing alone in my small boat on Port Phillip Bay in Melbourne, Australia. I had undertaken this very pleasant pastime many times and was aware of safety requirements to handle the situation. I was anchored about two kilometres offshore waiting for the fish to bite when my mobile phone rang. It was a friend from Melbourne and I spoke to him for about 10 minutes while standing up watching my rods. 

Almost as soon as my friend rang off, I felt the strangest sensation with my head spinning and the next thing I knew I’d woken up face-down in the bottom of the boat, covered in blood from cuts on my face. I was very lucky not to have fallen into the water.

I thought it was some sort of virus and just tried to ignore it. About 10 minutes later, exactly the same thing happened and I decided to pull in the anchor and head for shore. All went well and with help from another boatie, who must have wondered what I’d been up to, I hauled my boat onto the trailer and drove back home, about half-an-hour away.

In hindsight this was a crazy thing to do, as I could have lost consciousness again while driving. On reaching home I rang my GP and went straight in to see him.

Tests and treatment

The GP assessed my situation and arranged for me to see two specialists. One was a cardiologist and the other a neurologist. The reason for the latter was that 50 years before I had suffered a serious fractured skull. The GP said to me, “I hope it’s your heart causing this and not your head.” He indicated that it might be very difficult to find the cause and fix it if it was due to something going on in my head.

There was one small thing that worried me slightly as I’d asked the doctor whether I should continue driving. His answer was “You never asked me that,” and he just smiled.

So over a couple of weeks I undertook a number of tests, both cranial and cardiac, and they couldn’t find anything wrong with me. My blood pressure, pulse rate and head x-rays were all fairly normal. So that was it and I continued to live my life as I normally did.

About two months later on a Saturday morning I was shopping at the local supermarket. I vaguely remember reaching for a tin of pineapple and a short time later waking up on the floor. A crowd of people had gathered and were looking down at me with concern... 

I asked the manager of the store to call my son to come and collect me and drive me home. My son took me home and I convinced him I was fine to be left on my own.  No sooner had he left me I fainted again and fell off the chair I was sitting on. When I regained consciousness I finally called for an ambulance. I walked to my front gate when it arrived and was put on a stretcher and taken to hospital.

Because it was a Saturday, the hospital told me that the specialist would not be in until Monday and so I was given a bed in the cardiac ward, a special drip and lots of wires stuck to my chest. It was slightly funny as there was a fairly loud beeping in time with my pulse that could be heard by the nurses who were on duty. At some stage I must have rolled over in bed and pulled off one of the sensors as the beeping went quiet. It took about five seconds for about six nurses to be in my room thinking my heart had stopped.

In short all was well and on the Monday a cardiologist arrived and fitted me with a pacemaker. It was the 8^th July 2008. I went back to all my usual activities.

Heart trouble continues

About four years after this, while still living in Melbourne, I started to feel some strange pain in my chest especially when I was lying in bed and when out walking. In late 2012 I went back to the cardiologist who performed an angiogram and gave me the ‘all clear’; I still have the image from the angiogram showing clear arteries. Also around this time, my then partner and now wife Sarah and I decided to sell up in Melbourne and retire to a lifestyle block with a tiny house in Roxburgh in the South Island.

We both worked very hard to develop the land which had about 20 old fruit trees, all of which needed pruning, a large grass section and garden, some sheep, chickens, plenty of rabbits and a few ferrets that ran wild. The work was hard for former city dwellers and we both found Central Otago cold and fairly isolated. So we sold up after about a year and shifted to Oamaru to be near the sea, which we both missed.

We loved Oamaru and the very large and spectacular house we had purchased there. However, we’d always known that we’d eventually downsize, perhaps in a few years. But when the opportunity came up to move into a brand new retirement village in Nelson together with a quick sale of our house, we decided to bring our plans forward. We spent several months travelling and visiting friends and family as we had four months between the sale of the house in Oamaru and when we could move into our retirement village unit.

And so it was that in mid-April 2015 we drove from my wife’s brother’s house in Dunedin to Nelson, towing the boat. Two days later on our first night in our new home, I had severe chest pains and we rushed into the Emergency Department at Nelson Hospital, not easy when it’s dark and you don’t know where it is. As it turned out, the ambulance service didn’t know where we were, it was that new.  

My pains were so spasmodic that I ended up being sent home with indigestion, or so they thought.  A couple of days later I was again in the Emergency Department, luckily a young doctor was in the room when I had an episode and I was booked for an angiogram the following day. They found a blockage in a cardiac artery and a stent was installed. So much for the diagnosis of indigestion.

For the next four months I worked hard on my fitness, building up to long walks that included hills, and working in the garden. Then to my surprise similar symptoms of chest pain and tightness of chest occurred again. It took a lot of convincing the cardiologist that it was not just reflux and, finally, another angiogram found that the original stent had blocked nearly completely. This was cleared and treated, and it appeared the procedure was successful, and for another four months or so I was feeling quite good.

Chest tightness returns

Six months later, on a trip to Melbourne in April 2016 I started feeling tightness in my chest again, especially after a meal or any excitement. Back in Nelson, we went back to the Emergency Department. I was sent home again with reassurances that it wasn’t another heart attack and a tweak to my medications should do it.

But things kept getting worse. It got to the stage where I could barely walk down the street. Sarah and I, and everyone we knew, were convinced it was my heart again. We even started to wonder whether I’d need a bypass.

Finally I had a long-awaited appointment with a different cardiologist. He quizzed me in detail about my current symptoms and discussed many possible outcomes: Yes it could have blocked up again, yes a bypass could be the answer, we’ll know more after another angiogram, another possibility is that they are phantom symptoms. And I recommend you delay your trip to Melbourne until we know what is going on. We couldn’t believe what we were hearing.

The cardiac staff were concerned enough about my condition that the angiogram was booked as urgent. We were fully briefed about the process if a bypass was required – mentally we’d prepared for the worst.

We were taken aback, then relieved, when the result of the angiogram was ‘all clear’. The cardiologist explained that it wasn’t the first time, and wouldn’t be the last, that he’d seen this happen. The brain can trick the body: what I was feeling was real, but not genuine.

Once I’d absorbed the news I felt as if a weight had been lifted. Sarah says that my colour improved almost immediately, as did my posture and my energy. Then we wondered, how could that be, how could I, intelligent and educated, have tightness and pain in my chest that was just ‘in my mind’? The influence of the mind over the body is indeed a powerful thing, as are the messages we get from those around us.

I’m back walking and gardening, but not like I was before. It’s not the end of the story and I still don’t have an answer. My arteries might be clear, I have a picture to prove it, but things still aren’t right, I still get a tightness in my chest almost daily and occasional pains.

At nearly 79 I know that I have to accept some slowing down and a few physical changes. It’s frustrating though, there is something causing these symptoms but I am not regarded as high risk. In the meantime I do the best I can, until the medical profession can give me an answer and offer me some relief.

Written September 2016