THE BEFORE TIME, AND THE AFTER TIME
Since the heart attack, I have an entirely different calculus for pretty much everything. This is most prevalent in the big questions, especially philosophy and major life choices. Part of this calculus is taking into consideration my safety and comfort now that I rely on health care services and medication far more than before. Travelling, long-term housing decisions, where’s the closest hospital from wherever I happen to be visiting for any significant period of time. We just returned from a ten day vacation, and, when I booked accommodations for our trip, I also researched each local hospital. It didn’t influence where we stayed, but it was good information to have.
One possibility will be a permanent move to the cottage, though not likely for many years. While the timeline for my care on the day of the heart attack was sufficient to save me, what does that look like when I’m older, more frail, more reliant on the Ontario healthcare system? In mid-2023, the emergency room facility in Minden was closed. This forced patients in the area, many of whom are elderly and care-dependent, to travel to Haliburton instead. that doesn’t sound like a big deal, but 25 minutes is often the difference between life and death. This is the latest in a long line of short-sighted choices by our Ministry of Health and our disgusting Premier. While healthcare reform is necessary in Canada, the solution isn’t making care harder to afford or harder to access. This decision has resulted in substandard healthcare for nearby residents, and significant consternation in the community.
All of this leads me to thinking about what it was like for me prior to the heart attack. I’ve talked about this in brief during some of my previous posts, but I’d like to get into greater detail here. While I didn’t know a heart attack was coming, and I didn’t really live my life in a way that was explicitly designed to avoid any specific maladies, I wasn’t then, nor am I now, reckless. But, I wasn’t careful. That doesn’t mean that nothing was going on in my mind. It doesn’t mean that there wasn’t, at the very minimum, a creeping, subconscious trifling.
It’s hard to put into words how this felt. I’ve tried very hard to examine how I thought about my health prior to the big event. I’m sure that I wasn’t being as careful as I ought to have been (the heart attack is a pretty strong indication of that), but I also know that my genes were a much greater factor. I know for sure that I did spend some time consciously thinking about some changes my body had been going through. After all, I was already in the early stages of exploring a diabetes diagnosis, and had been prescribed a very low dose statin for cholesterol. I’m also pretty sure that I was walking into a lake of very slowly forming molasses. At first it just feels like water, but, over time, as the sugarcane refined, I moved slower and slower. I know this is true, because, since completing cardiac rehab, and the use of my new medications, I am objectively healthier, more active, and happier.
Oh Bart, You scamp
But, what’s hard to be sure of, is if what I was feeling in the months and years leading up to the heart attack was an accurate warning. I loathe confusing correlation with causation, and I know that humans are exceptionally bad at accurately reading signs that their body gives them. As I mentioned in HEGHLU'MEH QAQ JAJVAM, not a day goes by that my body doesn’t give me a false signal that I’m about to die. It takes a great deal of willpower to calmly analyze each of these twinges, cramps, itches, and pains and set them aside as what they are: ultimately unalarming. I have experienced more of these moments than I can count, and none of them have even led to a visit to a walk-in clinic, let alone the emergency room. It hasn’t even been close.
The moments happened before the heart attack as well. They are the same ones that everyone experiences throughout their life. I’ve always wondered what causes them, and how many of them are psychosomatic. Obviously, the body is constantly engaging in its standard machinations. It’s an unending ballet of chemical and mechanical nonsense that prods at the nervous system and begs you to notice. There are decent medical explanations for all of this. While human understanding of our biology is incomplete, we know the cause of an event like a muscle spasm. But, unless you are hooked up to some kind of constant body scanning machine, you couldn’t be sure of any root cause of what you’re experiencing. And if you don’t know the root cause, how can you possibly know if you’re actually in any danger in that moment?
And that’s what leads me to doubting whether or not any of my concerns (conscious or otherwise) prior to the heart attack would have actually been of any use to me. Entering a lake of slowly forming molasses has its impact. But, if you don’t know you’re doing it, and every warning sign is actually a sign of something else, or a sign of nothing at all, then you don’t really know which way is up. This is the multi-faceted jewel that a serious medical incident bestows upon you. You doubt whether or not anything you knew in the ‘before time’ could have been helpful, or if anything in the ‘after time’ is real either.
There was this sense of racing towards a precipice. The wild, careening, downhill, scything through of a thicket of bladelike fronds, each one of them striking me as a tiny sting. At the end of the bracken is a short area of freedom, no thorns to injure. The calm before the storm. But then comes the cliff edge, and the undeniable pull of gravity and the end below. Sometimes, maybe only in the deepest recesses of my mind, this is how it felt.
But it doesn’t feel like that now. The twinges, cramps, itches, and pains are still there. Sometimes it’s something very minor that comes and goes instantly. A microscopic, shooting pang in my abdomen that vaguely feels like the pains I was having shortly before leaving for the hospital on the day of the heart attack. It happens so fast that occasionally it feels like it may not have been there at all. It’s not a delusion or a hallucination, but it’s also not entirely tangible; like trying to grab vapour in the vain hope that the molecules contain some convenient message.
Sometimes it’s a more lasting moment of discomfort that feels like it could be serious. The most prominent of these is shoulder pain that feels similar to August 4th. This has only happened a couple of times in the last eleven months, and usually results in taking my EKG and my blood pressure a few times to see if these diagnostic tools can shed any light on the situation. In those moments, I’ve never felt like I was just about to die, nor was I sure that I was having another STEMI. But doubt creeps in. Maybe that’s exactly what’s happening, and the waiting to see, knowing I don’t have enough information to call an ambulance, can be excruciating. For those concerned about the possibility that I might be ignoring acute medical stress, I can assure you that’s not the case. I’ve memorized the early signs of heart attack, and promised myself (and Jenny) that I’ll talk about it when it happens, and be ready to call for help.
I was recently talking to a close friend of mine about our shared situation of nearly losing our lives recently. She’s experiencing the same issues that I am. I’ve also heard similar stories from the folks in my cardiac rehab cohort, and read about this in several online forums. Additionally, my psychiatrist explained that all of this was very common. While that’s not entirely comforting in the acute moments, it’s nice to know that I’m not alone. All of this to say that these feelings are both inconvenient and alarming, but that I’m also dealing with it as best as I am able. Recovery is a process; and I like processes.
