Heart Health

Over the last couple weeks I’ve been plagued by recurrent headaches, all of which are a little different from each other. Often it is difficult to tell whether it’s a migraine or a tension headache – it’s probably both: starting as a migraine and then adding tension from being tense because of the pain. Add a bit of sinus trouble due to rapidly changing weather / pressure. Unpleasant.

In order to avoid medication-induced (rebound) headaches I am reluctant to take my prescription meds, instead I try to wait and see if the headache goes away by itself. Sometimes it does but often it doesn’t in which case I am left with a headache so bad that it only slowly responds to medication.

Last week I had a pretty bad – but not really bad (yet) – headache that just wouldn’t go away. It ended up getting worse and keeping me awake, I was unable to go to sleep. After midnight I was fed up and, looking for something that would kick butt (more so than the usual Fioricet), I took two of the Tylenol #3 (= with codeine) that my then-dentist had prescribed last summer for post-crown-prep pain. Because three or so years ago I had an adverse reaction to morphine when I was in the ER for what turned out to be gallbladder issues, I had never taken any of the Tylenol #3 – both morphine and codeine are opioids -; I didn’t want to take a chance getting sick from the codeine. But this time I didn’t care. I figured it couldn’t be that bad.

Tylenol kicks in mercifully fast. This time, so did the side effects (from the codeine, I assume): nausea, stomach pain that started above the stomach and extended to below and then around the left side into lower back, sweating, dizziness. The nausea responded to peptobismol and then phenergan, but the pain just wouldn’t go away. I tried walking around, sitting and putting my head between my knees – the pressure on my stomach felt good -, and ended up sitting in the recliner for quite a while.

I pondered whether going to the ER would do any good – but what could they do for me? Give me more painkillers?

After about four hours, the pain fairly suddenly subsided and I was able to go back to bed and sleep.

Jonathan who works as a CNA in a hospital said that my symptoms were awfully similar to a (female) patient who had come to the hospital and ended up having a heart attack. Heart attack symptoms for women can be startlingly different from the stereotypical (male) symptoms. Lovingly, he said that I was “a woman of a certain age”, and having my heart health checked out may not be a bad idea, if for no other reason than to have a baseline for what’s “normal” for me.

My doctor agreed and set up an appointment for a stress test. Which happened today. Treadmill, three minutes at a moderate pace and a 10% incline, then speeding up and more incline for another three minutes, then faster and steeper, all at three minute intervals, and so on. The goal was to get my heart rate up to 148 and see how long I could keep going (faster and steeper) before I couldn’t anymore. The speed wasn’t a problem, I think I could have gone faster and longer, but the incline was hell on my legs. I am not used to running uphill. Well, I am not used to running, period.

In my normal daily life, I move a lot, I don’t sit still for long, I always have a reason to get up, for something, anything. But I never exert myself. Sprinting up the stairs to answer the door is about all the “exercise” I get. So it didn’t take long at all for my heart to be at 148. I was able to keep going (very fast walking, almost jogging in the end) for 8 minutes, uphill, when I was way out of breath and had had enough = wouldn’t be able to continue. After a 30 second cool-down period, I was able/allowed to sit down. When I wondered out loud that an athlete who is in top shape could keep this up for much longer, the radiologist said “seventeen minutes” has been the maximum – but added that of course most of the people she sees on the treadmill have some kind of heart problem (or at least suspected problem). The 17 minutes was a rather competitive (but also very healthy) 16-yr old.

The curious thing now is that for several hours after the test I felt as invigorated as I was exhausted. I can now understand from (admittedly limited) experience why people love to run. How it can become an addiction – want to get that feeling again! Must run! And why everyone who is NOT depressed tells the depressed that exercise is invigorating and will make them feel better. Unfortunately, it takes energy to get going and running BEFORE you reap the benefit of having run, the energy that comes from having run. And energy is one of the things that someone who is depressed simply doesn’t have.

The radiologist said the data will be sent to a cardiologist to review, and then to my doctor to share with me. She didn’t see anything unusual, and the fact that I was able to keep going for 8 minutes (they need 6 minutes to do the test) and had neither chest pain nor any other symptoms – other than being out of breath – was a good sign.

Neither Jonathan nor my doctor nor Mark nor I think there is any kind of heart problem, but it’ll be nice to have the baseline of what is normal for me.

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