My view ...

The private blog of Andy Prevost. My experiences, my words. On any topic ...

A heart attack

I was totally oblivious to the possibility of a heart attack, or even the symptoms – and how to tell if it is in progress.

Despite this, I am lucky. While going through a heart attack, I managed to drive myself and my wife to the hospital. Her concerns about driving didn't really strike me, I had doubts about the symptoms truly being a heart attack. So, I went ahead and drove with a promise that if I felt worse I would pull over and call an ambulance on my cell phone. I managed to get to the hospital.

Never again. I'll describe the symptoms and what happens (at least to me) and advise you: if you go through something similar, do not hesitate – call an ambulance. If you drive, you are putting yourself (and everyone else on the road) in danger. I was lucky, but will never repeat this again.

Here's how it all started. I had been feeling poorly for three days. I can't define it any better than that – just felt "not right". Not much in the way of energy, wanted to rest a lot. On the fourth day, I decided to get off my a** and get something done. Sitting on the sofa just isn't me. To the backyard I went and pruned several trees (looks great now, by the way). I was out there for a few hours, cutting and gathering the tree limbs and leaves. It was a hot day and felt a slight tightness in my upper chest – right in the middle. Just above the tightness I felt a not near-burning sensation. Thinking I was just over doing it in the heat, I asked my wife for a cold drink of water. Didn't help. Neither did a second.

I persisted and cut down a few more tree branches and gathered them into the pile.

Sat down to rest and asked for more water. The tightness and hot throat sensation did not go away. My arms were already feeling heavy – but I was also lifting a reciprocating saw and climbing a ladder to get to the branches. I thought it just natural that my arms would feel a bit heavy after all that work. However, I noticed a slight tingling and numbness in my left arm – just below the shoulder to just past the elbow.

I turned to my wife and mentioned this. "Maybe we should go to the hospital, this might be a heart attack", I told her. "Ah, never mind, I don't think it is.". Another gulp of water, and no easing of symptoms. "Sorry, dear, I think we need to go to the hospital. I may be wrong, but would rather be safe ..."

Here's where it gets stupid. I really wasn't sure of the symptoms. I had never heard them described this way. I expected a lot more pain. I expected a near-blackout experience. My thoughts were that going to the hospital was more preventive than necessary. That's why I decided to drive myself (my wife does not drive). Dumb idea. Not only did I put myself and my wife at risk, I also put everyone else on the road at risk. An ambulance or anyone else to drive you to get medical assistance is the right way to do this.

When we arrived at the hospital, I pretty much had to tell them my entire medical history. Despite this being a long weekend, there really wasn't many people in the waiting room and we got in fairly quickly.

I was on a heart monitor quickly. The nurse took poked me about half a dozen times to find a vein that would give her enough blood for the lab tests. My veins are pretty much all collapsed from years of being poked for blood donations and my own health issues over the past ten or so years. Not only collapsed, there are tons of scars. Just from this past weekend, I now have about a dozen new bruises and a new "divot". One of the nurse's attempts was quite painful. My left wrist is now swollen and deep green/blue – nurse called it a "blown out vein" ...

Blood tests confirmed the presence of troponin ... an enzyme that is present with a heart attack.

Next process was a procedure called an angiogram. That is invasive. They inject a dye near the heart and then monitor how much of that dye gets through each vein and artery. That is how they determine the percentage of blockage. In there is blockage, they can insert a stent during the same procedure. If the blockage is extensive, they will schedule a separate procedure for bypass surgery.

Before the angiogram, they prep you by shaving your wrist (right hand). They also shave your groin area ... that is just in case the wrist is unsuitable to insert the probe to deliver the dye. Uh ... shave my groin area? Gheez, 'lil Andy now looks like a grub worm with a mohawk. If the wrist insertion point does not work, they have two additional areas they can insert the probe. The first would be on the right side of the groin, the second on the left side of the groin.

An angiogram takes roughly one hour. You are given an anesthetic at the insertion point (wrist) ... other than slight discomfort, you really don't feel much. They also give you a general "happy" injection – you are still aware, but really don't care. During the hour long operation, the biggest issue is slight claustrophobia from all the monitors and devices circling near your head and upper chest area. Once the procedure is done, the doctor will let you know the result of the procedure.

Then it is off to the recovery room for at least two hours.

Now the painful part kicks in ... my wrist was used for the probe. They cut into the skin and cut an artery – the probe is inserted into the artery and then winds its way up your arm and across your chest to your heart. Once they remove the probe, they have to make sure the artery is well healed and sealed. To do that, they use a plastic clamp. That's the painful part. Gheez, that thing hurts. There just isn't a comfortable position where it doesn't hurt. Fortunately, for most of the two hours in the recovery room, the "happy" injection has not completely worn off, but it still hurts. The clamp is on for 1 hour and 15 minutes. They then gradually loosen the clamp over a 50 minute period until it is completely off – they then replace the clamp with a compression bandage. The compression bandage hurts a bit.

You can't eat while waiting for the angiogram. Waiting could take anywhere up to 12 hours. They are keenly aware of the hunger and have a meal ready for you after the operation. My operation ended at about 10:40 pm. I was looking forward to eating, but my meal had been prepared seven hours earlier and the nurses threw it out. I ended up with the kitchen dregs ... a dried out sandwich and a sealed piece of cheese and sealed small portion of diced peaches.

Throughout all this process, you are on a heart monitor. Depending on the department you are in, there are different heart monitors and each department only use their own preferred device. In the emergency department, I had three: one from the sub-acute department, one from the acute department. When they transferred me to a hospital room, the acute department actually changed the heart monitor to a portable unit while I was waiting for transportation to the room. In the cardiac ward, I was on a full size device, alternated to a portable device to go to the operating room, put on a different portable device for about 10 minutes while I waited my turn on the operating table, and then another portable device while being transported back to my room, and then a plugged-in device from that point on until released.

From the operating room, I was put on an IV drip. It was ordered for a total of 12 hours. Noisy device that woke all my room mates at about 3 am when I turned and compressed the IV line.

The hospital release process takes a few hours. They go through your new pills and all the warnings that go with that.

Even though this is normally a two or three day process, ask someone to bring you your own night clothes, fresh clothing, and their help to get you cleaned up. You can't do it on your own, and it is not the hospital's responsibility to make sure you wash, brush your teeth, or smell nice.

I have a good sense of humour. Having a heart attack didn't take that away.

There were several times that I wanted to get to the bathroom. I didn't feel like using a bed pan or urinal. So, I unplugged everything and went to the washroom. That brings the nursing staff to your bedside awful fast ... "dang thing kept flat lining", I said. "I unplugged it and went to the mirror to check I was still breathing" ... LOL.

The doctor that performed the angiogram had a good sense of humour too. He has to go through a process before starting so that you understand the risks and everything involved. When he was done, he asked if I had any questions. "Sure do", I said. "Were you drinking today?". Without batting an eye, he held out a trembling hand and said "just enough to calm this down ... oh, dang". We both roared laughing.

I did have a favourite nurse ... and she had a great sense of humour too. After recovery, the IV drip machine started beeping around 3 am. She came and quietened the device. I watched the buttons she pressed. When it happened again around 7 am, I pressed the same button – not the same effect though, beeping got faster. When she got there, I said I had tried all the different buttons. "You didn't find the 'blow up' button obviously, you are still here" ... LOL

A few jokes at the end before I went home ...

I want to emphasize that a heart attack or the possibility of a heart attack is no laughing matter. The process may last a few seconds, a few hours, or a few days. Ignoring it could end all that waiting for you. This is a dead serious issue. Become familiar with the symptoms and what to do about them.

Categories: Health

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Smoke Cessation

Smoke Cessation. Quitting Smoking. Butting out. I think I started looking for ways to quit smoking not long after I started. I was a teen and the very first shirt I bought with my own money got a burn hole from a cigarette ember. Nice big hole too with darkened burn mark edges.

You could always tell who the smokers were. Burn holes in shirts, coats, jeans. Look at the gloves ... burn marks on the fingers. Same with cars, burn marks in the seats (if you got lucky, you could wipe it away quickly, burn your fingers, and only have a char mark on the seat ...).

Most embarassing burn mark? Brand new girl friend and I was smoking in her parents' house. I was laying down in the living room, ash tray close by ... and the cigarette slipped off the ash tray onto the carpet. Oh gawd, oh gawd, oh gawd ... what the hell do I do now? Not only was this a new relationship, it was one of the first times at her house ... and a brand new carpet too. Most embarassing. Not sure why, but they didn't kill me. And, for some odd reason, they let me marry that gorgeous girl too ...

Over the next 40 + years, quitting smoking became a joke. I had all kinds of people wanting to support me to quit smoking.

"How's the smoking coming along?", they would ask. My reply was the joke: "Coming along fine, just fine. It's the quitting part that has me stumped!" ... really funny.

Smoking took its toll. For at least the last twenty years of smoking, I was coughing regularly. Coughing in the morning brought up some interesting colors. I was in the corporate world and had some brand new suits I only wore once and burned holes in them. New white shirts and ties with burn marks, worn only a few times. I think back to having meals and drinks with customers and being the first one to light up. Gheez, what the hell was I thinking. Ruining my health and offending my clients. And that didn't even open my eyes to the smoking issues.

What eventually opened my eyes to the drastic health issues was being diagnosed with diabetes type 2 and Idiopathic Chronic Pancreatitis. Research shows that smoking is a cause of pancreatitis – mine is diagnosed as idiopathic (meaning no known cause), but I am fairly certain smoking was the cause.

I never succeeded with any smoke cessation strategy. I took seminars lasting up to 8 weeks in a group "buddy" setting. I end up quitting for a few weeks, and then light up again. That seemed to be the way it always worked. Quit for a few weeks and start right back up again. I tried cold turkey, Champix, hypnosis, Zyban, acupuncture, Nicorette patch, Nicorette Gum, Nicorette Inhaler (well just about every Nicorette product made including the lozenges, etc). Nothing worked.

That is, until I discovered a vaping kit that a local vape shop clerk taught me how to use. The clerk showed me how to fill and refill the atomizer, change the coil, start and shut down the battery, press the fire button, inhale, etc. The clerk even helped me pick the right e-liquid, nicotine strength, and quantity to start with.

Since that day, I haven't had a cigarette. That was years ago and I have gradually reduced the nicotine strength. 

Vaping is not promoted for smoke cessation. I know of no manufacturer or retailer that will claim vaping will help you quit smoking. Quite the contrary, it is promoted as an alternative to smoking. A healthier alternative. There are only four ingredients: Propylene Glycol, Vegetable Glycerine, flavorings, and nicotine. None are carcinogens. Is it healthy? Not by a long shot, healthy would be to just breathe air. But it is healthier than smoking. Far more healthy.

I vape for quite a few years and enjoyed it. It only took a few weeks after I started vaping to get my sense of taste and smell back. Only a few weeks to improved sleep and more energy. Only a few weeks to start feeling "different" ... better blood circulation, lower blood pressure. And no more burn  holes (no combustion).

I am now at the point where I still vape. My E-Liquid only has two or three ingredients now (no nicotine). I've broken the nicotine addiction, but still enjoy the different flavors. Quite frankly, I'm not sure if that is because I am diabetic and enjoy some of the sweet fruit flavors. I suspect it has a lot to do with it. But, I am also vaping a lot less than I used to. I used to go through three or four batteries each day. Now 1 battery will last more than 1.5 days.

I know the government doesn't want to hear about vaping and how it can help you quit. Vaping wasn't designed to help you quit, it was invented by Hon Lik as an alternative to smoking (for this father). All of us vapers have used it that way – as an alternative to smoking. I know many vapers that have completely switched from smoking to vaping and never touched another cigarette after switching. I know many that have completely eliminated nicotine too. Many still vape and many have quit vaping altogether.

It really doesn't matter if you switch to vaping or are a dual user (smoking and vaping). Vaping is tobacco harm reduction. Each cigarette you can avoid saves you from 7000+ nasty chemicals and 70+ known carcinogens in tobacco cigarettes. Each time you light up a cigarette, cigarillo or pipe, you are accelerating your expiry date. Avoid just one cigarette, and you add a few minutes to your life. Time that you will get to spend with your spouse, kids, and grandkids ... and likely their spouses too.

You won't get governments or health agencies to help you quit. Their strategies are the pharmaceutical solutions that have a success rate less than 7% after one year. That's the best they can do ... and it's also the best they WANT to do. There's a lot of money being made on pharmaceutical solutions – they cost you and your insurance company more than tobacco products. There is no incentive for governments to get us to quit, the bulk of money tobacco products are sold for go directly to government. More than 66% in Canada and nearly the same in other countries and jurisdictions. Governments are reliant on tobacco revenue – so much so that they will block strategies that do work to help  you quit smoking.

I chose vaping as an alternative to smoking, I used vaping to quit smoking, I used vaping to quit nicotine on my own time line. In my first year of vaping, I saved over $3000. I saved even more every year after that – money that went to fund vacations, toys, and enhance living. Money that I did NOT contribute to government tobacco revenue. Money, I am proud to say, that stayed with me.

Vaping can work for you too.

Categories: Tobacco Harm Reduction

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Zero NIC

Many years ago I chose to use electronic cigarettes as an alternative to smoking regular tobacco cigarettes and cigarillos.

I initially started with a kit and a tobacco E-Liquid that had a taste similar to my regular cigarettes. At the time, I was smoking about 30 cigarettes a day (a large pack of 25, plus five more – on average). The vaper that helped me pick a starter kit suggested starting at 24 mg/ml nicotine strength. That's what I started at. About one week later, I reduced that to 18 mg/ml. I think the initial strength of nicotine was too high, 18 seemed to be ok for my needs at the time. I also switched to fruit flavors. After about five days off of the tobacco products, my sense of smell and taste returned. The tobacco flavor I had picked initially no longer appealed to me ... but quite a few of the fruit flavors available did.

Over a few years, I managed to further reduce nicotine levels. When I was at 12 mg/ml, I had a "mini-stroke", a TIA. The doctor suggested dropping the nicotine level down (nicotine is a vascular constrictor) ... I did the next day, down to 6 mg/ml. Now I was at one-quarter of the nicotine strength I had started with, and in roughly one year. I even made an attempt to drop to zero nicotine ... but an unfortunate and rare issue cropped up: in my case, nicotine withdrawal increased insulin resistance (that's the exact opposite to what is supposed to happen). Despite the  high blood sugar levels, I persisted at zero nicotine for over 10 weeks. I was concerned enough at that point to re-introduce nicotine to get my blood sugar levels in control. I returned to 6 mg/ml and blood sugar levels returned to normal. After much research, I decided to wean myself off of nicotine by reducing the nicotine levels slowly and over a longer period of time.

The first drop was to 3 mg/ml. That lasted for about nine months and then dropped to 1.5 mg/ml. After about four months, I dropped that to 1.0 mg/ml. And after a few months, dropped to 0.75 mg/ml. Again after several months, I dropped that to 0.5 mg.

At each increment downwards, there was really no change in how I felt, or increased desires for nicotine. There was an adjustment period where the amount of E-Liquids increased. That leveled off after several weeks, though, and returned to "normal" E-Liquid consumption.

After only about one week at 0.5 mg/ml, I decided to complete the journey and switch to zero nicotine.

As I write this on June 14 2016, it has been exactly one week ago that I switched to zero nicotine. Over that week, I tested blood sugar levels more often – and the result has been absolutely no change in blood sugar levels: they are at acceptable levels (meaning nearly normal for a diabetic).

What are the next steps? I'm not sure at this point. I have handled the nicotine addiction portion of smoking to a point where I no longer need the nicotine. With all my other health issues, though, I'm not sure how much effort I want to put into dropping the entire physical manifestations of vaping ...

I do want to point out that nicotine is additive, but it is not harmful. There are quite a few health benefits to nicotine. Here's a few links where you can consider these benefits:

You decide for yourself ...

Categories: Tobacco Harm Reduction

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