February is American Heart Month and Go Red for Women. Heart Disease is the number 1 killer of women. We don’t always recognize the symptoms. Many factors increase the risk of heart disease, not just cholesterol or having weight issues. I have heart disease and got it young; I was thin, exercised, ate okay, did not have high cholesterol. Below is the first post of a group of essays called “The Heart Chronicles” that I wrote for my blog starting 2011 about my experience of being ill, getting the right help, the work of ongoing recovery and my gratitude for so much well being. If you even suspect you may have a heart problem, do not delay: seek help, be of good courage and win the battle for greater health.

I am a born walker.  I love the way my arms and legs swing rhythmically and how my breathing deepens, the close up views of place and people from  sidewalks or forested trails. My appreciation of walking likely started when I was a child. I rode my bike often but I walked ten blocks to school and back both alone and with friends. I took leisurely walks around the neighborhood to see friends or just to seek folks on front porches or working in their yards–I wanted to see what was going on. I spent hours in nearby Birch Woods, jumping over roots and navigating leggy plants, around birches, maples, elms, poplars, oaks, along the creek. Sometimes I fancied myself a spy and kept tabs on the crusty old Benfers (and their strawberries and tomatoes and such flowers!) in their sprawling and gorgeous garden in the plot of land by our house, or shadowing Stark Nursery’s customers poking around rows of bushes and trees– where later I ran about, a cowgirl on a wild horse as sunset spread vividly above.

I also recall my mother walking with frightful efficiency and pace, two heavy bags of groceries in her arms, my short steps scurrying to keep up with hers. Freedom was unfettered movement of all kinds–the hallmark of children and those who love to be on the go. But when I became a mother, my children actually nagged me to slow down. Then one of those years I realized they were power walking past me, well-trained.

Now I walk daily unless constrained by intolerable weather or bed-bound by illness. I hike in woods and on numerous trails around the Pacific Northwest, as nature nourishes me. I walk during the day in the city and at night after ten to eleven hour days at my counselling job, and my spouse often joins me. We update each other on day’s events, enjoy beautiful old homes adorned with graceful gardens in our neighborhood. But mostly I walk not to be sociable or to rid myself of stress but because my body loves to move–and my life depends on it.

Almost eleven (note: the heart event was in 2001; this was written in 2012) years ago my husband and I were hiking in the Columbia River Gorge area. We had taken a well-used trail with steep ascending and descending trails that took us deeper into emerald-green of an early September day. I felt sweaty, and a bit breathless but thought little of it. I’d experienced shortness of breath before–and even since I’d quit smoking 9 months prior. I pushed myself harder, not one to shirk at a challenge.  I could hear our destination waterfall in the distance. I would rest then. As we climbed up railroad ties embedded in a hill, my legs began to feel rubbery and to weaken, my chest compressed and breath came hard. I was having trouble getting oxygen in me and it hurt each time I tried. My spouse had moved ahead of me. People passed by with barely a glance as I began to crumple. I willed my legs to carry me up the last bit. Then it landed with a vengeance: the proverbial elephant on my chest. It weighed so much and created such deep aching I could not cry out. I somehow–about on my knees– pulled myself over the top step to where my husband stood. Then fell forward onto the viewing deck as Bridal Veil Fall roared in my ears, then was muted by the physical crisis.

It was a hallucinogenic dream sort of trip through primeval forest as I stumbled, then was half-carried by Marc to the car. Breathing was labored. An odd electric sensation shot through my chest from time to time. I felt nauseous, so exhausted it was as if I might sleep an eternity. But once in the car we did not head to the hospital. I thought only: I’m tired, need to sleep in my own bed, it can wait a night. We went home and I said to Marc that I would make an appointment to get my lungs checked. Was it the start of COPD– or cancer? Damned cigarettes. I knew viscerally I was in serious trouble. Tomorrow, I thought, and fell into a restless, haunted sleep.

When I awakened weary and anxious the next morning I held in my mind one clear thought: Find a heart doctor. Not a lung doctor. It was as though I had been sent a blaring message: my heart was warning me. Rather than look online at my insurance providers list, I oddly–perhaps testament to how bad things were–went through the phone book’s yellow pages and asked each cardiologist’s office closest to my home if they took our insurance. I felt urgency that superseded all. After a half-dozen calls, I found an office that accepted the insurance and had a physician who would see me without a referral. Dr. P. was a new doctor in the large cardiology practice. After I described all my symptoms to a nurse, I was given a slot first thing the next morning but was informed I should call 911 if previous symptoms returned.

I shivered with fear, then calm enveloped me. I had unprecedented faith in forthcoming medical help. This, despite the two doctors I’d sought over the previous year having told me I had “anxiety due to menopause, take a benzodiazapine and relax.” I left disgusted, and without a prescription. I knew there was more to it, but what? I carried on with my life, trying to ignoring the too fast/missed beats, weird pains and general uneasiness–maybe it was just stress symptoms…until a hike in the Coast Mountains, August 2011, where I couldn’t get back up the steep trail without breathlessness with racing heart. Still, I waited another month–the doctors knew better, right?– until that momentous hike in the Columbia Gorge forest. It is amazing how denial can befuddle us.

I could list the tests, share the discussions we had that day but what really happened was that Dr. P. listened. He heard me–my symptoms (which included a worsening rapid heart rate with increasingly less physical exertion, feeling breathless, uncomfortable in my chest–perhaps, yes, as if anxious at times), asked me probing questions– and took immediate action. He believed I’d had a heart attack but it would be hard to discern at that point. I was fifty-one years old and had no risk factors other than having smoked for thirty years until the last seven months. He didn’t believe it was the smoking, though it was perhaps a contributor. Perhaps stress or a genetic link. But I was too healthy, overall, in good shape, and young for such an event. He seemed nearly as shocked as I did but knew my heart was ill.

Dr. P. informed me he was newer to this work but had done over three hundred angiograms–the procedure most used to determine if and how badly an artery is closed or clogged. An attending cardiologist and he would do all they could to help me not only stay alive but become healthier for the long-term. Did I trust him? Was the procedure going to reveal what was needed to help me? I asked myself as I went home to share the news with Marc. As I awaited his arrival, I stared out our big picture window and knew that I did. I was also caught in a strange state, knowing I could have been dead or might yet be, but also felt vibrantly alive, if a bit out of body as well. I also knew I was ready for whatever came next. I thought it all good enough.

On September 17, 2001 I was provided a way back to health with the first stent implant. The tiny device propped open an artery that had narrowed and was more than 90% closed. I was, he said, lucky to be alive. And it wasn’t cholesterol but inflammation that was the culprit. I had been diagnosed with coronary artery disease. It was not the end of it. I would have four angiograms over the next two years and another stent implant as well as changes in heart medications. I returned home each time with wild arrhythmias that sometimes still want to bully me. Tachycardia became an intimate foe, from zero to one hundred and forty until we found the right medication )I was allergic to many).. I learned that if it held at one hundred and twenty I could bear it but if it went on and on, I might still call 911. But medications finally worked better. I went to cardiac rehab. I became brave enough to walk on my own again. Ultimately, with time and exercise and support systems, my heart became much stronger and it beat far more safely so I could inhabit a life worth living.

And so, though always an active person, I began to walk more, first ten minutes and then twenty minutes, in a few weeks forty-five, then finally an hour or two, six days a week, sometimes seven. I had taken time off from work and might have become engaged in swimming or bicycling; I flirted with the idea of flamenco. or something else exotic. But it was simple walking that drew me out of the painful sense of loss and into the world; walking that gave me a little thrill of anticipation; greater encouragement each day as I felt my heart flutter, jump, pause and startle. Walking reunited me with a life of kaleidoscopic wonders. Everything tasted, smelled, looked and felt better. My heart pumped hard, oxygen surged through me so that my mind clarified; my spirit felt more courageous, and lighter.

Oddly, my emotional heart felt more open to everyone and all I care about. I had been a tough woman for many years so that I could survive an assortment of trials, get past loves that had soured. I discovered the path to healing a heart is more challenging but richer than I had imagined. Not a day has passed that I don’t find a reason to laugh for the sheer pleasure of it: my heart became profoundly capable of more living. My emotions were loosened so I felt fully human, closer to who and what I knew as a young child.

And each time Dr. P. tells me: “You’re a star patient. You’ve beaten the odds so far. Your hard work pays off every day.”

I tell him: “You listened to me and saved my life.”

That day I walked my fingers to the yellow pages? They took me to a person who is a fine and committed cardiologist, one who has always cheered me on my journey. Maybe it was a guardian angel who left me the urgent directive that early morning. But I still walk every day out of respect for him, for myself, for this irreplaceable treasure called life. I discovered the power of a mended heart. I intend to use it well.

GO RED FOR WOMEN:

G: GET YOUR NUMBERS

Ask your doctor to check your blood pressure and cholesterol.

O: OWN YOUR LIFESTYLE

Stop smoking, lose weight, exercise, and eat healthy.

It’s up to you. No one can do it for you.

R: REALIZE YOUR RISK

We think it won’t happen to us, but heart disease kills one of three women.

E: EDUCATE YOUR FAMILY

Make healthy food choices for you and your family.

Teach your kids the importance of staying active.

D: DON’T BE SILENT

Tell every woman you know that heart disease is our No. 1 killer.