3. Diary of a SCAD Heart Attack Survivor - Making the Connections

Published 1st August 2021

Hot 'Flashes' and Heart Attacks

Spontaneous Coronary Artery Dissection - a heart condition that can't currently be predicted or prevented. Yet.

So here’s a funny thing……

I am 50 and perimenopausal!
I know!
Hil-are-ious!
As if!
No way!
Surely not! 
Really?!

Aerial Bodywork with the beautiful soul Jean-Charles David.
It felt amazing!
Surely I cannot be an 'old lady'...

And I’ll tell you another funny/weird/random thing –

Menopausal symptoms and risk of Cardiovascular Disease (CVD) can be directly linked!

Did you know that?  I certainly didn’t! 
Who knew!
So, in true Jilly style-y, I’ve been reading and researching the subject, as often as my wee heart will let me.
Like a student about to submit their final dissertation, I now have piles of papers listed in a Word document entitled ‘Important Notes!’

Papers such as this, to name but one:
Vasomotor Menopausal Symptoms and Risk of Cardiovascular Disease: A pooled analysis of six prospective studies
(catchy title...)
Now some of the info in these papers is a wee bit over my head,  but click on the link and take a look for yourself – it is very interesting. The conclusions were as follows: (VMS = vasomotor symptoms = hot flushes)

Conclusion

Severity rather than frequency of VMS (hot flushes and night sweats) was associated with increased risk of CVD.
VMS with onset before or after menopause were also associated with increased risk of CVD.

In-ter-esting....

Last year, 2020, I was definitely having the menopausal ‘heats’ (heats rather than ‘flushes’, as I didn’t sweat.  Not at all)

As 2020 ground on - it had more pressing matters than Jilly’s menopausal symptoms - my ‘heats’ became more noticeable, and sleeping at night became a thing of the past.  Something only to be remembered with fondness.

That being said, not being ‘allowed’ to work due to Covid regulations, was suiting me very nicely, thank you very much. I am a full-time, self-employed, sports massage therapist.  A ‘close contact service provider’.
The industry that sits between hospitality and events & entertainment, like nightclubs and theatres, as far as Covid regulations are concerned.
We were off for a long time.
For the first time in over 20 years, I was having a proper break.  My first ‘allowable’ downtime since the age of 22 ish.
It was summer.  I was gardening, walking, occasionally running and spending more time with my new partner, experiencing the joy of being in a healthy, happy relationship.  
It was wonderful! (Once I knew that our Government was arranging financial support for the self-employed that is) but you get my drift, I was happy.

The cat that had moved in with me a few years earlier was loving having me being at home too.  She was super happy, following me around all day.  She would sit on a chair beside me, whilst I worked at my desk.  Potter about beside me when I was gardening.  I did draw a line at her repeated attempts to come with me on my walk though… She was a cat who thought she was a dog and enjoyed, or should I say ‘demanded’, attention in much the same way.

I digress. My point is, that even with all the covid stress in the world, and once I was ‘allowed’ to form a bubble with my lovely man, I was happy, relaxed, and grateful for a little bit of time off.  My ‘heats’ were manageable, and I could cope with the sleep disturbances.

At the end of July/beg. August I was allowed back to work in the clinics.
Cue significant increase in stress levels and a workload that was off the scale!
Guidelines! New booking systems! (cue IT stress)
And the cleaning!! Oh, dear God the cleaning.  New protocols for washing everything that exists in my world. Repeatedly.  And then some more. 
My house resembled a laundry.  
Every. Single. Day.
Plus, the psychological impact of switching from
STAY 2M AWAY FROM EVERYONE
to
“Welcome patient!  It is a total pleasure to be in your personal space, for nearly an hour”, was a tad discombobulating.
My heats became more frequent, more noticeable, but still manageable and I put the increase in their frequency down to the challenging work environment that I now found myself in.

Then, my menopausal symptoms became much worse.

Inability to sleep and the head aches!……
From the start of January, going to bed at night was a nightmare. Torture even. Sleep was illusive, a fleeting concept that my brain only toyed with.
I knew there’d been a big change in my sleeping habits when the cat stopped sleeping on the bed. Previously, Smudge and I would remain in the same position ALL night. My boyfriend had commented on it when we first started sleeping together, "God you don't move at all once you're asleep!"

But, after a month or so of coping with me flinging the bedding about, tossing and turning, constantly getting in and out of bed, she'ld given up - she didn't need to put up with this nonsense, and she toddled off to find a more peaceful place to kip. She was not happy.

I felt quite sad that Smudge and I weren’t sleep buddies anymore.

I also had to begin to use cool pads on my pillows, every night all night.

The relief of laying my boiling hot head on the ice cool pad was heavenly!  A fan had been set up beside my bed too. 
God… I have reached that stage….. how awful do I feel now? How old am I?
This. Is. Hell.

On top of the sleep issue, I was having headaches nearly every day.  'Cos 'Hell' was just not 'hellish' enough....
It became easier to note in my journal the days that I did NOT have any head pain.  
They varied in intensity.
Sometimes merely a dull, numbing ache, other days, a really impressive head pain, and sometimes debilitating migraine pain that only Paramol and sleep could take the edge off.

This was also a marked difference to my ‘normal’ patterns.
In the past, I'd have a migraine, maybes twice a year, and I’d know what had triggered it. 
Usually, a lack of sleep, with a few days of irregular eating patterns, and bit of stress or too much work and bingo –
all systems go on the Migraine front!
However, a couple of Paramol, which would always make me sleep, straight to bed for... maybes. an afternoon and evening, and I’d be right as rain.
Not anymore.  Nothing would shift them completely.  I mean Kerrist... NOTHING could make me sleep, I just had to wait it out and, a few days later, it would ease.

And the other 'Life Destroying' symptom? 
The heats…

They become much, much worse..... 

They were ‘violent’ and extreme, appearing at any time of the day or night, not governed by what I had eaten or how I was feeling emotionally.   
They would take over my body, regardless of whether I was busy running around, exercising or just sitting watching the TV. 
If anyone DARES to suggests that they are worse if the woman gets anxious about them coming on, I will quite possibly do that person physical harm…..

My head starts to ‘buzz’, to vibrate at a very low, gentle frequency.
My breathing becomes shallow and laboured.  
I have to breathe through my mouth.  
My whole body feels as if it would be happier running and preferably a marathon, but I can’t even walk.
The dizziness appears. 
It feels like my brain has somehow begun to float within my head.  I can’t decide whether I am going to topple over to the side, faint, throw up or just pass out on the spot.  
My stomach churns as an internal fire ignites within my brain. 
Suddenly, my brain is made of molten lava, expanding within the cranium, pressure building.
There is an overwhelming desire for my chest, upper back, neck, face and head to sweat, but it doesn’t come. The heat, and the pressure inside my head, is intense.  I want to open up my head and let it out – like steam billowing out from an old steam train’s funnel.
The rest of me is a normal temperature… and my feet are freezing.

From the chest up -
I. Am. On Fire.

My partner began to recognise my early warning signs; the shallow, laboured breathing, “uh -oh, you gonna blow babe?” as he puts his cup down, removes my laptop or dinner tray from my lap as I start ripping clothes off my upper body – and not in a sexy, come an’ get me kindof a way either, jeez… not sexy at all, more…. maniacally!
Depending on how quickly it happened, (and where we were!) he would sometimes have to help rip my clothes off – his initial excitement at this strange turn of events, didn’t last long.  
About as long as when he thought that he was helping by taking my socks off too –

“DON’T TAKE MY SOCKS OFF”, I’d cry!
“But your hot babe, no?” he looks confused.
“Yes” I’d try to explain, “but my legs and feet are cold!” “Just up here, up here”, as I gesture wildly to my torso and head, throwing my sweater and T-shirt across the room.
“Oh, Ok babe, your face is beetroot – you’re going to explode!”

I remember wanting to stick my head in a bucket of cold water, imagining the steam that would hiss from my head

5 minutes later, it’s over.  I’m sitting on the sofa, exhausted, breathing heavily, half naked, whilst my room looks like we’ve had a stripper in, who’s recently been on a drugs binge washed down with 10 gallons of Red Bull.
My man hands me a drink of water and gathers up my clothes, sits beside me, waiting for my breathing to return to normal,
“I got you babe” he says, holding my hand. 

I love my man
😊

Now.
Here’s another funny/random/weird thing….

As my man had unwittingly said, I looked like I was “gonna blow” when I had a heat. 
And something did blow.
A wall of one of my coronary arteries, leading to a SCAD heart attack. This type of heart attack is called Spontaneous Coronary Artery Dissection.  For more info on SCAD see the link in the blue box below

And the final, funny thing, the pinnacle of weirdness….

From the night of the SCAD heart attack, THAT NIGHT
I had NO HEATS whatsoever. 
Now, THAT'S ‘funny’ isn’t it?  How random is that?!
My sleep is better, actually it’s amazing!
AND my headaches have drastically improved.

Result!
OK, so it’s maybe a rather extreme way of reducing one’s menopausal symptoms, but hell, who cares?! They've gone!
* Jilly does her happy dance* "Life can get back to normal!

As I write, 4 weeks on from the ‘event’, I have begun to have some very gentle 'warmths' again, but I just remove my sweater – no big deal, all fine, all cool, nothing to see here!

Currently, I have absolutely no need for the cold packs nor fan.
We’ve put the fan back up in loft.
The cold packs are lying, unused beside the bed.

It’s like as if the pressure that the heats produced, was just too much for my heart.  As if it just could not cope with the ‘violence’ of my heats but once the pressure had been released, life became much more manageable again.

Or…. maybe the heats were so extreme because I had a compromised heart???

Who knows!  Who cares?!

As far as both my partner and I are concerned, it is a very, silver lining to the scare that we both had following my Spontaneous Coronary Artery Dissection heart attack. And, according to the most recent data, 90% of SCAD patients will not have a recurrence within 3.1 years. Cool! That's my new mantra, "90% don't have another in 3 years, 90% don't have another in 3 years," again, not the most 'catchy' mantra I've ever used...

I’m away to bed. To cuddle my man as I fall asleep.
Without the need for painkillers, cool pads or fans 😊
Let’s just hope that I’m not one of the unlucky 10% eh?..... read on to discover what happened next….

Coronary Heart Disease (CHD) kills more than twice as many women as Breast Cancer in the UK every year,
and is the single biggest killer of women worldwide.

Despite this, it’s often considered a man’s disease.
The British Heart Foundation, Women & Heart Attacks.

SCAD is when a tear or bruise develops in a coronary artery that prevents normal blood flow. This can cause:
a heart attack,
heart failure,
cardiac arrest
and can be fatal.
Current data indicates:
90% of patients are female with an average age of 44-53,
– many of whom have no or few heart disease risk factors.
ECGs and O2 levels may be normal.
Assess troponin levels, repeating 4 hours later.
(NB. Trop levels may be clinically insignificant)
For information:
https://beatscad.org.uk/what-is-scad/
https://academic.oup.com/eurheartj/article/39/36/3353/4885368