Widow Maker — The Left Main Coronary Artery

John J. Hohn, Writer

I have had high cholesterol all my life – stratospheric – in the mid-300 range. I also can not tolerate statins. Lipitor, Mevacor, Crestor, Zetia, etc. I tried them all. At one point, I signed up with the lipid clinic. Under a doctor’s direction, I started taking massive dosages of statins. My cholesterol totals were checked twice a month. My total LDL and HDL combined total dropped to less than the magic total of 150. Then one night, as I was getting out of my chair, a bolt of pain in my left leg dropped me to the floor. It felt as though a rod had been driven down my thigh from my buttocks to my knee. It was the worst pain I had ever felt. It hurt to lie still. It hurt to move. My wife was aghast. Call 911?

Cure Worse than the Affliction . . .

Then, after what seemed like minutes, the pain subsided. Instinctively I knew it was a reaction to the medicines I was taking. I stopped altogether. I dropped out of the clinic and began doing my own research. I found, for example, that the statistical viability of the venerable Framingham Study weakened once subjects passed their 70 birthday, a milepost six years back in my review mirror. So many other factors entered into the mortality rates in the eight decade that high cholesterol shared its grim reaper status with a host of other diseases and anomalies. Experts did not agree that high cholesterol was a problem. I had a vested interest in believing I was not threatened by the waxy buildup in my arteries. Some authors even made a case against the pharmaceutical industry for pushing statins onto medical providers who were too busy or too tired to do their own research.

My wife and I were doing a lot of the right things. I was a regular at the gym for over thirty years. I did my cardio. Three times a week, I got my heart rate up to 80% of its max for a sustained 20 minutes or more. I was not overweight. We rarely ate red meats. We avoided sugars and sweets.  I abstained from soft drinks. We avoided hydrogenated oils and fats, high fructose corn syrup (corn syrup). I started taking daily doses of Omega-3, niacin, Co-Q10, clopidogrel, coated aspirin. I sat down each meal to a mini chemistry set in front of me. My ratio of HDL to LDL was right where it needed to be. Vegetarian, vegan, low-carb diets all had advocates. I decided that nutritionists shared a position with economists – if they were lined up head-to-foot around the equator, they would all end up pointing in a different direction.

One thing is certain. No one can trust the rulings and proclamations of the Food and Drug Administration. Lobbyists hammer away at our congressional representatives, venial humans like the rest of us, who are no brighter, no more enlightened, and perhaps a shade more greedy and narcissistic than the rest of us. Money in the billions is available to sway legislation. The FDA does not have the best interests of the nation’s health in mind any more that the SEC seeks to protect the average investor from the scams and crooked dealings of the big banks and brokerage firms..

May, 2010, my cardiologist detected an anomaly in the results of my stress EKG. “It’s up to you,” he counseled my wife and me. “If it were me, I would have the procedure. Then we will know what we are talking about.”

Moving Confidently Ahead with Our Lives . . .

The procedure was an angiogram. We consented, and it revealed that I had minor blockages of three coronary arteries. The left main – the widow-maker – was not among them. Two short hospitalizations and I walked back into my life ready to begin my aerobic workouts and my exasperating golf game without a hitch. The results seemed to substantiate that I was on the right track, that my exercise regimen and diet were working. We moved confidently ahead with our lives, proactively seeking a healthy, happy lifestyle. Our long term aspirations led us to decide that, for all the attractions of our current residence, we felt we would be happier moving back to Winston-Salem, the town we had lived in for more than 30 years. We bought a house and moved.

Major Coronary Heart Arteries. The Widow Make is upper right.

The move, of course, meant that I needed to gain entry into the medical care provider system in my new community. My cardiologist in Wilmington had sent me on my way in December, 2015, after checking my EKG and a routine physical. “You look great. Keep it up,” he announced cheerfully. My new physicians were more thorough. But, in fairness, even they seemed convinced by my general healthy appearance, my diet, and workout regimen that nothing could be too seriously wrong. But slowly things began to breakdown.

The results of a new stress test were positive (in medical terms “positive” means “bad.”) “There’s trouble with the early part of your heartbeat,” my cardiologist observed. He prescribed Isosorbide, a blood vessel dilator, and somewhat more alarming, an emergency supply of nitro tablets to be taken if I experienced chest pains again  (see my previous article). An angiogram was scheduled and the full scope of my troubles became apparent. In five years, my left main coronary artery – the widow-maker – was 90 percent blocked. I had been hoping another stent or two would solve the problem. “It would only make it worse,” my cardiologist reported. If not stents, then perhaps the newer non-invasive heart surgery procedures would spare me the horror of having my sternum cut from my clavicle to my diaphragm, pried apart, and all manner of other fantastic manipulations of my vitals. But it was the only way. I was rushed to the hospital.

It’s Not My Time . . .

“This is not my time,” I confided in my good friend. “I just don’t feel that I am through with my life yet.”

“I don’t think that it is your time either,” she replied, a survivor of not one but two open heart surgeries. I took some comfort in recognizing the open heart surgeries were no longer experimental. They’ve been around since the 1960’s and have become routine.

Even so, I thought, I have lived a good life. I can’t change my past. What is done is done. I had deliberately set out to atone for my most regrets. So many foolish things, when recalled, cause me to cringe to this day. But they were not evil acts. I am a foolish man. Yet given that, I have been thoughtful about my beliefs and my faith. I have wanted my beliefs to be reasonable. Once reason is abandoned in the name of religion or any belief system, a threshold is crossed in man’s intellectual makeup that makes anything possible, be it Charlie Brown’s Great Pumpkin or the notion that every human soul enters life unacceptable in the eyes of the Almighty because the child inherits a sin from an illiterate savage ancestor.

If I pray any more, it is certainly not in the traditional sense which often is nothing more than repeating a composed piece from memory. I am thankful for the life I have lived. I would have chosen to avoid the pain of divorce, of parting with my children, and of bearing with financial failure at the height of my earning years. But all that happened. Sometimes deserved; sometimes not. Thorns among the roses. As life goes on, I want to learn more. I want to become wiser and more understanding. Perhaps I can write something better than anything I have yet to compose. But when a summing up takes place and the end is a tangible possibility, my first and nearly overwhelming utterance is that I am thankful. I have loved as well as I was capable at the time. I have enjoyed the love of so many. My life, up until the time the anesthesiologist turned out the lights, had been a flawed success. Jagged but complete. Very little left undone that I needed attending to.

I have little to ask for by way of any supplication. In fact, I am not sure I believe in prayers of supplication. They may relieve stress at the time of crisis, but the record on them being answered is not encouraging. Hindsight shapes the answers. There is no control group data – the outcome for others suffering the same crisis but choosing not to pray.

I believe in praise and thanksgiving. I do not know my Creator well. I know dishonesty and cruelty when I see it. There is too much of both in the world. I believe in truth. I believe we are drawn to beauty because it reflects the Divine. I believe nature strives, if often extravagantly, for perfection and sometimes overshoots the mark.

I woke up from the operation a depleted human being. My wife and stepson were at my side. I drew strength from their love for me. My recovery would take months, perhaps a year or more,(see my subsequent posts), but I wanted to go on and on just as much as ever.

TO BE CONTINUED . . .

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