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And The Band Played On …

Dan was determined 2012 would be his "Year of Me." However, things didn't get off to the start for which he'd hoped. His rheumatoid arthritis-related heart troubles continue.

Rheumatoid Arthritis Heart

Last time, we recapped the sordid events of 2011, and those of you who follow my column know that besides one very happy chance meeting, the 12 months of ’11 were generally less joyful than most funerals. That’s fine though, because 2012 is here now, and a new chapter in the "book of me" has begun.

I made a promise to myself that 2012 was going to be the year of me, and in contrast to 2011, this year was going to be filled with positive events. It is going to be the year that I really break out with my writing, the year I get my first book officially released (look for it here on CJ soon), and the year my health finally stabilizes. I was giddy when 2011 ended, and along with reconnecting with some of my old friends, I was given a wonderful surprise party on my birthday in January that set the New Year off with a bang.

Flying high from my surprise party, I went to my first doctor’s appointment of the year. Since my heart attack last September, a Manhattan cardiologist was monitoring my progress, and it was time for a visit. The visit was a special one, as it would provide me with a very crucial bit of information, a bit of information that those closest to me (and myself) had been waiting for. I was going to find out if my heart was akin to Michael Jordan and was going to make a comeback, or was more like Jerry Seinfeld, and going to make it’s exit for good after a successful run.

As it was described to me, having RA was about equivalent to drinking and smoking cigarettes when it comes to causing plaque buildup. This was unknown to me until after my heart attack though. I never thought that RA could affect my circulatory system.

For those of you who are not familiar with the mechanics of a myocardial infarction, let me give you a crash course. The way it works is this. Inside the arteries that lead from the heart, plaque can build up. This plaque is made up of cholesterol, as you probably know, and buildup can be caused by many factors. Smoking, drinking, and eating fatty foods are all causes of heart disease, but in my case the main cause was rheumatoid arthritis (RA). As it was described to me, having RA was about equivalent to drinking and smoking cigarettes when it comes to causing plaque buildup. This was unknown to me until after my heart attack though. I never thought that RA could affect my circulatory system. I probably should have realized the danger, but as they say, hindsight is 20/20.

So, I had some serious plaque building up in the main arteries leading from my heart and because of this I was at much higher risk for a myocardial infarction (heart attack). What causes the actual attack is not the plaque itself, but the body’s response to the plaque. When a bit of buildup breaks off from the side of the artery, the body misreads this breakage as a rupture of the actual artery itself. Because a ruptured artery means instant death, the body goes into overdrive sending all the clotting agents it has to the scene of the rupture. Since the rupture is actually a bit of torn-off plaque inside the artery, the body’s clotting agents do their work on the interior of the vessel. When the artery closes completely (or almost completely) due to the clotting inside, you have your heart attack.

Now that the heart attack is occurring, there are parts of the heart that are not being supplied with blood. Because of this, the actual cells of the pumping organ begin to die. The longer the blockage is left in place, the more damage can occur. The damaged cells that are left after an infarction can regain some of their function with the right medications and a good dose of luck. Those of you who follow my column know that I do have a significant amount of luck. It just happens to be all of the bad kind.

He recommended that I get a defibrillator installed. "A defibrillator!" I exclaimed, "I thought those things came with paddles and a rolling cart!" The doctor smiled and told me that these days a defibrillator was the size of a box of Tic-Tacs, and it was installed underneath the skin. Any time that the unit detected an irregular heartbeat, it would shock the patient’s heart back into the correct rhythm. Since my heart was damaged and at higher risk for slipping into an arrhythmia (an irregular heartbeat), I needed constant protection or else I could suffer fatal consequences. He told me to come back in a few weeks for a final test to see how well my heart was operating.

So, as you may have guessed, when the cardiologist was done with the examination to determine what part of my heart function returned after four months of medication and rehabilitation, he let us know that there wasn’t any good news to share. It seemed that the top part of my heart was still not moving at all, and was significantly scarred. Scarring is what happens when cells die, and that part of my heart had died after being deprived a supply of blood for more than six hours. This was certainly not the news I was hoping to hear at the start of the "Year of Me."

"Oh great," I thought, "2012 has already started off with a bang." It looked like I was going to have to worry about yet another part of my body for the rest of my life, and this just happened to be one of the most important parts. I asked the doctor if there was any chance that a new treatment was in the works to bring the heart cells back to life. He told me that stem cell research would probably provide me with a solution later in my life, but for now, I was out of luck. The doctor then added the final coup de grace, the kicker that made the previous news seem pale by comparison. He recommended that I get a defibrillator installed.

"A defibrillator!" I exclaimed, "I thought those things came with paddles and a rolling cart!" The doctor smiled and told me that these days a defibrillator was the size of a box of Tic-Tacs, and it was installed underneath the skin. Any time that the unit detected an irregular heartbeat, it would shock the patient’s heart back into the correct rhythm. Since my heart was damaged and at higher risk for slipping into an arrhythmia (an irregular heartbeat), I needed constant protection or else I could suffer fatal consequences. He told me to come back in a few weeks for a final test to see how well my heart was operating.

So, it looks like the perfect "year of me" is going to have to wait another 12 months to begin. This year seems like it is going to be just like most of my others -- arthritis-related complications filling my schedule with doctor’s appointments and hospital visits. Not that I’m complaining too much, mind you, I did meet the love of my life last year amidst all the drama. Hopefully this year will have something just as positive to offset the negative that 2012 has already handed me. If not, well, then I’ll keep playing on, just like the band did on the Titanic right up until the end.

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