Five Kids, Hockey, Swimming and a SCAD
by Micaela Fassina
Since February is Heart Health month, here’s a story for you. My name is Micaela and I survived a heart attack.
I was 44 years old, with 5 children between the ages of 5 and 13. I was relatively healthy, and trying to get into better shape. I was doing aquafit 4 times a week and learning to play hockey in a weekly mom’s clinic offered by our local hockey association. There is no history of heart problems in my family, I don’t smoke, or drink excessively, and I try to eat as healthy as 5 kids and a busy schedule let me. I’m a stay-at-home (or in-the-van) mom: at the time of the heart attack we were in the middle of a kitchen & 2 bathroom renovation and had 4 kids in soccer, 3 kids on swim team, 2 kids in diving and one in synchronized swimming. (Before you say anything, we do not force our children into any activity they don’t want to do – this was all their choice.)
On July 18, 2017, it was business as usual. The kids and I were at our community pool for their daily lessons and my aquafit. However, a child (not mine!) had been sick in the pool and it was closed while it was being shocked with chlorine. So lessons were dry-land, and the moms decided to do “land-fit” instead. I set aside my iced coffee, fully expecting to finish it in half an hour, and sat down to do some sit-ups. Except I couldn’t pull myself up for even one! Ok, on to lunges. Three lunges in, I experienced the strangest thing I’ve ever felt: an explosion radiating out from my chest going down both arms and up my neck into my jaw, and at the same time, a vice clamping down on my chest, all of it painful. I figured it was heat stroke, or sun stroke, or dehydration, or something. I went to sit down, but was now feeling nauseous and I knew something was very wrong. We had just recently lost an acquaintance to an undiagnosed heart attack, and my symptoms mirrored his. So I called my mom to come get the kids and then lay down in the grass. In the 10 years we’ve been members at our pool I never once lay down, so next thing I knew I was surrounded by concerned friends and lifeguards. They called 911, while my sister-in-law called my husband. Other moms were trying to keep my kids occupied and out of the way; apparently one of my kids was swinging a baseball bat around! Two of my kids refused to be distracted and sat watching me at my most helpless. I tried to reassure them, but was so sapped of strength that I could barely talk.
I never lost consciousness and my heart never stopped, but my memories of that time are disjointed and surreal. I remember trying to crack jokes to lighten the mood, and being disappointed that the firemen that answered the call weren’t better looking. I kept on eying my iced coffee hopelessly, wishing I could finish it. A friend rode to the hospital with me, and I made sure that she had grabbed my cross-stitch to bring along, just in case. By the time I was going through triage, I was already feeling better and was hoping it was just an embarrassingly strong case of indigestion. In fact, when my husband arrived at the ER, he didn’t have to ask where I was; he just followed the laughter.
Tests after tests were run: blood work, multiple EKGs, CT scan, ultrasounds and X-rays. Everything was coming back negative, except for one item in my blood work: my troponin levels were rising. Troponin is an enzyme released when the heart has been damaged – proof that I had suffered a heart attack even though I was perfectly healthy according to all other test results. After a night in the ER, it was decided that I would be admitted and sent to have an angiogram, which is a procedure where a catheter is fed through an artery in your wrist (or groin) into your heart. Dye is then injected through the catheter while you watch live X-rays images of your heart pumping. If necessary, this is also the time when stents would be inserted. It took a while, but the cardiologist finally found the remnants of a 30% tear in a secondary artery, which had already scabbed over and was healing by itself. Two days after the actual incident, I had an official diagnosis: Spontaneous Coronary Artery Dissection or SCAD.
SCAD affects mainly, but not only, otherwise healthy women of child bearing age. There are no specific or consistent symptoms or warning signs. Some people experience the same pain I did, while others compare it to severe and lingering heartburn. SCAD can be a minor tear like mine, or a full-blown rupture requiring bypass surgery, or instantly fatal. It can recur, but why in some and not others is a mystery. Because SCAD is a rare diagnosis, there is currently not much research or information.
I’m currently on a daily regimen of blood thinners, beta blockers and baby aspirin for at least one year. But there’s nothing I can really do to prevent another SCAD from happening, since no-one can tell me why it happened in the first place! They have ideas: it might have been stress from the reno or over-exertion, or the heat, or my not having had breakfast that morning, or Mercury aligning with Pluto, or Zeus arguing with Poseidon on Mount Olympus… I sometimes wished I had been a smoker or morbidly obese, because at least then there would be a reason for the heart attack, and something concrete I could do to prevent another one from happening. And that is another source of frustration: trying to make people understand that SCAD is different from a “traditional” heart attack. My mother is still trying to rationalize what happened; she remains convinced that there must have been something in my life I could have done differently.
My life since SCAD has been different, but the same. It took a couple of months for me to feel “normal”. I was not allowed to exercise for 3 months, after which I did a stress test (12 minutes on a treadmill) and got the all clear for everything except heavy lifting and isometric exercises. I’m seeing a psychologist for my PTSD, and thanks to social media, there is a great on-line community of fellow survivors offering support and understanding from around the world.
The initial recovery combined with the medications left me exhausted for quite a while. I have to watch myself and my stress levels, and make sure I have more “me” time and that I don’t over-extend myself – too much. With 5 kids currently in hockey, swimming, music and drama, there are days when I have to be in multiple places at the same time and I don’t know which way to go. But that’s what family, friends, a good support system and carpooling are for. And when I’m having a bad day, it’s ok to say, “I can’t do this” and go hide under the covers for as long as I need. Every time I hear of a woman my age passing away suddenly and for no known reason, I wonder if it was SCAD (Dolores O’Riordan springs to mind). But ultimately, I’m learning to not dwell on the what-ifs and the what-might-be. The most important thing is that I am alive and well right now, and still rocking the mom-wife-daughter-sister-friend thing.