Flowers on the Table

Here’s the deal.  I love to work.  I have seemingly unbounded energy, big ideas, dreams and a thick skin.  I love a challenge.  I’m not afraid of conflict when the greater good is the goal.  So I’ve had a lot of high stress jobs.  Politics, government, volunteer powered community radio station, all at the executive level.  You get the idea.  No surprise I might develop high blood pressure.  Did I mention I was only 38 when I began the diagnosis process?

So, here’s the story.  First I ignored and abused my body.  Because I loved my job and couldn’t imagine that I was ill, I didn’t tell my husband or anyone else that I was having splitting headaches and dizzy spells until they became commonplace and frightening.  In November 2006 my awesome doctor, Susan Beck, noted high blood pressure readings at my annual exam.  She suggested I monitor the readings and reminded me that my job was increasingly stressful and could be impacting my health.  I “forgot” to tell her about my headaches and other symptoms and ignored her advice.  By Christmas, I felt nervous about exercising.  My intuition told me something was seriously wrong and I finally told Scott and then my doctor what I had been feeling.  My blood pressure readings in the doctors office were again quite high.  This time, we left the doctor’s office and bought a blood pressure cuff.   It only took one day of readings to have me ordered off birth control pills cold turkey and back into her office for further testing.  

Dr. Beck initially prescribed a low dose (25mg) of Toporal XL, a commonly used, time release beta blocker and a battery of blood tests to see if I had other problems that could be causing my blood pressure readings.  The good news at this point was that I hadn’t had a heart attack.  Believe it or not, you can take a blood test that will determine if you’ve had a heart trauma.  And my kidneys were good.  No diabetes.  No thyroid issues.  My EKG was normal.  But my resting pulse was over 100.  And there was one suspicious result – my C-reactive protein (CRP) levels.  

CRP levels measure inflammation in your body and high levels have been linked as heart attack and stroke risk indicators.  The CRP scale is small: 1 is low and high risk readings are around 3.  I had a CRP reading of 19.3 – literally off the charts.  There are lots of factors that can register inflammation.  Blood pressure is only one.  Birth control pills are notorious for increasing inflammation and I had been on them for years.  Having a cold or other virus can mask the results.  But, the readings were high enough that my doctor ordered more tests to see what was going on.   I took a stress test and had a CT scan.  Everything was normal.  No enlarged heart or leaky valves.  I was feeling relieved that maybe only high blood pressure was my issue.  After slowly raising the dosage to 100mg the blood pressure medication finally stabilized my readings at normal levels and the dizziness and headaches were less frequent.

My doctor, Susan Beck, has a smooth, soft and serene bedside manner.  Just being in the room with her calms my spirit.  She’s smart, funny and very wise.  She knew about my job managing a non profit radio station and had read about some volunteer controversy in local newspapers.  When I told her in more detail about the behaviors of some disgruntled volunteers who fought my leadership at every turn, petitioned against a new mission statement and were now threatening a lawsuit, Dr. Beck gently suggested that my job might be impacting my blood pressure and health. 

“But I love my job,” I told her.  She smiled and looked directly into my eyes.  “It’s your choice,” she said. “But you are experiencing life-threatening health problems.  While it seems likely that you have a genetic disposition to high blood pressure, if you want to manage it, things have to change.  Changing your diet,  increasing exercise and stress reduction can help you.  But something else probably has to give.”

I knew I had to make some decisions, but I couldn’t understand where heredity ended and a physical reaction to stress began.  In fact, I couldn’t believe the heredity at all.  I had never heard of and had never reported a history of heart disease.  I didn’t think I had one.  I knew we had a history of Alzheimer’s and alcoholism, but no cancer, diabetes or anything else usual or unusual.  I started asking questions about my family’s medical history.  What I found was pretty surprising.

I called my Dad first because I knew he had some heart thing, but I wasn’t sure what it was.  He provided the first facts.  He has an aarrythmia, an irregular heartbeat.  He had been medicated for it for twenty years.  But no high blood pressure.  His father had died of a heart attack in 1985.  But grandpa had suffered from rhumatic fever as a child and had always had a weak heart.  None of that seemed like the genetic link I was trying to isolate.  Then my Dad dropped the bomb.  “There’s no history on my side, but your mother’s dad died from arthlesclerosis.”  All I knew about the man who died when I was barely a year old was his love of drink.  “You mean liver sirosis?”  I asked.  “No,”  my dad said.  “He had hardening of the arteries.  Didn’t you know that?”

I called my mom next and asked her about Grandfather.  She said “well, your grandfather had uncontrollable high blood pressure.  That’s how he died.”  I was stunned.  I knew he had been sick, but I had always gathered that it was complications from acute alcoholism.

I don’t remember meeting my mother’s father, Edgar Olaf Dannevik, known to friends and family as Dan.  He died when I was a year old.  Fading snapshots show a tall, gaunt man with thinning hair-colored hair and a long face.  He looked completely ordinary and familiar.  Family lore was mostly about his drinking.  He was an alcoholic who sometimes disappeared for days at a time.  He also played the piano and my grandmother said he liked to dance.  He went to college at Kansas State in Manhattan and got an engineering degree.  A couple of years ago I had done some geneology and found his college yearbook.  Grandfather Dan had been in a college fraternity with my grandmother’s brother (that’s how they met) and was a cheerleader!  No body seems to know what he did for a living.  He worked as an inspector for the government is all we know.  I knew that he was sick for a long time and that they sold their house to pay for his care.  He died in 1969 at Barnes Hospital in St. Louis.

Now I learned that my grandfather was the first recipient of a plastic aorta at Washington University Medical Center back in 1960.  His aorta burst and somehow he lived.  My mother remembers that his blood pressure was monitored every four hours, twenty-four hours a day for years.  He survived the surgery and lived nine more years.  I felt pretty sure that I had found an obvious genetic link to my blood pressure.  Which was kind of a relief – I hadn’t given myself high blood pressure by working too hard, caring too much and generally overdoing everything.  Of course, that behavior wasn’t helping anything either!

So, after a quick review of our finances, Scott and I decided that it was time to quit my job.  I gave six weeks notice and when my resignation made headlines in our daily paper I knew I had made the right decision.  Although in just three years I had stabilized operations, streamlined programming, tripled the station’s income and staff, funded three new studios of brand spanking new equipment and had more volunteerism than we knew how to handle, a few disturbed and unhappy folks filed a lawsuit against the radio station before my last day as manager.

But the story is not over yet.  All my questions about my grandfather got my mom thinking and we discovered more.  She didn’t have high blood pressure and neither did her brother or sister.  But they are all on cholesterol medication.  And my aunt and uncle have both had TIAs – mini strokes.  So, when Dr. Beck got the results of my IMT test, a new $90 procedure, not covered by insurance companies, that takes an ultrasound of your coratid arteries to measure plaque build up without invasive surgery or foul-tasting dyes, the results were depressing, but predictable.  In spite of having normal cholesterol levels, I had significant plaque in my corated arteries.  In fact, though I was 38, my arteries were given an age of 55.  The final test ordered measured the stability of my plaque.  And the news wasn’t good.  My plaque was not stable.  It could move around, meaning I was at risk for a heart attack or stroke.  Now I was really glad I had quit my job.  It probably saved my life.

Finding out you have a serious health condition is terrifying.  Once the initial diagnosis of high blood pressure was made, medication prescribed and battery of further testing ordered, I was often overcome by a heavy fear that I was dying.  At night, lying in bed, trying to breath deeply and stay calm enough to sleep, I would dose off for a few moments and then awake suddenly, gasping for air, sure that I was having a heart attack.  I was sure I had pain running down my arm and deep in my chest.  Happily, these were anxiety attacks, not heart attacks.  I was confused and stunned and scared, so none of this was out of the ordinary. But I did have a secret weapon – I have the most amazing husband in the history of husbands.  He helped me stay calm and focused.  He supported all my decisions.  And, most importantly, he made me believe that I could get better.