by Carolyn Thomas ♥ @HeartSisters
Summer Ash is a self-professed space cadet. She’s an astrophysicist at Columbia University’s Department of Astronomy in New York City, where she serves as the Director of Outreach.* Five years ago, she underwent open heart surgery after she was diagnosed with an aortic aneurysm (that’s when the tissue of the aorta balloons out dangerously). This condition was likely linked to a congenital heart defect Summer was born with called a bicuspid aortic valve. About 99% of people, as she explains, are born with a normal tricuspid aortic valve (meaning three leaflets in the valve), but she was one of the 1% born with only two. With her kind permission, I’m running her story here as it was originally published on her blog, Defective Heart Girl Problems.
“I think there is a big misconception about how fast ‘young people’ heal from a surgery like this. There’s healing and then there’s HEALING. On one hand, being young and strong and in good health (with one obvious exception) means I can physically heal faster than the average open heart surgery patient.
“On the other hand, the average open heart surgery patient is much older and often in poorer health – so much so that doctors often find a less invasive way to operate on the heart: a partial-sternotomy, a thoracotomy in between the ribs, or even going in through the femoral artery, all of which are less invasive than a full sternotomy.
“My surgeon said that since I was in such good shape, he would just go the direct route. My body could clearly take it. I would ‘bounce back’.
“Turns out growing new bone between my sternum wires, reconnecting my muscles and nerves across my chest, and regaining my strength was the easy part. It’s at least straightforward. There’s a checklist of things to do: sit up, stand up, walk, walk again, and walk some more. Keep walking. It may not be linear (it most definitely was not), but at least there’s a path laid out for you. Millions of people have healed from this before. Six weeks after leaving the hospital, my surgeon declared me fixed and told me to go live my life.
“But almost two years later, I’m struggling to do just that.
“My surgery was on the books and over with well before my mind even accepted it was happening. I focused all my energy on understanding what would happen to me physically and I didn’t stop to consider what might happen to me emotionally.
“Sure I had the occasional breakdown while recovering, but it almost always stemmed from pain and fatigue and frustration. It wasn’t until six months later that the first cracks began to show while I was organizing my medical bills in preparation for filing my taxes. I had a massive envelope full of receipts and I was entering them into a spreadsheet, all out of order.
“The second after I typed the entry “taxi to hospital” for the morning of my surgery, I completely broke down. It was as if all the fear since I found out about my aneurysm had been filed away in a corner somewhere and I had just stumbled upon it. This happened a few more times and then it ended as suddenly as it began and I thought nothing more of it.
“A year later, it all resurfaced, only this time it came in waves, each one bigger than the one before. I started to have visceral reactions to things that reminded me of surgery, both directly and indirectly. I felt other people’s pain as if it were my own.
“When once I had no trouble watching medical dramas, I now actively turned away from scenes in the OR. I had to skip over the news items in my Facebook feed from the two heart surgery groups I was a member of. I started avoiding my godparents’ neighborhood on the Upper East Side where I stayed during my recovery. Every time I crossed Park Avenue, I would have a flashback to when I couldn’t make it across the intersection in one cycle of the light. Riding in a taxi only made me remember how vulnerable I felt being in a car after surgery. If I saw anyone in the subway walking with a cane, I would immediately remember how terrified I was of being jostled when I started commuting on my own again. I started feeling the need to adopt a defensive posture and protect my chest again.”
“The city became a minefield. My mind became a minefield. It was so bad at one point, even seeing the shape of a heart (anatomical or symbolic) would trigger me.
“And my bionic heartbeat morphed into the worst trigger of all: one that I couldn’t escape. It went wherever I went. It was inside of me.
“Something had to be done.
“There is nothing medically wrong with my heart so no procedure or prescription could do anything about the pounding in my chest. As an alternative, my GP suggested clinical hypnosis or biofeedback as a way to try to transform it into more of a background sensation. I had heard of biofeedback before and it piqued my scientific interest so I decided to explore that option first. That’s how I found Dr. Leah Lagos, a psychologist trained in biofeedback, who I’ve been working with since mid-March.
“Through working with Dr. Lagos, I’ve come to realize two things:
- All the of emotional and visceral reactions I mentioned above are actually symptoms of post-traumatic stress disorder (PTSD). I approached my surgery as a logical, medical necessity and focused all my energy on planning the practical steps for my recovery. I spared little or no energy for what I thought about needing to have my most vital organ repaired. My rational brain took the wheel and relegated my emotional brain to the back seat. As a result, my body, and my heart, actually experienced my surgery as trauma. Which makes a lot of sense when you think about what my body actually went through: my torso was sliced open, my sternum sawed in half, my ribs forcibly spread apart, and my heart was stopped. Yes, all these things saved my life. My rational brain knows that and accepts it. But ever since I woke up in the ICU in tremendous pain, my emotional brain (via my heart and my body) has been screaming “WTF?!” – which ties into #2…
- I’m fucking pissed at my heart for letting this happen to me.
“At first I thought my bionic heartbeat bothered me so much because it felt like something must still be wrong. Why else would it be so loud and so forceful? Surely it must be trying to tell me something. But it’s not fear it triggers, it’s anger. Really raw anger.
“When something starts going wrong in your body, you usually get some kind of clue: a twinge, a pain, a change. Something that hints at a difference. Something that tells you things aren’t quite right. Something that makes you think twice. Nothing like that occurred here. Nothing at all. My aorta was expanding and stretching to its limits and my body never said a word.
“My heart, the organ that gives me life on a moment to moment basis, lied to me. It violated my trust. When it was in grave danger it sat in silence. Now it’s perfectly healthy and it won’t shut up. I don’t know what to believe anymore. I’ve lost all physical confidence in my body.
“So that’s where things stand at the moment. The biofeedback is helping me make great strides on both these fronts, but it’s an ongoing process.”
Image credit: Ana Teresa Barboza
Q: Have you, like Summer, had the experience of “sending your emotional brain to the back seat” during a medical crisis?
NOTE FROM CAROLYN: I wrote much more about the link between heart disease and mental health issues in Chapter 5 of my book, “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon. Or if you order it directly from my publisher, Johns Hopkins University Press (code: HTWN), you will save 30% off the list price when you order).
* Since this post was published, Summer is no longer a New Yorker. She has moved to a new home and a new job! She’s now the Senior STEAM Education Specialist for the National Radio Astronomy Observatory in Socorro, New Mexico.
The day I made peace with an errant organ
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Not just for soldiers anymore: PTSD and heart disease
How a heart attack can trigger PTSD
61 thoughts on “The delayed ‘Trauma Drama’ of heart disease”
To Summer – I was 57 when I had the same procedure done almost 10 years and every day I feel the same way you feel. Sometimes I start thinking of bad things. I’m retired now with nothing to do but I find sometimes it’s a struggle to get around but then I think about my grandkids and I feel better. I’m glad I’m not alone on this fight we call surviving.
All the best to you and excuse my writing English is my second language
The amount of time it can take to carry out open heart surgery is based on the kind of procedure and also the desires of the person. As a consequence, the National Heart, Lung, and Blood Institute (NHLBI) says coronary artery bypass takes 3 to 6 hours.
This helped a lot because I was stabbed in the chest a few months ago and now that I am physically healed (albeit with over 200 stitches resulting in what makes my chest resemble Frankenstein) I am emotionally not ok.
I grew up in a rough neighborhood and was always one of those people who would get in fights around the neighborhood when drinking so I was used to being bloody after fights and had stabbing attempts prior and guns pulled on me, so I can only imagine what someone who didn’t have this lifestyle would go through in my same situation.
I was in ICU for two weeks punctured lung and I bleed out and lost consciousness in 5 minutes after being stabbed, my friend tried to wake me up but couldn’t and it took 6 minutes for the ambulance to arrive. They woke me up somehow and the first thing I said was I have O negative blood and and punctured lung, let’s go. I kind of tripped the EMTs out and same with the cop in the ambulance by my reaction which was just like I had done this multiple times which in some ways I had.
With that being said I didn’t think it would take that much of a toll on my emotions but now I wake up crying daily remembering friends that passed or just basically anything related to death.
And it feels like I am mourning the loss of my own self. The scariest thing for me in those 5 minutes after the altercation while I was sitting there with blood coming out of my mouth and forming a large puddle around me was that it made sense why I was in that situation, I had lived my life like a Wild West cowboy and it made sense but I was really sad in what the last moments I thought of my life because I knew my 3 siblings were going to have to get old with me as only a photograph or memory and that same feeling comes back daily and I cry and cry and I’m just living every day super sad and I don’t know how to fix it, like what do I do?
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Dean, your comment is very different compared to most of the heart-related reader comments I get here on this site. I’m so sorry you’ve had to go through all this. But I can also see why this particular article (a guest post by Summer Ash) seemed to speak to you – because she was describing several emotional and psychological reactions she went through that must have somehow rung true for you, too. Thank you for taking the time to write. I say this because somewhere out there is another reader like you, who will read YOUR words here, and feel like they’re not the only one feeling like they’re going crazy.
I’m not a doctor so cannot comment specifically or answer your ‘what do I do?’ question, but I can tell you generally that your “loss of self” observation is more common than you would believe. You are in fact mourning the loss of your own self – and that’s a profound experience for anybody to face. You’re the same person, but in many ways you likely don’t feel at all like that person. You may never go back to that old Wild West cowboy life – or you might. You’re at a massive fork in the road where you get to make choices that only you can make.
No wonder this experience is taking a toll on your emotions. It would be pretty unusual if you weren’t feeling so emotional. You have just survived what many do not – and that’s got to be a stunning reality to come to grips with. You may also be experiencing symptoms of Post-Traumatic Stress – look that up and see if maybe that seems to fit, too.
I think you might find this podcast interview interesting or helpful: it’s an interview called “Overcoming Psychological Scars After a Knife Attack” with Will Flint, a British man (former national championship bodybuilder) who survives 12 stab wounds and internal injuries serious enough to end his competitive days. For example, he talks about how the physical trauma can be surgically treated and stitched up, but it’s the psychological pain that stays with you and can feel far worse… If you can, you might consider talk therapy – a friend, a pastor, a doctor, a counselor – somebody you trust to just let you talk it all out.
Good luck to you, Dean – take care and stay safe…
I am in this boat that so many are in.
We all leave at different times, at different speeds in charge of various vessels, some of which are not sea worthy at all.
Right now I’m 9 months post-MVR via open heart surgery. I had an appendectomy on day 18 post-op valve surgery, got sepsis, respiratory failure etc. And spent a month in hospital.
My wife had to cope with all this whilst raising our three girls and shielding them from all this.
I work in health care and I’m a specialist nursing practitioner in cardiology and resuscitation. Being cared for by the people I teach. A humbling experience. Thankfully I’m generally a nice guy.
I’ve returned to work at a point where I’m physically just about there. Psychologically however is another matter.
Since I’ve come back I’m very angry with everyone and everything though I don’t mean to be. The slightest thing can set me off. Loud noises, kids screaming while playing.
I’ve accessed Counseling and a one hour Zoom became a 90 minute monologue. Poor but amazing counselor. Won’t let me go a week and to see again on Monday. I actually feel completely rudderless in a storm. Just huddling down, hoping and praying.
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Hello Baltic – thanks so much for weighing in here with your personal perspective. You are not alone.
As all heart patients eventually learn (but NOT likely because we were actually warned!), both physical and psychological healing are critically important elements of recuperation. Doctors and nurses may get this on some intellectual level, but not until they become patients do they really get it.
I’ve personally observed that patients who are also healthcare professionals seem to have a particularly tough time when they’re unable to bounce back the way they’re used to bouncing back in life. Lots of expectations on how they “should” be coping… In your case, you also had severe medical issues complicating your recuperation – no time to catch your breath.
I like to quote cardiac psychologist-turned-shocked heart patient Dr. Stephen Parker who gets it right when he describes the “swirling emotions” of responding to a heart disease diagnosis, e.g:
– relief at survival,
– disbelief and anger that it happened,
– grief for everything that was and will be lost,
– gratitude to those who helped,
– extreme vulnerability in a previously safe world,
– fear of what the future might bring…
Dr. Parker also taught me how having your own serious heart condition inevitably makes a person a better healthcare professional.
The way Summer Ash describes her own “delayed trauma drama” in this article was helpful to me because her story reminds us, just as yours does, of the valuable role that professional counseling can play in navigating that storm. You may have just found your rudder.
Best of luck to you and your family.
Take care, stay safe…
The most affirming thing I’ve read since my open heart surgery 18 months ago.
I am physically healing but there is a mental and emotional element that has been nagging at me this whole time. It is time to seek help (not sure how to approach this).
Thank you so much for helping me realize I’m not crazy.
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You are NOT crazy! Glad you found Summer’s guest post here! Please talk to your physician about getting some resources for professional talk therapy to help you through the mental/emotional issues that are so often reported among heart patients. As I once quoted journalist Jan Wong, these issues are “common, temporary and almost always treatable…”
Good luck to you…
This post is very relatable. My heart isn’t supposed to be so loud, but now it is. At first I didn’t want to accept this made me different.
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Reblogged this on Caring for the Caregiver .
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Wasn’t sure if this went through because it disappeared and asked me to login through WordPress. Sorry if it’s a repeat:
First of all, I’m a guy, so hopefully I’m not treading where I shouldn’t, but this website came up and Summer’s article spoke so much to some of my feelings. I had CABG x 6 surgery going on 6 years ago. I was 47 years old. I have a family history of coronary artery disease; my dad was 42 and my brother 39 when they had heart attacks. I was 46, so I felt like the “winner” of the family lottery.
I had my first heart attack the day after Thanksgiving. It had all the classic symptoms for men. Textbook. I knew pretty much what was happening before I ever got to the hospital. After all, I’ve lived with this possibility for 20 or more years after my dad had his heart attack. I’ve been on statins since I was 20 years old. It was always in the back of my mind. It was decided that they wouldn’t do surgery after my heart attack. They changed some of my meds, added others, and sent me home feeling like a ticking time bomb. At that time, I was told that most likely, if I started having issues, I’d have similar symptoms to the classic ones I had just had.
My body betrayed me. The ONLY indication I had that something was wrong was a slight tightness in my chest that would come and go. I finally decided to have it checked out, and was told that the major artery on each side of my heart were both 95% blocked. I was a fatal heart attack waiting to happen.
Next thing I knew, I was having surgery within the next 48 hours. I remember waking up on the ventilator when I wasn’t supposed to, and I was trying to use the sign language alphabet to tell them I couldn’t breathe. There was a lot of bustling about, and then they just put me under again. Apparently, my waking up wasn’t anticipated.
Now, any time that I have a little strange feeling in my chest, I get anxious, which only makes things worse. It just starts spiraling. To make matters worse, I’ve been treated for clinical depression for over a decade and continue to struggle with a low-grade chronic depression even though talk-therapy and drugs have helped quite a bit. I manifests itself in just being in an emotional “funk” for extended periods of time. Not debilitating like it had once been, but just a funk.
So now I don’t feel like I can trust my body to give me signals. I feel like I’m always on alert, even though maybe I don’t always have to be. And I’m also reaching that age in life when I’m really assessing what I’ve done and where I’m going – you know, the ol’ “mid-life” bugaboo. Parts of me feel like I should seek counseling again, but it was so messy and draining the first time, I don’t know that I have it in me to do it again. Just trying to cope day by day.
Anyway, thanks, Summer. I know this site is for women and for you to share your stories among yourselves, but I wanted you to know that your story touched me, too. Thanks.
PS One more thing…Summer was exactly right regarding family members may not be the right people for some of the emotional support. Because heart disease is so common in my family, I kept hearing about how my dad experienced this or my brother went through this, ad nauseum. It did nothing but upset me. I’m not them.
My experience was my experience, and it felt like no one was listening to what I was feeling. Made me angry. One of my excellent cardiac nurses picked up on this in the hospital, and she had a word with my family, which was helpful. Yes, be careful in whom you confide. It can make a difference.
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Hello Mike – your comment wasn’t a ‘repeat’ (I didn’t get the first one, so thanks for trying again).
I’m not a physician, but I can tell you generally that there are so many important points you raise that are absolutely common in both men and women. I’m going to include a few links to more info as I respond here.
Having a heart attack (as cardiac psychologist Dr. Stephen Parker – himself a survivor of several – likes to say) is a “deeply wounding event and it is wound that takes a long time to recover from, whatever the treatment.”
What you were told after that first heart attack post-Thanksgiving was not correct. We OFTEN hear patients report that the symptoms of their second heart attack were not like those of the first, as you yourself discovered. And that ‘ticking time bomb’ sense is what cardiac researchers call hypervigilance.
That sense of “betrayal” you mention is also very common. The late Dr. Sherwin Nuland describes our coronary arteries as “friends of the heart when we are healthy, but when they are diseased, they betray it at its most needful moments.”
I could write a whole book on unhelpful things people say to heart patients! Comparing your experience to those of others seems to be irresistible! (You think YOU have pain? Let me tell you about REAL pain!!) I think it’s terrific that the wise nurse observed that tendency in your own family and intercepted. I wrote more about that here.
And I agree 100% with Summer and with you that family members are not always the most appropriate people to confide in. Our friends and families want and need us to be “normal” again. It’s very distressing to them to see us not “getting better”, which can lead to them being dismissive or poor listeners. I like to quote the work of Dr. Wayne Sotile who has written about this very topic. But that’s why talk therapy can help – a trained third party who is not a relative!
If you truly feel that therapy at this time wouldn’t be helpful for you, try to come up with something, anything that you love to do in order to inject some joy into every day. And then do more of it. You pick. You’ve had a lot of traumatic events happen to you. No wonder you are feeling bad. I’ve written tons about depression and heart disease (a history of depression increases our risk of heart disease, and a heart disease diagnosis increases our risk of depression, oh joy!) Just search the CATEGORIES box on the right sidebar here for “mental health issues” for more.
Good luck to you, Mike…
Thank you so much for your story, Summer. I had open heart surgery late October 2018, which was preceded by a pacemaker being fitted 4 weeks prior. I had a triple bypass, aortic valve (mechanical) replacement and like you, an aortic aneurysm repair (the vascular surgeon told me it would’ve burst and killed me in the coming months if it hadn’t been discovered and repaired).
My heart disease was diagnosed quite by accident and then it was all systems go and whilst the physical repair is still happening (OMG the pain!), I am struggling so badly with the mental side of things, and your story, is my story.
Nobody follows up the mental side of things. Who do you talk to? Neither friends nor family have gone through OHS, doctors don’t understand, nobody does. So thank you, I honestly thought I was the only one, and that I was somehow weak and going mad.
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Hi Davina – I’m so glad that Summer’s story touched a chord for you. You are not alone! I think her story is a good example of how a successful, competent person like her can experience those “cracks” while experiencing mental health issues that may have never shown up before this medical crisis.
I hope you are able to make an appointment for talk therapy. For Summer, that help was in the form of a psychologist trained in biofeedback for her PTSD symptoms, but it doesn’t have to be only biofeedback. The important thing is to find somebody you can trust to help you gain some perspective, and to learn some tools to help you make sense of something that makes no sense. A therapist doesn’t have to have personally experienced exactly what we have – but the specific training needed to really listen to what we’re going through.
Our family and friends are often not the most appropriate persons to confide in. They need and want us to be “back to normal”. It can be very distressing for them to know we are still suffering – another reason that a trained third party is so often a more helpful resource. Choose very carefully whom you decide to confide in among family and friends (it may be somebody surprising – e.g. not necessarily somebody in your family or close circle of friends). I wrote more about this in “I Don’t Want to Talk About It“. You might also want to check out the links (above, under “See Also”) to articles about living with PTSD after a medical crisis.
Best of luck to you…
I relate to this on every level. Mine was brain surgery. I’m still recovering from the PTSD from it as my brain continues to betray me. It’s a very difficult thing to go through. Thank you for sharing your story. 🙏
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Thanks for that perspective Jana. It doesn’t so much matter the specific reason for major surgery, but the emotional, mental, psychological and spiritual impact of a serious diagnosis on one’s life. Researcher Dr. Kathy Charmaz does a lot of work on what she calls “the loss of SELF” in such patients…
Thank you Summer for your article. It was like reading my own life. Although I didn’t have an aortic surgery, mine was just as emotional. May we speak on the phone cause this texting is aggravating.
Thank you so much
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