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Mountain Passages: The Heart of the Matter

Sometimes we get signals about our mortality. By Alan Stark.

Every once in a while the Mountain Gods give a warning. The warning can be subtle such as a glimpse of white puffy clouds over a peak at 10a.m.

The curious thing about getting these warning is our manner of dealing with the warning. We start with complete denial, continues on with an actual or planned change, then we feel growing discomfort, followed by flat-out fear, some deal-making, an action of some sort, and a resolution.

So you were late to the trailhead, and by the time you get above treeline, those white puffy clouds are morphing into a grey thunderstorm cell.

“Thunderboomers are not a big deal. I’ve been around plenty of storms in the mountains. This one looks like it will pass way to the south. No worries.”

“Hmmm. It’s not tracking south as much as I thought. So maybe if I hike a little more to the north above treeline—just in case.”

“Damn. That cell is headed right for me. Gotta get out of here.”

“Holy shit! Fricking lightning just hit below me.”

“Pleeease Lightning God, if you get me out this one, I’ll never start late again.”

Sure.

Sooner or later we’ll all ignore warnings from the Mountain Gods. If we don’t get caught-up in the natural selection process for our stupidity, we’ll go through the same routine again and again.

I did just that—ignoring a Mountain God warning right after Thanksgiving. I was awake in the middle of the night and felt pressure under my sternum. It was nothing, just enough discomfort to wake me up. As a borderline hypochondriac and since I’m no longer 40 anymore, I’ve learned to ignore all sorts of signals from my body, as they are just part of the process toward geezerhood. I went back to sleep.

The same thing happened several nights later and again the next night. Now I was slightly concerned. Chest pain is one of several key symptoms of a heart attack, along with shortness of breath, pains in arms and jaw, nausea, and sweating. After 40, we all learn the drill. Truth be told, I was really concerned and began to feel the pressure at odd times during the day.

But I’m moderately fit, I work at altitude in the backcountry twice a week in the winter. I’ve run about a million miles of trails and have my share of century-ride caps. I’ve never had any chest pain other than from broken ribs. How could this be that my chest hurt?

So to prove that my imagination had run wild, I went for a long run. There was no pressure in my chest. Proof that I didn’t have a problem. All fine and good until later in the afternoon when the pressure came back. Now I knew I had a problem. What to do? I couldn’t bring myself to show up at the ER because I was afraid of what they were going to find. Better to tough it out. Maybe try another run the next day. Maybe the pain will just go away.

So let me stop here for a moment. Is any of this familiar to you? Have you done this sort of thing before? Is this denial something you are experiencing today and feeling one level of fear or another?

Nope, the pain didn’t go away. I suppose that the pressure I felt was about the same, but as I drifted through the next week, my imagination took over and the pressure seemed to increase. I got more and more worried. I could have cared less about the Holidays, because I was by now convinced that I was going to die of a heart attack. It was just a matter of time. Absolute fear set in.

But maybe I could make a deal with the Mountain God in charge of health. Maybe if I ate better and gave up my evening cocktail. I didn’t have a drink or a beer, and I ate about half as much as I usually do. Not surprisingly, I didn’t feel any pressure in my chest that night.

Terrific.

But later the next day, while sitting at my desk, I felt the pressure again. Fear and dread rolled back into my life.

The fear I felt stayed with me all the time. I couldn’t stop thinking about dying of a heart attack. I was essentially frozen by the fear of my impending death.

Blue Eyes looked up from her soup and said, “Are you okay? You look terrible.”

“I feel terrible.”

There it was out.

“How?”

“My chest hurts.”

“Call Kaiser now.”

We were headed out to cut a Christmas tree on friend’s property. I was imagining having a heart attack while dragging a tree back to the Highlander. I had to smile at the irony, but I simply couldn’t do that to my best friend.

An RN at Kaiser calmly went through a series of basic heart attack questions over the phone and told me to come in. At Kaiser an LPN asked more heart attack questions and then put me on an EKG. At this point, while I’m sure I’m still dying, I’m also immensely relieved to be getting checked out. A doc, who I had never seen before, comes in and asks even more in-depth heart attack questions. She finds out that I had gone out for a symptom-free run two days ago.

“Smooth move.” she says, “Essentially giving yourself your own stress test, were you?”

I nodded in agreement and Blue Eyes made her frowny face, something I had occasionally seen before.

After looking at the EKG she said,” Your heart is fine.”

“You can do one of two things. You can either go home and make an appointment with your PCP to get to the bottom of this or you can go through the heart attack routine of a blood test to see if there has been any recent damage to your heart, a chest x-ray to take a look at the size of your heart, and probably another EKG.”

We elected to do the heart attack routine.

Five hours later, nothing. No heart damage, my heart size was normal, my lungs were clear, and the protein test for heart damage was negative.

The next week, David, my PCP suggested that I had a wicked case of ongoing acid reflux.

So what did I learn from this experience? Probably nothing.

Know two things about asking for medical help. If you talk to your PCP about how she makes decisions, there is a good chance that she will eventually mention Occam’s Razor, which loosely means, “always go for the simplest answer.” In my case, eating spicy food and age caused chest pain; all exacerbated by an overactive imagination. And if you ask her more questions about her work, she will probably tell you that 50% of the complaints from patients are nothing or go away quickly, 45% of the complaints require routine medical intervention (mostly non-invasive) and only 5% of what she sees are dangerous and possibly life-threatening. In other words if you visit your doctor, there is a 95% chance you won’t get an awful diagnosis.

Alan Stark is a backcountry ski patroller in the Roosevelt National Forest and lives with this Blue-Eyed person and her dog in Boulder and Breckenridge. He can be reached at alanbearstark@gmail.com

4 thoughts on “Mountain Passages: The Heart of the Matter”

  1. The males on both Mom & Dad’s side of the family (quite a small Hillbilly gene puddle) harbor wonky heart valves. Dad & a few uncles went before 60, and Dear Li’l Brother had all 4 valves replaced with shiny plastic ones when he was 35. He’ll be 52 in a few weeks, and is the picture of health — medical science works! I was diagnosed with mitral valve prolapse when I was 35 and noticed that I was slowing down, but was too busy bumming around the mountains and banging nails at minimum wage for 6 months at a stretch to craft a comprehensive health care plan. But I did have a strategy: drink until it stops hurting.

    In celebration of my 40th birthday I made a 2-week January circumambulation of Pikes Peak, a doddering sprint to the summit and then back to Manitou and my wife, apartment and job. Three days later I felt weak and confused and so left work and went home and to bed. The chest pressure came, and then the ache in my upper arms, neck and jaw. I was sweating in the chilly apartment and felt a need to get to the bathroom and puke but didn’t have the strength.

    Thankfully, my dear wife, a nurse, came home and found me in those straights. She knew as well as I that a trip to the ER would bankrupt us. She gave me aspirin and warm tea and hugged me until I slept.

    From that day on I’ve been like a Jeep dropped down into compound low. I can still do things, but very slowly. I lost my job (slow, competent carpenters are not in high demand), and eventually Dear Wife got tied of the resultant poverty and headed east. By May, without my nurse and no way to pay rent, I sold my tools and guitar, loaded my backpack and took off down the spine of the Rockies at a very slow pace.

    I hitched up to where CO 512 almost hits the Divide and started walking south. It took three weeks to reach the Sawatch at my new speed, then after a couple of days in my beloved hometown of Salida where the post office flubbed my re-supply I made a month-long starved detour down the Sangres to Blanca Peak and back, and then back onto the Divide until getting off on CO 17 near the New Mexico border.

    I hitched from there to US 285 at Antonito, back up through the San Luis and South Park, past Denver and into Wyoming. I walked the whole damn way through Wyoming without one ride. Then near Scotts Bluff, NE I got robbed and bloodied. Scotts Bluff did take care of me though, and I remember that town fondly. Hitched from there up to the Pine Ridge, SD rez, hoping to make a Habitat project that I just missed. I did meet Jimmy though. It impressed me that he was still there to help button things up after the press had lost interest and wandered away.

    Then the long hitch back here to my ancestral home in Carolina where I sit today and try to figure out how to be a Southerner for the first time.

    The heart leads us along paths that the mind hadn’t imagined.

    }}}}

  2. good of you, Alan, to remind me/us/everyone.

    a coupla-three times a year i remember Charley Jackson, fellow physics student at Moo U back in college daze. he was (allegedly) gettin’ his poo-poo together and was EXPELLED from the physical realm while meditating on a mountain-top by lightning. no kidding.

    i’ll probably “go” either some way like that, be it a 5000-pound boulder droppin’ down on the car in Glenwood Canyon, or lightning, or an errant semi runnin’ over me and my bike — all of which are? are they? “better” than slow gradual deteriorating malaise in a rest home sum-wear.

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