11 August 2013

Hello everyone.

I try to keep this blog mostly professional, with only occasional forays into more personal topics. This is one of those forays.

A little over two weeks ago I was speaking at a Windows 8 user group in the Twin Cities. Like most user groups they had pizza, and i ate a couple pieces.

About half-way through my talk i had _horrible_ heartburn. A searing sensation from the center of my chest up into my throat. And I got dizzy and a little short of breath. To the point that I apologized to the attendees and did the rest of my talk from a seated position. I though it was heartburn.

Following the user group I picked up some Tums (heartburn medication) and chewed a few tablets as i drove home. These had no impact, nor did a couple similar meds my wife gave me when I got home.

I couldn’t sleep. Between the discomfort and the worry about what was going on, I just couldn’t sleep.

Why worry? Well, just a couple weeks prior to this point, Jeffrey McManus (a fellow speaker and colleague) passed away in the night due to a heart attack. And he was two years younger than me. So this idea of a heart attack was pretty fresh in my mind, and I knew that the symptoms for a heart attack and heartburn were similar.

So I got online and started doing some research to find out the differences. It turns out there are NO MEANINGFUL DIFFERENCES. If you have heartburn that doesn’t respond to antacid or anti-gas meds, you should assume you are having a heart attack.

As a result my wife drove me to the ER, where they admitted me right away of course. They don’t mess around with chest pain.

Interestingly enough, after a bunch of tests they found no indication of a heart attack, but also no indication of heartburn. In other words, no immediate cause of my pain and discomfort. They gave me the choice to go home or remain in the hospital for some further tests the next day – mostly what’s called a stress test where they have you run on a treadmill while monitoring your heart.

My wife opted for me to stay. I _probably_ would have stayed anyway, but she was clear that in her mind this wasn’t optional (have I said I have the most amazing wife?).

A few hours later they said they wanted to a CT scan. One of the techs that does the stress test noticed that one of my blood tests wasn’t quite normal, and thought it would be worth doing a scan before the stress test. This turns out to have been a life-saving call.

The CT scan revealed something called an ascending aortic aneurism with dissection: http://en.wikipedia.org/wiki/Aortic_dissection

In the majority of cases this condition is identified post-mortem. I was extremely fortunate that it was discovered while I was still around, before the aneurism burst.

Everything changed at this point. As in they wouldn’t let me sit up, they immediately put me on a regimen to radically reduce my blood pressure, and they started checking with all hospitals in the Twin Cities to find the first available heart surgeon. The level of intensity was a _lot_ higher than it has been.

I think fortunately the next surgeon was in my hospital. The other primary possibility was in another excellent heart hospital, so that would have been fine, but this way I didn’t need to be transported across the city.

I woke up somewhere around 8 hours later. Or I should say that my first memory of waking up was around 8 hours later, as I apparently “was awake” after perhaps 5 hours and my family was there with me, but I have no recollection of that time.

I was in the hospital for another week before they sent me home, and even then my memories are a bit hazy due to the pain meds.

So here I am after about 1.5 weeks of being home and I’m on a lot less pain meds, so my mind is at least reasonably clear. I have another 10 weeks of healing before I can resume all normal activities, though just 4-6 before I can do things like go back to work full time.

I apologize to the LA .NET User Group and VS Live Redmond attendees who’d hoped to see me, but as you can tell I really had no choice but to cancel my appearances at those events. I do expect to be at Modern Apps Live and VS Live in Orlando in mid-November.

The primary things I’ve learned from this whole thing include:

• You can’t easily tell the difference between heartburn and actual heart issues, so if antacids don’t work, error on the side of caution
• I have the most amazing family and friends, who’ve been incredibly supportive, and continue to be supportive as i heal
• My coworkers at Magenic are wonderful, and have ensured that I have no stress or worry about anything work-related, in addition to being broadly supportive through goodwill and kind thoughts
• The online/professional communities to which I belong (CSLA .NET, various Microsoft communities, Regional Director, MVP, and others) have also been extremely supportive, and I truly appreciate the outpouring of goodwill

Some other observations:

• I hate sleeping on my back – I always have disliked it, but after being confined to that option for a couple weeks I feel comfortable using the word ‘hate’
• Hospital food is actually pretty good when you haven’t eaten anything for days
• I am _shocked_ by how weak something like this can make a person – to the point that something simple like taking a shower is a major undertaking that takes a lot of planning and requires a long nap afterword

On the other hand, the fact that I’m here to make these observations and to write this blog post makes it all worthwhile.

I wanted to write this post for a couple reasons.

First, to thank everyone who has been and continues to be so supportive as I recover.

Second, to let colleagues and followers in my various communities know why I went dark so suddenly, and why things like CSLA releases might take longer than normal.

Third, to share my actual medical experiences in the hopes that even one person someday goes to the ER when they have “heartburn”. In my case I was sensitized to this issue due to the recent death of a colleague, and I’d prefer to have as few other people suffer that fate as possible.