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