1:
The Gold Standard
First symptoms, first hospital stay ~ Angiogram ~ Manchester terror attack ~ “My cardiologist”
May2017
“I think you have a problem with your heart.”
So she said and the heart in question sank. I had just described to my doctor the various symptoms that I had recently experienced while riding my bike: chest discomfort and a heartburn feeling. This had been going on for about a month during morning cycle rides to work and was easily dismissed as a consequence of my increasingly bad habit of having heavy cream on my morning ‘Special K’.
Some weeks earlier, I had gone on a regular fitness ride from my home in Mill Valley to the Golden Gate Bridge via Sausalito. On the start of the climb into the Marin Headlands there it was again: the heavy chest and heartburn but this time also something new. My energy level dropped and I had to pull over and hang my head on the handlebars as if I had just drained myself completing a stage of the Tour de France. I was exhausted but strangely not out of breath. Another cyclist passed me, detected my distress, and yelled out: “Are you ok?” I wanted to say “Not really – this is very wrong” but instead I shamefully replied: “I’ll be fine – thanks”. Apart from the blatant lie, I knew that this hill was never so challenging. I also hate to be overtaken by other cyclists on a climb. Still, after a few minutes by the road, my energy level – and pride – were restored. I cautiously cycled up the rest of the hill and completed the ride without further incident.
About a week later at the family dinner table, my 10-year-old daughter told of a curious occurrence at her school that day. During a PE session, a whole bunch of kids had simultaneously exhibited asthma symptoms. It was May and pollen levels were reportedly very high. I wondered how unusual mass outbreaks were.
With this still in mind, I set out the next morning for my commute cycle to work. I had decided to catch the ferry to San Francisco from the terminal in Larkspur. This meant the start of the ride from Mill Valley would be over Camino Alto grade – a steady 300-foot climb of around one mile – a vigorous, five-minute-long cardio exercise. As I started the climb, not unusually, I saw two other riders about 100 meters ahead chatting side by side. I was slowly catching them.Target in sight! But as the hill steepened, my legs turned to jelly, and shifting down gears was of little help. The other cyclists pulled away and disappeared around a switchback bend. Yet I persisted – I know how this hill should feel whether I am fit or unfit. Something unusual and new was happening, but I could not or would not yield until, nearing the summit, I was most definitely compelled to stop and pull over. I was now not only lacking in energy and feeling strong chest discomfort but was also nauseous and salivating. I remembered my daughter’s tale about her classmates the previous day and thought:Wow, did I just have an asthmaattack?
I recovered quickly as I freewheeled down the other side of the hill and, eventually, made it to work albeit with an abnormally low energy level. While grabbing a coffee, I confided in a colleague about my ride and my asthma speculation. She was unsure but was unequivocal that I should not delay contacting a doctor. I made an appointment as soon as I got back to my desk. There was a slot the next day – Friday, 19th May 2017.
So here I was, face-to-face with my doctor. She quickly dismissed my asthma suggestion but she must have noticed my shocked e