Introduction and Motivation

I do not write this story looking for sympathy or sorrow. Instead, as corny as this sounds, I hope to maybe save the life of one of my friends.

On October 15, 2023, I underwent open heart double bypass surgery. The following summarizes how I ended up with a bypass and the days in the hospital that followed.

Much more importantly, I discuss my good fortune to have detected my cardiac heart disease (CHD) without noticing any symptoms. I want to share how I detected CHD so that you can share with your friends and loved ones, in the event one of them has a time bomb in their heart like I had!

Please subscribe to my blog so you can find out when I post updates to my blog.

First, A Shout Out!

I will never be able to express the amount of appreciation I have for the nursing staff at the UNC Rex Heart and Vascular hospital. I wish I could list their first names here, but have decided not to for privacy reasons.

How Does One Know To Go To A Cardiologist?

At age 50, colonoscopies are recommended, and for good reason! Colon cancer is SO AVOIDABLE with regular colonoscopies.

Unfortunately the medical community does not an analogous test to flush out heart disease. They rely on you having chest pains or extreme fatigue, neither of which I had. In other words, the ball is in your court regarding detection.

My recent experience has shown there are a few non-invasive tests that can be performed to give a reasonable idea of your heart health. I discuss them later. TWS Link to section.

How Did I know To Go To A Cardiologist?

This is probably the information folks are wanting to know. Before I was diagnosed with CHD, I considered myself to be in pretty good shape for a 61-year old. I am non-smoker, averaged only one or two servings of alcohol a week, worked out three times a week, ran once or twice a week, would regularly walk 18 holes of golf, and was constantly on my feet doing small engine repair. Given no symptoms of heart issues, I was rather confident I was in good health.

Now to the good fortune that I have no doubt saved me from a likely fatal heart attack. The following is the most important thing to take away from this as far as how I detected my coronary heart disease!

In September 2020, I purchased a KardiaMobile 6L because of its incredible capabilities of providing a six lead ECG (a.k.a. EKG) along with heart rate reporting. This device analyzes the data recorded and lets you know if you’re in Normal Sinus Rhythm or have some issue with your heart.

To me, this device seemed like cheap insurance. After every workout and run, I would use my KardiaMobile 6L to look at my heart rate and EKG. So from September 2020 until early July of 2023, “normal sinus rhythm” was always reported (except after some of my runs where my heart rate was >120, in which case an expected Tachycardia was reported).

Suddenly, a couple of readings in July 2023 that reported “Possible Afib” kicked off the data gathering phase with a series of tests to determine what was going on with my heart.

You can purchase a KardiaMobile 6L by clicking the link below (I strongly recommend you spend the extra money to get the six-lead version!):

Assessing The Situation

After the second possible AFib from the KardiaMobile 6L, I went to my general practitioner to kick off the investigation. He recorded an EKG, but no AFib was detected.

Thankfully, without me asking, my general practitioner immediately referred me to a cardiologist at WakeMed. At the same time I requested an appointment with a cardiologist at UNC UNC Rex who basically saved my father-in-law‘s life and is well liked and highly respected by my wife and in-laws.

Because I was a new patient at UNC Rex for a high-demand cardiologist, it took almost a month to get an appointment. (Tip: if you know a good cardiologist, you may want to make an appointment so that you become an existing patient, and thus get higher priority if time is critical.)

WakeMed Cardiologist Visits

Before my initial trip to the WakeMed cardiologist, my friend Ken recommended a couple of non-invasive tests to me to facilitate data gathering:

CT Cardiac Calcium Scoring to evaluate the amount of calcified (hard) plaque in your heart vessels.
Lipoprotein (a) test measures the level of lipoprotein (a) in your blood. A high level may mean you are at risk for heart disease.

In my initial WakeMed appointment, I requested that those two tests be performed. (Frankly I’m not sure if the cardiologist would have even suggested these, but that’s just speculation).

The cardiologist had those scheduled, along with the following:

A 48 Hour 7 Day Heart Monitor Patch to see if I was indeed having sporadic AFib.
Stress Echocardiogram to check for the presence of blockages in the coronary arteries.

My WakeMed Test Results

As you will soon see, my test results were cause of great concern to me.

Stress Electrocardiogram

Overview

A stress electrocardiogram (ECG or EKG) is a diagnostic test that measures the activity of the heart during physical stress. It is also known as an exercise ECG or treadmill test. The purpose of a stress ECG is to evaluate how well the heart responds to increased demands for blood and oxygen when the body is under stress, typically induced by exercise.

Here is the sequence of events with a stress echocardiogram:

The patient arrives wearing comfortable clothing and athletic shoes.
An ECG is recorded and ultrasound images of the heart are captured to capture a baseline readings of the patient’s heart at rest.
The patient gets on a treadmill that is gradually elevated in order to increase the patient’s heart rate.
Once the maximum heart rate is reached, the patient immediately gets their ECG recorded and ultrasound images captured of the patient’s heart at stress.
The cardiologist analyzes the results and provides guidance to the patient on suggested course of action.

There are numerous metrics recorded with a stress echocardiogram, too many to discuss here. However, there are two metrics that are relevant for discussion here:

Ejection Fraction (EF) – a measure of the percentage of blood pumped out of the heart with each contraction.
Horizontal ST Depression – a value of > 0.5 mm indicates possible myocardial ischemia, which is when blood flow is obstructed by blockage of some degree in a coronary artery.

The following table summarizes the different degrees of EF:

EF Percentage	Level of Reduction
50-70%	Normal
40-50%	Mildly reduced
30-40%	Moderately reduced
<30%	Severely reduced

EF Percentage Overview

Some of the key implications of a severely reduced ejection fraction include:

Heart Failure: A severely reduced ejection fraction is often associated with heart failure. Heart failure occurs when the heart is unable to pump blood effectively to meet the body’s needs. It can lead to symptoms such as shortness of breath, fatigue, fluid retention (edema), and exercise intolerance.
Increased Mortality Risk: A low ejection fraction is a strong predictor of adverse cardiovascular events and mortality. Individuals with severely reduced ejection fraction have a higher risk of sudden cardiac death and other complications.
Impaired Exercise Capacity: Reduced ejection fraction can result in decreased cardiac output, limiting the ability of the heart to supply oxygen-rich blood to the body during physical activity. This can lead to exercise intolerance and reduced quality of life.
Arrhythmias: Severe reductions in ejection fraction can disrupt the normal electrical activity of the heart, increasing the risk of arrhythmias (irregular heart rhythms). This can further contribute to the risk of sudden cardiac death.
Complications of Heart Failure: Chronic heart failure can lead to complications such as kidney dysfunction, liver congestion, and pulmonary edema. It can also exacerbate other health conditions.
Impaired Pumping Function: The heart’s pumping function is compromised when the ejection fraction is severely reduced, affecting the ability of the heart to efficiently circulate blood and maintain adequate perfusion to vital organs.

My-Calcium-score

After this was interpreted by the WakeMed cardiologist, he called me and told me it was a low risk issue, but given my high Lipoprotein (a), horrible CT cardiac calcium score, and family history, he recommended that a stent be inserted.

My Stress ECG Results

For my age, my target heart rate is 135 bpm and the maximum of 152. During the test, my heart rate got to 142 before the technician had me stop. At that point I was really huffing and puffing!

At that point, the ECG and ultrasound data was gathered.

Fortunately, my EF was 60-65%, which is falls in the normal range.

However, unfortunately my horizontal ST depression was 1.5mm, which is higher than the acceptable < 5mm.

After this was interpreted by the WakeMed cardiologist, he called me on the golf course and told me what he found was a low risk issue; however given my high Lipoprotein (a), horrible CT cardiac calcium score, and family history, he recommended that a stent be inserted. Needless to say, the last 6 holes that day were a blur.

CT Cardiac Calcium Scoring

Overview

CT cardiac calcium scoring is a non-invasive imaging technique that uses a CT scanner to assess the amount of calcified plaque in the coronary arteries. Note that calcification of the arteries is exactly the same as hardening of the arteries.

Currently, insurance companies do not pay for this test. I ended up (gladly) paying $250 for this test. However, I later found out in Raleigh that these tests are $99 at Cardinal Points Imaging. Shop around!

The following table summarizes the calcification level and risk of coronary artery disease based on the cardiac calcium score:

Score	Calcification Level	Risk Of Coronary Artery Disease
0	None detected	Lower
1-10	Minimal Calcification	Low
11-100	Mild Calcification	Low to moderate
101-400	Moderate Calcification	Moderate
Over 400	Extensive Calcification	High

CT Cardiac Calcium Scoring Summary

My Cardiac Calcium Score

Needless to say, I was quite frightened when my cardiac calcium score came back as 1342.5! Here is a breakdown of each artery:

Artery	Cardiac Calcium Score
Left Main	0
Left Anterior Descending	555
Left Circumflex	155.8
Right Coronary Artery	631.7
Posterior Descending Artery	0

My Cardiac Calcium Scoring Breakdown

Lipoprotein (a) Level

Overview

#My-Calcium-score

The Lipoprotein (a) (a.k.a. Lp(a)) levels are determined via a blood test.

The following table summarizes Lp(a) levels and associated risk of coronary artery disease:

Lipoprotein (a) Range	Risk Of Coronary Artery Disease
<14 mg/dL (less than 140 nmol/L)	Lower
14-50 mg/dL (140-500 nmol/L)	Increased
> 50 mg/dL (greater than 500 nmol/L	Elevated

Lipprotein (a) Summary

My Lipoprotein(a) Level

My Lp(a) level was determined to be 166 nmol/L. Not nearly as concerning at my cardiac calcium score, but still, more elevated than desirable.

Heart Rate Monitor Interpretation

Overview

There are many types of heart monitors, but I was given a Zio XT monitor to wear for seven days. This monitor is simply a data logger, and has no means to transmit the data or alert anyone if an anomaly is found. After seven days, I removed the patch and mailed the patch to somewhere for analysis (e.g. to look for AFib).

My Heart Rate Monitor Results

I mentioned to the WakeMed cardiologist that I was going to run/walk a 5K on the upcoming Sunday. He suggested I hold off getting the heart rate monitor until the Monday after the 5K, right after my stress echocardiogram.

I later mentioned this sequencing to the UNC Rex cardiologist. He was surprised and said that the monitor should have been attached before the 5K, in order to measure the heart under stress. This shows the value of getting multiple opinions.

Fortunately and thankfully, the data recorded by the heart monitor showed that my heart exhibited no AFib over the course of those seven days. Later I will discuss a potential reason why my KardiaMobile 6L reported “Possible AFib.”

WakeMed Cardiologist’s Conclusions

TWS: calcium, family history, stress test-> stent

UNC Rex Cardiologist Visit

Interestingly enough between my initial consultation in the stress test the cardiologist said I was OK to run a 5K so I ran in the Carolina Hurricanes 5K on September 19. I didn’t push myself and walked every now and then, but I completed the 5K and definitely got my heart rate up.

So the day after that, I got the stress test and the next day in the golf course the doctor called me and said well it’s a low risk based on your genetics and calcium score. I believe we should put in a stent scheduler will be calling you.

Right at this time, the UNC Rex cardiology appointment was came up and so I pushed off the scheduler from WakeMed. He recommended a CT angiogram that where they inject die and can tell how much better understanding of blockages in the heart. At this point, I dropped a WakeMed doctor since wake me at cannot do the CT angiogram. I never really mentioned it.

CT Coronary Angiogram

Overview

So the CT angiogram is done and it turned out that my Widowmaker artery was more than 70% blocked. 70% is where they will do something like a stent versus just trying to control the cholesterol statins and perhaps diet.

Tom: Apparently stress can cause high blood choleterol

So that point he scheduled a cardiac catheterization on (of course) Friday the 13th of October. Last stroke of luck. Both of the boys were in town for us to go on a boom trip unfortunately had to cancel that trip but at least they were there to help Andrea navigate this situation.

Tom: Apparently stress can cause high blood choleterol

UNC Rex Cardiologist’s Conclusions

TWS: Due to >70% blockkage, time for cardiac cath. note we don’t recall him ever saying stent vs bypass.

Time For Cardiac Catheterization

Overview

With the cardiac catheterization a.k.a. cardiac cath, the cardiologist (at least in my case) puts a catheter in your groin and goes up in your heart and look around (a “look see” as the UNC Rex cardiologist described it). If the cardiologist confirms a blockage(s) > 70%, a cardiac surgeon would insert the stent(s).

If a stent(s) would not adequately rectify the blockage, a bypass would be required. Note that the room where the cardiac cath is performed is not a sterile surgical room, so a bypass would have to be scheduled.

My Cardiac Cath Results

So I went into the room and the cop. The cardiologist is there next to me and he put in the catheter which actually hurt a lot and then I could feel the contrast dye inside my body and then I woke up. It turned out that I had “coded on the table and they had to defibrillate me that’s pretty crazy at that.

Andrea met the cardiologist. He said, “Well we had a surprise. I don’t member the last time this happened.” and then he mentioned about me coding. It turns out that my left main artery is really narrow and the left main feeds two of the four main arteries in the heart, so because of this bypass was needed.

The Bypass Consultation

So Saturday the I was in the room and waiting for status update in the cardiac surgeon PA came in. She said that well you know it’s the weekend and I usually don’t do stuff on the weekends. Your vital signs are stable so because we have Buck schedule during the week. Maybe it’s a Tuesday or Wednesday you’ll get the surgery done.

Less than an hour later, the cardiac surgeon came in and said “I don’t like what I saw in those images. You might live this Christmas, but you will not lift next Christmas. How would you like to proceed quote parentheses I think he loves using that line parentheses. He actually scheduled the surgery for early Sunday so clear that showed the urgency of the situation.

To wrap up this conversation, the cardiac surgeon said, “Well, I’ll see you naked tomorrow morning on the operating table.” This clearly shows how confident the surgeon was, and that he had a bit of a sense of humor.

Surgery Prep

Needless to say, that was an eye-opener for us. So 4 o’clock in the morning Sunday morning I had to take a shower and then two female nurses shave my body so much for dignity then I was glad off the surgery and of course you go on a certain operating room. You see all the shiny stainless steel in the bright lights, and then I will send you were in the postop waking up feeling like crap.

Early Days of Post Op

So I woke up there’s some two IVs hanging out of my neck there’s three tubes going into a box coming out of my stomach for a drainage and how convenient the catheter for urine.

Tom, here mention the hallucinations.

Fortunately, I was in good enough shape or I could get up out of bed pretty early in the process San Jose able to get up to go to the bathroom by myself although I don’t need to for the first few days obviously unless I could get up to my car and legs are in good shape which I am thankful for this is what I had planned for.

I was quite fortunate that I didn’t lose my appetite. My mom and a good friend of mine had heart attacks and after the surgery everything tasted like metal and they had no appetite at all. I was frustrated at the time with my mom and she couldn’t eat, but now I feel kind of bad about that.

So on Tuesday while someone was visiting me, my heart went into a fib, and my pulse rate went really high just kicked off another battle. I was put on an IV of amiodarone and to hopefully change my heart to get back to normal sinus rhythm.

Latter Days of Post Op

So on Wednesday, they hooked up the box and on the walker, and I took my first steps after the surgery. It was quite painful to get up with those three tubes in my stomach. Everyone kept saying things would be much better once those tubes came out, and they were correct, thankfully.

Tom here put how awesome and it was

So Friday or so they put me on oral version of amiodarone two get my keep my heart out of a fib in Normal Sinus Rhythm. So we went home Saturday afternoon and.

Home Again! (Spoiler Alert: Not For Long)

Because of the fact that they cut my chest wide-open I had to I have to sleep on my back until like eight weeks so that the bone heals. When I got home Saturday night, I tried to sleep on the bed but we couldn’t get the pillows comfortable enough, so I ended up going in the recliner in the bonus room.

So about 115 or so. In the morning I woke up. My heart was really beating really badly or hard whatever and much Danny Dries Shukri and I went downstairs and got my KardiaMobile device and also took my blood pressure and everything was OK. Early that early in the morning Andrea came by and put her I watch on me and it turned out that I was in a fib my pulse is in the one teens.

I went downstairs and got my KardiaMobile device and it also noted possible a fib which validated the Cardia mobile device in my mind. I called the doctor hotline and they sell out and Sunday go to the emergency room and they will they will take care of you and hopefully get into the heart and vascular Hospital.\

So they kept me on amiodarone IV for a few days and then move me to an oral tablet. On Saturday they sent me home with a tapered load of amiodarone right now. I am at one pill for the next week and a half or two weeks.So they kept me on amiodarone IV for a few days and then move me to an oral tablet. On Saturday they sent me home with a tapered load of amiodarone right now. I am at one pill for the next week and a half or two weeks.

Emergency Room Fun

The weekly drive, but this point my blood pressure oh sorry my BPM was in the 130s every now and then that was getting kind of scary so I went to the hospital ER and saw those sick people in emergency room waiting room. Luckily Rexis as a chest separate chest area and they said go sit in that chair and very quickly I was on the table getting an EKG done

So I was led to the little cubby in the ER and talk to some other doctors and nurse doctor nurse there at that point he really wanted the heart doctor to take over but the protocol is the ER doctor owns everything so after about noon they put me on an IV of amiodarone and six hours later at 3 PM. Luckily a room opened up at the six floor where I was earlier I was in room HP 6018 this time versus a three 6024.

They are we met an awesome nurse named Helene that Andrea ended up printing on the Facebook. At 5:44 PM on that Sunday the 22nd, my heart went back into normal sinus rhythm.

Second Stint On The Sixth Floor

Should I Have Known Much Earlier?

Looking back, I was experiencing issues that would indicate heart disease, specifically a lack of stamina. I have run off and on for several years, including numerous 5Ks and three half marathons. The last few years I have been battling foot issues, but have managed to run a couple of miles every five days or so.

I noticed that my runs were more of a struggle, and I had reverted to a run/walk approach. I simply rationalized it as, “well, I haven’t run a lot lately. I just need to build up my cardio.” I now believe this was a missed clue on my heart issue. I never had chest pains worthy of concern.

Another things I should have considered is the fact that both my father and mother had heart attacks at the age of 71. Sadly, my father collapsed and died from a heart attack March 21 of 2000, and my mother had a heart attack (and really miraculous to have survived) in July 2000.

The medical community did not consider 71 as a young age to have a heart attack, and thus did not put me in a higher risk for CHD. I in fact had a stress test in 2001 or so (out of my own paranoia that some light-headedness was a sign of something going on with my heart), but nothing was found. I had also tweaked my diet for a while, but eventually reverted back to my not-so-healthy diet.

What’s Ahead

Now I am eating a heart healthy diet, walking a couple of times a day, and trying to drink a lot of water. I am looking forward to cardiac rehab starting in late December!

Please subscribe to my blog so you can find out when I post updates to my blog.

My goal is to continue describing my experience in the hospital and what to expect, educate folks on cardiac health, and perhaps motivate people to adjust their lifestyles to avoid going through what I am going through.

Stay tuned for updates! Did I mention to subscribe? 🙂

Future Content: Describe a heart-healthy diet, give example of protein bars instead of hot dogs backfiring, fake meat being unhealthy

The USDA recommended daily allowance is 20 g of saturated fat. However, a heart-healthy diet limits the intake to 15 g. For both diets, sodium intake is recommended to be 2300 mg, which is roughly a teaspoon full of salt.

Hospital Highlights (future blog?)

As I mentioned earlier, the nursing staff was just incredible
My cardiac surgeon was “quite confident,” which left me and my wife feeling as comfortable as could be expected for such unchartered territory.
The food was better than expected.
My wife had a surprisingly comfortable bed (conversion from couch) to sleep in so that she could help me out.
The nursing staff didn’t really make a big deal if there more than the limit of two guests. (Except in post-surgical ICU)
A personal note, but the hospital was only a 13 minute drive from our house, the parking was easy and my wife always felt safe.
The rooms were quite large and comfortable.

Hospital Lowlights

Post-surgery, I was getting my finger pricked 3-4 times a day to check my glucose. Apparently insulin given to me during surgery is the reason.

Tom mentioned the horrendous rash earlier

Grinding pumps make annoying sound
Can I cross feet? Thought
Thoughts of cardiaversion not working and life on meds
Thoughts of me being hypocrite when talking about mom and no appetite
Bumping button
Drop glasses
IV
Light in bathroom
Tall nurse raised bed, bed locked. Could not raise or lower back of bed
Iv under wheels
Air bubbles in line a couple times
Bag emptied quicker than nurse thought it would, causing tubing to be flushed
Realized appetite gone during the night and probably gone for months
Someone came in and ddint re close curtains
Surprise X-ray
Nurse tech gave me water during npo
Constant movement of sheets over leg to regulate comfort
Probably slept no more than 15 minutes in any setting. Maybe 4-5 total
Pillow partially came out of pillowcase that I was using to block bathroom light, which hit face and annoyance that needed to fixing in
Realized there were so many opportunities for me to pick up on this

Here’s what ChatGPT came up with:

Here’s a refined version of your hospital experience lowlights, suitable for a personal blog, patient experience section, or advocacy site. The tone is respectful, honest, and reflective—conveying discomfort without being overly negative:

Hospital Stay: A Candid Look at the Challenges

While I’m deeply grateful for the care I received, my hospital stay came with its share of difficult moments. Here are some of the less-than-ideal aspects that made recovery even more challenging:

Frequent Finger Pricks: After surgery, my glucose levels were tested 3–4 times a day—apparently due to insulin administered during the procedure. It added unexpected discomfort to an already taxing recovery.
Persistent Rash: One of the more aggravating issues was a severe rash that developed—an intensely uncomfortable and distracting side effect.
Environmental Discomforts: The constant hum and grinding of medical pumps made rest difficult, as did a bright bathroom light I tried to block using a pillow. At one point, the pillow slipped from the case, letting the light hit my face—a small annoyance that felt huge at 3 a.m.
Bed Issues: A tall nurse raised my bed, then locked it. I couldn’t adjust the back or get comfortable. Meanwhile, an IV line ended up trapped under a wheel, adding frustration and risk.
Air Bubbles and Fast-Draining Bags: On multiple occasions, I noticed air bubbles in the IV line. One time, a bag drained much faster than expected, forcing the nurse to flush the tubing.
Disrupted Privacy: A staff member entered the room and left without re-closing the curtains, compromising my privacy and peace.
Physical Discomfort: Sheets were constantly adjusted over my legs to try to regulate my comfort, but nothing helped. I probably didn’t sleep more than 15 minutes at a stretch—4 or 5 hours total during the stay.
NPO Misstep: Despite being on NPO (nothing by mouth), a tech gave me water—potentially dangerous if not caught in time.
Unexpected Procedures: I was surprised by an unscheduled X-ray, with no clear explanation given beforehand.
Mental Strain: I found myself dwelling on whether a planned cardioversion would work—and what life might look like if it didn’t. I also struggled with thoughts about being a hypocrite, remembering how I judged my mother for her lack of appetite—only to realize I had no appetite myself, and might not for a long time.
Physical Mishaps: I dropped my glasses, bumped the call button by accident, and questioned simple things—like whether I was even allowed to cross my feet. Each small incident added to a growing sense of vulnerability.

Through it all, I became keenly aware of how many moments I could have tuned into more closely—missed opportunities to advocate for myself or just acknowledge what I was feeling.

What Should You Do NOW?

Test link here#My-Calcium-

score

FAQ

Did I see a light when I coded during the cardiac cath? Answer: At first I was saying no. However, I recalled that during the procedure I was under “Conscious Sedation.” In this state, I could respond to requests during the procedure, but at the end of the procedure I would have no recollection of the procedure. So in theory I could have seen light, but due to the nature of the sedation I was under, I’ll never know!
What is the official name of the surgery I had? Answer: Coronary artery bypass graft surgery, or CABG. Pronounced “Cabbage.”