For September 2004


September 16th, 2004 

Heart Attack

 At 6:00 AM on Sunday the 12th of September, suddenly, like a switch, began an ache in my chest. It was like a tooth ache feels, about a 2 or 3 on a 1-10 scale of pain. Annoying, but not sharp or horrible. In seconds, it spread to my neck, my entire jaw, and ran as two thin strips of ache down the back of both of my arms at the same time. I did not feel particularly afraid, which is very strange considering I have fairly severe panic disorder.

I began to sweat, and my stomach felt upset. I began to wonder what was happening to me, and initially worried that this might be a heart attack, but because I had put my family through two previous runs to the hospital fearing such a thing -which turned out just to be a panic attack- I was afraid of 'crying wolf' yet again.

The ache lasted. Nothing cured it. Taking antacids did not help my stomach. I thought maybe it was all just cramping muscles from sitting in my chair for so long. Stretching my arms did not help. Massaging my jaw did not help. Changing position did not help. I went to bed. It was way past my usual bed time of 4am.

In bed, the ache went on. Sandra woke up and noticed my distress and asked if I wanted to be taken to the hospital. Afraid again of causing a fuss for nothing, I refused. The ache lasted all night as I tried to sleep. After a few Tylenol-codeine pills, I got a little sleep.

The next day, the ache continued. I took a warm shower, thinking it was muscle pains again. It did not help. Dinner went by. The ache remained. Finally, I gave in. Finally I stopped being an idiot. Finally I agreed to go to go see a doctor, the next day, on monday.

My doctor did an EKG, and immediately sent me across the street to St. Peters. I had had a heart attack, no question.

Being a Catholic hospital, I knew that the fact I am lesbian, and the fact that I am a transsexual woman, could potentially cost me my life, but I had no other place to go. I told them Sandi was my sister, a story we stuck to throughout my stay. I let them assume that I was on hormone replacement because of a hysterectomy. After many tests, some repeats, it was confirmed again; definite heart attack.

I was put up in room 1023, wired up to a portable EKG machine, various medicines began to drip into my arm, and thus an ordeal began.

Sandra stayed with me, she never left me alone throughout the stay, she slept on a cot at the foot of my hospital bed, and held my hand when I tried to sleep. Eldenath relieved her when she got off of work, giving Sandra precious time to go get some decent rest, a shower, and food. Stephen called regularly from up north where he works weekdays at Microsoft to help us survive the Great Bush-Haliburton Depression of '04. I have a marvelous, loving, wonderful family. This is how loving spouses care for each other.

Long story short, they stuck a catheter up the femoral artery in my groin, all the way to my heart, where I, awake and alert, watched them squirt x-ray contrast dye into my arteries. The result? Very, very strange.

It turns out that I have no evidence whatsoever of plaque "I don't see any sign of plaque buildup at's all perfectly clear...there must be some there...but...I'm just not seeing any.." said my cardiologist. "Now this, here, see" he said, indicating one of my arteries "I've never seen anything like this before..."

The heart has three major arteries that feed it, running over the outside of the muscular pump. One runs right down the middle, and the other two branch off like the letter 'T' to the left and right, curving around the heart. From these major arteries branch off smaller and smaller sprues which feed the heart muscle with blood.

The arteries running down the middle of my heart, and around the left curve of my heart were wide and clear and normal. But the artery curving around the right side of my heart is bizarre. It starts out normally, wide and open, but then terminates like a finger of a rubber glove in a dome, from which comes a tiny, thin, miniature continuation, a small miniature of the artery, only 30% of the diameter it should be. It runs this way thereafter, the remainder of it's full length. It may be a mutation, or a malformation of development, but whatever it is, apparently I have always had it. It must have become blocked somehow, either through being plugged, or from spasming closed, since there is no sign of any problem anywhere else in my heart.

The fact I had a heart attack at all is unusual to begin with. I have low cholesterol, low blood pressure, I do not smoke or drink or do drugs, I have a family genetic history that is not a high risk for heart disease, and I my only real traditional risk factors are that I am slightly overweight, and I live a sedentary life that orbits my computer and game machines.

The doctor was stumped. "I can't do anything about this...thin artery...because I don't even have a stent that small, and if I stuck anything in would probably do more harm than good". So that ended the catheterization.

The decision was to give me 24 hours of serious blood thinners and platelet busters, to clean out any potential unseen clogs somewhere in my body. There was nothing to directly treat.

I was released soon after. The final verdict? My heart attack was very mild, and perhaps the damage to my heart was about 1% - 2% overall. It is not impossible that I may have lucked out and merely had damaged heart muscle and not actually dead heart muscle in that one to two percent, which means that there is at least a chance that my heart could recover completely. As much as a heart malformed to begin with can recover, anyway.

Even then, there is hope: such stress on the heart often initiates angiogenesis, and new blood vessels can grow into and over the damaged or stressed region. If I am very, very fortunate, I may end up with some improvement to that malformation, if new blood lines spring up to cover for its inadequacies. Time will tell.

Even so, a heart attack is not a good thing, and I have to be careful, and take things easy, and gradually heal up...I have been harmed, and I know it. I can feel it.

One thing that bothers me is the medication shoved at me to take post-hospital. A raft of five drugs, all of which are pat, standard post-heart attack medication, but most of which simply do not apply to me. An expensive cholesterol reducer, with some nasty potential side effects, when I already have better than average cholesterol levels. A blood pressure reducing agent with the nasty side effect of the potential of inducing a heart attack if it is stopped at a later time, when already my blood pressure is low, especially for my age. Worse, it is a nitrate compound, and I am mildly allergic to nitrate compounds. Beta blockers, which also lower blood pressure, as well as slow the heart, but which can have nasty side effects which my Stephen made a special phone call just to warn me about "I took those things and I just felt terrible, they really messed me up...I would really think twice about taking those, Jenny", which again treats a problem I simply do not have.

Two of the medicines make sense. One is a bottle of nitroglycerine tablets, in case I start to have heart problems again. This old, standard emergency medicine opens vessels fast, providing help to an ailing heart...basically emergency insurance in case of another attack, or angina.

The other medication is a platelet medication that reduces clotting. Seems wise, and reasonable, a continuation of the treatment I received in the hospital to 'clean out' any unseen clots. Might as well go the course, especially since there are no terrible side effects from taking it.

But I am left with a problem, of course, which is whether to blindly follow the textbook, stock raft of medication for my unique, non-textbook problem (and to face some potentially dangerous, even fatal side effects), or to literally take my life into my own hands and pick and choose what I believe fits my situation correctly. In the current age of factory medicine (get 'em in, move 'em through, charge 'em high) where the total time my doctor afforded me was certainly less than one hour over all (most of which was taken up with the catheterization procedure, he spent less than five minutes actually talking to me otherwise), combined with the obvious oddness of my situation...what would you do?

I think I will continue to research these drugs more, continue to get the opinions of my family members, and ultimately choose what I rationally consider the best course for me. There simply is no longer any time, even at the best hospitals, to individually consider any patient. Our family has seen so many of our relatives seriously fucked up by this problem, by blindly assuming doctor-knows-best. I don't think I want to be an additional tragedy story. So I am, with the help of those I trust, going to take some responsibility for my own recovery and treatment.

I wish medicine in America was not like this. I wish I could have doctors who were not only highly ranked (as mine was), but who could take the time to individually study my case, and work out personalized and appropriate medical choices just for me.

But this is not the case.

I hope I am clever enough to make the best and most correct choices here. They seem pretty obvious and clear...but I will continue to research. In the mean time, I am only going to take, I think, the anti-platlet drug for now.

And I will keep that bottle of nitro near me at all times.

So what do I think caused my heart attack at a young age?

I think too much stress and anger and depression, over too many years, released too much cortisol and put too much stress on my body. With cortisol potentially roughing-up my arteries, a potentially stress lowered immune response, and a tendency to ulcers (heliobacter is considered a strong factor in heart disease and heart attacks in Europe, if not in backward America, since the bacteria, or the bacteria that inhabit the gums is always found in arterial plaque) combined with my deformed heart artery to create a critical situation.

I got worn out, overly worked up and upset, and something somewhere broke loose. It was probably a microscopic blood clot that had formed around an inflammation in a vessel somewhere in my body. I suspect the clot jammed into that narrow mutant artery, and plugged it most likely only partially, or the damage would have been far, far more than only 1 to 2 percent.

Alternatively, I just got too tired and worked up, and that little narrow artery spasmed. It had a 'charley-horse' happen, and clamped partially shut.

Now this makes sense considering that earlier that day I had gotten overly angry at some stupid stuff, overly excited playing a game with Stephen (to the point I had to stop because of odd feelings of being ill) and then stayed up too early in the morning being overly excited playing the Warhammer 40K demo which had just come out (excellent game, by the way). Just too much, in one day, for a person who has been absolutely pissed off for the last 14 years or so.

I need to just...let stuff go. The concept of being 'heartbroken' is literally true, I think. I have to let go of some stuff that happened to me, and learn to keep myself calmer, and happier, overall. If I want to live.  And I do.


Obviously, there is going to be a severe interruption of the comic for awhile.




September 10th, 2004 

Pacing Is Vital

 Burnout is always a danger in any large project, and it is greater, I think, the more is demanded of the artist in question. I have had to take almost two weeks now off from Pastel just to be able to function. I have not even wanted to look at it, or the Forum in that time. Which is probably the way to do such a break, actually, complete dissasociation for a while. I am feeling better for it, and as can be seen, a new page has just gone up.

I often imagine how very much easier it would be if I had chosen to do my next project as a nice, easy to whip off every day black and white cartoon, rather than a comic that essentially demands of me the equivalent of an gallery-quality oil-painting every day in terms of labor. Which is not to say I think my petty painting is gallery-quality, rather that the work I put into it is the same as that I remember from my oil painting days, or my acrylic painting days. Basically, it is a lot of work to do each page! I miss good old easy black and white lines!

And this makes me feel quite ashamed for my final ten pages or so of Unicorn Jelly, in the Epilogue, actually. Nearing the end of my 666 pages of Unicorn Jelly (Hee Hee!), I was so very worn out that I rushed the last few pages. I am to this day unsatisfied with my work there, frankly it needed about ten more pages to flesh out the ending of the epilogue, to give some better indication of what was going on. The information is there, but it is entirely too terse, too demanding of the reader. Shame on me. Still, it felt like pulling teeth to draw anything at that point, but looking at it now, from my current perspective, I have little pity for myself back then.

But then, back in the Unicorn Jelly days, I never took breaks. I missed doing my comic only because of illness, or because I had no choice, as in my family went on a trip that I was expected to participate in.  I drove on relentlessly, so perhaps it is no wonder that I crashed out nearing the end of over 600 pages (not to mention the reams of supplimentary materials!) having been so merciless with myself.

Not so with Pastel, I think. This time around, I intend to take breaks when I need them, and not try overly hard to prove myself insanely dedicated. Insane I may be, dedicated I certainly am, but the two states are best kept apart, or so I am thinking now.

So, if I take the odd hiatus, it will be to keep my pace, to prevent stumbling and faltering in the telling of the story, so that -hopefully- the ending to Pastel will be of the same quality as the beginning and middle, and not suffer because of my own suffering.

And that is the story of that.




By Jennifer Diane Reitz

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