I’m 46 years old, never smoked, never done illicit drugs. I eat everything and enjoy food, but consume in moderation. I enjoy pastries, ice cream, and chocolate but partake only a couple times a week and nowhere near the amounts I used to consume in my teens & 20s. My BMI is 22.9, nowhere near overweight, and close to being in the best physical shape of my life. And yet, I just had a heart attack a couple weeks ago.

After going through my 30s in typical tech-life fashion, I found that I had gained 20 pounds and lost muscle. I remember one day when I was 38, I was putting on pants and the waist felt tight. Again. Through college my pant size was 28/29, but over the years that crept up to size 30 then 31. I refused to go up to size 32 and decided to do something about it. We changed our eating habits and joined a hot yoga studio, attending twice a week. Within a year I lost 20 pounds and had dropped my pant size back to 29.

I started to lift weights regularly to gain strength & muscle. This became a regular habit over the years even as I moved homes & jobs multiple times. I continued to lift two or three times a week and, in the months before COVID-19 shelter-in-place, attended Rumble Boxing once a week for intense boxing-style strength & cardio. I liked the variety, and it’s just fun to punch a heavy bag (it is surprisingly taxing). I could bench press 120% of my bodyweight, deadlift 180%, and squat 130%. I could do four sets of 10 pull-ups in a work out session. Even confined at home, I continued to exercise with my set of adjustable dumbbells, kettlebell, and pull-up bar. I had never felt physically better than I have in the past year.

Almost three weeks ago I was working out and felt more winded than expected. I had eaten a large meal a couple hours previous, and I felt like I had bad indigestion. I cut my workout short and went upstairs to sit down and prep for an upcoming class that I teach at CMU Silicon Valley – remotely, of course. My wife said that I was sweaty and didn’t look good, and I told her I felt a bit nauseous and felt this pressure under my diaphragm. About 90 minutes later, as I worked at my desk, I found myself opening my eyes and coming to with my wife holding my head, screaming my name. I had fainted, face-to-keyboard, and was out for 10 to 15 seconds. I felt like I had just fallen asleep. She called 911.

Because of the COVID-19 situation and the fact that I was awake, lucid, and didn’t feel particularly in distress, we decided not to go to the emergency room. We consulted with a couple doctors over video and, after reviewing my condition, we all thought it was gastrointestinal. I felt nauseous but not particularly in pain. I was able to walk around without getting dizzy. Over the next couple hours I threw up what remained of my lunch and felt a bit better, though my blood pressure was elevated and I started running a low-grade fever. We did another telemedicine session before going to bed, and they also came to the same conclusion based on my symptoms, general health profile, risk profile, and family history. I decided to take the next few days mostly off from work, though I had a final class to teach the following evening that I decided to continue with.

Over the next few days I felt some slight pressure in my abdomen, had fluctuating but higher-than-normal blood pressure, and an ongoing low-grade fever. We had been reading some reports of COVID-19 infections that manifested themselves with similar gastrointestinal symptoms, so I got tested that Wednesday at a drive-through testing facility. I took it easy, and by Thursday felt mostly normal. I worked half a day and then worked a mostly normal day that Friday. Saturday morning I got my test results back - negative.

Though I felt mostly normal, it was still a mystery, and my wife wanted to rule things out before I went back to life as normal. We consulted with doctors again and got a referral to see a cardiologist for a stress test. Because of the COVID-19 situation, just getting the appointment scheduled was itself an ordeal and took a few days to even get through to the right people. We finally got it scheduled for this past Monday – two weeks after my initial incident. I had been back to living normally the previous week, working normal full days, walking the dog, eating & sleeping regularly. Nothing felt out of place, though I would say I felt 95% rather than 100% normal.

I was scheduled for a stress echocardiogram, a heart imaging technique using sound waves, so on Monday I went to the cardiology lab. They placed a number of electrodes on me in preparation for the stress test and had me lay down on my side for the echocardiogram. I had no idea what I was looking at, but I could tell that it was my beating heart on the screen from various angles. I could also tell that the technician was seeing something unusual, just based on the things they were doing. I asked if there was something unusual. “I’m just the one taking pictures, the cardiologist will be able to tell you more.” Okay, so clearly there was something out of the ordinary.

They stepped out briefly, and when they came back, they said that the doctor had decided to do a full echo, rather than a partial, and were going to forego the stress test. Clearly something was off. When the cardiologist came in to review what they had seen with me, they said that there was some abnormal function in my left ventricle. They pointed to the screen where a looping video of my heart was playing and described how the valve and the part of the heart around it seemed to beat properly, but the bulbous part was barely pumping. This needed to be looked at, obviously. They recommended that I follow up with a cardiologist and that they would be sending me the detailed results of my echocardiogram later that afternoon.

This was not what we were expecting to hear – this was meant to rule this out, not confirm something. My wife’s instincts were correct, though she was obviously not happy about it either.

We got the report and discussed it with our doctors who were quite surprised – it was unexpected. A friend got us in touch with a heart surgeon friend who also took a look, and they were the first one who said that this suggested that I had had a heart attack, though a detailed examination with a cardiologist should be able to confirm. We were able to get an appointment the next day with the same cardiologist who had reviewed my echo.

I went to bed for the first time knowing that I may have survived a heart attack. Really?

The next day I took a couple meetings at work that I felt I wanted to take and had time for, and everything frankly felt normal. My appointment was mid-afternoon, and back to the cardiologist I went. We did a detailed electrocardiogram (ECG or EKG, a procedure that records the electrical signals in your heart), and the cardiologist confirmed the suspicions from the day before – I had suffered a heart attack, and there was damage to my heart muscle. It’s unclear why, and given the various options for next steps, the gold standard was to do an angiogram – a procedure where they insert a catheter into the heart to inject dye which allows x-rays to see your blood vessels in detail. The doctor said it was likely that at least one of my coronary arteries had a partial or complete blockage that caused the heart attack. Given that here I was, more than two weeks later, feeling mostly normal for some reason or another, suggested that I wasn’t in immediate danger, but it was prudent to move quickly. We were able to schedule a procedure with a surgeon the following morning. A silver lining of the COVID-19 situation is that hospitals are doing far fewer procedures than normal, so schedules were loose. I was going in for an angiogram and potentially angioplasty to open up the expected blocked artery the following morning. I got four new prescriptions to address my newly confirmed condition, and we picked them up on the way home from the hospital. Things were moving fast.

Telling family & friends that day that I was going in to get heart surgery because I had survived a heart attack a couple weeks ago was as shocking to everyone as you might expect. Variations of “WHAT?!”, “Holy shit”, and “OMFG” were common reactions.

I slept fine for the first half of the night, but woke up before sunrise and was in and out of sleep until the alarm went off. I couldn’t eat or drink anything and missed my morning latte terribly, but today was obviously an exception.

We went to the hospital and found out that my wife wouldn’t be able to wait for me inside the hospital. New evolving procedures due to COVID-19 were understandable but disappointing. It was difficult to say goodbye in the lobby after checking in. Here I was going to the hospital for heart surgery, and my wife had to wait elsewhere. Fuck this pandemic.

The staff, nurses, and doctors were amazingly professional and empathetic. I felt about at ease as you could under the circumstances. Side note – almost all the nurses I encountered were Filipino. Even though we are only about 1.4% of the US population, 20% of the nurses in California are Filipino. I was shown to my prep room where I changed into my gown and socks before getting onto the hospital bed. I got tested for COVID-19 again, as per new procedures, but the rapid version this time where they can get results in ~15 minutes. It came back negative. I got blood drawn, an IV line put in, and an uncomfortable leg & stomach shave around the groin area in case they had to go in through there instead of the wrist. When they said I was about to get wheeled into the operating room, I texted my wife one last time, knowing that there was a small chance I wasn’t going to make it through the next hour or two. I felt sad but had no major regrets, even though I knew that she was crying in the parking lot.

The procedure is a marvel of modern science. What used to be major heart surgery is now an outpatient procedure, meaning it no longer required an overnight stay at the hospital. A catheter was going to be inserted into an artery in my wrist or groin, then to my heart, while I would be lightly sedated but conscious throughout. If needed, stents would be placed in the affected arteries to improve blood flow.

They started. The sedative started to take effect, making me feel every so slightly out of it. They had removed my glasses, but I could see blurry images on the screen of things moving around. I remember answering some questions from the doctor and nurses, but otherwise I was a partially disinterested witness to my own surgery.

When it was over, they wheeled me back to the prep room. I asked for my phone and texted my wife, “hi”.

It went about as smoothly as we could have hoped. They were able to go in through my wrist, so my asymmetrical shave was an unnecessary fashion statement. They found that my left anterior descending artery (LAD - also known as “the widowmaker”) was 99% blocked and put in two stents, wire mesh tubes, to prop it open. Now I just had to recover under observation. The procedure risk at this point was internal bleeding, especially around the entry point, so a pressure cuff was put on my wrist. It hurt and made my hand partially numb. Over a period of a few hours they were able to relieve the pressure and remove the cuff. I was instructed to act as if I had broken my arm for the next couple days to give the wrist time to heal completely. After a test walk in the hallways, they declared me fit for release and wheeled me out where my wife was waiting for me. 10 hours after I walked into the hospital, I walked out.

Seeing her and giving her a hug made it real. I thanked the nurse and gladly got in the car for the ride home. I felt relieved. Family, friends, and colleagues were also glad to hear that everything went well and that I was on the way home. It was surreal to think that here I was, 46 years old, in otherwise good physical shape and in good health, driving home with a couple stents in a coronary artery after heart surgery because I had a heart attack over two weeks ago. I mean, WTF.

I am thankful to all my loved ones for being there for me and my wife throughout this ordeal. I deeply appreciate the doctors, nurses, and hospital staff who were professional, empathetic, and diligent in doing their work – I wouldn’t be here recounting my story if it weren’t for them doing their jobs. And I feel lucky to be working for Google – my boss, colleagues, and team have been nothing but supportive and encouraging me to focus on my health. Thank you, thank you, thank you.

I’m sharing my story for a few reasons. One, I think it’s mine to tell and it blows my mind that I lived through it. Sharing it this way allows me to tell my broader network of friends and community that I survived an event that many don’t, and I’m glad I’m still around and kicking. Two, it’s a cautionary tale – even though I’m healthy and otherwise don’t have the usual risk factors, I still had a heart attack and didn’t even know it. It could have been nothing but shitty luck, crappy genes, or maybe my general health is actually what prevented this from being worse than it is. Who knows, and hopefully we’ll get more answers in the upcoming weeks as I do my followups. There’s a good chance that I can get back to a normal life, but there’s also a chance that there’s some long-term effects that require substantial lifestyle changes. We shall see. Three, hopefully it’s a reminder to someone out there to take care of themselves a little better, hug a loved one, or give them a call. If you’re a friend and we haven’t talked in a while, please reach out. It would be good to hear from you. Four, it’s an attempt to demystify and destigmatize this. It can happen to anybody, even the young(ish) & healthy, but I’m living proof that it’s survivable. As that peasant in Monty Python and the Holy Grail said, “I’m not dead yet!”

I am at home recovering, not working, and trying to stave off boredom. If I didn’t know any better, there’s no way I would be able to tell that I am recovering from heart surgery right now. In fact, I feel better than I did earlier in the week. I can’t wait to get back to living my life, exercising, working, walking the dogs, and hopefully eating things in moderation. My wife & I appreciate having each other even more, and my dogs still make me laugh. I’ve got books, TV shows, movies, and video games to catch up, and I’ve got some home improvement projects waiting for me.

Stay healthy & stay well.