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Okay, now that I’ve updated you (probably ad nauseam) with my back and knee surgeries, I’d like to share with you what’s really on my mind. (I know. aren’t spinal fusion and total knee replacement surgeries enough?)

Imagine you’re me in the pre-op waiting room getting ready for knee replacement surgery. You have to get there two hours before surgery, most of which is spent just waiting interspersed with the occasional person who comes in and pokes you with something sharp. It’s a very stressful situation. You’re worried about the surgery. You’re worried about pain and recovery. You’re worried if your new knee will work as it should. You’re just generally worried.

The surgical center I chose has an internal medicine group that monitors your overall health while in the hospital. They come in during this pre-op time to discuss any concerns and let you know that they will be part of your medical team.

In this case, I had a very pleasant lady MD who reviewed my current medical conditions (including RA and Sjogren’s) and what health aspects would be monitored during my two-night stay at the hospital. Then she asked me when I had my heart attack.

Excuse me?

She said that my electrocardiogram submitted with my medical clearance showed a Q wave. A Q wave is basically the lack of electrical activity in the heart and this is normally caused by scar tissue (which does not conduct electricity) that is formed as a result of a myocardial infarction, i.e., heart attack. The EKG had been faxed so the information wasn’t very clear, but it clearly stated a Q wave was present.

Of course I was just trying to catch up on what a Q wave was and (on top of worrying about everything else) digest the fact that I might have a damaged heart and/or a condition that could be conducive to future heart attacks.

She went on to say that this appeared to be an artifact — which is evidence of a previous heart attack, not something that was occurring during the EKG. She went back and pulled my medical clearance from April when I had my spinal surgery and the same Q wave was also on that EKG.

She did go on to tell me that a Q wave associated with certain leads of the EKG are normal but because of the quality of the fax, she couldn’t be certain of which lead was associated with the issue. However, she encouraged me “strongly” to see my cardiologist to get checked out once I was recovered enough after surgery.

I honestly don’t remember having a heart attack, but I’ve also heard of mild or silent heart attacks where people don’t even know they’re experiencing one. I can think of a couple of times in the past year or so when I’ve had symptoms similar to those associated with “silent” heart attacks.

And of course, there is the whole RA-cardiac connection that is gaining more and more recognition in the medical community.

She also pointed out that my cholesterol was extremely high and I needed to discuss this with my PCP or cardiologist after surgery as well.

On one hand I am just reeling from all this news. On the other hand I am really upset with my PCP who did not proactively discuss this information with me prior to my finding out about it from a complete stranger.

But then they came in to give me happy juice and roll me into surgery so I didn’t have time to really process everything then.

I am hopeful that all of this is just a combination of a bad fax copy and an over-zealous internist. But just in case it isn’t, I have an appointment with my cardiologist next week. He will be able to take a new EKG and immediately see what’s going on. And if there is any question, we can do a stress test or other diagnostic procedures and really figure this all out.

In the mean time, I have one more, potentially serious, health issue on my mind.


I appreciate you letting me vent all this stuff. I’ll be sure and let you know what the cardiologist says. Thanks for checking in.