Settling In

Rejoice in the Lord

God never moves without purpose or plan

When trying His servant and molding a man.

Give thanks to the Lord though your testing seems long;

In darkness He giveth a song.

Chorus:

O rejoice in the Lord, He makes no mistake.

He knoweth the end of each path that I take.

For when I am tried and purified, I shall come forth as gold.

I could not see through the shadows ahead;

So I looked at the cross of my Saviour instead.

I bowed to the will of the Master that day;

Then peace came and tears fled away.

Now I can see testing comes from above;

God strengthens His children and purges in love.

My father knows best, and I trust in His care

Through purging much fruit I will bear.

Ron Hamilton

Job 23:10 But he knoweth the way that I take: when he hath tried me, I shall come forth as gold.

It was about 12:30 when I was brought to my room. The nurses were so helpful. Nurse Ashley went over to the OB department and got bottles, formula and blankets for Michael. She also  brought in an electric breast pump and helped me with that. Of course all the milk had to be dumped because of the strong meds they were giving me. I still had hopes that I would be able to nurse again, so I wanted to keep up my supply of milk. Dr. Prya was in and out all afternoon. My gums were bleeding a little. She seemed concerned about that. I guess with such strong blood thinners they have to keep an eye on things like that. They also kept checking my arm where they had gone in with the catheter. Since they went directly into the artery they had to watch for bleeding. A very tight band was around my wrist. As the day went on they started loosening it. It was very sore. I was told to use that arm like a broken arm. Sometime in the afternoon I overheard Ashley telling Edward it's good we went to the hospital right away because it would have been lethal... I felt completely helpless. My head was still throbbing. Everything was spinning out of my control. I could do NOTHING to help myself. I was flat on my back, not even allowed to get up to use the rest room. Of course we are never in control of our lives, but when everything is going well it sure seems like we're in control. That realization was driven home like never before. My heart might do anything - like stop or whatever - and I could do NOTHING about it. It was such a helpless feeling. All I could do was lean on the Lord. That was when the CD that was given to Irene became such a blessing. You know how songs sometimes get stuck in your brain? Well, the phrase that was stuck in mine and was going over and over was "O rejoice in the Lord He makes no mistake". We were in shock, but God was not surprised. This was no mistake or surprise on His part. He has a reason for allowing everything that happens. We just are not able to see or understand all of it. I think of a song an older preacher used to quote.

1. Not now, but in the coming years,
   It may be in the better land,
   We’ll read the meaning of our tears,
   And there, sometime, we’ll understand.
• Refrain:
  Then trust in God through all the days;
  Fear not, for He doth hold thy hand;
  Though dark thy way, still sing and praise,
  Sometime, sometime we’ll understand.

Edward called our parents in PA to tell them what had happened. He was also in contact with Dave Grices who were overseeing the rest of the children. They came to the hospital that afternoon bringing Irene with them. She would stay with me overnight. We had decided it would be best for Edward to spend the night at home with the children rather than with me in the hospital. It would bring some normalcy to their lives. Dave shared some scripture with us and prayed before they left. That meant so much.

And what was happening with the seven children we left at home when we rushed to the emergency room? I will let Irene do the next post about that.

Creighton University Medical Center

In my last post I left you with Edward and Annetta with Baby Michael on the parking lot. I had not fed Michael yet, so the first thing they had to do was go to Walmart and get a bottle. We had some sample formula at home that the hospital had given when he was born. The children had been begging to feed it to the cats, but I had not let them. There was this thought in the back of my mind that we should keep it for a while in case we need it.... After getting the bottle they went home. Edward was still in his everyday clothes, so he wanted to change before going to the hospital in Omaha.

Michael drinking his bottle before they left for Omaha.

When we left for Omaha with the helicopter they said it should take about 20 minutes to go the 50 miles. It was a beautiful day. I kept my eyes closed most of the time because it was a bit scary. This was my first time flying. The whole side seemed to be glass, so I had a good view of everything. It was a time of deep meditation. I had a heart attack. I didn't know how serious it was, but I knew some people die from heart attacks. Was I going to die? Was I really ready to die? I prayed and had such an assurance of peace with the Lord. It is something I cannot put into words how I felt so "carried". What scared me the most was the thought of leaving my children motherless. To me that has always been one of the saddest things that can happen. I pleaded with God to heal me for the sake of my family. After a while I opened my eyes and saw the Woodmen Tower and knew we were almost there. I am by nature a shy person and do not like to go to unfamiliar places.... definitely not by myself! God's grace was sufficient and He reminded me that I don't need to worry. They will be taking me wherever I need to be etc. EVERYTHING was out of my control. More on that later.

When we landed at Creighton there was a man at the door waiting for us. They immediately took me to the cath lab where I was surrounded with people. As they were pushing me around and getting me ready for a catheterization Dr. Priya followed asking me all kinds of questions... when did the pain start, what was I doing when it started, besides all the usual questions of whether you have any allergies to medicine etc etc. I remember having a chest ex-ray and ultrasound. Then they said they'll be giving me something to make me sleepy while they do the cath. I never felt sleepy, but later I didn't remember some things, so I wonder if I did sleep some and wasn't aware of it. They inserted the catheter at my wrist, which I heard later is more pleasant than if they do it in the groin. When they went in with the catheter I started getting severe pain again. Since it was a dissection I had, it is possible that when they put the dye in that it caused it to tear further. Someone told me they have to put two stents in. Some of that time is fuzzy in my memory. I do remember thinking the doctor sounds very impatient. After hearing some of the nurses' comments later in the week I realized that I had been in critical condition and he was trying to help me as fast as he could. When we came up to the 4th floor to the Cardiac Care Unit Edward and Annetta were there waiting for me. We still didn't know any thing except the fact that I had a heart attack and they put two stents in.

Helipad at Creighton. This pic was taken later in the week from the waiting room in the CCU.

Heart Attack!!!

Sunday July 14, 2013... A day forever etched in our memories. We know that all things work together for good to them that love God. "O rejoice in the Lord He makes no mistake".

I woke early because I still had a pretty bad headache. Since I couldn't sleep because of it I got up. It had been hot and sweaty the day before, but I put all my dirty clothes on thinking I would take my shower after the others are at church. (That was not a good idea!) I took Baby Michael downstairs with me so that he wouldn't disturb Edward. Before doing anything else I took 3 ibuprofen. They had not been helping much, but I was afraid to not take anything. Maybe they would at least take the edge off. I made my cup of coffee and settled on the recliner with my Bible to have my morning devotions. One by one the others got up. It was a lovely summer morning. Joel had sore throat and fever, so he was planning to stay at home with me. Some thought I should go to church with the baby so that we can show him off! :) I probably would have considered it if I would not have had this headache and besides, Joel was sick, so I knew home was the best place. While the girls made breakfast I checked emails. Sunday mornings are always more relaxed, so it was later than usual when we sat down to eat. We sang our usual Sunday morning song and prayed. I don't remember exactly when the pain started, but all of a sudden I got this pain in my chest. I dished out my food and got Rhoda's ready thinking it might go away, probably means nothing. It didn't go away and I said to Edward I have this pain in my chest... It was getting worse so I handed the baby to Irene and went to lay on the couch. I thought maybe it's like a panic attack or something and if I relax it will go away. It didn't. Instead it got worse. I couldn't lay down or relax. I asked Edward to come pray for me, which he did. I said maybe if he would rub my back it would help, but it didn't. It wasn't long till he asked, "Should we go to the hospital?" I said, "Yes I think we should, or call the ambulance." He decided to drive, so Annetta quick grabbed the baby and the car seat. By that time I was feeling somewhat out of breath and nauseous. As we were leaving, Simon anxiously called after us, "Do you think it's her heart?" Edward called back that he doesn't think so. After all, I was only 40 years old. Why would I be having a heart attack?

The roads were almost empty, but we passed every vehicle we came upon. One tried to drive in the middle so we couldn't pass. Maybe after a while he realized we might have an emergency?!?! Whatever, he pulled over and let us pass. At 80 mph it didn't take long to drive the 17 1/2 miles to the hospital in Atlantic. By that time I was feeling a little bit better, but Edward said since we are here we'll get it checked out. As soon as we came in they took me back to a room while Edward stayed at the desk to fill out paper work or whatever. Nobody fooled around. They put a heart monitor on me and did an EKG. Dr. Atkinson was there when the results were printed out. "There is definitely something going on with the heart," he said. "You need to get to the city as soon as possible. Where do you want to go, Omaha or Des Moines?" By that time Edward was also in the room. We chose Omaha because that was only half as far from home. As I lay there I wondered whether we would drive in ourselves or if they would take me in the ambulance. Just then the doctor came back and told us the helicopter is on the way. When we expressed our surprise he said, "Time is heart. The sooner the problem is fixed, the less damage to the heart." The seriousness of the situation was beginning to sink in. All this time Annetta was in the waiting room with the baby, not knowing what is happening. Is Mom dying? Are we going to be motherless? It was pretty traumatic for her. They soon let her come into the room too. While waiting for the helicopter they worked on getting me stabilized with aspirin, nitro pills under my tongue, morphine, oxygen and IV. It was interesting how the nitro pills immediately took away most of the chest pain, but just as fast I had a pounding headache (on top of what I already had), side effect of nitro. The second EKG they did was normal. Dr. Atkinson was puzzled. My mind was reeling with shock. How can this be happening? We always tried to have a pretty healthy diet. I was only 40. I had a newborn and 8 other children that needed me etc. ect.

Soon the flight crew from the Mercy One helicopter came in. They transferred me to their stretcher. I wasn't even allowed to get out of the bed. They just slid me over. The stretcher was very narrow and they strapped me on. They wheeled me over to Edward and Annetta who was holding Michael so that I could tell them a teary good bye. And then we were off, leaving them on the parking lot gazing into the sky. My husband had the presence of mind to take a few cell phone pictures. 

Meet Our Family

 Before I go any further with my story I want to introduce you to our family. These pictures were all taken in June and July 2013. I had my heart attack on July 14 when Michael was 12 days old.

Edward & Rachel with Rhoda

Irene 16

Annetta 15

Joel 12

Simon 11

Marian 8

Jonathan 6

Ruth Anna 4

Rhoda almost 2

Michael newborn

Headache and Stiff Neck

Since it was so hot Tuesday, we kept the air conditioner going when we went to bed. I was supposed to feed Michael every two hours. He did well, but I was so tired I kept falling asleep on my rocking chair! Maybe that is what caused my stiff neck. I don't know. Sometime after midnight I woke up with a terrific headache. I sat up in bed, holding my head. I also had chills and a stiff neck, but it was the headache that really scared me. Edward got some ibuprofen for me. Michael was waking up, so I got him. We turned the air conditioner off, since I was so cold. My head was pounding so bad I couldn't relax to feed Michael and could hardly lay down either. It seemed that after a while the ibuprofen took the edge off and I was able to fall asleep again. In the morning my head was pounding again. I have had a lot of headaches, but never before or since, have I had a headache like that. I also had a very stiff neck. I was so worried I was crying. What is wrong with me. Nothing relieved the headache much. Since we had to take Michael back for blood work anyway, I also made an appointment for myself. My doctor wasn't in, so I saw one of the other doctors there at the clinic. She ordered some blood work to make sure I don't have meningitis. Those tests looked OK, so the final conclusion was that the headache was caused by the stiff neck. Later when I went to the hospital with a heart attack the ER doctor thought that headache was probably angina, but when I asked the cardiologist later he said he didn't think so. My stiff neck soon got much better, but I had that headache for a week.

Wednesday evening Edward had to go to church for brothers' meeting I was feeling pretty bad, so I went up to our bedroom to rest and let the older children take care of the little ones. Later in the evening I fell asleep. I woke a little before Edward came home and was feeling much better. When he came home one of the first things he asked was, "How are you feeling?" When I said I was feeling better, he said they had prayed for me after they were done with their meeting. God answered their prayers. My headache was still there, but I was feeling somewhat better.

Thursday evening Edward and some of the older children went to pick more cherries. The trees were just loaded! We love cherries, so they picked and picked. :) Probably 12 ice cream buckets.

Almost everyone helped with pitting the cherries. I supervised from the rocking chair. :)

Irene and Annetta made pie filling with most of them. Some of them we just put in the freezer.

The finished product!

Almost 2 year old Rhoda kept things interesting. While the others were busy with the cherries, Jonathan (6) came in from the sun porch and said, "Rhoda is running around on top of the piano and I can't get her off! Big sister got some pictures before getting her down.

Friday evening Irene and Annetta went to sisters' meeting. I didn't feel up to going away yet. There was still some pie filling to finish, so I kept the canner going. Edward had to work late. I was so glad to see him come home!

Friday forenoon some of the girls' friends came to visit. One of them was getting ready to go to Haiti and they wanted to say good bye. She gave a CD for a gift. Irene had really wanted a CD like that and it turned out to be a God given blessing. Of course that CD got played over and over. One of the songs especially was really going to bless me in the days to come, but I will leave that for later... The name of the CD is "In the Presence of Jehovah". http://www.altarofpraise.com/product-p/ap1098.htm. 

First Week Postpartum

I should have written all this down sooner. I forgot too many details!

Michael (he goes by his middle name) was born on a Tuesday. We came home from the hospital Tuesday evening. Everyone was so excited and I was tired. I soon went to bed with the baby. Edward and the big girls got the others ready for bed. Michael was very sleepy. I thought he should nurse before we settled down for the night, but he wasn't interested. I think it was that sugar water they gave him! :( I didn't sleep very well. It bothered me that he didn't want to eat, so I got up several times to try to get him to eat. Maybe I should have just relaxed???

That first week was kind of busy. Friday we took him for the Newborn metabolic screening test. His weight was down to 6 lb 1 oz. We were also busy getting ready for company. My brother James and his wife Anna Mae and some of their children were visiting from PA. They came Saturday with my brother Reuben and Vera and their children. I was excited about it. Since we live so far from all of our family it's special anytime they come to visit. They arrived around 9:00 and stayed for lunch. The girls did a good job getting everything ready and making lunch. Edward grilled chicken. They left after helping with the dishes. I was really worn out. I didn't think it would bother me so much. I guess since I was 40 now I didn't bounce back like I did when I was younger! Michael was still very sleepy and not nursing well.

Sunday Marian and Jonathan stayed with me and the baby while all the others went to church. It was a relaxing day and I rested well. Sunday afternoon everyone except the baby and I went to a graduation party. Later I wondered what would have happened if I had my heart attack then????

Tuesday, when he was a week old, we took him to the hospital for his circumcision. That went well. He now weighed 6 lb 3 1/2 oz. He was pretty jaundiced and still not eating very well. The doctor said to force feed him every two hours and lay him in the sun, then bring him back again the next day to check his biliruben levels. I was so tired and felt kind of feverish. That was normal for me. I usually felt worse when the baby was a week old than I did the day after it was born. Doctor called it milk fever. It was a hot, sunny day. We made a little nest for him on a chair inside the west window.

I was so thankful Edward put the window air conditioner in our bedroom. I could rest much better. Force feeding went well. Maybe he was waking up and getting hungrier. He nursed much better. Definitely an answer to prayer. When we took him back for blood work the next day his levels had come down.

Monday of that week the girls went to pick cherries. They picked 6 ice cream buckets full. They pitted them and made pie filling. Tuesday evening it was so hot. The children were all begging to go swimming, so Edward took them to Mormon Trail Park where there is a nice lake with a beach. Again I was alone with the baby. It didn't bother me at all. I was probably just glad for some peace and quiet! It gets pretty noisy with nine children around.

Welcome Aaron Michael

Psalms 127:3-5 Lo, children are an heritage of the LORD: and the fruit of the womb is his reward. As arrows are in the hand of a mighty man; so are children of the youth. Happy is the man that hath his quiver full of them: they shall not be ashamed, but they shall speak with the enemies in the gate. 

Since my heart attack was likely related to pregnancy and child birth I will start with Michael's birth.

All our babies were born at home except our oldest, Irene, who was born at Lancaster Community Hospital. When I found out I was going to have Michael we weren't sure what to do. The midwife we had for some of our other babies was going through some legal issues, so we didn't feel clear about having her. We didn't know of any others near by. Since we almost ended up in the hospital anyway when Rhoda was born we decided a hospital birth was our best option. I didn't even have a doctor, so now I had to decide which doctor I want! Edward had worked for several of the doctors in Red Oak and learned to know them well, so we were taking the children there when we had need for a doctor. We liked the doctors there, but there were only male doctors. Atlantic was a bit closer and they had several women doctors. In January the Atlantic hospital had open house for their newly remodeled OB department. We went to check it out. There I met Dr. Tressa Wilcox. I have seen her so often now she is more than just my doctor, she is a friend. :)

July 2, 2013 - We left for the hospital soon after midnight. I woke Irene and Annetta to tell them we're leaving. Labor was slow till a little before 10:00 things started happening fast and at 10:03 Aaron Michael was born. Everything went well, and we were very happy to have a little boy! Now our family was 5 girls and 4 boys. He weighed 6 lb 8 oz and was 19 1/2 in long.

In Daddy's arms, getting acquainted. :)

In the nursery with Dr. Wilcox.

He was a very relaxed, contented baby. He nursed well then went to sleep. One thing that was different at the hospital was all the things they did to the baby. They kept checking his blood sugar and told me it was staying too low. I would either have to nurse him some more or give some sugar water to get it up. He was sleeping soundly and I knew it would be practically impossible to wake him enough to nurse. I didn't think it was anything to be concerned about, but finally I gave permission to give some sugar water. I often regretted it. I could hardly get him to nurse after that. Edward stayed with me all afternoon. The hospital treats new parents to a gourmet meal. I do not remember all we had, but it was very good. Since I was such an experienced mom :) and everything was well, they let me go home that evening. Don Chupps were burning their old house and the children really wanted to watch that, so Edward went over there to pick them up and brought them all along to the hospital to bring us home. They had not had supper yet, so they stopped at Walmart for some food. Then the whole troop came to the hospital!

Almost two year old Rhoda meeting her new brother. Everyone was so excited.

And finally we were home with our sweet little boy.

Thou Passest Through

When Thou Passest Through

"When thou passest through the waters"
Deep the waves may be and cold,
But Jehovah is our refuge,
And His promise is our hold;
For the Lord Himself hath said it,
He, the faithful God and true:
"When thou comest to the waters
Thou shalt not go down, BUT THROUGH."

Seas of sorrow, seas of trial,
Bitterest anguish, fiercest pain,
Rolling surges of temptation
Sweeping over heart and brain -
They shall never overflow us
For we know His word is true;
All His waves and all His billows
He will lead us safely through.

Threatening breakers of destruction,
Doubts insidious undertow,
Shall not sink us, shall not drag us
Out to ocean depths of woe;
For His promise shall sustain us,
Praise the Lord Whose Word is true!
We shall not go down, or under,
For He saith, "Thou passest THROUGH."
    By Annie Johnson  Flint

When thou passest through the waters, I will be with thee; and through the rivers, they shall not overflow thee: when thou walkest through the fire, thou shalt not be burned; neither shall the flame kindle upon thee.

Isaiah 43:2

Psalm 62:7-8

 In God is my salvation and my glory: the rock of my strength, and my refuge, is in God. Trust in him at all times; ye people, pour out your heart before him: God is a refuge for us. Selah. Psalm 62 : 7 - 8

We rightly praise God for the good times, but we learn to know God in the hard times.

Spontaneous Coronary Artery Dissection

On July 14, 2013 I had a spontaneous coronary artery dissection (SCAD). This blog will be about my experience. I am not a very good writer, but I wanted to write down my experience so that we don't forget the details and also to bring glory and honor to Jesus, the Great Physician.  

 What is SCAD? Following is an article from Mayo Clinic.

Spontaneous coronary artery dissection — sometimes referred to as SCAD — is a rare emergency condition that occurs when a tear forms in one of the blood vessels in the heart.

Spontaneous coronary artery dissection (SCAD) can slow or block blood flow to the heart, causing a heart attack, abnormalities in heart rhythm and sudden death.

Spontaneous coronary artery dissection (SCAD) tends to affect people ages 30 to 50, though it can occur at any age. People who develop spontaneous coronary artery dissection (SCAD) are often healthy, and many don't have risk factors for heart disease, such as high blood pressure and diabetes.

Spontaneous coronary artery dissection (SCAD) can lead to sudden death if it isn't diagnosed and treated promptly. For this reason, seek emergency attention if you experience heart attack signs and symptoms — even if you think you aren't at risk for a heart attack.

It's not clear what causes spontaneous coronary artery dissection (SCAD).

Spontaneous coronary artery dissection (SCAD) causes a superficial tear inside an artery. When the inner layers of the artery separate from the outer layers, blood can pool in the area between the layers. The pressure of the pooling blood can make a short tear much longer. And blood trapped between the layers can form a blood clot.

Spontaneous coronary artery dissection (SCAD) may slow blood flow through the artery to the heart, which makes the heart work harder. Or blood flow through the artery can be completely stopped, causing heart muscle to die (heart attack).

Doctors and researchers have found some similarities among people who have experienced spontaneous coronary artery dissection (SCAD). It's not yet clear what role these factors play in causing the disease. Common factors include:

• Female sex. Though spontaneous coronary artery dissection (SCAD) can occur in both men and women, it tends to affect women more often.
• Giving birth. Some women with spontaneous coronary artery dissection (SCAD) have recently given birth. Spontaneous coronary artery dissection (SCAD) was found to occur most often in the first few weeks after delivery.
• Irregular growth of cells in the artery walls. A condition called fibromuscular dysplasia (FMD) causes the irregular growth of cells in the walls of one or more of your arteries. This irregular growth can weaken the artery walls and reduce blood flow. FMD can also cause high blood pressure, a stroke and tears in other blood vessels. FMD occurs more often in women than it does in men.
• Extreme physical exertion.
• Blood vessel problems. Diseases that cause inflammation of the blood vessels, such as lupus and polyarteritis nodosa, have been associated with spontaneous coronary artery dissection (SCAD) .
• Inherited connective tissue diseases. Genetic diseases that cause problems with the body's connective tissues, such as Ehlers-Danlos syndrome and Marfan syndrome, have been found to occur in people with spontaneous coronary artery dissection (SCAD).
• Very high blood pressure. Having untreated, severe high blood pressure is associated with spontaneous coronary artery dissection (SCAD).
• Cocaine use.

In some people, spontaneous coronary artery dissection (SCAD) can occur again, despite successful treatment. It may recur soon after the initial spontaneous coronary artery dissection (SCAD) or years later.

Doctors are studying why spontaneous coronary artery dissection (SCAD) recurs and who is most likely to experience a recurrence.

The goal of treatment for spontaneous coronary artery dissection (SCAD) is to repair the tear in your damaged artery and restore blood flow to your heart.

Which treatments are best for you will depend on your situation, including the size of the tear in your artery and its location, as well as any signs or symptoms you're experiencing. Whenever possible, doctors allow the damaged artery to heal on its own, rather than repairing it through invasive procedures.

Medications

After spontaneous coronary artery dissection (SCAD), your doctor may recommend medications to restore blood flow to your heart. Medications can include:

• Blood-thinning drugs. Drugs that reduce the number of blood-clotting platelets in your blood (anticoagulants) reduce the risk of a clot forming in your torn artery.
• Blood pressure drugs. Drugs used to treat high blood pressure can lower your heart's demand for blood, reducing the pressure in your damaged artery. You may continue to take blood pressure drugs indefinitely to reduce the risk of another spontaneous coronary dissection.

For some people, medications may relieve symptoms of spontaneous coronary artery dissection (SCAD). In these situations, it may be possible to forgo further treatment. If chest pain or other symptoms persist, other treatments may be needed.

Placing a stent to hold the artery open

If your spontaneous coronary artery dissection (SCAD) has blocked blood flow to your heart or if medications don't control your chest pain, your doctor may recommend placing a tiny mesh tube (stent) inside your artery to hold it open. A stent helps restore blood flow to your heart.

To position the stent, doctors insert a long, thin tube (catheter) into an artery — usually in your leg or arm — and thread the tube to the arteries in the heart. The catheter is guided to your damaged artery using X-rays or other imaging tests.

A wire with a deflated balloon is passed through the catheter to the tear in the artery. The balloon is then inflated, expanding the stent against your artery walls. The stent is left in place to hold the artery open.

Surgery to bypass the damaged artery

If other treatments haven't worked or if you have more than one tear in an artery, your doctor may recommend surgery to create a new way for blood to reach your heart.

Coronary artery bypass grafting is a procedure that involves removing a blood vessel from another part of your body, such as your leg. That blood vessel is stitched into place so that it diverts blood flow around your damaged artery.

Continuing care

After your treatment for spontaneous coronary artery dissection (SCAD), your doctor may recommend other types of care to help you recover and to prevent other health problems. These may include:

• Undergoing cardiac rehabilitation. Cardiac rehabilitation is a customized program of exercise and education designed to help you recover from a serious heart condition, such as a heart attack caused by spontaneous coronary artery dissection (SCAD). Cardiac rehabilitation often includes monitored exercise, nutritional counseling, emotional support and education.
• Reviewing your family medical history. Some inherited conditions, such as the connective tissue disease Marfan syndrome, have been found to occur in people who experience spontaneous coronary artery dissection (SCAD). Your doctor may refer you to a genetic counselor to review your family medical history and determine whether genetic testing may be right for you.
• Looking for weaknesses in other blood vessels. Your doctor may recommend using CT scanning to look for weaknesses and abnormalities in other blood vessels, such as those in your neck and abdomen.

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