Monday, September 14, 2015

My Heart Attack

Yesterday I received my copy of the October 2015 Reader’s Digest. As is my practice, I generally read it cover to cover the day I receive it. One of the articles was titled, “The Race To Beat Your Heart Attack.” I was especially interested in this article as I am a heart attack survivor. And I found the article to be very pertinent to my own experience.

I wrote about my experience in my autobiography, “My Life,” but most of the people viewing this on my blog will not have read it. So although the basis of what follows is that book, I think it’s worth repeating. If it even helps one person survive or even manage a heart attack situation in the future, then it will have been worth the retelling.

Here are a few quotes from the Reader’s Digest article:

“In recent years hospitals have slashed the time it takes to clear a blockage in a patient’s arteries. Often it took more than two hours for blood to flow to a patient’s heart again. Now nearly all hospitals treat at least half their patients in 61 minutes or less. From 2003 to 2013, the death rate from coronary heart disease fell about 38 percent…”

“In November 2006, the American College of Cardiology announced a national campaign…”

“They looked for opportunities to shave a minute or two here and there. They had paramedics do an electrocardiogram and transmit it directly to the emergency room”

Since my heart attack occurred in 2005, it was before most of these changes took place in many hospitals. However, the hospital where I was taken was already beginning to experiment with these changes and so I am a survivor. Here is my story.

Heart attack 

In January of 2005 I had a major medical incident.  It was a Sunday afternoon.  My wife Donna and I had gone shopping after church and were at the Trexlertown Plaza.  We were in Kohl’s.  As is often the case on a Sunday afternoon, I was getting tired and ready for my Sunday afternoon nap – that’s usually the only day I could take one.  So I went out to the car to nap while she finished shopping.

I awoke perhaps a half-hour later, but wasn’t feeling quite right.  I thought that perhaps I just needed to wake up a bit more, so lay there quietly.  But I wasn’t starting to feel better, in fact I was starting to feel worse and was starting to feel pain in my left arm and the left side of my chest.  After considering this for perhaps a minute – all the while the pain worsening – I came to the conclusion that these were classic symptoms of a heart attack.  Rather than try to find Donna, I pulled out my cell phone and dialed 911.  I told the operator that I thought I was having a heart attack, told her where I was located in the parking lot, and said, “Come and get me.”  I also told her that my wife was in Kohl’s.  Before the ambulance arrived, Donna also came back from shopping.  I was told later that the 911 operator had called Kohl’s and they had paged Donna, but she was already leaving the building by that time.

I should mention here that my medical exposure for heart attacks was based on the TV show “Emergency!” which aired from 1972 until 1977. But the scenarios from that TV show were about to be played out in real life for me. I don’t recall anyone one the show calling 911 on themselves. But I wasn’t going to wait for someone else when I knew I needed help – fast! I was also about to experience things like “diaphoretic,” a term which I had often heard on the show and had never bothered to check out the meaning of. When the EMTs applied it to me, I recognized it, and when I checked it out later I found it meant that I was sweating profusely even though I was not overheated. But at the time, I was dealing with this emergency both physically and mentally and a lot of what was going on was just being automatically filed away in my mind for later processing.

By the time the ambulance arrived – only a few minutes later – I was no longer able to exit the car on my own.  The EMTs took me out of the car, put me on a stretcher, and loaded me into the back of the ambulance and told Donna that she could meet them at the ER.  They removed some of my clothing (just use sharp scissors – I sacrificed my shirt, pants, and even my belt that afternoon – a small price to pay!), and putting a couple of leads on me, they connected me to an EKG machine.  Meanwhile they first gave me a couple of baby aspirin, then a couple of nitrate pills to hold under my tongue and asked if that helped – it didn’t.  They had a new technology in the ambulance at the time – being able to send the EKG results directly to the ER via the EMT’s cell phone.  Thus, when I got there they were already waiting for me, they had confirmed that I was indeed having a heart attack.  In fact, they were already preparing the cath lab for me – just had to clean up after the prior patient and put me next on the schedule.

They gave me a shot of morphine, but it really didn’t do much (when they asked how much pain I was feeling on a 1-10 scale, I said, “I’ve had a kidney stone, so on that scale this is only an 8.”)  Shortly after Donna arrived, they wheeled me out the door to the cath lab.  After swabbing me down with what seemed like a gallon of disinfectant (colors the skin yellow), they made an incision in the vein in my groin and threaded the catheter up through my heart, out the aorta, and down the coronary artery.  (I was not paying much attention at the time, just trying to deal with the pain – this is all what they told me later.)  They confirmed that I had 100% blockage of the LAD (Left Anterior Descending artery) and 75-80% blockage of the Circumflex artery.  They dealt with only the former at this time.  The surgeon put a wire mesh stent on the end of the catheter and pushed it through the blockage, then inflated the balloon on the end of the catheter which expanded the mesh and opened up the artery (it compresses the fatty deposit that is the blockage against the artery wall).  The pain immediately disappeared!

They then closed up the incision and sent me upstairs to the cardiac care unit (CCU) for the next few days for observation.  Total time from onset of initial symptoms to opening up the blockage was less than an hour.  It was this quick reaction that probably saved my life.  I’ve read that the survival rate from this type of blockage is about 7%.  That’s why it’s known as the “widow maker”.  I am not only part of that 7%, but have zero long-term issues.

You can see how my experience so much mirrors the Reader’s Digest article. Even though this was before the 2006 campaign by the American College of Cardiology, I was able to experience having the EMTs take the EKG, the quick response team in the ER, etc. I only knew that it was new at the time because while I was in the CCU someone from the hospital asked me to sign a form to allow them to use my case as training material since those kinds of things were still experimental.

While I was in the CCU that afternoon there was one complication. They cut into a major blood vessel in your groin to insert the catheter, the stent, etc. Afterwards they stitch it closed, then they put a heavy bag of sand over the incision point – both to immobilize you and to keep the incision point stable. But even with those precautions, sometimes the blood vessel still “leaks.” It did in my case and I started getting a large bruise as the blood was flowing under my skin. The nurses recognized this immediately. The “treatment” is to express the area and stop the blood from pooling around the incision point – giving you a larger “bruise” but that will eventually go away. With men they also have to try to move the blood away from the scrotum which is only a few inches away. Otherwise the scrotum can fill with blood and it will get swollen and quite painful. So, like many medical procedures, you just have to put aside any ideas of modesty as the nurse massages the area to spread the blood around until the blood vessel stops leaking. I had a large discolored area when it was all over, but that was a small price to pay.

On Wednesday I made my second trip downstairs to the cath lab to get the other blockage cleared (again via a stent).  This time I was wide awake and very aware of what was going on.  The doctor has three monitors.  One displays my vital symptoms, one is a real-time x-ray of the area around the heart so he can see where the catheter is, etc, and the final one is like the second but can be “frozen”.  When he is nearing the area where the blockage is, he can squirt a bit of dye out the end of the catheter that gives contrast of the arteries and “lights up” the blood flow – he then freezes that image on the third monitor.  He can then guide the catheter to that exact spot before expanding the stent.  Amazing technology!  By stretching my neck and looking around the large x-ray machine that was over my chest, I could see all three monitors and know what was going on.  The spatial exercise of looking at the picture on the monitor and translating that to where inside my chest and heart the catheter was actually located was interesting.

On Thursday I was released from the hospital.  The next Sunday I was back in church, like I’d never gone through this, and people were amazed.  Of course I couldn’t drive for a couple of weeks and was out of work for about six weeks, but that was not much compared to the second chance on life that I’d been given.

I’d always wondered how strong my faith in God really was – if I was being threatened with my life, would I deny him.  Now I know.  While all the events – from initial symptoms to the surgery – were happening and it was a good possibility that I might not survive, I was absolutely at peace.  There was no panic, no prayers of desperation, none of that.  I was confident in my relationship with God and the knowledge that no matter what happened that I would be seeing Him whenever my life here on earth would end.  Now, ten years later as I write this, I still have that absolute assurance that He is with me and I am with Him.



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