The Heart is a Lonely Hurter, Part One

My heart attack...

It's almost a friend now. I've lived with it for almost a year now and it's turned my life upside down in every conceivable way. An intimate friend, but a very tough and demanding one.

3/2/09 9:30am:

It's a brilliant Monday morning and I'm at work south of downtown San Antonio running steel conduit - work I normally could do in my sleep. But for some reason I can't concentrate. My mind is wandering, beads of sweat break out on my upper lip, and a nasty litlle nausea keeps nagging at me. I try to climb up a stepladder, and the room begins to swirl.

Wait a minute. I didn't drink last night, so why do I have hangover?

My new friend, Mr. Heart Attack , governs my daily schedule. M/W/F is cardiac rehab, alternate Tuesdays for psych counseling, Thursdays I upload (via modem) accumulated data from my LifeVest, appointments for MUGA scans, echo cardiograms, EKGs, bloodwork, and of course the cardiologist. I've set up an online calendar (thank you, Google) to keep track of it all.

3/3/09 9:30 am

It's Tuesday morning...24 hours since I started feeling sick. I have to hold a gun to my head to get myself out of bed. Feel rotten, but not particularly concerned - you get sick, you get well, no big deal. I convince myself to drive the 2 miles to the local minor emergency clinic. Feel like I'm coming down with the flu.

The doctor gives me a quick strep throat screen (negative), and sends me home with anti-nausea meds.

My cardiologist (a lovely Indian lady...or perhaps Pakistani...I don't have the nerve to ask) has returned from out of town, and should be in possession of the latest MUGA scan results. At issue is a quantity called the "ejection fraction," a measure of the fraction of blood pumped out of a ventricle with each heart beat. If the EF is too low, there is a danger of abnormal heart rhythms. Dangerous, and potentially fatal.

3/3/09 8:30 pm

It's now Tuesday evening. For the past hour I've been hopping around like a frog on meth. I don't know what's wrong but I cannot force my body to remain still. My wonderful wife is looking at me strangely, half in concern - half in irritation. "What kind of show is he putting on now?" she seems to be thinking.

Then the hammer falls with a vengeance.

A pain in my left shoulder, like the mother of all dislocations. My chest has an industrial strength vise clamped around it and is only getting tighter. I tell my wife to take me to the emergency room of our small town hospital.

They don't waste any time. After an EKG and an enzyme test, they quickly stabilize me and transfer me to a large hospital in San Antonio...it's a thirty minute drive by ambulance, just enough time for an interventional cardiology team to be assembled. I'm wheeled directly into the cath lab and asked to sign some papers. "Don't worry," the Doctor jokes, "the actual procedure will take less time than this."

It's around midnight.

I am sedated, but fully aware of what was going on. After several hours I'm really scared. There is no denying the tension and frustration in the doctors' voices. It's not going to work, I'm thinking. "You idiot," I tell myself, "You waited a full 36 hours to get medical help!"

Finally after last ditch action, some success. The doctors finally break through the clotting by forcing in enormous amounts of clot dissolving meds. After verifying that distal flow is established, they are able to successfully implant two stents.

My God, I'm alive!




Part Two

Related articles by Zemanta

• Cardiologists discuss how far myocardial infarction management has come (kevinmd.com)