The Heart is a Lonely Hurter, Part Two

Click here for Part 1


My health insurance administrator is kind enough to send me periodic updates on the amounts they've paid out to doctors, hospitals, ambulance services, and lab tests. It's more than a little scary to contemplate the total financial burden I've placed on my brother (and sister) members of the International Brotherhood of Electrical Workers, who in effect self-pay into our own insurance plan. More than a hundred grand, easy, and I'm not out of the woods yet. My only solace is the 35 years I've contributed to the fund with sicks days you could count on one hand.

It wasn't supposed to happen. Me, the solid oak...I could outwork the youngsters easily (and did). Many were the evenings, at the dead ends of twelve hour days and 70 plus hour weeks, when I and a handful of others were the only ones left manning a job. When it counted...when it had to be finished. Endurance is everything.

That's was my reputation: reliability and competence. It meant a lot to me. A hell of a lot.

3/7/09 midnight

A whirlwind week is ending. A unrecognized heart attack on Monday, hospitalization Tuesday night, and two stents implanted in the wee hours of Wednesday morning. A day of recuperation and release from the hospital by Friday. There is surprisingly little pain, mainly at night when I try to sleep. (My wife has set up a bed downstairs so I don't have to climb the stairs)

I'm profoundly grateful (that doesn't even begin to express it) to my wife for the way she has held up. Two wrecks at the same time doesn't cut it, not with a teenager in the house. But I know just how shaken up the last week has left her.

It's a cool still night, and I stand outside looking at the stars...all six of them. Hooray for civilization and light pollution. I remember summer nights at my grandmother's house - millions of crystal stars and the brilliant white smudge of the Milky Way splashed from horizon to horizon.

Suddenly, from nowhere, there are tears running down my face. Dude. Stop this. What the...remember Edmund Muskie. Glad no one is seeing this.

A few words about stents:

A stent is a spring-like medical device designed to be placed in artery to keep it open (See illustration above). The newer and more advanced stents have a drug-eluting coating that help prevents "restenosis," the return of clots and scar tissue that choke off blood flow. I have a total of four: the two implanted immediately after my heart attack plus two more implanted during a scheduled procedure 3 weeks later.

4/16/09

A dragging sense of limbo seems to have overtaken my life. It's been six weeks and my direction is more confused than ever. Our one income family status is slowly dragging us down, despite a small (temporary) disability stipend from our insurance. I'm trying to fast track my doctors into clearing me to return to work, but there are complications.

Dr. B, while implanting the second set of stents, saw something about my ventricular function he didn't like. He told my wife Sandy that the ejection fraction was too low, and the danger of heart arrhythmias worried him. An implanted debrillator could be an eventual solution, but he wanted a further test to get a more accurate picture of Rick's ventricular function.

Enter the MUGA!

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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

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