Here’s what happened to me (to us) on Oct. 26, 2008. I wrote this for an old blog in November of ’08.
My heart attack wasn’t like the heart attacks you see on TV or in movies. You know the scene: The over-worked, over-stressed, hard-smoking, hard-drinking dad or grandfather suddenly grabs his left arm and doubles over in pain as if he were struck in the chest by a knight’s lance. That’s the Hollywood heart attack.
Mine wasn’t like that.
Mine might have started quietly, months before I knew it was happening. There were signs, but the omnipresent fatigue I felt all summer and into the fall could easily be explained by the presence of a newborn baby and a 2-year-old toddler in the house. Or maybe I was so tired all the time because of a mild case of depression brought on by losing my newspaper job of 16 years in a July staff reduction. Perhaps the fatigue was just a natural byproduct of completely ignoring my own physical fitness as I approached age 40. I ate poorly. I didn’t exercise at all. My sleeping habits were atrocious. Maybe the constant, oppressive fatigue I felt was caused by all of the above.
Or, maybe, it was the growing glob of plaque building up in my right coronary artery. A portion of my heart wasn’t receiving the clear, clean flow of blood it needed to function properly. Robbed of the necessary oxygen, my heart sent me signals. Usually it told me to find someplace quiet and comfortable to lie down and sleep for two or three hours after taking care of the boys all day. Sometimes it told me to walk a little slower at Busch Gardens or up the aisle at the grocery store. Sometimes it told me the chores can wait, because it’s much more important to put my feet up on the couch and rest. I did what my heart told me to do, because that’s how I’ve always lived my life.
Beth didn’t like it, and I don’t blame her. For all she knew – for all I knew – I was just being lazy and unwilling to hold up my end of the bargain when it came to household responsibilities. So much was left undone at the end of each day. Dirty dishes piled in the sink. Toys strewn across the family room floor. The lawn uncut and untrimmed for weeks. It wore on Beth’s patience. Who could blame her? She certainly held up her end, working a 5 a.m.-2 p.m. shift and pretty much handling all the household cleaning and laundry in what spare time she had while taking care of the kids after she came home. It wasn’t fair. I knew it. Yet, I had to listen to my heart.
I even decided to go to the doctor for a physical. This is not something I did lightly. I do not like to attend appointments at offices or shops. The dentist, the barber, the primary care physician … it’s all the same. I’ve always felt weird about the process: sign in, find a seat in the waiting room, try not to make eye contact with the other patients or customers (none of whom want to be sitting there WAITING, either), look up hopefully every time the door opens to the mysterious “back rooms” where the magic elixir is distilled, turn back despondently to the five-month-old Sports Illustrated when someone else is (inevitably) called back.
Eventually, I was ushered into the inner sanctum and, long story short, I was healthy. Blood work was assigned (another appointment, another office, another waiting room, another old magazine) and it showed my cholesterol levels within “normal” ranges. A little on the high end of the scale, perhaps, but certainly nothing to trigger an alarm that a 39-year-old, underweight, seemingly healthy man might be on the verge of a heart attack.
So it went. Then, about two weeks before my heart attack, I came down with one of the nastiest colds I’ve had in years. Fever, sore throat, coughing, body chills, the works. It knocked me flat for three days. Heavy doses of Dayquil and Nyquil kept me going until nothing was left but the cough and, of course, fatigue. I was even more useless around the house than usual. I could barely bring myself to leave the house, I was so tired.
Finally, on Oct. 26, a Sunday, we decided it was time for me to get some fresh air and a little exercise. We piled the family into the CRV and took off for Busch Gardens. It was a lovely day and it felt good to be out again. We walked around for two hours, rode the train around the Serengeti Plain and looked at the tigers before grabbing a barbecue lunch at the Stanleyville Smokehouse. Jay ate grapes and watched a roller coaster splash past. I look back now at the photos I took of that little outing and it is chilling to think that, had things gone really bad later that night, those might have been the last photos I ever took of Beth, Jay and Chris.
We came home and for about two hours, I felt fine after the excursion. We had dinner plans that night with some neighbors, and I figured if I just took it easy the rest of the afternoon, I’d be able to last through the evening.
Then I coughed. It was a wracking, deep cough. A different cough from the lingering, nagging cough I developed with the cold. This cough wouldn’t stop. I knew right away that something was wrong, and my first instinct was to get Beth to cancel our dinner plans.
As she made that phone call, the cough deepened. My ears began to ring. My head began to spin. The cough kept coming. I collapsed on the bed and tried to call out to Beth. She was on the phone and didn’t hear me at first. My head was spinning and my ears were ringing and I curled up in a fetal position on the bed as I coughed and coughed. I called for Beth again and she came. At some point I realized that both of my arms had gone numb. There was a tingling sensation from my shoulders to the tips of my fingers in both arms. Then I noticed tightness in my upper chest. No pain, but uncomfortable tightness. I thought I was having a bronchial attack, that maybe that bad cold had developed into pneumonia and I was “drowning” in my own fluids.
I remember Beth asking me if I had pain in my left arm. I remember telling her no. But I somehow couldn’t relay to her that I couldn’t feel anything in my left arm, even though the numbness and tingling in my right arm had begun to subside. I think now that I was delirious, perhaps going into shock. It was when I realized that my left arm was still numb and that the tightness in my chest wasn’t going away that I might be having a heart attack. It seemed absurd, and I dismissed the notion, and even now I can’t quite grasp the fact. Yet, there I was on my bed, about to die if nothing was done to prevent it.
Delirious, panicked, I yelled for Beth to get me to the emergency room NOW. She quickly called for a neighbor to come over and watch the kids and we took off for University Community Hospital. The drive to the ER was excruciating, but not because I was in pain. I was delirious and terribly frightened and poor Beth was dragged into my delirium as she drove. The traffic was slow for a Sunday afternoon, and I remember yelling at poor Beth to JUST DRIVE and GET AROUND THIS SLOW BASTARD and I THINK I MIGHT BE DYING and DON’T YOU UNDERSTAND HOW SERIOUS THIS IS??? Eventually, I succeeded in sending Beth into an equally numb and quivering state of shock through my delirious ranting. She said then that if I did die, these were the greatest four-plus years of her life and she wouldn’t have changed a thing. Right about that time, I pulled both my legs up under me in the front passenger seat and just tried not to cough or yell at Beth. I vaguely remember us driving around the hospital complex looking for the ER entrance. We found it, and Beth pulled up to the door to let me out while she found a parking spot.
Inside, I approached the reception desk. Two young women were talking to the receptionist. I remember waiting in line for about five seconds before I said, “Excuse me, I’m sorry to interrupt, but I think I’m having a heart attack and I need attention now.” I was, in retrospect, far calmer at that moment than I should have been. But then, that was probably the shock talking. In fact, I was so calm that the receptionist didn’t seem to take me seriously. Her first response was to point out that she was busy with these ladies and would I please take a seat in the waiting room.
So … I turned toward the waiting room. As I walked away in a daze, I heard the receptionist ask from a thousand miles away, “Sir, have you been here before?” I didn’t know if she was talking to me and I didn’t care, so I just sat there with my head in my hands and waited for Beth. The receptionist asked me again, “Sir, have you been here before?” At that point, I think, she came over to where I was sitting and Beth arrived at the same moment. They got me into triage, where the blood pressure monitor read 168 over 99 and an initial EKG showed some sort of irregularity.
I don’t remember being checked in or processed; maybe I never really was. I vaguely remember leaving the triage room and sitting for a few minutes in the waiting room before being called back to the chest pain area of the ER. There, in my own curtained-off cubicle, I was made to strip and changed into the standard backless hospital gown. They hooked me up to monitors for BP, heart rate and oxygen intake and ran another EKG while pumping saline fluid through an IV in my left arm. Beth was with me the whole time. In the next cubicle, another chest pain patient made awful noises that sounded horribly like a horse being strangled.
After a while, my symptoms stabilized. I was taken for a chest x-ray, which showed nothing irregular with my lungs. A doctor came and tried to explain what might have happened. He seemed to have come to the initial conclusion that I might have some sort of heart virus. The blood work was inconclusive at that point. He was inclined to send me home.
Something made him order another EKG, though. While the tech set me up for the test, I had another bad coughing spell: the same deep, wracking cough that hit me at home. I couldn’t see the monitors, but Beth later told me my face went white, my blood pressure immediately dropped to something like 60 over 30 and my heart rate fell to about 40. The tech got this panicked look on his face and called for nurses and the doctor. They attached defibrillator pads to my torso and inserted another IV into my right arm, just in case they had to try to revive me with electric shock or some sort of steroid they apparently pump directly to the heart in case it stops beating. They also put me on oxygen. I barely remember much of this moment.
What I do remember is the sudden realization at some point that I might die. And I remember that the only thing that moved me to tears at that point was the thought of my little boy, Jay, growing up without his Daddy. It moves me still. I sent Beth home after a while, and I begged her to read Horton Hears a Who to Jay as a bedtime story. I broke down in tears as I begged her to squeeze him and tell him how much I love him.
Later, the doctor came in and explained that my blood work had revealed a concerning level of troponin, or cardiac enzyme. The measurement was low, he said, around 0.025. That was an indication that I might have myocarditis, which apparently is where he got the idea that I might have a virus in the heart muscle. The way he explained it was that a troponin reading of 1.0 or higher was a clear indication of a heart attack. They’d keep me overnight, take blood at regular intervals and monitor the level of cardiac enzyme to see what was going on. Shortly after that, I was moved to a double room in the hospital’s regular wing (as opposed to the Pepin Heart Hospital there on the grounds). While I was being moved, the nurse pushed my gurney head-first into the elevator. It looked to me like there was barely room for my feet. The nurse actually said, “Don’t worry, we’re not going to amputate your feet.” Which was a pretty bad joke, considering some poor guy a few years ago had the wrong foot amputated at that very hospital. In my new room, I was assigned an overnight nurse named Anthony, whose regular job was working in the heart wing and happened to be assigned to my wing that night. All this happened while Beth was taking care of arrangements for the kids.
Beth returned after a while and helped me get as comfortable as possible. I was strapped onto several monitors and taking constant saline fluid as well as oxygen. Beth went back home to be with the kids after a short visit, and I tried to get some sleep. The uncomfortable tightness in my chest came and went. The cough was pretty persistent, although it never was quite as deep and wracking as it had been earlier. I drifted in and out of consciousness for several hours. Sometimes the discomfort in my chest woke me up. Sometimes it was Anthony checking in on me or taking more blood.
Sometime after midnight, I grew extraordinarily nauseous. At this point, I still didn’t know for sure that I had suffered a heart attack. Irrationally, I began to hope that the whole problem was food poisoning, that the barbecue I had eaten that day at Busch Gardens was trying to take revenge. This theory gained credence when, around 2 a.m., I vomited over the side of my bed. Between gasps and hurls, I remember I cried out, “What the hell is wrong with me?!?” The old guy sharing my room didn’t say a word. In fact, he never even acknowledged my presence. I got the impression he was a little bitter at having to share the room with a raving lunatic who clearly might die at any moment. After Anthony cleaned me up and mopped the floor next to my bed, I presented the food poisoning theory, hoping against hope for some confirmation. He was tactful enough and kind enough not to shatter my hope that Busch Gardens was to blame for my predicament.
After the regurgitation, I settled back in for a fitful attempt at sleep. At 4 a.m., Anthony came back for more blood. I later found out that the midnight and 4 a.m. blood work showed a dramatic increase in troponin levels: around 5.33 at midnight and 7.5 at 4 a.m. The cardiologist, who had scheduled me for a 10:30 a.m. angiogram the next day, was called in early and my procedure was moved up to 7:30 a.m.
Sometime around 6 a.m., the cardiologist, Dr. Vasco Marques, came into my room to explain the angiogram and answer any questions I might have.
Me: “I know the general term for what I had was a heart attack, but what’s the scientific term?”
Cardiologist: “A heart attack.”
Then it was time to sign waivers and read about angioplasty and have my groin area shaved to clear the way for the insertion of the tube that would snake its way through my body and into my heart. Anthony came in and insisted on prepping me, even though his shift had technically ended an hour earlier. He was kind and very good at his job. I thanked him for watching over me through the night.
Among the papers I had to sign was something that gave the surgical team clearance to open me up in case emergency bypass surgery was necessary. The angiogram would reveal what was wrong, and they hoped to be able to solve the problem with angioplasty: suctioning out the clotted blood and accumulated plaque and inserting a mesh stent to keep the area open in the future. They were prepared for the worst-case scenario.
I called Beth and my mom and dad to let them know what was going on. Beth was busy trying to get the kids settled and wouldn’t be able to make it to the hospital before I went into surgery. I called my friend Chris Anderson and left a message. Then it was time to be rolled into the operating room.
I remember feeling a little giddy as the surgical team prepared around me. They introduced themselves by name, one at a time, casually, as if we all were about to sit down to a nice breakfast at Cracker Barrel. I asked only one question: “When will you apply the anesthesia?” And I think I meant to the groin area, where they would be inserting the tube. But there was another level of anesthesia, some kind of IV Benadryl, and once they pumped that into my system I was out of it entirely. I don’t know if I ever completely lost consciousness, but I do have a vivid memory of closing my eyes and thinking, “Will I ever open them again?” I tried to think of my family as my faculties began to drift away.
Less than two hours later, I came to on the table and asked if we were done. Someone told me yes. I asked what it was they found. Someone said it was a 100 percent blockage of the right coronary artery, and that it was completely fixed and everything was fine. Someone also said I had tried to lift my head several times during the procedure and they were a little concerned that a hematoma had formed around the insertion point in my groin but that there was no real cause for concern.
They wheeled me back to my new room in the Pepin Heart Hospital wing (a private room) and I waited a while for Beth to get there. I called Chris and my parents. When Beth got there, I was awake. I felt good, considering I’d had a heart attack less than 24 hours earlier. Beth stayed with me as much as she could during the day. A neighbor, Cam Caudle, came by to visit. Chris came by in the morning, and he came back that night to watch Game 5 of the Rays-Phillies World Series. He stayed until the game was postponed by rain. I called Beth to say goodnight and slept very, very soundly.
They let me go the next afternoon. I was prescribed a battalion of new medicine to take every day for the rest of my life, including aspirin. I was warned not to pick up anything heavier than 10 pounds or drive for the next two days. In fact, I did neither until my follow-up appointment with Dr. Marques two weeks later.
Beth’s mom and dad came down from Massachusetts to help us during the first week. My mom and dad came down from North Carolina the second week. Drew Carnahan, who is married to my brother’s wife’s sister, swooped in and was our guardian angel for the week after my mom and dad went home.
I felt better, physically, than I had in months. Yet, Beth and I settled into a terrible pattern of bickering, usually at night. The strain of so much mental and emotional pain this year had finally gotten to us both. I really believe that I remained in shock for at least two weeks after I had my heart attack, and Beth was so overwhelmed emotionally that she could barely function. How we held it together for that horrible time after the heart attack, I don’t really know. What I do know is that we stuck together through the most difficult time in either of our lives.
The follow-up appointment with Dr. Marques brought only good news. “No restrictions. No worries.” He spent a lot of time answering our questions and setting our minds at ease. He told us that the normal person has 60 percent functionality of the heart, and that after my procedure, I had 62 percent functionality. He cautioned that I must always take my medicine, eat well and exercise, but that I should otherwise be 100 percent fine.
Can it be that I actually had a heart attack? It must have been inevitable, because they attributed it to genetics; my maternal grandfather had his first heart attack at age 41. But come on … a HEART ATTACK? Me? I still can’t believe it. I still can’t believe that I nearly died on Oct. 26, 2008. I still can’t grasp the enormity of it, even though I went through it with a (fairly) clear mind. Maybe if it ever happens again, I’ll be convinced. Or not.