At about 9:30 P.M. on Friday, October 18, 2013, I had a heart attack. Over the span of my life up till that moment I’d been slowly building an 80-percent blockage in my left anterior descending artery. I didn’t know it was happening, but it surely made its presence known that night. Since that moment I’ve had a lot of time to think about the situation, my survival, and what it meant (and will continue to mean) in my life.
I’ll share the story of that night and also share my feelings and thoughts about it all.
When thinking about the timing of the heart attack my first thought was that it was pretty darn inconvenient. My wife was out of state and scheduled to remain that way for the rest of the weekend. I live half an hour from any hospital under the best of conditions, with the need to wait for an ambulance crew to arrive only adding to the delay before I would encounter a doctor. The nearest medical centers aren’t particularly well-equipped to help someone having a heart attack, either. They can evaluate a patient and gather information, but there are a lot of intervention treatments they simply cannot offer.
Upon reflection, though, calling the timing and circumstances inconvenient would be a mistake because that assumes that there is some set of conditions that would, when compared to mine, be a convenient time to have a heart attack. That’s just not true. There is no such thing as a convenient time to have a heart attack. It’s a crisis no matter the time or place.
When the pain set in I felt it in my chest first. It was a sharp, stabbing pain that spread and turned into a fairly agonizing combination of sharp pains and continuous aches. At first I did not call for medical assistance. I’ve had episodes of esophageal spasm in the past. That’s sort of like super-bad acid reflux and the symptoms are very much like the ones a person experiences during a heart attack. I thought I was having another such event.
I lay down on my bed and sipped some water, waiting for the pain to pass. I made my way to my living room and sat down a recliner next, still waiting for the pain to pass. When I felt the pain in my left arm begin, and the numbness starting at the fingertips, I realized I was in trouble. I decided to call an ambulance and dialed 9-1-1.
The emergency dispatcher asked me a bunch of questions. Where was the pain? How bad was it? How did my left arm feel? Was I sweating? Was I nauseous? I answered each question as it became tougher and tougher to breathe or deal with the pain. Did I have any aspirin in the house? I wasn’t sure, but I could check the medicine drawer.
Could I reach it? The answer to that turned out to be a resounding “no.” I made it to the front door and unlocked it and then turned toward my kitchen, lurching toward the cabinet where all the pills are kept. I made it about two steps before I lost my balance. I fell to my knees. I took a few gulping breaths, which hurt a lot, and started to crawl. My knees dragged on the floor. My hands slapped down one after the other as I moved. I was holding the phone in my right hand and thought it would break every time I had to put that hand down as I crawled.
I came within five feet of that medicine drawer when I collapsed.
I told the 9-1-1 operator I could not make it, and that I was on the floor. He told me not to lay on my back in case I vomited, as that could make me aspirate my vomit. I rolled onto my side, thinking the operator had a point as I felt my gorge rise, burning and painful, into the back of my throat.
When the ambulance crew arrived they found me on the floor and started cutting my shirt off so they could examine my chest and start attaching sensors and defibrillator pads. I don’t remember what they were asking me other than trying to get me to say my name out loud. I do remember the pointless thought that the undershirt they sliced off me with their shears was a fresh, new one I had owned less than a few weeks.
Once the medical crew arrived the 9-1-1 operator got off the phone and I had a moment to call my wife as the EMTs worked on me. I can’t imagine the horror she felt being hours away when this happened.
Obesity contributed to my condition, a fact which makes me hard to move onto a gurney. I weigh nearly 300 pounds. It took several strong men to move me off the floor and onto that rolling table. They got me out of the house and into the ambulance. A paramedic named Linnea worked on me along with the rest of the medical crew inside that vehicle. The ambulance did not move an inch. I don’t know what factors determine when they can move a patient, but whatever they were, we could not seem to cross that threshold.
Something about my condition made it hard to get a good reading on the electrocardiogram machine. Like many large people it is hard to track down my veins so getting an I.V. started is a chore. Before long I would have them in three places, one of which they referred to as a pigtail because it had two ports. They gave my nitroglycerin and baby aspirin. The pain was awful. For some reason I was trying not to swear too much and, during a particularly bad spike of pain, cried out “Crikey!” I remember asking the ambulance crew not to tell anyone that was my last word if I died.
We started moving and I heard the crew talking about going to a hospital north of my home. That made me really begin to worry. I had expected to go south to a facility partway between my house and where my wife was. I knew she would be expecting to find me there. It scared me to think that she would get there and not be able to find me.
I did not know it at the time but my wife had called a family friend who lives just a few blocks from the hospital we had presumed I would be driven to. He was there and learned I was being diverted someplace else. I’m not sure of the logistics of how it happened, but between his help, the hospital, and some cell phone calls my wife figured out where I was headed.
I arrived at the hospital north of my home and was surrounded by doctors and nurses. People from my wife’s side of the family started showing up. The nitroglycerin made my head hurt. The medicines they gave me for pain had me out of my gourd. I had to pee and was subjected to the indignity of having a nurse hold my penis and aim it into a plastic urinal so I could empty my bladder without making a mess. Automated blood pressure cuff compression crushed my left arm, already in pain, making it hurt even more.
It was only when a helicopter crew showed up that I knew I was really in trouble. Medi-flights are not summoned for trivial matters. I was to be flown to Dartmouth-Hitchcock Medical Center (DHMC), the teaching hospital for the ivy league Dartmouth University Medical School. Some of the best doctors in the country work there, a fact which would shortly become more relevant to my life than I would have ever imagined a few hours earlier.
The helicopter crew told me that there were two things I could not do in the chopper. The first was vomit; I would be strapped in on my back and that would cause the same problem the 9-1-1 operator had cautioned against if I threw up. The second was “freak out.” One of the crew asked me if I was nervous or nauseous. I tried to smile but what I said was, “I’m having a heart attack. I’m terrified.” That got me more drugs for nausea, pain, and something to calm me. I don’t even know what those drugs were.
What I do know is that they got my higher than a kite. I remember the ceiling of the helicopter. Some of the instrument panel lights and knobs looked like haunted house scare masks to me, which I pointed out to the flight medic. For some reason I told him the only thing that would make the flight cooler was if someone played “Danger Zone” or the theme from Airwolf, an 80s action show. Incredibly enough he produced an MP3 player that had both. I guess helicopter crew members have good senses of humor.
When I landed at DHMC they wheeled me into the catheterization lab without stopping for anything. You know the fan has been well and truly hit if a medical center does not wait for paperwork before sending you into an operating theater. For whatever length of time that took I was on my back, looking up at lights and equipment I could not identify. I heard a lot of different voices and several accents. There was a sting as a local anesthetic was applied on the right side of my groin and then some odd pressure and pulling sensations as a stent was inserted.
I lose some memory after that, but the next thing I knew I was in the cardiac intensive care unit. I was on my back and instructed not to move at all because any motion of the legs could open the incision point they had used to insert the catheter. This was incredibly painful for me. Hospital beds are uncomfortable to begin with. I have arthritis and spinal stenosis and degenerative spine issues on top of that. Laying flat on my back is painful under the best of circumstances. Having to hold that position for hours was awful.
They moved me out of the ICU and into the regular cardiac unit a few hours later. I spent the next three days there. At first I had no roommate. After about a day and a half I got one, a Canadian man who was named something like Gaston. He snored like a lawn mower and I intensely envied his ability to fall asleep easily in a hospital.
I have sleep apnea but did not have my own CPAP machine on the first night. The hospital provided one but their masks did not fit me. I don’t think I actually slept a wink that night. My wife brought my equipment the next day and after that I was able to sleep – sort of. Hospitals are full of lights that are never off, and sounds that never stop, and alarms and bells that happen randomly according to medical necessity all day and night. Drugs have to be administered and vital signs taken and shots delivered – and there is no such thing as a delay to let you get more rest.
Hospital food is hospital food, which was OK most times and completely awful others. It showed up three times a day on a regular schedule and made me wish quite powerfully to be home.
Being a cardiac patient also carries a few other unpleasant perks. First among them is constipation. The drugs you get cause that in most patients. On the other hand you do urinate a lot – but they want you to do this into another plastic urinal so the nurses can measure and record the volume of the liquid. The urinals are unpleasant and, since you use the same one repeatedly, unsanitary. It’s embarrassing to call a nurse and ask her to measure your urine output.
You also don’t get to bathe. Bathing requires removing your heart monitor, something that is simply not permitted for a long time after you get a stent installed. Even when you do finally get permission to shower it’s almost impossible to do well because you have to keep your I.V. dry. The plastic wrapping that the nurses apply before you shower does not stick well on a guy with as much arm hair as I have, so I was trying to shower and scrub left-handed with my right arm held over my head to keep the I.V. out of the shower stream.
Such showers barely made a dent in the grimy film coating my body and, after three and a half days I stank horribly. I tried hard to keep my arms pinned to my sides so I would not sicken myself with my own stench.
The pain in my chest diminished with time, but the pain in the groin near the incision site felt about like taking a dodge-ball throw to the loins. I jokingly referred to the heart attack, and then the incision pain, as feeling like being punched in the chest by Bruce Lee and then kicked in the crotch by Seabiscuit.
Not long after you get a stent the doctors want you to be up and out of bed, trying to walk a bit here and there. That’s both uncomfortable and, since a hospital gown is not exactly a custom-fitted garment, very likely to leave your rear-end visible. I’m pretty sure I gave more than one accidental peep show as I walked around the cardiac unit to keep in line with the doctor’s orders.
After an 11th hour chest pain event I was discharged on October 22. My wife drove me home and, after a stop at the local pharmacy, I was back in my house. I used my own toilet. I brushed my teeth at my own sink. I shaved. I showered in my own bathroom and found myself appreciating that part of my home more than I ever thought possible.
My life is different now. Thinking back to the night of the heart attack and the joking around I did I realized something: I really was terrified. The entire experience was an exercise in handling bone-deep fear. I use humor in these situations in the same way people whistle in the dark or throw salt over their shoulders. When it comes down to it, though, that Friday night I could have died. In fact, I would have died if not for the incredible skill and competence of everyone who helped keep me alive. I am deeply indebted to them all.
I am also deeply grateful to the family members, and family friends, who turned out in large numbers to support me and support my wife.
It’s still a somewhat surreal situation. I am a 42-year-old man who just had a major heart attack. I have to keep telling myself that for the reality of it to sink in. There’s a measure of denial in which my mind wants to engage. It does not want to believe something so horrible actually happened – but it did.
I paid the price for a lifetime of ignoring my health, and will continue to pay that price for the rest of my life, however long that may be. I have to make serious changes in what I eat, forever. I have to make serious changes in my activity levels each day, forever. I have to weigh myself daily to check for fluid-retention-based weight gain, forever. I have to take certain medicines every day, sometimes more than once a day, forever. I have to carry a small bottle of nitroglycerin tablets with me no further from me than arm’s reach, forever. I even had to buy one of those weekly, day-by-day pill organizers.
My life, as I knew it, is over. That does not mean that my life in its entirety is over, however. All it means is that my days of slacking off about exercise are behind me. I have to exercise every day, even if that exercise is as simply as taking a walk. My days of eating without thinking are over. I have to plan my meals more carefully and learn new meals to prepare that will keep me healthier. My days of accepting my obesity are over. I have to lose weight so my heart will be able to sustain me without the strain caused by supporting a 300-pound body.
I need to rise to these challenges if I am going to survive.
There is good news, though. I have tremendous support in place. All the help I could want or need is available to me, and in that I am fortunate. The changes I must make are all changes that would improve anyone’s life, whether or not they have had a heart attack. Most importantly of all I lived through this and have a chance to do better in the future. Not everyone is so lucky.
I survived my heart attack. Now it’s time to thrive in the aftermath.