Problems of the heart: A case study

 

It’s been pretty well documented about my heart problems since last July.

For a number of reasons, I want to share what happened in detail this past Monday when I had to enter the hospital again. I think it’s not only important for my family, but you my friends, may get some information you can use here.

I’ve learned some things as a heart patient that I think is very important, so here is my story for the past 2 days.

Monday, Feb. 23, 2009  3:00 AM

I woke up with a pain in my left leg. No reason, just a pain. It didn’t make sense at the time, but it may have proved to have been beneficial and I didn’t know it at the time. I got up and made myself some coffee trying to play doctor on myself and figure out why my leg was having shooting pains under the knee. I had just started a pretty nice work-out regimen and just figured it was some sort of muscle spasms from working out on Sunday.

I went on in to work and at about 10:00 AM, I felt like my chest was pounding too fast and furious for some bizarre reason. Since we have a medical assisting program at our college, I was able to ask one of our instructors to take my blood pressure. By this time I was having some chest discomfort and the shooting pains that were in my leg at 3:00 AM was now the shooting pain in my chest. My blood pressure was a whopping 160 over 100. Not good. Then the instructor thought it was best to call the paramedics. I was getting pretty scared at about this time. I damn sure didn’t want another heart attack, but that’s what it was looking and feeling like. The Dallas paramedics arrived and by that time my blood pressure was coming back down to normal. My doctor and I still don’t know what created that spike in blood pressure. So I thought everything was going to settle down and get back to normal. I declined the paramedics offer to take a ride down to a local hospital just to check things out. This prooved to be an interesting decision on my part. I thought if I were going to have any issues, I want to go to the hospital I went to before in Arlington. So I decided I would take off, but I would drive to my doctor in Arlington and let him see what he thought.

I got to the my doctor’s office in Arlington at about 1:00 PM.  Amazingly, as soon as I got to my doctor’s office, the chest pains began again. My doctor’s office is right next door to Arlington Memorial Hospital, and they actually put me in a wheel chair and took me to the emergency room there. What are the odds of being in the right place at the right time?

I got checked in to the hospital and was given a nitroglycerin patch which supposedly opens up all the arteries and lessens any vein or artery constriction. Please understand I’m not a doctor, and these details are just how I understand them which means there may be some factual errors here. I was scheduled to have a heart catheterization Tuesday to find out what the problems were. I was pretty bummed at this point. I was more scared than anything, but I wanted to know what the problems were to stop having pain.

 Tuesday, Feb. 24th, 2009, 7:00 AM

A nurse aide came into my room and turned the morning light on. I couldn’t have anything to eat or drink until after the surgery. I wanted a cup of coffee so bad I couldn’t see straight. The only thing the aide could offer me was a shave to my groin area.

Cardiac Catheterizing(cardiac cath) is a procedure that helps doctors see how well your heart is working. Doctors insert a thin, hollow tube called a catheter into an artery in your arm or leg which leads to your heart. The catheter in this image is used to deliver dye that will show up on an X-ray (contrast dye) to visualize the coronary arteries.

I was also going to be totally awake for this surgery. Let me repeat that. I was going to be totally awake for this procedure!

I had my cell phone in my room and was frankly surprised most of the nursing staff let me use it in my room. I was busy texting my family and friends on any and all updates. I was even commenting my status on Facebook. It helped keeping my mind busy and not getting so afraid. It really helped out. The nurses came to get me at about 12:30, an hour after the original time had been scheduled for my surgery. They rolled me in a prep room and did all the necessary things and then we went in the operating room. They moved me on to the operating table. Not only was this the place, it was cold. So for someone that’s scared to begin with, the cold room seemed even less friendly to the touch.

(idea here) I’m going to publish as I go, so stick with me here. Sometimes I have to take a break and just go lie down.

The following began the most incredible event of my life. This entire procedure was recorded and was videoed for a teaching tool and I guess just to have on record. I will be getting a copy of this surgery and all that was said during this surgery here in a few weeks. You will understand why I think this is key after I tell you the story.

The doctor and all the nurses introduced themselves on camera, and they got the tv monitors in position so that I could see as well what was going on. The doctor used a local anaesthetic on my right groin area and without being too technical or graphic, slid the catheter up the groin vein to my heart and I could see my artery that was having issues.

So there I was. Laying there in a very cold operating room, my full groin exposed to the world, with my life in the hands (literally) of 4 people I had never met in my life aside from a brief 10 minute doctor’s appointment the day before. It was pretty scary. But the doctor was cool.

Dr. Taylor could have been Hawkeye, right out of the TV series M.A.S.H. 4077. He had a very warped since of humor. The good thing about that was, I was so busy studying his jokes and trying to catch the punch lines, it took my mind of the seriousness at hand. (Pun intended). He mentioned he had worked at Cook General Hospital in Chicago, and Charity Hospital in New Orleans. He had seen his share of gun shot victims. He made me feel confident he had seem some wild stuff, and this procedure would pretty tame in comparison. It was a relief to me to know that, even if I was awake at the time.

The catheter slid up into my heart, and the camera above my chest took many pictures. Every time the camera would take a picture, the lights in the operating room would dim. I made an analogy to the folks around me that it reminded me of a prison when they put the  juice on the electric chair. They laughed at my joke, but I make some of my best humor when I’m scared as hell. Many more pictures were taken all during this process. And then, the doctor moved the monitors so I could see two different pictures. The first picture was of the old stent that was place in the artery back in July. There was a horseshoe-like build up of plaque right in the middle of that stent. But there was also a small wire that was rubbing up against my artery! Dr. Taylor said this wasn’t malfeasance of the previous doctor, it was just a bad side deal that happens with stents. Sometimes things happen. Dr. Taylor said this happens in about 10% of stent surgery. And then Dr. Taylor gets right above my face and makes the following declaration:

“I can fix this right now and there is a 1 in 100 chance you will have a heart attack right here, or I can close you up and there will be a 25% chance you will have a heart attack and I won’t be able to help you.”

Hey, doc…wait a second I thought. Can we have a time out here? How about a cup of coffee? Maybe a beer? Maybe we should do lunch and talk this over a little bit.

“Is there some family outside I need to talk to?” he says?

 

In a split second, my mind reeled back 58 years of life to remember where any and all friends and family were at that moment. My parents long since deceased as well as brother and sister. My kids who are all grown with their own families, spouses, and lives and all living out of town. Nephews and nieces and their kids, scattered like a west Texas wind.

“No doc, there’s no one outside.” I said.

 

So the doctor began the mission of fixing the problem. Previous to this point, the good doctor was kidding with his nurses, making jokes and being Hawkeye Pierce.When he started back on this mission, he became focused and quite. The conversation became intense to me. It was at that point I became even more fearful of my operation. They were discussing different sizes of stents to insert like sizes of nuts and bolts. Even more amazing to me is, after each time the doctor inserted a certain size of stent and saw it wasn’t the size he wanted, he would take it out the long tube and out of my groin area. “Do we have a 2 1/2 TLB stent he would ask? And the nurse would say yes but it’s a 2 1/2 TCB not a TLB or whatever the nomenclature of the part was. I was getting concerned they weren’t going to have my part size. At that point I thought about the show the 6 Million Dollar Man. I wondered how long the doctor was going to search for the correct size of stent. Then he told the nurse let’s try this size and make it “sloppy” which I took that to mean wet? At any rate, he inserted that stent and he liked the results. I felt like he had accomplished his mission and we could all get me sewn up and maybe I could check on getting out of this place. Not so fast. Then there was a little mission of angioplasty.

Before the surgery

Doctor Taylor had the stent he wanted, he got it in place. Now he wanted to use the balloons to clear away some plaque while he was there. What scared me about this part of the operation is he was going to blow up balloons in my artery. To hear someone say “blow it up! 10, 15, 20, 25, 30….” I half way was wondering how much my artery could expand. There wasn’t any pain associated with it…but it sort of made me nervous to wonder how big this balloon was going to get. I think this happened 3 or 4 times. I felt some what comfortable in knowing that at least the stent was in, and now we were just doing the balloons if that makes sense. My mind was trying to imagine the wire scrapping my artery, and balloons in my veins. It was scary as hell.

And then it was over.

The operation was done. Dr. Taylor stepped back and looked at the monitor and was pretty satisfied with his work. If he was satisfied, I knew I was gonna be satisfied. He let me have copies of pictures of the heart and as soon as I can scan them I will post them here. Words can’t express how glad I was when this ordeal was over. They rolled me to the coronary care unit, and that became the first phase to recovery.

After the surgery

Epilogue

I survived again. There are two sides to this story. The physical and the mental. Once again I was able to make it to the hospital in time. I’m very thankful for that. I’m a little miffed at the wire that was rubbing my artery, but I now understand what was causing my pain. The good news is I survived.

The mental side is what I’m dealing with now. Dr. Taylor says it’s very common for heart patients to go through a period of depression after that kind of surgery. He said the after-care program I will go through will address that too.

I will be ready to go back to work next Monday. Even though today is now Thursday already, it doesn’t take me long before I have to go lay down again, but I think by the time Monday is here, I will be good-to-go. I wonder though. I wonder how other people view me now. Do people see me as a dead man walking? Do people see me as someone who has gotten a medical issue solved and can enjoy life for the next 20 years? I wonder.

I guess the question should be how do I feel about myself?

I’ve thought a lot about my mortality. I’ve had plenty of time to think about it. I love life so much, I love everything about life and all it holds. At some point it will end. At some point your life will end. But I have to look at life as a journey. A journey to another journey. Without that faith, I would be really depressed if I thought this was all there was to it.

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