Friday, January 25, 2013

The Heart Failure Chronicles: Part I

Leonardo da Vinci heart illustration, 15th century.
I had a heart attack but didn't know it was a heart attack. It's flu season and my belly hurt. I was at work on Monday and it was almost closing time so I headed home so as not to ralph all over my workplace. You would have done the same thing. My boss Rita had the norovirus the week before. So did her husband Mike. She came home from work one evening to find Mike writing in pain on the front room floor. She took him to the emergency room where the docs looked him over and said, "Norovirus" or "stomach flu" or something like that and sent him home. He and Rita both had bodacious stomach cramps for two days, accompanied by ralphing and the other thing. Two days later, my coworker Annie and her entire family came down with the crud.

Meanwhile, I was at home with a belly ache watching crappy daytime TV. You'd think 500 channels would offer something beside Judge Judy reruns and a whole channel that shows "Frasier" 24/7. There's one for "Seinfeld" too.

On Wednesday, I went to the doctor.

"I have a bellyache," I said.

"There's a lot of norovirus going around," said the doc.

"That's what I hear. I have a bellyache."

"Any vomiting," asked the doc. They usually don't say "ralphing."




He looked pensive. He wore a dark suit and a stethoscope around his neck. He's an old-timey GP, with extended office hours and a staff that's seen me through sinus infections, bronchitis, assorted infections. He gave me a physical in September and pronounced me fit as a fiddle.

He never asked me about my heart. I have no history of heart trouble. My family has no history of heart trouble. My blood pressure is always 118/78. I swim every other day at the YMCA. I lost 30 pounds this year and feel fit as a fiddle most of the time.

He gave me an anti-nausea shot and sent me home. "Get plenty of rest and drink lots of fluids," he said. I've heard that before. I did as ordered. The next morning, I awoke with a horrible pain in my stomach and along my left side. I called the doc. He sent me over for X-rays. He called later. "Pneumonia," he said. "We'll order some antibiotics."

Crap. Pneumonia was an ancient scourge with me. I hadn't had it much as an adult but was hospitalized several times with it during childhood. I was 10 the last time I had it and that was the last time I spent a night in the hospital as a patient.

I took my antibiotics. The pain began to subside. Ten days of antibiotics with lots of fluids. I wasn't eating much but suddenly had a hankering for egg mcmuffins. Because I was sick, Chris was willing to grant me almost anything in the way of comfort foods. This was a bad thing, as it turned out.

It was Christmas week. I was camped out on the couch. Don't remember much except somebody gve me a cast iron frying pan. Not sure why I had asked for a cast iron frying pan although I'm a pretty good cast iron cook during summer camping trips. I'm an old Scout and learned a lot back in the days when when out scoutmasters were crusty old Army guys who smoked a lot and were very bad examples that way. I suppose they also brought booze to our winter campouts in Colorado's Collegiate Range and sat around telling old war stories while we snoozed.

Turns out, I didn't have pneumonia. But I'm getting a little ahead of myself. I was home for two weeks. I wasn't feeling much better but two weeks is two weeks and I had deadlines to meet. I watched a lot of football on New Year's Day. I was wearing a groove in the couch cushions. It was time to go back to work.

The next day was Jan. 2. A damn cold Tuesday. I took my daughter to school and then went to the store. Not sure what I bought but I dropped the groceries off at home I sat on my couch. I couldn't breathe. It was like an asthma attack, although I hadn't had one of those in decades. I called Chris.

"I can't breathe," I said.

"What do you mean you can't breathe?" She was at work and I could hear the hubbub in the background. I tried to think of what I would say if she called me at work and said she couldn't breathe.

"I'll be right home," she said.

I sat there alone, gasping for breath. We live at 6,200 feet. One sometimes sees athletes playing the Broncos at 5,280 feet hooked up to oxygen. I felt that I needed some oxygen. That's odd as I've been living a mile high for decades.

Chris arrived home and said, "Let's go to the hospital."

I stood. Walked to the door. And that's as far as I got. "I can't make it to the car."

I stood gasping at the bookshelf.

Chris got on the phone and called 911. I returned to the couch. Five minutes later, the EMTs were swarming around me. Two young men and a woman. They brought out some oxygen and hooked me up. That was better. Took my vitals. Guided me out to the gurney. I lay down and they covered me up and it was cold as hell. They boosted me into the back of the ambulance and hooked me up to some sort of vaporizer to help me breathe. The woman EMT told me to relax and I said I was too scared to relax. They fired up the siren and zoomed me to the ER. They put some sensors on my chest and took some sort of reading which I found out later was an EKG. By the time I got to the ER, the diagnosis was already floating around the halls. "Congestive heart failure."

I'd had a heart attack some time during the past two weeks. Maybe several heart attacks. In minutes, I had an IV in my right arm and a guy was drawing blood. They hooked me up to another breathing machine. A nurse came in and asked where the pain was.

"I have a bellyache." As I said it, I realized I was saying the same exact thing I'd been saying for two weeks.


I circled my stomach with my left hand. "All over."

"Hmm," she said. I'd been hearing this for two weeks.

"Any vomiting?"

"Why do people keep asking me that?"

"We've had some bad cases of stomach flu."

I felt like saying, enough with the stomach flu already -- I've been through that and pneumonia and I still have this fucking belly ache.

An orderly appeared and took me to X-ray. The X-ray tech looked familiar. She introduced herself and said she'd been the Wyoming Arts Council's Poetry Out Loud winner the first year we conducted the competition.

I remembered her name. Kamaria.

"What are you doing here?"

"Poets gotta make a living."

I thought that was pretty funny. I laughed but my lungs ached. Kamaria put me on my back, injected some sort of truth serum into me and sent me into the maws of a large machine. I couldn't breathe. She told me to take a deep breath. Don't poets have more empathy? The machine moved me out. "One more time," she said. I remembered her up on the Atlas Theatre stage, reciting Langston Hughes and Walt Whitman. I tried to remember the names of poems. "I hear America singing." Walt taking care of Civil War wounded at D.C. hospitals. His brothers was one of the wounded. Now there's some empathy for you. Maybe Kamaria was following Walt into the medical field. Wish I'd done that, once upon a time wanting to be a nurse like my mother and my grandmother.

Channeling Walt Whitman at the CRMC telemetry unit.
I was still thinking Civil War when I returned to my slot in the ER. I was happy to have a room. There were people lined up in the hallway. People coughing. A young woman with a freckled back. Doctors and nurses hovering and typing stuff into a bank of PCs. I thought of the Atlanta scene in "Gone with the Wind," all those casualties lined up, most of them dead or dying or about to be left behind as the Yankees closed in.

"Congestive heart failure." A doc I hadn't seen before looked at me. He was Indian or Pakistani or something else. A young nurse stood at his elbow. "Dr. Khan," he said. "I'm head of cardiology."

"Congestive heart failure."

Dr. Khan nodded. "You had a heart attack."


"You tell me."

"I've been sick for two weeks."

He looked over at his nurse. She scribbled on a pad.

"Can you lie down for an hour?"

"I can't lie down for five minutes."

The nurse again took notes.

"We want to take a look at your heart," said the doc. "We have a great cath lab. We want to see your heart and open up any blockages."

This was all new to me. "Open heart surgery?"

He shook his head. The nurse took notes. "We try to get our heart patients up to the cath lab ASAP."

"What's a cath lab?"

He explained the catheterizing lab to me. Lie me flat on a table and give me some drugs to relax. Put some dye in my heart. Go through my groin and put a camera up to the heart, check out the arteries. Open to blockages with balloons and maybe install a stent if needed.

"What's a stent?"

He explained that it was a tube that the docs put in the artery to keep it open after it was clogged by plaque and cholesterol and inflammation.

This was a lot stuff to take in. "Cath lab is open 24 hours a day," he said. "We've been here since 4 a.m."

I told him that I doubted if I could lie flat for the time needed for balloons and stents and cameras. He nodded. The nurse took notes. And they disappeared.

Another nurse came. She said they might take me to the cath lab as time was of the essence. I was feeling a bit scared and would have felt more scared if I wasn't hurting so much. Some time passed. My wife was making calls, alerting the troops, calling my work to say I probably wouldn't be in today.

All told, I was in the ER for a couple hours. Not bad, when you consider all the horror stories people tell about 12-hour ER waits. The hospital's building a new ER right outside the doors. It will be three times the size of the current one which should take care of that "Gone With the Wind" congestion.

I was admitted to the hospital with congestive heart failure, heart failure or just massive heart attack. I heard other terms later. I was transported to a room on the telemetry unit where I was wired for sound along with the rest of the floor. They monitor our hearts in a bunker full of computers and computer geeks. I was glad to be so monitored, as I'd never had a heart attack before.

Thus began my first night in the hospital....

--To Be Continued--

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