Saturday, January 26, 2013

The Heart Failure Chronicles: Part II

My blockage was in the Left anterior descending artery (LAD) which supplies blood to the front and bottom of the left ventricle and the front of the septum. Thanks to the Cleveland Clinic for the artwork. 
Beware the Widowmaker.

That's the potent nickname for the heart's main trunk artery. Get a blockage in that big boy and, well, it's all over but the mourning.

I beat the Widowmaker. My cardiologist was a bit stunned by it. He tells me that Widowmaker-caused heart attacks that come into the ER usually don't make it. He told me this after inserting a big stent into my artery. I appreciate him not bringing this up the day I brought myself and my blockage into CRMC in the hopes that the crew there could save my life.

I'm here, am I not?

I was on the path to recovery the moment I reached the ER. It didn't seem like it, not at first, because I was a sick lad with a clogged heart and a bad pump and congestion in my lungs. A week later, I had a tube in the Widowmaker and was on the way home.

The care was superb. I don't have much to compare it to as I haven't been a hospital patient for approximately five decades. In 1960, I was in a Mercy Hospital ward with other children. The nurses wore white uniforms and stiff white caps. Nuns in black habits ran the hospital. On Saturdays, they let the kids come over to the nunnery to watch "Mighty Mouse" and "Sky King." The docs were rarely seen but were officious and efficient when they arrived, always attended by a nurse hovering in the background. An antiseptic smell wafted through the air. Shots were administered in huge glass hypodermic syringes with long needles. That may be just how I remember them, as I was a little kid with a fear of needles.

Fifty years later in Cheyenne, I had my own room that overlooked the construction of CRMC's new cancer center. Several times a day, choppers buzzed my room on their way to dropping off emergency cases on the CRMC helipad. An efficient procession of nurses, CNAs, phlebotomists, doctors, chaplains and therapists trooped through my room. My heart was monitored by the folks in the telemetry unit. I ordered my meals from room service. Everyone was kind and caring.

I was admitted to the hospital on Monday. On Wednesday, I was scheduled for the cath lab. People spoke of the cath lab in hushed tones, as if it were a special place, a shrine to modern medicine. The cath lab nurse arrived and described the procedure. Dr. Chapman the cardiologist looked in on me. Mid-morning, two nurses arrived with a wheelchair and guided me to the cath lab. When we reached the inner sanctum, I was greeted by a group of doctors and nurses and technicians. Led Zeppelin blasted from the stereo. The room was cold and brightly lit. I was unloaded on a table. I was hooked up to an IV and Foley and my right groin was shaved. That was the site for the insertion of the catheter. Dr. Chapman was in the control room behind a glass window. "We're going to give you something to relax you," said the tech. Suddenly, I was so relaxed that I missed the whole procedure. When I awoke, I couldn't breathe. They hooked me up with a breathing machine and wheeled me back to my room. The stent is in, someone said. And I was glad. Blood was flowing in my heart again and maybe I was going to be all right.

Not so fast, bucko.

My heart was damaged. I'd gone for a week or two with a blocked or partially blocked artery, which deprived the heart muscles of blood. Sometimes those muscles can go into hibernation for a time and a renewed blood flow brings them back to life. Sometimes. My pump's efficiency was about half of what it was supposed to be. They plied me with drugs that lowered my blood pressure and helped my heart pump more efficiently. They gave me a drug called Effient that coated my platelets so that they would coagulate at the stent site. I now take Lipitor to lower my cholesterol. I probably should have been taking this all along.

Get thee to the ER. That's the cardiologist's refrain these days. When people complain of heart attack symptoms, they don't mess around. EKGs are administered in the ambulance and if it's a heart attack, they want to get that patient treated quickly. The quicker they can open the artery, the less damage is done.

I wish I would have known that. I wish that I'd had an inkling that the pains in my belly were heart attack symptoms. I was my doc had thought of administering an EKG while I was in his office. I wish a lot of things. I pray that my heart returns to normal over time. If not, I'll be fitted with an internal defibrillator which will monitor my heart rhythms and shock me back to normal should I go into arrhythmia. Right now I'm wearing an external defibrillator. It's a vest with sensors that track my heartbeat. It's also equipped with paddles that will shock me back to life should I have a weird rhythm. I wear a book-sized battery pack around my neck. It's a great conversation starter.

I've learned a few things. You may be having a heart attack even if I doesn't seem like a heart attack. Your symptoms may be atypical. Get thee to the ER. You may save your life or, at least, avoid damage to your heart.

--To Be Continued--

No comments: