Heart attack

By | September 18, 2021

So, I had a mild heart attack the other day.

I woke up Monday morning with a sore left arm and a bad case of heartburn. I rationalized the sore left arm as having strained it carrying heavy scuba tanks and dive weights on Saturday. I don’t know how I explained the heartburn, though, because taking Alka-Seltzer and Gas-X and Zantac did absolutely nothing to help with it. Being stupid, though, I took Tylenol for the pain and got on with life.

Until Tuesday, when the symptoms were still there and not going anywhere. I did a telemedicine appointment with some doctor or another using Teladoc (which my insurance and employer encourage us to use) and the doctor had been on the call with me maybe five minutes before he bluntly told me to get a cardiac workup at an urgent care clinic or something ASAP. I called my primary care physician’s medical practice and my regular PCP was unavailable, but the doctor they could squeeze me in with basically said “Don’t bother coming to see me, get to the ER.”

I wasn’t too sanguine about that, given that our local hospital, the University of Vermont Medical Center, has been lambasted in the media recently for really, really long wait times to get scheduled for specialist services… not to mention Covid-19 patients taking up hospital resources in the emergency room and elsewhere. So I grabbed a thick book and headed on in to Burlington and to the ER.

The ER waiting area was maybe a third to a half full, which boded well. I checked in at the desk — they already had me in the system from seeing various UVMMC doctors over the years. When I said “I need a cardiac workup” the reception clerk said “Chest pains?” I nodded. She said “Take a seat, we’ll call you.”

And what happened next was, frankly, amazing. Almost as soon as I sat down, I was immediately called back up and was whisked into the mazy environs behind the ER desk where they promptly did an EKG. They sent me back out to the waiting room and again, almost as soon as I’d sat down, they called me BACK in and proceeded to do ultrasound and two chest x-rays and take multiple blood samples. “You had a heart attack,’ they said. “Your heart releases an enzyme called ‘troponin’ after a heart attack. Based on your level of troponin, you had a mild heart attack — it could have been much worse, but you definitely did have a heart attack.”

Within an hour I’d been formally admitted and was parked in a bed in a room that used to be the pediatric emergency area (it had all sorts of cute art on the walls) and was scheduled for heart catheterization the next morning, Wednesday. I didn’t get into a real bed (as opposed to an ER bed) until 11 pm or so, but then it was in a nice room on the fourth floor of the Miller building at UVM, the cardiac care floor. Every four hours or so while I was there they did more blood draws to keep an eye on my troponin levels; they kept climbing slowly and minutely but consistently.

I don’t remember much about the actual heart catheterization because once I was on the table where all the magic happens — where they inject the dye and watch your innards on the big screen and then send in the catheter and stents — they’d given me some sort of happy juice in my IV drip that was supposed to leave me awake but not in pain, but in actuality, basically knocked me out. I don’t recall sleeping but I do recall thinking I’d been there five minutes and then asking “Have you started yet?” only to be told that they were actually almost done.

The attending physician was blunt after the procedure was over. I asked how much plaque they found and he rather firmly said “A lot more than we expected.” But that’s why they wound up putting in four stents. They were not able to clear all the minor vessels around the heart but hope to get some of those cleared via the cardiac rehab outpatient program, which I’ll be starting in this coming week. Later on, when I had another chance to talk to him (and after multiple people had mentioned the importance of a low sodium, low saturated fat diet) he said “well, a lot of it is probably heredity. You mentioned a family history? High BP and multiple heart attacks and such?” It’s vaguely comforting to be able to blame my genes for the wretched state of my coronary arteries but it’s also a bit embarrassing to have “a lot more than we expected” at the age of 53 (I turn 54 on Monday, but I was 53 at the time).

I was kept inpatient until my troponin levels started to decline; they kept going up throughout Wednesday and on into Thursday morning. It wasn’t until they analyzed the 9 am blood draw that the troponin had finally begun to go down and I was safe to release.

I can’t say enough about the staff at the hospital. Every single person I encountered, from resident to fellow to nurse to attending, you name it, was extremely courteous. Every question I asked — and I asked a lot of them — was answered thoughtfully and fully, without any of the “oh, you wouldn’t understand, it’s all medical stuff” that I might have expected. I was also just flat-out amazed at how fast they got me back there and started administering care. I didn’t get a chance to even crack that book I’d taken along until along about 10 pm or so the first night; I was always being whisked from one test to the next. (I got three ultrasounds, including one in the middle of the night administered by a rather worried looking doctor that I didn’t encounter again while I was there, so I don’t know what that was about.)

I’m also very grateful to Carole, who didn’t say “I told you so” even once and who came to visit multiple times — Tuesday evening and twice on Wednesday — to see how I was doing and let me know she cared. She knows that going forward some things are going to have to be different around our house; we need to work on reducing stress, balancing chores more evenly, cooking with a LOT less salt (she can add more if she misses it) and avoiding fat, and getting a lot more exercise.

I got a ton of walking in over the winter — going out at night with an orange reflective vest and headlamp on and walking in the dark, in the snow… but come spring, work got so busy that I was often still at my desk at 9 o’clock at night and was too fried to walk. Two things have to change there — one, I have to balance work/personal life better and not BE working at 9 pm, and two, I have to get back in the habit of exercising. Since I have the 2021 San Diego Susan G. Komen 3-Day breast cancer walk (sixty miles in three days) coming up in mid-November I really need to get a lot of walking in.

I feel extremely lucky. Like “six standard deviations from the mean” lucky. I live near a major medical center and in an area where people have taken Covid-19 vaccination seriously. I’ve got insurance, which thoughtfully emailed me a letter the day after I was discharged informing me that they would, indeed, cover the whole thing.

Now I just have to be worthy of that luck and take my own health much more seriously. I can’t guarantee I’ll be so lucky a second time.

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5 thoughts on “Heart attack

  1. Jeff wojcik

    Jay that was an insightful dissertation on a very scary event I am so glad the UVM experience was so positive. Seems they have the triage and prioritization pretty well developed. Sorry to hear of the heart attack, So glad you have come through the event and recovering well. Also glad you are more reflective of your health Best wishes for continued prosperity

  2. Marith Flugelhorn

    Yikes, I’m glad that you are doing okay and that the care was so good! Hopefully the adjustments going forward will help you feel better in general as well as protecting health. Fingers crossed for you! Trip sends good wishes as well!

  3. George Curlanis

    You have my wishes for strength, comfort and health. Your plans sound like great ways to live healthfully! God bless!

  4. Brad Wise

    Jay, glad you survived and thank you for sharing this great story of amazing care! I don’t know what our FRM clients would do without you.

  5. Pingback: My Completely Mystifying Heart Attack Recovery

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