"Minor" Heart attack turns into Major Trouble

by Mitch
(Belle Mead, NJ)

In November 2007, having just thrown a surprise party for my wife's 50th birthday, things were looking up. My mother-in-law had passed from lung cancer in May, after a relatively short (7 month) fight, but things were beginning to get back "on-track". The party was a big success - but two days later signs of trouble emerged.

I was 2 months shy of my 49th birthday. About 9 AM Monday morning I developed really bad indigestion. I attributed it to food from the party and another party we had attended the next day. It was extremely uncomfortable, but after about 2 hours, it went away and I felt better. Tuesday evening it came back with a vengeance - I took some anti-gas meds, which did nothing to help. I suspected a heart attack, but didn't want to admit it to myself. I was only 48. Yes, I hadn't taken care of myself. Despite multiple times having dropped a significant amount of weight, I hadn't kept it off and once again was near my heaviest - in the high 200's. I had high blood pressure but had refused medication, still determined to lose weight and control the BP that way. Still, I was in denial that a heart attack could find me at 48.

I went downstairs and googled "heart attack vs. indigestion". When I compared my symptoms to what the web results were telling me, I decided not to fool around. I asked my wife to call 9-1-1. Sure enough, it was a heart attack. Not major as heart attacks go. A small "diagonal" artery had closed completely and was causing my pain. The surgeon but in 2 stents and opened it back up. I was in the hospital from that Tuesday night (right before Thanksgiving) to the following Wednesday. I don't remember a whole lot about the hospitalization - presumably because I was kind of "out of it" as they couldn't get my white blood count stabilized. I vaguely remember coming home and I don't remember anything about the next day Thursday (my wife says I stayed upstairs all day).

Friday, I remember. I was supposed to go to the blood lab (which is right across the hall from the cardiologist's office) for routine, post-hospital blood work. I was VERY sluggish. It was a LOT of effort to put one foot in front of the other. I managed to shuffle from the parking lot to the blood lab. The nurse tried multiple times to get blood and she could not find a vein that worked. After a number of tries, she gave up.

Leaving the blood lab, I said to my wife, "Can we go across the hall to the doctor? I really don't feel well". I couldn't even walk from the waiting room to the exam room - had to go in a wheelchair. The nurse in this office did manage to find s vein and get blood, but shortly there after my blood pressure dropped precipitously and I think I went unconscious (or came close). An ambulance was called and I was taken to one hospital where i was stabilized and then transferred to a second hospital. Next thing I know, a Thoracic Surgeon is telling me "you have two choices: I can open you up and attempt to clean out this infection; or I can do nothing and you're going to die". I remember saying, "so if you open me up, I've got a shot?". A little bit later, after a big hug from my wife, I went to sleep. I woke up about 2 weeks later.

My wife can better tell you about those 2 weeks, but here's what I know. I had pericarditis. They drained about a wine bottle's worth of fluid from my chest. They removed the stents and tied off that artery. I had multiple blood clots, pneumonia, fever. They left my chest open for those 2 weeks and kept on cleaning it out. Finally, they did a debridement (http://en.wikipedia.org/wiki/Debridement) which was apparently "touch-and-go". If too much damage had been done to the heart, I might not make it.

The next three weeks or so (two in the hospital and one in a rehab center) were mostly about recovery. There were the delusions and hallucinations from the heavy meds I was on (apparently, I told one doctor that "I was fine until the plane crash"). There was the pre-mature discharge to one rehab center that turned out to be a disaster and landed me back in the hospital. But mostly, it was about recovery - healing and getting back on my feet.

I returned home 2 days before my 49th birthday. There were further complications - a blood clot developed in my right leg that delayed home and cardiac rehab. It took me a long time to get my energy level back near normal, but finally, I made it to cardiac rehab, back to work, and back to what we've called "a new normal".

Did the stents cause the infection? or were they totally unrelated and coincidental? I guess I'll never know for sure. The thoracic surgeon says the infection came on so quickly after the stents were put in, it's likely that it had been there all along. Others say, that it's possible the stents were the cause. I'm coming around to that point of view, but I can't be 100% sure.

It took me a very long time and I'm still working at it, to overcome the mental/emotional aspect of all this. We have two girls, who at the time were 11 & 8 years old. The impact on my wife and girls and what "I put them through" has weighed heavily on me. I balance that with the gratitude I feel for still being around for my family, but I've had a tough time balancing all my emotions. My father died of heart disease related complications at age 56. That's another thing that's weighed on me --- "Am I going to meet the same fate?". True, I don't smoke cigarettes like he did and when I'm watching myself, I'm more active than he was. Still, I don't want to leave my kids as early as he left me (I was 16).

Like, I suppose, many who have had heart disease, every pain or discomfort that's occurs is a cause for momentary concern (or panic). My poor wife has had to deal with me asking "what's that?" for over two years now. Part of the problem, is that despite all that's happened, I still haven't done a great job of taking care of myself - eating right & exercising. I decided recently, that now's the time to give both of us a break and start working on getting myself back in shape - so I'm turning it around ---- starting to feel better and hopefully, she will too.

My most recent scare occurred in mid-June 2010, when after having had a minor respiratory infection, I woke up one morning to shortness of breath and later that morning, nausea & sweating. Came close to fainting. The EMT said my heart rate was 170-190 and another heart attack was suspected. Fortunately, the heart rate self corrected at the hospital and I didn't have to go to the cath lab. I was monitored overnight and they determined that it was NOT a heart attack. I'm attributing this episode to a known side affect of a medication, Avelox, that the GP gave me for the respiratory infection.

Aside from that, I've been doing well. Feeling better physically, emotionally, mentally. It's taken a long time for me, but I'm starting to make the shift from a "man who's not in good health" to a "man who's taking care of himself and who is looking forward to living again".

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