But let us start with “the event”. Wednesday morning, 8 o’clock, I awoke to a crushing pressure in my chest. The classic elephant’s foot, pressing down on me. In addition, there was a pain radiating from my heart and down my left arm. You don’t have to be a board-certified cardiologist to know this is not good.
Jo gave me two aspirin and then she called 911. Within 20 minutes, a fire engine and an ambulance were at our motorhome and men and women were clambering round, trying to figure how to get me onto the gurney outside the door. They refused to allow me to walk out on my own. That would have been so much easier on me and everyone else. Four men picked me up and tried to pass me down the narrow entrance way to our rig. They pretty much made life hell but managed to man-handle me out to the gurney. There they strapped probes on me and got me into the ambulance. One technician popped a nitro-glycerin pill under my tongue and we were off to the hospital, Jo following behind with a friend from the campground.
Florida Hospital in Tampa is a sprawling, multiple-block-long series of buildings. The emergency staff sprang into action and repeated what the EMT people had done in the ambulance. They stuck another nitro tablet under my tongue. That opens up the blood vessels. But the price is a raging headache. Their heart monitor tracked everything going on in my ticker and, after a few hours, a doctor appeared. He said they could find no damage to my heart but they wanted to move me to a room where I could be monitored constantly.
I didn’t see a cardiologist until 5 p.m. which was disconcerting. I was pretty grumpy by this time because I had not been able to eat anything for 22 hours. My elephant foot was still on my chest and I was not being treated. The cardiologist, Dr. Mohammadreza Tabesh, was a quiet young man, exuding a peaceful confidence. He said there would be four EKGs made during the first 24 hours and I’d had two already which showed nothing. He said a nurse would be monitoring me every hour.
Another patient was brought into the room and he seemed to be in much worse condition than I. He seemed to be drowning in his own fluids. He’d lie in his bed, out of sight, and gurgle when he breathed. About once every hour, he’d press his panic button to summon a nurse, screaming that he was drowning.
My nurse came in and woke me at 1 a.m. on Thursday to take another EKG. She disappeared. My elephant was still in the room. Things changed in 20 minutes. She was back with a team of nurses and technicians. “The EKG showed you were having a heart attack while we were taking the EKG,” she said. We have called the cardiologist and a senior nurse. We’re moving you to the catheterization lab and will prep you for the doctor.” This involved shaving my pubic area. This was done by Jukie, a cute young South Korean nurse. She worried aloud that she was shaving too much. But another RN, a guy, said to keep going.
I phoned Jo at 1:45 a.m. to alert her to the change. She can’t drive at night because of cataracts in her eyes that cause extreme flaring of light. But I wanted her to know that something was up.
The cardiologist, looking a little rumpled, was all business. He inserted a catheter in my groin took a look at what was happening to my arteries. I was able to watch as he came to the first blockage. It was like a dam: blood here, then a blank spot, then blood on the other side. He said I needed four stents. But he was worried about two of them because of an intersection in the artery which would have required two stents to be very close together. He saw very little damage to my heart muscle.
He said he’d like to consult with a cardiac surgeon to help determine if I should have stents or if the surgeon should split my breastbone, open me up and do four bypass surgeries. That was not an appealing option from my point of view, All I could visualize was a chicken breast being split apart with a cleaver.
I was moved into the cardio intensive care section, where I was assigned a nurse whose only job was to look after me and one other patient during her 12-hour shift. Mary was her name and she was my new best friend.
Mary was all business, but she had a great sense of humor. She hooked me up to more monitors than I thought possible. As best I could see (all of the monitors were behind me) there were more than 20 readouts occurring simultaneously.
I was being drip-fed nitro now. And this didn’t cause a severe headache. I also was being drip fed loads of other fluids.
The surgeon stopped by on Thursday morning to lay out the options from his point of view. He said I could go either way: stents or bypass surgery. He liked bypass surgery because he thought it would last longer than the stents. But he also was aware of the impact of the surgery in terms of being able to function and work. He praised Dr. Tabesh, my cardiologist, saying he was quite conservative and was an excellent cardiologist.
He said he would be unable to operate for one week, however, because Dr. Tabesh had given me a specific drug that must be out of my system before he could cut.
That pretty much made my decision easier for me. I was not willing to sit in hospital for a week, waiting for my system to cleanse itself. I chatted with Dr. Tabesh and asked him about the drug he had introduced. He explained that it is necessary to use it for one year in conjunction with inserting the stents because it makes the blood more slippery, thus reducing the possibility of clotting at the stents.
I told the cardiologist I wanted to move ahead with the stents. He said he could do two the next morning but I would have to wait until Monday for the second set because it would require too much of a chemical in my bloodstream so he could see the blood flow on the monitors were he to do all four in one sitting. He said my kidneys would have too hard a time processing the chemical. Arrrgggghhhh. Nothing is easy.
I was prepped on Friday morning and carted off to the catheter lab again. Jo kissed me at the entrance to the lab. She leaned in and whispered, “I’m not done with you yet. See you soon. I love you.”
The lab hummed with life and energy. The full team was waiting. Dr. Tabesh came in, shook my hand and it was cameras, action, roll ‘em.
He opened up my groin, slid the catheter in and up my femoral artery, across my chest and there was my messy artery. In went the first stent, inflate. In went the second stent, inflate. And there went the blood. It was like a dam had been cracked open. Now the blood flowed through that river of life. I was able to watch all this action on the hi-res monitors.
Dr. Tabesh sat quietly watching the action. I could feel his mind working. He told me he thought he would like to run a stress test on the location of the final two stents to see the state of that artery. I said, “Go for it, doc.” He injected a chemical that sent a great rush of warmth through me. He studied the picture on the screen for two minutes and turned to me. “I think we do not need to stent this area,” he said. “The stress test shows you are getting adequate blood flow there. I suggest we leave that alone and revisit it if needed at a later time.”
I was wheeled back upstairs to intensive care and this sets the scene for “the episode.”
Mary hovered around, constantly checking where the catheter entered my groin. She said she worries about blood clots forming there. After about three hours, Dr. Tabesh stopped by to check on me. He said if all went well, I might be able to leave the next day, Saturday.
He then left the building. Mary removed the catheter from my femoral artery and placed a heavy donut over my groin. She returned a number of times to check my groin to be sure there was no leakage.
I asked her about the catheter, how it worked, where it went, etc.
And, as she explained it to me, I noticed I began to yawn involuntarily. I then noticed I was beginning to feel very hot. I told her that and the moment I did, I had the sensation of falling backwards and going down, down, down. There was no fear but I knew I was dying. I may have said, “I’m not going to make it” because I could hear Mary going into overdrive, calling out for assistance and calling for specific drugs and fluids. There was great urgency in her voice. But it really didn’t matter because I had fallen so far backward that I knew I would not be back. I could hear her tell me to hold on. “You’re going to come back. You’re going to come back.” But I didn’t think so.
And then I stopped falling. I was hovering now. No worries. No fears. Nothing. No bright light. But I felt myself rising. I heard her say, “He’s coming back.” I thought of Jo and was relieved that I would see her again, that it wasn’t over.
I remember Mary asking a nurse to stand by my bed and keep an eye on me because she had to go pee. I thought that was kind of funny. I looked at the nurse, whom I didn’t recognize, and began chatting with her. I was curious, I said about whether the monitors would have all this data recorded, or do they just give moment-by-moment information. She smiled at me and said it was all recorded but she was there the whole time and had seen everything.
I asked her about my blood pressure. “That dropped to 32 over 22,” she said. “And your pulse went as low as 24.”
Mary was back now and I asked her about what happened. She said she believed she had affected the vena nerve, a major nerve that crosses our groin area and curves around to the anus. If it is traumatized, she said, it is possible to produce these results. She said this is why people straining over a bowel movement can pass out. (I could have this wrong, because all this is being reconstructed from memory, of course.)
She said she had ordered two one-liter bags of saline solution to be pumped simultaneously into each arm without any restriction. So I had been given two liters of fluid in an incredibly short time. She told me I would need to begin eliminating this fairly soon. Otherwise she would have to insert a catheter. I told her there would be no more catheters. And I set about to pass a couple of quarts of pee.
She remained ever vigilant, wanting to know how that was working. And she threatened to catheterize me but I said “no way”. I began flowing on my own and that solved that problem.
Dr. Tabesh came in to visit me in the early evening. He wanted to hear about the episode and said I would not be leaving on Saturday. Maybe Sunday if all went well on Saturday.
And all went well. I was moved out of the intensive care unit on Saturday afternoon and moved to the first floor to a private room where my night nurse was Marina, a very sharp Russian RN. There was a whiteboard on the wall, giving me the Day, Date, Names of my nurse and my technician. There was a slot for “Goal of the Day” and I asked the nurse to write “To leave tomorrow.” They liked that and chuckled because no one bothered to fill that line in.
I woke up on Sunday morning and walked over to my whiteboard to change the goal to “Leave Hospital Today!”
And so it was. But, just to keep life interesting, the park where we are volunteers phoned just before I was released to say the park was closing because of the tropical storm and we were required to evacuate the rig from the park immediately. We told them we would be back in about an hour or two, after getting our prescriptions filled. We planned to eat a light lunch and then we would be ready to move.
While I was unable to drive the rig or the car, I was able to show Jo all the things I normally do when we disconnect our umbilicals and leave our site. But Jo did it all. Then she drove to a commercial park nearby where we had already called to be sure we could stay. They gave us a handicapped site which is easier to back into. Jo finished the journey by backing the rig into our new slot. We plugged in the umbilicals and set up house.
