I had a heart attack

As of tonight, it will be one week since the heart attack. My dad returned to DC the other day, my mom goes back today, and now it is time to tackle this on my own. Here’s a more complete recap of, well, everything.

Monday, June 10, 8pm: I had just finished moving the south side of the front lawn. [The north side, a week later, is still unmown. One side of my front yard is shaggy.] I started to rake up the clippings, and as I did I thought to myself that this was more work than I expected. Soon, I was short of breath and a little dizzy, so I stopped and sat down until it passed. I got a drink of iced tea and then went back to it, but the second time the dizziness and hyperventilation started almost right away. Still, I didn’t panic or anything — I took the time to put the rake and lawnmower into the garage.
I went inside to lay down. By this time, my chest had tightened — it wasn’t a sharp pain, but more like a sore spot, as if I’d pulled a muscle.
But it all started to get worse. I couldn’t breathe except for very short inhalations, my chest got more and more sore, I had a tingling around my jaw as if I was about to vomit, and I was very hot and sweating. I started to roam around the house trying to find a place to lie down and relax — the bed, the couch, the floor — every place was too uncomfortable or too hot. I ended up on the bathroom floor, with a wadded up towel as a pillow; the dog upset and worried followed me from place to place.
Within 10 minutes, the symptoms subsided enough for me to contemplate what I should do next — since my breathing was better, it didn’t seem like a life-threatening situation, so I didn’t call 911. Instead I called Jann to see if he’d ever heard of this sort of thing before. Then I called the Kaiser Permanente advice nurse. Her advice? Get to the hospital, now.

I wobbled out to the street and found the only neighbor around that night; Naomi drove me out to the Kaiser emergency room, where upon hearing my symptoms they immediately did an EKG. Once the doctor looked at it, they informed me that I would be brought in for a look, and while I would probably go in before others in the emegency room, I wouldn’t be first. How prophetic — it took 3-1/2 hours to be seen. After 2 hours, I told Naomi to go home. After 3 hours, I decided to go home myself, since I felt fine — I figured I could come back for an appointment. By that point, I was next in line so I stayed — thankfully.

[Tip: paying for your emergency room visit with American Express means that you earn more points toward a magazine subscription.]

Blood was drawn, history was discussed, blood pressure and heart rate were monitored. The consensus seemed to be that it was not a heart attack, but they always proceed on the worst case scenario. After all, I was just too young.

And then, in the early morning hours, the doctor came back and reported, matter of factly, that the blood test had shown a elevated level of enzymes which are released during a heart attack. The monitor showing my heart rate went crazy. All this time I had assured myself that I had just had some kind of exhaustion or stress… and for the first time a doctor was telling me that I had a serious medical problem.

Basically, a heart attack happens when blood flow is interrupted and the heart muscle begins to die. I realized that this was completely my fault, that my blood vessels were probably blocked by Outback Cheese Fries and Ben & Jerry’s.

From his point, it was all serious. They immediately moved me from the cramped little room at the end of the ER to the large room right next to the main nurses’ station. They slapped nitroglycerin on my chest. They started IVs, and brought in two more doctors including a cardiologist. And they admitted me to the hospital. By 4am, I was upstairs in a hospital room, having vitals checked and blood drawn every few hours. But this was just a temporary stop.

Soon after the sun rose, an ambulance arrived. After the complicated logistical nightmare of disconnecting all the tubes and wires on me then reconnecting them to portable equipment, I was off on a gurney for a ride to another hospital. The Kaiser hospital didn’t seem to have the facility, so I was transported to Good Samaritan, farther south in Silicon Valley. Once we got there, it was straight to the Cardiac Catheterization Lab with no other stops. I lay there for an hour or so contemplating what was going to happen next, which is where I really started to panic.

There’s a certain invulnerability in each of us, we go through our lives assuming that we are not going to die — at least, not in the foreseeable future. And even when it was announced that I’d had a heart attack, the doctor assured me that I wasn’t going to die. But when they started talking about what would happen next, I wasn’t so sure.

They told me what was to come: angioplasty. Starting in a large vein in the groin, they would thread wire up to my heart, where they would inject dye. This dye would show them via xray what was happening with the blood vessels. If they found a blockage, they would insert a balloon: inflating the tiny balloon in the blood vessel would flatten the blockage against the vessel walls allowing blood to flow again. Then, they’d put a stent in place — a stent is basically a mesh tube — to keep that area open.

They told me, in hedged language, that this procedure was routine and performed thousands of times per year. But they also told me what would happen if they discovered multiple blockages and anything more serious: open heart surgery. They made this sound ominous and it really scared me — the risks associated with such surgery made it sound like I should be prepared to not return from the operating room.

They gave me drugs an hour before going into the lab; I was somewhat loopy when they wheeled me in but I remember a couple things: first, the room was like a high-tech spaceship bridge, and there was a very cool bank of LCD monitors hanging from a track in the ceiling, they moved them around for better viewing with the touch of a finger. Very cool.
Second, I was still wearing my underwear when I went in, but it was finally time to remove my shorts. Mothers always tell you to wear clean underwear just in case you’re in an accident, and I had — but they never tell you to wear conservative or boring ones, and that particular Monday I was wearing boxer briefs with Eeyore on them. Luckily, it gave me and the nurses something to laugh about.
I never saw my Eeyore boxer briefs again.

I was hooked up with more drugs, and passed out. I don’t know how long I was out, but I woke up near the end of the procedure, feeling loopy and groggy and having weird half-awake dreams and hallucinations. I could hear someone calling out numbers in response to the surgeon finishing something, numbers that seemed like they were counting down what they’d done, but in my drugged state I couldn’t make a pattern out of them. But I thought they’d installed 30 stents.

I must have fallen asleep again, because when I woke up I was on a gurney being taken to my room. Hooked up to even more tubes — I had IVs in each arm, and multiple wire on my chest and side for the heart monitor — I couldn’t move in that bed. In fact, I was told not to move for 4 or more hours. This was to protect the entry wound, which could pop open if I moved. No matter, I couldn’t have moved if I wanted to with all the tethers attached to me.

The first hitch in my recovery appeared: my right leg turned blue. It seemed to have a good pulse and was warm, but this worried the doctors and they added yet another IV line. Soon, it went away.

After a few hours, I started to get the story. It turns out that I had two blockages in very large, important vessels. They said that I was on the verge of needing open heart surgery. They installed three stents — one blockage was big enough to require two. But they also told me that there was no damage to my heart and that it was strong.

And then they said that I could go home the next day, Wednesday morning. With no fanfare, the doctor came in and said that I could go home as soon as someone could come to pick me up. They prescribed a list of meds, and I sat there for half an hour trying to remember Jann’s phone number so I could get a ride. This worried me, because the part of his number I couldn’t remember was the 3-digit exchange… which is the same as mine. Side effect from the drugs? I dunno.

We went directly from the hospital to Kaiser’s pharmacy, where I picked up 5 different meds; then to the airport where my parents were arriving.

I really didn’t want my parents to spend the money to fly across the country, and considering that I was able to meet them at the airport I figured that the whole thing was being overblown. I mean, I had been through the emergency room, two hospitals, a cardiac procedure, and back home before they were able to get here by plane. It seemed like a waste of their time. In fact, this points out a very strange aspect of this whole thing: heart attack Monday night, home again Wednesday morning feeling fine. It belies the seriousness of what happened and makes it all seem like a minor incident. I’ve had migraines that were more debilitating.

When I am sick, I want to be alone. I want peace and quiet and solitude. What I got was a tiny house full of people, which made me feel like I needed to worry about them instead of me — do they have towels? Where will they sleep? Do they need lunch? I wish they would stop putting dishes away. What are you looking for? I’ll get it.

But then the next day arrived, and with it came the pain. I felt just fine when I left the hospital, but the next day it felt as if someone had kicked me in the groin, and it was destined to feel like that for the next — well, it still does. Suddenly a bruise appeared, angry and dark purple and huge, from my thigh all the way up to my waist. And that’s when I started to heed the directions I’d been given about not lifting anything over 10 pounds, not bending over, etc. No, these were tasks that I now turned over to my 60-something parents, who were not much better at it than me.

It turned out to be nice having them here; showing my dad the house for the first time — he hadn’t been to San Jose in 30 years — and doing dad stuff like the hardware store; mom walking with me around the neighborhood and identifying flowers; having someone to help cook meals.

I’ve spent this week limping around, peeling EKG stickers off my body — there were so many and in so many places that I didn’t find them all at once — planning meals, reading food labels, taking pills, and worrying that if I exercise or exert myself that it will all happen again.

Mom flies home tonight, and this will be the first time since it all started that I will be alone. And once I am alone, I know that I will start contemplating more weighty issues. I’ve been filling my time with a smile and my parents and trying to appear optimistic; all in an attempt to not think too deeply about what happened, all in an attempt to avoid psychological examination. But every so often, I just sit there in a stupor, with a subtle wetness appearing in my eyes, and think to myself:

I had a heart attack.