Happy Heart Attack

 

By Rick Boettger

 

Flying home to Key West last month, my wife Cynthia was so fuzzy and shaky I had the attendant call ahead for EMS to get her off the plane. They saved her life. Her blood pressure had cratered and she could have died from a strange heart attack.

 

 

Amazingly, this is a story full of joy, with a few useful lessons about modern medicine, particularly at our vitally-important local hospital. The crowning joy is that in only two weeks Cynthia is in near-perfect health again.

 

 

It took just minutes for EMS to get her off the plane, stabilize her, and race to the Emergency Room. They had lost my Power Of Attorney, but Cynthia was able to speak and tell them to let me in. First lesson: Travel with a copy of your POAs, as Cynthia does.

 

 

The doctors and nurses were fine with my staying with Cynthia as they started dosing her with BP-raising medicines and saline, as long as I kept moving my chair to stay out of their way. I actually got to see a reading of 34/20 at the beginning. At one point a nurse turned off the monitor so I wouldn’t be upset, but I got the doctor to turn it back on. Second lesson: Assert your right to information.

 

 

When Cynthia was moved up to the ICU, I went home for the POA and a couple hours sleep. Back at the ICU, Cynthia was receiving what seemed to be excellent medical care. The cardiologist was mystified at what had happened, and tested everything. In a day, her EKGs had stabilized, and eventually three echo-cardiograms, two of her heart and one of her stomach, showed everything to be in perfect condition. A slight enzyme elevation showed that damage had occurred to the inside of her heart, or else it would have been hard to say there was anything wrong but the symptom itself. Kind of a myocardial infarction without the heart attack.

 

 

Lesson 3: Call your personal physician yourself. Lower Keys Medical Center uses the new “hospitalist” system. That is, one doctor is dedicated to hospital practice, staying there, overseeing and coordinating your care. Ours is one of the most respected in town, used himself by other doctors. But the hospitalist is supposed to confer with your personal physician at least twice, at admission and discharge.

 

 

Cynthia had asked twice in my presence, even in the emergency room, that someone call her Dr. Norris. I too wanted them to know, in particular, that Cynthia has generally low BP, recently a 90/60, so they shouldn’t try to jack it up too high. But no one called. Finally, I reached him myself at 6:30 a.m. the third day. He answered with great concern: “My little Cynthia, who is always so happy and cheerful?” And he contacted the hospital as soon as he got his girl to school.

 

 

It was important to get Dr. Norris involved because Cynthia trusted him enough to allow the final test, a heart catheterization. This means a narrow tube is run up a vessel in your wrist right into your heart to inject an iodine dye for contrast in the MRI. Cynthia knows a similar angiogram on my mother’s cerebral arteries went horribly awry and killed her. These procedures on the heart have a one in a thousand death rate.

 

 

But we went with it, and we were overjoyed when the cardiologist came out with great news: “Her heart is in perfect condition.” I immediately said, “So she can come home then,” and he answered, “Sure.”

 

 

Last lesson: Get the hell out as fast as you can. I tried to sleep in her room one night and only lasted through two wake-ups just as you’ve hit deep sleep. Makes you nuts. Cynthia was suffering from the cold as well as the sleep deprivation. We insisted in getting out as quickly as possible. We also had to stop them from trying to treat every conceivable cause of what remained an inexplicable event.

 

 

The hospital has excellent Internet, which allowed me to quickly research the beta blocker they wanted to keep her on. She had all of the side effects, and a recent meta-analysis of 200,000 subjects showed that the strikingly positive effects found 30 years ago on 1,800 Norwegian patients have not been replicated in larger studies, and thus is not recommended as follow-up for patients like Cynthia. We had to insist, and sign to decline its use.

 

 

Cynthia was better as soon as she was sitting in the 85 degree weather on our front porch, and sleeping uninterruptedly through the night. Without drugs. The saline had increased her weight from 122 to 147 pounds in three days. It took five days and a brief diuretic to get her weight and BP back to normal, from the high 155/95 the earlier drugs and saline had increased it to.

 

 

Remarkably, this heart attack had many happy outcomes. We know Cynthia is in strikingly good health, like her mom who lived to 91. She is happy for the 100 emails and cards she got, as well as everyone’s honoring her request for no phone calls or visits just yet. And she is happy because her husband has improved.

 

 

As I was looking at that 34/20, I got through it by deciding to leave with her if she didn’t make it. At that time, I wished only for her to somehow survive. Even bedridden, I could still bask in the smile and laugh I do not want to live without, and at least we could still holler at the TV news together. As she has gotten better, my feeling is one of euphoria. I didn’t think I could love her more, but I do. And it shows in that I am actually happy to do so many things for her, especially related to cleaning stuff up, that I refused to do or only did begrudgingly before.

 

 

So I guess one final piece of advice: Ladies, if your husband is not bringing you his A-game, consider a near-death experience to slap him up side the head. I think I now understand how a new mother loves her baby, and it is a precious feeling.

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