Janet and I had just returned from church on March 20 and headed out for a 40 mile bike ride that included one of my favorite hills that I love to hate, Simms Mill Road outside of Liberty, SC. I had just finished chugging up that hill, watching my heart rate hit 159 (I was trying to stay below 160). At that rate I wasn’t able to stay on Janet’s wheel. We stopped at the top of the hill and ate a banana, 20 miles into the ride. I seem to remember feeling OK then. We continued another couple of miles and I was starting to feel cold and not quite right so we stopped at an intersection and I put on a rain jacket. I also tried to discreetly slide a nitro tablet under my tongue to see if it would help this little pinging on my breast bone. Janet, ever the eagle eye, caught me in the act and then read me the riot act.
I sat down on the inside shoulder of the intersection and laid my bike down. After a few minutes I took another nitro tablet, with no apparent result. The little ping had gained some momentum and the pain train was starting to accelerate leaving the station. At that point, I lay down on the road and waited for another 5 minutes so I could take the last nitro. At that point I didn’t care what I looked like or what people might think. I did have the presence of mind to lie down where I wouldn’t get run over. A car stopped and asked if they could help. We briefly debated getting a ride home with them. Then three other cyclists happened upon us, asked if they could help and then convinced us (well probably me, Janet was already convinced) to call 911. The cyclists all took off their jackets and covered me up, which was really nice of them. I hope to see them again sometime and thank them. I remember thinking one of the ladies had really good looking in shape legs-funny where your mind wanders off to at times. The last nitro was like spitting into the ocean-nothing. I remember thinking, déjà-vu, all over again.
EMS arrived pretty quickly and got me loaded up-Janet riding shotgun up front. I Googled the route this morning, and found it to be about 21 miles and 34 minutes going through Easley to GHS. Well the EMS guy started doing EMS things, hooking me to an EKG machine, blood pressure reading, starting an IV port in my arm, asking a bazillion questions that I answered through clenched teeth. He inquired about my pain on a scale of 1-10, making careful note of it on his rubber gloves. He wrote everything on his rubber gloves-some part of me thought that seemed pretty practical. I replied that the pain which had been an 8, (but now the train was starting to really move) and was now hitting about 12. He then called a doctor on his cell phone to get permission to give me some morphine. I thought to myself, morphine, that’s the ticket, it always seems to work in the movies. He said it would take about 5-10 minutes to work and I might taste a coppery feel in my mouth, that I might get nauseous, etc etc. I was thinking, just hit me with the needle and forget all this freedom of information stuff.
So 5 minutes pass and I see we are passing the Wal-Mart in Easley and I’m thinking, dang, we still have a long ride. Oh yeah, so 5 minutes pass and nothing, nada, zilch, zippo-old Mr. Poppy Seed didn’t do a thing for the pain. So then I start working on the EMS guy for another shot. We had a leisurely discourse about morphine usage protocol, noting that one had to wait 10 minutes and usually the doctor wouldn’t approve another injection especially if your blood pressure wasn’t over 100, which is where I was. By now the pain train was really rocking. I politely (not) asked him to get the doctor on the line now, so we wouldn’t be wasting time around the 10 minute mark-I told EMS that I was 266 pounds and probably needed more than an average dose. He took another couple of readings, jotted some more info on his gloves and I breathlessly confirmed the pain was still a 12. Not sure that the last part was really necessary because by then I was kicking the back of the ambulance door pretty hard with my cycling cleats-I was basically making a lot of a noise-none of this stoic stuff, suffering in silence, no John Wayne for me. So EMS gets the Doctor on the line again and hallelujah, gets the OK for another hit of morphine-EMS guy looked a little surprised that he got the approval.
So I eagerly watch the second magic injection, thinking OK, this is all going to get better starting now. I remember looking out the back window, thinking dang, why are we still in Easley? The EMS guy is saying the EKG is not indicating a heart attack. I asked him if I was going to die and he replied, “Not if I have anything to do with it.” I began to have bad thoughts about the morphine because nothing was happening. I remember realizing that we were sitting at a traffic light. I remember saying several times (actually more like screaming), “turn on the f-bomb lights and get this thing going.” Like Ralphie’s Dad in “The Christmas Story”, there are probably some expletive deleted phrases still echoing around the atmosphere above Easley. I mean they put lights and sirens on these vehicles for a reason. Apparently we did not meet some EMS protocol for being in a hurry since apparently the EKG was not indicating a heart attack. I remember thinking, so what, do you think this is heart burn or indigestion?
In Genesis, there is the story of Jacob wrestling with God all night-it was quite a tussle. For the next 20 minutes, I felt like I was wrestling with the Devil who was trying to crush my chest-it was quite a tussle. I kept looking out the back window, noting our slow progress. I could hear Janet pleading with the EMS people to put the ambulance into overdrive-didn’t happen-never did figure out why-something to be pursued on another day.
It is hard to describe the Devil’s grip-mentally I had the image of someone trying to drill a hole through my breastbone, over and over again. I kept thrashing about like a gigged fish, trying to break out the back door with my feet. The EMS guy had loosened all my straps, so I had free rein to slam around. I finally decided to kick off my shoes and in a moment of clear thinking shouted to Janet not to forget my shoes when we got to the hospital. I thought, damn, this is going to be an expensive ride anyway and if I kick out the rear window, it will make it worse. I finally realized that I had to keep wrestling, that the morphine wasn’t going to get it done.
Arriving at GHS finally, I thought, OK, now these people have the magic bullet. Well yeah, sorta, it just takes a long time to load the gun. So I roll into the heart people ER and get descended upon by the team. Where’s the morphine? Oh, we have to do a few tests-draw some blood. Oh and by the way, if you could just calm down and quit flopping around, we’d like to put another IV port in. I thought to myself, sure just quit flopping around, so simple, why didn’t I think of it? Another bazillion questions, age, medications, social, DOB, yadda yadda yadda. I try to be cooperative because I know they just want to help-it just that this Devil fellow is still squeezing my chest for all he is worth. It was harder to kick though, since there wasn’t anything in reach to really hit against except the door frame where the Doc kept popping in and out of. And I definitely didn’t want to lay him out. Finally after what seemed like 10 minutes or so, they started a nitro drip of some sort and the train finally started to slow down. Where before, it seemed like it was going to fly off the tracks, now it was just humming along at a respectable pace. One of the guys came along to shave my groin in case they used an artery down there for the catheter insertion. While he did have an electric razor, I decided to concentrate real hard and not move while he was doing his job. I didn’t want any slip ups there.
Eventually the train started slowing down and I kissed Janet goodbye heading into the cath lab-thinking, man this was a heck of a ride. I got another stent, in the same place as the previous one. They said it was about a 99% blockage. They wound inserting the catheter through my wrist rather than my groin, so that was good-much quicker recovery. So by Sunday evening, the train pulled back into the Critical Care Unit and I was able to get off and greet all my faithful supporters on the platform and that felt really, really good. I slept awful that night but at least I was feeling the pain.
So here is the interesting part. The next morning, breakfast arrives and I felt wasted but not hungry, an odd kind of feeling. I had only had a bowl of granola and a banana on Sunday so I should have been starved. I take a sip of orange juice and I felt that sugar rush hit my system. I kind of paused, with Janet holding the cup at my lips and I got all clammy. About that time a nurse hustles in and was surprised to see me upright and awake. Apparently my heart stopped for about 9 seconds and then re-started and it triggered an alarm at her station. She then brought in a graph and showed us this long flat line. Later Monday morning, the Doc came by and we discussed the stent procedure and then he pulls out the chart with the heart stoppage and suggested I get a pacemaker. Janet remembered an incident several weeks prior where the same thing might have happened late at night. So we took a vote and decided to go for the pacemaker-luckily enough they had an opening Monday afternoon and away I went- déjà-vu all over again. Almost the same time the day before getting the stent, I was getting the pacemaker, kissing Janet goodbye at the door to the lab. Only in America. Interesting enough, the Doctor speculated that morning that all my thrashing about may have stimulated my heart to keep doing its thing. Who knows, I just know that not thrashing about wasn’t an option.
So I wake up Monday night, with a device about the size of 2 silver dollars buried in my left upper chest muscle with leads running to my heart, where they are basically screwed into the heart muscle. Oh, and I had a 4 lb bag of sand sitting on my chest as a compression device for the first 12 hours-not really high tech but I guess it works. I can’t do anything with my left arm for awhile. The PA, Brad, said no vacuuming or taking out the trash for awhile, actually probably the rest of my life. So there is always a silver lining.
So what does this all mean? Beats me. I know I don’t want to go another round with the Devil. As I review things about risk, here is how it settles out. Hereditary factors are not in my favor. Cholesterol is not currently a problem-my total cholesterol (measured on Monday) was 84 versus target of below 170. My bad cholesterol (LDL) was 34 versus target of below 70. My blood pressure runs about 115/68 which is in the excellent range and that is without blood pressure medicine. I get a pretty good amount of cardio exercise. So, the final piece is weight, which after an $80,000 spa treatment this week came in at 265-so I lost almost 2 pounds. That is too high, so I am going to drop a lot of weight. Hopefully my doc will let me get back on the bike soon. For those of you who have an opportunity to influence some of your coronary heart disease risk factors, my advice is to get serious and improve the areas that you can influence. If you can avoid getting on the train with the Devil, then I suggest you do whatever it takes. That ride is not anything like the ones at Disney.
