My Heart Attack

The following is a journal describing my cardiac arrest, heart attack and bypass surgery.  The major events from the week stay in the hospital are listed in chronological order.  This is the event that inspired this blog.

July 1, 2007: The Day I Died

Heart Attack Admittance Report

Hospital Admittance Report

It happens to everyone eventually, but I got to come back.   The timing of my experiment with the afterlife was pretty poor as my daughter was just three years old and my wife was five months pregnant with our son.  I remember very little of that day except that it was hot and I drove my aunt to and mother in-law to the airport on separate trips.  That’s all I recall from July 1, 2007.  Lucky for me, my wife is a note taker. After all, who doesn’t grab a pad and pen after finding her their spouse on the floor, calling 911, performing CPR, arranging childcare, and hopping into an ambulance.  My thanks to her for providing the details for the rest of this story (oh, and for saving my life).

8:00 PM – My wife and I are reading our daughter a good night book.  I told my wife I didn’t feel well and went downstairs to lay on the couch.  My wife tucked our daughter in and came downstairs several minutes later.  As she approached the family room, she heard what she thought was me snoring (I don’t snore).  When she entered the room she found me seizing, gasping for air and quickly turning from gray to blue.  She didn’t know it at the time, but I was in full cardiac arrest.  I was no longer breathing when she pulled me off of the couch and onto the floor to begin CRP.

8:07 PM – My wife called 911 and started CPR.  The paramedics arrived within 5 minutes.  The paramedics repeatedly used a defibrillator to shock my heart by to life.  At the same time, they administered a shot (or shots) of epinephrine.  I was now stable enough to transport to the hospital. My wife called my mother to come over and stay with our daughter.  The survival rate for those suffering a cardiac arrest outside of the hospital is 5-10%.  If you are brought to the hospital on a weekend, even less.  I was brought in on a Sunday….before a major holiday.

9:40 PM – I am brought to the cardiac catheterization lab.

11:40 PM – The doctor meets with my wife.  My right coronary was 99% block.  They were able to get it open to 50% with a balloon.  According to the doctor, the rest of the heart “is a mess” with additional blockages.  I need bypass surgery but only have a 50/50 chance of making it through the night at this point.

I have discussed the situation with his wife.  She understands the gravity of the situation.

Currently medicated to keep artery from closing again.  Also on anti-seizure medication. The next 24 hours are critical for long-term prognosis.  Doctors will periodically turn down sedation to determine responsiveness and prepare for bypass surgery. Doctor’s also concerned with possibility of neurological damage from lack of oxygen to the brain.

July 2, 2007: Seizures and Uncertainty

12:15 AM – I am still having seizures (they started at home during the cardiac arrest onset).

Catheterization Report

Catheterization Report

7:30 AM – Neurologist provides a very blunt assessment of my condition.  Not optimistic with neurological responsiveness at this time.  Told to prepare for worse-case scenario – permanent brain damage or vegetative state.

9:00 AM – Nurse informs my family to expect a roller coaster of positive and negative indications of progress.  My youth and restlessness are both positives.  However, there is still a high amount of uncertainty.

10:20 AM – Chief of cardiovascular surgery visits with family.  Informs family that bypass surgery is a definite if I am able to recover enough to handle the procedure.  Expect at least 6-8 vessels.

7:30 PM – Cardiologist visits with family.  I am still on a balloon to assist with heart pumping.  Best-case scenario is surgery in 7-10 days.  I also have pneumonia from aspiration during seizures.

9:00 PM – Nurse removes bite block.

…a very grave prognosis, which can be markedly improved if he can undergo cardiac catheterization

July 3, 2007:  The Day I Woke Up

6:00 AM – The nurse reduces the sedative and I wake up for first time.  Nurse explains where I am and what happened.  I still have a tube down my throat at this point and can’t speak.

7:30 AM – Neurologist visits again.  She is impressed with sudden progress – I am able to open eyes, give thumbs-up, squeeze her hands and move my legs when requested.

8:00 AM – Balloon assist is removed from aorta.  Swan line, a catheter to the heart, is also removed.

11:00 AM – Head of ICU visits and approves the removal of the intubation tube.  Sedatives are reduced again.

12:30 PM – Sonogram on neck to check the flow of blood to the brain.  Awake enough at this point to pull the nasogastric tube out by myself.  Probably should have waited for a nurse on that one.

2:00 PM – The cardiologist stops by – recommending surgery in 7 or 8 days.  Much more alert but memory is shot.  Also thought my brother was my doctor.  Quite a few visitors this afternoon.

7:30 PM – Head hurts – received Tylenol

July 4, 2007:  The Brain Bounces Back

10:50 AM – Infectious disease doctor pays a visit.  Treating for pneumonia because of germs in sputum.  I guessed the date was July 14, but I did know what hospital I was in.  Progress.

11:00 AM – Removing swan line out of leg artery.

…if he recovers neurologically and survives to surgical revascularization

11:30 AM – Neurologist visits again.  Blood flow to brain is perfectly normal.  All neurological gates passed to prepare for surgery.  She is surprised with how quickly I came back.

 2:00 PM – Head of cardiac surgery stops by again.  Surgery scheduled for one week out.

7:20 PM – I have a chest pain but forget to tell the nurses (didn’t want to bother anyone – oops).  Reminded that I have to communicate (life long issue).

July 5, 2007:  The Memory Test

2:40 PM – Passed first memory test.  Was asked to remember the terms “ball”, “cat”, “apple”.  Successfully repeated the terms 5 minutes later.  More progress

4:00 PM – Moved to cardiac step Down room. Now off seizure medication.  Still on antibiotic, beta-blocker, blood thinner.  Also still remembered “ball”, “cat”, “apple” when quizzed.

 7:00 PM – Another chest pain.  Received a small dose of morphine.

July 6th, 2007:  Out of Bed

10:00 AM –  Neurologist stops by to check me out again.  She states that I am ready for surgery.

11:30 AM –  Quizzed by the doctor on “ball”, “cat”, “apple” again.  Could only remember cat.  Head hurts.

12:30 PM –  Asked for the oxygen and mentioned fatigue.

1:20 PM – Out of bed and walking.  Did three laps around the unit.

3:15 PM – GI Unit came by to do a Endoscopy.  I have a slight laceration from the intubation.

7:00 PM – My brother brought in speakers for my iPod and portable DVD player.  My wife finally brought me my computer!  Very happy now.  Watched Walk the Line.

July 7, 2007:  My Daughter Visits

For some reason, most of the notes in the journal were written by me today.  My penmanship is awful!

10:00 AM – The nurse for my upcoming surgery stops by to prep me.  They will pick me up at about 6:00 AM on they morning of the surgery.  A vein will come out of my chest and leg.  Warned that the first two days after surgery will be rough.

10:30 AM – Pain in arm and itchy feeling around heart.  I pressed the button right away this time.  My IV needs to be flushed.Elise_Hosp

1:15 PM – My three year old daughter visits for the first time.  Very cute.

7:00 PM – Results of endoscopy show a small tear/erosion above the stomach.  Likely caused by intubation.  Will treat with a proton pump inhibitor (PPI).

July 8, 2007:  Get Ready for a Defibrillator

Cardiac Electrophysiologist visits.  Discusses possibility of defibrillator implant after bypass surgery.

July 9, 2007:  My Quintuple Bypass

12:45 PM – Bypass surgery is complete.  Five vessels were passed.  Repaired the sternum that was broken during resuscitation.  Surgeon declares survival is truly a miracle.

3:30 PM – Family allowed into the cardiac ICU.  I am covered in iodine with a tube out of my neck, taped over my forehead, a tube down my throat, a tube out of the side of my chest, and one out of my abdomen to drain fluids.  I also have a couple of IVs hooked up.  I have a large bandage down the middle of my chest and my leg (where they removed a vein) is wrapped in an ace bandage.

7:00 PM – They start to turn down the sedation.  Just like last week, I am very unhappy about the tube down my throat.  My arms and legs are thrashing.  My wife, brother, and two nurses are trying to hold me down so I don’t aggravate the chest incision.  The tube down my throat is removed, making me much happier.  However, unlike last week, I am in a lot of pain.  Once the nurses could tell I was “with it” they administered morphine.  Soon after I was cracking jokes with all, but still very uncomfortable.

10:00 PM – I am in and out of sleep, and still very uncomfortable. The bed is too short and my back hurts.

July 10, 2007:  Things Will Get Better

1:00 AM – Thankfully, I am moved to the step down unit ahead of schedule.

5:30 AM – Catheter removed.

8:00 AM – I am very tired and uncomfortable.  I manage to eat a yogurt and half a muffin.  The cardiac surgeon stops by.  He said the surgery went well and the arteries looked better than expected.  Most of blockage was concentrated in one area.

8:30 AM – Cardiologist stops by.  Assures me that today is the worst day, things will improve significantly by tomorrow.

10:00 AM – Short walk around the unit with my wife and the nurse.

11:00 AM – The neurologist is back.  I am able to tell her the date when she quizzes me.  Not bad considering my wife wasn’t quite sure.

11:30 AM – Still feel pretty lousy.  My blood counts are low and a transfusion may be necessary.  I am becoming a pro at using the breathing/inhaler device that measures my lung functionality.

Defibrillator Implant  Report

ICD Report

July 11, 2007:  The Doctors Call

All the doctor’s stop by for a visit.  I went on multiple walks today.

July 12, 2007:  All In My Head

I am having multiple head issues today.  Can’t hold head still, constant throbbing, hallucinations when eyes are closed.  Still very anemic.  Doctor’s let me decide on transfusion, I ask to wait a day.

July 13, 2007:  Opened Back Up

8:00 AM – A test is performed to see if I have an “electrical” problem.  No surprise – I do.  I am sent to have a

defibrillator implanted inside my chest and attached to my heart.

He required a rescue shock of 200 joules

2:30 PM – Oxygen level is low and fever has developed.  Oxygen mask back on and Tylenol for fever.

4:15 PM – EEG is conducted.  Purpose is to test neurological function.

Heart Attack Discharge Report

Discharge Report

July 14, 2007:  Now What?

10:00 AM – Chest x-ray to check for fluid.

11:00 AM – Doctor and nurse visit.  The focus of the discussion is discharge – TODAY!  EEG results were normal.  There is some fluid in the lungs, but not too concerning.

5:00 PM – Discharged – Now?