What I did over the weekend
TL;DR: I had a heart attack; looks like I’m gonna be fine.
Updated 8/29: TL;DR: I’m home, feeling fine; more details added, too.
Monday of last week we learned that our basement floor will need to be jackhammered up to replace a broken sewer pipe under it, so I started moving stuff out of the basement to get ready. Up the stairs to the garage. Including a bunch of boxes of books. Sometime afterward, I noticed my chest felt a little tight - I figured I was just unused to that kind of work lately.
On Saturday, I went lap swimming for the third time since Monday, but stopped early because I could feel the tightness while swimming (which I hadn’t the first two times).
Sunday was just like the rest of the week, except that after our early dinner the tightness increased noticeably within about 10 minutes, crossing into the “uncomfortable” range. I asked Gina to drive me to the hospital, and off we went. When we started, I wasn’t thinking “heart attack”; I was thinking that this was probably “something commonly mistaken for a heart attack,” but halfway through the 10-minute drive, the tightness spread across my upper back. This was worrisome, but there still wasn’t any nausea, breathing trouble, sweating, lightheadedness, any substantial pain - none of the traditional symptoms.
We got to the hospital and Gina dropped me off at the ER door (note: it’s not like she abandoned me there on the sidewalk - I was walking fine and just had this awkward tightness, and blocking the driveway seemed like a bad idea, so I told her to go park). After waiting my turn and saying “chest pain”, I was immediately taken back and wired up for an EKG, which told them “heart attack” right away.
They took me to a different room, and as I changed into a gown, ABOUT A BILLION PEOPLE came in to help. (This is a teaching hospital, and I think it’s great; in this situation it seemed like there were a dozen people in the little room with me, and a dozen more in the hallway.) The cardiologist explained that they were going to put in a stent via an artery in my wrist and got my consent, then off we went to the cath (-eterization?) lab.
This room seemed bigger, and was fairly dimly lit except for a big wall of monitors; I met several people quickly, including the doctor performing the procedure. They moved me from gurney to a bed under an X-ray machine set up to move to point at my heart from different directions - I couldn’t see much else other than the ceiling tiles, and everyone seemed at least 10 feet away. The procedure wasn’t at all uncomfortable; I remember a local anesthetic needle stick, and the slightly weird feeling of something being fed in at my wrist, but couldn’t discern anything in my heart other than the chest tightness.
Oddly, I wasn’t really focused on what specifically was going on - the conversation between the (five?) participants was technical, though I eventually figured out that when I heard some of my high-school human-physiology terms relating to relative body directions (like “caudal”, posterior-ward; thanks, Mrs. Reidy!), the doctor was commanding moves of the x-ray thing. Which also zoomed close to my face a lot.
They used a balloon they’d inserted to expand the clogged artery (by the way: the “left anterior descending”; it has a nickname, too), and the balloon had a stent around it that expanded to stay in place and hold the artery open from now on. The doctor called out to me to tell me this part was done, and it wasn’t until then that I realized that the chest tightness was gone.
A short while later the procedure was finished - I think this was maybe an hour after I walked in, 90 mins at most - and they wheeled me to a room at the cardiovascular ICU.
The rest of the story is happily less interesting. I was basically watched for improvement, primarily in the level of one blood chemical (“troponin”, I think) that the heart releases when it’s damaged - they wanted to see it peak and come down (which it did, starting midday Monday). I got lots of tests, all right in my room: several more EKGs, a ultrasound that took about an hour, etc. I didn’t sleep much that night, not because it was noisy - it was super quiet there - but because I sleep on my tummy and it didn’t seem like that’d work with all the monitor wires. (The second night the nurse offered to move the monitor stickers to my back, which helped - and I woke up the next morning face up without having pulled off the wires I was lying on. The third night I kept the wires on the front and carefully slept face down.)
They moved me a few rooms down the hall late Sunday night, to a room with an amazing view (unless one is in bed, which faces away from the window). That’s where I spent the rest of my stay - they talked a few times every day about moving me to the regular cardiac care unit, but never followed through. They started encouraging me to walk around (carrying 10 feet of all the monitoring wires and a lunchbox-sized unit that detached from the big monitor in my room, and wearing an extra gown in back to avoid inadvertent mooning) and my nurse suggested privately that seeing me walking might influence the doctors into sending me home, so I was happy to play that game. I could also sit by the window and enjoy the view (that’s the top of the Portland Tram on the right):
Midday Tuesday, two game-changing events: they removed the (wired) oxygen sensor from my right index finger (so I didn’t have to do everything lefthanded) and the blood-pressure cuff from my left arm, which meant they could switch me to a pocket-sized wireless monitor instead of having to lug around the wires and lunchbox). Also, it occurred to me to ask if I could wear underwear under my gown (yes!), which, let me tell you, makes you feel a lot more human. I celebrated by walking two and a half miles around the floor - whoever noted on a hall whiteboard that 9 laps is a mile is a master of healing gamesmanship. The rest of the time I was reading, watching Netflix, listening to podcasts, and looking at the view. I never really got bored.
By 5am Wednesday they were pretty definitely going to send me home, and also maybe still going to move me downstairs; the former happened, the latter didn’t. I was visited by a bunch more nice people as part of being sent home, and got the take-home-game version of the drugs I’ve been on: a statin to help with cholesterol buildup, a blood thinner, a beta blocker that’ll reduce the work my heart is doing, another drug to “help the heart’s remodeling happen right” (I know they don’t want platelets to stick to the stent). I can also look forward to lifestyle changes and “cardiac rehab”, which I’m set up to start next week. And no swimming for a little while? Whatever they say.
I slept great in my own bed Wednesday night, and got to start Thursday (today) with a real shower. Before lunchtime I went for a 30-minute 1.3-mile walk, which tired me out a bit but felt great.
The OHSU Phil Knight Cardiovascular Institute Intensive Care Unit is not like anyone’s stereotypical idea of being stuck in a hospital. There were so many people there who took such good care of me; from my walks, I’m pretty sure that I was in the best shape of any patient there, but everyone met my every need and kept me & Gina informed (we got to watch the “rounds” discussion of my case every day and ask questions!). Pretty much everyone, no kidding, commented on how important it was that I came in when I did. I regret that I don’t have virtually any of staff’s names because things happen so fast and the people are so numerous, but the nurses assigned to me were wonderful and I know their names: Amy, Kirstin, Spencer, Catherine, Cassie, and Rebecca. (Small Portland story: Gina ran into Catherine at the bakery around the corner today, so I got to race-walk over there to say hello, which was the high point of my day today!)
I’ve also gotten lots of messages from lots of friends, which I’ve really appreciated. Two of my oldest friends, Greg & Mark, passed the word, and if I wasn’t already eternally in their debt I would be now. Of course, Gina did everything I’d let her do; I’m not the best partner patient!