And Then It Happened

My husband and I were on vacation in Florida for two weeks. We had a place on the ocean and it was beautiful. The first week was cool, then it started warming up on Saturday and Sunday, and it was 80 and sunny. The forecast for the second week was the same, so we were excited. Monday was beautiful and we worked out for an hour, had breakfast and went to the beach. I had a feeling of fullness in the morning, but I worked out anyway and it never got worse, so I ignored it. We had a great day. At three o’clock I went up to get ready for happy hour with my husband, and his aunt and uncle. I had a little indigestion, so I took a Tums and felt a little better, but I asked my husband if we could stop on the way to buy Pepcid. After taking the Pepcid, I still had some pain in my shoulder blades. Indigestion, I thought, maybe too much grease or hot sauce on my chicken wings from lunch. People kept assuring me that it wasn’t my heart. “You’re in good shape,” they kept saying. Michael’s aunt had had a bypass, so she knew the symptoms, and I am a cath lab registered nurse with 25 years of experience. By the time we reached the restaurant, I wasn’t hungry, so I drank seltzer water. After leaving the restaurant, I had the worst pain you could think of. Not pressure, not burning, just indescribable pain. That convinced me that I was having a heart attack. I began sweating from head to toe and it was a cold sweat like I was standing in a cold shower. My husband looked at me and asked what was wrong. I told him I was having a myocardial infarction and to find a hospital fast. We’re from New York and here we were in the middle of Florida — how do we find a hospital? Thank goodness for GPS. My husband punched in “hospital” and we were off to Martin Memorial Medical Center in Stuart, just seven miles away. When we arrived at the hospital, my pain was worse and my heart was palpitating. I’m sure it was ventricular tachycardia. My husband left me off at the door, so I stumbled through it and announced that I was having a heart attack. “Please help me,” I said to anyone that would listen. The lady at the desk simply asked me to take a seat and fill out the paperwork. I decided to walk through the emergency department doors and announce my arrival. I called a STEMI alert on myself. Afterward, I would reflect on how many people could die in the waiting room after being told to sit down and fill out paperwork! They did a stat ECG and my STs were elevated anteriorly and laterally. In a matter of minutes, I had two IVs, metoprolol, heparin, morphine, eptifibatide, and, of course, baby aspirin. The most important thing I received was compassion. One nurse kindly said she would stay with me. The STEMI team was on their way in and I could only think about what part of their evening I must have interrupted. Next thing I knew, I was on my way to the cath lab with a handsome doctor and a wonderful nurse at my side. The doctor explained that he would use a drug-eluting stent, I agreed and off we went. When we got to the lab, all I could do was cry. I thought, this cannot be me. I’m only 53, I work out, I’m 115 pounds, take fish oil, control my blood pressure, and my cholesterol level is great. Sure, I smoke and take hormones, but women don’t get heart disease, right? I was scared and cold. The cath lab team wrapped me in blankets, soothed my fears, wiped my tears, gave me good drugs and saved my life! After three hours of working on me and using all the techniques available, the clot in my proximal left anterior descending artery (LAD) went distal and couldn’t be broken up or removed. I was on a dopamine drip and they were thinking about a balloon pump. But my pressure came up, so they transferred me to the ICU on eptifibatide and heparin in the hope that the clot would dissolve. Luckily, I had no narrowings in my arteries, which were clean. Two days later, I went for a repeat cath and my distal LAD was totally occluded. I had apical damage along with thrombus and my ejection fraction percentage was 30-40. I would wake up in the ICU and PCU, and all the nurses were wonderful. They let me cry and listened to my fears. My cath doctor and cardiologist were both great, but one was more positive than the other so, of course, that is who I listened to. The doctor explained to me that if I had come in that afternoon with indigestion, they probably would have sent me home because my ECG would, most likely, have been normal. It has now been four weeks since my MI. I’m on beta blockers, ACE inhibitors, clopidogrel, ASA, Lipitor, and coumadin. They haven’t scheduled my follow-up echo yet, but I’m feeling almost human again. For two weeks, I was afraid to sleep because I thought I wouldn’t wake up. I have cried a lot. Thank goodness for my husband, family and friends. I’ve gone through all the stages: denial, anger, depression and now, acceptance. It’s a beautiful, sunny day. My daughter just turned 24. My husband is retiring at the end of the week. My son is at college awaiting spring break. I’m sitting here writing this article and, thank God, I’m alive. What I remember most about my cath lab experience is how much the people cared for me. They saved my life through both medical and spiritual treatment. We often have said to our STEMI patients, “We saved your life,” and the next day the patients don’t know who we are. I remember, and I thank you again. Women do get heart disease and they survive if they are treated promptly, like I was. Addendum from Martin Memorial Medical Center: Martin Memorial’s policy in the emergency departments of our two hospitals is to administer an ECG on patients complaining of chest pain within 10 minutes of their arrival. When it’s determined that a patient is in need of a cardiac catheterization, we work diligently not only to meet the national door-to-balloon standard of 90 minutes, but to reach that goal much earlier. It’s a goal we attain nearly every time, but we know this is vital component of quality care and won’t be satisfied until it occurs with each patient. — Karen Ripper, Senior Vice President/Administrator, Martin Memorial Medical Center and Chief Nursing Officer.

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