Heart Attack In Small Town While Traveling On Business - Of All The Luck!This is going to be a long post. I'm hoping by relating a lot of detail it may be helpful to some of you.
My name is Jim Goodman. I'm 61 and live Raleigh, NC, where we have world-class medical research universities and healthcare. I've always liked building things, and following a brief stint in banking after college, I began working in construction. I became a very skilled carpenter (still my favorite job to this day) and had the opportunity to work on once-in-a-lifetime custom projects around the country, along with projects in the Caribbean and Japan. Eventually, I started my own custom home building business. That evolved into a small manufacturing business, making building products, and I was fortunate enough to sell that to my largest competitor in 2006. I have been working for that company ever since. My employer is located in a small town in Alabama, and I have been traveling to company headquarters for a few days, about every 6 weeks. On April 6, 2016, I was on one of those trips when I had my heart attack. At 9:00 AM, I was walking from the offices out to the plant when I felt what seemed like a knot in my esophagus. In retrospect, I had had that feeling a couple of times the day before, but it went away in about a minute, and I didn't think anything of it. But this time, it did not go away. The pain spread across my chest and into my upper left arm. I did a u-turn and walked back to the office. I sat down in a chair and waited for the pain to abate but it didn't. I asked one of my colleagues to take me to the emergency room in the little regional hospital 3 miles down the road because I thought I might be having a heart attack. I had gone from feeling perfectly fine to this point in less than 10 minutes.
I walked into the hospital ER and told them I thought I was having a heart attack. I then promptly threw up my delicious Hampton Inn breakfast. They ran an EKG on me and did blood work. The EKG did not show any anomalies and my blood work came back clean....no troponin. The ER doctor then thought that maybe I was having a gall bladder attack. They did an ultrasound of my gall bladder and that also came back negative. By this time, 2-1/2 hours had passed. I was moved up to a hospital room and was being given blood thinners. I frankly don't know all that transpired between noon and 5:30. I am not sure if I was continuing to have blood tests and EKG's or not. The bottom line is, a blood test was done late in the afternoon, and at that point, the troponin showed up in my blood, and they knew I was having a heart attack. At 5:30, they put me in an ambulance with a nitro drip, and we drove down to Dothan Alabama, where the Southeastern Alabama Medical Center had a full cardiac care unit and cath lab. I was met in the ER by one of the cardiologists, and they did immediate blood work and another EKG. My troponin level had dropped from the mid 7's down to the mid 6's. My pain had also decreased significantly with the nitro drip. The cardiologist looked at all this information, along with the amounts of blood thinners that were in me, and he made the call that the catheterization needed to be delayed until the blood thinners worked their way out of my system, because I would be at high risk for bleeding out on the table...and my symptoms had seemed to have stabilized.
The catheterization was done at 6:00 AM the next morning. By this time, 21 hours had passed since the onset of my symptoms. They found that my LAD was 100% blocked (and calcified) and with some difficulty, they were able to get the catheter through it and implant a large stent. I had no other blockages, though a large branch artery did have 40% blockage, which would be dealt with medicinally. Once the big artery was opened, the pain began to go away.
Next came the echocardiogram and this revealed that my heart muscle was damaged, my ejection fraction was around 25%, andI have hypertrophic cardiomyopathy....all bad. Because of the extent of damage and the weakness of my heart, my interventional cardiologist inserted an aortic balloon pump to take some of the load off my heart. I was put in the ICU and had this device in me for 5 days. My condition was stable but guarded. I was now at high risk for cardiac arrest. I was not permitted to bend my legs at all for that 5 days, but the wonderful nurses I had in the ICU helped to make me as comfortable as possible. As my oxygen saturation and blood pressure numbers improved, the time came to remove the balloon pump, and I was moved into a regular hospital room. I was shocked at how weak I was. You hear the stories of people not being able to walk across the room, and that was me. A 10' walk to the bathroom and back left me huffing and puffing. With my low ejection fraction, I was fitted with a Zoll Life Vest external defibrillator, that I will be wearing for 90 days. My entire stay was 7 days. My wonderful wife had flown down for the week, and we now prepared to fly home to Raleigh. Fortunately, I did not need supplemental oxygen, as that is a complication for the airlines that requires several days of preparation. However, I did need to be wheeled around in a wheelchair as I had nowhere near the strength required to walk the airports.
When I got back to Raleigh, I was able to quickly get an appointment with my PCP, and she quickly got things in motion. She was able to get me an appointment with the cardiologist I wanted and also with a sleep doctor (more on this later). I have had my first meeting with my cardiologist and liked him very much. I have a high level of confidence in him and the entire team in his practice. I have my first cardiac rehab appointment next week, and will also be having my first echocardiogram since the heart attack at the end of next week. This should give an indication of how much if at all my heart is recovering following the heart attack. I am hoping, but not counting on my EF recovering above 35% so that perhaps I can escape an ICD.
So that's my story so far. Now I want to talk about what has gone on with me emotionally and what lessons I have learned.
Being in the ICU for 5 days, I had a lot of time to read about my heart disease on the web. I became more and more depressed. I couldn't believe my rotten luck of being in small-town Alabama when it happened. The delay in treatment had caused significant damage to my heart and looked like it would take 20 years off my life. This was not what I had planned. My cardiovascular disease even took a back seat to what I was reading about cardiomyopathy and what I saw as impending heart failure. I was terrified of what seemed to be the very real likelihood of continuous decline and ending up on a ventilator, without being able to do anything about it. For a couple of days, I truly felt suicidal and was researching the surest pain-free ways to kill myself if I needed to.
But then I started coming across some more encouraging information. I read scholarly articles stating that you can live with heart failure for many, many years and that with proper diet, lifestyle changes, medicines and medical care, you can still live well with a heart that has the diminished functions that one finds with heart failure, without your heart ever progressing to a steady decline. And even more encouraging was what I read about the potential of stopping and even sometimes, reversing cardiovascular disease by following the diets and lifestyle changes advocated by Dr. Dean Ornish and Caldwell Esselstyn. So this new, encouraging information gave me hope and has changed my outlook from hopeless to optimistic
When I was told that I was indeed having a heart attack, my first thought was disbelief. I had always thought I had pretty much hit the genetic jackpot with regard to cardiovascular health. Both my parents are still alive at age 90, and all 4 of my grandparents lived into late 80's and early 90's. But, there were recent warning signs that there could be problems lurking. 2 years ago, my mother had a minor heart attack, and when she was catheterized, she had 5 blockages that were calcified. Her cardiologist said she has had these blockages for a long time. This was the first case of heart disease that we have ever been aware of in my family, and should have been a red flag. But I also had some subtle signs of heart disease;
- Severe sleep apnea & poor sleep
- Having to get up and pee 3-4 times per night
- Socks leaving impressions around my ankles because of fluid retention
- Never feeling rested, no matter how much sleep I got
- Shortness of breath when lying down
- Numbness in my toes for the past 3 years (have been working with a neurologist, thinking it's peripheral neuropathy, but may be a circulation issue).
Another way I had hurt myself was by not exercising regularly. I'd go through periods of a month or two where I would walk 3 miles a day, but I would not keep it up. Well, that's changing too. I am anxious to start cardiac rehab and get on a regular exercise regimen.
Since moving to NC 25 years ago, a slim, fit 165 lbs. carpenter, I have morphed into a still short (5'-9") sedentary, 230 lbs. stressed out desk jockey. I thought I was eating quite healthy (albeit with too large portions) prior to my heart attack; lots of soup, salads, salmon, fruit, poultry, etc. But, the soup and salmon usually came out of a can and the organic salad dressing came out of a bottle. I didn't buy deli-sliced turkey; I bought pre-cooked complete turkey breasts (which I mistakenly thought was healthy) and sliced them up to put on my salads. The foods had the right names, but there were far too many that were processed. Well, when I got out of the hospital, I really scrutinized the labels on those processed foods that were part of my diet. I was always paying attention to calories, but not nearly enough to the amount of salt. So when I started looking at and adding up the salt content on those labels of my low-calorie foods, I was shocked to find that I have probably been eating 5000 - 6000 mg of salt per day, without knowing it. I'm now on a 1500 mg sodium diet and I see that I need to just cut out as many processed foods as possible to get there. It's not debatable....my life depends on it. As I said previously, I was really depressed for the first few days in the ICU. But then one of the web searches I did was "can heart disease be stopped or reversed" and started reading about Dr. Dean Ornish's and Dr. Caldwell Esselstyn's research on the benefits of very low-fat & vegan diets. In my case, at my first meeting with my new cardiologist, he strongly advocated their dietary approach. He had patients who had adopted this type of diet with great results. So that gave me hope....which I really needed. the prospect of being able to have some control over my future health and the seeming real likelihood of being able to at least halt or even reverse my heart disease has completely changed my outlook on my future.
Most of all I am grateful to be alive and to have a second chance. When I was in that ICU, having come close to dying, all the frivolous, insignificant stuff I had been worrying about INSTANTLY went out the window. Talk about a reassessment of your priorities! I don't know why it took something like this to get my attention, but it certainly did. My family and friends are now absolutely my top priority, as they should have been all along. Nobody on their deathbed wishes they had worked more at their job. I know it will be a balancing act between lifestyle, diet, meds, exercise, stress management and medical care to beat the odds and live another fulfilling 20 years. But that's my goal and it gives new meaning to my life.