May 11
jgoodma1 , Posted on SUPPORT NETWORK Blog

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 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).
I just never brought up to or pushed my PCP on these issues,  I did a sleep study and got a CPAP machine for my apnea 8 years ago.  But the whole sleep study experience was terrible.  I never met with a doctor, it was a production mill that just pushed people through as fast as possible, a 25-year-old kid fitted me with the mask and kicked me out the door.  Nothing fit properly and it was intolerable.  I could not sleep with it.   I stopped using it after 6 months, and never demanded that I be fitted with a setup that worked for me.  BIG MISTAKE! While I was captive in the ICU in Alabama, I got a non-stop earful from my nurses and doctors about how important that CPAP was and that I had done damage to my heart that was equivalent to that of being a 1 pack per day cigarette smoker (I don't smoke).  My cardiologist in Alabama told me that the root cause of my heart disease was my failure to use my CPAP machine.  Needless to say, I have a sleep study coming up in about 6 weeks. 

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 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.

  • terranovalaw
    Jim I am happy to hear you are on the mend and have such a positive outlook. Two things jump out at me 1) having a top notch facility with a cath lab nearby can save lives and minimize heart damage and 2) you are in the right frame of mind to enjoy the gift of many more days. I too had a 100% blocked LAD. Fortunately for me I immediately recognized symptoms and the hospital with cath lab was less than a half mile away. No history/avid runner/great numbers/51 at time 1.5 years ago. As a result, no heart damage.
  • terranovalaw
    Continued from above: Like you, I got my diet in order. For me, it was effortless because the fear made me lose my taste for fried food/processed food/sugary snacks etc. I know that it is a lot harder for other MI survivors. Keep up the great work. I am back to running (presently sidelined with knee issue but fine heart wise) and continue to take mess religiously. Life is a great gift. Be well. Joe Terranova
  • Lorb
    Hi Jim Thank you for posting this. You have a great attitude for the future. My son age 32 had a stroke recently and your attitude helped him.
    I was never depressed, because I know the LORD. I bound for heaven ,if if I die soon (probably go by stroke), which I suffered at 75 in 2012. Sinse then I have moved to FL and been divorced, and lived by myself for one year then with a friend who watches out for me.You should consider Christ as your friend and go to heaven, too.
  • GamecockinCola
    Jim, this is a really eye opening post, because I just recently had a heart cat and stent for a 99 % blocked LAD at 46 years of age. You're making me realize how close I could have been to this same outcome, as I also travel a good bit for work. Though I didn't have a MI, I'm still having some of those same thoughts to process -- dealing with the idea of one's own mortality. The mental part is a huge component of the healing, and we have to get ourselves in a spot where we know we will triumph and find quality of life. Unlike you, I have a really horrible family history with heart stuff on my Dad's side, with a grandfather who died at 47 of a heart attack. So we all have our issues to deal with, don't we? Thank you for being so honest. BTW - I'm also looking at the heart disease reversal diets. Prior to my stent, total cholesterol was fine, my triglycerides were fine, but my HDL/LDL needed work. Doc thinks my diet is not a big concern, but I think one should embrace everything one can to feel proactive and on the path of improvement.
  • Kg
    Dear Jim, I am a nurse and now have cardiomyopathy, LV failure and palpitations. As someone who has always promoted a healthy lifestyle I was in shock when this developed. So with some exploring I found this blog and just read,your story. Thank you so much for sharing your experience with your cardiac disease. You went through so much , some which was difficult to read about inadequate care! Your positive attitude and changes in your life are really inspiring! I have been pretty angry with life in general and reading your story has given me some hope for the future. I like you now prioritize my life daily and wake up to my first thought of anticipating each day ahead as a gift to enjoy with my family and friends. Thank you and God bless you!
  • Revkeener
    Wow, your story is inspiring. Im glad your still here Jim. God bless you.
  • tormedic
    This past march I had a NSTEMI like yours no 12 lead changes and elevated traponins as well. I was very fortunate at 48 to reprofused on its in and my angiogram required no stents I was in aND out in 3 1/2 days. What I wasn't prepared for was the depression and mood swings post MI. I have been having a really hard time with this as well. My history is PTSD and low testosterone which I was taking injections. For so now I am post mi tired depressed and no sex drive with out testosterone. So I get it
  • milam.ellen
    This is one of the most encouraging posts that I have read. I had also been a very healthy person, not overweight, non smoker, not diabetic, exercised daily for years and yet I ended up with 90% blockage in the LAD and 70% blockage in the Left Main Artery. They placed stents in both blockages and I've been told that some of the lesser vessels still do have 30-40% blockage. I've been religious about my exercise and diet for 7 years now, but still feel that I'm a ticking time bomb. Your post is very uplifting and optimistic and it gives me a greater feeling of hope and having some control over this disease. Best of luck to you and to all of us as we move forward with hope and conviction that we can live normal lives!
  • purple heart
    purple heart,
    I'm glad you did not give up! Anything can happen! I survived a cardiac arrest at 34 and spent 3 months in the hospital! I went to three hospitals and was airlifted by helicopter to the 3rd one! I was on the bi-vad machine and my liver and kidneys started to fail! I was on the heart transplant list until they took me off! I was removed from the bi-vad machine and my heart started pumping again!!! I survived!!! I had an ICD implanted!! Don't be afraid to get one! They are like having a doctor monitoring 24/7! An ICD is a life saver. I'm on my forth one! I wish wonderful things for you! Don't give up! So many positives await us all! Best of luck!
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