“I am lying in a surprisingly bright glass-walled room…”

29 Jul

by Carolyn Thomas    @HeartSisters    July 29, 2018

Royal Jubilee Hospital, Victoria, BC - CanadaI am lying in a surprisingly large and very white, bright glass-walled room in the CCU (the coronary intensive care unit) of our local hospital. Through these walls I can see several people who look like nurses and doctors seated at a long desk outside my glass box, staring at computer monitors. It’s action central out there, where staff can observe and monitor every heart patient, each of us in one of the glass boxes.

I can see assorted tubes, lines and beeping machines surrounding my bed or attached to my body. Two nurses are looking down at me, one on either side of my hospital bed, closely examining my right wrist.  They are checking the wound that has been opened up there in order to insert a catheter through the radial artery, up my arm, around the bend of my shoulder, and into my beating heart. I find it oddly touching that each of these women is gently holding one of my hands. I feel like weeping, and so I do.

I have no more pain. No more pain crushing my chest or radiating down my left arm. No more of the increasingly debilitating symptoms I’ve been suffering for the past two weeks. If anything, I’m simply feeling surprised. I have had a heart attack. I HAVE HAD A HEART ATTACK! I, Carolyn Thomas, have had a frickety-frackin’ heart attack. . .

I now sport a shiny stainless steel stent, a hollow tube resembling fine chicken wire, implanted in my left anterior descending coronary artery (LAD), one of the largest arteries feeding the heart muscle, the artery that was found to be 95% blocked.

I am also surprised that, although sedated, I’ve been able to watch the catheterization procedure to implant that stent live on a big screen overhead in the cath lab.

That’s my heart up there on the screen. My beating heart, squirts of contrast dye swooshing periodically into the catheter through the radial artery in my right wrist, outlining my heart’s coronary arteries with every beat. I don’t know it yet, but this radial approach is now the default angiography access in up to 95% of procedures performed here in Canada as it is in much of Europe, Japan, and many other countries – except the U.S. (where the groin or femoral artery access is still used in most cath labs). 

Screen Shot 2018-07-27 at 5.17.03 PM“But look! The interventional cardiologist performing the procedure points out to me one remarkable area where the dye is clearly unable to get through. Blood flow in that part of the LAD artery simply seems to abruptly disappear. But then the catheter-led angioplasty balloon is inserted, inflated, and – oh! – another surprise, an involuntary wee scream of pain – while the balloon fully inflates to fill the artery, momentarily stopping all blood flow to the heart muscle downstream from that temporary blockage.

Within seconds, blessed relief as the balloon is deflated and swiftly removed from my body, leaving behind its perfectly placed little stent passenger. That stent will help to permanently prop open that once-blocked coronary artery, and will remain inside my heart for the rest of my life.

Another nurse walks into my big glass box to ask if I’m hungry. Another surprise: she brings back a tray carrying a roast beef sandwich on white bread, wrapped in shiny cellophane.

This is what they serve people on the cardiac ward?

The CCU is a calmly busy place, what with cardiologists and techs coming and going, nurses hovering to check vital signs, emotional phone calls with my children, Ben and Larissa, each living out of town but now busy making plans to come home right away to be with their mother. Nurses set up patient education videos for me to watch on my overhead TV screen, all about heart attacks and cardiac anatomy and what’s just happened to me. How does a person get any rest around here?

I think I drift off to sleep during most of the videos, but the helpful nurses just keep resetting them for me. I’m helped out of bed regularly to practice walking around my glass box.

I eat my roast beef sandwich, and decide I have never tasted anything more delicious.

Nurses periodically come by to check my wrist wound, which is covered by a clever inflatable cuff pressing down firmly against the open artery. Three visiting cardiology residents from Sweden interrupt my sandwich to interview me for an hour. They ask me many questions and take careful notes. I ask the young Swedes to remember my story when they get back home whenever they are tempted to dismiss Swedish women with classic heart attack symptoms like mine (central chest pain, nausea, sweating and pain down the left arm) because of what look at first like “normal” diagnostic test results.

At one point during the first day in the CCU, I am happy to see that two of my Victoria Hospice colleagues are also waiting to visit me.

I spot the wide-eyed faces of Rod and Brenda near the desk outside the glass walls before they see me. They walk carefully up to my bedside, and they seem uncharacteristically quiet.

I’m thinking that their faces reflect surprise because I look better than they’d feared – or is it that I look really bad?  So I try to sit up a bit straighter in bed and paste on my best smiley face to reassure them. I will very shortly learn to perfect those pasted-on smiles, no matter how I’m feeling inside. Brenda explains that the news of my heart attack has rocketed through our workplace. She and Rod know about my unfortunate trip to Emergency two weeks ago when I’d been sent home despite cardiac symptoms, misdiagnosed with acid reflux, and they are anxious to catch up on every detail to report back to our hospice colleagues.

But the nurse soon returns to shoo them out of the CCU. Before they go, I ask them to tell Dave, our boss, that I might not be back at work tomorrow, but will most definitely be back on the following day. I catch the eye-rolling as they leave.

The time drifts by in a surreal blur with interrupted naps, more slow walks, more wound and heart monitoring, cardiology consults, and a six-week follow-up appointment booked. Before I’m finally discharged from the hospital, I’m handed some printed wound care instructions and a prescription for a fistful of new cardiac drugs, which we’ll pick up at the pharmacy on the drive home.

And home is where the enormity of what has just happened to me begins to finally sink in.

This post is taken from the first few pages of Chapter 4, “The New Country called Heart Disease” in my book A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press, 2017).

The rest of Chapter 4 includes six related sections based on several of my 700+ Heart Sisters blog articles in these specific themes:

Q: Have you ever experienced a delayed reaction before the reality of a new diagnosis was able to sink in?

See also:

 

10 Responses to ““I am lying in a surprisingly bright glass-walled room…””

  1. Jodi Jackson Gypsy Heart Design July 31, 2018 at 6:21 pm #

    Hi Carolyn! I love this and know it so well! I laughed out loud at the fact that they served you a roast beef sandwich. My first meal they served me was breakfast and they brought eggs, bacon and toast with butter. What? I could hardly believe it. The nurses assured me it was ok because it was turkey bacon! 🙂

    Hope you are well!

    Liked by 1 person

    • Carolyn Thomas July 31, 2018 at 9:42 pm #

      Lovely to hear from you, Jodi! One wonders if hospital dietitians like both of ours have ever popped over to the cardiac ward to plan some special menu items for heart patients?!

      It struck me while reading your comment that the first meal post-op is an especially good teaching opportunity: serve the freshly-diagnosed heart patient a simple, healthy (ideally Mediterranean diet-based) meal, as if to say ‘this is the delicious way you’ll be eating from now on because this is a heart-healthy way to eat! I don’t mind the egg part (because eggs are now generally considered not to affect cholesterol, as we once believed) – but what a great teachable moment to serve a nice fruit plate!

      Yes, I’m doing well and trying to stay cool in our (unseasonably) hot west coast weather lately!!

      Like

      • Jenn August 1, 2018 at 1:22 pm #

        I remember having to speak to a dietitian because my meals in the hospital were much saltier than what I ate at home. She said I was on a cardiac diet – 2000mg of sodium/day. I asked for 1000mg because that’s what I was used to, and I was getting a lot of swelling with the hospital diet.

        She told me 2000 mg was the lowest the hospital provided but could she do anything else? I told her I was used to having lots of fresh fruit, so she did order 1 serving of fresh fruit be added to each of my meals. I skipped the salty soups and gladly ate the fresh fruit.

        Liked by 1 person

        • Carolyn Thomas August 1, 2018 at 4:48 pm #

          Great suggestion about adding fresh fruit to each meal – and nobody ever complains that there isn’t enough salt on the canteloupe! I really hope that your dietitian took away that fruit addition idea for ALL heart patients!

          Like

  2. Sue Murphy July 29, 2018 at 8:13 am #

    Delayed reaction!!! Yes… It has taken two years for all of it to sink in. Yes, I had three 90+% blockages, two in the LAD. I now have four of those delightful stents. Plus three new meds to add to my already large arsenal. And now there is the possibility of more stents as blood pressure is back up. Doc is thinking we are looking at possible renal stenosis.

    I still feel like a deer caught in the headlights. But….life is good…it could have been a heart attack.

    Liked by 1 person

    • Carolyn Thomas July 29, 2018 at 8:30 am #

      Hi Sue – It amazes me how the human body (i.e. yours!) can manage severely blocked coronary arteries, four stents – and maybe more stents? Yet here you are, and life is good despite those deer in the headlight moments. Best of luck to you…

      Like

  3. Nancy Bradley July 29, 2018 at 7:09 am #

    I look forward to reading your blog. I find it kind of eerie as well, because I feel like I’m reading my own story.

    I too was misdiagnosed with GERD and sent home and two weeks later back in the hospital, this time by ambulance.

    After 6 days and one stent later, through my right wrist, I was sent home with no instructions and no care plan.

    Liked by 1 person

    • Carolyn Thomas July 29, 2018 at 7:35 am #

      Good morning, Nancy – I’m very familiar with your own story from the Heart and Stroke Foundation’s 2018 annual report, and wrote about our freakishly similar stories of misdiagnosis and survival here. I have also mentioned your story in my women’s heart health talks.

      Since my own heart attack, a number of physicians have assured me that what happened to me in 2008 could NEVER happen to women now, because diagnostic testing tools have improved, because docs are so much more aware of women’s heart disease, blahblahblah.

      I could hardly believe that our cardiac experiences of misdiagnosis and survival were almost exact duplicates, except yours happened in Kamloops and mine in Victoria.

      The horrifying difference: mine happened 10 years ago, and yours this year.

      You and I were both the same age when we had our heart attacks, both got the same misdiagnosis in the ER, both 95% blocked LAD, both waited two weeks to return to the ER until symptoms became unbearable. By then, as you wrote: “I thought I was dying.” Me, too! When I first read your story, I almost fell off my chair.

      And “No instructions and no care plan” on discharge – also true for me here…

      Thanks so much for taking the time to share your perspective here. Hope you are doing well and staying cool in the heat… ♥

      Like

  4. Jenn July 29, 2018 at 7:06 am #

    I spent time in CCU when I had a large clot on each of my 2 artificial heart valves.

    My typical coping mechanisms are intellectualizing and using humour. So right away I was asking questions to clarify the diagnosis and the treatment plan. The desired outcome was no clots and the least harm to me in the process. The treatment plan kept changing, but I was kept up to date on every change. This was happening on a weekend. Finally, the decision was made that my chest would not(!) be opened up for a third time to replace the valves (each had starred in its own chest-opening surgery years earlier).

    The treatment was to be a clot-busting drug, given by IV over 4 hours as well as IV Heparin. While this was happening the ultrasound tech and the cardiologist were glued to the bedside cardiac ultrasound, the stroke team from neurology was on standby in case the procedure caused bits of clot to break off and travel to my brain and cause a stroke, there was someone in case a bit of clot caused a pulmonary embolism.

    RNs seemed to be everywhere. I had 2 or 3 IVs, a continuous cardiac monitor, BP going automatically, and I think a urinary catheter because I was not to move at all. Of course all the residents in cardiology and now neurology who were following me were there.

    My glass-walled room was just big enough that I could see my husband backed into a corner. Most people had been called in from home on this Sunday afternoon. Everyone was very serious and focused – mainly on the machinery. The procedure was started. The machines would tell most of the story. I was to speak up if I felt anything unusual. No one in the room had previously witnessed this application of this procedure. The tension in the silent room was almost unbearably thick.

    After about 1/2 an hour with no change in any parameter I said in a strong voice, “Okay everybody, this was just a drill. You all did well. You can all go home now.” Everyone in the room burst out laughing and then started talking quietly and behaving like normal people.

    The entire 4 hours didn’t go entirely smoothly, but the treatment worked. The clots were gone and I had no residual harm. I was thrilled with the outcome and pleased that I had had good relationships with the members of the staff who treated me and that there was nothing I didn’t understand.

    Only when I had been back at home a couple of days and no longer had to figure out and keep up with the information I was getting at the hospital and translate a version to family and friends did I allow myself to relax. Suddenly my legs felt like jelly as I realized I was very lucky to be alive and “well”. For a day or two I felt overwhelmed by what I had experienced.

    Liked by 1 person

    • Carolyn Thomas July 29, 2018 at 7:21 am #

      Hello Jenn – that sounds like a very high-drama event! What a relief that the treatment worked as planned – so much could have gone sideways, but didn’t. The image of your “husband backed into a corner” of the glass box really struck me, as did your successful attempt to break the tension with a joke. I think that ‘legs turn to jelly’ feeling you mention is remarkably common long after the intensity of the drama is over. So glad you emerged successfully…

      Like

Your opinion matters. What do you think?

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s

%d bloggers like this: