I 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 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 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 blocked left anterior descending coronary artery (LAD), one of the largest arteries feeding the heart muscle – the kind of heart attack doctors used to call the “widow maker”.
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 in the U.S. (where the groin or femoral artery access is still used in most cath labs).
“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. 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, emotional phone calls with my children, Ben and Larissa, each living out of town but now busy making plans to fly 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 in the next hospital building. She and Rod of course know about my unfortunate trip to Emergency two weeks ago when I’d been sent home despite cardiac symptoms, misdiagnosed with acid reflux; they are now 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 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).You can ask for it at your nearest library or local bookshop or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher (use the code HTWN to save 20% off the list price).
The rest of Chapter 4 includes six related sections based on several of my 900+ 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?
What I wish I’d known before my hospital discharge, (my guest post in the British Medical Journal (BMJ), part of their “What Your Patient Is Thinking” series
“Best narrative I have ever encountered on this topic” (an overview of my book from the Cardiac Health Foundation)
Dr. Martha Gulati, Chief of Cardiology at the University of Arizona, wrote the world’s best foreword for my book