Operation did his heart good
Glenwood Springs, CO Colorado
RIFLE, Colorado ” Three months ago, my husband Paul had a heart attack at the age of 43. Heart disease runs in his family ” his father and brother also had attacks in their early 40s. Both are still alive, and Paul survived his as well.
According to the American Heart Association, heart disease is the No. 1 killer in the United States. And Paul’s doctors say they are now seeing younger and younger patients with heart disease.
In an effort to educate and perhaps prevent others from going through this traumatic event, I am sharing our experience and how we’re coping with it now, along with information from his physicians and the American Heart Association.
It was 2:30 a.m. when Paul poked at me, waking me up.
“Honey,” he whispered softly in the dark. “I’m having chest pains and my arms are numb.”
I immediately sat up in bed and suggested we go to the emergency room. But he didn’t want to.
“It’s just indigestion, and I think I was sleeping on my arms wrong,” he insisted.
I wasn’t sure I believed him, but he was adamant about not going, so we went back to sleep.
The next morning, I asked how he was feeling and he admitted that his chest still hurt. Then he left for work.
After talking to a couple of my girlfriends and relaying my fears, I knew that he had to get to the doctor.
“I don’t care if it costs $500 for them to tell us you have indigestion, I want you to go,” I pleaded and then started crying on the phone. “Please, please just do it for me.”
He finally agreed, and I made the appointment for him that morning.
Afterward, he called and said his EKG and blood pressure were fine. What he didn’t tell me was that the doctor had wanted him to check into Valley View Hospital in Glenwood Springs for more testing after learning that Paul had a history of heart disease in his family.
He wouldn’t go to the hospital, but he did agree to take a stress test the following morning. He also didn’t tell me that evening that the chest pain continued and got even worse.
When he went in for the stress test, the physician quickly pulled him off the treadmill and called me at home.
“You need to get him down to St. Mary’s Hospital in Grand Junction,” the doctor told me.
“So I should make an appointment?” I asked.
“No … he needs to go NOW,” he said urgently.
I offered to come get him at Valley View, but was told he was OK to drive home. So I called our friend Grady to take us to Grand Junction.
It wasn’t until later that anyone realized Paul was in the midst of having a heart attack as he drove down Interstate 70 on the way home.
Grady and I were waiting in the living room when he walked through the door. We put him in the back seat of the car and immediately took off. Both Grady and I could see that Paul was listless and even worse, he was gray.
Grady drove more than 90 mph all the way on the normally one-hour trip to Grand Junction and even ran a few red lights.
A nurse was waiting for us when we got there.
Paul was quickly prepped for a coronary angiogram in which they go up through the groin to take an X-ray picture of the heart. If a clogged vein or artery is found, they can put in what is called a “stent.”
According to the American Heart Association, a stent is a wire metal mesh tube used to prop open a vein or an artery. The stent is collapsed to a small diameter and put over a balloon catheter. It’s then moved in the area of the blockage and when the balloon is inflated, the stent expands, locks into place and forms a scaffold that holds the artery open. The stent stays in the artery permanently, holds it open and improves blood flow to the heart muscle and relieves symptoms.
Grady and I sat in the waiting room for a little more than an hour while Paul was having the procedure done.
Finally, the cardiologist, Dr. Daniel Duffey of Western Slope Cardiology PC at St. Mary’s, came out and sat down in the chair across from me. He looked very serious.
“I didn’t expect to find what I found,” he said honestly. “There’s nothing left to put a stent in. He needs bypass surgery.”
I didn’t know much about bypass surgery, but I’d heard the words “double” or “triple” bypass. I asked him how many.
“I think five,” Duffey said.
My head reeled as I tried to grasp what he was saying. Quintuple bypass surgery. Open heart surgery. My husband is 43.
Paul had suffered what is called in medical terms a “myocardial infarction” ” a heart attack. At one point, someone told me he was living on one frayed vein.
“When can I see him?” I whispered.
Dr. Duffey told me they were going to take him up to the third floor where he’d stay the night and be operated on the next day.
I honestly don’t recall going to the third floor. All I remember is that Paul was lying in bed and had an IV and other tubes in him and nurses all around.
After seeing him, I stepped out of the room as it was kind of chaotic while they hooked him up to the machines. I stood outside of the door and laid my head against the wall and began to sob. I kept telling myself that this wasn’t happening, but it very much was and I had to deal with it. I was trying to be quiet, but Paul heard me.
“I’m OK, Heidi,” he called out feebly from the room. “Don’t worry, I’m OK.”
But we both knew he was very much not OK.
A nurse handed me a glass of water and I tried to collect myself.
Then the surgeon who was going to perform the bypass surgery the next day came in the room.
I don’t know what I was expecting ” some crotchety old man or something ” but she definitely wasn’t it.
Dr. Sara Pereira has worked as a cardiovascular and thoracic surgeon for St. Mary’s Hospital since June 2007. She formerly worked as a cardiothoracic surgery instructor and assistant professor of surgery at the University of Alabama at Birmingham. She is a wife and the mother of a 13-month-old daughter.
I looked at the very attractive, petite woman who looked to be in her late 30s with dark hair pulled back and beautiful green-hazel eyes.
“I’m Sara Pereira,” she introduced herself with a warm smile.
“I’m Basket-Case,” is what I wanted to say.
Dr. Pereira explained that she would operate in the early afternoon, probably around noon, and wanted us to watch a video that would explain the procedure beforehand.
When I asked how many veins/arteries she would be working on, she simply said “whatever I find.”
They’d given Paul medication and he was sleepy, so I decided to go home to Rifle so I could make arrangements for someone to look after our pets. I knew we were going to be at St. Mary’s for a while. Grady and I agreed that he’d pick me up the next morning around 9 a.m.
When I got home, I called family and friends to let them know what was going on. I learned that you never know how many people really love you until you see how many offer to do whatever they can to help. And thanks to our friends, we were covered. They would come over and take turns staying at the house.
Then I went to bed and cried while I rocked myself to sleep alone in our king-sized bed and prayed as hard as I could.
The next morning I was waiting for my girlfriend to come over so I could tell her how to take care of the pets as I expected I’d be at the hospital for several days or more.
But at 8:30 a.m., a nurse from the hospital called and asked me where I was.
I told her I was making arrangements for someone to come over and was waiting for my ride. We hadn’t planned on being there until 10 a.m. when Paul and I could watch the video before his surgery.
“Well, we’ve had two surgery cancellations and we’re ready to take him in now,” the nurse informed me. “And he wants to go.”
There was no way I could be there in time, so I asked to speak to Paul.
“I just want this to be over,” he said. “Come down when you can.”
It hit me that if something went wrong with the surgery, this might be the last time I would ever speak to my husband.
“I love you,” I said, trying to be courageous. “You’re going to be just fine.”
“I love you, too,” he said.
Then I hung up the phone and bawled.
Grady came and picked me up and it was a quiet ride to Grand Junction. The surgery was expected to take 31⁄2 hours. By the time we got there it was already more than an hour under way. We sat in the waiting room and did just that ” waited. Several good friends showed up as well. There’s not much to say when you’re waiting to see if the love of your life is going to live or die. Absolutely nothing matters. At one point, we walked outside for some fresh air and I looked down between my feet. There was a large cigarette butt. I’d just quit smoking four months before and if there was ever a time I’d wanted a cigarette in my whole life ” this was it.
“Don’t do it,” one of his friends said, reading my mind. “He would be so disappointed.”
I knew he was right because Paul, who has never smoked a day in his life, had been so proud of me when I quit.
Shortly after we went back to the waiting room, a nurse came out to give us a report.
“Things are going very well,” she said, and then looked at me. “Please stop holding your breath.”
I didn’t even realize that I was.
Another hour and a half later, Dr. Pereira came out and took all of us into a little room. She said that she had grafted four veins and an artery and that it had gone well. Then she turned and looked at me and asked how I was. Clearly I wasn’t doing very well, but her calm and confident manner made me feel better.
“You can see him after they get him set up in the Coronary Care Unit,” she said. “But he’s completely out of it, and he’s not going to look like your husband.”
I had one more question.
“What would have happened if we hadn’t gotten him here when we did?” I wanted to know.
“He would’ve had a massive heart attack and died,” she said bluntly.
When I went to see him, she was right ” he didn’t really look like my husband. He had tubes in what seemed like every orifice of his body. A big ventilator was in his mouth and his tongue was swollen. I asked the nurse if I could touch him. I just wanted to brush back his hair and kiss his forehead. I wanted some contact.
After that, everyone left and I went back to my hotel room. I poured myself a big glass of wine and tried to absorb everything that had happened.
Later that evening, I returned to visit Paul and saw that some of the tubes had been removed. He was awake, but still out of it because of the morphine. I watched the monitors that rated his heart rhythms and his breathing. I ran my fingers through his hair while he closed his eyes and I could watch his breathing on the monitor become more relaxed.
I went back to the hotel room and called friends and family to let them know he was OK. Then I dropped into bed from exhaustion.
The next morning, I called the hospital only to find that they had moved him to the “telemetry unit” ” a “step down” level from the cardiac intensive care unit, which allows hospital staff to monitor things like a patient’s heart rate, breathing, blood pressure, temperature and level of oxygen from a remote central control site.
Paul actually walked and pushed his own wheelchair from CCU to the telemetry unit.
“I’ve worked here for eight years, and I’ve never seen anyone do that,” his nurse later told me with amazement.
As I walked over to the hospital that morning, it suddenly dawned on me that it was my 47th birthday.
When I got there, Paul was up and waiting for me. His color looked much better, but he still had a lot of tubes.
“Hi. … Happy Birthday. … I love you. … Thanks for saving my life,” he said as soon as
I walked into the room.
I was just happy to see him awake and alert.
“That must’ve been the worst birthday you ever had,” someone said to me later.
“Nope,” I answered honestly. “I was in the hospital, not the funeral home. It was the best birthday I ever had.”
Over the next few days, the various tubes were slowly removed, and Paul seemed to get better and graduated from eating Jell-O to an actual turkey sandwich, which made me happy. He’d lost 15 pounds in four days.
I hadn’t eaten in four days and lost 10 pounds myself. And when I caught a glimpse of myself in the hospital bathroom mirror, I was horrified. My face was pasty white, and I had huge purple circles under my eyes. I was not pretty.
But things improved, and Paul continued to get well. In fact, he was discharged on the sixth day. Before we left, a dietitian came to tell us about a low-fat, low-sodium diet, and others came to help prepare us for post-heart attack life and what to expect.
While Paul was anxious to go home, I could see that he was also nervous about leaving the safe environment of the hospital. If something went wrong, at least medical care was moments away, unlike at home. But I had faith that they wouldn’t be letting us go if it wasn’t right.
“Should I rent a hospital bed for downstairs?” I asked Dr. Pereira. “All of our bedrooms are on the second floor.”
She looked at me and smiled.
“Why can’t he go up the stairs?” she asked. “I want him to move. It’s safer for him to go up the stairs now than it was a week ago.”
Still, I was very nervous. I would lie in bed at night and listen to make sure he was breathing. I counted out the various pills he had to take in the morning and the evening over and over to make sure I had it right.
I had to help him with showering at first ” washing his back and helping him to dry off with the towel, along with monitoring the eight-inch long incision in the center of his chest where they’d sawed open his sternum.
He wasn’t allowed to lift anything or raise his arms at first, but slowly he was able to do more. After a few weeks, he enrolled in Valley View Hospital’s cardio rehab program, which would get him exercising while monitoring his vital signs. They also provided helpful information on what activities he could do and when he could do them, along with healthful eating tips.
“I started this program 20 years ago,” said Karen Stripp, who holds a master’s degree in cardiac rehabilitation. “Valley View didn’t have one.”
She sees about 30 patients a month who range in age from 28 to the 90s.
“The most important thing is to return to what is normal for them,” Stripp said. “It’s all about confidence and saying, ‘I know I can,’ whether it’s walking, biking hiking or skiing. “
While a patient is exercising, Stripp monitors their heart rate and rhythms, blood pressure and oxygen levels.
“And I’m always watching their faces and talking to them,” she said. “People should be able to talk to you while they’re exercising.”
The exercises are measured in METS ” Metabolic Equivalents, which are a measure of work.
“They usually start at around 3-4 METS, but we like to get our folks to six or more METS,” Stripp said. “The goal is to increase the functional level.”
The program is an average of 12 weeks long, which is the time the sternum and the incision are usually healed.
At six weeks, Paul had already attained the goals Stripp put out for him for the 12 weeks.
“Paul is unbelievable,” she said. “What he is able to do, I never thought I’d see.”
Two weeks after the surgery, we had an appointment with Dr. Pereira for a re-check. She looked at an X-ray of Paul’s heart, results of some blood work and inspected his incision. He got a good report card.
Once again, I was very impressed by her bedside manner.
“What is your philosophy?” I asked her in an interview later. “Not only do you save people’s lives, but you have an uncanny calming effect that makes people who are terrified feel so much better.”
Pereira told me that her own mother had passed away at 63 with liver and heart problems.
“I spent a lot of time in the hospital,” she said. “I always told myself that I would not treat my patients like we were treated. Although it can get really tough sometimes with some people because they’re really frustrated.”
Pereira studied general surgery for five years and heart and lung surgery for three years, finishing her training at the age of 33.
“I went into heart operations because I was fascinated with it,” she said. “There’s not a lot of women who do this, but I knew I loved to operate.”
She performs about two surgeries a day, which can take anywhere from three to six hours.
Pereira urged us to come visit her when we were in town again, and we did.
“You look younger,” she beamed at Paul, giving him a great big hug. It was like seeing an old friend that you didn’t know very well, but had just saved your life.
We chatted for a while, and then an elderly couple came in. We didn’t want to take up her time, so we got up to leave. Turns out, they were doing the same thing we were.
“I’ve been waiting for you,” we heard Pereira say as she gave them each a hug. “I haven’t seen you in a while, and I wanted to know how you were doing.”
I was starting to learn that this kind of caring was typical Sara Pereira.
Later in the month we had an appointment with Duffey, the cardiologist, who checked Paul out and answered questions that we had about his ongoing care.
Again, Paul got a good report.
Duffey, who has worked at St. Mary’s Hospital for 25 years, said he is seeing more and more patients Paul’s age.
“Seeing somebody who is 43 years old with this used to be a real unusual thing in the past,” he said. “But now we’re seeing people this age once or twice a month.”
Duffey’s youngest patient has been 28.
When asked why, Duffey said he believed it had to do with a poor diet that included fast food, lack of exercise, obesity and an unhealthy lifestyle.
He then asked me if I’d driven Paul to the hospital the day we brought him in. I told him no, his friend drove, but I was in the car.
“We weren’t sure he was going to make it,” Duffey said.
Three months later, Paul is doing extremely well. He’s mowing the lawn, taking out the garbage and doing most of the other household things he’s always done. He’s back at work full time, barbecues on the weekends and even enjoys a couple of beers on occasion.
Things are pretty much back to normal, although they will forever be somewhat changed.
Medications have to be taken twice a day, daily exercise is a must, and our diet has radically changed. Not that we ate unhealthily before, but now we have to be aware of sodium and fat contents in all the foods we eat. Let’s just say, bratwursts and potato chips are not part of our world anymore. We eat a lot of fruits and vegetables, lean meat and whole grains. We’ve both lost weight, and we feel good.
There is life after a heart attack. But if you experience symptoms and especially if you have heart disease in your family, please go see your health care professional and get tested. We were fortunate that Paul survived his. Some people aren’t so lucky.
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