The Main Event

On the morning of Tuesday, February 21, 2012, I thought I was having a heart attack.

I woke up at 6:30 A.M. feeling like a pissed-off construction worked was trying to break out of my ribcage with a jackhammer. At first, I thought I might simply be dehydrated, so I asked my wife if she wouldn’t mind getting the kids off to school, drank a large glass of water and laid back down for an hour or so.

When I got up finally, the pounding in my chest was still there, strong as ever. I went to the kitchen, poured myself a coffee, grabbed my laptop and went to work. I’m fortunate enough to work from my home office when I’m not travelling on business, so I plopped down at my desk and started reading through email.

At 10:30 A.M., four hours after waking-up with this Afro-Cuban pulse pounding away inside me, I sought out some advise from my mother-in-law, a registered nurse. My wife had been pleading with me to go to the emergency room for awhile and, eventually, I succumbed to her wishes. You see, I’m not big on doctors or hospitals. I never have been. I see so many people drag their kids into the hospital when they have a simple cold, and I’m always that guy saying, “They’re just going to tell you it’s a cold. You can prevent it or treat the symptoms, but you can’t cure it.” And most of the time I’m right.

This time I wasn’t.

By 11:00 A.M. I was lying on a gurney in the ER of my local hospital. I had myriad wires attached to my chest and one on the calf of each leg. A monitor just out of my line of sight sat to my left next to my wife.

The ER doc came in. She was great. She smiled a lot and spoke with a very soothing tone. As she introduced herself, she kept averting her eyes to the monitor. Her smile never broke, but it began to look a bit forced. Then, I heard one of the nurses whisper something to the doctor that sent a shudder through my already stressed nervous system:

“BP is 189 over 110 and he’s tachy.”

“Tachy.” I knew that term from watching the show ER all fifteen seasons it was on the air. It was a term used by the nurses on the show to describe heart attack patients. I know now that tachy is simply an abbreviation for tachycardia, which simply means “rapid heart beat,” but it scared the hell out of me at the time.

Holy crap, I’m having a heart attack.

Thirty minutes later, after a painful shot of blood thinner in the abdomen, a needle the size of a whaling harpoon stuck in my arm for blood and an IV inserted into my left hand (my constant companion for the following forty-eight hours), I was informed that I was going to be admitted. This was something that in my forty-one years on Earth had never before happened. I was going to spend the night in the hospital. This was no broken finger or twisted ankle, something they could throw an ace bandage on and send me home with a $45 ice pack and mild pain killers. This was serious shit. Shit they would have to monitor which made it all the more frightening.

I’m grateful I had a private room and that my loving spouse was with me the whole time, but it quickly started to feel like a prison cell. The staff was very kind and attentive, but I had a needle sticking our of my left hand, an O2 hose sticking out of my nose, numerous telemetry monitors stuck to my chest and wraps around my lower legs that would inflate and deflate to aid circulation in my lower extremities. As I tried to sleep, I was woken-up every couple of hours during the night so they could take my blood pressure, stick me with a needle to collect blood, do a “quick” EKG and check the sensitivity of my feet.

I felt like an eighty-year-old man. Most unpleasant.

In the end, I did not have a heart attack. My heart was in a state called “atrial fibrillation,” or “a-fib.” Essentially, the top two chambers of my heart—the atria—were taking tango lessons, pumping up and down the cardiac dance floor to a beat all their own, while the lower two chambers—the ventricles—work horses that they are, continued to keep blood moving through my circulatory system. The result was an uncomfortable pressure and “fluttering” in my chest. There was also the unfortunate possibility that, because the atria weren’t pumping correctly, a blood clot could form in the left atrium and get pushed into my blood stream, the likely outcome being a pulmonary embolism or a stroke.

Good times in the intensive care unit.

After two days of excellent if not exhausting care, my cardiologist decided to release me on my own recognizance. He said that I was still in a-fib, but it had stabilized. He was going to put me on medication for a month in the hopes that my heart would fall back into a sinus rhythm on its own. When I asked him what would happen if it didn’t, he said, “Well, then you’ll come back in here and we’ll use defibrillator paddles to shock it back into a sinus rhythm.”

I was sorry I asked.


The Cause

And what caused the a-fib in the first place? The best theory is that it was sleep apnea combined with job-related stress. I was diagnosed several years ago with this fairly common sleep disorder, but I’d lost a lot of weight and, when I did, I stopped snoring. In turn, I stopped using my Continuous Positive Airway Pressure (CPAP) machine. My doctor, in no uncertain terms, informed me it was time to blow the dust off and start using it again.

You see, when you have obstructive sleep apnea, your airway is blocked multiple times a night as you sleep. This blockage doesn’t wake you completely, but it pulls you out of deeper, more restful levels of sleep. It also has more insidious effects that I wasn’t aware of until my doctor explained them to me in the hospital.

Humans are innately endowed with a physiological “fight or flight” response. This evolutionary holdover, when faced with danger, releases a cocktail of cortisol and adrenalin into your system. These so-called “stress hormones” prepare your body for extreme feats of physical exertion. Oxygen is diverted to your extremities, your heart rate quickens to supply oxygen to the muscles, you become more alert. Every time someone with sleep apnea stops breathing during the night, these hormones are released into your bloodstream and these reactions take place.

This isn’t really conducive to a good night’s sleep, obviously. It’s none too good for your cardiovascular system either. When your body is supposed to be down for maintenance, my body was ramped-up, my heart rate and blood pressure climbing because of the stress hormones. My body, overall, was simultaneously deprived of oxygen while needing more than normal. Not a great combination for long-term cardiac health.

My doctor postulated that the cumulative effects of this nocturnal stress finally threw my heart into a-fib. What’s more, it’s highly likely that I was in a-fib long before I really felt it on Tuesday morning. It was just subtle enough that I could dismiss it as indigestion or gas.

In other words, that whole “ticking time bomb” thing you read about in the newspaper or see on the evening news, I had one of those in the left side of my chest and, as such, this story might have had a very different ending.


The Aftermath

One of the real ironies of these events is that, Monday night, just as I was laying down to bed, I thought to myself, You know, I’m going to take a jog in the morning. It’s been too long since I had a decent run. I pulled out my running shoes and some warm sweats and went to bed.

Here’s the thing: If my doctor is right and I’d been in a-fib for some time already, I might have headed out for a morning jog along the sparsely travelled country road near my house and thrown a clot from my malfunctioning left atrium and dropped dead along the side of the road. It’s the classic “Guy Running to Get Healthy Drops Dead While Running to Get Healthy” headline.

Sure, it would have been cliché, but clichés become clichés once they happen enough times.

Prior to last week’s events, I’d already been reflecting on reaching “mid-life.” This week, “mid-life” might have ended up being age twenty for me.

I’ve felt mortality before, like when you have to put the break pedal through the floor of your car because the guy in front of you brakes suddenly on the interstate, or when your hand slips out of a hand-hold while rock climbing. But these are events, scary moments that causes your breath to catch in your chest, but from which you recover after a few minutes. Last week? That was the first time I’ve really looked at my body as something that can atrophy and eventually die with no event at all.

It gets a guy thinking.

Many of the things the twenty-year-old me wanted to accomplish have been done, and many not done. Same as everyone, I suppose. There’s a whole list of things I still want to do.

The key, I think, is to stop waiting for the right time to do the things that will fulfill you and make you happy. Time could run out in the next minute, the next year, the next decade. Who knows? I mean, last Tuesday I was planning to go for a jog and, instead, ended up in the ICU for two days.

What comes next? I haven’t figured that out yet, but I’m sure it will provide ample fodder for many future posts. For now, I’m happy to be convalescing at home where I can look out the window and feel the sun shining on my face. I can feel the cold wind and watch the snow melt across the yard. I’m happy to enjoy my time with my loving wife (who never left my side at the hospital), my beautiful and intelligent daughters, and my excellent family and friends. All simple things that, for a short time last week, I thought I’d never get to enjoy again. 

As of 4:30 P.M. CST today, my heart is back in sinus rhythm. That’s a good thing, but the question remains: What comes next? That’s yet to be decided, but I think being here, right now, in this moment, is a damn good start.