OK, I’ll get this out of the way quickly. Yes, I did recently have a heart attack.
On March 4, 2021, I woke up in the middle of the night with chest pain. It was about 3 am, and I didn’t want to admit what I knew it was. Either a clot or a heart attack.
I didn’t want to admit it because of what it meant. At a time when my family was preparing to sell our house and move, I would not be able to help. All of that responsibility would fall on my wife and teenage daughter. And I’d have to admit I couldn’t help.
At a time when my career is on an upward track, I’d need to slow down. I’d been knocking out several growth opportunities. And on my job, I took a marginalized and overlooked project – bringing enough attention to it that now it was one of 2 feature projects on our contract. It was getting the attention and the staffing it needed from the beginning. At the time, it was still struggling because those changes had not yet occurred. But it was close. And my absence meant the product vision would suffer. And with that, so would the team.
On a day when I was scheduled to start my next certification, I’d have to drop out of class. As a lifelong learner, missing an opportunity to grow thru learning is something painful to me.
A lot was riding on it NOT being a heart attack.
I even tried to do things to lessen the pain. I tried to make it through the class. But by 11:00, this wasn’t going away.
So, if you know my history from previous posts, you know the local hospital is not a place I want ever to see the insides of again. That’s part of the reason for moving. I tell people I fired that hospital a few years ago.
An ambulance, therefore, is not an option – they’d strap me in, sedate me and take me to the local facility.
Just writing about this shows I can be pretty stubborn. And often stubborn equates to stupidity. Even though I’d do the same thing again, I’ll just say my actions are not what I would suggest to anyone else.
About 11:00, I messaged my boss and explained I thought I was having a clot and would have to miss the rest of class. Then I drove myself to one of the big hospitals in Lexington – about 40 miles away.
I told you I was stubborn.
Diagnosis
In the ER, they began running the tests. Blood tests showed the markers of a heart attack. EKGs should my heart was still very strong. Later, my physician would say that I have a heart that is as strong as an athlete. That’s amazing because I’m no athlete, and I’d just had a “Minor” heart attack. But before the afternoon was up, they had me on a table to investigate how serious it was and determine how to resolve the problem.
I was awake during this procedure. A catheter was run up my right wrist to my heart to investigate. I could feel the wire jiggling thru my shoulder as the cardiologist pulled it back out. With any luck, a stent could be inserted right then, and I’d be home quickly.
That was not my lucky day.
They observed multiple blockages that a stent could not resolve. So I guess when I told my boss that it was a clot, I was right. I just wasn’t completely right. And perhaps that was a bit of denial, refusing to admit what I knew. One of the blockages was 100% Left Arterial Descending (LAD) artery and is called the Widow-maker by cardiologists.
Cabbage
Over the next few days, I was treated to constant IVs of blood thinners to prepare me for what would come next. There was some debate as to whether I would have a triple or quadruple bypass. The answer, surprisingly to me, depended not on the blockages but my legs. The graft material would come from there. And it seems that the vessels in my legs were narrow or undersized for the job. Going to surgery, I didn’t know what the verdict would be.
Most people call it a “bypass.” Medical staff call it “Coronary Artery Bypass Graft (CABG)” and pronounce it “Cabbage.” In the hospital, someone asked a question about my “Cabbage,” and I said I don’t like it. Since I hadn’t heard the term, I wasn’t intentionally trying to be funny. But whether you mean the food or the surgery, I’ll stand by that opinion.
The surgery was done on March 9. This is the kind where they split the sternum. It took about 4 hours and ended up being a triple. Though I’m not exactly the most health-conscious, I am sure that my circulatory structure played a more significant part in this than my lifestyle. Stating it simply, smaller pipes get clogged easier. My heart is probably stronger because it’s been dealing with those small vessels all this time.
Coming out, I had all the tubes and IVs you can imagine. Four tubes, to be exact.
On day two, I was told I needed to walk. Walking is a huge milestone for heart surgery. Those that don’t walk don’t make it. Which means the tubes came out. Not exactly the most comfortable thing.
Walking has become a big part of my recovery. First, it was down the hall with a walker and an escort. Then it was multiple laps. And eventually, it was by myself.
I was sent home on March 12. Boy, that seems fast.
Beginning Recovery
By “home,” my family and I decided the best place to recover was at my Mom’s house so that they could continue to prepare the house to sell and that I could recover in peace. I wasn’t allowed to lift anything over 10 pounds, and I couldn’t drive for eight weeks. I wasn’t allowed in the front seat because if an airbag went off, it would probably kill me. The eight weeks were to let my sternum heal enough. Being in a place where lifting, driving and having the stress of preparing a house to show was recognized by all of us as a bad idea.
Once “home,” I commenced walking. Mom’s house is out in the country, about 2 hours from where we live. A lap up the driveway and back is about .1 mile. And a lap around the yard is about 1/4 mile. There are over 60 trees on the property and all kinds of birds and other critters. I got to know many of their daily patterns on my walks.
I started back to working from home about three weeks out. At first, I was taking it easy – proving to myself that I could handle sitting in virtual meetings. Eventually taking back over on presentations.
Cardiac Rehab
A month after surgery, I was allowed to begin rehab. That consisted of walking on a treadmill for 5 minutes, an exercise bike for 5 minutes, a device for arms that worked for 5 minutes, and the beast – an elliptical – for 2 minutes. Each was at the lowest setting. After each machine, I got my blood pressure and oxygen, and I was on a heart monitor the entire time. This was three days each week. Each week, I added one level of intensity and one minute of duration to each device. And while taking rehab, I did additional walks each day it wasn’t raining or too cold.
At work, I still was proving to myself that I could do the job. But, before long, I had built back up to a normal pace and got mentally back in the game. And with my project approaching a critical phase, we had some unexpected changes.
First, my project moved from being the one given attention or priority to the one featured on this contract year. It had been underappreciated and neglected previous to my work on it. That transition also meant that the team rolled over. A new team. New visibility. New opportunities. New stresses. Not exactly what you’d seek out during recovery. But precisely what I needed to prove to myself that I can still handle it.
Then my company got bought out by Booz Allen Hamilton. So again, this will bring new opportunities. But frankly, it won’t affect me much personally until sometime in the future.
In the middle of all that, there was a walking challenge issued for all employees at Liberty to walk to remember the challenges many Veterans face. The challenge was for 20 days leading up to Memorial Day. I decided to take the challenge in earnest. By day 3 of the challenge – in mid-May – I walked over 10,000 steps, between 4 to 5 miles each day. As of this writing, I still haven’t run any. But I’m proud that for the walking challenge, I placed 3rd of all participants. Not bad for an old guy with a triple bypass.
The Purpose of a Heart Attack
During this time, some family friends brought something to my attention. My Mom wasn’t communicating like she normally did. At first, I thought she was trying to be quiet while I worked from home. But after a couple of people mentioned it, I started thinking of odd behaviors I had noticed and had written off. So maybe there was more to it than I thought.
One night, a relative was visiting, and we started asking Mom questions. She was taking much longer to answer than she should and often not finishing sentences. When it took her 15 minutes to come up with the name of her favorite TV show, something was wrong. Was it a stroke?
The next day, Friday, May 28, I called the doctor, and he said to take her to the ER. I had to lie to get her to go. I told her I was taking her to her doctor, but when I passed the hospital (the same one I just got out of), I turned in to the ER. To be honest, I wasn’t supposed to be driving until the following Tuesday, not because of medicines, but because of having my sternum cut open. I figured I only had one shot to help her.
Once in the ER, I described the symptoms she was having. After some quick physical tests, the ER doctor quickly ruled out a stroke. A brain MRI was ordered, and it came back in about 2 hours with the news you never want to hear. The Dr. reviewed the MRI with us, and it showed multiple tumors. Each lit up different portions of her brain. There were 6 of them. She would be admitted for more testing to determine what these were.
PET scans were done the next day to determine what caused these tumors. The results were inconclusive. The tumors came there from someplace, but they couldn’t determine where.
Saturday, we got the whole picture. Wherever these tumors came from, it’s likely that Chemo won’t help anything that gets to the brain. There’s not any treatment for this. And even if it does respond to Chemo, whatever this is will come back. If she doesn’t get treatment, she might have two months. If she does get treatment, well, we’ve all heard about the horrors that Chemo does while fighting cancer. The remainder of her time would likely be spent with pain from those treatments. So do you want to do this when the medical assessment is hopeless?
My family, of course, was shocked. But, given the situation, my wife said I should stay at Mom’s for as long as I need to – even up to a year. This while my wife and daughter continued to prepare the house to sell.
Hope
My Aunt Carole called Sunday morning and said to come over to see her in the family’s greenhouse immediately. When I arrived, she introduced me to one of her friends, Larry, who had brain cancer. He gave me the names of doctors and told me how to fight this. His cancer was also considered a death sentence. But while I talked to him, he was alert, knowledgeable, and you’d never know there was anything wrong if he didn’t tell me.
On Monday, May 31, they sent Mom home. I asked Carole to pick her up. I had driven to Lexington many times that week, and I needed to rely on family so I could last through what we were facing. I was laying the groundwork for realizing this is a long goodbye, and I knew I couldn’t do it all alone. Describing how Mom looked and acted on the trip home, Carole later said she didn’t think Mom would last a week.
Given that the doctors didn’t know where the cancer originated, the logical way to fight this was to attack those tumors in the brain. That meant radiation therapy. The first treatment was scheduled for Thursday, June 3.
Before those treatments were to begin, I tried to follow up with Larry’s leads. He reminded me that the Markey Cancer Center was one of the top 5 centers in the US. Markey is associated with the University of Kentucky Medical Center. The earliest available appointment was June 12. So I felt resigned to continue with the recommended radiation treatment to do something as quickly as possible. The clock was ticking, the tumors were growing, and something had to be done to stop them. I knew of no other options.
Hope Re-affirmed
Then the unexpected happened, not that any of this was expected. On Tuesday, we received a call from Markey. Someone had canceled. They asked, “Can you come in Wednesday, June 2 at 8:30?”
It’s close to a two-hour trip. My Mom’s mental abilities were fading quickly. We’d have to leave at 6:30. And I just became allowed to drive that week. There’s no question that we were going to do this. I’m just stating those details again because, well, timing is everything. I’m sure the timing of this call was helped by a family connection who works in Public Relations at UK Hospital. I don’t think there was really a cancelation.
And that timing meant that we got into Markey just before making a mistake.
Dr. Villano at Markey said there are some diagnostic tools that they could still do. But, first, we need to do a biopsy. The first hospital did say they could do that. But they also steered us away from trying. So now, we have someone willing to fight for his patient. I mean, if the first hospital is right, we’re in no worse shape no matter what Markey and Dr. Villano do. But if they’re wrong, then why not try to fight? And if it’s somewhere in between – then still fight for life.
Timing makes all the difference. If the radiation treatment had begun, that means no biopsy. The material would be destroyed, and they wouldn’t be able to analyze the biopsy. Markey wouldn’t have any idea how to treat this. And I had been a day away from taking away all treatment options.
The biopsy took two of the largest and most accessible of the six tumors. The results of the analysis showed this to be small cell lung cancer.
Now I need to explain, although we had been tobacco farmers, neither Mom nor Dad had ever smoked. And the PET scan showed nothing in the lungs. As I understand it, and I’m far from an oncologist, this kind of cancer doesn’t metastasize in the lungs but travels. And it gets past the blood-brain barrier and collects inside the brain.
Treatment
Treatment began after a brief recovery period from the brain biopsy the following Wednesday, Thursday, and Friday. Chemo is very effective for pushing back small cell. But it is not a cure and will come back. But between now and then, Mom might have a long time left. Who knows how long?
After her first round of Chemo, Mom was transferred to a physical rehab center for two weeks.
Honestly, the first week after her first treatment, I thought the decline was continuing. The speech problems continued. And there were some problems with bodily functions that surfaced during this time.
Then, the second week, she started holding conversations. She would tell me stories of what was going on in the hospital, which staff member was going on vacation, where and for how long and describe her conversations. Mom was returning.
After two weeks at the rehab hospital, she came home again. Home health comes by often. And she has already had her second Chemo treatment.
This means she has lost her hair. But she’s embracing the new floppy hat look.
Today – July 4th – she was doing finances in Quicken. Carole came over, and they talked for 2 hours. She couldn’t have done that a month ago. Carole asked if she remembered coming home from the hospital, but she had no memory of that at all. There’s a 2-3 week period where her memory is quite spotty. Some things she remembers in detail. Others, not at all. Mom’s a little disconcerted about that memory loss. But she can initiate conversations. It’s incredible that a few weeks ago, she couldn’t string together a complete sentence without giving up.
And of course, for the 4th, we took in some burgers (don’t tell my cardiologist) and the local fireworks.
What Is the Purpose?
The purpose of a heart attack is to put me in a place I needed to be to prolong life. If I hadn’t had my heart attack, I wouldn’t have seen the behavior and communication issues. I wouldn’t have been here to take her to the hospital, where we uncovered a problem. She might still not have had her first treatment. And frankly, she might not be here now.
As hard as heart attacks are, I’m glad I had mine when I did.