The phone call came like a jolt to my system. I never heard my name being called on the nursing home's overhead page. Someone came to the desk where I was sitting, and told me I was wanted on the phone. My husband Jim, who was calling, calmly informed me that he was having a heart attack. When we hung up, he called 911, and started the process of saving his own life.
When the signs of a heart attack strike, getting help fast is just as important as getting the right help. That fact hit home when my husband Jim woke up on this summer day with the chest pain that wouldn't go away. Both Jim and I work in healthcare, and we'd been aware of the signs and what to do about them. A large magnet, from our local hospital, that was tacked on our refrigerator reminded us, too, by saying "Time is Muscle, Time is Tissue."
Birthday Cakes Delivered
I felt as if a giant clock had begun ticking, counting down, if you will, and that each second could be stealing him from my life. For the next half hour, I finished some work I was doing, and then walked across the parking lot to the emergency room (ER) that Jim had been taken to.
As I reached the ER door, someone I didn't know spotted me and came to open it, leading me to Jim's cubicle. He looked small, pale, and more frightened than I could ever remember seeing him. His hands were his hands so cold, I thought, but I never let my smile fade. The tears I wanted to shed dried up.
A small army surrounded him, all working like cogs in a huge medical machine that was doing its utmost to save him. In just a few minutes, I heard a nurse calling another hospital and arranging a helicopter for Jim. Meanwhile, people moved in and out of the cubicle, each on a mission to do their part to treat Jim. The nurse closest to Jim's head, Donna, seemed to be running the show, and I learned later that since she knew Jim, who worked nights in the hospital, she delegated the care of her other patients so she could care for him.
Two tall, well-built men in dark blue flight jumpsuits arrived, and prepared Jim for his flight to the nearby medical center, where some kind of heart surgery would take place. Someone hastily shoved a consent form into my hands, and I found myself signing it, without recognizing the words on paper. I got the attention of Nurse Donna, and asked her to step out into the hall. Though much had been going on, little was actually said to me.
"Donna, can you tell me something?"
"Yes, sure," she said, with a calming steadiness in her gaze.
"Has Jim really had a heart attack?"
"Yes, he has. We're moving him to the cath lab at Albany Med. They're already prepping so they can help him."
Less than a half hour later, they loaded Jim aboard the helicopter, for his 15 minute air trip to Albany Medical Center. As the clock ticked, the chopper took off, and I left the ER to begin the long drive to Albany, NY. Walking toward my car, I saw and heard Jim's helicopter flying straight over my head. I looked up at it for a few seconds as it headed west, and wondered if he'd be alive when I saw him again.
The drive took an hour. I stopped at a convenience store along the way to get a drink, hesitating, and a flash of uncertainty tried to creep in. Hurrying through the building-maze that is Albany Med took a few minutes. I reached the seventh floor cath lab and spotted a receptionist. I identified myself.
"Oh, he's already done. Press the red button near that door, and I'll let you in." What did that mean, "done," I wondered to myself.
Out of nowhere I noticed one of the flight crew next to me just then, and he led me to the recovery bed where Jim, already awake and looking much less pale, waited for me. During my drive to the hospital in Albany, another small army of medical pros, with names that I later found hard to pronounce, had saved Jim's life. The small blood vessel near his heart that was causing him so much pain now had a new stent that opened the flow of blood and oxygen to his brain and body.
Jim was moved to the cardiac care unit nearby, and after 48 hours, he was discharged, without any permanent damage to his heart muscle. Follow-up tests confirmed it. This, we learned later, made him the exception to the Rule. The Rule was that most people whose hearts fail suffer muscle damage, and need rehabilitation. Jim never went to rehab, and actually returned to work a mere three weeks later.
Jim's team, all of his caregivers that day, helped him to beat the odds, and stay alive. Later, I learned that in 2006 many hospitals, including the two that treated Jim, had set an ambitious goal-get a heart attack patient from ER door to the right treatment in 90 minutes. When I thought of the complexity of everything I'd seen that day, the odds of making the 90 minute goal seemed slim. That it all worked so flawlessly comforted me beyond words.
Time is life. That was the lesson for me. Listening to your body and knowing the signs of trouble are critical to staying alive and well. In a medical crisis the sense of time changes, and time can feel like it moves faster and slower, sometimes even in the same moment. How that happens is still a mystery to me. How the crisis will end is by no means certain, like a suspenseful mystery story. Twists and turns seemed to appear when I least expected them.
When the clock starts to tick, hearing it and springing into action makes all the difference. There's no time to deny it, or be scared. When you're in the hands of trained, caring people, fear can be chased away and replaced by hope. As I lit the candles for Jim's birthday cake recently, I remembered that a clock can be your friend, too.
Side Bar
"Door to Balloon" Time-It Matters*
Door to Balloon Time, or D2B for short, is a term used by medical professionals to describe the time it takes from arriving at the hospital with a blocked coronary blood vessel until blood flow is restored to the heart. The balloon part refers to the use of angioplasty, or propping open a blocked artery with a balloon tipped catheter. D2B target time, for 75% or more of the patients having a heart attack, is 90 minutes from arrival (door) to restored blood flow (balloon). Patients who achieve this time and treatment goal are more likely to survive a heart attack than those who don't.
A study released by the American College of Cardiology in late 2009 showed that while 50% of 831 hospitals surveyed were meeting D2B goals in 2005, that number had risen to 80% by March 2008. While paying attention to the signs of heart trouble and seeking help quickly is still important for patients, medical professionals have been doing their part by giving the right care, faster, and diagnosing problems much more quickly. As Dr. Elizabeth Bradley, from Yale University, lead investigator of the D2B study put it, "This campaign (D2B) has changed the way heart attack care is delivered -- for the benefit of patients."
The Clock Is Ticking - How Jim Survived a Heart Attack
*Reference: http://tiny.cc/uajbs
The End
Marilyn E. Jess Shaftsbury, Vermont
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