The Dangers of living… Part 1, Heart Attack on the road.

Any followers of my blog here know that I often go silent for many moons at a time.  Sadly, I don’t find the time to update things regularly, partly due to my job, partly due to my attitude on free time, and partly due to not always having access (despite having a iPhone and iPad and other gadgets).

All that said, this last ’bout of quiet has a little more than the usual reasons for it, and its serious as a Heart Attack.  In fact, it was a Heart Attack.

I don’t often comment on myself, and its difficult to discuss it now, but I will so bear with me.  My last post was about my new camera.  I showed off some neat ice pictures, and tried to look at the new year in a new light.  What I didn’t report was that I was in pain when I was writing it.  In fact the mild pain in my chest had been a constant of my life since just before Thanksgiving.  I chocked it up to getting older and was trying to find the time to get it look at, but my job kept getting in the way.  (Most doctor’s offices don’t have parking for big rigs — with their trailers attached, and I don’t often get to run around without one).

Roughly 36 hours after I published that earlier post, I was becoming very ill.  One of the persistent dangers of living on the road, is the constant risk of food poisoning.  I was certain I had come down with a particularly virulent strain of Salmonella.  On an evening in where I had 227 miles to go (not quite four hours of driving), I had to stop four times.  Usually on a four hour trip I needn’t stop at all.  In addition to that worse of powerless feelings of imminent vomiting while on the commode, I was having serious trouble managing my internal temperatures.  My legs were freezing cold, but the area between my shoulder blades was burning, sweating hot.  On the last of my stops I took some Imodium with a pint of milk and ate a chicken sandwich.

Proceeding on, I got all the way into Roanoke, Virgina when a sudden ‘instant’ case of nausea overcame me.  I was on a clover leaf off-ramp and probably deserve an Iron-Jaw medal for holding it back.  As soon as the roadway straightened out, I had the time left to pull over and out of the way, set my 4-way hazard flashers, set the brakes, pop my seat beat, open my door…   And then launch my lunch out the open door.  One of the worst parts of this was the knowledge that sitting there I was in trouble.

In my profession, much emphasis is placed on communicating delays and problems.  I told the nights dispatcher I was ill and that I needed to get some rest after I delivered, and that I would not be available in the morning due to the need to get seen by a doctor.  It was serious enough that I knew I needed to see a doctor, even if it meant an Urgent Care clinic, which in hindsight was likely to be the only option for a Saturday.  The response I got back was every bit as supportive as I could have hoped for.   The messages felt genuinely concerned for me and assured me that I could take the time I needed.

I drove the dozen or so miles to the deliver, and dropped my loaded trailer, and signed out for the load.  I backtracked to a nearby truckstop and shutdown for the night (or so I thought).  I got another message asking if I had gotten to a safe haven and hoping I was ok.  The message also asked me to call and check in with our Safety Department so they would have a record of where I was if it was needed.  So I called the Safety Hotline and talked to another very supportive person and they assured me that if I thought I was in bad enough situation to need a doctor, I needed a doctor and they would stand behind me.  He also during the course of the call started to worry about me and asked me to call a non-emergency number to ask about a health&welfare check.  I agreed and dialed the number he gave me and ran into a messaging telling me the hours that line was answered.

I had slept the last night in a truckstop that didn’t have running water for showers, so I put together a shower bag to take inside when it started to become difficult to breathe.  I hit my rescue inhaler and decided to head for bed, that rest was what I needed.  I had just lain down when the Qualcomm chirped off with another message from dispatch, this time hopes that I’d be feeling better soon.  Since I had gotten up to read the message, I sat in the driver’s seat for a few minutes, trying to catch my breath and my thoughts.  That was around 3am.  It was while I was sitting there, when the mild dull-ache in my chest retreated in the face of the hard Angina that attacked. Instantly I knew things had changed.

For those of you that don’t know what Angina feels like, I can only offer you analogy.  For those that do know, indulge me a sidebar. Imagine if there was an empty space inside your chest, protected by your ribs.  Now, that empty space isn’t your lungs but between your lungs and your ribs.  The mild pain I had felt for two months was a balloon in that little space in my chest, and it was inflated only enough for me to feel it pressing against my ribs and restricting my deepest of breaths but otherwise only an annoyance.  Leading up to the attack, that balloon was being slowly inflated more and more, until a giant hand grabbed my ribcage and squeezed until the imaginary balloon inside burst, with the resulting trauma.  When I felt that pressure and a sudden increase in pain (that balloon bursting) I knew I was in deep trouble and called 911 without further delay.

The county 911 operator answered in two rings and I explained that I couldn’t breathe and was having chest pains.  I told her where I was parked in the truckstop, and that I did not have a trailer, and that I had all the interior and exterior lights on I could.  She quickly started gathering all the information needed, and double checking it.   It was in this second run through of my location that I started to lose my breath to the point where I was becoming almost impossible to understand.  At this point the operator switched from information gathering to the other half of their jobs, crisis support.   She told me she wasn’t going to make me talk anymore but to stay with her.  She didn’t put me on hold, I could hear her dispatching units in the background.

I had not felt much panic, even in the face of all the difficulties breathing or anything else.  I knew I was young and (at least in my mind) in reasonable health, and that help would be there soon.  Still, I was feeling so very tired that even holding the phone up was starting to exceed my strength.  I put my iPhone on speaker and set it on the dash close by.  The operator detected this change, and I heard her remark off-mic “Wait one [unit], I’m loosing him.”  Then to me, “Sir? Are you still with me?”

My voice would not come, so I did the only thing I could think of, I triggered my iPhone’s keypad and tapped a number twice.  She reacted at once, “Are you unable to breathe?”  Two beeps.  “Ok, hold on, help is on its ways.  I need to tell them where you are, just hold on.”  More radio chatter.  I could hear it better now.   Perhaps she turned it up for my benefit or I’m remembering it better, I cannot say for sure.  It wasn’t log after that I saw the first responder.  It was not a Fire Engine or Ambulance, but a Rapid Response SUV with all lights going.   He went right passed my truck without even seeing me.  That’s when the panic started to germinate in my mind.  Somehow I found the energy to gasp out, “He passed me!”.   I heard the operator relay this information, and I heard the SUV zoom off to turn around and try again.   On his second circuit, he went past again, and this time, I didn’t so much as yank the airhorn cord, but hung to it as my sole lifeline, sounding a steady blast of racket for which the other truck drivers in the lot were likely upset about.  He still didn’t seem to react until the Operator, quick on the uptake ordered him to halt and listen for my horn.  15 seconds later he was climbing my steps, and he took my phone and signed off with the 911 Operator.  The call had lasted 12 minutes and 43 seconds.

On the early morning hours of January the 4th, it was all of 9 degrees Fahrenheit.  Cold and windy, and I’m hanging out of an open door with my jacket half off while the first responder is starting to take measurements and ask questions I didn’t have the breath to answer.  An oxygen mask came next, and soon after that I was able to start answering some of the questions.   He wanted to know how long.  Instead of answering him I grabbed the Qualcomm and referenced the events, providing far more accurate details than I suspect he is used to getting.  With the oxygen, I was able to talk again, though still felt short of breath.  At least I could talk again.

The Fire Department arrived next, and there was about four people in turncoats hovering around asking more questions.  Someone put a Nitro tablet under my tongue and instructed me on its use.  It tasted like “molted copper pooling in my mouth” without any heat at all.  Felt rather dragonish, actually.  He warned me that I might have a headache, but that didn’t come.  Several of the surrounding truckers were climbing out of their cabs and showing their respect and concern in a fashion that doesn’t get seen often.  Several moved their rigs to let the emergency vehicles in closer to my truck, as well as keep trucks from the fuel islands from coming our way.

The Ambulance actually was in the lot before the Fire Engine but because of another driver moving around, wasn’t able to reach me as quickly as the others.  When the time came to leave, they told me to shut everything down and that they would help me to the ambulance.  I grabbed the Qualcomm and entered a rather terse message that likely sent alarm bells ringing, “EMS is here, they are taking me to the ER”  Sending that, I asked the paramedic on my right to grab my laptop bag and that previously packed shower bag.  Then it was time to go.  I was helped by three strong lads down the steps of my cab (and it took all three, I was so weak), and to the waiting gurney.  My sense of things grows faint here.  I was shivering due to the cold, and was likely close to entering shock.

Once in the Ambulance, the heater was turned on and it felt glorious.  More questions, another nitro tablet and this time with an aspirin chaser.  The leads for the EKG were going on, and I was still in pain, and was having trouble explaining that point, especially since that sneaky pain had quit the former place and ‘jumped’ to a new site more central to my solar plexus.  The bloody doors of that ambulance were still open, my bare chest was exposed and the heater kicked off.  But before my rage could build to a full rant, the missing paramedic jumped in and the door was closed behind him.  I had asked they lock my truck and had given them a key.  It was returned to me along with my phone.  I clutched them both as tightly as I could, for all the world like a little boy and his teddy bear.

The ride to the hospital was long, about 28 minutes, though to my perception it was not at breakneck speed and hairpin turns and such.  When we got to the hospital the gurney was met at the doors by a gaggle of scrub-clad people.  All the questions I had answered what seemed like a hundred times were answered again.  I had no strength to fight the logic battle.  Once into the ER room, a constant supply of people entered and left as my clothes were removed and a gown applied.  Here to my memories of the events get fuzzy, though this time for a far better reason.  The EMTs and Paramedic were reviewing everything that they had done.  Three nitro tablets, a 81mg aspirin, 6 liters O2…   Some medical talk I didn’t understand specifically but understood to mean the details of my heartbeats.  The doctor asked if I was still hurting, and I said I was.  Then 5mgs of Morphine was pushed through the IV in my left arm (the one on the other side was in use by something else).

If you’ve never had Morphine, then you only know it as having the ability to numb even the most intense pains.  I felt warmth move up my arm from the IV port, to my shoulder where it vanished.  Moments later I felt it in the small of my back, warm and wet, and for all the world like I had just wet myself as Alan Sheppard is shown to have done in his Mercury Flight during a hold on the pad in the Movie “The Right Stuff”.  I thought of this because I was in a not-dissimilar posture, though I was sitting up on a bed, not in a reclined chair.  Its odd the things one thinks of at a time like this.  But the great thing about Morphine is, I no longer cared.  Pee the bed?  No worries!  Naked in front of a whole platoon of medicos?  Not bothered.   That earlier panic?  Gone!   The whole group of scrub-clad folks want to make me the guest of honor at a gang-bang, Bring it on!  In less racy language I was out of my flipping mind, off in Morphine-land.

I was asked several times about my medical coverage — though no one held up my care or treatment looking for my insurance card — because they wanted to know if I could afford drugs.  I wasn’t entirely sure what was reason for this, but I assured them I had insurance.

There is another gap in my memories while they wheel me up to the Cath Lab, and there is more talk about my condition that I didn’t understand.  Something about my EKG was ‘hinky’ — the doc’s words — but wasn’t typical.  He wasn’t sure, but decided to proceed with the procedure.  He explained to me what was going on, what was about to happen, and — the news I hated most at that moment — that I would likely be on lifetime daily maintenance drugs.  I signed his paper, without really being sure I knew what was on it.  In the ordinary case of things signing a legal document under duress isn’t admissible, but I was not in my home state, had no other party to sign for me, and understood enough of my situation to know I was in peril and needed help.

More questions, “I’m allergic to seafood…”  So they had to pre-treat me for an allergic reaction to the dye they needed to use.  Panic was starting to set in, so they knocked me out with a concoction the rest of the world wishes came in six-packs.  I start to fade out of conciseness here, and reality gets weird.   The cold slab of metal I was being sacrificed on felt like it was being raised in the middle and lowered on the ends.  My nausea returned, and they advised me to hold my head to the side and let it hit the floor if I had too.   Minutes or Hours, I had no frame of reference but my next thought was an odd set of perceptions.  A rather beefy male nurse was lifting my gown and almost in giggles about giving me “..just a little manscaping here…” as he shaved my neither regions…  Where I a bikini beauty, and not male, it might be called a “landing strip” or more simply a “Brazilian”.   I drop out again, and there is one frozen frame of memory where I’m staring at a ziploc-baggie covered metal case, the backside of some sort of display unit.

At this point, I must of necessity switch to narrative mode as I was not around to witness the next few events.  The heart has three major groups of blood vessels.  One of these had become completely blocked.  After finding this, angioplasty was performed, that is snaking a very flexible instrument with a long balloon on its tip into the clogged vessel and then through inflation, clearing the blockage.  Sometimes that is enough, but they decided that wasn’t enough in my case and installed a stent there.   All of this happened through the catheter they had installed in my femoral artery, by first jabbing my crotch with a nine-inch long spike, hence the manscaping…

When I woke roughly four hours later, I was in the CCU, lying flat on by back, and with the Duty Nurse in my room.  She was worrying about my iPhone.  It was about to die and was wondering if I had brought the cord for it.  I told her where to find it and she not only plugged it in to charge for me, but put it where I could reach it.  A few minutes later I was sending messages and making phone calls and spreading my news.

The word spread on Twitter and several of my close friends started to retweet the news and then something magical happened.  People I didn’t even know started blowing up my iPhone with messages of love and hopes of swift recovery.  Even today the flood of messages I got that morning is still enough to get me emotional.  Aside from restoring lines of communication, I was told with certainty, I did indeed have a “STEMI” Heart Attack.  Such was what happened on the first morning of my hospital stay.

I’ve broken this story up into several bits, and this is the end of the first one.  Check back soon for the next part.

Spoiler:  I got better.

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