Attack of the Heart

Pt 1 of 3: In we go.

A couple of Fridays ago I had a heart attack.

Not a great big, ‘Oh it’s a miracle I’m still alive!’ heart attack, and not a ho hum, ‘Yeah, these things happen.’ heart attack.

It was somewhere in the middle. I suppose I had it coming. Sure, I stopped smoking a couple of decades ago; my diet has morphed over the same period from one of lots of grease, fat and sugar to one with very little of those previously prime ingredients. Over those years I’ve lost about 15 kilos and kept it off. So I think the Heart Foundation would be very happy with me. But as I say, I probably had it coming. My family history includes 100% cardiovascular incidents as initial C.O.D.

My father had a heart attack and died when he was 49. He was resuscitated after some minutes spent on the ‘other side’ and after a succession of further heart attacks, he finally succumbed to lung cancer at 56 when I was 26. When I was 33, my eldest brother, at the relatively young age of 39 (with two young children), had a heart attack and was gone; just like that. About five years later my mother died from a stroke. Having been found by her grandson, she remained unconscious until she died gently two days later, when the three of us surviving brothers had been able to come and see her. About five years further down the track, my second eldest brother had a sub-arachnid haemorrhage which left him pretty well vegetative and horizontal for the next 7 years, until his final release. My next sibling up, like myself, has heart issues but looks like breaking the mould - that’s just like him. So there I was a couple of Fridays ago with my family inheritance in tow, slowly making my way through a game of Scrabble and picking away at my dinner unusually slowly - thinking to myself all the while, "This pain in my chest seems too high up for indigestion and anyway I haven’t had enough to eat to have indigestion. And, why would I have this nausea and be feeling a bit like shit, out of nowhere? But I haven’t got a brick on my chest or someone tightening a belt around it so I should be alright. Oh well, I’ll keep a bit of an eye on it." Then with the Scrabble and the dishes packed away I thought I might just consult Dr Google. 'Heart attack symptoms' brought up the Heart Foundation Page and front and centre was their little chart about the symptoms and what to do. It stated that everyone had their own individual symptoms - how egalitarian - but there was a not too uncommon suite of experiences that sort of gave the game away. When they mentioned the nausea and the generally feeling a bit like shit (not their term), I thought to myself, ‘hmm?” I went to my beloved and in the family tradition of, ‘don’t tell your mother, we don’t want to upset her’, I did a neat little samba around my physical condition to tell her the story of what I’d read on the net, and the cause for my consulting it, and how I was feeling now and maybe, just maybe, I’m having a heart attack. We decided to be sensible. We called 000. I gave a precise and methodical description of the evening’s events. I also alerted the operator to my awareness of the very subjective nature of pain and how maybe everything was ... well maybe not really all that … and the operator told me to "stop doing anything and sit down and wait for the ambulance" that she had already dispatched.

(From here in I'll use false names for the usual reasons of privacy. Except for the cat. Oh yes, and Melinda - she gave me permission.)

We were told to have the front porch light on, have the door unlocked and await their arrival and to isolate the family pet (Rupert, an awesome rag-doll cat, so laid back you couldn’t stir him with hot cattle prod, but prone to get in on the action when things look interesting). So we immediately ran around slowly, getting my medication and a couple of things for me to take. (But not spare undies, Whaaat?) When they get here, in next to no time, Steve and Kath are great ... they just come in and gently and surely, take over … questions, a little spray under my tongue, no effect, little sticky tags on the chest, another little spray, more questions as tags get connected to the portable E.C.G., and the whole time Melinda and I are being inexorably moved into the reality that I am, although not in a state of cardiac arrest, almost certainly experiencing a myocardial infarction. Due to Melinda’s fatigue condition, we acknowledge that she will not come to the hospital with me, and anyway it was 11.00 pm and things would change to a slower gear from here in. We would now be moving into the ‘wait and see’ realm of tests, results and reports.

Our front entry is a meandering little path with steps and plenty of beautiful rose bushes; in short, an ambo’s nightmare, so the stretcher had been pre-set in the driveway for me to climb on to, ready for the 10 metre journey to the ambulance. Only 10 metres, but all gravel. Kath took the front of the stretcher. Well, spare me if she didn’t nearly go under the travelling bed to become another customer for the big yellow and green taxi. Steve at the locomotive end, over compensated for the gravel, almost steam-rolling her beneath my chariot. We all made it into the ambulance in one piece. Steve was at the wheel and Kath sat facing me in a very functional chair, offering little sprays to little effect. I now realise the sprays were partly of diagnostic value because whether they had effect or not, gave some information about my condition. It was all very interesting and then we were at the the casualty centre at the Royal Adelaide Hospital - the good ol' RAH - old, worn and and somehow comfortable like an old couch with the humps and hollows in all the right places - except for the ones that weren’t. So now it’s like the old days with the Department of Defence, working alongside the army folk - ‘Hurry up and wait’ is the order of the day. Now in the emergency department, I hear Kath do the handover above the ruckus of Angelina, the aged Alzheimer's patient, somewhere just out of sight over my right shoulder.

I hear about myself as object. And I hear things about myself that are foreign and also comforting - they know what they are doing. This is not new to them and at the same time I am still being dealt with as unique. They know so much about me and even some stuff I don’t think I told them. (Perhaps they have my Akashic Records on hand somewhere?) And then Kath accompanies me into the casualty bay proper where Amy, the experienced nurse, tends me with humour, skill and confidence - she even used the phrase, ‘like a bought one’, - it’s all good. Then there’s young, oops, I’ve forgotten her name, but she was eager and although a little unsure of herself, very ready to seek guidance and do a good job. I felt safe. Kath bid me farewell. I was thus handed from one set of safe hands to other sets of safe hands. I spent some time there with the Friday night, midnight ramblers of Adelaide, who’d come unstuck in some form or another. Then it was off to the coronary ward. Escorted again, this time by Amy and her young protégé. I was again ‘handed over’ in the comfortingly efficient third person. Now it was Eliza, a young and gentle angel of the night, who got me a charger for my phone, and because there was no reception, an actual phone, so I could call Melinda and let her know of my progress through the South Australian Health Service. Her calm on the other end of line allowed me to find an ease that soothed a part of me that I hadn’t recognised, until then, was in a state of ongoing quiet agitation. Another everyday blessing, in the land of public healthcare; I had a whole room to myself. For how long we couldn’t tell because if someone more deserving, by dint of the gravity of their condition, was to arrive I could be up the corridor into the communal ward in no time flat.

I was now settled into the ward. Previously, in casualty, I’d been prepped - cannulas inserted, blood taken, sticky tags put on all over my hairy chest and arms to hook up to and unhook from, the ECG machine that would beep should I accidentally disconnect even a single tag. X-rays were already in my file and I could now settle back to getting better. Now on the ward, it was a little (well, very little really) like being a hide strung up in a tanning yard. My left wrist contained a cannula and the left shoulder was shawled in myriad leads from the ECG, so I was tethered on the left side quite effectively. My right forearm also contained a cannula with not one, but two, drips. So there I was, like Richard Harris in ‘A Man Called Horse’. (Okay, I’m getting a bit over dramatic here, but my situation was to become a bit of a pain in the bum over the next 36 hours or so.) Now, I like to sleep on my side. Either side, it doesn’t worry me too much, depending on how my right arm tennis elbow or the bursitis in my left shoulder are going at the time. Just one side or the other. So the choice I faced was: do I rip the drip, or pull the plug and set the alarm bells ringing? The challenge is on and I’m up to the task. First; the drip stand on my right; I pull it a little closer to the bed, to give me some room to manoeuvre; then I gather up the wires with my right hand and ease them and the sheet and the blanket out of the way while I slowly drag my body over onto my left shoulder, scrunching up the sheet underneath me as I go, which then has to be pulled back from under with a little lift of the hip and a not-too-sudden pull on the sheet, lest by getting caught on a loose flap of blanket, sheet or my person, the cannula is torn from my right arm. (I won't burden you with the reverse process.) (You will be happy, and not too surprised, to hear that this procedure for either left- or right-side lying, was mastered just as I had the drips removed at 5.00 am on the second night; a man’s great attempts to secure independence from the pitiless bondage imposed by impersonal life, thus rendered merely another divine comedy skit.)

And the dawn came. I probably had, what with discomfort, the perfecting of the sleeping position samba, and various readings being taken through the night, not to mention the obligatory disposal of that which came endlessly in through the drips, about 1.06 hours of sleep. And before I knew it, it was time for 'rounds'. It was then I met my cardiologist with his retinue of registrars and whoever. An early middle-aged man, he was clear, open and very reassuring. I liked that he treated his peeps with respect and ease. (I have since Googled him and he's actually internationally awesome.)

There was some initial treatment to be administered immediately, and I might need a stent or two but that would have to wait for the angiogram; which in turn would have to wait for Monday (it was now Saturday morning). Damn, there goes the last shred of the possibility I was given last night, that had been taken away earlier this morning, but which I held onto stubbornly all the while, of getting it done today - if things were bad enough. Shit, I was too healthy! Anyway, whatever that first step was it had a pretty quick outcome. I started sweating, the cold variety, and again felt a bit like shit - all signs of plummeting blood pressure - all hands on deck, the bed was tilted back, my feet in the air like a fat lady in an old postcard from the English seaside. So this initial treatment gave a clearer picture of the situation. I was now to go in for that angiogram this afternoon, in about three hours as it turned out. Yay! This meant calling in ‘the team’ on their day off. Uh oh, now I’m conflicted. I don’t want to put anyone out, and at the same time, there's my 'self interest' little demon on my shoulder wringing his hands with glee, reminding me I want out of this place as soon as possible.

Fortunately the decision is not mine, it’s my guardian cardiologist’s and who am I to argue with him? (I know when to take orders.) (As it turned out an ‘arrest’ patient came in while I was on the table, so it’s like I was the team’s warm up for the main event.) In the next instalment: Don gets a stent - or does he? Life on the angiogram table and, 'what’s that wiggly thing doing there?'