My heart attack, Part 1: a first-person account

I had been swimming for about five minutes. The pain ran in a narrow band across my upper chest. It was not extreme. It wasn't sharp or tingling. It didn't radiate down an arm. I didn't sweat or feel a sense of indigestion.

I should say, I don't smoke. I eat healthy and exercise regularly. My weight is fine. I get annual checkups. I have less stress in my life now than at other times in recent memory. My father had a heart attack when he was 61, eight years younger than I am now, but as a doctor once told me, "He did that to himself." If I was at risk of a heart attack"“ beyond being male and Jewish "“ no one had warned me. I was one of those last guys you'd think it would happen to.

Could be muscular, I thought. Are you going to be a wuss and stop, or a fool and continue?

About 15 minutes later, with the pain neither worse nor gone, I called it a day. I showered, changed, skipped a shave. When my wife came up from her locker room, I said, "I think we better go to the ER." (Author's tip: If you want to skip to the head of the line in an emergency room, the magic words are "chest pain.")

Doctors disagree

Three EKGs, two blood panels (and four hours) later, they still weren't sure what I had. The cardiologist was inclined to release me. (I was all for that.)

But the ER doc was skeptical. The third EKG had been abnormal. The second blood panel had shown an elevated enzyme. And when he'd given me nitroglycerine, the pain had vanished. So they did an echocardiogram.

Then everyone's expression changed. My wife, who was looking at the screen, told me later that the picture showed "this big wave breaking. And then it froze."

Damn quickly, they kicked some guy off the table in the Cath lab "“ the second time the poor fellow had been bumped that afternoon "“ and wheeled me down there.

A stent primer

They put two stents into a completely blocked artery. Do you know about stents? Many of my friends didn't. One asked if my chest had been opened. Another asked about stitches. (The answers are "No" and "None.")

A portion of your pubic hair is shaved (on both sides "“ perhaps for symmetry in the locker room?). You get a local anesthetic. An incision is made in your groin and something passes upward through your femoral artery to the place in question.

A balloon is inflated with liquid to open the blockage. The stent— a small, hollow, metal-mesh tube— follows to hold open the previously closed portion. I'm not sure exactly how this happens. My guess has to do with an itsy-bitsy submarine crewed by Steven Boyd and Raquel Welch, but this is probably mistaken.

Listening for "'Code Blue'

I remained conscious through this procedure. But I had little idea what was happening. I felt nothing. I could hear the doctors and nurses and technicians talking, but it was technical stuff, mainly numbers.

The reassuring thing was that everyone seemed calm. No Code Blues were exclaimed. No alarms rang. No one ran from here to there, calling for electric paddles. The procedure was supposed to take 45 minutes, but I could see a clock— I was there more than an hour.

I spent one night in the recovery room and one night in a more normal wing.

Coffee, burritos and sex

It's been a month. The first night in bed at home, off the machines, I was anxious as hell. For several days, any twinge or ache within two feet of my chest caused me to wonder if I should pop a nitro. (So far, my refusals to do so have proved appropriate.) But I feel no pain or discomfort. "I feel fine," I say when asked.

I'm on six medications, which lower cholesterol and blood pressure and block betas and stave off indigestion. I'm instructed to avoid stress and strenuous activities. I may walk "“ but no hills. I may ride an exercise bike "“ with no resistance. If I tire, I am to stop. Double espressos "“ even the occasional burrito "“ are fine. I may masturbate "“ but I can't have sex.

The shaved hair hasn't grown back completely, but the swath of black-and-blue has virtually cleared. I've been to a high-tech lab to have my blood analyzed. Apparently, it's not simply a question of cholesterol level, HDLs and LDLs and triglycerides. Cholesterol breaks down into a dozen components, and even if your gross numbers are good"“ as mine were "“ there may be an interaction between your sub-components and your genes or clotting mechanism or inflammatory process, so that the results are not.

A card for metal detectors

My cardiologist assures me that when she receives the results of this analysis, she'll devise a treatment plan "“ medication, diet, exercise "“ specifically for me. I have an explanatory card in my wallet for use when I set off metal detectors.

Tomorrow, I return to the hospital to have a partially blocked artery stented. This procedure requires only a one-night stay. Supposedly, this is a much simpler procedure: They're not operating under emergency conditions, and they already have a road map to follow. A 92-year-old man we know took his lady friend out to lunch immediately after his was done. (I've collected many such success stories about stents.) Five days later, I'll begin cardio-rehab.

Mortality, front and center

This experience, of course, has brought thoughts of my mortality front and center. I had been, the cardiologist had said— pinching together her thumb and index finger— "This close." (Author's tip: If you feel unusual chest pain, don't ignore it.)

"Hey," I thought, "I'm a heart attack victim. Impaired and fragile. From now on, that is me."

But my cardiologist reassured me. "You're not massively obese," she said. "You don't smoke." She assured me that in six months I'll feel better than I did before. (She posits that I didn't realize how the restricted blood flow was affecting me.) "And you should believe everything I tell you," she added, "because I just passed my boards two days ago."

So I am looking forward to beginning rehab. I'm curious to see how this experience will affect me.

"Breath the air," my primary care physician told me after he got the news. "Smell the flowers; fondle your wife... and yourself." I consider the possibility of spiritual transformation.♦


First in a series of articles.
To read responses, click here.
To read the next episode, click here.