The Silent Heart: A Personal Journey Back from Cardiac Arrest
126
The Silent Heart: A Personal Journey Back from Cardiac Arrest
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Product Details
| ISBN-13: | 9781475932591 |
|---|---|
| Publisher: | iUniverse, Incorporated |
| Publication date: | 09/28/2012 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 126 |
| File size: | 182 KB |
Read an Excerpt
The Silent Heart
A Personal Journey Back from Cardiac ArrestBy Larry J. Matthews
iUniverse, Inc.
Copyright © 2012 Larry J. MatthewsAll right reserved.
ISBN: 978-1-4759-3257-7
Chapter One
The Event
It's 7:15 in the morning at a place where time begins and ends. I'd rather not be here, but this morning I told my wife, Sue, "I need to go." The drive took only five minutes. Now I sit here in a wheelchair.
I'm pushed into an emergency room examination area while Sue gives my name and address to the receptionist. People in white move around me like the gears of a clock, ticking steadily. There's no rushing, no signs of alarm—just efficient, continuous movement. Sticky plastic disks are pressed to my chest and legs while questions fill the air. "Where is the pain? Is it sharp or dull? When did it start? Are you taking any medications?" I glance around, as if the answers are hidden somewhere in the room. All I can see are white tiles, white curtains, and faces on heads sticking out of white smocks. More questions. I hope I'm answering these correctly. There's no telling what these people will do if they catch me lying.
I'm asked to remain still while the electrocardiograph does its work. This routine is familiar, since doctors administered an EKG to me four months ago in San Antonio as part of a periodic physical examination with the army. The EKG was normal then, as were my lipid panels, good cholesterol, bad cholesterol, blood pressure, and triglycerides. Everything was A-okay. A woman—presumably an emergency physician—inspects my new EKG results. She looks at me calmly and says, "Mr. Matthews, you're having a heart attack." Sue must have finished her business with the receptionist because she's at the foot of my gurney. We exchange a bewildered look.
This makes no sense. I took an army physical training test last summer and achieved a personal best in the two-and-a-half-mile walk. I have no family history of heart problems and none of the traditional risk factors, other than smoking. Don't tell me smoking alone can cause a heart attack.
A nurse hands me a tiny, white tablet and tells me, "Place it under your tongue."
I do as I'm told, and the discomfort in my chest seems to be subsiding. Yes, I feel better. Thank God. Someone must have started an IV and injected medication. I recognize the sensation—those few seconds before a general anesthetic takes effect when you are asked to count backward from one hundred. You start with one hundred. Your fingers and toes tingle. By ninety-nine the tingling spreads up your arms, and by ninety-eight your entire body is ...
Silent
Life expelled from the lungs
Floating, swirling, thinning,
Into a musty odor,
Leaving children
Like fractured teeth
With only one root.
I don't know how long the dream lasted, and I don't recall the details. I only know it was a very pleasant dream, and I'm perturbed now that someone is yelling, "Larry, Larry!" I'd like to finish my dream, but instead my eyes open. A bright, round, white light shines above me. Someone starts in with the questions again. These are easier. "What is your name? Do you know where you are? What day is it?" No way am I answering any of these questions wrong. Someone—maybe that ER doctor—is kind enough to inform me, "Your heart stopped." The words don't make any sense. My heart stopped? I thought I was sleeping, dreaming. Sue is among the strangers who have gathered around. She wears a look of fear.
More white appears. It's the white hair of a man leaning over me. He introduces himself as Dr. Something or Other. He operates with Swiss-clock efficiency as he holds a clipboard in my line of vision and clicks through the dangers inherent in the procedure I'm about to undergo.
"Do you understand?" asks the man with white hair.
I must have said yes convincingly enough, because he hands me a pen. Is this what is meant by the phrase "signing your life away"? The pen slices across the Ts in my name as the gurney begins to move. Someone is at my head, someone else at my feet, swiftly guiding the way through a double door and down the hallway. Sue rushes to keep up, an unexpected participant in this race for life. When we arrive at the doorway to the cath lab, she says good-bye with a touch.
The lab might be nicely decorated, but I'm in no position to appreciate it. I'm on my back, staring at more lights. What is it with all of these lights? I sense the people around me, but I can only catch an occasional glimpse of a hand, an arm, or the side of a head. They move quickly in here. The clock is ticking faster. While they work, they rattle off fragments of sentences, telling me what they are doing in a kind of abbreviated hospital-speak. It reminds me of the patter of a magician as the trick is being performed.
Are their words intended to distract me? If so, they don't succeed. I feel the blade tugging at the hair on my thigh. Liquid evaporates into cold as the area is wiped clean, and then I feel the stick of a needle. This isn't so bad. I hear the words, "Relax and breathe deeply. You're going to feel a little discomfort." Relax, my ass! It's not humanly possible to relax when a knitting needle is being driven up your femoral artery. A severe, shooting pain in my groin area causes my core muscles to contract. It's an automatic response. Then, as quickly as it began, the pain subsides. The needle must be in. I try my best to breathe deeply and relax.
Someone says, "You're going to feel a slight burning sensation as the angiogram dye is injected."
The sensation is more than slight, but it's not altogether unpleasant. It is in fact a rush of heat into my chest that dissipates as it pushes out to my limbs. The people around me are quiet as they continue their work, or maybe they've added something to my vein—something to obscure time, cloud my thoughts. I recall being told to direct my attention to the monitor for a look at the arteries in my heart. I want to say, "No thanks. No television right now. Can't you see I'm a little busy?" But the words never come out. This doesn't seem to be a good time to risk irritating these people.
They appear to be finished, and it seems like they just got started. The gurney moves again. It is not a race this time, just a casual push out of the cath lab, down the hall, and into a recovery room. I see new faces here. Smiling people greet me like long- lost family members at a wedding reception. They fiddle with the lines sticking into my body, with the dials, and with the monitors attached to me.
Sue appears and takes my hand. She looks dazed. The clock on the stark, white wall behind her reads 9:00 a.m. We have spent less than two hours in this place, and time begins again for me.
Chapter Two
Hospital, Day 1Wednesday, October 29
There's a reason it is called a recovery area. The idea is for you to use your time here recovering from your illness or injury. However, I suspect a state of recovery will remain long after I've been moved from this place. The actual name of this part of the hospital is the cardiac intensive care unit. It's a large room with beds dedicated to matters of the heart. Its size is an indication of the huge number of people in our country, both men and women, who are struck down every day by cardiovascular disease.
It's a Fact
Every thirty seconds or so
Another death occurs in America
From cardiovascular disease.
I'm told to lie still, with my feet straight out—no bending my knees, and no moving about. That's not easy for me. Over a decade ago, I was acting in an outdoor community theater production of Kiss Me, Kate. My part called for me to roll off a bench and land on a concrete stage surface. The repeated pratfalls brought lots of laughs but resulted in an enormous black-and-blue mark that was swollen from a few inches above my knee to just above my hipbone. I decided I needed a trip to the doctor. The x-ray showed no broken bones but revealed signs of degenerative disease in my lower back. So now, lying still in bed for long periods of time is painful, even under the most favorable of conditions. Being completely immobilized like this is pure hell.
Shortly after 9:30 a.m., someone checks the site where my femoral artery was attacked and indicates there is some bleeding. This is no surprise to me, but for some reason, the hospital employees decide the sight of blood is reason to put a narrow corset around my upper thigh to apply pressure and stop the bleeding. During my days of medic training in the army reserve, I learned to strap a wallet to the patient's inner thigh using the patient's own belt to stop bleeding in the lower extremities. This method is apparently too practical and way too cost effective to use in modern-day hospitals. Sue has my wallet anyway, so I decide to keep quiet about this alternative method of halting blood loss.
At around noon, after an ample dose of morphine, the medical device used to gain entrance to my femoral artery is removed, and the pressure-inducing corset is replaced. I don't ask, but I assume the device was left in for those extra three hours just in case a revisit to the cath lab was required for a stent replacement or readjustment or whatever. Perhaps it's the same principle used by automobile mechanics when you have major work done on your car. Just in case they've screwed up, someone takes your vehicle for a test drive. What if they forgot to tighten a bolt or left a tool on top of your engine? Whatever the medical staff's reason for leaving the device in so long, it's great to have it out of my thigh. A nurse informs me my right leg must remain still but that I can move my left leg. Thank God. My aching back finds some relief.
The word must be out about my death and subsequent return to life. Gawking visitors begin to appear at the foot of my bed. My oldest daughter and her husband are the first to arrive. Later there are visits by my sisters-in-law, my minister, and others. They all appear to be relieved and comment on how good I look. What were they expecting to see? Perhaps sunken eyes and ashen skin? The reality is that my heart is pumping better than it has for a long time. I should look good. Blood is flowing freely again.
Finally the corset is removed, the visitors leave, the morphine runs thin in my veins, and I'm left alone to reflect on the events of the day and to sleep. The night nurse interrupts my solitude. A woman from the American Red Cross is calling. My youngest daughter, a member of the Minnesota National Guard, is with her unit at Fort Stewart, Georgia, preparing for deployment to Kosovo. The Red Cross is inquiring about my condition and asking whether my daughter should return home. I'm not sure what to say.
It's late. I relax and finally find sleep, only to be awakened by an alarm sounding on one of the monitors still attached to my body. A nurse rushes in and silences the irritating noise. The machine that takes my blood pressure every hour was complaining loudly. The one-half tablet of blood pressure medication given to me earlier caused my systolic pressure to drop below one hundred. Perhaps this explains my ease in getting to sleep. My system has slowed down—way down. More than it should. Perhaps I'll ponder this dilemma more tomorrow. Now I lay me down to sleep.
Chapter Three
Hospital, Day 2Thursday, October 30
My youngest daughter is flying in from Fort Stewart, Georgia. My middle daughter, a nurse who resides with her husband in Petaluma, California, also arrives today. It's difficult to comprehend the celebrity status that has prompted my children to rush to my side. I haven't performed any lofty acts of heroism or philanthropy. I think they are rushing to me in part because they are afraid. Perhaps they fear they won't see me alive again, that I may die while they are miles away.
Is this a commandment of some kind? Thou shall not be away from your parents when they die. Does this rule apply to all family members or just those you are closest to and love the most? Are there certain cogent excuses that allow you to break this rule without penalty? For instance, can you miss a family member's death if you have a job interview, a conference to attend, dirty diapers to change, a speech to give, or a serious illness of your own? I must admit, I do not understand the specifics of the family member death commandment (FMDC), but I surely do love having my children near.
Other visitors stop by too. My younger brother and his wife drop in on their way to the airport. They're headed out of town for a business meeting. I have relatives coming and going. My sister-in-law and her husband visit and later another sister-in-law drops in. Sue has four sisters, and three of them live nearby. At some point during this gathering of family members, I am transferred out of the cardiac intensive care unit (ICU) and into a regular hospital room. The greatest advantage of this move is realized by other ICU patients who find relief from the steady flow of my friends and relatives through the cramped living space.
I finally say to Sue, "Enough visitors for today, thank you."
As happens in most marriages, there are times when Sue and I get on each other's nerves. I have irritating habits and behaviors that send her over the edge, and I get particularly annoyed when she insists on telling others how to behave. I lovingly refer to this kind of behavior as "orchestrating."
In the last forty-eight hours, there have been two occasions when I have absolutely appreciated Sue's tendency to orchestrate. The second of these occasions is when she clears my room of all visitors. Yesterday I was drugged and energized by the awareness that I had survived a rather close brush with death. Today I am feeling the effects of the trauma to my body. I am tired and need rest.
The first incident of Sue's orchestrating I am thankful for occurred in the emergency room (ER) yesterday morning. While Sue located a parking space for our car, I walked up to the ER receptionist. She was a pleasant woman who took my name and instructed me to be seated in the waiting area. While I was acting like I wasn't feeling all that bad, Sue marched over to the receptionist. She explained in no uncertain terms that her husband had chest pain and needed to be seen immediately.
Sue's tendency to orchestrate can be very beneficial at times. There are occasions when her tendency to take control, tell people what to do, and direct traffic is essential. I will most certainly look at Sue differently from this point on. I might not be alive today if it hadn't been for her persistence in the emergency room.
Catheterization
Such an ugly word.
To insert a catheter
Into a patient.
It's a violation,
An attack.
But when a stent,
A collapsed metal mesh pushed
From the thigh to the heart,
Is inserted and inflated,
Holds the artery open,
And saves a life,
Catheterization is beautiful.
Chapter Four
Hospital, Day 3Friday, October 31
It's Halloween. Something scary should happen today, but then Halloween seemed to come a little early for me this year. I've been scared enough this week.
I attended two rehabilitation sessions today. Rehabilitation shouldn't have been difficult, but just standing and walking seem to be arduous since my cardiac event. Cardiac event? This is a generic term referring to all the heart-related problems: heart attacks, murmurs, cardiac arrest, surgery, sudden death, arrhythmia, etc. The list goes on and on.
Although the term "cardiac event" may have a noble origin and serve some real purpose in the medical community, I can't help thinking of it as a soft substitute for the harsh reality and associated connotations of the term "heart attack." Superman's father died of a heart attack, and even young Clark Kent couldn't do anything about it. The Godfather died of heart attack in a garden, of all places. Everyone has been exposed to images of death by heart attack, and most of us believe those pictures are not pretty. A cardiac event sounds like an expected arrival, like a scheduled sporting event. You get in your car and go to it intentionally. You pay money to get in and clap when good things happen, and when the event is over, you go home. It's no big deal. Cardiac event?
Anyway, there I was in the rehabilitation room with four other patients. All of them appeared to be older than I was. Heart disease is supposed to be an old person's malady. Fifty-six-year-olds should get indigestion from eating too much hot Mexican food or aches and pains from overdoing it on the basketball court. Fifty-six-year-olds should not have heart attacks. But there I was with the other cardiac event victims, following the instructions of a young physical therapist.
The physical therapist talked us through a number of stretching exercises and reminded us that we could sit down anytime we felt uncomfortable. I was amazed at my own hesitancy. I was never one to shy away from exercise. Football, basketball, and baseball coaches throughout my high school years taught me that pain is a good and perhaps a necessary part of a strenuous workout. But in the hospital, I was constantly evaluating my body's reaction to these pitifully easy exercises as if at any second my heart might give up and stop beating again.
MET
Metabolic equivalent?
Where's the third word?
One starting with a T?
An awkward way of saying
Oxygen used.
One is for resting,
Two a bit more,
Three must mean I can
Walk on home.
The rehab therapy specialist stated that before leaving the hospital, I must perform at the 3.0 MET level on the hospital treadmill. I exercised at 3.0 METs today and celebrated with a glass of water in anticipation of returning home to my own bed. Unfortunately, a nurse informs me that my cardiologist forgot to clear me for discharge.
(Continues...)
Excerpted from The Silent Heart by Larry J. Matthews Copyright © 2012 by Larry J. Matthews. Excerpted by permission of iUniverse, Inc.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Contents
Preface....................ixAcknowledgments....................xi
The Event....................1
Hospital, Day 1....................5
Hospital, Day 2....................8
Hospital, Day 3....................11
Hospital, Day 4....................14
Hospital, Day 5....................16
Home Again, Home Again....................19
Cardiac Rehab....................21
Session Two of Rehab....................24
Changing Habits....................28
Worship....................32
The Comforts of Home (Depot)....................35
Sue Recalls....................38
The Matrix Reloaded....................41
Getting Out....................44
Giving Thanks....................47
Weekly Reader....................50
Amy Recalls....................53
My Doctor(s)....................56
Tuna Christmas....................59
Sarah Recalls....................62
Sadness....................65
A New Year....................68
No Promises....................70
Super Sunday....................73
Warning Signs....................75
Why Did This Happen to Me?....................78
Having a Purpose....................81
Christine Recalls....................84
Face to Face with Myself....................87
Carbohydrate Hell....................90
Broken Eyes....................95
A Passing....................98
Clean Bill of Health?....................101
New Beginning....................105
And Then....................108