2023 Heart Attack

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2023 Heart AttackAll
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Feb 18th Melissa had a heart attack, stroke, and had to have CPR for over an hour.
Feb 18th Melissa had a heart attack, and had to have CPR for over an hour. Then somewhere in there had a stroke. Now the recovery begins. I journal because it helps me cope and accept. I try to layer it so that high levels are readable, and lower levels let me capture details and organize my thoughts.
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Created: 2023-02-24 
You can click on the weeks for each day journal, or click on "All" to see all the days statuses.


Week 1[edit source]

           Main article: 2023 Heart Attack/Week 1
2023-02-18 to 02-24 - Heart Attack, Coma, Transfer to Houston Methodist, proof of life
  • Melissa was running on Saturday (02/18) and had a heart attack (and stroke), and had to have CPR for over an hour.
  1. Melissa was runnning with her Kingwood running group when she stopped, put her hands on her knees, and looked like she was having a seizure. Theresa (Physicians Assistant) was running with Melissa and started CPR and treatment. Mirna (Medical Assistant w/ICU) had come back, and took over CPR.
  2. The Hospital the paramedics took her to (HCA Kingwood) was looking at the case details (54 year old woman, with CPR for an hour, and Ventrical Tachicardia that wouldn't get into rhythm) and was kind of writing her off. They told me to say goodbye, when she got sinus ryhthm, and they were surprised when it stuck and she lived through the night. Then they were implying that if she lived, the odds are she'd be brain dead. We started trying to move her to Houston Methodist (much better place) as soon as possible, and it took until Tuesday to get her there.
  3. They had put her in a Coma, did hypothermia (normothermia) to keep her temp down, my neighbor friend slept in the waiting room for 3 days while I slept in the hypothermia room with Melissa, but on day 3 she passed her tests that she could respond to questions (SAT) and breath on her own (SBT) so they transferred her.
  4. By Friday that they had her of the vent, she was talking a little, Melissa's Mom got there to help. Melissa's short term memory was only about 10-20 minutes, but her long term memory, ability to recognize people, chuckle at jokes, and so on, was doing quite good.


Week 2[edit source]

           Main article: 2023 Heart Attack/Week 2
2023-02-25 to 03-03 - Steps forward and back. Upgraded, but had a stroke. Talking better, seeing worse.
  • The Second week was a lot of milestones and steps forward
  1. You could talk to her at times, but the TBI (Traumatic Brain Injury) meant she could kind of focus on only one thing at a time. So if she was in pain, that's all she could talk about. Completely reasonable one minute, almost angry toddler the next. (and she was having neuropathy).
  2. They took her off a big nose vent, to a little oxygen tube, then nothing, and upgraded her out of the CCU to a regular room.
  3. Her memory was now lasting over a day (or two).
  4. Her limb control was hit and miss. She'd say she couldn't move it, then would. (Especially when she wasn't paying attention).
  5. I was getting more freaked out about her vision. Like her limb control, sometimes she could see you, sometimes she couldn't. And it was hard to figure out if she could see at all. (She would track, then wouldn't).
  6. There were also halucinations (which at first we thought she was talking of dreams, before we realized she meant she could see it "right now"). She was saying things like how big the space she was in, but we thought that was part of the stroke or TBI to be spacially disoriented -- turned out it was halucination. She literally thought she was in a mall or parking structure.
  7. Her speech was started one word at a time, and it started slow (and she'd drop off last sylable) -- and if she missed something, she'd start over completely. Then she started getting better, but over-annunciating everything to compensate. Later on, it turned to complete sentences and a little mumbly but intelligible and in her voice.
  8. Her friends were visiting (Mandy, Carrie, etc) and she was sometimes was very good with them. But if she was in pain (often), she went back into inconsolable mode.
  9. Then by late in the week they moved her from Cardiology to Neurology. Figured out that she's had a stroke (as well as the Anoxic Brain Injury) -- did a brain angeogram (it was way to low to get it with grabbers, and too late to try tPA). But conversations were much more fluid by then.


Week 3[edit source]

           Main article: 2023 Heart Attack/Week 3
2023-03-04 to 03-10 - Lots of visits. I worked on rehab choices. Cheek infection. Husband in crisis. I'm done.
  • The third week was visits, progress, and her panic over what had happened and wanting her life back.
  1. I was doing domestic chores, working on Rehab choices, while managing Melissa visits/calls/contacts with people. (She loves people, and needed the stimulation). And still taking a few work calls, and being perpetually freaked out about next milestones, and what she still needed for her qualify of life. (And having no control over any of it).
  2. Out neighbors/friends/community had been incredibly supportive all along, had setup meals, and Mary (Melissa's Mom) was at our house and commuting in/back with me or Mirna.
  3. Linda (coworker/workout buddy), old friends/coworkers were sending well wishes through me, Mandy (Freind) was being a saint and just rubbing her face, giving her social stimulation, helping her groom and making Melissa purr. Shannon (running friend) came by. As did Mirna, Carrie (her friend + haircutter), and a few other workout friends (Diane and Mary).
  4. Melissa got a face infection (Salivary gland/MRSA), they got it under control with Antibiotics quickly
  5. And the Hospital was every day talking about an MRI that they never got to, but would do CTs instead. But she started PT/OT (Physical and Occupational therapy) and was doing well... but starting way further back than I'd thought.
  6. By now I figured out that the halicinations were halucinations (called Charles Bonnet Syndrome / CBS), and wondering why the staff hadn't explained more about how this was "normal" (or at least not unexpected) with some stroke victims. I was explaining it to Melissa, but while she remembered a lot of things -- remembering that the halucinations weren't real was tougher for her. "Oh, that's not real?"... "When are we going back to my room".
  7. By the end of the week she was fearing that this was her life now. She couldn't see the progress because her memory didn't go back that far (as well as she's seeing it from the other side). And she was really upset. She was done, and just wanted to go home and die. But we were able to talk her through how much progress she'd made and was making, and how quickly she'd get better. And that got her some skeptical peace. (As she started noticing the progress, she got much better).


Week 4[edit source]

           Main article: 2023 Heart Attack/Week 4
2023-03-11 to 03-17 - End of Halucinations, Lots of visits. Melissa 6.1 (w/De-Fib Pacemaker).
  • The fourth week was visits, getting her Pacemaker upgrade (w/De-Fib), and getting her into Rehab.
  1. Lots of friends visiting (or calling) which keeps Melissa engaged, talking, and happy. She loves people.
  2. She got her new Pacemaker (Melissa 6.1) w/De-Fibrillator functionality. That set back rehab a couple days
  3. They did some tests before releasing her to rehab... but she got there Thurs night, and started work on Friday.
  4. Friday was tough; she's declared legally blind for Rehab and that didn't go over well. But she worked hard, sat/stood, got a shower, is eating better, and is rated high on cognitive abilities. So the work begins.


Week 5[edit source]

           Main article: 2023 Heart Attack/Week 5
2023-03-18 to 03-25 - M's Birthday and Rehab.
  • The fifth week begins kicks off with her Birthday, and the first week of Rehab. She is making progress -- but not happy with all of it. They said work. And it is. There's pain, but she is getting more self sufficient and some progress. But much slower than you want. Good days and bad.

Latest[edit | edit source]

Day 29[edit source]

           Main article: 2023 Heart Attack/Day 29
2023-03-18 (Saturday) - Rehab Day-2; Happy Birthday! PT/OT, Lots of visitors, and some sight improement.
  • Summary
  1. Melissa's birthday!
  2. She did an excellent physical therapy day, ocuputation therapy (brushing hair, teeth, getting in/out of bed/wheelchair). Ate with a fork but has problems seeing to stab, but can feed herself. Got to use the big girl potty. She worked it, well.
  3. Visitors included: Richard and Vickie, Diane, Theressa and her daughters -- and of course her Mom (Mary), Devon and me.
  4. We called or were called by Cousin Alexis, Brother Devon's Family, Lisa, Debi, Bill (Dad), Aunt Betsy. Her brother Mark and Robin sent a video message, her other brother left a text messages, as did many other friends, and I read her many cards and texts.
  5. She got a Birthday Cake, Flowers, she's been out of the "gown" since rehab, and wearing home clothes (sweats).
  6. Vision improvements: she was able to see the TV a little bit (though I think it gave her a little nausea after a while). But she was starting to be able to see people across the room. She has good peripheral vision for motion. The biggest quirk is things look far away and small. But I keep pointing out to her that it comes and goes, and seems to be getting a little better.


Day 30[edit source]

           Main article: 2023 Heart Attack/Day 30
2023-03-19 (Sunday) - Post Birthday Standing, Mandy visit, clothes and iPad upgrade pending.
Summary
  1. Post birthday! My brother went home to his family, but it was a good visit for everyone.
  2. She was standing in rehab, they keep working her on transfers (how to move from bed to chair and back), and making her sit upright more.
  3. They got her out of diapers and using the bedpan (or toilet), depending on her energy. She mocks that as "rediculous" that an adult considers using the toilet as accomplishment -- but it is.
  4. Her vision seems to be getting better. She wanted her flowers where she can "see" them, and a picture Theresa left (with them running) she was pointing out some of the other people in the photos. Which is new, that's only an 10x14 or so, with like 5 sub-pictures in it. The vision comes and goes, so isn't 100% of the time (and it seems she's using her peripheral vision more than her primary); but the ratio of how often she can see, how far, and how much detail, all seems to be improving. This is a good sign. When it plataues, we might want to deal with a neuro-opthamologist -- but for now, it's just waiting to see how much comes back on its own (pun intended).
  5. I brought her more street clothes (e.g. sweatpants instead of normal tights/workout pants) and T-shirts. She cared a lot that they matched so I opted for two colors that even I couldn't screw up -- shades of Pink and shades of Grey (far less than 50).
  6. I suggested that I turn on accessibility on her iPad, so she can work it with touch/speech gestures and do things like listen to books on tape, and so on. She was happy with that when I bring it to her next.
  7. Mandy came, and Mary and I bowed out. Both for the break, and also so they can get into turbo-gab mode, without outside interference.
On the Accessibility Stuff:
  1. I wasn't sure if I was going to get a negative reaction as that brings up vision impairment, but she was very excited about the quality of life improvements. I'd actually mentioned it in passing once before (that I could make it more accessible), but I think it got lost in the noise, or just people don't know that accessibility often means "disability friendly", as in vision impaired.
  2. She didn't know an iPad or iPhone had these modes, and was surprised when I was telling her how important iPhones/iPads had become to low vision people. (Sort of weird that a slicks screen with no tactile feedback, and an almost completely vision based interface, would be so important to the vision impaired. But i knew that). And I didn't know she didn't know about that, so was kind of waiting for her to ask.
  3. Since one of my tasks at Adobe has been as a program manager for Accessibility (and have championed many improvements over the years), I know a bit about it, but I am curious what she thought I did when I talked about that aspect of my job, or if she was just turned on spousal-mute-mode whenever I talked about it. (The Peanuts teacher, "Wa wa waaah wah").
  4. Ironically, while I managed bugs and features for it (and worked with the site limited folks a lot), since I'm not vision impaired, I generally looked at it (pun intended) from a bug-fix point of view, and not often as a user.


Day 31[edit source]

           Main article: 2023 Heart Attack/Day 31
2023-03-20 (Monday) - Tougher day; sight regression, exhaustion, pain.
Summary
  1. I got there and Melissa was distraught that she couldn't see, "everything is black" (except for one bright spotlight) and she wanted us to darken the room (so we did). Then complained she couldn't even see shadows and colors. Then a bit later, I put my face right up to hers, and she said, "Oh, hello". And later commented on the nurses teal colored top. So it seems to come and go, and when it goes, she loses it. I don't know if it's blood sugar, fatigue, or just neural overload -- but it seems to come back. (And we've had this scare before a couple other times).
  2. Melissa had done great with speech therapy (they'd already seen progress). And Melissa had done PT earlier in the day, but had been exhausted. But she was also having a high pain day -- all over. Floating between can't get comfortable and just wailing about the pain. Mary took a break, and I just kept trying different things. Melissa was like a toddler that was so tired they couldn't rest. I was having a tough time as my normal technique of find the pain and rub it out, wasn't working. (Touching her was hurting). Then they came back for the 1:30 pm PT, and started talking her through different positions. And getting her on the other side (she'd wanted to lay on her right), but getting her to lay on her left, pull her right leg over, and stretch out the hip/butt, that helped, and she got better. Went down, and did a little PT, before they took her off for a cat scan and ophthalmology.
  3. Because Melissa had complained about sudden loss of vision, they took her off for a cat scan to make sure there was no additional stroke or brain bleed. I wasn't really worried, this felt more like chemical/tired than any stroke symptoms. But they have liability based protocols (defensive medicine) so they made sure, and she was fine. (According to the test). No tPA (brain-draino) required, which is good.
  4. And Ophthalmology called about her vision. They didn't seem to understand how much it was coming and going. (They always thought she was at her worst). So they were actually encouraged by how good it was when it was working. They also recommended me to UH or UT's outpatient stuff when she got out of there; basically rehab for vision -- once they got her to where she could walk and be physically independent.
  5. Melissa isn't normally a huge fan of Panda Express, so I brought her some. She loved it. I figured that with bland hospital food, some fried rice and noodles would go over well. (Along with many packets of flavor like soy/plumb sauce/etc. -- anything that could hack the hospital food into "edible"). Hubby scored!
  • Defensive medicine isn't all good. In fact, an abundance of caution slowed the process way down -- like getting the vent out, likely resulted in much more infirm immobility and longer vocal and overall recovery. At least one cardiologist thought that the angiogram to check on the heart, might have been what scraped off plaque and caused the stroke. And a lot of the protocols that kept her down and immobile and off foods until thoroughly signed off on, likely meant longer recovery/rehab and is costing her today. They will sacrifice the recovery speed of 99 patients, if it prevents 1 accidental death lawsuit -- and I'm not sure most patients sign up for that. But I'm also not ready to challenge the protocols that had a positive outcome.
  • So this CT scan was likely unneeded, and increased her exposure to radiation (or other complications) by some small amount. But they have a better safe than sorry attitude. I'm not sure that all of these are playing to Melissa's advantage -- and she's an outlier. Younger, healthier, and might have bounced back quicker, if she had been on a faster track. But it's hard to say, and they have developed these protocols based on a lot more evidence than I have. So kinda have to defer a bit. They play the odds -- but that also plays to the middle of bell curves. And Melissa is an outlier. But I don't have the balls to take risks with her, even if it meant an easier recovery later.
  • Reading is always got too many black holes. When I was dealing with Stroke Pain, as Melissa is crying -- it took me into dark places. People that never recover from it and have it for their entire lives, and stuff like that. The same wiht a lot of the vision stuff; you can't read something that implies some percent never recover and not start going down rabbit holes. Then there was all the other stuff I caught by listening in, that I had to force myself to ignore. (The Watchman device she was on, was only 90% effective -- but she likely threw a clot anyways, and there was still more there. Or that she had DVTs in both arms. Or various blood chemistry flags that could imply bad things). So I veer away from in-depth reading and try to have faith. And I can't start diving too deep into the studies and questioning doctors on overly defensive medicine, because it requires me knowing way more than I can handle knowing at the moment.


Day 32[edit source]

           Main article: 2023 Heart Attack/Day 32
2023-03-21 (Tuesday) - Better day. Lethargy, Starvation Diet, but still putting in the work.
  • Summary
  1. Melissa is a bit lethargic, but putting in the work. (3+ hours a day). I blame the food/calories for some of it (but sure the pain meds, muscle relaxers, and other drug cocktails aren't helping). 4 days of Vegetarian Lasagna (the only thing on the menu that's vegetarian?) means she doesn't eat much... then she doesn't have energy. She's hard enough to get to eat when she's not getting hospital food. I told them "She eats some non-veg items like Chicken Soup, or French Onion soup"... so yesterday they brought her meatloaf (the food, not the singer). WTF!
  2. I did some shopping for M, I just got her spices and sauces to help flavor her food. While she won't give me many orders, she did request a bowl from Chipotle. I'll try to get some calories in the girl, she's looking a little prison-camp survivor.
  3. Today I got her Falafel from our favorite Greek place (to bring in tomorrow). When they asked where my wife was, and I told them -- they said the care package was on them. In the meantime my neighbors are meal-training me incredible BBQ, and Fajitas, and so on. I'm stuffed. If you aren't in a Hospital in Texas, they'll feed the crap outta you (or into you). In the meantime, they've been giving Melissa colon-blow because she hasn't pooped in a week. They did a scan and she doesn't have enough in her to worry (not realy that corked up), but when that stuff finally takes effect, I'm thinking a scene out of Dumb and Dumber or Hall Pass is coming.
  4. A week ago, she was just getting her Pacemaker replaced and could barely sit up. Now her talking/memory is improved, she's brushing her own hair/teeth, using the big girl potty, in Sweats/PJs/Home Clothes, feeding herself, at least finger foods (forks are harder when you can't see, but she can hit the target once loaded).
  5. I called UH has a Low Vision center to help people with reduced vision (often due to stroke/accident/etc). They used to work with the Rehab's in area, but stopped under COVID and I guess it's impossible to get two bureaucrats to agree on anything that increases their liability... so it'll now have to happen AFTER Rehab. They have lots of tools and techniques (light magnifying devices, prisms, etc), but we'll have to get a referral from her Ophthalmologist. And they won't give that, until she can go into their office on her own. (The equipment is too big to bring to the patient). Trapped in the ministry of silly walks. But we'll get there, and I think we need to see how far her vision gets first. In the meantime, I describe pictures to her -- like of her Nieces wedding reception.


Day 33[edit source]

           Main article: 2023 Heart Attack/Day 33
2023-03-22 (Wednesday) - Setback. Back to CCU. Drove in a Husband, drove home a widower with a broken heart.
🗒️ Note:
It is with sincerest apologies that I might break it this way to people who don't know. Mary and I tried to call many people and relay the message more personally. But writing is my catharsis and outlet. And a lot of people I might not get to, will read this.
  • Summary They called me at 4:00am. Melissa was having trouble breathing, was lethargic, and an X-ray showed that she might have a blockage (megacolon), and her white blood cell count was spiking. They were sending her from Rehab back to CCU (Walter 10-22). I drove down and now we wait. Poor girl is back on the vent (what she hates), and a bit of a restart.
The worst day of my life
At 11:52pm the love of my life died. What happened is that her entire colon was blocked up, and it was causing septic shock. They stabilized her but it was too late for anything but removing her colon. I don't care about my wife having a bag, but it's not about me, it's about her (and her wishes). She was "done" weeks ago. She wanted her life back -- and this latest setback robbed her of the last hope. We had done a DNR (Do Not Resuscitate) for a reason, and this was it. She fought as long as she could. The choice was make her suffer, and (a) the best case would end up torturing her with a life she couldn't stand (blind, neuropathic pain, her hobbies of running, cooking, dominoes, organizing, or most of the things she loved were gone)... or (b) there was the far more likely path was torturing her poor little body with more trauma before she would still eventually pass due to complications from not being ambilatory. (You can't heal if you can't move, and she wasn't yet mobile, and gutting her was going make it worse). With the help of family, I chose to follow her wishes, let her suffering end, and let my partner of 32 years go back to God.
Details
  1. If they removed her colon, it's 2-3 weeks recovery for a healthy person. Even then you have rough prognosis, and lots of complications if you can't move around. She wasn't yet close to walking on her own. She had many more weeks of recovery from the stroke/heart attack, and this easily doubled that (if miracles happened). And she was out of miracles.
  2. To give you the full sense of scale:
    • she had DVTs (Clots) in both arms, and one lingering on her heart. If the arm ones threw, it was a pulmonary embolism. If the heart one dislodged, it was a massive stroke.
    • she was legally blind, but there was a chance that some vision could come back, and we could use some assistive devices and training to help. But she was distraught about that. I was hoping we could get her past that and a quality of life that satisfied her. But it's not up to me, it's up to her. (She would lose it about not being able to see).
    • she had horrible neuropathic pain ("make it stop"), which we weren't sure if it was permanent. Exercise and stretching contracting muscles/tendons can help, but she didn't yet have the strength to do what it took to end it. If ever. And I was terrified as this doesn't go away for some stroke/anoxia victims. A life of her on drugs for pain, was terrifying me for her.
    • Now you throw on top her having her colon removed (she was already severely malnourished, and needed that for healing) -- and the recovery/complications. I couldn't keep torturing her just to keep her around. I had great conversations with her Cousin (Julie) who was a Nurse, and we talked through outcomes with the doctors. They got and respected our decision.
    • Evem if I could deal with all of those things, it was never up to me, it was up to her. She was on a vent -- but we'd had these conversations before, and put it in writing. My Step-Dad died of sepsis, and it was my Brother and I that had to make the decision for end of life. Now my wife. It seems my purpose in life is to kill the people I love. Though, I take strength in the fact that I was following their wishes, and putting their needs above my own. (There's a black hole in my life).
    • The little fighter, fought to the end. We gave her pain meds and let her rest. Still, for 7 hours she survived with her pacemaker turned off, in sepsis, running 40/22 blood pressure, a 46 heart rate, and still getting her Oxygen Saturation into the 90s. She fought her whole life, and beat all the odds, except this one. (We all lose this one in the end). She wasn't supposed to live to see 5 weeks when she was born (most kids with her birth defect died in infancy), and she made it 55 years. They told her to take it easy on her heart, so she became a flight attendant and ran half a dozen half marathons. Telling Melissa "no" was always a dare.
  • What if? I'd talked to Mary and pondered, what if Melissa had just died on February 18th, when she went down. Melissa wouldn't have had to deal with all those challenges. But then she wouldn't have gotten to say "hi" and "goodbye" too all her friends that visited. Melissa wouldn't have gotten to prove what a tough little fighter and odds defier she was. Mary wouldn't have gotten to be a Mom to her baby girl for the last month of her life. And I would have had 33 fewer days with her. They weren't all good days, but I cherish every one (and the 11,680 others that we were together).
  • Story of us There's a little thing I'd been working (slowly). Some sampling of photos of things we'd done over the years. It's nowhere near complete... but hints at the beautiful zest for life and being that was my wife. One of the greatest gifts we got was EARLY in our marriage (still newlyweds), we had to go through open heart surgery. (Replacing her double-bypass). It gave us perspective on what was really important. I might be a dick, but I was there for her whenever she needed me. She might annoy me, but I was always lucky to have time with her.




2023 Heart Attack/All • [1 items]

Grief
Grief.png
02/18 my wife had a Heart Attack, and passed away on 03/22/23; the hardest day of my life. Except for the ones after it. Which isn't completely true. I just entered a new phase of life; grief. I had to let my wife, the love of my life go. She died, by my choice (to support her wishes). But what now? Since the future is dark, I just focus on the present.


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Story of us
This is the "Story of us"... the pictures/tales of some highlighted trips, events or milestones in our life.



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