2023-02-18 (Saturday) Heart Attack (V-tach)
Melissa has a runnning group she does on Saturday's and I'm at the Gym Swimming
- I had just got in the pool when the music on the underwater headphones went out, and the phone was flashing.
- I answered a local number (odd time for a call) and was expecting spam. Instead I got the call that someone who lives with a heart patient is always dreading, "This is Theresa, I run with your wife, and she went down, they are doing CPR on her right now".
- I'm on my way, and jumped out, threw my clothes on, and started driving the 15 minutes to where she likely was.
It's wierd, you're in a fog. You know this is real... and you've kind of had to program yourself to this possible day. Before we got married, I knew of the risks, and negotiated with myself -- you can love this person, but the odds are higher that you'll have to deal with her death, sooner than many. And you won't get the guys easy-way-out by dying first.
The start of the drive, you're in full, "this could just be minor", as well as the terror, "of this could be it". At least you kissed her this morning in passing (with a side of grab-ass), and said the usual, "Have a great run/swim" and we'd see what the day brings.
Your life together is crashing down with toughts like, "we had a great 30 years, with lots of challenges and adventures -- better than most every get". Along with bargaining/pleading/praying, "please don't let this ride be over -- my life would be so empty without her". Which is selfish -- this is about her. Stop crying stupid, and focus on what's important; her. |
Where do you go?
Fortunately, where she was, was along the route to the closest hospital where I knew they would take her (more or less). So once I was in the car, heading towards her, I called Theresa back. OMW! They were still at the start of the running trail -- I knew loosely where to go. There was some back and forth, and it took a while for them to get going, but I intersected them in route, and followed them to the hospital. (Riding on their tail). The dynamics of coordination in these crises is worse than I thought.
- I was talking with Theresa on the 15 minute drive (intermittently) and they said the ambulance was arriving... so I went left at the intersection towards the hospital (instead of right towards where they were) figuring they were just behind me. And I wasn't sure I could find her on the trail without a lot of guidance distractions.
- I got about 5 mins down the road, before I got ahold of Theressa again. And found out they handn't yet left, and had been paddling her, and it wasn't working. (It never worked for me either). I should go back/there (I think Theresa was implying this might be your last chance to see her semi-alive). So I turned around. (And stayed on the phone).
- While almost back, they finally decided to take off (with Melissa on a CPR machine), they still hadn't gotten her into rhythm.
- I U-turned and waited in a parking lot until they passed (I had seen the lights in the distance) and then followed them all the way. Theresa was inside the ambulance and relaying that the crazy guy following her Melissa's husband.
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I'm not dead yet
- They brought Melissa in, and stuck me in the private greiving room. I understand this is protocol to get me out of there. How do you watch the love of your life being torn away from you?
- A couple other people from her running group joined.
- I was doing the math. This wasn't a quick zap and she's back that I'd been praying for on the drive over. This was our life as I knew it ending.
- The staff let me know that they'd been working an hour, and didn't have sinus rhythm and this didn't look good. They'd try for a few more minutes.
- About this time my friend Richard called, Vickie (his wife, Melissa's friend) had sensed something was wrong when Melissa didn't answer a text, and I told them I was at the Hospital and Melissa had gone down. They left for there immediately. More on Vickie and Richard
- Bargaining: Not yet. Not yet, please not yet. She's a fighter. While also rambling things about at least she was doing what she loved and fighting to the very end (through sobs).
- Then they came in and said she was in sinus rhythm, but unlikely to hold and I should come say goodbye while I could. I held her hand and caterwauled about loving her, fight baby, and whatever. And to the shock of everyone (pun intended) the sinus held for 1/2 an hour, and more.
- After an hour or two and they were transferring Melissa to ICU, I looked at the doctor that was prepping me for her going -- she shrugged her shoulders and said, "Sometimes it's me, sometimes it's God. That one was God".
I was filled in on details later:
- Mirna was a marathon runner and Medical Assistant. She was also the one that did CPR on Melissa.
- While Theresa is a PA, the way Melissa manifested was she stopped, put her hands on her knees/bent over, and was non-responsive but standing (and tense).
- Theresa thought it was a seizure (there was a little foam at the edge of her mouth) and muscle tension (without looking grand maul). So Theresa laid her down and was checking on siezure, and had called Mirna.
- Mirna being a minute or two ahead, came back and is bit of an alpha-personality with New Yorker roots, checked pulse and went into full CPR.
- When the Doctor was writing her off and implying she was gone, Mirna stormed out of the waiting room and into the ER and gave him a piece of her mind; she had just done a lot of good work on Melissa (gotten to her quickly, and kept her alive), and was not going to let them throw it away! They better keep trying or it was on them!
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What happened?
Basically, a V-fib event (Ventricular Tachycardia, that likely went into V-Fib). There were warning signs. Her doctor said no Woodlands Half-Marathon that was coming up, and she was scheduled for a chest MRI on Thurs.
- Typical Melissa since he said no Woodlands half, he hadn't specifically forbidden her the 10K Rodeo Run, or a 6 mile training run... probably because she never told him. That's how her sneaky-brain works. But if Melissa listened to doctors, she wouldn't have had any quality of life at all. And she's not too good at listening to Husbands either. She's a fighter.
- We don't know exactly why she went into V-Tach/V-Fib. The black box dump of her pacemaker showed it went into that. But basically, it's a 2-lead pacemaker (upper chambers) with defib ability (for the upper half) -- and V-Fib is a lower chamber event. So it recorded it, but couldn't do anything to stop it.
- Once in it, they couldn't pull her out. Which is surprising.
- The 3 things it most likely would have been is (a) plumbing (blockage that starved the heart) (b) electrical (the signal that tells your heart to beat, was jumping over scar tissue and causing it to beat out of sync) (c) chemical (potassium/electrolytes were way off). The post-event angeogram showed no blockages. At the hospital is showed her potassium was way off -- but the event can cause the potassium or vice versa. As a layperson, I was guessing that they were having a hard time getting her out of V-fib because it took a while to fix her electrolytes (before the heart would sync) -- and she isn't great with chemistry management (takes caffeine + sugar before running, etc). But the experts are still going to diagnose root cause, and not go with Hubby's best guess.
- The remedy matters on what it was. Most likely if they think it is electrical, they'll do an ablation to weaken the electrical signal to her lower chambers, and replace her 2-lead pacemaker with a 4-lead. (So her lower heart won't flutter, and if it does, it can defib it).
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- Siezure? Melissa's tongue was swolen, and there was a little blood in her mouth. And it manifested with muscle tension. (And once they shocked her 6+ times, and pumped her full of drugs, she was having some involuntary arm movements). So they were trying to valudate it wasn't a siezure and got a CT scan pretty quickly. But nothing. Then they put her in ICU room 2-20. The night attending said if she spasms (twitches like she's falling backwards) that "those patients are toast". If she'd gotten the hiccups that night, I would have lost my mind. (They just didn't understand what they were saying, and how a distraught Husband would take it).
- Start Transfer to Houston Methodist While Kingwood E.R. had followed prootocols and saved my wife's life (a little too reluctantly), I was already getting a bad vibe, and wishing she could be in Houston Methodist (her Hospital, one of the Best in the State + Nation + World for her issues). When Mirna called and explained that we should try to get her moved, that I could just request the transfer, which I did immediately and as respectfully as I could. They understood and started the process. And Mirna kept pressuring them to raise the level (to get Melissa prioritized). More at Hospitals
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