First anniversary of my heart attack

More accurately, first anniversary of my catheterization.

A year ago I worked in a place whose management style was far from being the right one for me.  Communications with the boss were throttled down because of a disability which made it difficult for him to type to me for long time, I was not granted adequate autonomy to do my work in a way comfortable for me, various measures which I suggested to make it safer to upgrade software were not taken, microscheduling was rampant, I was in anxiety.  I stayed on because of the standard advice not to leave work before lining up other work in its place.

Eventually I could stand it no more and resigned.  However my contract called for me to stay one more week to transfer my know-how to my successor.  I stayed for one more week, and noticed that I don’t feel well each day in the morning.  I had some strange pain in my chest, pain of the kind which I never felt in the past.  Drinking hot tea eased the pain.  I attributed this ill-feeling to work related anxiety.

At last, the week was over, but I still did not feel well in the morning of July 2nd, 2009 even though my last day of work was the day before.  So I decided it’s time to visit my primary health care provider (Kupat Holim).  My ECG was taken and there was something was abnormal with it, but still ambiguous.  My family doctor asked me some questions and finally told me to go to hospital for more tests.  I was advised not to take the bus but drive there by my car.  I preferred to take taxi instead, as otherwise there’ll be a problem with my car’s parking if I have to stay longer in hospital.

In the Golda-Hasharon hospital’s emergency room, my ECG was taken again and my blood was drawn out for some tests. Some time later, a nurse came with a big (300mg) aspirin pill and oxygen bottle. I was told to chew the aspirin pill and leave the mess below my tongue.  I also was to breathe oxygen.  Finally I was informed that they suspect an heart attack.  The curious thing was that when I was in the hospital, I did not feel pain.  Few days later I got the documents with blood test results, which showed that my blood had troponin, a marker for destroyed heart muscular tissue i.e. heart attack.

I was then carted off to the cathlab.  While en route I was given the authorization forms to sign.  The warnings section had gems such as death, serious disability, heart attack, etc.  In the cathlab I noticed the label “Mennen Medical”, a company for which I worked years before, developing software for one of their products - a computer which is used for collecting and analyzing data in…cathlabs.  It reminded me of the sign in IAI (Israeli Aircraft Industries) asking the employees whether they would agree to fly on the screw they are manufacturing now.  However I do not think that my own software was actually used during the procedure done on me.  I was a relatively easy case.

The catheterization procedure was carried out while I was awake and I could follow the displays (but not fully understand what is going on).  I did get local anaesthesia in my crotch, where they inserted the catheter.

After catheterization, I was carted off to the cardiac intensive care unit, where I was to spend the next four days.  Eventually I was informed that I had one blocked coronary artery, and the blockage was easily opened using a balloon and a stent was placed there.

I did not realize at first my condition, so I naively asked whether and which of my plans for the night and the next few days need to be cancelled.  It emerged that I do have to cancel all plans, including a trip to England which I planned to have a week later.  My Nokia 9210i cellphone, even though not in good condition, proved to be real boon during the first several hours after catheterization.  I was able to send a FAX message to my travel agent to cancel my trip, to send SMS messages to several people with whom I planned to meet or chat during the next few days, to update my long distance girlfriend about my situation.  It did feel weird to be almost as active as I would be if I were working, so short time after catheterization.  However it didn’t require me to exert physical effort so it was OK.

During the first night of my stay in the intensive care unit, a symphony of pains played out throughout my body.  The hole in my crotch, where the catheter was inserted, was being closed by pushing a ball against it.  It is a challenge because the hole opens into a major artery and the blood partially lost its ability to clot due to medication - the conflicting requirements are that on one hand, clotting will form in the hole, but on the other hand - not in or around my heart.  Pain one.  Pain two was the pain of hunger, as I was not allowed to eat much during the first several hours after catheterization.  The third pain were the chest pains as arteries rearrange themselves to deal with the changed conditions as the blockage was opened and the stent was inserted.

Days passed and gradually the antibiotics infusion has ended, I got more or less regular meals, I was allowed to walk to the restroom.  One thing worried me.  I knew that I have essentially to enter a new culture, to learn its ways and habits, to learn what to eat and what not to eat, how about physical exercise, what medications to take.  So when the woman in charge of educating new cases came with booklets, I was glad about this.  She left me with several booklets and I spent the last two days in intensive care reading those booklets.  Meanwhile, a technician with portable ultrasound machine came and scanned my heart - turned out that my heart retained practically all its functionality - my heart attack was really minor.  In other words, I got out of it cheaply.

When I was due to be discharged from hospital, there was some concern that the hole in my crotch did not close properly.  However an ultrasound scan cleared this question and I was discharged.

When I was discharged from the hospital, a friend took me home where I took a shower (at last!) and checked my E-mail backlog.  Nothing urgent, but lots of spam.  Fortunately my E-mail inbox still had room for several E-mail messages when I checked it.

Then my friend took me to a pharmacy to obtain the medications prescribed to me and from there to the medical hotel where I was to stay during the next 5 days.  The hotel has a cardiologist and a nurse available all the time, and my ECG and blood pressure were taken each day, sometimes more often than that.  There were also lectures, and in two of them the lecturers made the effort to make the subject accessible to me.  One lecture was about the medications we are now obligated to take, and the other - about the kinds of foods we may eat and those that we should avoid.

Turned out that I need to avoid milk chocolate, one of my favorites.  :-(

I was also to walk each day and to exercise lightly.  The walk times began with 10 minutes, two times a day, gradually increasing during a month to an hour each day.

After my time in the medical hotel, I returned home.  At beginning I needed help buying food, because the supermarket was too far away for me to safely walk to it.  However, after a week at home I already could walk to the supermarket and fully take care of myself.

Near end of July, one morning I felt strong nausea.  Again to my primary health care provider and then to the hospital’s emergency care.  This time, my blood proved to be troponin-free.  My nausea also ended while I was in hospital.  It was a false alarm.  I got discharged after about three hours and went to have a lunch in a fast food Chinese restaurant.

I did not return to work until beginning of August, at which time I started working for another company.

At end of August I had argometric test, and at beginning September I started my visits to the heart rehabilitation institute, twice a week.  Heart rehabilitation consists of exercise, which gradually and slowly gets more and more strenuous. I was pleased to meet an old acquaintance, someone who was and is active in the Association of the Deaf in Israel, in my group.

I am left with the feeling of having gotten prompt and good service from the clinic, hospital and medical hotel.  Several months later I had a chat with someone who was having excruciating back pain.  She told me of all the waiting times she needed to wait before CAT scans, biopsies, etc.  I told her “next time, get a heart attack instead, and they’ll attend to you promptly”.  :-)

Nowadays I go with three 100mg aspirin pills and an up to date ECG together with my money, keys etc.  If I get another heart attack, the aspirin will weaken the clot and the ECG will make it faster and easier to diagnose my condition.

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