Thursday, December 24, 2009
Thursday, December 3, 2009
Surviving a Widow Maker Heart Attack
Below is Gary's account of what happened during his "widow maker" heart attack (blockage in the left anterior descending artery) in the mountains in Montana on November 16, 2009 at the age of 50:
As many of you know, I’ve been “hooked” on elk hunting since joining a group that George Roberts organized back in 2006. Elk hunting is in tough terrain and requires tremendous preparation and peak physical fitness. Since returning from that 2006 hunt, I have been diligent in working out and keeping my cardio fitness level strong. Prior to this recent hunt, my resting heart rate was 52. All of the above saved my life.
My good friend, Mike Magnotti, and I drove from Texas to Montana to begin hunting on Sunday, November 15th. Sunday was a great hunt with approximately 10 miles of hiking in 6-10” of snow. There was nothing to shoot at, but we did see a cow moose on our way back down the mountain which was cool.
On Monday, Eric Weare joined my guide, Ben, and me. Eric’s hunter had “tagged out” the day before, and they left the elk meat hanging overnight. The three of us drove as far as we could then rode horses for over an hour to as close to the meat as we could get. Then we hiked in for the final mile or so.
When we arrived at our hunting location, it was a beautiful setup where we could glass three clearings covering more than 180° of visibility. Immediately upon our arrival, I started to experience pain in my back between my shoulder blades. It continued to grow to the point that I became less focused on hunting and more on getting comfortable. Eric had me rest by a tree while he and Ben glassed for elk or deer. I was convinced that I had somehow hurt my back on the ride in.
My pain level had subsided some when Eric spotted a nice mule deer. I rushed over and setup for a shot, but it ran into some timber before I could get it into the scope of my rifle. Approximately 10 minutes later, the deer made another appearance about 330 yards to my right, and I was able to get off a good shot.
Eric suggested that I stay there at our glassing area while they went to retrieve the deer. Needless to say, there were no complaints from me. I was actually feeling a bit better by now, but I was concerned about further damage to my back... and I still had to get off the mountain somehow.
After Eric and Ben made it back, they took a pack horse to the opposite ridge to retrieve the elk quarters from the prior day. Then we hiked to the other horses and proceeded down the mountain. I was still feeling pretty good although the pain was more constant now. The horse ride down was beautiful with many stunning views.
By the time we loaded the horses into the trailer and made it back to the lodge, the pain was getting worse and had begun to spread. I passed on dinner and hit the bed early. Julie Weare agreed to drive me to see a doctor in Libby the next morning.
I started having chest pain as we drove to Libby so Julie took me directly to the local hospital. Within ten minutes of being checked out in Libby ER the next morning, they told me I had experienced a fairly serious heart attack. They immediately ordered a helicopter to haul me over to Kalispell Regional Medical Center where they have the best capabilities for heart issues in the state.
Julie was into paparazzi mode by now and took a picture as they hauled me to the helicopter:
In Kalispell, I learned that I had suffered a “widow maker” heart attack (blockage by blood clot in the left anterior descending artery). The doctors were not happy that I had waited more than 24 hours before treatment, but they found that I had no blockage or plaque in any other artery. One doctor told me that I could have even passed a stress test the day before this happened if the artery was less than 75% blocked. Very strange stuff.
Tuesday was a day of waiting to see how my heart would react to the medicines.
On Wednesday because my heart rate and blood pressure were unstable, the doctors decided to do an angioplasty to assess whether or not they could put in a stent, remove the clot and stabilize my blood pressure. The doctor talked to my wife and told her that this was not a low risk procedure, and she should make arrangements to come to Montana as soon as possible. Dr. Williams performed the surgery, and I received a stent to hold the artery open. I made it through the surgery but had to lay flat for ten hours. Becky and Maggie happened to call when they were pulling the catheter out of my neck that evening. It was quite painful, but I made it through the night.
Atrial fibrillations (a-fibs) are common after such a severe heart attack, and I experienced four separate bouts of them on Thursday (three in the morning and one in the evening). Atrial fibrillations happen when the heart gets out of normal rhythm and bounces from a low to rapid beat ("irregularly irregular," as our own Dr. King says). The risk is that the irregularity will allow a clot to form, which could cause a stroke. Normally, a-fibs are treated with drugs, and/or by shocking the heart back to a normal rhythm.
Since I can't do anything the easy way, my first introduction to the a-fibs was when six people showed up in my room with a defibrillator I now affectionately call “Big Red”:
By the way, they don’t use paddles like you see on TV or in the movies. The nurses attach sticky pads to your chest, and connect those to the machine with clips and wires. Nothing spells "f-u-n" like 200 Joules of electricity coarsing through your body. Turns out the “you won’t feel this” medicine had not kicked in yet for three of the shocks, which caused me to say less than nice things to the group in the room. I believe I was also at least 18 inches in the air (over my bed) at the time. For the fourth round, they knocked me out. Perhaps it was something I said...
Each a-fib experience was less severe with the min/max range of heartbeat being less wide, and now, they appear to be a thing of the past. However, I’m currently taking more drugs than Jim Morrison, and certainly hope I can cull that list way down over the next month or two.
This photo was taken on Saturday:
For awhile, the doctors were concerned that I might develop another clot in the apex (bottom) of my heart because it wasn't functioning at all yet. They put me on blood thinners and ordered daily echocardiograms to check. Thankfully, no clots developed.
However, I did develop pericarditis (fluid around the heart) and pleural effusion (fluid around the lungs). What was really fun was when the two fluid-filled sacs rubbed together each time my heart beat! That's called a pericardial rub, and it was the first time my doctor had heard one live and in person. He asked Becky, me and the nurse to listen to it. Sounds like footsteps in freshly fallen snow. The pericarditis was uncomfortable and made me cough a lot. Felt like I was hacking up a lung every few seconds, and speaking set off more coughing episodes.
I was scheduled to be released from the hospital on Monday, but I suffered another round of a-fibs on Sunday evening. These were solved with medicine, but it delayed my departure by a day.
I was finally released from hospital on Tuesday, November 24th, but needed to stay in the area for another few days until the doctor thought it was safe for me to travel. Here's a picture of me on my last day in the hospital (getting scruffy, as Maggie commented when Bec posted it on FaceBook):
After leaving the hospital, we migrated to the Hilton Garden Inn for my recuperation. Only downside, other than being confined to a small one-bedroom was that I had to put on regular clothes (no more Jack Nicholson shots of my backside dancing through the hospital halls):
Several times a day, I'd ask Becky to go for a walk down the hall in the hotel. On Wednesday, November 25th, I was feeling much better so we decided to try a flight of stairs. Big mistake! Shortly thereafter, the a-fibs started again. Back to ER we headed, but I didn't need a tryst with Big Red this time, either. Dr. Briles and Dr. Williams were able to convert the rhythm back to normal with a shot of beta blocker.
I spent Thanksgiving watching mega-football and eating turkey cold cuts from Walgreen's because nothing else was open. Didn't really matter because 1) I wasn't hungry, and 2) I couldn't taste anything any way.
On Friday morning, I had to go back to the hospital lab for a liver function blood test. While previously at the ER, Dr. Briles was concerned that my liver enzyme levels were elevated. He said it often happens after a heart attack, but could also be due to the meds. Luckily, the blood test showed that the enzymes had decreased by half and were back within a normal range.
Saturday and Sunday passed without incident, and we took the time to check out some of the local area (Flathead Lake, Whitefish, and Glacier National Park). Actually, Becky checked it out while I slept in the car. It was the only way I could get a lights out, decent nap. Bec said that if I had to have a heart attack, Kalispell and its hospital were a great place to recover. Beautiful scenery and wonderful care...a guy can't ask for much more than that.
We finally left Kalispell on a 6 a.m. flight on Tuesday. We made it back home by 4:30, and I was wiped out. But...it’s great to be home!
I don’t know much about my rehab or the expected long-term impact on my heart yet. Everyone in Kalispell expressed amazement at my recovery. I’ll find out more next Tuesday when I meet with a local cardiologist.
My loving and adorable wife, Becky, (OK, I added that loving, adorable part-BG) flew up to Kalispell to be with me and was nothing short of amazing (of course!-BG). She was there for everything and put up with all of my whining and requests (not much whining, but a LOT of requests-BG). I’m not sure what I would have done without her there (me, either-BG).
NOTE from BG: I am very lucky that Gary survived this ordeal, and we take time to count our blessings every day since the attack. Please follow this link to the American Heart Association to review the symptoms of a heart attack (and stroke). By sharing this story, we hope that we will help people recognize the symptoms and get earlier treatment.
As many of you know, I’ve been “hooked” on elk hunting since joining a group that George Roberts organized back in 2006. Elk hunting is in tough terrain and requires tremendous preparation and peak physical fitness. Since returning from that 2006 hunt, I have been diligent in working out and keeping my cardio fitness level strong. Prior to this recent hunt, my resting heart rate was 52. All of the above saved my life.
My good friend, Mike Magnotti, and I drove from Texas to Montana to begin hunting on Sunday, November 15th. Sunday was a great hunt with approximately 10 miles of hiking in 6-10” of snow. There was nothing to shoot at, but we did see a cow moose on our way back down the mountain which was cool.
On Monday, Eric Weare joined my guide, Ben, and me. Eric’s hunter had “tagged out” the day before, and they left the elk meat hanging overnight. The three of us drove as far as we could then rode horses for over an hour to as close to the meat as we could get. Then we hiked in for the final mile or so.
When we arrived at our hunting location, it was a beautiful setup where we could glass three clearings covering more than 180° of visibility. Immediately upon our arrival, I started to experience pain in my back between my shoulder blades. It continued to grow to the point that I became less focused on hunting and more on getting comfortable. Eric had me rest by a tree while he and Ben glassed for elk or deer. I was convinced that I had somehow hurt my back on the ride in.
My pain level had subsided some when Eric spotted a nice mule deer. I rushed over and setup for a shot, but it ran into some timber before I could get it into the scope of my rifle. Approximately 10 minutes later, the deer made another appearance about 330 yards to my right, and I was able to get off a good shot.
Eric suggested that I stay there at our glassing area while they went to retrieve the deer. Needless to say, there were no complaints from me. I was actually feeling a bit better by now, but I was concerned about further damage to my back... and I still had to get off the mountain somehow.
After Eric and Ben made it back, they took a pack horse to the opposite ridge to retrieve the elk quarters from the prior day. Then we hiked to the other horses and proceeded down the mountain. I was still feeling pretty good although the pain was more constant now. The horse ride down was beautiful with many stunning views.
By the time we loaded the horses into the trailer and made it back to the lodge, the pain was getting worse and had begun to spread. I passed on dinner and hit the bed early. Julie Weare agreed to drive me to see a doctor in Libby the next morning.
I started having chest pain as we drove to Libby so Julie took me directly to the local hospital. Within ten minutes of being checked out in Libby ER the next morning, they told me I had experienced a fairly serious heart attack. They immediately ordered a helicopter to haul me over to Kalispell Regional Medical Center where they have the best capabilities for heart issues in the state.
Julie was into paparazzi mode by now and took a picture as they hauled me to the helicopter:
In Kalispell, I learned that I had suffered a “widow maker” heart attack (blockage by blood clot in the left anterior descending artery). The doctors were not happy that I had waited more than 24 hours before treatment, but they found that I had no blockage or plaque in any other artery. One doctor told me that I could have even passed a stress test the day before this happened if the artery was less than 75% blocked. Very strange stuff.
Tuesday was a day of waiting to see how my heart would react to the medicines.
On Wednesday because my heart rate and blood pressure were unstable, the doctors decided to do an angioplasty to assess whether or not they could put in a stent, remove the clot and stabilize my blood pressure. The doctor talked to my wife and told her that this was not a low risk procedure, and she should make arrangements to come to Montana as soon as possible. Dr. Williams performed the surgery, and I received a stent to hold the artery open. I made it through the surgery but had to lay flat for ten hours. Becky and Maggie happened to call when they were pulling the catheter out of my neck that evening. It was quite painful, but I made it through the night.
Atrial fibrillations (a-fibs) are common after such a severe heart attack, and I experienced four separate bouts of them on Thursday (three in the morning and one in the evening). Atrial fibrillations happen when the heart gets out of normal rhythm and bounces from a low to rapid beat ("irregularly irregular," as our own Dr. King says). The risk is that the irregularity will allow a clot to form, which could cause a stroke. Normally, a-fibs are treated with drugs, and/or by shocking the heart back to a normal rhythm.
Since I can't do anything the easy way, my first introduction to the a-fibs was when six people showed up in my room with a defibrillator I now affectionately call “Big Red”:
By the way, they don’t use paddles like you see on TV or in the movies. The nurses attach sticky pads to your chest, and connect those to the machine with clips and wires. Nothing spells "f-u-n" like 200 Joules of electricity coarsing through your body. Turns out the “you won’t feel this” medicine had not kicked in yet for three of the shocks, which caused me to say less than nice things to the group in the room. I believe I was also at least 18 inches in the air (over my bed) at the time. For the fourth round, they knocked me out. Perhaps it was something I said...
Each a-fib experience was less severe with the min/max range of heartbeat being less wide, and now, they appear to be a thing of the past. However, I’m currently taking more drugs than Jim Morrison, and certainly hope I can cull that list way down over the next month or two.
This photo was taken on Saturday:
For awhile, the doctors were concerned that I might develop another clot in the apex (bottom) of my heart because it wasn't functioning at all yet. They put me on blood thinners and ordered daily echocardiograms to check. Thankfully, no clots developed.
However, I did develop pericarditis (fluid around the heart) and pleural effusion (fluid around the lungs). What was really fun was when the two fluid-filled sacs rubbed together each time my heart beat! That's called a pericardial rub, and it was the first time my doctor had heard one live and in person. He asked Becky, me and the nurse to listen to it. Sounds like footsteps in freshly fallen snow. The pericarditis was uncomfortable and made me cough a lot. Felt like I was hacking up a lung every few seconds, and speaking set off more coughing episodes.
I was scheduled to be released from the hospital on Monday, but I suffered another round of a-fibs on Sunday evening. These were solved with medicine, but it delayed my departure by a day.
I was finally released from hospital on Tuesday, November 24th, but needed to stay in the area for another few days until the doctor thought it was safe for me to travel. Here's a picture of me on my last day in the hospital (getting scruffy, as Maggie commented when Bec posted it on FaceBook):
After leaving the hospital, we migrated to the Hilton Garden Inn for my recuperation. Only downside, other than being confined to a small one-bedroom was that I had to put on regular clothes (no more Jack Nicholson shots of my backside dancing through the hospital halls):
Several times a day, I'd ask Becky to go for a walk down the hall in the hotel. On Wednesday, November 25th, I was feeling much better so we decided to try a flight of stairs. Big mistake! Shortly thereafter, the a-fibs started again. Back to ER we headed, but I didn't need a tryst with Big Red this time, either. Dr. Briles and Dr. Williams were able to convert the rhythm back to normal with a shot of beta blocker.
I spent Thanksgiving watching mega-football and eating turkey cold cuts from Walgreen's because nothing else was open. Didn't really matter because 1) I wasn't hungry, and 2) I couldn't taste anything any way.
On Friday morning, I had to go back to the hospital lab for a liver function blood test. While previously at the ER, Dr. Briles was concerned that my liver enzyme levels were elevated. He said it often happens after a heart attack, but could also be due to the meds. Luckily, the blood test showed that the enzymes had decreased by half and were back within a normal range.
Saturday and Sunday passed without incident, and we took the time to check out some of the local area (Flathead Lake, Whitefish, and Glacier National Park). Actually, Becky checked it out while I slept in the car. It was the only way I could get a lights out, decent nap. Bec said that if I had to have a heart attack, Kalispell and its hospital were a great place to recover. Beautiful scenery and wonderful care...a guy can't ask for much more than that.
We finally left Kalispell on a 6 a.m. flight on Tuesday. We made it back home by 4:30, and I was wiped out. But...it’s great to be home!
I don’t know much about my rehab or the expected long-term impact on my heart yet. Everyone in Kalispell expressed amazement at my recovery. I’ll find out more next Tuesday when I meet with a local cardiologist.
My loving and adorable wife, Becky, (OK, I added that loving, adorable part-BG) flew up to Kalispell to be with me and was nothing short of amazing (of course!-BG). She was there for everything and put up with all of my whining and requests (not much whining, but a LOT of requests-BG). I’m not sure what I would have done without her there (me, either-BG).
NOTE from BG: I am very lucky that Gary survived this ordeal, and we take time to count our blessings every day since the attack. Please follow this link to the American Heart Association to review the symptoms of a heart attack (and stroke). By sharing this story, we hope that we will help people recognize the symptoms and get earlier treatment.
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