It was the birthday that I had marked subconsciously with a bit of dread.
September 15 came and went without incident, but I knew it was only the start, not the end of a significant year. Twenty-six years ago, my father died at age 69 from heart-related issues. And now I had just turned the corner on that age. His father, too, had passed away in his 60s from coronary disease.
While it did give me pause to consider, I was not overly concerned. After all, I was in fairly good shape for a man of almost 70. I walked the dogs regularly, sort of watched my diet, visited the doctor every three months to have bloodwork checked, mowed the lawn and raked the yard and was in good enough shape to walk miles and miles on recent vacations.
Why should I be concerned about this age thing? My two older brothers are clicking along fine; just add me to the list of those beating the genetic odds.
Days later, however, the odds caught up with me.
The First Symptoms
Five days after my birthday, I visited the family doctor with what I thought was an acid reflux issue. He checked me out thoroughly and hooked me up with numerous wires for an electrocardiogram. At the end of the exam my blood pressure was fine, pulse rate was great and the EKG showed nothing. To ease his mind, he did order a stress test.
Two days later my wife and I drove from Aiken to Louisville, Kentucky, for a wedding. I began noticing a tightness in my upper chest near the collar bones after exertion and had to rest for several minutes before things returned to normal. This persisted throughout the weekend, and when we got home Sunday evening, unloading the car was an ordeal.
I went to bed early that night and slept uncomfortably. On Monday I was still in bed at 8:30 and had no desire to get up. That is unusual for this morning person who has typically risen well before 7:30 either to walk the dogs or go to the USC Aiken classes I teach.
My wife looked at me and immediately picked up the phone to call our doctor.
“He looks terrible,” she told the receptionist. “His face is gray and he has a family history of heart disease. He needs to see someone today!”
She was told to bring me immediately and not bother stopping in the waiting room. While I protested because of being in my morning state of dishevelment, Mary Lou told me to put on clothes and get in the car.
Five minutes later we were walking through the waiting room to the area where vital signs are taken. My 130/80 blood pressure reading from five days earlier was now 190/98. My pulse rate, typically 60 or less, was in the 80s. Nurses Pat and Patsy, a pair I have known for years and who have always greeted me with smiles, had concerned looks on their faces.
In an examining room, I was again wired up to the EKG and lay patiently as the machine spat out its stream of paper with squiggly lines. Patsy ripped off the paper and took it to the doctor for a look. Seconds later he came in. The EKG was significantly different from the one taken just a few days earlier.
“You’re going to the hospital,” Dr. Ray Vaughters Jr. said. “We are calling an ambulance.”
Those words let me know the severity of what was happening, but I was still alert enough to let my stubbornness show. I told him we had driven over to his office, and we could drive to the hospital just a few more minutes away.
“We are calling an ambulance,” he said with a tone of finality. End of discussion.
The Ambulance Ride and the Hospital
Ten minutes later I was placed on a gurney and rolled into a waiting ambulance. The attendant, Kristi, started an IV and connected me to another EKG machine, and I was on my first-ever ride in an ambulance.
Rolling along the bypass toward Aiken Regional Medical Centers, I asked Kristi if the ashing lights were on. If I was going to be in an ambulance, shouldn’t I get the full treatment?
“No,” she replied, “you’re not going to die today.”
Those were comforting words.
At the hospital, I was rolled into an Emergency Room examining facility with a nurse waiting for my arrival.
“Mr. Wallace?” he asked while peering at a computer screen as I was wheeled in. I nodded affirmatively, and he began the work that nurses do. Seconds later two more nurses and a student nurse from USC Aiken came in. Another IV was started so blood could be taken. I was given four baby aspirin. I was connected to yet another EKG.
A man entered and identified himself as Dr. Miller. He said he had looked at the EKG and was not alarmed by what he saw, but I could expect to spend the night and perhaps undergo some more tests including a stress test.
“OK,” I thought to myself, that’s not too bad. “I’ll be back home tomorrow and be able to teach my classes at USCA.”
After a chest X-ray and nurses still in the room to watch over me, the doctor returned. There was a dramatic change.
Troponin Levels Prove Alarming
One of the many things checked for in the blood of a heart patient is something called troponin. It is released by the heart when that vital muscle is under stress – like a heart attack. While the normal level is something well below 1.0, mine was an alarming 11. Dr. Miller said that I was being turned over to the on- call cardiologist and would be prepped for the catheterization lab.
Dr. Miller wished me luck and left the room, but the nurses got busy again. I was given a nitroglycerine tablet under my tongue. My wife said that my color at that point was getting back to normal. But there was more. Often for heart cath procedures an incision is made in the groin, so I had to be shaved and disinfected in that area.
At that point all modesty was gone, and having female nurses work on that part of my body was of little concern. All of this happened so quickly, I scarcely had time to be embarrassed. As all the attention was being directed to my most personal area, I recall one of the nurses saying that if Dr. Arthur was on call, sometimes he likes to go in through the wrist.
Half an hour later I was being rolled down the halls of ARMC with two men from the cath lab guiding my gurney. After a few twists and turns I was rolled into the lab and gently eased onto a metal table.
Blockages and Stents
After brief conversations with the lab techs, I looked up to see the face of Dr. Ansermo Arthur. He greeted me warmly and told me he was indeed going to make a slight incision in the wrist, inserting the catheter there.
“You’ll feel a little stick,” he said, “but you won’t feel anything after that. The arteries have no pain receptors.”
I did feel a prick in the wrist, but after all the others I had had that morning, what is one more needle to a pin cushion? And amazingly, I felt nothing else. I had imagined I would feel the catheter line moving up my arm and into my chest. Nada!
With Dr. Arthur to my right and a large video display to my left, I was fully awake while a foreign object was being pushed into my heart. I looked at the screen and could make out a thin line with what appeared to be smoke emanating from the end. It was the catheter with contrast dye being released.
“There’s one that’s holding on by a thread,” Dr. Arthur said matter-of-factly.
I inquired what he was referring to.
“This one,” he pointed to the screen, “is 99 percent blocked. But there is no damage to the heart.”
Another artery was 70 percent occluded. (That’s one of the medical terms I learned, and it means “stopped up.”)
The more egregious of the two arteries was ballooned open and a stent placed inside to keep it that way. Dr. Arthur decided the second occlusion was not an immediate concern and could be handled either through medication or with a scheduled appointment at another date.
The procedure lasted mere minutes, and I was told I would be fine. I did have a heart attack, Dr. Arthur said, and it could have ended poorly if I had not gotten the medical help when I did. Whew!
Changing Lifelong Habits
Following the heart cath procedure, there were two restless nights in the hospital, the first time I had ever spent the night in a healthcare facility. (I don’t count the night in a Chicago hospital waiting room while daughter No. 3 was in labor with her first.) I missed three meetings with my USCA classes and was put on restrictive activities:
Don’t lift anything over 10 pounds, don’t do anything strenuous, eat a low-sodium, low-fat diet, take the prescribed medications.
Initially, the diet part was the most difficult. Have you ever cut out salt as completely as possible from your diet? It wasn’t easy, even when a dietitian said that salt was an acquired taste. After all, it was a taste that I had not only acquired, but had relished for more than six decades. The thought of going to the movies without getting overly salted popcorn and a soft drink was unimaginable. But life had changed, and diet was part of it.
With the help of three caring daughters and a loving wife, adjustments were made. We began watching food labels and eliminating those with high sodium content. We started paying more attention to heart-healthy foods and ensuring that we didn’t over-indulge at the dinner table (or the breakfast or lunch table!).
With my wife and me following a stricter eating regimen, we both lost 10-plus pounds in the first month. That was simply a byproduct of eating smarter and healthier.
Three weeks later, I was back in the cath lab getting reacquainted with my friends there. Two stents were placed in the artery that was 70 percent blocked, and I was back home that afternoon.
Eating better has been only part of the road to good health. I joined the Cardiac Rehab program co-sponsored by Aiken Regional and USC Aiken. Three mornings a week, I join others on a 36-session workout journey strictly monitored by medical professionals and students at the school. I am probably in better shape than I have been in years, and as I am writing this I still have two-thirds of the program remaining.
Dr. Arthur has released me to do whatever activities I am comfortable with, and I don’t have to see him again for half a year.
Looking back, I see that events of that week could have turned out quite differently. There were warning signs that I didn’t suspect had anything to do with the heart. I was on the road and could have had an attack while behind the wheel or far from medical help. I feel blessed that it did not happen that way.
This has been an unexpected voyage that has opened my eyes to a better, healthier lifestyle.
The dread I had for this particular birthday proved to be real, but thanks to a team of family members, friends and healthcare professionals, things are looking good that I will reach the next birthday and beyond.
Taking Care of the Ticker
A stent in time saves nine.
Okay, you realize that the saying is “A stitch in time saves nine,” but the sentiment is the same. Take care of small problems before they become large. And just as important – take care that old habits don’t create additional problems.
Cardiac rehabilitation is almost as important to heart patients as the procedures that saved them in the first place. In Aiken, we are fortunate to have a program in place that takes cardiac patients to a new level of health following a heart episode.
The Aiken Cardiac Rehabilitation Program is a collaboration between Aiken Regional Medical Centers (ARMC) and the University of South Carolina Aiken (USCA). It provides patients with a safe, medically monitored regimen of exercises over a 12-week program to strengthen not only their hearts, but all of their bodies.
Wanting to get better as quickly as possible following a September heart attack, I jumped at the chance to take part in a program that I had been only vaguely aware of. I received a call from Holly Guy, program coordinator, and went to the USCA Wellness Center for a face-to-face meeting.
Holly told me about the program, checked to make sure I was insured for coverage and arranged for my first visit to the machines that I would get to know so well during my time in rehab.
Before each session, those of us in the program get a monitor and connect four leads to chest and torso. We weigh in, have our blood pressure taken and tell one of the USCA sports and exercise science students working with the program if there have been any health changes since our last visit.
Then it’s on to our individually prescribed program which starts out rather light but intensifies as we progress from week to week. Treadmills, ellipticals, upper body cycles, weight apparatuses for legs, arms and abs help us get stronger and work longer as the weeks progress.
As we work on each device, the USCA students regularly monitor our heart rates and our perceived level of difficulty. Blood pressure is taken while exercising and again a final time after we have rested to ensure there are no problems. And sometimes there are problems.
On my first session two weeks after a stent had been placed in a major heart artery, I was on my first device, the treadmill, walking at an easy pace when Holly and the cardiologist with the program, Dr. Don Pennington, came over and asked me to step off. I was escorted into a room and had numerous leads placed on me and an EKG done. The doctor saw something odd in the EKG reading and before I knew it I had another appointment set up to see Dr. Ansermo Arthur. Another week later I was back in the hospital to have two more stents placed in a different artery.
I was one of the few people to be suspended from the cardiac rehab program on my first day. But I returned following the placement of the additional stents and feel stronger and healthier because of the program.
For information on the Cardiac Rehabilitation Program co-sponsored by Aiken Regional Medical Centers and the University of South Carolina Aiken, contact Program Coordinator Holly Guy at 641-3734 or email email@example.com.
People with similar experiences tend to flock together to share their commonalities. Heart patients are among them.
Mended Hearts is a national organization that brings together heart patients, their families and friends, as well as medical professionals, to share their experiences and inform others about cardiac health and care.
The Aiken Chapter No. 294 has provided stellar service to heart patients and the community at large since its creation in 2001. The Aiken unit was honored as the best Mended Hearts chapter in the nation for 2008.
Specially trained and accredited visitors from the local unit visit cardiac patients and their families at Aiken Regional Medical Centers and routinely visit patients at the ARMC/USCA Cardiac Enhancement Program at the USCA Wellness Center. Through their personal health journeys, they offer hope for new cardiac patients and their loved ones.
The local chapter puts on an annual golf tournament to raise money for cardiac outreach projects in the community. Funds from the tournament over the years have gone to Aiken County to purchase automated external defibrillators, to the Cardiac Enhancement Program at USCA for specialized cardiac rehab equipment, for patient simulator mannequins and equipment in the USCA School of Nursing, for patient simulator mannequins and cardiac teaching equipment at Aiken Technical College, and to provide EKG transmission capability for 10 Aiken County EMS ambulances.
The local chapter meets on the second Friday of the month at 10 a.m. in the Alan B. Miller Nursing Building on the campus of USCA at 10 a.m. All are welcome.
Jeff Wallace has lived in Aiken for more than 60 years. He graduated from Aiken High, attended USC Aiken and graduated with a journalism degree from USC in Columbia. He worked for more than 30 years at the Aiken Standard where he retired as editor. He also taught middle school and currently is an adjunct faculty member at USC Aiken. Jeff has served with a number of local organizations including United Way of Aiken County, the USC Aiken Partnership Board, the Greater Aiken Chamber of Commerce Board, the Ruth Patrick Science Education Board and Public Education Partners. He is also active in St. John’s United Methodist Church. He and his wife Mary Lou have three daughters and seven grandchildren.