Heart Attack

In February 2006 I climbed Mount Kilimanjaro, the highest mountain in Africa. The occasion was the celebration of my sixtieth birthday. It’s a six-day trek up a mountain nearly 20,000 feet high. At 3AM on summit day we were a couple hours down from the top when we stopped to rest in the near-freezing temperatures. For some silly reason Bill Keig and I started imagining what kind of a meal we would like to eat. You’d have to be there to realize how utterly absurd this conversation was. We were at about 18,000 feet. We were many, many miles from any kind of restaurant or other civilization…  My fantasy meal was something like a breaded pork chop with gravy and a twice-baked potato, some hot veggies and a piece of apple cobbler… I think Bill wanted a porterhouse steak. We then turned to our head guide, Naiman, a Masai native with many Kili climbs to his credit. I’ll never forget his answer..  After a little thought, he said, “I would like a bowl of beans and rice...”

This is called a reality check... a sudden shift that brings you back to the real world. In our case Naiman’s simple desire for a bowl of beans and rice made our extravagant food dreams seem pretty absurd.

A heart attack is also a reality check. One that changes everything, literally, in a heartbeat.

For me we’ll start the story on the evening of Tuesday, January 13^th. I was editing short ‘Grandpa Adventure’ videos of my adventures with my grandchildren. I post them on my YouTube page for them to watch. In the early evening I suddenly felt a sharp pang in my heart. This was like nothing I had ever felt before. My first thought was to call Linda, but she was working and is unable to answer her cell phone during her employment. I checked my laptop and Google’d ‘Heart Attack.’ There were a half dozen symptoms listed. By the time I got half way down the list – check – check – check… I knew something seriously bad was happening. The last item suggested taking two aspirin to mitigate the effects. I ran desperately through the house. Motrin, Ibuprofen, Excedrin, Sudafed. Where is there just plain old aspirin!!? Suddenly I remembered that my big backpack had a pretty comprehensive first-aid kit, I ran into the garage and tore open the kit and forced down two aspirin. I was fading fast. I considered calling an ambulance, but knew it would take a long time for them to get to our house. My forehead was sweating a strange, cold sweat. I felt woozy. I decided to drive to the emergency room at West Health, about five minutes away. This is not recommended behavior, but in my case, I felt it was my only option. Things were deteriorating very fast.

I arrived at the emergency entrance and saw that I was supposed to park about a half block away in a small parking lot. I realized that at the rate I was fading, I simply had to stop the car in the ER driveway and find someone. This is the last memory I have. I woke up nine days later in the ICU at Abbott Hospital. What actually happened has disappeared from my memory. According to the doctors, I made it into the desk inside and said, “I think I’m having a heart attack!” Within about one or two minutes that is exactly what happened. A major myocardial infarction. 

There are different levels of heart attack - from small ones that the person suffering it isn't even aware of... to big ones, where there is no question. I had ninety-nine percent blockage in the left coronary artery, often referred to by the docs as the ‘widow-maker.’ Without intervention, you are dead in six minutes. Unfortunately, this event was followed by something even worse. Cardiac Arrest. The heart stops completely. The 'electrical circuits' which usually drive the heartbeat - stop or become confused. One doctor described this as an 'electrical storm' in the heart. There is no clear signal to make the heart muscles contract in sequence.  Six times they tried to restart my heart with the electric defibrillation pads. Hopefully, these shocks will clear away the 'electrical storm' and allow the heart to find a clear beat again. Nothing worked. I was assumed dead - there was no longer a heartbeat. In my records I was delared 'clinically dead.' The attempts to restart my heart with the defibrillator had failed. The very high voltage jolt from the defibrillator can't be administered forever, it's just too damaging to the body. The ER docs had done everything they knew and it was time for a last-ditch effort. They strapped a Lucas chest compression machine on me. This uses a battery-powered motor that runs a plunger, kind of like a toilet plunger, to do chest compression's at a rate similar to a heartbeat. Nobody wants to use this technology unless it's necessary.  All of the outside flexing of the rib cage is known to break the ribs of the patient. I was packed into an ambulance and shipped to Abbott Northwestern Heart Hospital- fifteen miles away.

Now let me interrupt the story by mentioning that my mother died of a heart condition. Her father died as the result of several heart attacks. The doctors had always asked me if I had any history of heart disease in my family. My reply was always that I did, but I was staying active, riding my bike hundreds - and thousands - of miles, kayaking, backpacking, snowshoeing, climbing, etc. My cholesterol was in line, my blood pressure was right on target and my weight was pretty close to where it should be. These stats and my active behavior always got me a positive nod from the docs. You can look at my earlier blog posts to get an idea of my lifestyle.

So where did I go for nine days of unconsciousness? My body was cooled and I was put into a state of a hypothermia. I was essentially in suspended animation in hopes that my brain function could be maintained while they tried remove the heart attack blockage with a stent and get my heart beating right again. If everything goes right they bring you back in a day or so. It must be done in a slow, safe, and controlled way. For me, I was in for nine days of out-of-body adventure. I have no way of knowing where these memories came from. I was on a drug called Propofol. I suspect that most of these memories are combined with snips of real experiences in the hospital during episodes when they tried to bring me back, but then reversed the process when a complication would occur. This happened over and over.

So here are a few of my adventures:

I was convinced I was in a tourist lodge in Ely, Minnesota that had been converted to a hospital room. Doctors were working on me and I could watch them from across the room. They labored over me for days. Sometimes I was seeing things from inside myself – sometimes from the outside. The details of the setting are so vivid that I could give you an extremely detailed view of the room and the conditions. Even the Minnesota travel posters on the wall. Sometimes they were looking into my face and calling my name, but I just couldn’t respond. The 'hotel room' was fitted out with all kinds of hospital gear which surprised me. At one point the hotel owner came in and told the doctors the room had been rented to someone else and they would have to clear out. This gave me  a very high level of anxiety. I was afraid we'd be turned out and I knew I was very, very weak.

I also found myself with Linda, driving to Denver, Colorado and stopping at a hotel with a restaurant. Nurses there were massaging my head and upper body while I lay on the carpeted floor outside the restaurant. People were talking to me but I couldn’t respond. Some were asking me to blink… but I couldn’t figure out why… I’m a certified open-water SCUBA diver and it was as if I was under thirty or forty feet of water looking up. Fish, other divers, and the dive boat were all way above me and my name was being called, but I couldn’t respond. It was just too hard. I felt like just staying down there forever where it was comfortable. Finally, we went into the restaurant to eat, but I couldn't talk. The seeming 'reality' of the Denver road trip stayed with me for a week after I was conscious again. My experience was so vivid that really felt that we had driven to Denver.

In my unconscious wanderings I also showed up in a small hospital, also in Ely. It had been converted from an old-style Holiday Inn where there is a large central court with a swimming pool.  Remarkably, this hospital closed for the weekend. They escorted me to the door and left me outside on my own while everyone left. I felt utterly abandoned and terribly cold, weak and vulnerable. I found a yard bag of leaves outside on the lawn curled up inside and tried to sleep, but couldn’t. A security guard found me and tried to arrest me. She accused me of being homeless and took a blood sample. She said that this would positively identify me and if they caught me there again I would be jailed. I told her I was a patient at the hospital waiting for it to open on Monday. She left and checked and confirmed this, and said I should be inside. I waited and waited for help to come but none ever did. All of this time I felt cold.

Next, in a larger adjacent room in the imaginary Ely hospital I witnessed a Turkish wedding and reception. There was music, treats, dancing, etc. I watched it all for hours from both inside and outside my body. Finally, the hospital re-opened and I was put back in a bed. I asked for warm blankets and was given them. My long weekend outside was thankfully over and the blankets felt so good.

At one point I was sitting on the edge of a sharp precipice with my legs hanging over the edge. Below me was an infinitely deep gorge.  Next to me I found two very large white-feathered wings, each, perhaps, six feet or more in length. I picked one up and examined it closely. Each wing was made up of thousands of very small feathers. I studied these wings in detail and realized somehow that each feather represented a prayer that had been said in my behalf. I thought, “These wings are so large that I could actually pick them up and fly with them.”

Finally, once again, I was back in the imaginary tourist lodge/hospital room in Ely. It was evening. My friend Fergus was looking into my face saying my name. For the first time, I remember being able to respond. I was finally back.

Now there were many, many more Propofol wanderings that occurred and continued to come over the next few days. I was totally convinced I was still in Ely for over a week. In spite of massive evidence to the contrary, I was convinced I was in Ely. The nurses would ask, "Do you know where you are?" I'd say "Ely" They would correct me. Finally, I decided to play their game. I'd say, "I'm in Minneapolis - but I know we're really in Ely." I looked at the whiteboard in my room and all the notations. I was convinced that one of the doctors had put an exercise class schedule there and I was supposed to attend. I just couldn't move. I felt bad about missing the doctor's classes.

I contracted pneumonia and had to be medicated.

The breathing tube I had in my throat for the nine days left me hoarse.

Nurses had to accompany me to the bathroom and wipe me.

Trying to sleep was next to impossible. They constantly woke me up to check on me. Bell-like alarms for other patients kept going off all night long. I was convinced that the alarm bells were really a vintage train bell mounted on the roof of the lodge I was in. People were always grabbing the rope hanging down from it and ringing it for fun. It annoyed me that they'd let people do this in a lodge that had patients in it. I fell into a delirious state for much of the time while I was coming to. It was all very disorienting.

When I came out of my suspension I had lost the ability to eat or walk. These had to be re-learned over the next few days. I would look at the fork on my tray and try to figure out how to get it into my mouth, but couldn’t make it go where I wanted.  Food, in general, smelled very bad with many ‘off-odors’ and I could eat next to nothing. I lost twenty pounds during three weeks in the hospital.

Eventually, I could walk with a walker. I could eat. After a few more days I could even check email. I was beginning to reappear in life after a long and perilous journey. Fortunately, my recovery was in the hands of highly skilled doctors and nurses who managed my trip. Not everyone comes back from these therapeutic hypothermia ‘suspended animation’ treatments. Generally, the ‘fitter’ you are, the higher your likelihood of a good outcome. In the end, my level of fitness actually served to bring me back quickly and safely. In fact, doctor after doctor looked at my charts and my progress and commented, ‘You must have been in really good shape... and no broken ribs from the Lucas machine’ Now, I don’t actually think I was in that good of a shape – but nevertheless, I’m back. I’m walking around. I’m alive. My family heart history finally ‘trumped the clock’ according to the docs. A frightening reality check on my mortality. 

A final word on fitness. One doctor told me that as my somewhat, genetically small, LAD artery was closing over the years, that my active lifestyle, my thousands of miles on bikes had caused a network of smaller blood vessels in the vicinity to grow and build capacity around the 'widow-maker' LAD. Without that extra capacity I had unwittingly developed, I probably would have died almost instantly from my heart failure.

During this time my dear children gathered, literally from around the world, to come to my side. My daughter Amber came from the Republic of Georgia on the other side of the planet. One day I’d awake to my oldest daughter, Kali, touching my cheek. The next day I’d turn over and it was my youngest daughter, Britta tucking in my blankets. My sweet wife kept all the medical details straight. My entire family, including many of my twenty grandchildren, rotated through my room. How can one value enough, such love and attention?

Today it’s almost exactly one month since my heart attack. I’m home, happy, weak and grateful. I have flown back to reality on wings of many, many prayers, uttered by hundreds of friends from around the world. I am amazed. The docs predict I’ll be able to return to my normal levels of activity. For now I’m happy to lie low. Nurse Linda keeps a close watch on my activity. She warms me up when I get into bed. She counts out my pills. She buys any food I want. She loves me. I’m a fortunate man.