Special Report: When Your Life Depends on Strangers.
From Nurse to Patient, What Happens when You are Hospitalized with an MI.
As some of you know I had an unexpected adventure a few years ago pre-Covid that for a few days took me inside Metrohealth Hospital in Cleveland Ohio.
October 23, 2019, was a typical Thursday, not by any sense an unusual day. It was the next morning the 24th that forever changed my outlook on life.
I woke earlier than normal having this feeling of a dull ache in my chest a little over on the left side below my fib cage. Very similar to indigestion or heartburn. Drinking water with antacid tablets didn’t make it go away. When my left arm had an unusual feeling that was a solid signal to get it checked out. I drove myself to MetroHealth ER and was told after a review of a 12 lead EKG I was having a heart attack, in this case, an NSTEMI, or Non-ST Elevated Myocardial Infarction. My heart muscle was not getting enough oxygenated blood due to the blockage of an artery. My life-sustaining heart muscle tissue was being destroyed.
I was taken by ambulance to the main campus and placed in the Coronary Intensive Care Unit at MetroHealth Hospital.
A lot of you want to know how I'm doing. Well, (Spoiler Alert) I'm doing well.
Here was my account of Friday, Oct 25, 2019, the day I went for a Cardiac Catheterization:
It's 10 O'Clock on a Friday morning. That persistent chest pain subsided to 2 out of 10 on the pain scale but remained my unwanted constant companion. Haven’t had anything to eat since Wednesday evening but I’m not hungry. An IV attached to my left arm kept me hydrated through the night. No other symptoms. The EKG Tech wheels in her rolling kiosk hook up 6 chest leads, then separate leads on each shoulder and leg. Tells me to lay back and relax.
A few long minutes later, she flips a switch, unplugs the leads and cord, and quickly rolls out of the room. People are milling around outside my room and a red chart is placed at the foot of my bed. I hear a voice telling me, "It's time to go.". I breathe a sigh of relief, but my chest pain increased as I tried to lay flat in bed on my left side as it did for the ultrasound done earlier.
Several people surrounded my bed and with a loud click to unlock the bed brake I was off. With the head of the bed elevated to maximize my comfort, I had a driver-side view of the corridors and hallway, and elevators leading me to the cath room. There must have been 5 or 6 people each with their hand on the bed holding some part as they push and steer around the tight corners. I was still connected to my IV and the wires from my chest led to a small portable Tele-Box neatly fitting my hospital gown's front pocket; my own portable EKG monitor.
My wheels for this ride were part of a new model of a cardiac bed that was motorized and battery-operated to keep the air mattress inflated. See, when a patient goes into a full arrest the mattress gets deflated and the patient is on a hard surface for CPR. It's sad to think for some patients that the sound of the air whooshing out the mattress is the last thing they hear. But not today, we are running through all the red lights with the silent sirens on as everyone in front of us moves out of our way. I had to stop myself several times from jumping out of this bed and helping the others push this baby to the finish line.
We're now slowly coasting to a walking speed as we round a few more corners into a large room. There are stalls with curtains covering the entrance and some had occupied beds. I'm wheeled out in the open between the wall and the counter that appears to be the nurse's station. The nerve center, as well as the heart of the operations. Nurses and techs were busying themselves with the tasks at hand, some getting pain medication while others are taking vital signs. My bed runners have all disappeared into the corridors and hallways. I was alone, waiting. Well, this certainly is not the Cath Lab. More like a PACU, a Post Anesthesia Care Unit. Where patients come out of surgery or some procedure and wait to wake up. Then when their vital signs are stable and are awake, they are whisked away on their rolling beds and a new bed with an anesthetized patient waking up takes that spot.
"Hey, guys! Let go for a ride around the corridors again till the Cath Lab is ready for me!" but no one reads my thoughts. No one turns their head to see me lying in this bed. I have become invisible. They are busy passing medication, taking vital signs, and talking about renewing their nursing license. So I lay here watching the unit do its thing. I strain my ears to hear any juicy hospital gossip. Ah, soon I hear a few nurses talking about... not having their nursing licenses renewed yet. "You won't be working here come the first of the month," I hear someone say. "Oh, I'll get it, don't you worry." That nurse sounded pretty sure of herself. She has less than a week to get it. Then a dark-haired female wearing a white lab coat pokes her head in through the doorway and makes eye contact with me. "There you are!" She exclaimed in a “glad I found you” voice. "We are ready for you, now." She said in a cheerful voice as she approached the foot of the bed, grabbed it, and yanked the bed away from against the wall. Turned it around and out the door, we flew. Another helper got behind me at the head and soon we entered a doorway with a sign that read Cardiac Catheter Room.
The room was much smaller than I had expected. 3 people in gowns and masks with heads covered in a surgical hoodies were moving about. There were large cardboard boxes on the floor as the bed rolled up to them and the table on my left side was small, narrow, flat, and covered with a light green sheet down to the floor. My bed was rolled alongside and the masked people asked if I can scoot over to their table on my left. At the head of the table, there appeared a large metal arm in the shape of the letter 'C'. My head and torso are soon to be swallowed by this gigantic metallic 'Pacman'. My bed was raised and I was asked to scoot over. A couple of other masked people entered the room and each one took turns introducing themselves in a pleasant friendly way. There was laughter and inside jokes being thrown around. The atmosphere was surely jovial. They asked if I was right or left-handed, and for my name, and my birthdate to verify they got the right victim to sacrifice on this cold metal altar. Then came out a clipboard with the consent for treatment for me to sign. Oh yea, I looked that over really well as I was making sure I don't see the names of Dr. Moe Howard, Dr. Larry Fine, and Dr. Curly Howard on the form. No loopholes that I could tell. I sign.
So now they get serious and explain what they are going to do. The plan is to insert a catheter into my right wrist in the Radial Artery that is just behind the thumb. Now there are times, he explains, they find the artery twists and turns so much they can't get the catheter to advance. so, plan B was to use the artery in my right groin to get a catheter in there. Both areas are shaved and prepped. Oh yea, there's a guy with an electric razor shaving off the hair on my right wrist and right groin.
Then the most painful of rituals: "pulling off the EKG pads" begins. My chest was covered in dozens of these EKG sticky pads since my admission to ER yesterday and I’m a hairy chesty guy. This was nothing short of pure torture! It seems everyone around me had a chance to play, but first, they have to make a wish, and the one with the most hair on the pad, well, their wish comes true.
Now they said they will give me a light sedative in my IV line. I think I heard 50 micrograms of fentanyl and 2 milligrams of versed. 50/2 was bantered about. I pray they don’t confuse the doses. Depending on how long this will take it could take a few doses. They asked me to raise my hips as a large flat board was slipped under my butt and the board extended to where my right arm would sit. Bed extensions slid into place on my left side wrapped around my torso and waist. No doubt, making sure this victim doesn't change his mind and run screaming down the hall. Just to be absolutely sure they had me remove my underwear and pajama bottoms. Nothing on but this hospital gown to keep me warm and I was cold. Then came out a large sterile surgical blanket that covered me from my neck to my knees and that felt so warm and toasty.
My right hand was taped down to the extension board and across my palm exposing the radial artery behind my thumb up and center. The injection was given in my IV and slowly I went into a light slumber. Unable to raise my head to see my right arm I felt what was a large razor-sharp scalpel cutting down my wrist. I imagined this is what an amputation must feel like and I knew when I woke up I would have someone else's hand attached. But the pain soon stopped and all eyes were watching the monitors on my left side. You see, what I was sitting on was an X-ray machine that was set up to view the heart and henceforth the catheter as it works its way upstream to the heart and around some arterial corner to the descending arteries of the heart. Some dye is released and the clots, if any, show up as obstructions on the monitor. And there they were. I can't remember what was said but I could see out of the corner of my eye the X-ray monitors. The contrast created a dark fluid flowing in my heart's arteries, fluctuating with each beat of my heart. My eyes strained to see as much as I could as I fought off the slumber of the medication. The meds won. I slowly awoke to see they were still trying to get another stent in place and sounded like they were having a difficult time. Another dose of 50/2 and I was out. I came to as the masked people were done and sounded pleased with their work.
Somehow I scooted over to my motorized cardiac bed and was wheeled back to my room. Around my wrist was a clear plastic band with a port to inflate and deflate air to create a tight dressing on the wrist wound. The plastic band was my only reminder I just had a cardiac catheterization with 3 stent placements. I recall it was 2:30 in the afternoon and a tray of food was brought into my room. Matt, my nurse, took my vitals, and reattached me to the heart monitor, yes, new EKG stickers were applied, and a pulse oximeter probe on my finger with that red LED light that makes me want to play ET and touch Eliott to make him feel better. But now the chest pain was gone and I had a food tray to devour, I haven't eaten in 2 days. A slice of turkey with gravy, corn, mashed potatoes, and gravy. The last meal I had at home was potato soup with extra potatoes I threw in and mixed veggies. That's what I thought had given me indigestion the next morning. I had turkey and corn and greek yogurt. Forget those potatoes. Now to rest up so I can get out of here and be back home.
Ahh, the pain has all but gone. Just a little soreness when I take a deep breath. Time to catch up on the local and world events on TV and maybe a sitcom or two. But something is not feeling right. A dull ache is returning in the same place. I call for the nurse and get a couple of Tylenol. It helped a lot yesterday but not it's not touching it. The pain gets worse and it's spreading over a larger area in my left chest It's 7 pm and laying on my back is unbearable. I turn to my side and no relief. I sit up on the side of the bed. A little better. I lean forward and it gets worse. Same if I lean right and left. There's this one spot where I can tolerate it. I get up and walk to the chair and sit. It's only getting worse. I call for the nurse and I get an Oxycodone 5mg tab. If anything the analgesic kept it from getting worse. The nurse gets the house doctor, a young woman probably in her mid 20's Asks me all the pertinent questions. Orders a 12 lead EKG Stat. I find it really hard to lay flat to get a good reading. Got to sit upright, Don't remember much after that. Fitful night. Only catching a few moments of sleep Something went wrong and my heart is letting me know. The doc comes in and said they are getting the cardiac cath team ready. They are going back in. I glance at the black and white clock on the wall. It's 4 am. People are moving my bed out in the hall and down the corridors. Round the corners and directly into the same cath room I was in earlier. The routine is familiar now. Scoot over. Butt up. Side extensions. IV sedation and I'm out. I come to and I find myself back in my room. The IV heparin stopped and another IV anticoagulant got hung up. The night nurse was giving her report to the day nurse and I called her over to thank her. I told her I was feeling better and she said I had Percoset available if I needed it and yes I needed it.
The docs were getting ready to make their rounds. A young guy in his mid 40's, wearing a lab coat. A short black beard covered his chin as he approaches me. Introduces himself and said he was going to my attending cardiac doctor. He looked at me and immediately knew what I was going to ask. "What happened?" "There is nothing wrong with the stents, they are doing well", he continued, "what we think you had was Pericarditis. The sac that covers the heart got inflamed." He said he ordered an anti-inflammatory drug that will help, Colchicine. My nursing background chimed in, "Isn't that for gout?" I asked and he replied, "yes, but it is the drug of choice for pericarditis as well." Within an hour after my first dose of 0.6 mg of Colchicine the chest pain disappears.
One more night here and if all goes well I can leave tomorrow afternoon. And all did go well. I had visits from family and friends that afternoon and the next day feeling better I was ready to leave.
It was an experience I will not soon forget and I had a zillion questions still unanswered. Medical science has done a good job of providing the answer to “how” but my biggest question is “why?” Why me and why now? And that… will remain a lingering question for a future health practitioner to answer.
This was an incredible journey and my most sincere gratitude goes to all the healthcare practitioners at MetroHealth Hospital who really know their craft well.