Sunday, October 08, 2006

What's your exit strategy?
My Heart Attack Reminded Me We Don’t Live Forever
by Paul Roberts

Lying on a hospital bed with a cancer diagnosis in the movie “The Thing About My Folks,” Olympia Dukakis muses about life and death. “One minute you’re here,” she says to her husband, played by Peter Falk, “the next minute you’re done.”

By many accounts, I was supposed to be done on September 25th, 2006. Ironically, it was my wife Anne’s 47th birthday. We were exchanging e-mails that afternoon – she from her corporate office, me from my home office, where I’m a 57-year-old independent writer and part-time faculty member at a local college.

The plan was to leave for The Eagle House Restaurant in Williamsville, a quaint suburb of Buffalo, New York, shortly after Anne’s arrival here around 5:30 p.m. But our plans were suddenly interrupted by chest pains that started around 4 o’clock.

Trying to describe the pain, which also radiated down my left arm in classic heart attack fashion, is like trying to explain the color orange to someone who has never had sight. Stabbing pain? Sharp pain? Pressure? Yes, all of those, yet something more. Something impossible to describe. You have to experience it yourself to truly understand, and I pray you will never have to.
I managed to endure the growing discomfort – hoping it would somehow just go away – until Anne arrived. We then headed for the emergency room at Millard Fillmore Suburban Hospital. But on the drive over I began to feel better, and foolishly insisted we head for the restaurant instead. “Are you sure?” my wife asked. Yes, I was sure.

I was wrong. A minute or two en route to the restaurant, the pain grew worse. So much so that I urgently pleaded with my wife to drive faster. Much faster. To the ER. She dropped me at the swing-out double doors and they took me ahead of most of the other patients, as they typically do with suspected cardiac cases. My chest felt like it was on fire, a stinging, sternum-crushing pressure that was making me nauseated. They tethered me to all manner of intravenous lines and bedside monitor connections.

While things didn’t exactly look rosy, Anne later told me she wasn’t overly worried. She knew I’d been in the ER twice within the last 6 months or so. The first time it was for similar chest pains, but they put me through every cardiac test known to man and found nothing. I later suspected it was an adverse reaction to medication I was on for high cholesterol – and voluntarily went off of the pills.

Then, several months later, I was again taken by ambulance to the ER, this time after a terrible bout with uncontrollable dizziness, vomiting, nausea, and a closed-throat feeling, as if I were wearing too tight a neck tie. Again, nothing definitive was found, though later my doctor’s physician assistant suspected it was vertigo.

Still, I carefully read the side effects of the high blood pressure medication I was on at the time. Sure enough, most of the symptoms I’d experienced were listed, both in the medicine box insert and on-line when I did further research. I likewise decided to stop taking that medication, too.
That, it turned out, was a mistake. A near fatal one.

Mind you, I’m not one of those stubborn, non-compliant patients. My plan was to find a new family doctor and re-establish myself with a medicine regimen. After all, I was aware that my cholesterol (and triglycerides) and blood pressure were high enough on the charts to require medication.

But it was while I was “between doctors” and off my meds that fate stepped in. Which brings me back to about 9:30 on the night of September 25, lying in unspeakable pain in the ER.
The chest discomfort was getting worse. I kept pleading with the doctors and nurses to give me more for the pain. More Lidocaine. More morphine. More of whatever they had that could make the pain go away.

Then I suddenly grew faint – that unsettling, dream-like and nauseating sense that you’re about to lose consciousness. This is another sensation difficult for anyone to relate to unless they’ve experienced it themselves. The last thing I remember is calling out for help – and feeling certain I was going to black out.

And then I faded to black. My wife later told me she looked in utter disbelief as my eyes rolled back in my head and my body began to convulse. The waveforms on the monitor were like the lines of a badly worked Etch-O-Sketch, random and formless.

“Everybody clear out!” a physician demanded – as Anne later told me. She suddenly realized how grave the situation had turned. She began making cell phone calls to family. And she began to pray.

My next sense of awareness, my next reality, was literally other-dimensional. It was as vivid, sharp, clear and real as anything I’ve ever seen or felt before. I was in the darkest room I’d ever seen, yet one bursting with blinding light. My perspective was not one of floating above my body, but rather as if I were seated in a chair in a corner of the room, dispassionately observing.
What I saw as clearly as anything I’d ever seen in my life – maybe more so – was the image of myself, abruptly sitting straight up on the ER bed. There was a horrifying scream. But I don’t recall if the image of myself was screaming, or if I – from that corner vantage point – screamed at the sight of me sitting up, as if I were coming back from the darkness. And the light. As if I was horrified to see I’d left for good, when somehow I didn’t think it was quite my time.
Then—though I have no sense of how much time elapsed – I began to see the gauzy image of doctors and nurses looking over me from my position on the ER bed. They began talking, perhaps explaining what they’d done – they shocked me with a defibrillator – and I thought, This could be real or this could be a dream. I didn’t quite know which.

Eventually I realized I’d come to. Or come back. A nurse later said to me, “Did you know you screamed when you came around?”

They informed me I would be taken immediately to their main facility downtown, which has a highly regarded cardiac unit. The siren-blaring ambulance trip lasted about 20 minutes. I have only a vague recollection of being hoisted onto the gurney, placed into the ambulance, and driven across town. Most of it was a surreal sense that, yes, this was happening to me, but minutes might have been hours, hours could have been days. Or seconds. In every way, my timing was as erratic as my heart had been only minutes before.

Once I arrived, they performed an emergency angiogram – going through my wrist rather than the more customary groin entrance point – and found a blood clot in an artery in my heart. They “neutralized” the clot (my term) and installed a stent, which is a small mesh-like cylinder designed to keep the artery open.

The next day I vomited a lot from all the morphine and probably other antiarrhythmic medications that had coursed through my body the night before, in an effort to reduce the pain. The nightmare was over. Or had it just begun?

Heart attack? Me? How we’ve heard it a million times before: “I never thought such a thing could ever happen to me!”

With the tremendous help of outstanding doctors and other medical professionals every step of the way, about whom I cannot say enough – and with prayers and the ultimate healing and fate-controlling hand of God – I’m here today, writing these words and thankful for what I have.
A wonderful doctor at the hospital, Dr. Fisher, told me I should write what he called a “Gratitude List,” jotting down the things for which I’m truly and ultimately grateful in life. Needless to say, it included the love of and for my wife, my daughters Catherine and Kristy; all my family, including my 88-year-old mother Mary, yet another jewel in my eternally blessed life.
You’ve heard it all before: watch what you eat, exercise more, eat less of the bad food and less of the good food, too. I was about 15 pounds overweight; that’s unhealthy. Limit cholesterol. Get out of a sedentary lifestyle; exercise makes the veins and arteries and heart function better. It’s also good for your mind, and the mind-body connection is huge.

I give thanks to so many, including, of course, our Creator. He ultimately makes the big decisions. On September 25th, he decided it wasn’t quite my time. Maybe, too, it was something of a birthday gift to Anne. Not so much the gift of me, but of an understanding as never before that life is short. Life is precious. That at any moment, you could be done.

I’ve enjoyed a renewed sense of religious belief over the past several years. This incident merely strengthens an already solid foundation of faith. It makes me more aware of the importance of an “exit strategy” – of being prepared, pragmatically and spiritually – for the date on the calendar when your time on Earth is through.

Be prepared, physically, emotionally, spiritually. Hug your loved ones. Do a good deed today. Take care of yourself, including your soul.

Then go live your life, each day. Enjoy it. Embrace it. And be sure to make a gratitude list.

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