On August 12, 2014, I underwent open heart surgery at East Texas Medical Center Hospital in Tyler in order to relieve the 95 percent blockage in my widow maker and the significant blockage in two of my other coronary arteries. During my first conversation with my surgeon after I left the intensive care unit, I heard him say: “You were a ticking time bomb. You are like an automobile that made it to the shop the day before it broke down on the side of the road.”
Six weeks later, I had my last meeting with my surgeon. Just before we concluded, I could not resist asking, “If I had not had surgery, how much longer would I have lived?”
The response was chilling: “Two months. Three months. Maybe six months or a year. We know that you had 95 percent blockage in the widow maker. When it gets to 100 percent, you will die.”
I survived because I listened to my body. I am writing this article with the hope that it could help others learn from my experience.
The Events of the Preceding Twelve Days
At 5:00 a.m. on July 31st, I rolled out of bed to go upstairs to my man cave for an aggressive workout on my Schwinn Airdyne. Before my feet hit the floor, I knew that something was wrong. I woke my wife, Robyn, and told her we needed to go to the emergency room—now. When we got there, I explained to the ER physician that there was something wrong in my chest; however, I could not be more specific than that. I immediately had an EKG and then spent the next eight hours at the East Texas Medical Center Hospital. Lab work was done on several occasions, and I wore a monitor while I was there. At the end of the day, I was told that it did not appear that I had a heart issue; however, I should consider scheduling a stress test.
On August 7th, I had that stress test and learned that I had blockage in some of my coronary arteries. My cardiologist told me that he would need to insert stints to relieve this blockage. Since Robyn was out of town, I chose not to have this procedure on the 8th, but to schedule it for the 11th. Even though my cardiologist was optimistic, we discussed whom I would want as a heart surgeon if surgery was required. He alerted that surgeon and an anesthesiologist that we might need them on August 12th.
On August 11th, I went to ETMC and talked with my cardiologist and the anesthesiologist. After that conversation, I thought I would be going home sometime after lunch. When I came out from under the anesthesia, I learned that the blockage was too significant for stints and that I would have surgery the following morning.
What Is a “Widow Maker”
That noted medical journal, Wikipedia, gives us this information:
The left anterior descending artery also known as the ‘widow maker,’ is an artery of the heart.
From the minute a widow maker heart attack hits, survival time ranges from minutes to several hours. Rapidly progressing symptoms should signal the need for immediate attention. Symptoms of initial onset may include nausea, shortness of breath, pain in the head, jaw, arms or chest, numbness in fingers, often of a novel but imprecise sensation which builds with irregular heart beat. Early symptoms may be mistaken for food poisoning, flu or general malaise until they intensify. A widow maker cannot kill instantly but induces cardiac arrest, which may do so within 10 to 20 minutes of no circulation. A victim with no pulse or breath is still alive, living off oxygen stored in the blood and may be able to be rescued if treatment is begun promptly within this window [emphasis added].
Lulled Into a False Sense of Security
In 2006, Robyn and I gave each other cardiac CT scans as Christmas presents—not exactly romantic, but each of our fathers had died of a heart attack or from complications following a heart attack. The results of my scan—confirmed by an angiogram—showed that I had moderate blockage in some of my coronary arteries. I took this news seriously and worked with my cardiologist and internist to address my condition.
My cardiologist scheduled a nuclear stress test each year for the next three years. None of the results of these tests indicated a worsening of my condition. Although my cardiologist continued to see me on an annual basis, he did not schedule any more stress tests for me.
My internist scheduled appointments and lab tests for me on a semi-annual basis. At each appointment, he would tell me that my lab results were pristine, and that he would not have a medical practice if all of his patients were as healthy as I was. He also prescribed medication to address cholesterol and blood pressure issues. After a year, my cholesterol level had dropped from 203 to 104, and I kept it below 110 for the next six years.
My responsibility was to eat properly and to exercise. I immediately became a vegetarian and, after three years, a vegan (a vegetarian who does not eat dairy products or eggs). At the beginning of 2014, I put fish back on my diet and became a seagan. Although my knees would not permit me to run or to walk long distances, I had a Bowflex and an Airdyne and exercised regularly. I thought that I was doing great, but heredity trumps hard work.
Were My Seven Years of a Healthy Lifestyle Wasted?
Not at all! My surgeon and my cardiologist each explained to me that my lifestyle had slowed the onset of the blockage to some degree. Because I was in excellent physical condition, I was a good candidate for open heart surgery. They also assured me that I would recover more quickly from the surgery because of my lifestyle.
How Could My Doctors Have Not Known of My Medical Crisis?
I thought that I had been asymptomatic for seven years and never mentioned anything to my cardiologist or my internist that would have indicated to them that I had a heart issue. Nothing in the laboratory results would have alerted them to that fact. Obviously, though, a stress test would have indicated that I had a significant issue. Why, then, did neither my cardiologist nor my internist suggest another stress test?
A respected local cardiologist wrote an article for our local newspaper in which he addressed how he determines who gets a stress test:
Stress testing is most often ordered in symptomatic or high-risk individuals to evaluate the probability that someone may have underlying cardiovascular or pulmonary disease, to estimate the severity of disease and to evaluate response to treatment Key words are “symptomatic”—stress testing is most appropriate in evaluating individuals with suspicious sounding symptoms, and “probability,” stress testing doesn’t deal in black and white answers about presence or absence of disease, but instead indicates how likely someone is to have underlying disease. People with a low likelihood of cardiovascular or pulmonary disease, people who don’t have symptoms, and people who are doing well on treatment often don’t need a stress test. Today we have very good evidence based guidelines that help direct us in our recommendations about who needs and doesn’t need a stress test [emphasis added].
But I Wasn’t Really Asymptomatic
How many times have we had a client say, “I would have mentioned this earlier, but I didn’t think it was important?” Now I understand how a client could fall into that trap. Although I did not realize it until several months after my surgery, I had a symptom that could have alerted my doctors to the need for a stress test—tiredness. Looking back, I remember feeling tired after walking to and from our two courthouses here in Tyler. Because I wear a three-piece wool suit year around, I thought at the time that the Texas heat was just getting to me. That mistake could have killed me.
The Road to Recovery
I thought that it would be a long journey from the intensive care unit at ETMC to being back in my law office and feeling better than I had in years, but I accomplished this in four months. When I left ETMC after seven days, I was exhausted by the three-mile ride to my home. Four days later, I was diagnosed with hospital-acquired pneumonia and had to spend another four days at ETMC. Then, I was really weak. By October 1st, though, I was able to return to my office on a limited basis and was back practicing law on a full-time basis by October 21st—and getting stronger every day.
The secret to my success? An absolutely fantastic cardiac rehabilitation program at ETMC. It was headed by a physician who was assisted by an RN and two clinical exercise physiologists who worked together as a team. They were magnificent. I went for one hour a day, three times a week for twelve weeks. At each session, they had me wear a heart monitor and checked my vital signs several times. When I began the program, this team held me back from doing too much exercise early on and then inspired me to work aggressively as I became stronger. When I finished the program in early December, the team told me that I was the poster child for cardiac rehab. [I have waited for a year to write this to make certain that my rehabilitation was as successful as I thought it was. It was.]
One Who Learned From My Experience
Two days after I had returned home from ETMC, Waldo came to my home and we visited about my experience. He was interested because he and I had similar lifestyles and because of the number of his friends who had required open heart surgery. Over the next several weeks, he became concerned and decided that he needed a stress test. When he mentioned this to his doctor, he was met with resistance. He was told that it was a waste of his time, and besides, his insurance carrier wouldn’t pay for the test. Waldo was not deterred and insisted on having the stress test. Four days after he received the results of his test, Waldo was scheduled for open heart surgery at Baylor hospital. He also had a triple bypass procedure—and he survived.
Do Not Worry About Being Embarrassed
When I was lying in the hospital bed on July 31st, I wondered if this was simply a waste of time for me and the doctors and nurses who were taking care of me. As it turned out, it was not. But even if it had been, there’s an old saying in every hospital emergency room in America: It’s better to be embarrassed than dead. If you ever have that feeling that something about your body just isn’t right, I hope that you’ll remember my experience.
Listen to your body and survive!