ST-Elevation Myocardial Infarction (STEMI) is a very serious type of heart attack during which one of the heart’s major arteries (one of the arteries that supplies oxygen and nutrient-rich blood to the heart muscle) is blocked. ST-segment elevation is an abnormality detected on the 12-lead ECG.
https://www.ecgmedicaltraining.com/what-is-a-stemi/
I experienced one of these on Saturday, May 30 2020 at approximately 7:00 p.m. in my right coronary artery. It was blocked 100%.
At first I did not realize the symptoms. The night before I had been running around with my son outside, and found I had a very hard time breathing. I have asthma, so I just figured it was an allergy or exercise induced asthma attack. I used my albuterol rescue inhaler, and about 30 minutes later felt fine.
I experienced another one of these hard to breathe episodes at 11:00 a.m. May 30. This one had a little chest discomfort, but I thought it was just because I was breathing so hard. Some albuterol, this time via a nebulizer, and I was good to go.
There was some work scheduled for my job at 1:00 p.m. I was able to get started on that and was just fine. I worked in my home office until about 4:00 p.m., at which time I went upstairs to be with my family out on the deck. I was still working on things, however it was not as intense as earlier in the day. I figured I could work on the laptop outdoors and enjoy the weather.
At 4:30 p.m., my breathing started to get difficult again and I had discomfort in my chest. The onset was fast. I did two puffs of my rescue inhaler, but that did not seem to help. I also did some additional albuterol via the nebulizer.
My chest got very uncomfortable. Some may call it the feeling of somebody sitting on the chest, but that’s not what it felt like to me. I also could not catch my breath.
My wife took a good look at me and said, “Do you need to go to the emergency room?”
I replied, “maybe”.
She took another look at me and said, “So are we calling 911 or am I driving you?” Under no uncertain terms would I not be going to the emergency room.
The albuterol was starting to help so I asked her to drive me. We were lucky that my sister-in-law was visiting, and she could keep an eye on the kids. Off we went.
My wife often drives fast; it is her nature. She drove faster than I have ever seen her drive before. Before long we were at the local hospital. During the drive, my breathing became a little deeper and my chest was a little less uncomfortable. I figured things were getting better. We pulled into the Emergency Department area.
She ran in to get some help and a wheelchair. Her and two other people rushed out the door and over to get me. I sat down in the chair and they wheeled me on in. They asked me a few questions to see what the issue was, and I explained I was having a hard time breathing and my chest was uncomfortable. I also stated I thought it was an asthma attack but it could be a heart attack.
It took all of 2 minutes to get past registration and into a triage room. I had my driver’s license and my insurance card in hand, and just handed them over. If you go to the emergency room, this is probably the best way to go about it. It was fast.
In the triage room they checked my blood pressure, set an IV to draw several vials of blood, did an EKG, and gave me a nitroglycerin for the chest pain. The nitro didn’t help.
The EKG looked normal. I assumed it was just a bad asthma attack.
I was asked to sit in a wheelchair, and off we went for two chest x-rays. I have no idea what those revealed, nor what they were looking for. I was back in the room within 10 minutes.
About an hour later they drew some more blood. The doctor suggested another breathing treatment and I mentioned I had used my rescue inhaler and did a nebulizer of albuterol at 5:00. She said that I could have as much albuterol as needed, and it would not be a problem.
At 6:45 p.m., a respiratory therapist came in with a mix of albuterol and something else. She instructed slow deep breaths, which I did to the best of my ability. My chest was still uncomfortable, but I was thinking it was just because of how hard I was breathing. My ribs hurt. It wasn’t my central chest.
Just before 7:00 p.m., the tech came back in and did another EKG. This time the tech running it said, “That’s a change” and ripped the leads right off my body in one big swing. She grabbed the printout and rushed out of the room.
Within a minute, the room was full of people. The first one in said, “We need you to take your pants off.”
In my confusion I turn to my wife and said “Do I really need to take my pants off?” She replied with a yes.
I undid my belt and slid my pants down. “Underwear too” and off they went. The next thing I knew a man with some clippers was trimming my most private area.
Then it hit me. They were prepping me for the cath lab or the operating room. I think I said something along the lines of, “I guess I’m staying?” Somebody nodded and said “Yes, you are”.
Then I got ,”Mr Welshans, you are having a heart attack. I have some papers to go over with you right now”. She went over multiple procedures and contingencies, and asked me to initial and sign for consent to treat. It covered everything from the heart catheter to full open heart surgery.
“We are going to take you right now to the cath lab and get you taken care of. You are lucky, the cath team left under 30 minutes ago. I think they might still be in the parking lot.”
At some point they gave me some morphine for the pain. I really didn’t notice a difference.
During all this, I looked up at my wife several times. Was this the last time I would ever see her? Was this the last time she saw me alive? There were so many emotions in such a short time. Fear, regret, guilt, but also hope for a good outcome.
I have never been more scared in my entire life.
With a quick I love you to my wife, I was wheeled out the door and down the hall, triage bed and all.
It was a short trip to the cath lab. All I could do was try to breathe normally. I was still having a difficult time of it. My chest was hurting.
As they wheeled me into the cath lab, I looked around. The room was dark for the most part. There were a couple of funny stickers on the x-ray arm. I wish I could remember them. One of the people in the room said “Welcome back!”. She must have been the x-ray tech for my chest x-rays.
They aligned the triage bed to the x-ray platform of the cath lab, and had me carefully scoot over, hips first. That was a hard plastic table.
Once they moved the triage bed out of the way, they carefully inserted a couple of things in the table to keep my arms from dangling off the side. That felt a lot better.
Somebody asked, “Can you slow down your breathing?” I replied that I was trying, but it felt like I couldn’t breathe. “Don’t worry we’re going to give you something to relax you.”
During this, somebody was trimming up my groin again. I mentioned that they had already done it in the emergency room. Whoever was doing it said to me “Well they didn’t do a very good job.”
Once that person was done trimming me up, they slathered the whole area with disinfectant, probably iodine. It was cold. They then put a drape over me with what felt like a hole over my hip. My manly bits were sort of covered. I honestly didn’t care.
I’m pretty sure the drugs were starting to kick in at this point. My memory is very hazy, and I have some time dilation. Versed is a hell of a drug.
I remember the doctor telling me who he was, and what he was going to do. I remember him ripping away the cover over my groin area. I remember him saying “You’re going to feel some pressure now”.
I very much remember the pressure over my right hip and groin area. It included quite a bit of discomfort as they shoved the things into my leg.
I don’t know how much time later I heard the doctor say “You’re going to feel a burning sensation in your leg.”. He was correct and I told him that I felt it burning. He said it was normal.
Time passed. I have no idea how much.
I do remember suddenly being conscious of something moving around in my heart. I could feel it. It was unnerving. I mentioned to the doctor that I could feel him in my heart. He replied “Yes. It’s okay, we are almost done”.
I flashed back to consciousness again. There was a hospital bed next to me, and I was hovering down towards it. Somebody said to me, “Cross your arms over your chest, Mr Welshans. Do not move your right leg. We are going to slide you over to this bed.”
They did just that. I’m pretty sure I said Weee! I just knew my breathing was normal, and my chest didn’t hurt. I assumed things were a success.
It was explained to me that they had installed two stents into one of my arteries. I was going to be OK. Whew!
The next thing I knew, they were wheeling my bed down the halls, up the elevator, and into the room I would be spending the next several days in.
It was now 9:00 p.m., at least I think so. My wife was brought to my room and we talked a little bit. I was just glad to see her.
The nurses hooked up a saline drip to the IV in my right arm. They also put a pulse oximeter on my finger and all the heart monitor leads on my chest.
I had my first experience peeing into a bed urinal. Basically a jar. It really didn’t matter to me that the nurse had to line things up. I was just happy to pee. Relief.
My memory is still very fuzzy of that first night.
I do know that we talked a bit with the nurse manager. She was doing all of my initial care in the room. At one point she said, “Well you look a lot more pink than the last time I saw you. When I saw you downstairs going into the cath lab, you were as white as this sheet”.
She also mentioned that she and another nurse had to pull a couple of things out of my leg, and they would have to put pressure on my groin for about an hour. She said it was going to be one of the most uncomfortable things ever.
I had to joke about it. I said, “I bet it will be. You know, two strange women around my groin area, with my wife in the room”.
At least I got a chuckle from the nurses and my wife.
She was right, they had to take turns putting pressure on my femoral artery, and a femoral vein to cut down on the bleeding as they removed the sheaths that allowed access for the catheters. Once I was appropriately clotted up, they put on a pressure bandage.
I was told once again to not move my leg for the next 4 hours. Do not lift it, do not bend it, do not do any movements.
After all, there was a hole in my femoral artery that was being blocked by a clot, in a body that was being treated with anti-clotting medication.
You better believe I didn’t move that leg.
I did ask what I should do when I slept. They replied that they were going to try to lock down my leg with a sheet, mainly as a reminder to not move the leg.
Again, my memory is hazy. There are gaps in it.
At some point my wife went home, and that started a very long night for me. I think the blood pressure cuff was set to automatically run every 15 minutes. Every time it ran it felt it was pinching my arm off. It also felt like it was cutting into the IV in that arm. Ouch.
The nurse also came in what felt like every 15 minutes to check on my femoral incision area. It may have been every hour in real time. I’m really not sure. It sure felt like every 15 minutes, right after the blood pressure cuff did its thing.
I had to pee several times that night. Once again with assistance into a urinal jar.
I got to the point where I joked with myself that I had left my dignity and modesty down in the emergency department. After all, I had a nurse peeking at my groin area several times over the night, and making sure that everything lined up so that I could pee. Privacy? Nope.
I did drift off at some point towards morning. I know this because I woke up to my heart monitor screaming for attention. I could feel my heart beating incredibly fast. I mashed my call button, but they were already on their way to my room to check on me.
It seems that once blood flow is restored to the heart, the heart gets a little sensitive about it. Anything will set off what is called a vtac, or ventricular tachycardia.
What it means is that the heart isn’t beating, it’s twitching. If it is twitching, it isn’t pumping blood.
The nurse explained to me that what I’m feeling is oxygen now profusing into my heart muscle much better than it was before. Those cells now have more energy and the mechanism to control them is used to how things were running before and it sometimes can’t keep up with how things are now.
Basically the twitchiness is very common and will go away in a day or two.
I tried to doze some, but it just wasn’t going to happen. They came in early for a temperature and blood sugar finger stick. Followed by another EKG. There was also a blood draw from one of my two IVs.
When it got to 8:00 a.m., I was met with a most delicious breakfast of scrambled eggs and hash browns. I wasn’t hungry until I smelled the food.
I spent the time until lunch dozing. I did not feel very good at all. The lack of sleep was awful.
My wife arrived after lunch, and that made the rest of the day so much better. We made small talk and serious talk about the future. She left just before dinner to go home and watch the kids.
Dinner was bleh. Dried out chicken or pork with the breading falling off of it. I ate the meat and left the breading. I also didn’t eat the pile of greens. I did, however, enjoy the sweet potatoes. I believe dessert was sugar-free vanilla pudding.
I slept that night, at least as much as you can in a hospital. They were in every 4 hours to check temperature and blood sugars. Also to look at the bandage in my groin. As an added plus, they strapped on the inflatable bladders to help prevent blood clots in my lower legs.
Those bladders alternate left right left right and varying degrees of squeeze. There is no rhythm to it. Overnight they started to hurt a little bit in pressure points.
Monday morning was another breakfast of eggs and hash browns along with some oatmeal. Yeah, it was delicious. It could be because I had not eaten in 14 hours.
This day they got me up in a chair and off the bed. It was nice to sit up. While I was in the chair they disconnected my IV and the blood pressure cuff. Both of those freed my arms up, which was nice.
I spent much of the day thinking. Being in the hospital gives you a lot of time to think. I also was on my phone a bit following up with recent social and political developments.
There was a little bit of a scare due to the protests and rioting that had happened in downtown Louisville. It seems some people had breached the emergency department at a downtown hospital and messed the place up. This placed my hospital on lockdown, as well. Thankfully they removed the lockdown and my wife was able to visit again.
I went for a short walk around the ICU. Apparently, my heart didn’t mind at all. My legs were ok, but I was a little light headed.
I got a visit by my cardiologist towards the end of Monday, and he was thinking that perhaps I would go home the next day. Good news!
I got up Tuesday morning and asked to go for a walk right after breakfast. I went twice around the ICU, and my nurse commented that I was doing great.
Before long lunch came around and a little while after I finished it, my cardiologist came in.
He said that he felt I was good to go home. He asked if I felt the same, and I fully agreed. We discussed a few things for scheduling, and what each of my new medicines did.
I was discharged and out the door 3 hours later. It was good to go home.
During the drive, my wife asked me if the trees and grass looked a little greener. “Are the greens greener?”
I replied, “Yes, and the sky is bluer”.
Pingback: Time to take the family on the boat | One Hobby Too Far