Showing posts with label Heart Attack. Show all posts
Showing posts with label Heart Attack. Show all posts

Friday, August 29, 2014

10 Years ago ~ HEART ATTACK ~ August 29, 2004




Image:dspecial.50webs.com/fire6031.jpg
I suppose if you’re going to have a heart attack, I had mine at an optimal time. I recently read an article about the efficacy of angioplasty and of stents (man-made 'tubes' inserted into a natural passage/conduit in the body to prevent, or counteract, a disease-induced, localized flow constriction). Its conclusion was that preventative stents are of questionable value—that the gold standard for inserting stents needs to be within an hour of a severe heart attack. That qualification fit my scenario to a ‘T.’

Saturday August 28th, 2004 was the wedding of Dan Hutchings & Rachael Lu, musician friends (Dan then of the Schola Cantorum at St. Francis) in the Green Room of the War Memorial Veteran’s building next to the opera house. Dan sang Schubert and Rachael accompanied him on the piano.

Dennis and I went to the ceremony and reception in the same room and sat at the table with Tom Hart from Chanticleer days. He said I looked terrific.

Earlier that day, I had gone to William Stout Architectural Books near work and bought a huge folio of Karl Friedrich Schinkel, the great 19th Century German architect. The book weighs about 80 pounds. I brought it home by taxi, but carried it upstairs and moved it around several times before settling on the floor in front of the Napoleon window in the dining room.

When I later suggested to my cardiologist, Sheryl Garrett, that this might have been the proximate cause of my heart attack the following morning, she agreed. She said it was the first time she had heard of a heart attack caused by a book! More common was somebody lifting a car engine.

On Sunday morning I woke up early, sopping wet. I frequently sweat a lot at night, but this was different. Dennis was still asleep. I decided to take a shower, which was probably not such a hot idea. Then Dennis got up and went down to the garden to read the paper, drink his coffee and have a smoke. I think I had some coffee. I’m sure I had already made a pot for him. Still sweating after my shower, and starting to feel a sharp pain in my back, I called to Dennis in the garden and asked him to make some phone calls for me. To demonstrate my priorities, the first was to John Renke, my organist and choir director at St. Francis, to let him know that I wouldn’t sing at church that morning. Then I asked Dennis to call the advice nurse at Kaiser.

Dennis described my symptoms to the advice nurse. As we were talking to her, my left arm started to go numb. She immediately said to call 911. Dennis offered to drive me to Kaiser, but the nurse insisted he call 911, which of course, he did. Within minutes there were six or seven strapping firemen in the house, hooking me up to all kinds of things and injecting me with whatever is standard procedure. Then they strapped me into a chair and carried me down to their emergency van, which must have been only a few blocks away when they received the call. For some reason they went up Fair Oaks to 20th St and then to Dolores on the way to Kaiser on Geary. I think Dennis was with me in the emergency van.

When we got to Kaiser, I was immediately taken to the emergency room. It turns out that Kaiser’s Cardiac headquarters for Northern California is at that very location. Had I been taken to a different Kaiser facility, I would have been transferred to that one. Within half an hour or so, I had an angioplasty with two stents. One of my main cardiac arteries had been 99% blocked. It was a heart attack waiting to happen.

Most heart attacks occur on Monday mornings about 8:00 am. I guess people are apprehensive about going back to work. I suppose my parallel is that Sundays used to be work days for me, when the Schola Cantorum had regular services every Sunday (until we got fired).

Fortunately, Karl Friedrich Schinkel caused my attack to occur early on a Sunday morning, when the emergency vehicle was close by, there was very light traffic, and when I had the actual heart attack the very moment we were consulting the advice nurse!

Dr. Sheryl Garrett was the doctor on call in the emergency room that day. She was not my surgeon, but heard about my arrival. Dr. Garrett later told me she has had two most memorable experiences among the hundreds of cardiac patients she has treated during her seven years at Kaiser. The first was a seventy-eight year old woman who had cardiac arrest the very instant Dr. Garrett shook her hand. The patient survived, then years later had another heart attack, and was still alive when I heard about her story.

The second memorable experience was seeing Dennis in the lobby outside the emergency room. Dr. Garrett had not yet met me, but had heard of my circumstances. She surveyed the waiting room and noticed Dennis among the group of people there. Immediately she knew who he was. She said his great concern, fear and love was absolutely palpable.

Although I was initially surprised by my heart attack, I really shouldn’t have been. There is significant history of heart disease on both sides of my family. Dad had his first heart attack at thirty-nine when he tried to hold his breath while swimming under water the full length of a pool. Then he had another one a few years later. I remember visiting him in the Harrisburg Hospital when I was three or four years old.


Of course, his dramatic cardiac arrest was in 1977 when he was sixty-eight. That was when Dad collapsed after giving a tight three minute roast of the mayor at the auditorium of the Hershey Medical Center, and Helen screamed and followed Dad in the ambulance –and Mother was left behind because she was trying to stay out of the way of the care givers. Many people thought Helen was Mrs. Bell. Dad’s performance ended the show! Lastly Dad died of a heart attack the day he was supposed to be released from Temple University Hospital in Philadelphia on October 30, 1982, about seven weeks before his 74th birthday. He had been treated for a major stroke the previous June, and was going home to recuperate before a scheduled operation on his other carotid artery.

Dad’s favorite sister Alice died of heart disease in her late fifties. And Mother’s mother, Julia Trump Rich, died of heart failure about age sixty-five.

Recently, of course, was the unexpected death of my first cousin Roswell Brayton, Jr. As his sister Anne said: “He was the golden boy. Nobody expected him to die so young.” He was almost the same age as I when I had my attack – a few months after his 55th birthday. Rozzie was the genuine athlete in the family. He was the star pitcher on his Harvard baseball team and made the Harvard Sports Hall of Fame. I guess he was also a fanatic golfer, as were many others of my Mother’s family. He had a wooden box full of score cards from every golf game he had ever played (over a thousand). It was buried with him in his casket. And since his father had lived until his early eighties, Rozzie had every expectation that he would do likewise. Nevertheless, he evidently had already planned that detail of his funeral.

The irony was, he died doing cardio in the company gym in Woolrich. I suppose the hard decisions he had taken to make Woolrich competitive to survive in the new global economy took its toll. As President and CEO of the family company, he had had to let go almost 80% of the US workforce. I’m convinced it killed him.

I received word [in October 2008] from Dennis’ step-mom Evelyn that his step-sister Jackie’s husband had died of a heart attack. The shame was he wasn’t feeling well and went in for a check-up, but the hospital didn’t do any tests for heart condition and thought instead he was coming down with pneumonia. He went back to work and died a few days later at the farm co-op in Clarence, Iowa.


Dennis had been sick for years, and I had been preparing myself to be a caregiver to him. The amazing thing is I never anticipated that he would be such a marvelous caregiver to me. I’ll always be grateful that I survived to be there for him at his end.

###

Today is also the ninth anniversary of Hurricane Katrina! 


Thursday, July 31, 2014

Internal Defibrillator Procedure ~ July 31, 2008





Six years ago today I had an operation at Kaiser-Permanante in San Francisco to implant an internal defibrillator-- or an implantable cardioverter defibrillator (ICD). This was recommended by my cardiologist, Dr. Sheryl Garrett, because of damage to my heart after my heart attack nearly ten years ago.


I was resistant at first, but was persuaded by two other cardiologists when my regular doctor was on maternity leave. My good friends Adam, Justin and Martin came to visit me right after the procedure, and Adam took me home by taxi the next day. Fortunately, it hasn't been used yet, though I am rather curious to know what it would feel like. My defibrillator is about the size of an average cell phone on my chest. The battery should be good for another three or four years. Then I'll need another minor procedure to replace the battery, which will actually be the entire unit. Chances are it will then be smaller and more powerful.


An internal defibrillator is a small, battery powered electrical impulse generator that is implanted in patients who are at risk for sudden cardiac arrest. They provide an electrical shock to the heart during periods of irregular heartbeat, and can save someone’s life. Internal defibrillators sense intrinsic cardiac electric potentials, and then send electrical impulses if the potentials are either too infrequent of absent, due to a problem with the patient’s heart. The electrical pulses stimulate the myocardial contraction, which causes the heart to beat at a normal rhythm.

The process of implanting an internal defibrillator is similar to the implantation of a pacemaker, since both devices contain electrode wires that are passed through a vein to the right chambers of the heart. In most cases, the wires are lodged in the apex of the right ventricle, and the device is kept in the patient as long as they live.

An internal defibrillator works to continuously monitor the heart, and detects overly rapid arrhythmias. They can detect ventricular tachycardia, which are a rapid regular beating of the ventricles and the bottom chambers of the heart. Internal defibrillators can also detect a rapid irregular beating of the ventricle, which is referred to as ventricular fibrillation.

When a patient experiences either of these arrhythmias, the pumping efficiency of the heart is impaired. Fainting and sudden cardiac arrest are usually a result if a patient experiences an arrhythmia, but an internal defibrillator can prevent that from occurring. Patients with coronary heart disease and heart muscle diseases tend to experience arrhythmias; therefore they are the most qualified candidates for an internal defibrillator.

The implantation of an internal defibrillator is much less invasive than is used to be, due to advanced techniques and technology. An internal defibrillator is a tiny computer hooked up to a battery, and then placed inside a tiny titanium case. It weighs only about three ounces, and is about the size of a cassette tape. The device is implanted under the skin below the collarbone, and tiny wires are used to send signals from the heart to the internal device. A programmer is also found on the small device, and it allows a doctor to set it at the correct rhythm for each specific patient.

The internal defibrillator is able to correct irregular and regular heart rhythms, just by sending a timed and calibrated electrical shock directly to the heart. It is similar to a defibrillator used in hospitals when someone’s heart stops, yet it is implanted in the body and ready to be used at any time. It can save the life of a loved one suffering from a heart problem, because a stopped heart needs to be shocked right away. By preventing cardiac arrest, patients with heart problems can live normal lives without having to worry. Patients with internal defibrillators can live normal lives and participate in activities they like, since they don’t have to worry about experiencing cardiac arrest or any other serious heart problems.

(Two years about a week and a half ago, I thought that my defibrillator was about to go off, because I had severe pain in that area of my chest. It turned out instead to be an outbreak of shingles-- nevertheless, not a very pleasant experience. I've been on anti-viral medication for a week, and with luck I should have no permanent residual pain. Evidently some older people do. I learned from a doctor at dinner at my weekend retreat that shingles is the primary cause of suicide in patients over 75. I think I caught mine in time. I was persuaded, however, to continue taking vicodin for pain-- that it's essential to break the cycle of nerve irritation. In addition, there is also a shingles vaccine, which I should get some day, since it is possible to get shingles more than once. My good friend Deb Cornue has had it twice a few years ago, and last year had the vaccine, which should prevent any additional outbreaks.)


Text:defibinfo.com/internal-defibrillator
Image:nhlbi.nih.gov/health/dci/images/scd_icd.jpg

Wednesday, March 12, 2014

ROSWELL BRAYTON, JR. ~ March 12, 2007




Seven years ago today was the sudden and greatly unexpected death of my first cousin Roswell Brayton, Jr. As his sister Anne said: “He was the golden boy. Nobody expected him to die so young.” He was almost the same age as I when I had my heart attack – a few months after his 55th birthday.

Rozzie was the genuine athlete in the family. He was the star pitcher on his Harvard baseball team and made the Harvard Sports Hall of Fame. I guess he was also a fanatic golfer, as were many others of my Mother’s family. He had a wooden box full of score cards from every golf game he had ever played (over a thousand). It was buried with him in his casket. And since his father had lived until his early eighties, Rozzie had every expectation that he would do likewise. Nevertheless, he evidently had already planned that detail of his funeral.

The last time I saw him was on my 55th birthday, when I went with my sister Julie to the Annual Woolrich Stockholders' Meeting. It was the only one I have ever attended. (I don't think my Mother had ever missed one.) The primary reason I went is that I was on my way to the 90th Spizzwink(?) Reunion in New Haven and just happened to be East at the time. (Three Aprils ago I went to the 95th.) I took the above picture after the meeting.

The irony was, Rozzie died doing cardio in the company gym in Woolrich. I suppose the hard decisions he had taken to make Woolrich competitive to survive in the new global economy took its toll. As President and CEO of the family company, he had had to let go almost 80% of the US workforce. I’m convinced it killed him.

###

Rozzie's son Nicolas P. Brayton is the major stockholder and now president of Woolrich. 

Monday, October 6, 2008

HEART ATTACK

Two months ago, I had an internal defibrillator procedure at Kaiser. It’s a little like having a small cell phone on my chest. My defibrillator is about four times bigger than a pace-maker. The point is not so much to enhance my day-to-day activities, as to provide insurance against sudden cardiac arrest, for which I guess I’m at serious risk. I had a major heart attack forty-nine months ago.

I suppose if you’re going to have a heart attack, I had mine at an optimal time. I recently read an article about the efficacy of angioplasty and of stents. Its conclusion was that preventative stents are of questionable value—that the gold standard for inserting stents needs to be within an hour of a severe heart attack. That qualification fit my scenario to a ‘T.’

Saturday August 28th, 2004 was the wedding of Dan Hutchings & Rachael Lu, musician friends (Dan of the Schola Cantorum at St. Francis) in the Green Room of the War Memorial Veteran’s building next to the opera house. Dan sang Schubert and Rachael accompanied him on the piano.

Dennis and I went to the ceremony and reception in the same room and sat at the table with Tom Hart from Chanticleer days. He said I looked terrific.

Earlier that day, I had gone to William Stout Architectural Books near work and bought a huge folio of Karl Friedrich Schinkel, the great 19th Century German architect. The book weighs about 80 pounds. I brought it home by taxi, but carried it upstairs and moved it around several times before settling on the floor in front of the Napoleon window in the dining room.

When I later suggested to my cardiologist, Sheryl Garrett, that this might have been the proximate cause of my heart attack the following morning, she agreed. She said it was the first time she had heard of a heart attack caused by a book! More common was somebody lifting a car engine.

On Sunday morning I woke up early, sopping wet. I frequently sweat a lot at night, but this was different. Dennis was still asleep. I decided to take a shower, which was probably not such a hot idea. Then Dennis got up and went down to the garden to read the paper, drink his coffee and have a smoke. I think I had some coffee. I’m sure I had already made a pot for him. Still sweating after my shower, and starting to feel a sharp pain in my back, I called to Dennis in the garden and asked him to make some phone calls for me. To demonstrate my priorities, the first was to John Renke, my organist and choir director at St. Francis, to let him know that I wouldn’t sing at church that morning. Then I asked Dennis to call the advice nurse at Kaiser.

Dennis described my symptoms to the advice nurse. As we were talking to her, my left arm started to go numb. She immediately said to call 911. Dennis offered to drive me to Kaiser, but the nurse insisted he call 911, which of course, he did. Within minutes there were six or seven strapping firemen in the house, hooking me up to all kinds of things and injecting me with whatever is standard procedure. Then they strapped me into a chair and carried me down to their emergency van, which must have been only a few blocks a- way when they received the call. For some reason they went up Fair Oaks to 20th St and then to Dolores on the way to Kaiser on Geary. I think Dennis was with me in the emergency van.

When we got to Kaiser, I was immediately taken to the emergency room. It turns out that Kaiser’s Cardiac headquarters for Northern California is at that very location. Had I been taken to a different Kaiser facility, I would have been transferred to that one. Within half an hour or so, I had an angioplasty with two stents. One of my main cardiac arteries had been 99% blocked. It was a heart attack waiting to happen.

Most heart attacks occur on Monday mornings about 8:00 am. I guess people are apprehensive about going back to work. I suppose my parallel is that Sundays used to be work days for me, when the Schola Cantorum had regular services every Sunday (until we got fired).

Fortunately, Karl Friedrich Schinkel caused my attack to occur early on a Sunday morning, when the emergency vehicle was close by, there was very light traffic, and when I had the actual heart attack the very moment we were consulting the advice nurse!

Dr. Sheryl Garrett was the doctor on call in the emergency room that day. She was not my surgeon, but heard about my arrival. Dr. Garrett later told me she has had two most memorable experiences among the hundreds of cardiac patients she has treated during her seven years at Kaiser. The first was a seventy-eight year old woman who had cardiac arrest the very instant Dr. Garrett shook her hand. The patient survived, then years later had another heart attack, and was still alive when I heard about her story.

The second memorable experience was seeing Dennis in the lobby outside the emergency room. Dr. Garrett had not yet met me, but had heard of my circumstances. She surveyed the waiting room and noticed Dennis among the group of people there. Immediately she knew who he was. She said his great concern, fear and love was absolutely palpable.

Although I was initially surprised by my heart attack, I really shouldn’t have been. There is significant history of heart disease on both sides of my family. Dad had his first heart attack at thirty-nine when he tried to hold his breath while swimming under water the full length of a pool. Then he had another one a few years later. I remember visiting him in the Harrisburg Hospital when I was three or four years old. Of course, his dramatic cardiac arrest was in 1977 when he was sixty-eight. That was when Dad collapsed after giving a tight three minute roast of the mayor at the auditorium of the Hershey Medical Center, and Helen screamed and followed Dad in the ambulance –and Mother was left behind because she was trying to stay out of the way of the care givers. Many people thought Helen was Mrs. Bell. Dad’s performance ended the show! Lastly Dad died of a heart attack the day he was supposed to be released from Temple University Hospital in Philadelphia on October 30, 1982, about seven weeks before his 74th birthday. He had been treated for a major stroke the previous June, and was going home to recuperate before a scheduled operation on his other carotid artery.

Dad’s favorite sister Alice died of heart disease in her late fifties. And Mother’s mother, Julia Trump Rich, died of heart failure about age sixty-five.

Recently, of course, was the unexpected death of my first cousin Roswell Brayton, Jr. As his sister Anne said: “He was the golden boy. Nobody expected him to die so young.” He was almost the same age as I when I had my attack – a few months after his 55th birthday. Rozzie was the genuine athlete in the family. He was the star pitcher on his Harvard baseball team and made the Harvard Sports Hall of Fame. I guess he was also a fanatic golfer, as were many others of my Mother’s family. He had a wooden box full of score cards from every golf game he had ever played (over a thousand). It was buried with him in his casket. And since his father had lived until his early eighties, Rozzie had every expectation that he would do likewise. Nevertheless, he evidently had already planned that detail of his funeral.

The irony was, he died doing cardio in the company gym in Woolrich. I suppose the hard decisions he had taken to make Woolrich competitive to survive in the new global economy took its toll. As President and CEO of the family company, he had had to let go almost 80% of the US workforce. I’m convinced it killed him.

I just received word from Dennis’ step-mom Evelyn that his step-sister Jackie’s husband died of a heart attack last week. The shame was he wasn’t feeling well and went in for a check-up, but the hospital didn’t do any tests for heart condition and thought instead he was coming down with pneumonia. He went back to work and died a few days later at the farm co-op in Clarence, Iowa.

Dennis had been sick for years, and I had been preparing myself to be a caregiver to him. The amazing thing is I never anticipated that he would be such a marvelous caregiver to me. I’ll always be grateful that I survived to be there for him at his end.


Titian in the Frari (Venezia)