“You’re trying to have a heart attack…”

“You’re trying to have a heart attack…”, said the cardiologist.  It was the last thing I expected to hear as I lay on the hospital gurney surrounded by a room full of other doctors, nurses, and techs all busily engaged in their duties.   The moment still seems surreal in my mind and I have not fully come to grips with the reality of it all.

Thursday January 30^th, 2014 was just like any other day for me.  I have bad days and good days that vary depending on energy and pain levels and that day was pretty good.  Occasionally when I have a good day I get out of the house and go with my wife shopping or to bible study.  It was about 9:30 PM and we had just returned home after meeting with a few friends.  Upon entering the house I noticed that I had heartburn.

Heartburn, post floxing, was nothing unusual for me.  I have digestive dysmotility so various things can cause heartburn for me. I will often get heartburn or pain and cramping in the hiatal area.  It wasn’t until about 15 minutes later that some different symptoms started appearing.   The pain moved slowly upward under the sternum and felt as though someone was grabbing my esophagus and squeezing it.  Again, this was not really unusual, I think many floxies can appreciate the amount and variety of pain the body can experience post floxing.     My pain was localized under the sternum and was not a crushing chest pain, but it did hurt.

I mentioned to my wife that I was having pain and heartburn in the center of my chest and that something was just slightly different but I couldn’t pinpoint it.  I tried ignoring it by sitting down and relaxing.   Nothing seem to relieve the pain; sitting, standing, walking, deep breathing, raising my hands above my head, and drinking some water, all was to no avail.

Being the constant analyzer that I am, I started looking at my day and week prior to this moment and was wondering if there was anything that I did to precipitate this pain, which by now I had preliminarily diagnosed as an esophageal spasm, but then the pain began to spread.  The pain was not sharp, or shooting, but instead dull and strong.  First it radiated out to both shoulders symmetrically and then down to the elbows in both arms.  The pain was equal on both sides, not just the left.  I had no breathing difficulties or numbness.   The final straw that prompted me to tell my wife to drive me to the E.R. was when the pain started expanding up into the jaw, again, not sharp but dull and strong.

The total time that had transpired from us arriving home till leaving for the E.R. was not long, maybe 30 to 45 minutes.  Before anyone chides me for not calling the ambulance, we do not live in a city, but in a remote rural area, where on a good day it would take the ambulance 30 minutes to get to our house, not to mention that winter has not been kind and the roads were not very good.  Our 4-wheel drive truck was a better choice.

Upon arrival at the small local hospital I said the magic words, “I am having chest pains” to the E.R. nurse. Immediately an I.V. line was started, blood was drawn, and aspirin was given, and I was give nitroglycerin, 3 times.   The nitro did not really help the pain much.  The E.R. doctor, who was very nice, looked at my cardiac enzymes, other blood work, EKG, and said that everything looked good.  She said as a precaution will keep you overnight and monitor your heart and notify your primary care physician.

During the night, the pain never completely went away and I was given several doses of fentanyl, which took the edge off, but I was still unable to sleep.  Also during the night I had another set of cardiac enzymes taken as well as an EKG, which were coming back normal.   It sure looked like I was right, a very bad case of heart burn accompanied by a severe esophageal spasm.

The next morning my primary care physician came in fairly early and he told me that my nightly labs and ER workup showed no signs of cardiac problems. He said to be on the safe side, we are going to run one more set of cardiac enzymes and EKG and I should have a stress test later that day.  He had been up all night with other patients and said he was going home but I would be in good hands with the staff physician and the cardiologist.  My physician left and I had one more set of cardiac enzymes and an EKG run.

Initially, I was told by the nurse that I could not have breakfast since I was scheduled for a stress test but since my labs were coming back normal they were going to push the stress test off to the afternoon.  She brought in a menu and told me to order some food.   While I was contemplating what I could even remotely eat from the hospital menu, the nurse came back in the room and told me to hold off on the ordering of food.  Little did I realize that all hell was about to break lose.

Into the room a female doctor quickly walked in.  I had never seen her before and she was evidently the staff physician.  She looked at me straight in the eye and said “your latest cardiac enzymes just came back elevated and your latest EKG was abnormal.”  Before I had the opportunity to speak, she continued “we have notified an ambulance and you are going to be transferred to St. Joe’s cardiac center, where a cardiac team will be standing by when you arrive.”

I was just getting used to the idea that I was right in my diagnosis and now the rug was pulled out from under my feet and the pendulum had just swung 180 degrees.  Keeping calm was the hard part.  Thoughts were racing through my mind at an incredible pace. Most were centered on how could this be possible, since I have no risk factors; I am not overweight, I do not drink, I do not smoke,  I am not diabetic, my cholesterol is normal, I have no immediate family history of heart disease, etc…

The trip to St. Joes took about 30 minutes despite the slick snowy roads.  The ambulance crew was very nice and I know they were trying their hardest to keep my mind off the present by making small talk.  They assured me that the cardiac team at the hospital was one of the best, a fact that I would soon find out.

Arriving at the larger hospital I was both relieved and full of apprehension. I had been praying the whole time worrying about my family.   Also knowing my wife and son were driving down to be with me at the hospital in the midst of inclement winter weather was also disconcerting.  Upon entering the hospital there was no waiting or stopping. The ambulance crew wheeled me directly to the second floor comprehensive care unit and into a large hospital room, already filled with nurses.

Once I was slid off the gurney, the ambulance crew wished me luck and quickly left, as two nurses started prepping me, while another nurse was asking me medical history questions.  Within a minute the head cardiologist walked in, introduced himself, and started asking me detailed questions about my chest pain.   He was very nice and soft spoken.  After a few minutes he looked me straight in the eye and said “Mr. Melvin, according to your enzymes, EKG and symptoms, you are trying to have a heart attack.“   Although I knew darn well why I was there, this moment was very surreal for me, almost unbelievable.

Within a few minutes and second doctor, and then a third entered the room.  The third doctor was a cardiac surgeon who told me that he would be performing the cardiac catheterization.  He also told me that from now on out, things are going to start moving very fast, as if they hadn’t so far.   The surgeon told me that he could tell from my EKG and my enzymes approximately where my blockage was at.  We would find out soon if he was correct.

My wife and son arrived just in enough time to say hello, exchange “I love you’s ” before I was whisked into the cardiac cath lab.   All of you in the fluoroquinolone community know the fear of taking new medications, and some of you who have had repeated hospitalizations know the reality of taking new meds in a life or death situation, well I was in that situation now.  I had already told the nurses what drugs I could not have.  Surprisingly enough, one nurse kept asking me if certain drugs would be okay to use or not, if there were more than one choice available.  Finally, it got to the point where I just said a prayer “dear Lord, guide the doctor’s hands and the help me get through this and the medication that they deem necessary.”  There was no way that I could deal with the all the worry that was associated with the heart attack and the new meds needed.

I was twilight sedated, my right leg anesthetized, and the catheter inserted into the right femoral artery.   Within a few minutes the surgeon said he had located the blockage right where he suspected, in the right artery, and he estimated it was about 97 to 98 % blocked.  After a balloon dilation of the right coronary artery a 4mm by 30mm stent was placed in the vessel.  The surgeon spoke to me and said that he saw no further blockages.   I let out a sigh of relief.

After about an hour on the table the procedure was finished. The surgeon moved the table down so I could see the computer monitors.  He showed me before and after video of the stent placement.  He told me that the nurses would take care of me and he would go and speak with my wife and son. A dissolvable plug was placed in the femoral artery, which required me to lie perfectly still for five hours after the procedure, one of the hardest things to do.

It was an emotional reunion back at the room.  We were still reeling with the surreal-ness of the situation.  My wife was thankful that I was alive and I was still trying to figure out how this happened.  I was shocked with the amount of drugs that was injected into me for one reason or another, but what was a body to do?

Twenty-four hours later the main cardiac doctor came in and spoke with my wife and me.  He said “the surgeon and I have looked over the video from the procedure and the echo-cardiogram that was performed directly after the procedure and we cannot find any damage done to the heart muscle.”  What a thing to be thankful for.

He also said that I wish I could tell you what to do to correct your lifestyle but I can’t since you have no risk factors.  Indeed, I had no risk factors.  One of the cardiac nurses told me that they are starting to see more and more people come in with no risk factors, very puzzling indeed.

Was floxing now the risk factor that caused this to happen?  Lord knows the tremendous amount of stress that floxing has put on my body these last seven and a half years.   The stresses and symptoms are almost too numerous to list here.  But, I do know that I have had changes in my glucose and lipid metabolism in addition to other critical areas such as hormones and digestion.

It is amazing how our future trajectory changes in a moment’s notice.  I now have different factors to consider in this complex journey.   Like I said before,  at the time of this writing, I am still trying to wrap my head around all that has transpired.  I will keep my readers updated.

Please read the update and sequel to this article: Another Heart Attack