Anything But a Normal Day

by Alan Eggleston

One of my readers suggested I share my recent health crisis experience. Perhaps it will help someone who experiences the same symptoms and save their life. Written over time.

I woke up with a terrible deep pain in my chest. My first thought was cardiac arrest, although it didn’t feel like an elephant sitting on my chest like I’d heard a heart attack described – more like Thor had hit my chest with his hammer. I could breathe all right, although as the session continued I became agitated and I started to breath abnormally. I called 911. The Fire Department arrived and calmed me down. Then the ambulance arrived and started taking my vitals and prepared me for transport.

At Saint Mary’s hospital they did an EKG and said they didn’t think it was my heart – that seemed fine. They did a CT scan next and then came the shocker: I’d had a “dissection of the aorta” – the major artery that comes out of the heart and feeds the rest of the organs with blood. What’s more, they said it was “dangerous” and they needed to get me quickly to Spectrum Health Butterworth, the biggest hospital in town that specializes in cardiovascular diseases.

The aorta isn’t a solid tube through which the blood flows. It’s a tube built up of layers of tissue, and a dissection is when the layers unravel, leaking blood.

It wasn’t until later that a member of the thoracic surgical team used the term “aneurysm,” a word I know all too well. My dad had one near his stomach and my uncle died of one at his stomach. But telling me that the situation was dangerous and that I needed to go pronto to the speciality team at another hospital said everything I needed to know at the time.

After more tests, blood samples, and a grueling two-hour MRI, the thoracic team said I had a “type b” dissection. They wouldn’t do surgery. I would be affected by this aneurysm for the rest of my life, but the treatment was to keep my blood pressure under 120 (the top number in a blood pressure reading) with medication. I spent several days in the ICU and then another few in the Leila Meijer Heart Center getting the meds right.

Time seemed to slow down while I was there. I’d fall asleep, thinking I’d spent hours in slumber, only to look up at the clock and see that only 15 or so minutes had passed. And the medications gave me strange recurring dreams that would startle me awake during sleep, over and over again. I’d find myself getting shivers that I would later realize were from agitation or stress rather than feeling cold. My doctor was reluctant to give me medication for stress, but he finally did so, and overnight, it helped me sleep.

I must say, I had the best nursing and technical care I’ve ever had. Not once did I lack for a response to pushing that call button, although initially I always seemed to lose track of that button – later I would grasp it and not lose sight of it. It might just have been my medications, but I could swear many of my nurses looked like celebrities, like one who was a dead ringer for Nancy O’Dell including voice (anchor of Entertainment Tonight) or Simon Cowell (American Idol), although his manners were much better. My hat is off to these dedicated professionals, who were always there when I needed them.

One set of nurses set out goals for me. Sit up in the chair three times that day, get up and walk the hallway that day. We accomplished two of the three. I was always tired and sitting up in the chair wasn’t all you might think it might be. I always felt a need to lie down. Even now, when my blood pressure rises, I can get it to go back down by laying flat.

The doctors focused on finding a mixture of medications to get my blood pressure under 120. They did it initially with IV fluids, then had to find pills I could take at home that would do the same thing. When they found the right combination, they sent me home.

A nurse explained the written instructions to me. One part told me what medications to take and in what doses. My wife drove me home and we stopped at the pharmacy to pick up my prescriptions, but they weren’t ready yet. Later in the evening she went back and picked them up and I followed the nurses written instructions.

The next morning, I re-read the instructions and compared them to the instructions on the bottles. One set were different. I called the surgical team to find out why and they said it was a different size pill and to take less. She didn’t say that I had taken too much the night before so take less now. I ended up taking too much and had to go to the ER again, spending most of the afternoon into evening in the war room like environment of an urban emergency room.

At one point, the ER nurse took my blood pressure sitting down, had me rest for a half hour, then took my blood pressure standing up – I nearly fainted. They reperformed the exercise several hours later and I was fine. So the decision was that I just needed to let the overdose run out of my system and restart the regimen as prescribed. We went home.

The thing is, this one medicine is really powerful and knocks me out. We started at 100 mg three times a day. Visiting nurses see me a couple of times a week and they agreed that was overpowering and with the surgical team decided to decrease it to 75 mg three times a day. And later I talked to the surgical team and we dropped it down to 50 mg three times a day. I vary when I take it, depending on when my blood pressure stays too low (it’s been as low as 84 but often stays around 104-110) and when it gets to the 120 threshold.  I take my blood pressure frequently, which the nurses seem delighted in.

A few years ago we bought an electric blood pressure cuff at Walgreen’s. The nurses say it’s accurate. I’ve found it invaluable now. It was only about $40 at the time.

I’m my best and brightest – feel my most normal – when I wake up in the morning, when my blood pressure is its highest. As the day progresses and I take this powerful medication, I begin to feel worse. My eyesight lessens, I get tired, I become more agitated, I can’t do as much for as long. I don’t like to read anything of length, and I lose patience writing anything of length. Arguments or too much excitement or too much anything stresses me out. Fortunately, my regular doctor prescribed an anti-anxiety medication to help.

But don’t think I’m complaining. I’m much improved from when I first returned home. I note incremental improvements. In the morning I take longer walks each day. I take the dog out in the morning, before anyone else is out. The struggle is later in the day after I’ve taken the strong blood pressure medication. And when my blood pressure gets low, I try to do things that bring it up, and when it gets high, I do things that bring it down. It’s a balancing act.

+++

So that’s my story of a day that was anything but normal. That afternoon was not unlike “Mr Toad’s Wild Ride” at Walt Disney World Resort, although I don’t know if it’s still a ride there.

I’m sorry if this wasn’t your kind of story. I hope it satisfied the curiosity of my friend the reader who requested it.

The struggle continues but so does the progress. “Slow and steady wins the race,” says the cliche. I believe it’s right.

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