A Blog From The Heart

"And what did you do on vacation?" "Oh, we went to the beach, ate great food, had a heart attack. The usual."

Yeah, that "heart attack" stuff is a bit hard to admit. I'm still trying to process what happened. But maybe if I type it all out, I can start to believe it?

Last Thursday, Mano and I were just sitting at the beach on Koh Phi Phi, enjoying a juice and soaking up the beautiful scenery. Suddenly, I felt a sharp pain in my chest, and a tightness like someone was giving me a bear hug. I joked to Mano that I was really getting old, because even sitting still made me tired these days.

But within a minute or two, the pain radiated down my arm. Mano took my pulse and found that it was racing, with several "skipped beats" per minute. He wanted me to go find a doctor, but I figured it was just dehydration. (Why would a trained heart nurse know more than me about this stuff?) So I just grabbed a Gatorade and took some aspirin and rested in our hotel room, waiting for it to go away. Probably frustrated, Mano sat out on the balcony.

But about an hour later, an interesting thing happened. Mano had a "hunch" to turn around and check on me. When he did, he saw me clutching at my chest and grimacing. The pain had become quite intense and spread to my arm and jaw now. The palpitations were quite frequent too. I couldn't ignore it any longer. Mano got help from the hotel staff to get me to the hospital, which was conveniently located just next door.

But this is an island adventure story, right? So it couldn't be that easy,could it? Turns out, the hospital had no doctor!

The only doctor on the island was in the Tonsai village clinic, about a km away. So, some dude in a lab coat scooped me into their "ambulance" (a motorcycle sidecar), which was the only motorized vehicle allowed on the narrow footpaths of the village. It was kind of funny actually. I half-expected the lab coat dude to start yelling "wooo-wooo-woo" like a siren.

A few minutes later, we arrived at a 2-room clinic attached to a 7-11. It served mostly a steady stream of hungover college kids, jellyfish stings and ear infections. But it DID have a doctor, and he seemed to know what to do.

My blood pressure was 170/100 at that point, and the chest pain was a bitch. The doc pushed some IV stuff (propanolol and fentanyl) and stuck a nifedipine tablet under my tongue. I immediately started swimming in my sweat, and became so nauseated that I filled every bucket within reach. Lovely.

But after a few hours, the BP and pulse came down enough to get back me back to the hotel to recover until I could get to the hospital the next day.

But the next morning, the island hospital was still without their doctor. So what to do? Should I get on an airplane and fly back to Bangkok?

Mano and I would be celebrating our 20th anniversary in just two days, so I didn't want to ruin our trip. We already had hotel reservations on nearby Koh Lanta, which was a larger island a short ferry ride away. Maybe they would have a hospital too? Besides, the the irregular heart beat wasn't that bad, and the pain pills were helping. So I could postpone the hospital visit for a few days, right?

The day after our anniversary, still experiencing chest pain, skipped beats and shortness of breath, Mano insisted that we fly back to Bangkok and get me to a doctor for tests. {sigh} But ignoring the whole "heart incident" was working so well for me! LOL.

BANGKOK

Within two hours of landing in BKK, we were at BNH Hospital's Cardiac Center. Bangkok is well-known for cutting-edge (LOL) medical care, and this hospital was one of the best. I assumed that they would put me on a treadmill and do an EKG, and then send me home with some meds, telling me to try to avoid being so dramatic for a few days.

But to my surprise, the doctor said that a lab test for a cardiac enzyme (Troponin) was extremely high, indicating that I had a heart attack recently. in addition, the irregular heartbeat and continuing chest pain made him concerned that I could have another cardiac arrest or stroke. He was admitting me immediately to the ICU for monitoring.

Awesome room! Nice view, and they feed me Thai food! Does your hospital do that? LOL.

 AN AMBULANCE RIDE THROUGH BANGKOK TRAFFIC
The three days in the ICU are a bit of a blur. But I definitely recall one humorous moment when I was placed in an ambulance for transport across town to Chulalongkorn Hospital's Cardiac Cath lab. The driver turns on the emergency lights and siren, and immediately halts to a stop in the horrible Bangkok traffic. No one pulls over and even attempts to get out of the way. So the only difference between our ambulance and all the other cars was that we were noisier.

STICK A NEEDLE IN MY GROIN?

I also recall several people standing around me while shaving my pubes - but all I got was a lousy angiogram! (I'm trying to work that into a t-shirt slogan. What do you think?)

Ever had an angiogram? I don't recommend it for entertainment, but it is not as gruesome as it might sound. Yeah, they slit open your femoral artery in your groin, insert something like a knitting needle, and shove a wire tube all the way up into the chambers of your heart. Then they squirt in some dye, and watch it flow on the row of monitors nearby. I kept trying to turn my head to watch too. Pretty cool, actually.

The doctor actually let Mano watch the video in the Physicians' room. How nice of them to respect our relationship AND Mano's medical knowledge in that way, right?

RESULT: The angiogram showed some minor plaque narrowing, but my arteries seemed to have enlarged to accommodate. Thus, there was no significant blockage remaining, meaning that I did not need a stent. Awesome!

They also did an echo cardiograph (like a sonogram) which also showed normal functioning, except for an insignificant mitral valve leak.

The PVCs that I am experiencing (early contractions of the ventricle, or something like that), are quite common, especially in people who have had a recent heart attack. The doctor is suggesting that they will go away in time. At least that is how I interpret it.

BED REST IN BANGKOK?
Really? Sounds like a cruel joke, doesn't it? But I'll take it easy for a week until my followup appointment, carrying my nitro glycerine tablet with me when I leave the house.

But I am thinking that maybe my plan to trek Mt Everest for three weeks in September might need to be postponed, don't you?

Seriously though, all through this, I know how lucky I was to have Mano with me the whole time. In so many ways.