Friday, January 30, 2009

It's Implant Day, at last!

Today will mark my final post for a few days, but the results of what happens today will determine whether it’s just through the weekend or longer. Today ends an adventure that began several months ago when my cardiologist first said to me, “We need to start a conversation. No decisions will be made today, but we must start thinking about the future.”

I have now passed the seventh year of my heart attack. Statistics show that second, and usually fatal, attacks occur just about seven and a half years after the first. There is a device called an Implantable Cardioverter Defibrillator (ICD) that can, in many people, change that statistic and add more time to the human life.

An ICD is like a Pacemaker with additional functions. When the heart speeds up, it acts as a defibrillator and shocks it back to normalcy. When the heart slows down, it paces it to normalcy like a Pacemaker. That's a mild oversimplification, but it gives the idea.

A miniature computer in a smooth case is implanted in the chest just below the left collarbone. Lead wires are run to the heart through arteries and inserted. Once activated, the heart is forced into rhythmic abnormality. If the device is working properly, it will correct the heart beat. I think I’m glad I’ll be under general anesthesia when the test is made.

Although there are several types of heart disease, the most common one is blockage. The arteries get blocked over the years preventing a good blood flow. I’m guilty of most of the causes of blockage: obesity, poor diet, lack of exercise. I have been taking drugs called “statins” to control my cholesterol, but they haven’t been perfect.

The road to today started when I was hit with what doctors call a Triple-A, an Abdominal Arterial Aneurysm, which burst. Most people bleed to death internally when a triple-a occurs. Mine happened just before dawn one morning back in November, 2001. I have a wife who is unbelievably solid in a crisis. She remained calm and called for Rescue.

The fire department is only about a mile from my home and the paramedics were here right away. Fortunately for me, they recognized what was happening and I was soon speeding to the hospital. I was still alive.

When we got there, another break occurred; one of the area’s best vascular surgeons was just arriving for his morning room visits. He saw me coming and immediately called for surgery. As I was being wheeled to the operating room, the last thing I heard was the optimistic voice of a nurse: “He does have a living will.”

Time was running out; and it did. I died on the operating table. Well, at least my heart stopped because it had run out of blood and didn’t know what to do. That’s an event that can’t happen in a better place, an operating room in a hospital. The surgeon later told me my body was fighting to live so hard he simply couldn’t let me go. I love that dedication.

While I was there, the decision was made to check my heart to see if there was any damage, and that’s when the blockage was found. That “road” I mentioned had actually begun many years ago, but not discovered. A heart surgeon was consulted and soon I underwent a four-way bypass. Recovery was/is slow and I still have heart disease and my heart’s pump function has now dropped to 30% or lower efficiency.

I still have those little bubbles, aneurysms, in my arteries and have them checked annually. The heart, however, has become the critical concern.

Those of you familiar with the bell curve know that in that curve, if one hundred students, for example, take a test, 5% might get an “A” and “E” while 15% might get a “B” and “D.” The other 60% would get the average, “C.” These numbers may vary somewhat, however.

Persons who have a first heart attack usually become susceptible to a second, often fatal, in that “C” range, which is in the vicinity of seven and half years after the first. My seven and a half years comes in May of this year. After that average range is crossed, the chances for a second attack drop off dramatically.

My cardiologists hope the ICD will help get me past that average. And so today one will be implanted in my chest. The operation itself is relatively low risk and I should be returning home tomorrow. If all goes well as it should, I could be back Monday, but the doctor says I’ll be relatively inactive for about four weeks.

My plea to anyone reading this is to undergo tests your personal care physician may suggest. Prepare a conversation with your doctor about heart health. Learning much earlier than I could save you the kind of situation in which I now find myself. This is not a fun trip, and it can be prevented or controlled with early education about heart health.


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