Esther and Ezra are visiting. Sara gives me a bean salad and a samosa for lunch. Then I finish the chair I'm working on. I feel fine. At 5:30, I'm cleaning up my tools and the phone rings. A Dr. Heathcote phones me directly from the lab (he cannot get Dr. Blackshaw on the phone, but left her a message) and tells me the blood tests are positive for heart trauma. I need to get someone to drive me to the hospital. (I find out later that my Troponin I level was 9.00, while normal is 0.04.) He will fax the test results to Surrey Memorial ER. I take a shower while we wait for Daniel to come take us (don't want to be caught with dirty underwear...) and collect some books to take along. Blackshaw also phones and says to take 2 aspirins right away.
We arrive at ER at 6:45, I start to tell the triage nurse that I was told to come and he should have my blood tests by fax, and he immediately knows who I am. (Aside: I should say that Surrey ER always looks like bedlam, so this kind of response really impresses me.) He measures my BP: it is 195/105. I am hustled through registration, and then bypass everyone (including a kid who is screaming at the top of her lungs the whole time) and get a bed. Even so, I have to wait for one to be vacated first (about 5 minutes). At this point, I've told my story (chest pains, when and where, no sweating, no racing pulse, no drug allergies, ...) 7 times and there's many more times to come. I get dressed in a gown, connected for ECG, IV, oxygen, have blood taken, and a cuff is automatically inflating every 10 minutes to measure my BP. I also get a blood thinner (enoxaparin?) injected into my belly fat.
A Dr. Breck comes by and takes my story again, and tells me I'll need an angiogram and probably angioplasty. We wait. We ask a nurse and she says currently no beds available in the cardiac ward. I'm thinking if I have to stay here in ER with its light and noise, I won't sleep and this is a bad thing.
Dan and Sara are looking on nervously while this is going on. Dan phones Jon and asks him to phone Rev. VanVliet. He comes immediately. He reads Ps. 73:24-26 and prays for us and the family. It's very comforting.
Just when he finishes, around 8:30, nurse Jane comes with the good news that a bed is available and I can go up to the cardiac unit. (It seems to be a general policy to give pessimistic predictions first so that the patient is not constantly having false hopes.) We go there: it's a beautiful ward. I happily transfer to a better bed (ER beds are too short and my feet were freezing). This bed has electric controls to raise or lower either end. I'm now wired up to an ECG monitor and cuff and cannot get out of bed. I have to pee in an "autoclavable".
Nurse Mona wants my story again. She is very nice: when she discovers I'm a scientist, she explains what's happening in greater detail than others have done (What is "Troponin", what is "non-elevated ST", etc.). I appreciate this very much. She applies a nitroglycerin patch and gives me 4 more pills; I've lost count. Daniel gives me his phone and I phone Richard to reassure him. Sara and Dan leave. I hope they sleep well. I complain of hunger and Mona finds me a turkey sandwich. Mona worries about my BP (now 160/100) and why was it never treated? She is actually a bit angry about it and says she will talk to my regular doctor. She tells me that there is no cardiologist in the ward, but one is on call. But at 10:30, Dr. Manyari comes in to see me. He asks the usual questions and wants to know whether TRIUMF produces thallium and technetium isotopes as currently he buys them from a lab in New York. Anyway, he goes over possible reasons for the attack. He says in particular that a very small percentage of patients have no blocked arteries at all. (I'm thinking: That's me.) He asks me for a preference for which hospital to do the angio: Royal Columbian, St. Paul's, or VGH. I ask him for the best one and he says St. Paul's, so we go with that. When he leaves, he tells me my main discomfort will be that I will be terribly bored, and to get some good books. But I already thought of that before I left home and so have Esther's gift (a book on Dylan) and a book on CD plus discman.
At 11:00 I'm getting a real headache, the usual kind, so quit writing and try to sleep. I can't. At 3:00, I tell Mona the headache is severe. My BP is now 110/50 (the lowest it's been in like 30 years) so she removes the nitro patch and I go to sleep. I learn later that nitro acts exactly opposite to my headache pills: it dilates blood vessels. This confirms that my usual headaches, which are confined to my forehead and upper sinuses, are caused by dilated arteries.
8:00: Breakfast is scrambled (made from powdered) eggs, hash browns, corn flakes, coffee, and 5 more pills of various shapes and sizes. The pills are for anti-coagulation and to lower BP. I phone Sara and ask for my lappy.
More blood samples, ECG (weird: I'm already hooked up for continuous monitoring with 5 probes, but now I get a separate 12-probe connection), more pills - two to get my potassium up because I'm at 0.34 and 0.35 to 0.50 is "normal".
Cardiologist on duty is Dr. Pierce: he sees me and allows me to use the portable wireless monitor so I can go to the WC, brush my teeth, etc. Yay!
I ask Carmen and she lets me move to the bed near the window. I am now the only person in this 3-bed room. Dan and Sara arrive with my toothbrush and lappy. They go down for lunch. Later, Tony, Ben, Esther, and Ezra come. Ezra is charming everyone in sight. They all leave at about 1PM and I keep Esther's instead of Daniel's phone. Rev. VanVliet phones to see how I'm doing. I listen to music on my lappy and my TV arrives. I watch some PBS programs. Esther vdG-Snijder phones Esther's phone thinking to ask Ben or Esther how I'm doing. So she gets me directly.
I still have a bit of a headache, so Carmen prepares an icepack for me. I wonder how dad is taking this, so I phone him. He is very relieved to hear from me. He tells me he loves me. Helen Elliott drops by to see me. She heard about me in church in the AM service and is on duty now. She mentions her respect for my cardiologist; I had no doubts, but it's nice to hear anyway. I get my twice-daily needle in the belly.
Sara and Daniel are back at 7:30PM with sushi. So I have a second dinner. Jon and Rosanne and Robin also come. Boy is she cute. Everyone but Sara leaves for the New Year's party, which, because my great kids don't want to leave Sara by herself, has been transferred from Aren and Deanna's place to my house. Sara stays till 10PM. I fall asleep at 11 and miss the "Happy New Year".
Breakfast is a big covered plate and inside... a single tiny carrot cake muffin. Quite a disappointment, but I have Bran Flakes and coffee as well. My brother Ben phones and then Sixten Koat. Great people. The day goes by very slowly. I watch some football bowls.
I'm told I will move to a private room within 10 minutes, but it takes 5 hours! Richard comes with Sara and they catch me up on their New Years. I keep lurking around checking out my new room, wondering if I could just hop into that bed (it's empty) and be done with it. But no. I'm anxious because my current room is crowded now with a woman who is seemingly on her last legs and a 40ish overweight guy who talks really loudly. I finally move: Two movers come and order me back into bed, then wheel me into my new room. Apparently, they move cardiac patients and there is only one way to do it. But the new room is great! I can shower, I can close my door, there is an excellent view out the window. I eat supper and then shower. Nurse Michelle has even found some Herbal Essences shampoo. But there is no shower curtain so it's a bit tricky.
My sister Rosemary phones (she lives in California and got the number from Ed). Sara and Esther show up and then Ed and Fritz. This is really nice as we have a stimulating theological discussion, and Ed has brought me a book on a guy's motorcycle tour called "Ghost Rider". Afterward, I get my belly needle and night pills. Also 2 Tylenol, but my headache is finally getting better. Daniel phones: He won the All-Star game, but is much more interested in how I'm doing. I close my door, lay the bed flat, and immediately fall asleep, not even needing the earplugs Michelle has so thoughtfully provided.
Spend the morning reading the book from Ed. It's great. Also writing some thoughts and trying to figure out the lyrics to Jokerman. Dr. Manyari comes and tells me the bad news that I won't be going to St. Paul's till tomorrow at the earliest.
Sara comes to visit. I love my wife so don't like the worry this is causing her. Later, the nurse (Sylvia) tells me it's tomorrow for sure. Still later, she shows me I'm scheduled to be there at 9:30AM. Dinner will be my last meal for a while. It's "Mandarin Turkey"; quite good.
I'm a little scared: the thought of a stranger sending a catheter up into my heart is a little disquieting. Moreover, stats say that the success (non-complication) rate is 95%. That's to reassure me, but I actually don't consider the number high enough. (Later, on reflection and after having seen the bad shape most angio patients are in, I think for someone like me the number probably is higher.)
Sara and Esther show up and visit for a while. I go to sleep at 11:20.
9:30: I'm installed in bed 6 and wait. Lots of other cases get in before me. Most of these people are blimps or physical wrecks for other reasons. I feel out of place. I'm of course very hungry but can do nothing about it. At 11, nurse Lisa comes to shave my groins. It's fine: Modesty is the least of my concerns.
At noon I sign a consent form for Petra who is doing a study to determine angio patients' sensations during the PTCA procedure. (BTW: PTCA is "Percutaneous Transluminal Coronary Angioplasty" you can find any amount of info just by googling ptca.) If I don't need PTCA, they won't ask me any questions. Anyway, it looks like my turn is soon.
Not so. Two other critical MI cases come in in the meantime and I'm bumped. At every delay, I use Esther's cell to phone Sara: "Not yet...".
I finally get in at 3PM. In the angio room, I get a little Valium in my IV, just to stop the nervousness (wow, I can really see the attraction in IV drug use). They prep my groins with some wicked stuff that stings and burns and paints me red. Then a slight prick and the doctor (who has one of those long hard-to-remember Sri Lankan names) starts feeding in the catheter. I can watch the progress on the computer monitor. Pretty neat. The X-ray camera is on a gantry and this allows it to move around keeping up with the end of the cath. When the camera gets near my face, I go into a sneezing fit! Then I watch as dye is injected and the Dr. investigates all the arteries one by one. I feel strange fluttery sensations in my heart and a sense of pressure (all normal, I'm told). Finally a large amount of some other dye that makes me feel warm all over and then suddenly makes it feel exactly as though I've peed myself. After 10 or 15 minutes of this, it's over. No blockage found! No angioplasty needed! Hallelujah!
3:30: I'm wheeled out and phone Sara the good news. She is elated and tells Esther, Ben and Daniel (Dan didn't work today so he could be with Sara). Next, I ask for a sandwich. Now the hard part: I have to continue lying flat on my back for another 2.5 hours. This starts with a big C-clamp with a sort of point at the business end that Nadia applies to the hole in my groin. It's clamped very tightly and only loosened in small increments every 5 minutes. After about a half hour of this, the clamp is removed and the wound bandaged up. I finally get my sandwich and some juice.
At 6PM, the paramedics show up to take me back to Surrey. I'm still in my lie-flat period, and my back is sore from it, but I'm happy and thankful. Back in my room at 7PM, I find that nurse Sylvia has thoughtfully saved dinner for me. She right away takes it and reheats it in the microwave. I love these nurses: haven't met a bad one yet. There was also a note on my pillow from Rev. VanVliet; apparently, George Wendt is in the next room and needs angioplasty.
Julia and Gerry show up, surprised to find I'm just back (they thought I would go on Thursday). Then Sara, Dan, Esther, Rosie come and give me big hugs. Sister Rose phones too and her relief is really evident and appreciated. Marge phones too; same for her. The kids go visit George Wendt for a bit. The nurses wonder who they are and who they will visit next.
After they all leave, I wash my hair (wireless monitor thrown over my shoulder) and give self a sponge bath. Tony phones too. Then I write a bit and go to sleep.
I can go home! I call Sara, and she comes to get me.