Trisha's Heart Condition
By Rob Pace
Almost ten years ago I was putting my two-year-old daughter to bed when she glanced out her bedroom window and saw my wife, Trisha, walking down the sidewalk heading away from our house on her walk. "I don't want Mommy to go!" she said.
"It's okay," I told her, "Mommy is just going for a walk around the neighborhood with a friend and will be back in a half hour."
The area where we were living was in a severe drought and we hadn't seen even a hint of rain for a couple months. But that evening it was beginning to storm, so they took a cell phone with them just in case they needed to be "rescued." Getting some exercise was good; getting soaked for their efforts would be bad.
About twenty minutes later I received a call from my wife's friend and - in a very controlled yet emotional voice - was told that my wife had just passed out and that she needed immediate help. Then directions were given to me as to where they were so I could bring a vehicle to get her.
Not knowing quite what to do, I locked the house with our two year old, her two older sisters and our infant son asleep inside and then quickly drove the mini-van the block or so away to where my wife's friend had directed me. My wife was lying half on a sidewalk and half in someone's yard. There was an unknown lady helping her and my wife's friend was at her side.
I wasn't prepared at all for what I was seeing. My wife's skin was white and bluish. The lady had my wife's legs propped up as she lay on the ground and was speaking to my wife in very firm and in-control voice. My wife was responding somewhat to what she was saying but seemed dazed and sleepy.
We eventually sat her up and attempted to lift her into the van to take her to the emergency room. She slumped in my arms, passed out and we laid her on the ground once again. Our friend dialed 911 on the cell phone. I talked with the operator, and an ambulance was dispatched. She then took my keys and drove the van back to our house to stay with our children until my wife's parents could drive down and be with the kids.
The paramedics arrived shortly and took charge. They were asking questions, giving care, getting her onto a gurney and into the ambulance. I found myself riding shotgun to the nearest hospital.
My mind was whirling: What happens if she dies? Do I move back with my parents? Rain was splashing on the windshield and the wipers rhythmically pushed it aside. What do I tell my two year old daughter? I just told her it would be all right and that mommy would be back in a half an hour. I prayed.
We arrived at the suburban mini-hospital that was nearest to the incident, and my wife was wheeled away to innumerable tests. They did an EKG and confirmed that there had been a heart attack and that her heart was not doing well. She was connected to IVs and they gave her a strong diuretic because she had massive fluid build-up in her lungs because her heart wasn't functioning properly.
She was responsive at this point and was attempting to joke with me and make the situation lighter. The problem was that she was still tinged blue and by the actions and overheard conversations with and between the techs and doctors, she was not doing well. A doctor was telling me that there were four or five possibilities that could cause her symptoms and that they "were all bad." Among them were a pulmonary embolism, a blood clot in the lungs, some type of cardiac aneurysm and something else I don't remember.
The final test at this hospital was a CAT scan. She was wheeled to the basement and I wasn't allowed in the room.
As I sat there in a plastic metal-legged chair, just outside the door, it reminded me of grade school, sitting alone in the corridor, waiting. The walls were khaki painted cinder blocks. The floor had dull colored tile. It felt like a tomb and small sounds echoed down its walls.
Twenty minutes seemed like an eternity.
Then they wheeled her out, and we were hustled back up into the main ER portion of this hospital. The cardiac doctor on duty called in a ICU ambulance to take her to the premier heart hospital in our metro area. He would have called the "flight for life" helicopter, but the storms had only increased as the night went on and prevented helicopter transportation.
His comment to the dispatcher was that she was "sitting on something", but he didn't know what. They needed her to get to that hospital as quickly as possible for a cardiac angiogram which would enable them to see what was happening with her coronary arteries and other structures around her heart.
So I got another ambulance ride to another hospital and the world seemed to be disconnecting form me. My wife was talking and joking with the paramedics surrounding her high tech gurney. My wife was stabilized, and I was floating.
At that hospital, they immediately wheeled her away to the angiogram lab, and I was shown to a waiting room. It was empty, like most things in the middle of the night. I laid down on the floor next to the wall and waited alone.
Going into the lab, my wife was greeted by a nurse in blue hospital scrubs complete with the rectangular face mask. She said, "You don't recognize me, but I'm your neighbor." The unknown lady helping my wife on the curb when this all started was the head nurse in charge of the angiogram lab at the premier hospital in our region of the country! She had been called into work just after the initial episode, but then asked to stay on a bit because she had heard they had a lady coming in, and in her heart she had thought, "I bet that's my neighbor."
My in-laws arrived an hour or two later and waited with me. The angiogram doctor eventually came out and told us that he had found the problem. The test had taken so long because initially they couldn't even find one of my wife's two main coronary arteries. It was discovered that she had a congenital anomaly of her left main coronary artery. That artery, which typically feeds the back side of the heart, didn't originate from the back side of the aorta, as it usually does. Instead it originated from the other coronary artery (the main one) which comes out of the front side of the aorta. To get back to where it needed to be, it had to run between her aorta and her pulmonary artery.
This all meant that at any time her left main coronary artery (which feeds roughly half of the heart) could have been pinched off, being squeezed shut between her own aorta and pulmonary artery. The aorta is always under a great deal of pressure(it is the main vessel that feeds all the other arteries). But the pulmonary artery is typically a lower pressure vessel - except when it isn't. As during exercise, or getting up out of a chair or bed, or during the labor and delivery of any of our four children (at the time).
Her particular anomaly is considered especially rare (less than 1 in a million people) and deadly (over 99% are only found at an autopsy), because when the heart is damaged the pressure in the pulmonary artery actually goes up. So, in her case, if her artery was pinched by the aorta and pulmonary artery, it would cause the pulmonary arteries pressure to go up - pinching the coronary artery even more and damaging the heart even more. Somewhat like a drowning person frantically clutches the person next to them and in the process killing them both. A deadly game of Catch-22.
Because she was stabilized, at this point, they put her into the hospital's CICU unit and scheduled an MRI of her heart the next day to determine the best course of action for the open heart bypass surgery that would need to happen as soon as possible. They were able to complete the MRI and plan the surgery the next day.
The following morning, the nurses in the unit were unnerved by seeing our three little girls with pink hair bows and dresses walking up the hallway to see their mommy, accompanied by my parents who had our infant son. The nurses were used to dealing with people who were toward the latter stages of their life and who were usually in that unit because of their own life choices.
The girls had a brief visit with their mommy, because to the enzyme levels indicating new heart damage had elevated. My wife was not stable anymore and emergency bypass surgery would need to happen that morning. I asked the nurse if I had time to walk my family out to the car before my wife would be wheeled in for surgery and she said yes.
Coming back into the hospital from the parking garage, my name was being paged over the loudspeaker to come immediately to the CICU unit. I arrived back at the unit to a very upset wife and some equally perturbed nurses and doctors. My wife was telling them, in no uncertain terms, that she was not going into the operating room without seeing me first, and that they had told me that I had time to see my family out of the hospital before her bypass. The surgeon was perturbed that he had a lady who wouldn't go into surgery when it was an emergency situation and time was of essence.
Later on the nurses said that her anger at that time released adrenaline into her system which had actually served to positively stimulate her heart and increase blood flow, almost prepping it for surgery. God works all things out for good.
The bypass took hours. Friends and various family members came and went from the waiting room. People prayed and spoke in low voices. And I waited. A nurse came in at one point and gave an update.
Eventually they came and announced the surgery was done and they were getting her "settled" in her room. After a bit I was allowed to see her.
What I saw were tubes, wires, and other medical looking things poking into or out of my wife's body everywhere. She had a breathing tube down her throat. She was still unconscious and as I stood over her I noticed that her skin looked like pasty plastic. In her bed next to her was a red heart-shaped pillow.
And THIS was a "successful surgery". I understood the word "successful", but my eyes were in conflict with what my ears heard.
I don't do hospitals. I mean, I almost get sick just entering a hospital. The general hospital smell makes me light-headed. But God is gracious and allowed me to be with my wife over the days following surgery. Amazingly, they never needed to pick me up off the floor, even though I actually observed most of the in-room procedures they performed. My wife did tell me to turn my head when they were taking out the "pre-wiring" for a pace-maker they had sewn into her just in case it might be needed.
Throughout that time there were wonderful friends and family who came in and completely took care of our children with little to no input from me.
Over the next few days I lived by the digital stat machine that existed over my wife's bed. It registered her heart rate, blood oxygen levels and other stuff that meant nothing to me. As the days went on she graduated to fewer tubes, less wires and forced walking. They removed the catheter for the most part to make her get out of bed and walk over to the bathroom.
Eventually she was able to come home. She had to sleep in a lazy boy type recliner for several weeks because her healing sternum couldn't handle being fully prone.
My mom and sister-in-law both came for consecutive weeks to provide daily care for her and our children. Ladies from our home school group came and cleaned our house for two and a half months. Other friends came and mowed our yard.
When the time came for cardiac rehabilitation, we found out that our insurance wouldn't cover that activity. We were just talking about the cost, and how I thought she ought to do it, but we just didn't have the finances at the time. I went out to the mailbox, and a lady from our church had written a note and a check saying that she felt that God had blessed them with a little extra that month and she felt it should go to us. The check was for just $5 less than the total cost of the cardiac rehab. We felt we could afford it for $5!
Months later we had one of our regular follow-up visits with the cardiac doctor after having regular EKGs, echo cardiograms, and finally a nuclear medicine test done. They said, "You are completely well." The EKG indicated a completely normal heart. The Nuclear medicine test indicated a heart ejection fraction of about 55, which is bulls' eye for normal heart function.
The doctor told us that she could come back in ten years for a check-up if she would like. If that seemed too long, she could come back in five. She was assured that her heart was completely normal. There was no activity that the condition of her heart would keep her from doing, including future pregnancies, and labor and delivery.
God is SO GOOD!
Looking back over it all:
God had provided a cardiac nurse living straight across the street to give immediate help.
God had provided a storm in the midst of a drought to provide an immediate phone call for help.
God filled up all the CICU beds in the regular hospital our insurance used, "forcing" her to be sent to the premier heart hospital in our region.
God allowed her to stabilize long enough for a complete MRI and surgery plan to be made.
God caused her to unstabilize soon enough after the surgery plan was complete so that she was operated on by the doctors a that heart hospital and not transferred to the insurance's hospital as they wanted.
God provided friends and family that selflessly gave our family care and basic needs.
God completely healed my wife's heart.
God has added two more children into our home after the heart attack.
"My flesh and my heart may fail, by God is the strength of my heart and my portion forever."
Psalm 73:26 (NIV)