Tuesday, March 25, 2008

Psalm 73:26 Part 1

Almost six years ago I was putting my two year old daughter to bed when she glanced out her bedroom window and saw my wife walking down the sidewalk away from our house. "I don't want mommy to go!" she said. "It's OK," 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 emotional voice was told that my wife had just passed out, she needed immediate help and gave me directions to where they were so that I could bring a vehicle over 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 directed me.

My wife was laying half on a sidewalk and half in someones yard with an unknown lady helping her and my wife's friend 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. But she slumped in my arms, passed out and we laid her on the ground again. Our friend dialed 911 on her cell phone and I talked with the operator and an ambulance was dispatched.

Her friend took my keys and drove the mini-van back to our house stay with our children until my wife's parents could drive down and stay with the kids.

The paramedics came and took charge. They were asking questions, giving care, getting her onto a gurney and into the ambulance and I found myself riding shotgun to the nearest hospital.

My mind was whirling, what happens if she dies? Do I move back in with my parents?

Rain was splashing on the windshield and the wipers rhythmically pushed it aside.

What do I tell my two year daughter? I just told her it would be all right and mommy would be back in 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 IV's and they gave her a strong diuretic (I think, I don't play a doctor on TV) because she had massive fluid build up in her lungs because her heart wasn't functioning properly.

She was responsive at this point as 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.

And I sat there just outside the door in a plastic metal legged chair that reminded me of grade school, alone. The corridor was khaki painted cinder block walls and a similarly dull tiled floor. It felt like a tomb and small sounds echoed down its walls.

Twenty minutes seemed an eternity.

Then they wheeled her out, and we were hustled back up into to main ER portion of this hospital and 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 from 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. And I laid down on the floor next to the wall and waited alone.

My wife was greeted going into the lab 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 when this all started had been the head nurse in charge of the angiogram lab at the premier heart hospital in our region of the country! She had been called in just after the initial episode, but then asked to stay on a bit because they had a lady coming in, and in her heart she had said, "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 said that they 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 heart, didn't originate from the back side of the aorta as it usually does. Instead it originated from the other coronary artery (the right main) which is comes out of the front side of the aorta. And to get back to where it needed to be it had run between her aorta and her pulmonary artery.

That meant that at any time her left main coronary artery (which feeds roughly half the heart) could have been pinched off, being squeezed 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 more 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 deliver 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 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 had stabilized, 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 holding our infant son. The nurses were used to dealing with people who were toward the latter stages of their life, and were usually in that unit because of their own life choices (i.e. extremely overweight and/or smokers.)

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