If you are unsure if your symptoms are those of a heart attack, read about my heart attack were I had not chest pain, no shortness of breath, no left arm pain - all of what I consider at the time to be the symptoms of a heart attack.
I had a heart attack on Sunday, November 10, 2002. One artery, which the doctor said provided blood to 40% to 60% of my heart, was nearly completely clogged.
I was on my way home, driving, from my father's home about 50 miles from our home.
about 5 minutes after starting home, I developed a mild headache, nothing unusual expect that it hurt on both sides of my head, about right above the front of my ears. I've never had a headache there before.
I put it off to tension or even low blood sugar - I hadn't eaten for a few hours.
about 15 minutes later, as the headache grew in intensity, my upper jaw began to hurt, right at the point where the lower jaw hinges with the upper jaw.
Just a short time later, my back started to hurt - just a slight ache at first. The pain was distributed across the top of my back, at my shoulders - there was, in effect, a band about 5" high of pain across my entire back right below my shoulders.
I took this to be from some heavy lifting I did at my father's. He is 85 and I moved some things he had no business trying to move.
By the way, I'll be 51 on January 2, 2003.
Well, about 35 minutes into the trip home, I had a pretty fierce headache, my jaw hurt quite a bit, my back hurt, and my arms were starting to feel quite weak, arm pain, just some weakness.
I went right by 3 hospitals at this point - I simply thought I needed to get home and rest.
about 15 minutes later I was passing right by another hospital - I mean RIGHT BY as this hospital was on the highway's outer road. That hospital is named "Christian Northeast"
about 10 minutes later I passed by yet another hospital - "Christian Northwest"
about 15 minutes later I had come to the conclusion that there was no way that I was going to make it home.
I started looking for a place to pull over - by this time I was in the North County area of St. Louis, not a rural area, and the area is a bit, well, bad.
I remembered that there was a large gas station and store at the intersection of the street I was on and the interstate highway I was heading for.
I pulled into the gas station and called my wife on my cell phone.
I told her that I was ill and could not make it home and to come and get me. She told me, later, that she literally dropped what she was doing when I called and said I needed her to come get me - she was cleaning the bathroom and answered the phone on a cordless phone that we have in the bathroom. She said she dropped the rag and bottle she was holding in the floor and took off.
Yes - we have a phone in the bathroom. Both Sharon (my wife) and I run a business from home and so we need to catch all calls - that's why we have a phone in the bathroom
I then got out of the truck (I was driving a Ford Ranger mini pickup) and laid down on the grass at the side of the parking lot, trying to find a position in which the pain was at least a bit less intense.
After a few minutes, I gave up and got back in the truck and sort of braced myself with my back to the driver's door and my feet on the passenger's door - this position seemed to lessen the pain a bit.
I phoned Sharon at least 3 times before she got there - the pain was so bad and I needed to know that she was actually on her way and how much progress she had made - needed to hear her voice.
She arrived about 15 minutes after I called and I simply crawled into the back of our Pontiac Montana mini van and laid down the floor - luckily there was an old blanket we had used to protect some furniture we had recently moved. I balled it up and put it under my head and shoulders.
I told Sharon we could not leave the truck where it was and she called one of my sisters who lives about 15 to 20 minutes away. She and her husband came to get the truck and take it back to their house.
about 10 minutes after Sharon called my sister, a police officer happened to pull a car over and they wound up in the gas station's parking lot, only maybe 20 feet from us.
My pain was still building and I suggested that Sharon could maybe give my keys to the police officer and he could wait for my sister and we could head for the hospital - for quite a while I had not considered that I needed a hospital, but shortly before Sharon arrived my decided that YES I need a hospital.
I had no idea I was having a heart attack. I considered a stroke, but the symptoms didn't seem to fit that either.
I just knew that I had severe pain in areas in which I had not had such pain before and wanted it to stop.
As Sharon was walking over to the police officer, my sister and her husband arrived (they had to have run some lights and push the speed limit quite a bit to get there so quickly), Sharon threw my keys to them and got back in the van.
She asked me "WHERE?" - she did not know the area. I told her how to get to the nearest hospital - it was the Christian Northwest" hospital that I had actually passed earlier.
Sharon made a wrong turn coming out of the parking lot but realized what she had done and got on course in a matter of seconds after executing a very quick U-turn.
We got to the hospital and Sharon parked as close to the door as possible. She opened the back door of the van and asked me if I needed a wheel chair. I said "No, I think I can make it."
As we approached the first set of doors - the entrance was the usual "air lock" sort of thing with two sets of doors - any way, as we approached the outer doors, I saw the wheelchairs that were in the "air lock" area and as we walked through the first set of doors I said "You know, a wheelchair sounds really great "
She turned one so I could sit in it - I actually plopped into it - and wheeled me through the inner doors, which had been opened my someone when they saw us coming.
I don't remember hearing Sharon say anything, but she tells me she said "chest pain" and I was gone. I actually had NO chest pain but I guess Sharon had not understood when I described my symptoms. I repeat, I had no chest pain.
Several days later she told me a was so pale and gray looking that there was really no need to have said anything. The staff took a look at me and shifted to high gear.
I was taken to a room, put on a bed, and "attacked" by a team of about 4 people who really knew their jobs.
One person took my shirt off, telling me, as I raised up to help her take it off, to just "lay down" and not help, she'd do it.
Another person put an oxygen setup on me and then waited with a blood pressure cuff, ready to put it on my arm when that sleeve was removed.
Someone else was taking off my shoes - I had not worn socks that day - and another person was wheeling over an EKG.
They got me hooked up and the doctor, who had been standing aside letting everyone do their job, said, after barely even glancing at the EGK output, "You ARE having a heart attack."
My thoughts were not "Oh No!" as might be expected.
Instead they were sort of "Ah, good, at least we know what is wrong."
I really did not "face my mortality", as many would have suspected.
I suspect that is because I did not have any breathing problems - I think everyone understands the stress and fear that you can experience when you have trouble breathing. That may be one symptom which really frightens everyone.
I was in a great deal of pain, but at no time did I have any trouble breathing and I simply did not feel like I was in mortal danger - though I was flirting with it. The nurse who took over my care after the others had "set me up" and the doctor decided on the treatment at one point put some self adhesive pads on my chest and one my back. He said he wanted to put them on so that if he had to shock me, he would not burn me.
The nonchalant way he said that and the casual way he put the pads on me, caused me to not even realize that he was talking about the possibility of my heart stopping or going into fibrillations, because of which they would have to do the "Clear! - Zap" think to restart my heart.
A few minutes later he told me that I had been throwing some "PCVs" but they had stopped.
Remember that by this time, the morphine was doing it job. While morphine does not produce the high of other drugs of its type, it does "relax" you quite a bit.
It was not until later that I realized that Mark, the nurse, was taking steps to be prepared to "revive" me should my heart stop or go into fibrillations. Sharon and I had a good laugh about it - you can laugh when things are under control and you're no longer having symptoms.
I could go on in more detail, but suffice to say:
I was administered quite a load of blood thinners and then morphine.
We were at the ER until about 2:00 AM (we had arrived right at 6:15 PM) waiting for a room in ICU at Christian Northeast hospital to open up.
You see, Christen Northwest, whose ER we went to, is being shut down and the only departments still open were the ER and the Psychiatric wards. In another week or so, ER will be the only department open.
Because of this I had to be transferred to another hospital for an ICU and they sent me, of course, to a hospital in their "system", to Christian Northeast. I had driven right past Christian Northwest hospital and could have been in an ER about 40 minutes earlier had I recognized the symptoms.
I stayed in ICU until around 11:00 PM Tuesday and then I was transferred to their PCU (Progressive Care Unit) and hooked to a wireless EKG so that I was able to get out of bed to use the toilet and to walk around. They let me walk around beginning on Tuesday morning.
Let me repeat the timing of all of this. First symptoms started right at 4:30 PM Sunday. I arrived at the ER a few minutes before 6:00 PM. I was transfered to the ER around 2:00 AM Monday. The cauterization and stent implantation was done sometime late Monday morning. I was transferred to the PCU around 11:00 PM Tuesday. I went home late afternoon of Thursday.
A funny thing happened after I was transferred to the PCU - the nurse who had brought to PCU, from the ICU had left. I decided I needed to use the restroom and got up and started walking over to it. A few seconds later the nurse came flying in and asked me if I'm okay and if I needed to have a bowel movement. I told him I was fine and I'd find out about the bowel movement when I got there - to the toilet.
I can picture him sitting at the nurse's station, shooting the breeze and my monitor suddenly showing a really increased heart beat and such. He probably thought something like 'Oh my god, I bring him up here and now he's in trouble."
I had some leakage of one valve on Monday when they did the catheter and implanted a stent, but it was much improved when an ultrasound was done on Wednesday, and the doctor, on Thursday when I was released, said that he expected it improve even more.
I was discharged from the PCU on Thursday, November 14th.
I was on Lipitor (40 mg), Accupril (5 mg), and Plavix (75 mg). The doctor also "prescribed" an 81 mg aspirin each day.
Now I'm taking Lipitor 40mg. I was taken off the Accupril and Plavix about a month and a half after the heart attack.
My main reason for writing this message is to pass on my mistaken notion of the symptoms of a heart attack.
I had always heard, and read, that shortness of breath, chest pain or tightness, and possibly pain in your left arm, where the major symptoms of a heart attack.
Had I know that the symptoms can be only a headache, jaw pain, and back pain among others, I would have stopped at one of the 5 hospitals I passed on my way home.
As it was, I wound up at the ER of the last hospital I passed and then in the ICU of the next to last one I passed
I could have been at an ER over 40 minutes early than I was. At least, I could have stopped at Christian Northeast, where I wound up in ICU later. I would have been there about 35 minutes sooner than I arrived at the the other ER.
As it was, I guess my luck held out and I made it to an ER in time for the blood thinners and other medications to be effective.
So - if you are in doubt, CHECK ON THE SYMPTOMS YOU ARE HAVING!!!!!
I am feeling quite well but I tire easily, big surprise, right? and I am making minor changes to my diet - we already followed a pretty good diet - and I have stopped smoking.
I decided to stop smoking, and really this is just a coincident, about the time the sound waves in the air, coming from the Doctor at the ER when he said "You are having a heart attack." almost reached my ears.
Now, honestly, my decision was just coincidental to the heart ache... if you buy that I have a bride in Alton, IL that I'd like to sell you. I have already disposed of a bridge in Brooklyn, NY but the bridge in Alton, IL is, itself, a great deal!
So - learn more about heart attack symptoms and be ready to make the decision to stop at or go to a hospital when you are in doubt.
The most that could happen, a side from your actually having a heart attack, is that they send you home because it was indigestion or such.
Just don't take chances.
-- Update as today, 1/22/09
I'm still on 40mg of Liptor and I take a full dose aspirin now - not an 81 mg.
My cholesterol is down from 250 at the time of the heart attack to under 110 most of time. My LDL is always below 60 and my HDL is usually around 37.
I'd like to get my HDL up because low HDL is not considerd to be a high risk for heart attacks but so far nothing seems to help. I've tried massive doses of Niacin - 2 g, that's 2000 mg, per day with no result.
Only twice since my heart attack has my HDL been above 40 and both times I could not think of anything in the way of diet or other facdtors which could have raised it.
I get my cholesterol measured pretty much every month. One hospital in town has a special on the third Thursday of each month. They charge only $10 for a full lipid panel. It is a complete panel, nothing is calculated.
As to diet, we already atea lot of chicken and fish when I had the heart attack. We've pretty much dropped red meat, even though once and a while I'll treat myself to a hamburger. I cook only with olive oil and try to use other poly and mono unsaturated oils whenever possible.
December 28, 2007 was a bit of a scare and a comedy of errors.
My left arm began to hurt. I wound up in an ER because the Urgent Care center I went to didn't do their job in diagnosing the problem.
Suffice to say that the ER staff pretty much coerced us (my wife and me) to have me admitted for further testing.
In the ER my EKG was normal, except for artifacts from my heart attack. All blood tests for heart enzymes and such were normal and while a nurse was taking my history and exploring my symptoms, we figured out that the pain was positional.
The pain would change as I moved my left are about and if I tilted my head back as far as possible, the pain intensified.
By this time I was pretty sure I was not having another heart attack.
But there would have been no way to convince my wife that I didn't need to be admitted. I told the ER staff that I'd sign any wavers they wanted me to sign but they said that regardless of wavers, if I was having a heart attack they would be liable. They were clearly more concerned about the liability issue than what was best for me.
I'm serious - their concern, about not admitting me, was that they might be liable if I left.
So I was admitted around 5:00 PM on Friday. Saturday, midday, they sent me to have an MRI to see if there was some problem in my neck or shoulder that was causing the pain - yes, they were thinking the pain was not a heart attack but had pushed and pushed us to have me admitted.
The MRI was not completed. My arm hurt so much that I could not lay still. The MRI technician called around to see if she could get me something to either deaden the pain or relax me so that the a pain didn't bother me, but she couldn't find anyone willing to prescribe someting.
Here we are in a huge hospital and she could find no one who would prescribe something!
So, the MRI wasn't done.
Later Saturday they gave me a stress test - the most expensive one they do.
Results - negative. As one doctor put it "No muscle was in danger"
I was discharged Saturday around 9:00 PM.
The bill was $10,000 and they had done nothing to treat the pain in my arm - when I left it hurt as much as it had when I was in the ER.
I was given a prescription for pain but I had trouble getting it filled because the pharmacist could not figure out the doctor's name. The signature was basically three loops and the doctor had not bothered to print their name in the space provided on the prescription form.
After I made 4 or 5 calls to the hospital, they figured out who had written the prescription. I had even faxed a copy of the prescription to the hospital to see if they could read it.
So, around midnight on Saturday, I got the prescription filled. I took some and about 1 1/2 hours later the pain was the same. I took another dose and it still did nothing for the pain.
I took some ibuprofen and in about 20 minutes the pain was almost gone.
All in all, the ER trip was unneeded. Had the urgent care staff done some diagnostics, I would not have wound up in the ER.
We couldn't pay the $10,000. The hospital has several charities which work with them and one was able to pay the bill for us.
We still had about $1,500 in doctor bills to pay. We are still making payments on some of them.
At least I had the stress test, something I had not done because of cost.
I get a little short of breath occasionally but basically I'm back in the shape I was in before I had the heath attack on 11/10/02.
There were smaller blockages for which they did nothing and perhaps one of them will rupture in the future. But we will take that as it comes.
I accept that I have Coronary Artery Disease and sometimes consider that my cause of death may be another heart attack but I don't let it get me down.
When I was in the hospital with heart attack, I asked everyone I saw if neck pain, back pain, and a headache were normal symptoms - I asked how often heart attacks occurred without the "clasic" symptoms. Every one said 'Oh sure, that happens all the time."
When I arrived at the hospital where they transferred me from the ER, one of the people who meet the ambulance walked along next to the gurney as I was taken to the ICU.
I told her that I had not recognized my symptoms as those of heart attack. I told her that my jaw hurt and my back hurt and, before I could mention the headache, she said "I bet you had one hell of a headache too."
I told her, and others, that they need to tell the public about this. Even today, when you look at a web site or literature, the first symptoms listed are chest pain, shortness of breath, and possible arm pain.
The others, like my symptoms, are listed but most of time things are worded such as to make you think that you will have the "classic" symptoms and perhaps you will have one or two of the other ones.
Here's what is on a wallet card you can download from the National Heart Lung and Blood Institute:
"If you or someone you are with begins to have chest discomfort, especially with one or more of the other symptoms of a heart attack, call 9-1-1 right away. Don’t wait for more than a few minutes—5 minutes at most—to call 9-1-1. If you are having symptoms and cannot call 9-1-1, have someone else drive you to the hospital right away. Never drive yourself, unless you have absolutely no other choice."
This clearly says that chest discomfort is the key symptom of a heart attack, and, oh yes, you might have additional symptoms.
I've email them twice about this and the wording of other information and their reply was "It says most heart attacks have chest pain."
I've tried to get them to add "Be aware that not all people having heart attacks have chest pain or shortness of breath. Some heart attacks occur with the other symptoms listed below without chest pain and shortness of breath."
They simply say that the material says "most heart attacks.."
I pointed out that this statement is not in all of the publications but they wouldn't listen.
I can't get them to understand that the wallet card clearly tells you that the key to suspecting a heart attack is chest pain.
You can find this wallet card at http://www.nhlbi.nih.gov/health/public/heart/mi/wallet.htm
Other misleading publications include:
Perhaps if enough people email them about the way they have things worded, they might consider making changes.
Even the AHA site - http://www.americanheart.org/presenter.jhtml?identifier=3053 - says:
"Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain."
These organizations have got to change how they discribe heart attack symptoms. They have to clearly state that heart attacks can happen without chest pain or shortness of breath; that the only symptoms of a heart attack could be only one of the other symptoms they have listed.
Yes, they say "Most heart attacks involve..." but they need to state explicitly that heart attacks can occur without chest pain.