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Narrative
chronology below describes her heart attack and treatment, then status
after a year
Overview of Diane's
Heart Attack &
Treatment
On Jan 11, 2008
Diane had an acute
myocardial
infarction - 70% blockage of
right coronary
artery - from a blood clot formed from eruption of lipids after a
vulnerable
plaque rupture (see
video). The duration of heart muscle oxygen deficiency was
reduced by >30 minutes, by receiving 1/2 the FDA dose of
clot-busting
Retavase in ambulance vs. hospital, part of a UT
clinical trial.
This artery had
experienced an uncommon separation (dissection) of the interior flow
area from the artery wall, that caused blood to flow down a newly
created "false plenum" which had the effect of partially collapsing
the "true plenum". This artery now has only 10%
stenosis after being fully reinforced with SEVEN expanding mesh
titanium stents. These
Liberté-brand stents by Boston Scientific were
positioned to allow all the smaller arterioles to still feed oxygenated blood to the right
ventricle.
(Note her two other coronary arteries displayed no
problems)
Detailed
chronicle below of her heart attack, treatment, monitoring
& rehabilitation for a month.
Friday Jan 11,
2008
The afternoon of Jan 11, 2008 Diane was at
Church of
the Redeemer with Dick Bird, getting music ready for a new Friday
night service. Suddenly she felt sharp pain spread to her jaw and
left arm so Dick
called "911". Our Rector Rev. Nan Doerr was already on her way over to
church and saw two ambulances go by, and got there in time to help EMS
gain access into the building.
The Emergency Room's
were full at St. Joseph's, St. Luke's and Methodist hospitals.
Fortunately
Memorial Hermann
has a new process that gets patients directly to Cardiac Catheterization
Lab, bypassing their ER procedures. EMS crew immediately began
treatment while Diane was being transported. They did not wait for
any of the required health insurance forms to be filled out - support
staff arranged for all the forms for
on patient "Yankee1229" (her hospital code name for the
first 24 hours) to be bought to Bob when he arrived!
UT Med School interventional
cardiologists
over several hours used
minimally
invasive procedures that started out with a coronary
angiogram
- live Xray images captured on digital video that shows arteries using
radio-opaque contrast injected - followed by a catheter inserted through a
groin incision in the
femoral artery.
This first catheter procedure used a live video camera which is how Dr.
Ali Denktas discovered the extent of the problems in the right coronary
artery. The team did the stent
placements guided by the live imagery. Early evening she was
transferred upstairs to the CCU of their
Heart &
Vascular Institute. Bob stayed in the CCU for several hours filling
out detailed medical history required, then slept in the
waiting room.
Saturday Jan
12
In the early morning hours a Resident removed the heart catheter
which had been preventively left in as a precaution after the procedure.
Later that morning a full
echocardiogram was done of her heart -from four angles - to look if any areas
of heart muscle were not fully responsive to the electrical rhythm
of the heart. She will get an initial opinion on Sunday, but the doctor
warned it might be six months before they fully know if the MI caused any
permanent damage, comparing the enzymes and heart function. Diane has
EKGs performed several
times per day. If all is still well Sunday, she will transfer to an
intermediate cardiac care room.
The doctor advised she can resume her job
within a week,
which doesn't involve lifting more than 5 lbs. While in hospital she is on
Aspirin,
Beta-blockers,
Lipitor, Plavix and
Protonix
Sunday Jan 13
Her doctor reported no problems with any of the diagnostics they
had performed, and only made adjustments to some of her intravenous
medication. He used the phrase "perfect" and teased why wasn't she in
her chair (because it was too low compared to the bed). The "markers"
in her blood that occur after an MI were coming down as expected, so he
arranged for her transfer to Rehab, which will start Monday Jan 14. She
was moved to Room 352 of
Cullen Pavilion.
Monday Jan 14
Diane begin doing in-hospital rehab walking exercises, but was not
able to do closed
cardiac MRI - and there is no open MRI for hearts. Diane was referred
for out-patient Phase II cardiac rehab near our home, at
Memorial
Hermann South-East. She was given
full details of the Retavase trial agreed to on Friday, with phone call follow-up to occur monthly for a year.
Tuesday Jan 15
She was discharged after lunch, received a written report of the
cath. lab procedure, prescription for medicines with literature on each,
and written advice about diet and lifestyle. Bob signed her up for
Clear Lake Community Ass'n
low-impact aquatic exercise classes Tues/Thurs 8-9 am for her knee
health and weight loss, and got map directions to her trice-weekly
cardiac rehab.
Saturday Jan 19
Diane has stayed home this week, getting up each day, and doing
small things around the house (making tea, feeding dogs, washing dishes)
and looking forward to being driven to church Sunday.
Sunday Jan 20
She sat in the congregation, joining in the hymns and prayers, staying
afterward for the annual parish meeting and lunch before going
home for a nap. She and Bob have decided to switch to evening aquatic
exercise on Tues and Thurs so they both can do it, once she is cleared
to do exercise other than supervised cardio.
Friday Jan 25
Diane's sister Joanne drove her to cardio rehab where she worked out on
the recumbent bike. Her next appointment with her cardiologist is
January 29, to get cleared for driving.
Thursday Jan 31
Had a follow-up appointment with her catheterization doctor, who
has cleared her to drive and go back to work. She's working two
days/week from 10 am to 2 pm i.e. half as many days as before.
Status at Three Months
Diane was in cardio rehab three
times per week; back at her Admin. Asst. job at
church Monday, Tuesdays & Thursdays, and taking part in prayer group and church
on the weekend. She has a Schwinn
recumbent exercise bike
and upper-body tabletop machine to do rehab at home.
Status After One Year
Diane has now chosen to step back from working in the office
at the
Church of the Redeemer.
She still composes the Sunday bulletin from home using
Publisher, and sets the weekly
service music to fit on half-page using
Sibelius.
She is enjoying taking our
five-year old grandson Brian to and from school, and taking her elderly
aunts lunch each week |
