Cast all your anxieties on him, because he cares for you.

1 Peter 5:7 ESV

Mornings in hospitals come early.  Painfully, rudely early.  I’m not quite sure why, but my experience has been that a 4 a.m. wakeup call is typical.  Nurses wake you up to take vitals, take blood, give medications, and generally make sure you’re still breathing.  You shouldn’t dream of sleeping beyond about 4 a.m.  My angiogram was scheduled for 8 a.m.  I was anxious to get it over with, but it was postponed multiple times to accommodate other patients whose situation was more critical than mine.  I understood the necessity of prioritizing patients in greater jeopardy over me.  I was apparently stable by comparison, so I couldn’t complain.  It was a bad day for anyone who’d received the cardiologist’s attention ahead of me.  Still, it was hard to wait anxiously for hours, dreading the time they would come for me, but also eager to put the angiogram behind me and to have more answers. 

The morning turned into afternoon.  Marty and I both watched the door intently for the next nurse or doctor that might step in and say it was my turn.  My stomach growled incessantly because I hadn’t been allowed to eat or drink anything after midnight the evening before.  Upon hearing my stomach roar, one of the nurses promised a food treat as soon as I was finished with the procedure.  As the day dragged on, I feared the doctor wouldn’t get to me that day at all.  Finally, unfamiliar nurses wearing surgical attire came in to get me.  I felt the sudden urge to bolt again, but they moved so quickly there was no opportunity.  For all of the medical personnel surrounding me, this was routine; something they did multiple times every day.  For me and Marty, it was a major life event.  Marty grabbed my hand in his and said a quick goodbye with a kiss.  He was trying to seem calm and confident as he said he’d see me soon, but I knew better.  He was scared too.

Nurses rolled my gurney out of the room and down the hall into an elevator.  I don’t know if we went up or down to a different floor.  My mind was completely engaged by the surreal nature of the experience.  I desperately wanted to escape, but that was not an option.  I was no longer in control.  As my gurney passed through a succession of large automated doors, it was as though I was being drawn deeper into the belly of a beast.  With each set of doors, my independence and autonomy seemed to diminish. It was given over to doctors and nurses.  They rolled me into a large room.  I couldn’t see it all but I could feel the expansive space around me.  A doctor seated himself next to my head.  I deduced he was the anesthesiologist.  He explained in a firm, directive tone that after the surgery I would receive a drug that I must take every day, at the prescribed time, and that I couldn’t miss a dose, ever.  His demeanor wasn’t meant to calm me, rather it was meant to communicate the seriousness of my situation, and to compel my compliance with the drug regimen.  As I focused on what he was saying, a flurry of activity continued around me.  I could feel someone positioning my right arm and wrist to face up on a hard surface.  A large flat panel monitor was moved in close to the gurney on my left side, while the cardiology surgeon took his place seated at my right wrist. I lost full awareness of what was happening as the anesthesia took over. I drifted in and out of a semi-conscious state as the anesthesiologist adjusted the levels of medication.  If I could feel something, I would say so, and then I’d drift out again.  At some point I was awake enough for the cardiologist performing the angiogram to tell me that he found blockages in the arteries of my heart.  He attempted a bit of levity by asking me if I would prefer to have him put in stents to hold open the vessels, or if I wanted the open-heart surgical option instead.  He drew my attention to the monitor where I could see the tiny wire inside a vessel in my heart.  He pointed out the blockage.  I chose the stents and drifted out again.  At some point later, they brought Marty in, showed him video of my heart on the giant monitor, and explained the stents as the fix for the blocked vessels.  A few minutes later I was wheeled back to my room where I noticed that the angiogram and stent placement had taken only about an hour.  So much anticipation and anxiety went into the lead up to the angiogram – it almost seemed anticlimactic, too easy compared to what I had imagined.

My body and my mind were simultaneously exhausted and energized.  Marty and I discussed how my health crisis was resolved in what seemed to be a remarkably easy and quick fashion.  The miracle of modern medicine brought me to a place of perceiving a complex, life-salvaging procedure as easy, quick, and relatively painless.  How truly miraculous was that?  While angiograms and stents have been a treatment for heart blockages for decades, the experience was all new to me as a patient and I marveled at the technological advances that made it possible.  I said a prayer of thanks to God for the development of medicine to the point where such a procedure was common, and for the skill and competence of the doctors and nurses that were caring for me.

A short time later my nurse arrived with the promised meal I desperately wanted all day, plus a treat of some cookies from a local bakery.  I was starving after having gone almost 24 hours without food, but hesitant to overdo anything.  I ate a small sample of the marginally appealing cafeteria food, and a few bites of the different kinds of cookies.  Marty had gone without eating all day as well, so he happily finished off the remains of my dinner.  Late in the evening, Marty finally exceeded the limits of all visiting hours, and was asked to leave.  In a hospital full of people, I was alone yet again, and not ready for it.  My mind was restless, still reeling from the events of the last few days.  The exhausting day should have prepared me for sleep, but I was far from it as an excited giddiness seemed to permeate my body.  I just survived a life-threatening experience, and I wanted to share it with someone that wasn’t exhausted from having gone through every anxiety-ridden moment of it with me.  I looked at the clock on the wall.  It was after 11:00 p.m., but in Alaska it was two hours earlier.  I immediately thought of my close friend Sally.  She’s a self-admitted night owl, and I knew she would be open to a call even at this late hour.  She was surprised to hear from me mid-travels, but happy to talk.  My tone was elevated, bordering on cheerful as I recounted the series of events leading up to my hospitalization.  Stunned and captivated by my story, she let out gasps and brief words of amazement periodically.  Once I told her about the apparent successful resolution, we both reveled in the incredible blessings of God’s timing to counter my resistance, of medical advancements, and the joy of being alive to tell the tale.  After more than an hour of excited exchange and laughter, I finally ran out of words and energy.  I expressed my deep gratitude for her friendship and knowing she was someone I could call in a crisis, and we bid each other good night.  Both my mind and body were finally relaxed, and it was not long before I drifted off to sleep.

I woke up an hour or two later, feeling nauseated.  My stomach warned me I didn’t have much time to get to the bathroom, so I leaped out of bed, dragging the IV pole and tubing that was still attached to my arm.  My body purged everything that was in my stomach.  I hadn’t experienced vomiting in many years.  I’d forgotten how painful it can be as the muscles from the lower abdomen to the esophagus strain to eject anything and everything from your digestive system.  As I heaved over the toilet, I worried about whether the violence of the muscle contractions might dislodge the newly placed stents.  It certainly didn’t seem it could be good for them.  As the nausea diminished and the heaving subsided, I made my way back to bed.  I pressed the call button for the nurse to report what happened.  My nausea wasn’t completely resolved, so I hoped the nurse could give me something to fix it.  He injected an anti-nausea medication into my IV drip, and mused about whether my body might have reacted to the dye used during the angiogram.  It was not common, he said, but possible.  I wondered whether it might have been the hospital food, but it many hours passed since I’d eaten it, so not likely based upon my body’s experience with questionable food.  Perhaps it was just the stress of the entire life-threatening experience.  The medication didn’t solve the problem, and I continued to purge periodically until I had nothing but dry heaves and a completely spent body.  I’d spent two or three hours clearing my system of all that ailed it, and the morning nurse shift change came on about the time I was beginning to rest again.  I felt horrible.  I was dehydrated and exhausted.  All I wanted to do was sleep, but mornings are no time to even think of resting in a hospital setting.  By the time Marty arrived, I felt far worse than the night before.  My body was completely drained of energy. 

The cardiologist came in to give me more details about the findings from the angiogram and an echocardiogram they performed afterwards.  He said the main blockage was in the left anterior descending artery (LAD) and a small bifurcated vessel off of that.  The LAD was 99% blocked, while the small vessel was about 95% blocked.  I was shocked.  How was it possible that I was able to hike so many miles with that kind of blockage, I asked.  He explained that there’s a wide variation in how individuals respond to these blockages.  In some patients, they might come in to the emergency room in full cardiac arrest with a 40% blockage, while others like myself, are still walking around with a much larger blockage.  He suspected that I didn’t get to the near complete blockage until I’d had the heart attack, with some lesser blockage prior to that, allowing me to continue functioning to some extent.  He also explained that the echocardiogram revealed that my heart muscle was not damaged by the heart attack.  I marveled for a few moments at that miracle, and then asked about the next steps in treatment for me.  To my amazement, he said I would take the medications that he would prescribe, and continue with my life, essentially the same as before.  Other than taking care of my arm where they’d inserted the wire for the next week, I’d be free to resume my usual activities within a few weeks, including the bike-packing trip we’d scheduled in about 10 days.

Within a few hours, I received all of the post-procedure briefings on medications, diet, exercise, and follow up with my primary care physician when I got back to Alaska.  The bout of stomach upset left me tired and feeling weak, but I was released to go home, or in my case, to our trailer located in the back parking lot.  We were given permission to stay there another night so I could rest before we started the long drive back to Montana, where our circuitous travels began.  As soon as we arrived at the trailer, I collapsed into bed and fell into a desperately needed deep sleep.  My journey to recovery would begin there and then, but it would not be over for a much longer time than the cardiologist, or I, could have ever imagined.