The Heart Attack (Part Three: Utica ICU)

You may want to check out part one and part two if you haven’t already!

When we got to St. Elizabeth’s in Utica, we were taken right up to the Cardio-Thoracic ICU. Again I had to wait in the waiting area while they got Matt settled. Matt’s sister Stacey arrived while I was waiting – it was so good to see her and have her with me. And as a bonus, she brought me a change of clothes and a hair brush, both of which I’d been without since Wednesday night. We were able to see Matt just briefly before the nursing shift change, at which point they asked us to step out, and the night nurse said she’d let us know when she was ready for us, about half an hour. I was not pleased at being asked to step out – I felt like I was the one constant throughout all these changes in location and caregivers, and I knew the story and could potentially even fill in missing gaps, and I’d sit quietly off to the side and wouldn’t get in the way, but I wanted to be there. I left as requested, though. It seemed like every time there was a new nurse, I had to start all over with proving that I would not be obnoxious and might even be helpful at times.

Stacey and I sat in the waiting room, and soon their cousin Sarah came back to be with us, also bringing dinner for me, because unbeknownst to us, the cafeteria at that hospital closed at 6:30. Thirty minutes went by, then an hour, and we still hadn’t heard from Matt’s nurse that we could come back, and I was getting increasingly nervous and irritated. Finally after an hour and a half had passed, another nurse came in, and I told her I was waiting to be able to go back in to be with my husband, and he’d had a heart attack yesterday, and his nurse had said 30 minutes, and now it had been an hour and a half, and no one was telling me why, and I was getting worried. She said she’d go check for us, and a couple minutes later Matt’s nurse came out and apologized and said we could come back. She said she had some nursing students that night, and she’d lost track of the time. It was a relief to see him when we got back. He had transferred over pretty heavily sedated, because he’d seem uncomfortable any time the sedation turned down, but she was already turning the sedation down a bit, and he seemed more comfortable than he had before. It was clear that the people in the CTICU had experience working with cardiac patients who needed a lot of care – they had a lot of protocols for how thin Matt’s blood should be, turning him every 2 hours, having him wearing compression socks, etc.

After my initial misgivings, I decided I did appreciate the expertise of this nurse, and she turned out to be really nice to me. She got me some blankets and a pillow and set me up in a quiet room just off the waiting room for me to sleep that night. This was now Thursday night, and I hadn’t slept at all since Tuesday night, but it was still hard to sleep. I’d close my eyes, and immediately my thoughts would return to Matt having his heart attack in the hotel room. I knew I was starting to get a little loopy though, and my body really needed the rest. Eventually I drifted off to sleep around 1:00 am and slept for about 2 hours, then laid there for an hour or so, reminding myself that Matt’s nurse had promised to come and get me if anything changed, and that must mean things were okay. I slept again from about 4:00 to 6:00 and then was awakened by Matt’s nurse. She said everything was fine, but she’d been gradually turning his sedation down throughout the night, and he was starting to wake up, and she wondered if I wanted to come see him. Of course I did! He was still pretty out of it, but it was good to see him half-awake and able to move around a bit.

That morning I signed consent for a PICC line to be placed – Matt had a lot of IV sites, all of which would expire after 4 days, and he was constantly being poked for blood draws, and the PICC line would eliminate the need for all of those. A nurse from the cath lab also came up to explain the procedure to me in detail and get my consent, and she also got me the forms to request all the images from the cath and to request all of Matt’s medical records upon discharge. After we’d done all the paperwork, I asked her if she thought they were going to do the cath that day – the day before, they’d said initially that he’d go straight to the cath lab upon arrival, but then they’d gone back on that and said it would be the next day or potentially even later, depending on his vitals and temperature. She said she thought it would be that day, but she called down to the lab to see if she could find out morning or afternoon, and they said actually they were all ready to go, but no patients were ready, and if he could go now, he could come right down. That was practically the only time in the hospital that things actually moved fast – they got him ready, and we went right down!

Danny and Sharon had arrived in the night, and they were waiting for us in the cath lab waiting area, so they got to see Matt for a few seconds before he went in. Then they and I went and got some breakfast in the cafeteria – I got apple pie, because I figured that if my husband had had a heart attack, I was allowed to have apple pie for breakfast, and Danny and Sharon agreed 🙂 They waited with me through the cath, and Matt’s sister Stacey arrived while we were waiting, too. And actually my friend Tammy’s sister-in-law’s sister lived nearby, so Tammy asked her and her family to stop by and bring us a small gift and pray for me, which they did.

And it really wasn’t long before Matt’s cardiologist came out. He said that most of Matt’s arteries looked good, but they’d found a blockage – in fact it was a 100% occlusion – in an artery, and they’d placed a stent. He brought pictures to show me of what the blood flow looked like before the stent was placed and afterwards. He said he expected that Matt would make a full recovery – that he needed to lose weight and get into a regular exercise regimen and change his diet, but he thought he’d be fine. Those were encouraging words to hear!

We went back upstairs to the ICU and were able to see Matt again. He was still fairly heavily sedated, but with the cath behind him and the stent placed, the plan was to wean him from the sedation and then allow him to try breathing on his own, which would allow him to be extubated. Danny and Sharon were able to see him again, and then they took off and headed for Camden to pick up our kids and bring them out for a visit. Our friend Dan and his father also stopped by again for another brief visit, and then Stacey and I were there with Matt for the afternoon.

We talked with the electrophysiologist when he came by that afternoon, a visit that left me more worried than my conversations with the cardiologist that morning. When I’d spoken to the cardiologist, he’d said they’d found the blockage and expected Matt to be fine, but he came back that afternoon and said he’d called in the electrophysiologist to consult just to make sure everything was covered. The electrical event with Matt’s heart could have been secondary to the structural blockage, but sometimes electrical events are truly primarily electrical in nature. The electrophysiologist was somewhat alarmed by the combination of Matt’s sister having passed away unexpectedly at a young age a few days prior and the blockage that was found not being in one of the most major arteries and the fact that we’d be traveling back across the country fairly soon after discharge. He said it really was most likely that Matt’s heart attack was primarily structural in nature, but electrical stuff is harder to pin down, and they’d monitor Matt’s heart rhythms over the next few days, and he might recommend that Matt be discharged with a life vest – essentially a wearable defibrillator. Just the possibility of any sort of uncertainty was alarming to me, but everyone still seemed to think this situation was probably pretty straightforward.

Stacey and I were able to hold Matt’s hands as he began to wake up, explaining over and over again that he’d had a heart attack, and he was intubated, and he needed to leave the tubes where they were, but he could relax his jaw and touch his tongue to the roof of his mouth, and that would make him feel somewhat better. He was obviously uncomfortable, but he needed to be totally off the sedation before they could let him try breathing on his own, and he needed to breathe on his own for an hour before he could be extubated.

While Matt was doing his hour of breathing, Danny and Sharon arrived with our kids! I was thankful that Stacey was there to stay with Matt, and I got to go out to the waiting area to see the kiddos 🙂 I can’t even describe how good it was to see them after nearly 48 hours away. Fortunately, in the backpack Stacey had brought me with my clothes, there were also some art supplies that I’d been holding in reserve, so I was able to take some of those out with me, and we made sticker-dinosaurs together and hugged and played. I got to nurse Atticus, too – normally highly distractable in any situation with other people, he was desperate enough that he settled in and ate snuggled up on my lap while everyone else played. It was so good to get to see and touch and interact with each of them again!

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But soon I began to feel the other side of the tug-of-war constantly pulling at my heartstrings – I needed to get back in and be with Matt. And really the kids were getting to the end of their capacity for waiting room play. Danny and Sharon took them over to their hotel to see their dog, Dixie, and then took them out to dinner, so Matt’s mom could continue to have time to get things organized at her house. She hadn’t really been expecting an invasion of three small children plus all of our family’s half-unpacked suitcases and understandably needed some time to get it all put together in some semblance of organization!

Stacey left around then, too, and it was just Matt and me. Truthfully, that night was really hard. I knew Matt would be somewhat loopy coming off of sedation, but I didn’t really understand what that meant. What it meant for us was that we had the exact same conversations over and over and over and over again – and each time it was new for him. He retained the fact that he’d had a heart attack pretty well, but he didn’t generally know where he was or why he was there, he always found it remarkable that he’d had a heart cath and that they’d gone in through his arm instead of his leg, and he never remembered his nurse’s name. It really freaked me out. His nurse didn’t seem alarmed – she said we’d just have to give it a few days – but it was still pretty scary to me. It was so disconcerting to have him awake and able to remember long-term stuff but not really able to function or remember anything in the present. Close to tears, I called a doctor friend of mine from home and asked her whether it was normal. She reassured me that it was, which was very comforting, but I was still nervous.

Matt’s lack of short term memory and the glimmers of doubt about the source of Matt’s heart attack and the certainty that its cause had been eliminated were enough to make me pretty anxious that night. I even texted a nurse friend and told her my chest felt super tight and I was starting to worry that I might have a heart attack too and asked if that was normal. She assured me that it was, that I could ask a nurse to check my vitals if I really got nervous, but it was really almost definitely all related to stress.

Danny and Sharon offered to come back that night after taking our kids back to Matt’s mom’s for the night, but Matt was so out of it, and he and I were both so tired, I just wanted to sit with him and try to get some sleep.

Since Matt was now awake, the nurses brought in a recliner so they could get him out of bed and let him sit for a bit. While he sat, I brushed his hair, and then he got back into bed for the night. Of course, from the moment he awoke, he was very interested in having access to his phone and even beginning to post on Facebook for himself. I tried to limit his Facebook postings, as his short term memory was still entirely shot, but he was not particularly concerned about that and enjoyed returning to his postings of awkward photos.

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The nicest thing about Matt now having a recliner was that I was then able to stay near him for the night and just sleep there. It’s impossible to sleep well in a hospital, but we both got some rest that night, and I was very thankful for the progress we’d made in 24 short hours – I went from falling asleep alone down the hallway from my husband while he lay unconscious after a probable heart attack, uncertain about all that the future would hold, to knowing that he’d had a blockage in one of his heart’s arteries and that it had been cleared and that, while he was still unknowingly living in a Groundhog Day existence, he was at least conscious, and I was able to be near him.

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