Title: How do I start?

Posted by: "Kevin McInerney" kevinmci@comcast.net

Date: Sat Jan 26, 2008 8:51 am ((PST))

I live closer to the Springbrook trail, with the exception
perhaps of Janeth. I was hoping to commit late - I was mostly
waiting to see what the weather would be like since I'm not
extreme enough to run in very cold and very snowy conditions.
But, I think I have a really good excuse to miss this month's
group run. If necessary, I could provide a note from my doctor.

How do I start?

Tuesday afternoon, I was in my doctor's office. I was actually
going to see one of the Physician Assistants, Jennifer, who is
extremely knowledgeable and personable. I arrived at about 110 PM
for a 130PM appointment. Initially, my pulse was 56. My blood
pressure was 126/86. And my temperature was 97.9. But it very
quickly went in a different direction.

Let's back up a little to the middle of 2007. I strained a
hamstring in June and did not run for about 5 weeks. When I was
able to resume running in July, I didn't have the same fire. I
would have a good week, then a bad week. I only logged 89 miles
in August despite being injury free. In September, I made a
commitment to resume regular running and began a string of 4
½ good months. Each month, the quantity and quality of
running improved. In December, I was up to 50-mile weeks and
logged approximately 221 miles for the month. So, I started 2008
with optimism and everything seemed to be going well. I averaged
50 miles/week for the first three weeks in January. I only ran 47
miles though in the week ending January 20 (the goal was 52).

Let's look at what happened that week. Monday - ran the target
distance and the target pace. Good run. Tuesday - good run.
Wednesday - good run. Thursday - good run. Then, we get to
Friday. In the morning, I ran 3 miles before work. I would say
this was a good run. I also wanted to run 4 miles in the evening.
I was in the Naperville Y on 95th Street. However, the first
mile was very labored. I stopped, and walked for a few minutes. I
started running again at a slower pace. It was ok for a few
minutes, then it became more difficult than it should have been.
So, I decided to call this a recovery run and alternated between
walking and a slow running pace. I finished the 4 miles but was
concerned about the occasional pain in my upper left chest.

I went home and searched the Internet. I had also done a hard
weights workout on Thursday so I wondered if I had strained a
pectoral muscle - as I found discussed on many websites.
Saturday, the plan was to run 10 miles. With the extreme cold
weather, my plan was to run 10 miles on the treadmill. I had
never run that far on a treadmill though. But, I had the same
problems as Friday. I alternated between a walking pace and a
slow jogging pace. After about 30 minutes, it became easier. And
I was able to complete 7 miles. Not fast, but I completed 7
miles.

Sunday. I tried to run but gave up after about 4 minutes. Monday.
I gave up after 2 minutes. And called my doctor and scheduled an
appointment for Tuesday afternoon.

So, we're back to Tuesday. I had no problems doing normal
activities - at work or at home before Tuesday. But at around
11am, I felt a pain across the top of my chest. It wasn't very
intense or very long but now I was really concerned. At about
1230, I headed out to get something to eat and then to go to the
doctor's office. As I was finishing eating, I had more intense
pain. Choices. Call 911? Go to the doctor's office? Or got to the
ER at Edward Hospital. The pain relented quickly so I went with
option 2.

And now we're back in the examination room. After explaining my
symptoms to the nurse, she decided to do an EKG since the PA
would want to see one. Aside from the fact that she first had to
dry shave my hairy chest with a BIC razor, that went fine. She
took the printout to the PA, and then came back to do another
one. But as she was securing the leads again, I began to suffer a
heart attack. I was sweating profusely. I was trying to find a
position where the pain was tolerable. Sitting, laying down,
standing. There was none. At that moment, the PA came into the
room, looked at me (at that moment, I was lying on my side curled
up in a ball), and asked if the paramedics had been called. The
answer was no and she directed one of the nurses to call
immediately. I think the entire medical staff was now in the
corner of the building where I was.

The doctor came into the room and placed a nitral under my
tongue. In a few minutes, my blood pressure dropped to 80/74 and
the pain subsided. When the paramedics arrived, I was pale and
clammy. But soon, the pain subsided, I became calm, and color
returned to my face. One of the paramedics, Bryl, took over
responsibility for me. Bryl had a massive heart attack when he
was 45 and I think he saw a lot of similarities in the two of us.
They placed me in the ambulance and at that moment I had no pain.
But the pain quickly returned. First a little, then a little
more, and even more. Bryl kept insisting that they weren't going
to lose me. And at that time, I didn't feel really bad so I
thought he was being a little dramatic. He also kept telling me
that I would have no pain when we got to the hospital. Ok, I
would do my best.

We sat in the ambulance for several minutes as they tried to be
sure that I was stable. I was getting anxious to be moving. Bryl
normally was the driver, but this time he wanted to stay in the
back with me. We get to the hospital, they take me out, and we
head down the hallway to the ER. And at that point, I passed out.
The next thing I knew, I woke up Wednesday morning around 8am in
a hospital room with my legs and arms strapped down and a
breathing tube in my throat. Soon they, unstrapped my left arm
and removed the breathing tube. I was still wearing my wedding
ring and a chain around my neck with a cross. So if I had
surgery, they would have taken those off, right? Every person who
came in would say "You're such a lucky man." Well, yes, But after
5 or 6 times, you wonder why they keep saying that. When my PCP
came in, he said "Good, I'm glad you recognize me." That seemed
odd. At the time.

But, I didn't pass out in the hallway leading to the ER. At that
moment, I went into full cardiac arrest. Aka The Big One. My
electrical system was totally screwed up. And I died.

Wow, it's really weird to write that.

They took me into the ER. They shocked me with the defibrillator.
Once. Twice. Three times. Four times. Five times. God decided he
didn't need me yet (but he sure took his time deciding). Finally,
my heart resumed a regular rhythm. I'm told that I became
belligerent, and they could not believe how strong I was. They
had to sedate me so they could continue to treat me. They
inserted two stints into my Left Anterior Descending artery which
is key in the distribution of blood through the body.

When they shock someone 3 or more times, this is a risk that
brain damage may occur. And with 5 times, it wasn't sure
whether I would remember anything or anyone when I woke up. But,
I came through ok, so it seems. The cardiologist came to see me
around 11am. Her, I had never seen before. So, it was ok not to
recognize her. And she began to tell me what happened. The 5
shocks. The insertion of the stints. Oh, how blocked was the LAD
artery? 100%. How the heck could I have been so active with so
many blockages in such a critical artery? Let's just say that
moment was very emotional. The rest of the day, I would slowly
learn more and more of the detail of the events on Tuesday. I'd
write more about them, but this is already long enough.

They also did an echocardiogram on Wednesday to evaluate the
eruption refraction - the ability of the left side of the heart
to send blood throughout the body. A normal person is 60%, an
average person after a heart attack is 30%. My score is 65%.
That indicates that my heart is very strong and its integrity was
not affected.

So what was the cause? I maintain a reasonably good diet, my
cholesterol is in the acceptable range. I exercise regularly, to
the point of being a fanatic. But, I have less control over the
genetics. And although there is no heart disease on my father's
side of the family, my mother has heart disease as well as her
parents and all of her siblings.

Running saved my life. Two specific reasons. One, my heart is
especially strong (I just had this problem with the arteries
being clogged). And I really didn't have many symptoms other than
exertion stress. If I had not run Friday, Saturday, or Sunday, I
would have never known. I would never have scheduled that
appointment which took me to the doctor's office. If I had been
at home or at work, I would not be writing this message.

I turn 50 on April 2. I had been waiting to have a thorough exam
around that occasion. I guess I waited too long. But don't be
like me. If you ever have chest pain, call 911. If you have a
family history of heart disease, start getting checked in your
30s. With the Heart Healthy and America Heart Check programs
available, be proactive. Spending $300 for those is better than I
went through.

I did make a very fast recovery because I am in very good
physical condition. I was able to leave the hospital on Friday
afternoon. The biggest challenge ahead for me is more emotional
than physical. I'm not indestructible. But I already died once.

I'm really proud of what my wife Lori and son (almost 16) Patrick
did this week, as we had to work through all the events. One last
thing on this almost surreal event. I'm leaving the hospital, I
get into the car, and the song playing on the radio is the
overplayed "I'm Going Home." Unbelievable.

Sorry about the length, if you made it this far.

Kevin McInerney
Naperville